EL PASO, Texas — It wasn’t until Alma Zavala was atop the 30-foot steel border fence that she realized how far it had to fall.
“I taped the wall,” she said. “My hands were bleeding from the rough edges. The guide was shouting, ‘Let go! Let go!’ I fell and felt my bones break.”
Zavala, a young mother from Mexico, lay on a bed at an El Paso shelter Wednesday, in a room with four other migrants who survived terrifying falls from a nearly three-story-high fence. Among them, they had undergone eight surgeries in the past month. Zavala’s right leg was secured with an external fixator that resembled scaffolding.
New public health data confirms what trauma surgeons at border county hospitals have suspected since the U.S. government began raising the height of the Southwest border wall to slow migration: The 30-foot fence causes more injuries and is far more deadly than any previous barrier.
Doctors say the falls and deaths pose a public health crisis for border communities at a time when the Biden administration and the state of Texas are investing in new border fencing amid record migrant apprehensions.
Hospitals in El Paso and San Diego counties will see patients suffering from border wall-related trauma at a rate of one per day in 2023, according to their chief trauma surgeons. Injuries range from complex lower extremity fractures, including fractures of the ankles, foot and leg bones, to severe spinal and cranial injuries.
Border wall falls result in “a higher mortality rate than COVID in the general population,” said Dr. Susan McLean, medical director of surgical intensive care at University Medical Center El Paso. “And that’s something that’s happening all over the border.”
The Biden administration announced in October that it would waive more than two dozen environmental protection laws to build 20 miles of new border fencing in South Texas this year, breaking a presidential campaign promise to stop the construction of new barriers. The proposed fence for Starr County was described as shorter and “movable.”
But the Department of Homeland Security is already replacing an 18-foot fence with a 30-foot version near San Diego. DHS did not immediately respond to USA TODAY’s requests for comment on whether the agency considers public health outcomes when designing the style or height of border barriers.
In a statement earlier this year on the rising number of migrant deaths at the border, Customs and Border Protection said, “Crossing the border illegally is inherently dangerous. in the hands of smugglers, whose priority is profit. »
Texas is also preparing to expand its border security measures. In addition to the concertina wire and buoys in the Rio Grande built as part of Gov. Greg Abbott’s Operation Lone Star, the Texas House last week approved a $1.54 billion Senate proposal to fund the construction of an additional 50 miles of border fencing.
“Texas will continue to use every tool and strategy to deter and repel illegal crossings between ports of entry as President Biden’s dangerous open border policies encourage migrants from more than 150 countries to enter illegally. the country,” Abbott spokesman Andrew Mahaleris said in an email response to questions about the migrant deaths.
“This wall cannot be climbed”
When DHS began construction of a 30-foot fence in Southern California in 2019, then-President Donald Trump described the barrier as impassable: “This wall cannot be climbed,” he said during a visit to Otay Mesa.
Border Patrol agents are rarely so starry-eyed. CBP prefers to use the term “border barrier system” in agency communications to refer to fencing, lighting, cameras, technology and roads – things that Border Patrol agents say slow down, but not stop, migrants who cross the border illegally and try to escape. apprehension.
The injured women at the shelter, each with a badly broken foot, ankle or leg, scaled the 30-foot fence in the same way: using makeshift rope ladders made of braided rope and plastic pipe, the type favored by El Paso smugglers. area.
They said they didn’t realize they would have to climb the wall; or that it was so high, or that there would be no possibility of going down on the American side. They also did not believe they would be eligible for a visa and never considered presenting themselves at a port of entry.
Once there, in the hands of dangerous traffickers, there was no turning back.
“They don’t treat you like a queen,” Zavala said. “You have to climb.”
She thought about her infant son, his delicate health, and the money she needed to pay for his frequent medical care. She let go and landed face down on the ground, her foot twisting unnaturally. She said she only felt cold at first and began crawling north on all fours.
Trauma from falling border wall
From 2000 to 2019 — when construction of the 30-foot fence began in California — University Medical Center in El Paso had just one death from a falling border wall, McLean said.
Last year alone at UMC, nine patients died after the border wall fell. Another 326 people were treated for injuries, giving a mortality rate of 2.8%, she said.
The University of California San Diego Health Medical Center has documented a similar rate of injuries related to falls from the border wall: 345 patients this year, from January to October, said Dr. Jay Doucet, chief of trauma. The human and financial costs continue to rise, he said.
“October was the worst month we have seen: 70 victims of major trauma,” he said. “That’s more than two a day.”
There is no comprehensive count of injuries related to falls from the border wall, Doucet said.
Trauma surgeons — particularly at teaching hospitals in counties along the U.S.-Mexico border — are independently collecting data to better understand a public health problem they believe outweighs politics.
Increased border wall fall trauma increased in San Diego and El Paso after 2020, coinciding with the expansion of the fence 30 feet taller and an increase in migration. Border Patrol migrant encounters increased from 400,000 in fiscal year 2020 during the pandemic to more than 2.4 million in fiscal year 2023.
“We noticed starting around 2020 that the numbers had increased,” McLean said.
“This constitutes a public health problem,” she said. “This is a large population and it’s a preventable problem with serious consequences.”
McLean and emergency room doctors have developed some best practices, she said, including routinely ordering spinal CT scans because migrants often suffer spinal injuries that they cannot recognize. not yet aware.
The height of the wall can be deadly. Vicki Gaubeca, deputy director for U.S. immigration and border policy for Human Rights Watch, says that’s intentional.
“The reason is that at 30 feet, your body naturally experiences dizziness and it’s easier to fall off the wall,” she said. “We’re talking about the equivalent of a three-story building. It almost seems intentional that they built it so high.”
Many migrants arrive at the border in poor condition after a difficult land journey, and their health complicates their path to recovery, Doucet said.
“Their infection rate is higher and their immunity is low,” he said. “They stay in the hospital much longer; their surgeries are more difficult. Their long-term recovery is uncertain. They do not return for clinic appointments. They do not receive rehabilitation care; they often have to withdraw their own basic products. “.
All of this also means local residents are waiting longer for care, he said.
There aren’t enough orthopedic surgeons at the hospital to meet San Diego’s growing needs. Patients with spinal fractures, whether local residents or migrants, now wait up to five days for surgery, compared to 2.5 days before 2019, he said.
“When the wall was built, there were comments that it was not possible to scale the wall,” Doucet said. “No one predicted the number of injuries that were going to occur. The number of injuries seems to be increasing regardless of administration.”
“If you are fighting for your life”
Zavala could spend weeks at the shelter waiting to heal.
The pain in her lower leg throbbed and went up to her hip, she said. She had to undergo a second surgery. But she said she knew she was lucky: The other men in her group stayed with her in the desert until Border Patrol agents found them and put her in an ambulance.
Crystal Sandoval, an immigrant advocate and director of cross-border strategies at the Las Americas Immigrant Advocacy Center in El Paso, has worked with hundreds of migrants and refugees on the El Paso-Juárez border and seen them face the most dangerous obstacles, whatever the consequences.
“The wall is absolutely not a deterrent,” she said.
“If you’re fighting for your life, if you’re fighting not to starve, for the future of your children and your family, I don’t think a wall or anything can stop you,” she declared. “It’s like saying we’re going to forget hope.”