By Ed Williams, Searchlight New Mexico, July 18, 2024
LAS CRUCES — At an appointment in late January 2024, Angelica’s doctor delivered the results of her biopsy: stage 2 cervical cancer. She needed aggressive treatment right away but getting it in her hometown of Las Cruces would mean a monthslong wait.
One month went by, then six weeks, then two months. By April, the doctor said she couldn’t afford to postpone treatment any longer. She needed to get to Albuquerque immediately, where he could quickly arrange an appointment.
“I can’t go to Albuquerque,” Angelica (her middle name) responded. “I don’t have papers. I’m undocumented. I can’t make it past the border patrol checkpoint. Am I going to die if I stay here?”
The diagnosis put Angelica in a life-or-death situation — one faced by every undocumented person in New Mexico’s southern borderlands who needs life-saving medical treatment. They must either find local care or take their chances with the U.S. Customs and Border Protection checkpoints that sit along every route to the state’s most cutting-edge hospitals in Albuquerque.
Las Cruces and Doña Ana County — home to one of New Mexico’s highest shares of immigrant residents — suffer from a shortage of doctors and medical specialists even more acute than the rest of the state.
A 2023 Legislative Finance Committee report found that the county already contends with one of the worst deficits of primary care doctors. Medical specialists, particularly in pediatrics, are virtually nowhere to be found. And the problem is only expected to deepen: By 2030, New Mexico is expected to have the second-largest physician shortage in the country, with a projected shortfall of 2,118 doctors, a gap that will likely hit especially hard in the already strapped southern part of the state.
An additional challenge emerged following the U.S. Supreme Court’s Dobbs decision of 2022, which eradicated a woman’s constitutional right to abortion. A year later, more than 14,000 patients from Texas traveled to New Mexico for reproductive health care. That surge has pushed many local patients to the back of waiting lists, advocates say, often forcing them to travel to clinics in other parts of the state for care.
Many are forced to seek treatment in El Paso, a city contending with its own severe shortage of providers, or travel north to Albuquerque or Santa Fe — and through the border patrol checkpoint on I-25, approximately 30 miles north of Las Cruces.
“Most people who live outside of checkpoints have no clue of this problem,” said Yolanda Diaz, who runs Cancer Aid Resources and Education Inc., a Las Cruces-based nonprofit that connects patients with medical services. Diaz has made as much noise about the issue as she can, speaking in city council meetings and writing editorials in newspapers throughout the state. Despite her efforts, she says there’s been little progress in fixing the problem.
Barriers to care
This latest crisis isn’t the first time a lack of local care jeopardized Angelica and her family. Six years ago, her 12-year-old daughter suffered a brain hemorrhage while at school in Las Cruces. She died in the ambulance while being transported to the nearest pediatric emergency center 45 minutes away in El Paso.
“Any parent that loses a kid isn’t afraid of dying anymore,” Angelica said. “I wasn’t scared for myself when I got my diagnosis. I was scared for my son,” who is 16 years old. “Who’s going to take care of him without me?”
The choice was clear: If she didn’t get treatment quickly, her remaining child would spend the rest of his life without a mother. With the help of her doctor, Angelica contacted Diaz, the patient advocate, who agreed to help.
It wouldn’t be simple. The barriers faced by patients like Angelica are “horrifying,” according to Diaz. Making matters worse, Memorial Medical Center — southern New Mexico’s biggest hospital and only facility accredited for cancer treatment — recently came under fire for allegations of denying care to underinsured patients.
With the clock ticking, Angelica and Diaz decided to try and find a backdoor route to Albuquerque. “Cancer doesn’t wait,” Angelica said, and neither could she.
Waitlists go on ‘forever’
Gaps in health care access are not uncommon in small communities along the southern border, whether in New Mexico or neighboring states. But Angelica — like all undocumented residents of Las Cruces, New Mexico’s second-largest city — faces hurdles not typically shared by those living in major cities.
