Title 42 ends this week: Here's what you need to know

S1: It's time for KPBS Midday Edition , Title 42 , which has stopped most asylum seekers since the pandemic , is being lifted this week. I'm Maureen Kavanagh with conversations that keep you informed , inspired and make you think. The end of Title 42 gives hope to thousands of migrants stuck for years at the border.

S2: This is really going to be the first time since March 20th , 23 years that asylum will more or less be back to what it was before the pandemic.

S1: But the U.S is not waiting with open arms. We'll hear about new border wall construction and the toll of border wall injuries. That's next on Midday Edition. Title 42 , The pandemic health restriction that has virtually shut down the US asylum program is ending this week. Thousands of migrants waiting at the US-Mexico border hope the end of Title 42 will be the beginning of a life in the U.S But the Biden administration is taking a carrot and stick approach with new border policies. More avenues for legal immigration are opening up and at the same time , the policies crack down on illegal immigration by continuing the construction of the 30 foot border wall and by immediately rejecting asylum claims by anyone who crosses the border illegally. KPBS border reporter Gustavo Solis is here with an update on what the new policies mean to the thousands who've been waiting at the border. Gustavo , Hello.

S2: Hello , Maureen. Thank you for having me.

S1:

S2: So once Title 42 is gone , migrants will be able to seek asylum at the border a little bit easier than they are now. I mean , there still will be limits to pre pandemic era and I'm sure we'll talk about that. But Biden administration is announced plans that includes sending more personnel to the border , specifically asylum officers. And how it will work on the ground is many migrants will enter the country and be placed in detention centers and go through something that's called an expedited removal. That means that they'll be given a credible fear interview if the asylum officer confirms that they do have credible fear of going back to their home , they'll begin the asylum process. If they fail that interview , they'll be automatically deported. There are some exceptions , though , like with everything with immigration law , like. Right , there's always exemptions , and that's with families. Families won't be put in detention and also just capacity issues , Right. The federal government doesn't have physical space to detain all of the migrants , the tens of thousands who have been waiting. So in those cases , more likely migrants will be allowed into the country , be given some kind of ankle bracelet or some other surveillance device and be told to follow up with ice.

S1:

S2: I mean , I think it's really important to remember that Title 42 is technically a public health order that was issued by the CDC. The Trump administration specifically. Really ? Stephen Miller used Title 42 during the pandemic as a way to block access to the US. We know now through the reporting and official documents that have been made public that doctors at the CDC were pressured into enacting Title 42. They didn't want to do it because there was no real public health basis for it as a health order. But they were kind of forced to essentially told , if you don't do this , you're going to lose your job. So Title 42 is really an it's essentially an asylum restriction masked as a health order. And what it does is that in order to stop the spread of COVID 19 , migrants without proper documentation can't enter the country. They can be turned away by the Border Patrol. And this obviously includes vulnerable migrants who are seeking asylum. And it is a huge shift from US immigration asylum policy , which dates all the way back to World War Two , when we had really kind of embarrassing moments as a country of turning away Jewish refugees. Since then , asylum law has recognized that people fleeing for their lives don't always have time to apply for a visa or live in countries where the governments won't issue them. Travel documents that sometimes they have to leave overnight , rush out of their homes , and when they get to the border , they may not always have the right documents in order. The law even said that it is legal for people to enter between the ports of entry , turn themselves in and request asylum so they're allowed in and given a chance in immigration court to present their case. And Title 42 kind of took that away. Title 42 allowed border officials to just say , Sorry , COVID is happening , you can't come in. And there was no element of due process or checks and balances in that whole policy.

S1: So I guess I'm assuming that with no other way in illegal immigration increased during that time.

S2: It has. But the numbers are a bit misleading , right ? There's been a lot of headlines on like record numbers of apprehensions , and those are true and accurate headlines. I think last fiscal year , apprehensions along the border were more than 2.5 million. But it's really important to remember that apprehensions don't equal individual people , right ? So just because we had 2.5 million apprehensions , it doesn't mean that 2.5 million people were apprehended. Actually , I've spoken to many people who were. Are apprehended multiple times. People who were turned away five , ten , 12 times in a week and just kept on trying and trying because with Title 42 , you can enter the country illegally and just get sent away right back. There's no real legal consequences compared to like Title eight , which is what we had before Title 42 pre-pandemic. If you crossed illegally , there would be legal consequences. You would the legal consequences would be that if you happen to cross again illegally , then there would be a harsh jail time and different penalties like that. But with Title 42 , you can essentially try again and again and again again , and there's no real consequence for it. So because of that , experts I've talked to actually expect to see a decline in apprehensions once Title 42 is lifted.

