Like many 9-year-olds, Cynthia Salazar asked for her father when she woke up from her appendicitis surgery in May. But her father, who was waiting below in the UNC hospital parking lot, worried that if he visited his daughter, he could risk being identified as undocumented.
Salazar’s parents, both undocumented, had avoided seeking medical attention for their daughter for several days — until she couldn’t walk. It wasn’t worth the risk of deportation, especially since her father had already been deported back to Mexico in 2007. He had only recently returned to the U.S. after a 10-year ban was lifted, and was working toward obtaining legal status.
They eventually took her to the local clinic and found that her appendix had nearly ruptured. She would have to go to the hospital for surgery immediately.
“That’s when my dad was like, ‘I don’t want to go, because what if they ask for my ID, what if they do this,’” said Cynthia’s sister Johanna Salazar, 21, a Deferred Action for Childhood Arrivals recipient and recent Durham Tech grad who lives in Carrboro.
“Just think about being a 9-year-old kid, going into surgery without your dad being there," Salazar said. "It’s pretty scary.”
The family's fears have become common within the undocumented immigrant community. While the U.S. is deporting fewer people under President Donald Trump so far, U.S. Immigration and Customs Enforcement agents have made 43 percent more arrests since Trump took office compared to the same period last year.
The uncertainty is leaving undocumented immigrants with the delicate balance between caring for their own health and running the risk of deportation.
“Families will feel unsafe, that at any moment they will have to decide between their families or health,” Salazar said.
A lack of preventative care
Two-thirds of clinics that serve an immigrant population said they had noticed patients were more reluctant to seek health care, according to a national poll from the Migrant Clinicians Network.
Mary Quezada, the health education director at the Women’s Health Information Center at UNC Health Care, said the organization has cancelled three of its Spanish-speaking childbirth classes this year because of no-shows, which she said is unheard of. When she called the women who signed up to find out what had happened, many cited concerns over safety.
Some flat-out told her they were scared of deportation.
“We take for granted that we can go out in the street and go shopping or go the doctor and do things,” she said. “This is a country where freedom is the word we want to use all the time, and then ironically it feels like a prison to them because they can’t really live their life normally.”
Federal immigration officials consider hospitals and healthcare facilities to be sensitive locations, where immigration enforcement actions are to be avoided except in extreme circumstances.
Health care providers are also generally not required to report a patient’s immigration status to authorities.
But just last week, an undocumented 10-year-old girl with cerebral palsy was detained in Texas after undergoing emergency gallbladder surgery. Her ambulance was apprehended at a border patrol checkpoint, and though agents allowed it to pass through, they followed it to the hospital and detained her once she was discharged.
Ron Woodard, director of the North Carolina immigration reform organization NC LISTEN, said the priority should be serving U.S. citizens in hospitals.
“Every time an illegal immigrant goes to an emergency room, who is paying for that?” he said. “Somebody is missing some help who is legally here.”
Alison Kiser, a spokesperson for Planned Parenthood South Atlantic, said since the election, Planned Parenthood has redoubled its effort to inform its patients that immigration officers are not allowed to make random checks at their clinics, especially after the repeal of Deferred Action for Childhood Arrivals. Close to one-third of the patients at its Durham clinic are Spanish-speaking, she said.
“During the last election and following the election, some of the rhetoric that we were hearing was just so extreme, and we were hearing anecdotally and very understandably that many of our patients, and many of our Latino patients, were understandably nervous, scared, anxious,” Kiser said.
And while immigration raids aren’t frequent in Orange County, word of raids in nearby counties can spread fear.
“That’s one of my fears, that people get paranoid and they stop treatments, they stop taking care of themselves, they don’t come to the appointments just because they are in shock, they are frozen, they don’t know what to do,” said Claudia Rojas, manager of the UNC Center for Latino Health.
Rojas said she believes this is especially problematic for patients with chronic illnesses such as diabetes, which typically require appointments every three or four months.
“They don’t want to have frequent follow up appointments,” Rojas said. “Their wish is they come once a year, that’s it.”
‘At that point it was too late’
The fear of seeking primary medical care often puts the burden on already-strained hospitals, as some immigrants forgo primary and preventative care and are faced with medical emergencies.
“I have a few patients that I know they are high risk, the chance that they may lose their baby just because they are not coming to their appointments is there,” said Quezada, who also works with OB-GYNs.
Salazar, the woman whose father was afraid to go into UNC hospitals, said her uncle was a recovering alcoholic, and after refusing to seek treatment, he developed terminal diabetes.
“He had yellow skin, he lost half of his weight,” Salazar said. “That’s when he decided to get treatment but at that point it was too late.”
He ended up returning to Mexico to seek treatment in order to avoid the risk of deportation. But Salazar said the care he’s receiving is poor quality, and his health is not improving.
Even if clinics and hospitals continue to be safe zones, some undocumented immigrants fear that they could be stopped by immigration officials on their way to appointments. In North Carolina, undocumented immigrants are not allowed to obtain driver’s licenses.
Salazar said immigrants are more afraid than ever to leave their homes in any situation.
“I know my mom, she always tells me, ‘You leave first, and then tell me how are the roads and everything,’” Salazar said.
Quezada said this fear is often echoed by the women she follows up with who don’t show up to her classes.
“A couple of ladies have said it straightforward: ‘I’m just afraid, I have all the kids and they’re at home and if I leave for a class and I get detained then what’s gonna happen to the kids?’” she said. “I cannot assure them that no one is going to stop them in the street.”
Araceli Leon, a fourth-year pharmacy student at UNC who just completed a clinical rotation at the Center for Latino Health, said transportation concerns often keep undocumented immigrants from picking up prescriptions.
“Do they risk going to get their medication, their required treatment, in driving without a license with a possibility of getting either a driving without a license ticket and the possibility of being a target for deportation?”
Mental health impacts
Fears of deportation affect not just the physical health of undocumented immigrants, but mental health, too.
Dr. Marco Alemán, a clinical professor of medicine at UNC, said he’s seen more and more of the nearly one-third of his patients who are immigrants come in with bodily complaints related to stress, such as headaches and stomachaches. He often sees the stress affect entire families.
“Many times in the last two or three years I’m finding people are more worried about their status, their immigration status, their children being affected to this, and that is really stressful to them,” he said.
Olivia, an undocumented immigrant who asked to exclude her last name from publication, said before the election her life was relatively normal. Now, she’s constantly stressed and afraid to make major decisions — like purchasing a car or a house — because she is unsure if she will be deported.
“Everything that's happened in your life — you're just thinking you can't make any small mistake because it would cost you a lot, so you think about how to avoid it,” she said. “I think all of this has a really bad effect on mental health. To live you have to work, eat and provide happiness for your soul, like church."
"And if you're spending time avoiding these activities or places, you can't have a normal life," she said.
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