Community Health Workers Must Adapt to Meet the Needs of Asylum Seekers at the Border
An Arizona CBO talks about coordinating care at the border.
Throughout the COVID-19 pandemic, community health workers learned to quickly adapt to a continually mutating virus, using new tools and technology to fight it and providing the right information and guidance to the people they serve.
But what does that mean for health care workers along the U.S.-Mexico border, where the number of asylum seekers has reached all-time highs?
To learn more about the unique challenges community-based organizations face when providing vaccination outreach at the southern border, Public Good News spoke to Gail Emrick, executive director, and Brenda Sanchez, program manager, of Southeast Arizona Health Education Center. Based in Nogales, Arizona, they talked about how their team has provided bicultural and bilingual information to the surrounding six-county region since the onset of the pandemic. Here’s what they said.
PGN: Both of you have worked at SEAHEC since before the start of the pandemic. As you prepare for fall, what has changed in the way you share information with your communities?
Brenda Sanchez: Specifically with the populations that we see come through the [Casa Alitas] shelter space, contrary to popular belief, there’s not as much vaccine hesitancy as we see in our general population in the U.S.
Most individuals that we’re interacting with have had at least the first set of the COVID vaccine.
They’re asking us, “How can I get the next booster?” or “Can you update me on what the U.S. regulations for the COVID vaccine [are]?” or “What vaccines are accepted [for entry] in the U.S.?” [Editor's note: This is no longer required for entry in the U.S.]
We have started to incorporate talking about the flu. Because last year, we saw how bad our flu season was, and we’re seeing that this flu season is probably gonna be just as bad. RSV as well. We see a large baby population and [child] population. So we also talk about RSV.
PGN: What specific information are people needing about COVID-19?
B.S.: We are making sure that we provide the migrants with basic information that they can really use in the shelter space. We emphasize the importance of masking and how masking is going to really help prevent all three of those health issues because we are in a congregate setting. We also reiterate the importance of handwashing and using hand sanitizer.
We provide them with tips and resources on how to keep safe while they’re traveling via airplane or by bus. And then once they get to their destination communities, we connect them with local [federally qualified health centers], local pharmacies that are offering various vaccines, and we explain to them, “These are the U.S.-approved vaccines” and “this is the booster that we’re on.”
Some countries didn’t provide all of the COVID vaccines like we did here in the U.S., so we provide that education. And now that fall boosters are coming up, we’re also educating on when is the best time to start getting those boosters, especially for individuals that have traveled from different [countries] that have different winter seasons.
Many of these individuals are also traveling with their families. And there’s a lot of familial ties. So in our messaging, we make sure to also emphasize with them, “Hey, if you get vaccinated, you’re also helping your family because it’s gonna keep you safe.”
I know that in the U.S., we had a large number of individuals that sadly passed away from COVID, but some of these other countries were also heavily hit, and it then had a trickle effect into their economy and led to more individuals having to migrate and such.
So in our messaging, we reiterate that family component and make sure that folks know that the vaccine is free, or that there are locations where they can get them for low costs. Because in other countries they are having to pay for them.
We know that individuals coming through the shelter space have limited resources. So we also emphasize prevention: “Hey, if we can prevent [individuals from] getting sick,” or “How can we prevent the entire family from getting sick?” Because that’s adding more cost that they will have to cover.
PGN: What do you wish people knew about life at the border?
Gail Emrick: The U.S.-Mexico border is the most unique in the world. If you’ve ever been anywhere like France or Germany or between, let’s say, Guatemala and El Salvador or Chile and Argentina—when you cross the border, there’s some nuances, you can notice that it’s different just because there’s a flag or a border check or something like that, right?
At the U.S.-Mexico border, there’s a lot of differences. And one of the biggest in the last, say 20 years, has been the increased militarization of our border. And that has made it really difficult for a lot of our families.
People have family on both sides. People have businesses on both sides. People live on one side, and their kids might go to school on the other side. Or you live on this side, but your job is on the other side. So there is constant and continuous commerce and travel and shared radio stations and shared family celebrations. And so when the border was artificially put there, [it] made an extra stressor for people that live on the border. And it’s one of those mental health issues that people might not realize until they really delve in and think about what increased militarization does to someone’s psyche.
But also all of the positives that come with living on the border. People hear negatives in the press, but it’s really fun to be able to have a community that speaks two languages. It’s really interesting to have cultural commonalities and differences and people just accepting that as the norm. You know, the types of food you eat, the type of music that you listen to. So I think there’s much more open-mindedness and open-heartedness in terms of people’s understanding and acceptance of something being bicultural. It’s a really beautiful place to live in and work.
B.S.: Something I would add is we do share a health care infrastructure. Especially for individuals working in those sister communities where it’s more accessible to cross into Mexico to go to the dentist, to go get their medication, or even to go see their primary care provider if they don’t have insurance or if they have a large copay. When we are interacting with community members, we have to be conscious when we’re asking questions, like, “When was the last time you saw your PCP?” Sometimes we have to double-check: “Did you see your PCP here in the U.S. or in Mexico?”
I think with COVID and vaccination, we saw something different where individuals from Mexico were coming into the U.S. border communities to get their vaccines because they weren’t as readily accessible in Mexico when the vaccines rolled out.
Something also very unique to our border communities is the diverse occupations that individuals have. We have a large agriculture, farm worker community, but we also have a mining community. We have individuals that are working in the factories that are helping process the goods that are coming through our U.S.-Mexico border. And then [we see] the health effects that those different occupations have and the resources that each of those occupations have based on their employer. Those are the things that, as public health professionals, [we have] in the back of our minds when we’re developing our health education materials and resources that we bring to our communities. We know that the occupations that individuals have are very diverse, even from border to border and from county to county.
PGN: What advice do you have for other community health workers or community-based organizations that work along the southern border or provide services to migrant communities?
G.E.: Never make assumptions. Never assume that because the person lives in a certain place, looks a certain way, talks a certain way—that they’re going to have a certain set of beliefs. I think the most important thing is to listen to their concerns. That is what I would say about any health issue. I mean, COVID brought that out. But people are complex individuals. Try to learn from everyone as you go.
B.S.: I think another thing that we’ve learned is to give people options. If they’re not receptive to one of your approaches, it doesn’t necessarily mean that they don’t care about that health issue. It could be that they don’t have the resources to access what you’re sharing or they have been exposed to other things in their community that [have] caused them to not trust what you’re sharing. So it’s really our job to make sure to bring another approach. And like Gail said, [do] not assume that individuals and communities [will] believe something that you think they will believe. Really listen to them and listen to their feedback. Then come back and apply that feedback to the approaches that you’re using.