S1: Let's talk about some of President Biden's new policies that are going to go into effect as Title 42 fades away. The new policies are trying to stop people from congregating at the border and offering asylum seekers other alternatives. Tell us about that.

S2: Yeah , I think there's two ways of looking at that. One like one , just realistically , there's already a lot of people congregating at the border , so the policies won't really impact the population that's already here. They're more tailored to populations that are thinking about coming to maybe give them alternatives to the route. So this one includes a couple of things. One of them is a humanitarian parole program that really started with Ukrainian nationals after the outbreak of the war when they were coming to Tijuana. But it has been expanded to other nations like Cuban , Haitian , Nicaraguan , Venezuelan nationals , really countries where the US doesn't have good diplomatic relations with with another country and have a hard time really deporting people. The way it works is there's a cap , I think around 30,000 arrivals each month from these countries and they have to have a US sponsor. Any any one of us , anyone listening can can go online and apply or sign up or volunteer to be a sponsor. And if they get approved and they get vetted , they can fly directly to the US without having to make that dangerous , costly journey across Mexico. And another thing that the Biden administration is doing to that end is setting up these processing centers , one in Guatemala , one in Colombia , probably more as as they make arrangements with other countries. But the processing centers are basically places that people can go to to see if they qualify and are eligible for asylum in the US , in Guatemala , in Colombia , without really having to go all the way to the border.

S1: There's also a stick , though , as as I mentioned in this , the carrot is that there are more options for asylum seekers. The stick involved is that illegal border crossers lose their chance to claim asylum. Now , some human rights watchers say that's a violation of international law.

S2: Yeah , a lot of human rights watchers would say it's a violation of international law. And a lot of I mean , that's the main criticism that's coming from liberals and progressives on Biden's policies , is that the stick is way , way , way heavier than the carrot right now. That's because even though the administration and these humanitarian workers will applaud the expanding legal pathways into the country , the restrictions outweigh those other policies. Right. In terms of enacting measures that will severely limit people's ability to apply for asylum. You mentioned one of them , the transit ban , which Biden really ran against. Trump tried to implement a version of this that was essentially like , if you cross through another country before you get to the US , you have to apply for asylum in that country first , which would essentially ban asylum for anyone who was in Mexican. Right ? Because they all have to go through Mexico to to get here. Biden is doing something similar , but limiting it to people who cross people who enter the country legally , which as kind of we said before , in the spirit and asylum law , like it leaves the window open for for people to enter the country legally and then turn themselves in. There's also like the expedited removal process I mentioned is also controversial because you're detaining vulnerable people who are requesting humanitarian aid. So you're detaining someone who is not really accused or charged with any crime , but you're also having them go through that legal process of the credible fear interview while they're in detention. And when you're in detention , it's very , very difficult to get access to legal aid. There's very few lawyers , especially in some of the more remote parts of the border. So there's been a lot of outcry over that because you're putting vulnerable people with limited resources , limited education in a lot of cases , limited language skills to present themselves in a legal proceeding without the help of a lawyer.

S1: I'm talking about life for asylum seekers. After Title 42 with KPBS border reporter Gustavo Solis. You know , there's always the question , what does Mexico think about all this ? Because illegal border crossers will be returned to Mexico. Mexico has been the site of border camps for several years. What's been.

S2: It's a little bit all over the map. I know , like , this gives Mexico and really the president , Andrés Manuel Lopez Obrador or AMLO , a lot of bargaining power over the US. All of this can only happen with Mexico's approval with Mexico's okay , right ? Like Title 42 , sending people from Guatemala , Honduras , Nicaragua back to Mexico. That can only happen with Mexico. Okay. So AMLO has kind of used this as a way to , hey , us will help you with immigration , but , you know , keep away from some of other issues like economic issues or things to do with the drug war and cartel enforcement and things like that on the ground is kind of a different story in Tijuana. There is well , you'll kind of see different camps , right ? There's a big history and culture of people in Tijuana stepping up for migrants , helping them out. Even folks here in San Diego driving across the border and donating food , clothes , blankets , everything , even their time to help the migrant population. But there's also a group , multiple groups within Tijuana , that have an anti-immigrant view. Right. Like Mexico doesn't have a lot of money. Tijuana's crumbling. We should be taking care of Mexicans before we're taking care of these outsiders so that mean people don't feel safe in Mexico , the migrants don't feel safe. There's been humanitarian Human Rights Watch as a nonprofit organization that's documented thousands and thousands of instances of migrants being assaulted , robbed , sexually assaulted , beaten , in some cases even killed after being turned away by Title 42 and being forced to be in Mexico.

