Border Barriers to Harm Reduction

Editor s Note This story is a collaboration between Puente News Collaborative and the Texas Observer As the healthcare workers approach the small collection of makeshift shelters along the train tracks that cut through the northern Mexico industrial hub of Ciudad Ju rez the people who gather in this place to use drugs prepare for their arrival They re ready to exchange used syringes for clean ones a practice that helps prevent injury and syndrome They prepare their kits in anticipation of the small packets of distilled water in which they can more safely cook heroin The workers for Programa Compa eros a nonprofit that provides supplies and assistance to vulnerable populations in Ju rez have invested years building relationships with people who use heroin in Ju rez s picaderos a colloquial term equivalent to shooting galleries Specific of these locations are essentially tolerated by local government allowing Programa Compa eros to develop established services the group calls these drug consumption sites But even at sites where there s little effort at coordinated narcotics enforcement gathering in one place leaves people vulnerable to abuses from Mexico s military and police forces who are increasingly flooding the city of million across the Rio Grande from El Paso The boundary has long been one of the majority of heavily policed parts of both the United States and Mexico Since taking office this year U S President Donald Trump has deployed additional troops to the already-militarized region and put pressure on Mexican President Claudia Sheinbaum to do the same Research about past limit deployments has shown that they make it more tough for wellness workers on both sides of the margin to reach vulnerable populations An older man receives a heroin injection with a clean syringe provided by Programa Compa eros from another individual also experiencing addiction in September in Ciudad Ju rez Omar Ornelas A -year-old man at the consumption site by the tracks who identified himself only as Erick explained that when he first met the Programa Compa eros outreach workers he was suspicious of the men in jeans and slacks and fresh T-shirts offering needles I thought they were like honestly a few kind of police or something like that Erick announced He could hardly be blamed for thinking that The presence of military forces in Ju rez is obvious throughout the city The skeleton of what s called the Torre Centinela the future command center for the state of Chihuahua s massive surveillance effort rises above Ju rez s downtown White Guardia Nacional pickups with machine guns mounted behind the cab and masked soldiers crammed in the bed can be seen cruising the city All-black Mexican army trucks patrol as well Erick declared defense forces do show up at the site but rarely to make arrests They come here and they get the guy that s selling and beat him up Erick disclosed The cops and the military If you have money on you you d better hide it because if they stop you here and you have money in your pockets they ll take it away from you Erick grew up in Ju rez and crossed the perimeter at age he reported living first in El Paso and later in New Mexico Two years ago after an arrest for driving while intoxicated he declared he was deported to Ju rez Erick had been involved in a gang in New Mexico and before his deportation was jailed at an immigration detention center in the West Texas town of Pecos where he started using heroin Back in Ju rez after a -year absence the only society he could find was in the picaderos Despite his suspicions Programa Compa eros was already well known among the other heroin users he d ascertained The organization s staff say their nonjudgmental approach and willingness to provide supplies that people who use drugs want like needles helps them build trust and direct people to other services Erick declared he now goes to the group s headquarters where services like showers clean clothes counseling and clinical and dental care are offered For nearly years Programa Compa eros has practiced harm reduction a broadly defined strategy for providing services to people who use drugs without attaching stigma or strict parameters and involving people who use drugs in planning and implementing that strategy Fentanyl a powerful synthetic opioid often produced in Mexico to meet U S demand is now on the streets in that country as well creating a populace healthcare predicament In May a batch of powdered cocaine tainted with fentanyl killed five people in Ju rez over the subject of two hours local bureaucrats commented Ju rez s location on the dividing line with Texas creates unique challenges for providing harm-reduction services Immigrants from all over Mexico and the globe flock to the frontier fleeing violence or instability and looking for work either in Ju rez or in the United States There s also the region of newest deportees like Erick oftentimes dropped into a country they barely know Robustness workers in the region must provide services to a particularly vulnerable population whose members sometimes speak little or no Spanish The increased militarization of the perimeter then pushes those vulnerable populations further into the shadows and makes them harder to reach vitality workers and activists say The atmosphere of militarization and surveillance is pervasive on both sides of the edge This only increased in February when Mexico launched Operativo Espejo to mirror the militarization on the U S side The effort both governments explained was aimed at deterring both immigration and drug smuggling In Mexico Sheinbaum deployed troops to the territory line with nearly to Ju rez The edge is hypermilitarized as we ve never seen reported Dr Patricia Gonzalez Zuniga a physician who s done research and volunteer outreach in Tijuana across the boundary