× Expand From a source provided to the Prospect The tent encampment in Matamoros, Mexico

In Matamoros, Mexico—just a few feet from the U.S. border at Brownsville, Texas—are hundreds of camping tents. Not quite a refugee camp, this informal space is home to hundreds of asylum seekers and migrants waiting for their asylum hearing in Mexico.

Under the Trump administration’s policies, nearly 50,000 people have been forced to wait in dangerous border towns in Mexico for asylum hearings. Some towns, such as Matamoros and Nuevo Laredo, have State Department travel warnings that advise American tourists not to visit for fear of violent crime, kidnapping, extortion, and sexual assault.

Indeed, out of fear of being kidnapped, asylum seekers have fashioned encampments as close to the U.S. border as possible, according to Todd Schulte, president of FWD.us, an immigrant advocacy group. Schulte recently visited Matamoros to check in with dozens of grantees that, over the past 16 months, FWD.us has worked with along the border to provide resources migrants need, such as humanitarian aid, communications support, and legal representation.

And on Thursday, hundreds of asylum seekers made their way onto the Gateway International Bridge, stopping traffic across the border and drawing international attention to their plight, according to BuzzFeed reporter Adolfo Flores. Because of the commotion, U.S. Customs and Border Protection told asylum seekers that their hearings scheduled for that morning—which they had been waiting in line for since 4 a.m.—had been postponed. It’s unclear when the hearings would be rescheduled.

The tent camps, Schulte explained, are a public-health disaster waiting to happen. In the Matamoros camp, he said he saw children with pink eye and more than two dozen pregnant women, among other growing health challenges. Many of the migrants have come from Central America, where poverty means that parents must choose between vaccinating their children and feeding them. The result is unvaccinated people living in close quarters—there have been outbreaks of chicken pox. But there is little to no access to health care in the camps.

“It’s unbelievably bad. I don’t know how else to say it,” Schulte said. “We should be really clear that we’ve created conditions that are completely unnecessary and inhumane conditions.”

The situation for migrants in the Matamoros camp is desperate. Not only is there barely enough food and water, but health care access is dismal. “There’s no camp door. There’s no sense of public safety. There’s an insufficient number of porta-potties, and people have had to relieve themselves in bushes,” Schulte told me. And there aren’t enough tents, forcing people to sleep under trees. Schulte described watching migrants bathing in the Rio Grande—which is only 60 to 80 feet wide—just across from a cow’s corpse.

“Any time you have a large group of people living in close quarters with minimal resources, there are health hazards,” wrote Dr. Mary Cheffers, clinical faculty member at the University of Southern California and doctor with Physicians for Human Rights, in an email. “When you get a large number of people together, you have high risk for a devastating epidemic,” added Cheffers, who has worked in large migrant encampments, such as in Tijuana. The second most common health hazard is water-borne diseases, which are compounded when sanitation measures are not taken and water is in limited supply. With the changing seasons, the climate has also become more hazardous, with freezing temperatures at night and brutal heat during the day. Hypothermia in desert climates, Cheffers wrote, can be a significant risk.

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× Expand From a source provided to the Prospect The Matamoros camp has rapidly grown from 650 residents to over 1,000.

“These things are supposed to be handled by the Red Cross and the UN and not Angry Tias and Abuelas,” Schulte said, referencing one of the small nonprofit groups FWD.us works with that provides resources to migrants.

The camps, which are among several along the border from Tijuana to Matamoros, have few resources. The people in them are vulnerable to disease, and many have already experienced violence and trauma on their way to the camps.

In a new report, Physicians for Human Rights documented the cases of 18 asylum seekers now waiting in Tijuana. PHR’s medical experts “interviewed and clinically evaluated” 18 asylum seekers and found that they experienced gang threats and violence; pressure to carry drugs under threat of beating, kidnap, or murder. Women faced sexual violence if their partners did not comply; and LGBT individuals faced threats, arbitrary arrests, and murder by both state and nonstate actors.

Once these asylum seekers arrived in Tijuana, they continued to face “violence, theft, and extortion by cartels, gangs, and police authorities.” Nearly every one of the 18 people PHR interviewed tested positive for post-traumatic stress disorder.

According to one lawyer, CBP officers have told asylum seekers that their hearings would be rescheduled if they appeared at an asylum hearing with lice or visible signs of illness. And although the Trump administration has not explicitly said that they have purposefully created conditions ripe for disease that will prevent people from applying for asylum, this is exactly the effect.

A CBP official confirmed in an email, “Approximately 20 individuals, including some family unit members” appeared for asylum hearings in Brownsville and Laredo, and “have had their immigration court hearings rescheduled after initial medical screenings indicated cases of lice, scabies or chicken pox.”

The conditions are heinous under the Trump administration’s “Remain in Mexico” policy—and by keeping asylum seekers in Mexico, it hides the conditions from the American public.

“Between Tijuana and Matamoros, there are dozens of these camps,” said Helen Perry, secretary and operations director for Global Response Management, which provides emergency medical and trauma care worldwide. “Because [the tent encampments are] so spread out, they’re not getting the attention the Rohingya did in Bangladesh,” she added, referencing a crisis where Rohingya, the Muslim minority group in Myanmar, fled violent attacks.

The Matamoros camp, according to Perry, rapidly grew from 650 residents to over 1,000. For Global Response Management, which is also grappling with the medical needs of those in Matamoros, that means 3,000 meals a day. Without those services, the result would be malnutrition and, in extreme cases, starvation. Where before people remained in these camps for only a few days, under the Remain in Mexico policy, people may live in such camps for months or even years while they wait for their asylum hearing in the U.S.

Mexican police informed Global Response Management that they can’t have a permanent structure in Matamoros, so Perry’s solution was a mobile medical clinic.

The truck would have its own water tank, four staff, and offer a suite of medical services. With roughly the same capabilities as a low-level emergency room or primary health clinic, it will be able to treat and track acute diseases, treat a range of ailments, including sprains, lacerations, ear infections, and dehydration. It will also provide malnutrition monitoring, baby exams, and vaccinations. Obstetrical and gynecological support may also be available at regular intervals.

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Every night, the truck will cross the border back into the U.S. to Brownsville and arrive in Matamoros each day. Ideally, the truck will be at the camp seven days a week, but right now, it will only be available for five. But even this is not enough.

The camps along the border are essentially refugee camps, Perry said. There is a real fear of gender-based violence and human trafficking therein. Creating a formal U.N. refugee camp would offer some protection—and ensure adequate resources are available. “Really, we need a formal U.N. response,” Perry said. “We need to get these people all to the same spot that has food distributions and housing and shelter—that’s more than camping tents. [But the] only way we get that is if the U.N. steps up and advocates for that. I know it’s more complicated than that, but it’s really needed.”

For now, GRM’s mobile medical clinic is the short-term answer. But it’s unclear how much longer smaller nonprofits can provide the care asylum seekers need.

“These people are no less human, no less deserving of human decency because they’re 200 feet from the U.S. border,” Schulte said.