S1:

S2: Right. I think the Union-Tribune had that great piece about homeless people waiting 72 hours for shelter beds , an influx of of migrants would put a little bit of stress on that system. There are other resources like like the Rapid Response Network , Jewish Family Services , different nonprofits that address the the migrant situation. But it is important to note that San Diego isn't a destination. It's more of a transit stop. More often than not , migrants who asylum seekers who come to San Diego. Really all migrants who cross the border from Tijuana to San Diego will stay in San Diego 1 or 2 days and then hook up with their families or relatives in other parts of the country. Right , Los Angeles , Chicago , New York , places like their final destination. It's rare that San Diego is the landing spot for a lot of the migrants who are crossing right now through Tijuana.

S1: You know , Gustavo , later this hour , we will speak with a San Diego surgeon who'll talk about the serious injuries he's seeing from people attempting to climb over the 30 foot border wall and , of course , falling.

S2: But I think it really needs more attention , just the human toll of this , like the how gruesome some of those injuries are and the death toll , too. I mean , it's been a record number of apprehensions along the southern border , but it's also been a record number of deaths along the southern border. But your question about could the new policies cut down the people attempting to cross illegally ? I think yes , but I don't know how much. Right it stands to reason if you block legal access to asylum and really just migration via Title 42 for three years and then you open those back up , people will be less desperate and try to , like everyone I talked to , wants to cross correctly , cross the legal way. The folks I talked to who cross illegally say are the ones who have been waiting the longest and are just so desperate that they're tired of waiting. They don't feel safe in Mexico and they feel like they have no other option. So it stands to reason that if you do have another option , you're less likely to cross illegally. But that ignores the original push factors that are that are pushing people out of their country. Right. Political instability , poverty , crime , climate change , discrimination , all those things are still happening in many parts of the world. I mean , the war in Russia is another one. So I think those policies won't really Biden's policies won't keep those people from leaving their homes in the first place. But maybe hopefully once they get here , they'll have a little bit of a more easier or structured way to come in , present a case , be vetted and at least go through the process of finding out whether or not they have a legitimate and legal reason to stay in the country.

S1: I've been speaking with KPBS border reporter Gustavo Solis. Gustavo , thank you very much.

S2: Yeah , thank you. Maureen.

S1: What do you think of the lifting of Title 42 ? Give us a call at (619) 452-0228 and leave a message or you. Can email us at midday at pbs.org. Coming up , a border wall bridge is going up across the Tijuana River.

S3: There is potential for massive flooding not only on the Tijuana side , but also potentially if we're in some serious flooding send as well.

S1: You're listening to KPBS Midday Edition. You. You're listening to KPBS Midday Edition. I'm Maureen Cavanaugh. Immigrant rights advocates claim that the continuing construction of a longer and higher border wall between the US and Mexico is a humanitarian disaster. A new report says it may also be an environmental disaster. A study commissioned by the EPA finds the proposed section of wall that crosses the T1A river could cause massive flooding consuming much of downtown Tijuana. So far , there's no public response from the Border Patrol. Voice of San Diego reporter McKenzie Elmer has been following this story. Mackenzie , thank you for joining us. It's good to talk to you.

S3: Thank you for having me.

S1: So if you can kind of give us a picture of the area where the border wall is supposed to cross the river. This is a part.

S3: Of the border wall that is not easily visible if you're a member of the public. The Tijuana River runs through the city of Tijuana and into the United States. And the point of the the point we're talking about is an actual I guess they call it by Customs and Border Patrol , a gap in the border wall. And it's where the river crosses into the United States. So the the point where Border Patrol is considering building this wall or is building this wall is where the river is concrete channel in Mexico and then runs into a natural channel into the United States. It's most easily visible from a drone or if you're lucky enough to be able to access the sort of private road that leads up to the wall that's typically only used by Border Patrol.