from San Diego California Now if you go like to a shopping center just to the store or a field you will find a lot of military trucks full of soldiers I work with people who are homeless and the stories that they advised us are very awful Whether it involves distributing clean needles and the overdose-reversal drug naloxone or just providing food clean clothes and healthcare care harm reduction focuses on diminishing the negative impacts of drug use rather than insisting that people quit Research has identified that needle exchanges not only reduce the spread of condition but are a gateway to other services people who use syringe exchanges are more likely to enter recovery research has located The El Paso-Ciudad Ju rez region which includes parts of Texas and New Mexico and the Mexican state of Chihuahua offers a stark example of the opportunities and challenges harm-reduction workers face along the territory line The region suffers from a lack of expenditure We ve been underfunded revealed Julia Lechuga an associate professor of healthcare psychology at the City University of New York s Hunter College who has conducted research about harm reduction in El Paso and Ju rez Frankly it s an uphill battle There are not enough support to provide harm reduction and provide intervention and cure A substance user prepares for an injection after receiving clean syringes Omar Ornelas The Trump administration s spending cuts which have targeted progressive policies including harm reduction have shrunk information for programs nationwide The State of Texas has targeted services for immigrants which creates uncertainty for organizations working in demarcation communities which have large undocumented populations Every organization in El Paso that provides substance-use services has lost funding and it has already had an impact in our ability to serve explained Jamie Bailey a peer recovery specialist and the co-chair and co-founder of the El Paso Harm Reduction Alliance It s a very laborious position to be in because you want to continue to be able to serve your district and you also don t want to turn away people that need help based on their immigration status But being on the limit also provides particular benefits Just as ideas about cure and outreach flow back and forth between Texas New Mexico and Chihuahua so does lifesaving medication Programa Compa eros for instance works its way around Mexico s restrictions on naloxone by accepting donations from groups in Texas In April Programa Compa eros workers Juli n Rojas and David Montelongo picked their way along a rocky path running between a cinder-block wall and the train tracks that pass by the consumption site in Ju rez Rojas carried a black backpack with the supplies for their day s mission Montelongo carried a red plastic container for the used needles they d be collecting Over the class of the day they stopped at a house in a residential neighborhood and an abandoned building in the city s historic downtown While passing through the heavily patrolled centro close to bridges that connect Ju rez to El Paso they were cautious subtly exchanging needles When sought if he thought syringe exchanges encourage people to try heroin a criticism levied by opponents Rojas who stated he has personal experience with drug use scoffed It s not a question of whether people will use he explained It s a question of whether they ll use safely Programa Compa eros workers revealed the worst period for militarization in Ju rez was during the s when the Mexican regime deployed troops to curb open warfare between criminal organizations They heard from people who d been beaten with boards and stabbed with their own syringes by Mexican precaution forces The violence still persists mainly by the municipal police the National Guard at times Rojas revealed But not with the same intensity as in those years Daniel Vela Carrazco a event worker and registered nurse with Programa Compa eros exchanges syringes with people who use drugs Omar Ornelas But if targeting of the picaderos for shakedowns continues and the people who use drugs there are forced further into the shadows it will be harder for Programa Compa eros to reach people who need its services The new troop deployments have raised concern among people who work in harm reduction that violence against people who use drugs will spike In Lechuga the strength psychology professor published a assessment that ascertained the s military deployment in Ju rez promoted engagement in behaviors that increased drug use and medical harms including HIV vulnerability The Mexican military deployment s impact also spilled over the territory line she stated in an interview as increased militarization on the Mexican side led to increasing harsh police tactics on the U S side In El Paso both the state and federal governments have rolled out highly publicized limit enforcement operations in current years Earlier this year videos circulated online purporting to show immigration executives knocking on doors in El Paso News stations indicated immigrants crowded onto deportation flights out of Fort Bliss the -square-mile U S Army post headquartered on the city s edge In March the Trump administration deployed armored combat vehicles to the borderlands The under-construction Torre Centinela project will share information with Texas law enforcement and is visible from El Paso All that can rattle drug users who may have suffered mistreatment from officers or may be experiencing paranoia announced Joey Montes outreach lead at the Recovery Alliance of El Paso I could imagine what they re feeling when they see actual leadership out there in vests with their badges big guns just roaming the streets Montes revealed So I m pretty sure that s scaring a lot of them into hiding The post Limit Fences to Harm Reduction appeared first on The Texas Observer