“I’ve seen patients wait a year or more for treatment for certain illnesses,” said Angelica’s oncologist, Dr. Luis Padilla-Paz. “No matter how well-intentioned the providers, there’s so little supply of health care providers to take care of these patients. And that compromises the outlook and survival for the patients.”
In Arizona, checkpoints lie to the south of large population centers, for example. The health care infrastructure in California is robust enough that San Diego residents are more likely to obtain local care.
In New Mexico, by comparison, the situation has now reached crisis levels, said Karen Kopera-Frye, a professor of public health sciences at New Mexico State University.
Patients are “waiting on a waitlist to get seen forever,” and end up with no choice but to try to get care elsewhere. “You can try to go to El Paso, but they’re busting at the seams as well,” Kopera-Frye said. “And undocumented patients, where do they go? If you want the good care, you go north. But you can’t, because there’s a checkpoint.”
There have been some bright spots in getting basic care to underserved communities, she noted. School-based health centers have shown success in some areas. And the state’s border region has an unusually high number of federally qualified health centers, a type of clinic meant to provide primary care services regardless of patients’ ability to pay.
“But if you need a specialist, you can forget that,” Kopera-Frye said.
Too great a risk
Little, if any, data exists to show the extent of the border checkpoint’s health impacts on undocumented families, or how many residents have been affected. Undocumented immigrants are unlikely to respond to surveys and are among the hardest residents for researchers to study, resulting in a profound lack of data about their plight.
A U.S. Customs and Border Protection spokesperson told Searchlight New Mexico that the agency rarely encounters undocumented patients at the checkpoint north of Las Cruces. That could indicate the problem doesn’t affect a large number of people — or that few undocumented residents who need care in Albuquerque are willing to risk the trip.
Advocates and patients say it’s the latter.
“There are a lot of families dealing with this,” said Elizabeth, a single mom in Las Cruces who gave only her first name because she is undocumented.
The mother of four teenagers, Elizabeth’s second child was born with a chromosomal disorder that affected her eyes, kidneys and bones. When she was an infant, the girl required a dizzying number of appointments with doctors, surgeons and therapists, sometimes three or more per week.
The referrals to doctors in Albuquerque came by the dozen. “I asked them, isn’t there anyone she can see here or in El Paso? They told me ‘No, there’s nothing. You have to go to Albuquerque.’”
It was too great a risk, she said. If she were ever to be picked up by border patrol, her children — all U.S. citizens — would be left without a parent.
“It’s humiliating,” said Elizabeth. “These are my kids. I’ll never leave their side. We try our hardest to do the best and to protect our kids.”
Over the years, she has managed to obtain some local care for her daughter, who is now 16, usually after many months of waiting for appointments with the few doctors in town who can partially address her medical needs. In many cases, she’s had to forego treatments completely.
Longing for home
Two and a half months after Angelica’s diagnosis, Diaz managed to arrange a way for her to pass the border checkpoint undetected — a route Diaz refuses to discuss. The relief was short-lived: At Angelica’s first appointment in Albuquerque, doctors told her that, in the time that had elapsed since her diagnosis, her tumor had doubled in size.
She would need at least three months of chemo, followed by a month and a half of radiation. Because of the checkpoint issue, she’d need to stay in Albuquerque for the duration. Even then she might need further treatment.
“I can’t be here four and a half months!” Angelica initially thought. “How will my son make it that long without me?”
In recent months, Angelica has shown improvement, taking chemo in doses, as she jokes, “that would kill an elephant.” An Albuquerque nonprofit that supports cancer patients is providing housing — a modest one-bedroom apartment in the southeast part of town, where she passes her days, window shades drawn, waiting for news that she can return home.
“I’ll be back soon enough,” she said, thinking about her son. “He’ll have to deal with me for another 40 years.”
Note: Searchlight New Mexico is a nonprofit, nonpartisan media organization that seeks to empower New Mexicans to demand honest and effective public policy.
Really simple solution, they need to relocate to the place they illegally migrated and get care there, why is that so had to contemplate?