S1: Now , I was just about to ask you another question , and I have proposed border wall as part of that question. I'm confused.

S3: Preliminary construction has been underway since November. Customs and Border Protection did confirm that to me when they were answering questions about the border wall. So they have said that because it's been such a rainy winter season , construction has been slowed. They've been waiting for the water to sort of dissipate because this river really flows seasonally or just when it rains , for lack of a better word. So , yeah , it is underway. They have all of the necessary green lights that they need in order to begin construction. And so I've heard that there has been some building going on in the levees to prepare for whatever the next phase of construction might be.

S1:

S3: I understand that the the way that it's supposed to look , its final form has changed many times , but still working to get more information on that. The best description I have is from a description from the North American Development Bank , which helped sort of push along this study we're going to talk about. But it's a it's a 900 foot border security barrier. They call it a cross that crosses the actual stream. So it's going to be a really a bridge where Border Patrol can cross with their vehicles on foot , conduct surveillance , I'm assuming , of this particular point in the river. And there'll be a series of columns that hold up the bridge , obviously. And then across the bottom will be a series of steel gates. I've heard 40 to 50 steel gates that would be raised and lowered electric with electricity by some kind of motorized mechanism. And so and also the bottom five feet of the gate is an impermeable sort of steel plate as far as they understand it , which is pretty key and important in terms of understanding what the concerns are here. When we talk about flooding.

S1: What does the new report say might happen if we get a really big rainstorm like we had this year ? Right.

S3: So this report that the Environmental Protection Agency commissioned , in lieu of any good understanding themselves what the Customs and Border Protection plan was for this particular wall shows that under various severe flooding scenarios , if the border gates that I just described failed to open properly , all of them there , it could cause a significant slowdown of the river water , which would back up potentially over the levees that protect the downtown Tijuana from any kind of flooding. Those scenarios. We haven't seen that type of flooding. They're called 100 year or 200 year storm events , which means a 100 year storm event means there's 1% chance of that type of magnitude of flooding or extreme flooding to happen every year. The best example we have is 1980 , where there was a flood event that that was somewhat comparable , which the researchers used to sort of look at flooding problems here. But it really depends , it seems. And the conclusion of the report was , you know , if this gate structure , if Customs and Border Protection isn't able to operate the gate properly or lift all of these these gates that make up the wall in time for a big rain event , there is potential for massive flooding not only on the Tijuana side , as I described , but also potentially if we're in some serious flooding the city as well.

S1:

S3: There's a lot of trash , a ton of trash that crosses the border. This through the river , tires , sometimes whole appliances. It's kind of hard to see the extent of the trash that has reached into the United States in the Tijuana River Valley because it's very overgrown. But that is a significant concern in terms of attributing to some of this flooding. We already know that that's a problem. So if , you know , modest rain or modest Tijuana river flow brings trash and it starts to pile against the border gate that is being built right now , it would create a kind of dam that would also , you know , potentially cause that slowing down of the river , backing up of the water and topping over the levees. It's kind of there's a lot of things that have to go right in order for flooding to not be a significant concern , according to this EPA study. And so I think what this shows is just like there could be a potentially delicate situation there if , for instance , the trash that piles up against the gate , if that's not being cleaned on a regular basis , and whose responsibility is it to clean that that trash and debris up ? We're not really sure.

S1:

S3: Again , the severity of the flooding and whether or not the barrier operates correctly. But there are maps in the study , in my story , that show some of the worst case scenarios of , you know , those 102 hundred year extreme storm events. If the barrier or if the gates are all closed , you see pretty significant flooding , you know , dipping into basically consuming Zona Norte and Tijuana and even down into Zona East , which is sort of just most of downtown Tijuana , a lot of the popular places that people visit. The report also talks about some smaller scale flooding conditions called a 50 year event , which means there's a 2% chance of flood of that magnitude happening every year. And we've gotten close to that in the past , some extreme flooding. And again , if all things go wrong , meaning , you know , a storm knocks out the electricity , which means the Border Patrol has to manually lift all of these gates across the river and there's debris in the river that also slows down the water. And we have that , you know , five foot steel plate at the bottom of this border barrier that already acts as a kind of dam. Even modest flooding could potentially cause overhead floodwaters consuming that Zona Norte in downtown Tijuana.

