Texas Hospital Sees 'Devastating' Border Casualties

Injuries suffered by migrants scaling the U.S-Mexico border wall have been "devastating," according to a hospital physician within walking distance of an area that many Texans have dubbed a crisis.

Texas has been a national epicenter of the escalating political flap surrounding illegal immigration with Governor Greg Abbott's ongoing feud with President Joe Biden. Abbott and statewide officials have attempted to enact their own legislation, essentially allowing them to subvert the federal government and enforce their own deportation laws.

Billions of dollars' worth of construction continues in Cameron, Maverick, Starr, Val Verde and Webb counties that are directly on the border. Physicians across Texas and extending to California, however, have warned that injuries suffered by migrants scaling 30-foot walls have become serious and more common.

"The injuries from an orthopedic standpoint are what we would describe as devastating for the most part," Rajiv Rajani, an associate professor and chair of the Department of Orthopedic Surgery and Rehabilitation at Texas Tech University Health Sciences Center (TTUHSC) in El Paso, told Newsweek.

"And it's a very unique social political phenomenon related to the border wall. We don't see this type of injury pattern in this regularity with any other phenomenon—typically high-energy car wrecks or falls from heights. People will get these injuries all over the country, but you don't get this cluster in volume of them."

At their busiest time, the physicians at TTUHSC see up to 10 migrant injuries per week.

Predominant types of injuries

An ongoing study by the hospital, yet to be publicly released, shows that about 75 percent of those taken to the facility for a border-related fall require treatment for lower extremity injuries. About 15 percent were upper extremity injuries, while head and/or spinal injuries comprising about 6 percent.

The hospital predominantly sees lower extremity injuries suffered from border wall falls, specifically the ankle area in younger individuals. Rajani said they can be described as pilon fractures, where the tibia or shinbone breaks near the ankle.

The fractures can result in a variety of complications. In the short term, this can include fixing wounds for immediate healing, infections, irritation and injuries to nerves and tendons. The long-term implications can be life-altering as patients develop post-traumatic arthritis that often prevents them from walking or working.

"There are a lot of variables that impact the propensity that we see these patients," said Rajani, who is some four minutes from the southern border. "We see political changes in the climate will change how often people come across a border versus through a natural process immigration process. We see changes in the weather [that] will affect seasonal migrant groups."

Impactful costs

There is also a heavy resource allocation to treat such patients, Rajani said, depending on the injuries and the necessary care.

A fall from a large height can result in a patient being put in what is described as an external fixator or an external frame, allowing swelling to subside before being fixed anywhere from 10 to 20 days post-injury.

Migrants often have to be accompanied bedside by federal Border Patrol agents if they cannot be placed in a local shelter or care site.

"That's OR [operating room] time that is allocated," he said. "Obviously, surgery skill set and time away from somebody else potentially. So, there's quite a few areas of resource allocation including implants, hardware, cost, money, and ultimately is going to be paid through our federal and state government."

That cost for the reimbursement pattern including surgeries and implants is "unpredictable," he added. That can be a six-month process or longer, whereas patients' private insurance would often lead to a physician being paid within a couple weeks. That does not happen, which creates difficulty in creating budgets and things like that."

Rajani also said that after treatment, even though their conditions should be monitored, the hospital often loses contact with patients, who either travel to another U.S. destination or board a plane and leave the country, depending on their situation. The hospital's follow-up rate currently sits between 10 percent and 15 percent.

"It's mentally taxing because the way we're trained is to provide the best care to anyone presented in front of us and use our skills and knowledge to provide improvement in the quality of lives of individuals," he said.

"So, for us not to be able to know if we have a complication to not being able to see them through and provide the services that many people can benefit from—it's very taxing because we feel like we've done a job but not finished the job."

Ryan Mielke, spokesperson for the University Medical Center of El Paso, told Newsweek that numbers of migrants served (and the costs associated with such treatment) vary due to not typically having 100 percent verification as to which patients are migrants unless they are escorted by law enforcement.

"We are grateful that much of the cost of care for escorted migrant patients is reimbursed by the federal government," Mielke said. "As a hospital, we care for patients as they present to us. Of those we have verification of migrant status, our records indicate that we are pending reimbursement from the federal government for approximately $6 million for fiscal year 2023.

"Of note, less than 10 percent of our charity care goes to medical expenses for migrant patients, with the remaining 90 percent going to patients with U.S. addresses."

In 2021, there were 279 migrants treated at UMC. That number fell in 2022 to 263 migrants, and numbers for the 2023 fiscal year are still being verified.