Migrants in cities across the US may need medical care. It’s not that easy to find

He didn’t want to talk much about traveling to Chicago from Venezuela, where a social, political and economic crisis has pushed millions into poverty and led 7 million to flee, Figuera and three of his kids included.

But somewhere along the way, he’d gotten pneumonia.

Figuera, who was living with hundreds of other asylum-seekers at O’Hare International Airport while waiting for more permanent shelter, returned for follow-up care at the county clinic. The stubborn cough came back, so he did, too. The staff checked his vitals, listened to his chest and gave him a hepatitis vaccine.

“I rarely get sick,” he said. “It was the journey that got me sick.”

Tens of thousands of migrants who’ve come to the United States are navigating a patchwork system to find treatment for new or chronic health concerns.

Doctors across the country say it’s rare that migrants receive medical screenings or anything beyond care for medical emergencies when they arrive at the U.S.-Mexico border, and there’s no overarching national system to track the care, either. Migrants’ options dwindle or expand after that — depending on where they end up — with some cities guiding new arrivals into robust public health systems and others relying on emergency departments or volunteer doctors to treat otherwise preventable health issues.

“You have these little islands of care. You have these little islands of shelter,” said Deliana Garcia, of the nonprofit Migrant Clinicians Network, which supported more than 1,000 migrants in need of medical care in the first 10 months of this year. “But how does anyone know what’s going on east to west or north to south?”

More than 2 million people crossed the border illegally between October 2022 and September 2023, according to Border Patrol data. For the most part, doctors said, the migrants are healthy; they have to be to make the arduous journey. It’s the travel that can turn manageable health issues into emergencies.

Because of that, public health leaders across the country — from New York to Los Angeles, Boston to Denver — say there’s high demand for care. And providing it is central to their organizations’ missions.

“It’s so core to what we do that I don’t feel like anyone’s really hesitated around this is the right thing for the organization to do,” said Craig Williams, chief administrative officer of Cook County’s health system.

The work is not without a price: Roughly 14,500 migrants have visited the Cook County clinic this year for immediate care, vaccinations and a foothold into the public health care system. The county spends about $2.2 million a month — or nearly $30 million since it opened the clinic about a year ago.

New York City Health and Hospitals logged 29,000 migrant patient visits in the last fiscal year, which ended in mid-June. There, health workers have administered more than 40,000 vaccines and provide medical screenings for all new arrivals.

Other cities are trying to manage as best they can, like Denver, where nearly 26,000 migrants have arrived within the last year. Dr. Steve Federico, a director at Denver Health, said the city’s process is inadequate.

Migrants are asked by shelter staff if they need immediate medical attention. If they say yes, they’re either sent to an emergency room or connected by phone with a nurse through Denver Health, a public hospital and health organization.

There are no basic health screenings, Federico said, which can increase the risk of infectious disease outbreaks among those living in shelters. In Chicago, one shelter saw a small outbreak of chickenpox.

Migrants face a lack of access to steady medical care in the U.S., as well as healthy food and stable housing. It can mean that someone with a chronic medical condition, like diabetes or hypertension, can end up in the hospital simply because they lost or ran out of their medications, or had them confiscated during their travels. Doctors said they’ve also seen migrant children with asthma who need new inhalers.

“You have what were essentially healthy people put in really remarkable circumstances, where they are not able to survive thoroughly and then they come across (the border) in a really compromised state,” said Garcia, of the Migrant Clinicians Network.

Some women are arriving far along in their pregnancies, and never had prenatal care.

“We gave the first prenatal visit to a woman who was nine months pregnant just two weeks ago,” said Dr. Ted Long, senior vice president at New York City Health and Hospitals, where more than 300 healthy babies have been born to migrant mothers.

Even when care is available, migrants can have a hard time getting it. Some avoid asking for help entirely out of fear of a large bill or longstanding distrust of the medical system.

Dr. Stephanie Lee is the medical director of refugee resettlement and coordinator of the unaccompanied youth program at Penn State Health’s Family Practice Pediatrics Clinic. She said she sees many patients who don’t have health insurance or don’t know how to get it.

“The process is so broken that you can’t even do anything,” Lee said.