I am trying to contemplate Angelica’s or Elizabeth’s situation and find it hard. For them to relocate to their places of origin (say El Salvador or Guatemala) would be costly, in all likelihood they would be strangers (foreigners) in that place since they’ve probably grown up in Las Cruces, and since they are dealing with serious issues that need special health facilities, they may not find adequate facilities (since these don’t seem to exist in Las Cruces, they must be relatively rare).
But the most difficult thing to contemplate is what the decision to repatriate (whether voluntarily, as you suggest, or by deportation, as they themselves think) means to their love of their teenage children and families. If they go back to where they were born, they will have to abandon them with very little possibility of ever seeing them again much less care for them. The alternative would be to take them along, which is not only costly but means permanently disrupting their children’s lives and willingly giving up their future possibilities. The kids, after all, are born and brought up in Las Cruces. I don’t understand why you think that your solution is so simple or even a solution. Can you explain?
One question and one observation. First, who is paying for the medical treatments of these illegals? I hope it is not the taxpayers ! There will always be poor and sick people in the world and there are simply not enough resources to help them all. All four of my grandparents were immigrants who had to prove financial security and good health before being admitted to this country even though they were a persecuted minority. Why was this changed?
And an observation, if you can’t do the time, don’t do the crime. Illegal entry is a crime.
Another observation, I recently received a request from the Citizen to increase my monthly contribution. I would consider it if the reporting was not always so blue. A little pink every now and then would make me smile. Emoji…
Your one question and one observation cover a lot of ground, and the only thing you say that I think is true is that people will get sick. As for poverty, which isn’t part of the problem Angelica faces in this story, maybe you should read Matthew Desmond’s Poverty, by America. Poverty doesn’t need to be always with us. Because it is man-made, various societies have been more successful at getting rid of it than others. According to Desmond’s evidence and analysis, we breed it. Check it out; you might agree with most its readers that it has solutions.
And, about the requirements for your grandparents immigration to the US, you should check on the government website for the up-to-dated information on the requirements before you publicize the misinformation that financial security and health are not required.
You seem to think that undocumented people living in the US should not get any benefits from taxpayers because they are criminals. This is a most strange idea since we taxpayers support one of the largest prison populations in the world, and that cost is constantly increasing as we chant, “get tough with crime.” I hope you are not saying that taxpayers should not feed and give medical attention in prison. Furthermore, undocumented people pay taxes, too, so it isn’t like the legals are paying for the illegals. It’s more like we all, legal and illegal, pool our money so all can benefit. Whether that is good or not, I’m not saying, but that is the reality we live in and agree to.
But are undocumented people really criminals? I thought it a pretty commonly accepted American principle that one is innocent until proven guilty. Undocumented people, by definition, haven’t yet been to court, so I don’t think you’re right to think of them as criminals.
Then, second, what kind of a crime is it not to have papers? It’s a misdemeanor. That’s kind of minor, don’t you think? Some speeding or even parking tickets can be misdemeanors. What you hope for — no taxpayer money for criminals — would apply to a lot of taxpaying citizens. Yes, you are right that entering the country illegally is a crime, but it’s not such a big deal, that one would want to think that the undocumented are not human enough to recognize the difficulties of their lives. These are people who help keep the whole society going, like every one of us, and paying taxes just like you and me and getting benefits when needed.
What I am saying is neither blue or red, just facts mixed with some values that are more ethical than political. I can’t speak for other contributors to the Citizen, but I don’t like political parties, which I think of as groups of people who usurped democratic ideals in the early days of the Republic. Let me tell you a story.
In a road race every car starts at a certain interval after the car in front, unlike track races where cars start together; so in road racing, each car is independently racing against the clock. During one race the navigator of one car told his driver that they were off the race route and he was lost. The driver said that it was okay because he could see the car that started ahead of them, and he would just follow that car and keep his distance. But the car in front kept going slower and slower and then came to a stop. They were both lost. That’s how blue and red thinking works.
