Boston Sunday Globe

Migrant shelters try to help traumatize­d survivors of assaults

Mental health aid urgently needed, advocates say

- By Giovanna Dell’Orto

CIUDAD JUAREZ, Mexico — Since he began volunteeri­ng two months ago for weekend shifts at a clinic in one of this border city’s largest shelters, Dr. Brian Elmore has treated about 100 migrants for respirator­y viruses and a handful of more serious emergencie­s.

But it’s a problem he hasn’t yet managed to address that worries him the most: the worsening trauma that so many migrants carry after long journeys north that often involve witnessing murders and suffering from kidnapping­s and sexual assault.

“Most of our patients have symptoms of PTSD — I want to initiate a screening for every patient,” said Elmore, an emergency medicine doctor, at Clinica Hope. It was opened this fall by the Catholic nonprofit Hope Border Institute with help from Bishop Mark Seitz of El Paso, Texas, which borders Juarez.

Doctors, social workers, shelter directors, clergy, and law enforcemen­t say growing numbers of migrants suffer violence that amounts to torture and are arriving at the US-Mexican border in desperate need of trauma-informed medical and mental health treatment.

But resources for this specialize­d care are so scarce, and the network of shelters so overwhelme­d by new arrivals and migrants who’ve been stuck for months by US asylum policies, that only the most severe cases can be handled.

“Like a pregnant 13-year-old who fled gang rapes, and so needs help with child care and middle school,” said Zury Reyes Borrero, a case manager in Arizona with the Center for Victims of Torture, who visited that girl when she gave birth. “We get people at their most vulnerable. Some don’t even realize they’re in the US.”

In the past six months, Reyes Borrero and a colleague have helped about 100 migrants at Catholic Community Services’ Casa Alitas, a shelter in Tucson, that in December was receiving about 700 people daily released by US authoritie­s and coming from countries as distinct as Congo and Mexico. Each visit can take hours, as the case workers try to build a rapport with migrants, focusing on empowering them, Reyes Borrero said.

“They might not have any memory that’s safe,” said Sarah Howell, who runs a clinical practice and a nonprofit in Houston treating migrant survivors of torture.

“The estimated level of need is at least five times higher than we support,” said Leonce Byimana, a director with the Center for Victims of Torture, which operates clinics in Arizona, Georgia, and Minnesota.

Most migrants are traumatize­d by what they left behind, as well as what they encountere­d en route, Byimana said. They need “first-aid mental health” as well as long-term care that’s even harder to arrange once they disperse from borderarea shelters to communitie­s across the country, he added.

Left untreated, such trauma can escalate to where it necessitat­es psychiatri­c care instead of therapy and self-help, said Dylan Corbett, Hope Border Institute’s executive director.

All along the border, the most staggering trend has been the increase in pregnant women and girls, some younger than 15, who are victims of assault and domestic violence.

Volunteers and advocates are encounteri­ng so many of these

‘Most of our patients have symptoms of PTSD — I want to initiate a screening for every patient.’

DR. BRIAN ELMORE, emergency medicine doctor at Clinica Hope

survivors that they had to focus scarce legal, medical, and shelter resources on helping them, leaving hundreds of other victims of political violence and organized crime to fend for themselves.

Service providers and migrants say the most dangerous spot on journeys filled with peril at every step is “la selva” — the Darien Gap jungle separating Colombia from Panama, crossed by increasing numbers of Venezuelan­s, Cubans, and Haitians who first moved to South America and are now seeking safer lives in the United States.

Natural perils such as deadly snakes and rivers only add to the risks of an area rife with bandits preying on migrants.

Asked about “la selva,” some women just suck in their breath — and only later reveal having saved their daughters by speeding them along and getting raped themselves, or enduring strained relationsh­ips with their partners who were made to watch the assault, Howell said.

“I don’t think it’s the first rape that most women I’ve talked to have experience­d. But it’s the most violent and the most shameful, because it was in front of other people,” Howell added.

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