S1: We're talking about the construction of a border wall bridge across the Tijuana River. And I'm speaking with voice of San Diego reporter McKenzie Elmer. Now , Senator Alex Padilla apparently questioned Homeland Security Secretary Mayorkas about this issue during a committee hearing in April.

S3: He said it was something he looked into , he would look into. I have been reaching out to Padilla's office to try to confirm what are the next steps there. I haven't heard back yet. So more to come on that. But it was interesting that the secretary acknowledged something Senator Padilla brought up , which was as we experience the challenge of climate change and these these kinds of extreme flooding events are expected to become more , you know , more unpredictable , more severe. And so that , you know , that has the potential to really potentially trigger some of these extreme problems with this border barrier. And Secretary Mayorkas acknowledged that. You know , he said you correctly describe the challenge of climate change and the fact that these extreme weather events is only going to increase. And that was kind of a key point that I uncovered when I got these this Freedom of Information Act requests. Uncovering these reports from the EPA. It revealed that the EPA and Customs and Border Protection were really at odds over what was necessary to actually study and prepare for in terms of designing this border barrier. EPA was basically telling the State Department , hey , you know , we don't think that Customs and Border Protection is doing enough to look at these extreme weather events , especially in terms of climate change , which has a potential to bring these so-called 500 year flooding events , which would be something that I didn't even know how to describe really in terms of how that would affect the area. We don't I don't think there's true modeling on that yet. As San Diegans know , the Tijuana River has been an extreme environmental crisis in this region.

S1:

S3: And that's I have evidence of that just from the records that I obtained. However , the EPA didn't provide me with Mexico's actual response to this problem. I reached out to the the consulate and they said , of course , we're concerned about any possible flooding that this US infrastructure project could entail. But they didn't really say much more other than that they have raised their concerns to the US about this project.

S1: It seems in a way that nobody in the US government is talking to one another about this particular problem. The Border Patrol is keeping silent. The EPA is running its own commissioning its own study , and the head of Homeland Security doesn't know about these risks.

S3: I guess , you know , that's kind of what I'm trying to do as a journalist to sort of fill in those blanks or potentially put some pressure on these agencies to try to answer some questions. You know , in the in the records that I obtained , there's clear evidence that , like EPA and Customs and Border Protection have talked some about this. There's been exchanges of letters. I don't have the same records back yet from Customs and Border Protection. Their public records process is a little bit more cumbersome , but I hope that in time , the true discussion over this project between these two kind of agencies at loggerheads will will be revealed in the near future. But it is the State Department that's sort of at the head of this kind of handling the bi national discussion on what what risks this poses for Mexico. And I don't even know what that binational discussion might look like , but I'm very interested to know.

S1: So are we. Of Voice of San Diego reporter McKenzie. Elmer , thank you. It's been good to talk to you.

S3: Thank you. You as well.

S1: Tell us what you think about the continuing construction of the border wall. Give us a call at (619) 452-0228 and leave a message or you can email us at midday at pbs.org. Coming up , the human toll of the 30 foot border wall.

S4: That's what has strained our hospital resources. Just amount of border fault injuries that we're getting.

S1: You're listening to KPBS Midday Edition. You're listening to KPBS Midday Edition. I'm Maureen Cavanaugh. Is the increase in deaths and severe injuries to border crossers who fall from the now 30 foot wall between the US and Mexico ? An unintended consequence or an intended consequence ? And either way , is this something most Americans can support. These are questions raised by the brutal results of those falls , as seen by doctors and surgeons in San Diego. Recently , a neurological surgery resident wrote an opinion piece for the LA Times about the increase in life altering injuries to border crossers falling from the higher border wall. Dr. Alexander Tenorio , who wrote the opinion piece , is here with me now. Dr. Tenorio , welcome.

S4: Yeah , thank you for having me. I really appreciate it. I think it's a very important subject.

S1:

S4: So I started in San Diego actually after that. But even then , during the time when I started , since I've been there now three years , we have seen the number of injuries keep going up every year.

S1:

S4: But more striking , the what I heard most of the time was that there were never this amount of injuries due to waterfalls. So the frequency was definitely striking for people that were there before it was increased in height to 30ft.

S1: So not only were the injuries less severe , but there were fewer people coming into the hospital. Exactly.

S4: Exactly. So as I mentioned in my my published studies and in my piece , you know , that's what has strained our hospital resources. Just amount of border fault injuries that we're getting at this time has significantly increased after its construction , which was completed at the end of 2019.