The issues we write about in the Citizen are often political, but our point of view is reason, and not partisan, party politics. It’s politics in the original meaning of the word, the discussion of issues necessary to the polis, the city, the people, in a discerning, knowledgeable, and reasonable way.
I see that Mr. Yeh is writing down to us less informed and knowledgeable conservatives again. Just the comment that “our point of view is reason, and not partisan, party politics” pretty much sums it up. That IS his partisan party position. Tell you what Mr. Yeh, take the last bunch of articles about facts we need to know that are supposedly not partisan and have them objectively reviewed by 100 randomly selected folks and if the majority think they are not partisan than I’ll not make any more observations about your articles since I’m obviously partisan and you aren’t. But if the majority thinks they are, than maybe you need to look again at what’s reason verses partisan. My main take on the article which relates to the whole illegal issue, is what about the person who followed the rules but is now behind the illegal on the list to get help. If that was you or yours I suspect you may write the same crap but your real feelings would be a little different. Such is the position of the hypocritical liberal.
The discussion is about the article, and your response to my reply to Mr. Horoschak has only one sentence about that. You invoke the image of standing in line for medical access, and apparently you think that an undocumented person in line delays access for the documented person behind. But you don’t consider what I reminded Mr. Horoschak. An undocumented person is not identified as an undocumented person. You don’t know who is undocumented or documented. That is true also of other people who have committed undetected minor crimes, like driving intoxicated or speeding or parking in a dangerous way. So if you or I are in line, what is the point of complaining that someone ahead of you may or may not have committed some form of illegality and thus is preventing you or me timely access?
Yes, the fact in this article is that a self-identified undocumented is getting medical attention. But I see no indication that there is a line or that that line prevents me or you from getting what we need. The line, and the assumed delay, is simply part of a fanciful argument. If you want to provide some facts, such as, the statistics of medical treatment in Albuquerque that shows the number of undocumented medically treated vs. documented people, or your experience of being denied medical access in Albuquerque because of unidentified undocumented people in line ahead of you, please do so. Then the argument would be publicly discussable rather than a fanciful, unsupported opinion.
The Citizen’s mission is to promote public discussion. It is not an online social media site for self-expression. A discussion is not a gathering of personal opinions. It requires a topic that is treated by the discussants as outside of themselves, something objective that can be talked about. Through that topic, the discussants engage in each others’ knowledge, points of view, and analysis and thought. Simply expressing one’s opinions is just butting heads. That is why ad hominem arguments are not part of discussion.
Since I’ve started publishing “What you need to know,” I’ve looked for articles that I think will further thought and discussion. This does not mean I endorse their point of view, if they have a point of view. It does mean that I think their news content is factual or their analysis is reasonable and thorough. Writing is not all self-serving, self-expression. It can be about the world outside the self. If you think that these articles are liberal and you self-identify as conservative, then these articles are precisely what you need to know.
In spite of your declaration, facts and reason are different from political partisanship. You are right to think that adherence to facts and reason comes out of the liberal tradition of public discourse. However, you ignore that they also come out of the longer conservative tradition which informed the Constitution.
And, in neither the conservative nor the liberal traditions are facts determined by popular vote. If that were true, we would still think the earth is flat.
I need to give facts!! What verses a hypothetical car race. How about this fact. You have 300 million folks in this country with a shortage of health care providers. You add 10 million illegals and you’re going to place a greater demand on those providers. Please dispute that fact. Or how about the fact that the number of liberal teachers in our education system verses conservatives has gone from 3 to 2 in 1900 to 5 to 1 in 2000 and they are now being hired at 50 to 1. Those are facts generated by a California professor who was concerned about the trend. Would you like to describe how our students are competing on the world stage along this same time line? Or maybe the fact that an increased number of students believe a socialist form of government would be better than our current one. Where do you think they get that idea? Let me tell a factual story (no car race) A neighbor (retired equipment operator) has a niece who was the first in his family to go to college. She started coming home providing the socialist “facts” and they had some heated discussions to the point by the time she graduated they weren’t speaking. Fast forward 8 years (marriage, job, two kids), she calls her uncle and tells him how sorry she is for not appreciating the value of his experience verses the political “stuff” she was being fed in college. Like you, I appreciate good discourse about facts but to claim my reference to a list makes the point invalid or fanciful makes me wonder how much you really care about facts.
