Claudine* was nine months pregnant when she arrived at the US-Mexico border with her husband and her three children in January 2021. She, her husband, and her first two children had left Central Africa seven years prior, moving to Brazil for migrant jobs in construction ahead of the 2014 World Cup. She gave birth to her third child in Brazil. When work became scarce and their immigration status expired, they began a multi-year trek, traveling through the dangerous Darién Gap, across multiple international borders, and across over 6,000 miles, to the US border.
At the time of their arrival, immigration through the US-Mexico border was heavily impacted by the COVID pandemic, and most asylum seekers were barred entry, but because of her pregnancy, she and her family were granted humanitarian visas. After release from detention, Claudine was brought to an immigration shelter where a certified nurse midwife provided prenatal care, possibly the first such care of her pregnancy. Healthy Babies, Children, and Mothers, an initiative of MCN’s Health Network, provides in-person triage at the immigration shelter with the nurse midwife for newly released asylum-seeking pregnant women. Then, MCN’s on-site Health Network Associates enroll patients into Health Network so that prenatal and other care can be arranged while they are moving to their final destination within the United States. Health Network is MCN’s award-winning, highly cost-effective virtual case management program that provides migrants with culturally competent support, treatment navigation, appointment set-up at health centers, medical records transfer, and connection to social services in their receiving communities. Without Health Network, hundreds of migrants like agricultural workers, asylum seekers, and others who need to move before their treatment is complete would struggle to find or maintain care.
While at the shelter, Claudine went into labor and was transferred to the local hospital. One day later, she was released and returned to the shelter. The nurse midwife, concerned about a disruption in postpartum care and well-child visits, enrolled Claudine in Health Network.
Brenda, Claudine’s Health Network Associate who accompanies the nurse midwife to the immigration shelter, was able to enroll her on-site. Claudine told Brenda that she and her family would travel to a Northeastern state. Brenda was concerned that the family did not have sufficient clothing or resources to endure the harsh winter conditions of that region. Unlike at the border, the Northeast was experiencing severe cold and the family did not have experience with winter weather, particularly with an infant, but Claudine was insistent. She pointed to the successful integration of her uncle, who had ended up in Connecticut, where he connected with a local office of a national nonprofit dedicated to refugee care. The nonprofit connected him with housing, health care, and other resources. Claudine was determined to follow his path, even as her own uncle discouraged her.
As part of enrollment, Brenda spoke with Claudine’s uncle as an “anchor contact,” a person with a strong connection to the family who is established. The anchor contact helps Health Network stay connected with the migrating patient in case direct communication with the patient fails during migration. Her uncle implored Brenda to stop Claudine from migrating to the Northeast, emphasizing the extreme winter weather conditions for which the family was unprepared. When Brenda raised the concern, again, Claudine declined to change her plans. She had heard from others, via informal channels, that migrants were living good lives in the area. Her uncle’s own success in resettlement confirmed the information she had heard. The advice of migration health professionals, even combined with her uncle’s advice, did not deter her from moving despite the dangers.
In the absence of formal migration paths, migrants depend on informal information channels, particularly instant messaging platforms with low barriers to entry and usage like WhatsApp, to make migration decisions. In many cases, this provides critical networks for newly arriving migrants, but the information can be unreliable or, in some cases, incorrect. In 2023, for example, social media posts claiming that the US would admit more migrants after a deadly fire at a Mexican detention center led to a thousand migrants asking for asylum, despite ongoing closures at the border at the time that would disqualify them from asking for asylum.1 Misinformation or disinformation among migrants spreads quickly, anonymously, and inexpensively. Additionally, social media may depict a quick migration or an easier life in the United States, but in one survey of Venezuelan migrants, 59% of respondents reported that they would not have begun their migrations to the US had they known what they had learned during and after migration, indicating, say the authors of the report, that “many Venezuelans on the move through Central America made ill-informed decisions about the risks and dangers they would face on the route, and that they were poorly prepared to deal with the migration processes in their destination countries.”2
Resources
Battling Mis- and Disinformation:
Clinicians serving migrants and immigrants can equip patients to understand what misinformation and disinformation are, and the steps we can take to protect ourselves, our fellow health care workers, and the public, from their negative impacts. While migration-specific misinformation remains a critical concern, misinformation is also frequently shared inadvertently in relation to other emerging topics like infectious disease and vaccination, climate change, and the 2024 election. Migrant Clinicians Network’s Misinformation and Disinformation page includes resources like quick written primers, videos, presentations, and MCN’s Five Key Questions handout, available in English and Spanish: https://www.migrantclinician.org/misinformation-and-disinformation-toolkit-clinicians-and-public-health-workers.html.
Learn more about Healthy Mothers, Babies, and Children: https://www.migrantclinician.org/healthy-babies-children-and-mothers.html
Health Network is available for any migrants with health concerns, moving before they can complete their treatment. Learn more about Health Network and how to enroll patients on our website. The information is also available in Spanish. https://www.migrantclinician.org/our-work/health-network.html. We regularly host webinars on Health Network. Watch our Upcoming Webinars page to find out: https://www.migrantclinician.org/webinars/upcoming.
*Patient’s name and identifying details have been anonymized or generalized to protect the patient’s identity.
References
1 Acevedo N and L Albinson. Misinformation fuels false hopes among migrants after deadly fire in Mexico. NBC News. 20 March 2023. https://www.nbcnews.com/news/latino/misinformation-fuels-false-hopes-migrants-mexico-fire-rcna77398
2 Digital lifelines: The use of social media networks among Venezuelan refugees and migrants heading north. Mixed Migration Centre. November 2023. https://mixedmigration.org/resource/digital-lifelines-social-media-venezuelan/