S1: You start your essay in the LA Times by remembering a page you got while you're on duty at about 2 a.m..

S4: So it has , you know , become something that unfortunately , we now expect. It was a page about a young man , as most of them are , who had a severe spinal injury after falling from the border. And the reason that one stuck with me is because he was a patient that was of similar age to me. You know , I am a first generation Mexican American. My parents crossed this same exact border before it was increased in height. So , you know , as you know , it could very well relate to that individual.

S1: Now , you describe this young man as frightened. He's surrounded by Border Patrol officers. Is this a potentially life altering injury that you're looking at ? Correct.

S4: And I believe this is one of the most devastating aspects of this. These patients , of course , they're coming here , you know , assortment of reasons. You know , the majority of them are due to , you know , violent economic conditions that aren't , you know , safe anymore. And they're coming here for a better life. And now they're in this hospital where the majority of health care workers unfortunately , don't speak Spanish. The majority are Hispanic. Correct. So , of course , he's frightened and he's with Border Patrol officers and he's in a collar and can't really move or move around or get up and stand. Right. So , of course , these patients are reasonably very frightened. So I always make it a point to go up to them , speak to them in Spanish , you know , tell them that my parents are from Mexico and try to comfort them. But , you know , I do have to separate my feelings from what I used to deal with in that situation , which is a patient that had a severe spinal fracture that unfortunately needed surgery.

S1: Can you explain what kinds of injuries you're seeing from falls from the 30 foot border wall ? Yeah.

S4: So as a neurosurgeon , we do , as you know , get we're one of the busiest services in terms of patients that come after border falls. And the majority are traumatic brain injuries and spinal fractures. And unfortunately , now we're seeing more commonly injuries to the vessels of the brain , which we call cerebrovascular injuries. And these tend to be due to more high impact injuries. So as you can imagine , these are these are a direct result of the higher border wall. And unfortunately , these higher impact injuries leave patients in worse conditions there. A lot of them are unable to talk , get up out of bed , walk , even recognize their families , much less talk. So they do leave them in in worse conditions.

S1: And there must also be more deaths from these falls. What do we know about that ? Correct.

S4: So the mortality has. Also increased. And we typically see traumatic brain injuries and traumatic vascular injuries as being more severe and causing more morbidity and mortality because as as you could imagine , the brain controls your the the majority of your function. Right. Your ability to recognize them and talk to them , you know , controls your breathing functions as well. It's one of the more important organs in our body. So this is a direct result of the higher impact these patients are getting from the higher wall.

S1: I'm speaking with Dr. Alexander Tenorio , a neurological surgery resident , about the injuries he's seeing from border crossers falling from the higher border wall. Doctor , you mentioned that the people risking death to try to climb the higher border wall and seeing that young man in the hospital bed basically your same age made this personal for you.

S4: And the reason that they left are very similar to the reasons that I hear of why these patients are coming. You know , my father , you know , he was living in a situation that was not safe for him. He did receive violent threats back in his hometown. There was no other option for him than to leave , fortunately. And speaking to these patients , which I do make an effort to speak to every patient that comes after a border wall , get their stories , you know , try to listen to them. They're coming for the same exact reasons. Not only that , there's a number of conditions that aren't livable anymore or political conditions that don't make it safe for them anymore. So , you know , this is you know , there's a lot of I feel like misinformation of why these patients are coming here. But , you know , am I , as one of the residents directly speaking to them , I can attest to those the conditions that they're leaving and what they're fleeing from. And this is something that I hope is this is a message that I hope gets out there to the wider public.

S1: You know , supporters of the wall might come back and say nobody will get hurt from the height if they obey the law and they don't try to climb it. Why isn't that a reasonable proposition ? Yeah.

S4: So from my standpoint as a neurosurgeon , what I could speak to is , you know , I have a duty to protect patients , to do no harm and to treat their conditions. This is from my standpoint , it is not a political statement. I'm not saying we should or shouldn't have a wall with. I am advocating for very strongly is that we should not continue to extend the height of these border walls Previously , when they're when they were 8 to 10ft , we wouldn't see the severity and the amount of injuries right now that it's you know , all the studies show once it gets above 12 to 13ft , that's when you start seeing these more high impact injuries. And that's what I could advocate for. That's one part of it , and that is what I'm advocating for. The second part of it is back to what I said. You know , these patients are coming here for conditions that don't make it safe in their home. And if trust me , if you hear these stories , we would be doing the same for our children and for our families.