Yes, let’s look at the fact you state. Since we are still talking about the article on Angelica’s dilemma, let’s look at that fact as it pertains to the issue. You are in the Albuquerque doctor’s office, and there is someone ahead of you. You don’t know that person’s legality status. What are the chances that person is an undocumented? According to your fact, it is 1 out of 30. You really want to rant about the injustice of something that has that little a chance of being factual? I would call this a misuse of factoids. You cite facts and declare truths which are in themselves fine. You say truisms such as where there is healthcare shortage the undocumented will place a greater demand on the system. But it turns out that “greater,” while literally true, is actually insignificantly greater. The real problem with healthcare shortage is money. Do you think Elon Musk has healthcare shortage problems?
What are the chances that person has been convicted of a misdemeanor? Well, according to Alliance for Security and Justice, there are an estimated 45 million people in the US who have been convicted of a misdemeanor. That is, 1 out of 7, or so. These are convicted people, but I assume that there are at least if not many more who go unconvicted, like those who cheat on their income taxes or who speed or who flash their lights to let you know that a speed trap is ahead. So, yes, an undocumented person might, on a very long shot, be ahead of you, but Angelica is not “plugging up the system,” and much, much less so than other “illegals,” that is, other undetected criminals. Why are you not ranting about a more likely scenario?
You distort the subject of the article by using it as an excuse for venting about “liberals,” as the rest of this comment shows. If you want to discuss an issue in public, do so with pertinent facts and about the issue. In this human interest story, the issue is a person’s problems with seeking health care when she hasn’t a visa to stay in this country. The story is not about other people’s problems much less your anti-liberal opinion. Or, do I misread you, and you are in fact saying that human interest is itself a liberal agenda which you stand solidly against?
As for all that business about teachers, you should read a good conservative view from the American Enterprise Institute:
https://www.aei.org/articles/teachers-and-the-right/. Your “fact” would have meaning if “conservative” in 1900 were the same as “conservative” today, but they mean very different things.
I have enjoyed this discourse but, as on ole retired gov auditor/accountant/CPA, to gain much insight when you consider 1 in 30 to be insignificant seems unlikely. You’re indicating over 33 million Dr. visits and over 4 million to gov funded health care centers annually by illegals is insignificant. Based on that, any facts I present that don’t support your position would likely be labeled as insignificant or even worse, misinformation. In that case, in the spirit of the old Bobby Bare song “The Winner”, I concede, you’re the winner. Yes, since it is your site you get to have the last word but please make sure it isn’t insignificant.
Thank you for allowing me the last word. I think you confuse some numbers. I use 1 in 30 as the odds of someone ahead of you or me in line being an undocumented immigrant. While those odds are derived from and are the same as the proportion of undocumented to the general population, they should not be confused. As odds, they do not inspire even a gambling man to bet on the outcome.
As for my use of the word “insignificant,” it refers very vaguely to the health care problem, which is not disproportionately caused by undocumented seeking medical care. The number of undocumented in your line is of very small significance relative to that problem; even though for a single undocumented, getting cancer is very significant. This is to say that numbers within the arithmetic system are constant, but words in the real world are dependent on fluctuating usage and mostly ambivalent until placed in the proper context.
I don’t know where you are getting numbers like 33 million doctors visits by undocumented. Since you say there are 10 million undocumented in the country, are you declaring as a fact that on the average they go 3 times a year to a doctor and another visit to a government subsidized health center (which they have paid into if the funds come from social security)? That is a fact hard to believe. They are not ole folks like you and me. If you go to https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/, you will find a more reasonable number, that about a third of undocumented immigrants seek health care once in a year. That is about 3 million, not 33 million. Here I would say the difference of 1 to 10 seems significant.