“As doctors working on the front lines of the migrant crisis, we’ve seen firsthand the negative effects of tent cities and the forced movement of migrants across the United States. The harms are physical and psychological, and they are cumulative.”

Adi Talwar

Immigrants who arrived in New York City on one of the three buses from Texas on Aug. 10, waiting in front of Port Authority to be transported to homeless shelters.

“Doc, we have a situation.” The text came in as many do: an urgent Whatsapp message from a concerned community member, one of the small but relentless cohort of mutual aid workers supporting arriving asylum seekers. “We have a little girl with a leg problem—can you help?”

The girl, who we will call “Sarah,” is one of many thousands of people in need who have been used as political pawns. Recently, we’ve seen asylum seekers used as political props by Republican governors as they are bused from the border to cities such as New York. As of September 2022, more than 13,000 migrants had been bused from Arizona and Texas alone. This is cruel, inhumane, and unjust—not only because of the deception often involved, but because it puts asylum seekers’ health at risk.

Unfortunately, the trauma does not end with the deceptions and mistreatment of the border states. Policies in blue cities like New York City are hardly better. Though the city recently closed its grossly negligent tent city, Mayor Eric Adams has suggested it could return, saying “nothing is off the table” as the city continues to receive thousands of new immigrants every week.

While Texas Gov. Greg Abbott claims those being sent to other states have gone voluntarily, New York City officials have said many were not given a choice. This treatment of migrants is cruel and unnecessary. But the effects of being forcibly moved and denied services go beyond just physical impact. Last month, another migrant in New York tragically took their own life—a sobering reminder that the mental scars from this traumatic experience can be deep, long-lasting, and potentially deadly.

Sarah’s leg was not fractured or sprained. The original cut, the result of a trip and fall in the jungle while crossing the Darién Gap in Panamá, had become infected. Sarah’s mother had been given some antibiotics while in Mexico, but Sarah hadn’t completed the treatment. It wouldn’t be until later that we would find out why not.

Originally from Venezuela, Sarah and her mother were processed for an asylum application at the U.S. border, where their documents and medications were confiscated before being placed on a bus to New York. Sarah hadn’t finished her antibiotics because the U.S. government took them away from her, and then the state of Texas deceived her into traveling to a city where she knew no one and refused to coordinate her arrival with local officials or charity organizations.

As doctors working on the front lines of the migrant crisis, we’ve seen firsthand the negative effects of tent cities and the forced movement of migrants across the United States. The harms are physical and psychological, and they are cumulative. Asylum seekers often come to the United States to escape violence, but our current asylum system inflicts a violent mental and physical toll on those who are a part of it.

For both medical and ethical reasons, we must stop the politicized movement of migrants across the country, and the United States government must work with asylum seekers in a manner that takes their health into account and treats them with dignity and respect. A better system is possible. Here is what we must do to make that a reality.

First and foremost, we must stop the cruel and unnecessary involuntary transfer of migrants from border states. The Department of Justice should investigate allegations that state authorities have violated federal law by forcibly busing and flying asylum seekers to locations that they did not wish to go.

Second, the government must work to ensure that the medical needs of folks crossing the border are met: rather than confiscating medications, Department of Homeland Security should release people from custody with a sufficient supply of medication to treat medical needs and provide medical files for affected individuals. States and cities hosting asylum seekers should also provide medical care near transit hubs so that asylum seekers can receive emergency medical services and provide referrals to local doctors for asylum seekers in need.

Third, blue cities and states must enact laws that benefit migrants, rather than harm them. In New York, legislators have introduced a bill which would expand the state-funded Essential Plan to offer healthcare access to any New Yorker, regardless of their immigration status, who earns up to 200 percent of the federal poverty level. Not only would the bill ensure that migrants in desperate need of medical care have access to it when they arrive, but it would also help the thousands of hard-working immigrants without documentation already living in New York continue to thrive. As the state legislature convenes this January, making this bill law should be a priority.

Back in the clinic, Sarah’s wound looked concerning—it was clear that she needed to go to the hospital. In the emergency department, Sarah was found to have a bacterial infection that had spread to her bloodstream. She was admitted to the hospital and started on powerful intravenous antibiotics. The treatment worked and she recovered from the infection. The recovery from her experiences will take longer.

We have the power to create an asylum system that treats migrants with respect and is conscious of their health outcomes. The current system is morally and medically untenable. As physicians, as community members, and as human beings, we call on our governments from the federal to local level to step in to fix this issue. Every moment we waste means more asylum seekers suffering at the hands of cruel politicians in red and blue states alike.

Kate Sugarman, MD, is a family physician and adjunct faculty at Georgetown Law School. Nathaniel Kratz, MD, is an assistant professor of Medicine at Columbia University and Medical Lead for Targeted Outreach at NewYork-Presbyterian hospital. Both authors are members of the New York Lawyers for the Public Interest Medical Providers Network.