S1: You said that most of the injuries and it stands to reason of those injured falling from the wall are young men.

S4: You know , they're not conscious anymore. They can't speak to their families. They can't , you know , unfortunately support their families anymore. And for patients that have spinal injuries , depending on where the injury is , they might not be able to move their legs or even their hands. So they essentially become paralyzed for a lot of these patients that are coming over the primary caretakers of their family. And if they're in that condition or unable to do that , you know , another piece of it is that a lot of these patients don't get appropriate follow up. Unfortunately , from the studies that we published , about only 16 , meaning one six , 16% , only 16% of these are seen in follow up care. And for a lot of these patients , they do get surgery. They do have devastating injuries , and they do need appropriate follow up care to avoid any further complications. And if you can imagine , if we're only seeing 16% of the patients were only capturing even a minimal amount of the complications that are actually occurring. So for a lot of these patients , you know , they have wounds that need to be taken care of. Unfortunately , I don't even know what happens to those patients.

S1: Have you spoken with other doctors and surgeons about this increase in severe injuries from the border wall ? I'm wondering what the collective opinion is on that.

S4: I have worked collaboratively with trauma colleagues here in San Diego as well , and they have done also great work looking at the injuries and advocating for this population , at least from the from from their standpoint as well. We. Are on the same page that these injuries are due to the the higher border wall and the are seeing from their standpoint , you know , greater severity of injuries in their field , meaning a dominant injuries , you know , injuries of their bones , their ankles similar to us , higher frequency and higher severity of injury as well.

S1: Let me ask you the first question I raised in the introduction.

S4: What I could say is that these are , you know , for us at least , and I believe for the general public , these are unintended consequences , meaning that many of us didn't foresee these amount of injuries and these severity of injuries. You know , this is the main message that I want to relay that these are the direct results of the higher border wall. Now , the part that I do think less people , both decision makers and the general public , were were able to predict or the economic consequences. I hope that all of us are on the same page , that these economic consequences that we're seeing are something that we don't want , meaning hospitals , especially hospitals serving border regions , are being strained of their resources because , you know , as you can imagine , a lot of these patients that we're treating don't have insurance. So we do have to apply for reimbursement. And for the majority of these the reimbursements , they don't cover the complete cost. So it's what we call reimbursement deficit , meaning we have to take those costs. And this is occurring in the background of the COVID pandemic. And it was occurring in the background of the COVID pandemic , which was already , you know , straining our hospitals. And with the the the surge in waterfall injuries , this was pushing us to the brink , essentially. And as I mentioned , this is something that , you know , I don't think any of us intended or predicted.

S1:

S4: As I mentioned in my piece , President Biden initially signed an executive order halting all funds that were allotted to the border extension projects that Trump initially signed off on. Correct. Unfortunately , throughout the border , there's been projects that have now been approved to continue , including here in San Diego , specifically at Friendship Park , which is , you know , a park that is a shared space between both sides of the border , where families tend to gather from both sides of the border and see each other. Now , there's the latest information I have is there's construction equipment there. And they are either in the process or already constructing 30 foot barriers there and going further. You know , we do anticipate , you know , there's already been talks of a broader proposal by Republicans in Congress to continue essentially all border extension policies and border construction policies that Trump had in place with anticipation of Title 42 expiring. So the fear with that is that there's going to be a surge in migration. And of course , there's talks in Congress of battling that back with this new border proposal. So I do want to urge the public to reach out to your local elected officials , to reach out to Congress , to reach out to the Biden administration , letting them know if what we're dealing with here in hospitals that are treating these border fall patients.

S1: I've been speaking with Dr. Alexander Tenorio. He's a neurological surgery resident here in San Diego. Dr. Tenorio , thank you very much.

S5: Yeah , thank.

S4: You for having me. I do believe this is a very important message and I appreciate your time.

S1: Thanks for joining us to hear about the changes happening at the US Tijuana border. We'd love to hear your comments. You can always reach us at (619) 452-0228 or by email at midday at PBS.org. Join us for the next KPBS Midday edition tomorrow at noon. And remember , if you ever miss a show , you can find the Midday Edition podcast wherever you listen to podcasts. I'm Maureen Cavanaugh , and.

UU: Thanks for listening.