Travelling to Tijuana, Mexico, Mirai encountered a challenging social environment that tested her inner strength. Despite initial apprehensions, her determination to help the local community propelled her forward. Through perseverance and courage, Mirai embraced the opportunity, emerging from the experience with invaluable insights and personal growth.
As I gaze upon the Wall for what could be the final time, I feel a knot of emotions rising in my chest. Nuanced, conflicted and unable to be detangled. I struggle to pinpoint how I feel about this experience ending. I stare out the window to see those imposing, rusted poles towering overhead. Every day I saw patients that braved unimaginable dangers to reach that borderline. For many it was the hopeful last step of a long and difficult path to seeking refuge. To them, the land beyond symbolised safety, fresh starts, and flourishing dreams. Despite seeing the Wall every day, I could never reconcile how a place could be so near, but simultaneously so impossibly far. The Land of Opportunity is just a stone’s throw away. Yet again, I am struck by the stark reality of the physical and yet strangely intangible gap between the privileged and the oppressed.
For the past four weeks, I've been living in Tijuana on medical placement with an NGO dedicated to providing healthcare to refugees and migrants awaiting entry into the US. My weekdays were filled with a variety of clinics: general medical, mental health, paediatric and obstetric, while Fridays were dedicated to LGBTQI+ healthcare. On Saturdays, we ventured out into the community shelters, providing healthcare street-style. As a medical student, I had the opportunity to witness many consults, perform procedural and examination skills, and volunteer in much-needed positions of this organisation with limited resources. Patients came from diverse backgrounds, including regions of Mexico, Haiti, Honduras, Venezuela, Russia, and beyond. Many with medical presentations I had previously only encountered in textbooks. Each interaction added to my repertoire of clinical knowledge and deepened my appreciation for the complexities of healthcare delivery in resource-limited settings.
Tijuana is known for its high rates of violent crime and pervasive police corruption - I came into the experience aware and alert. I remember seeing the slum housing for the first time, feeling daunted by the foreign air and palpable sense of desperation of some of these neighbourhoods. For a girl from Brisbane, Australia, Tijuana was by no means an easy place to live. Despite residing in what locals deemed the 'nicer' area of town near the beach, my daily commute to the clinic, nestled beneath a shelter in the downtown district not far from the red-light district, exposed me to the raw and difficult reality for many. Saturdays meant venturing to the much less developed parts of the city, often with crammed and derelict housing or sometimes merely tents. Combining a foreign language and culture with a lonely apartment on a student budget, I initially seriously reconsidered my decision to committing to a month of living here. My time here saw me navigating flooded roads, enduring power outages and lukewarm winter showers, and supporting a colleague after their car had been stolen. But amid these challenges, I found myself pushed into a realm of discomfort that ultimately fostered growth that I would have otherwise not experienced. I was challenged to adapt, persevere, and discover resilience fuelled by my passion for healthcare.
Treating asylum seekers within an overwhelmed public healthcare system presented a unique set of challenges. The lack of continuity of care, exacerbated by the absence of medical histories, language barriers and low-level of health literacy, often meant the team was left to piece together incomplete narratives with unanswered questions. Many had untreated chronic conditions such as diabetes, hypertension and HIV. Compounding these difficulties was the stark reality of limited resources, where investigations and medications that would routinely be ordered in Australia had to be questioned with more scrutiny.
Against the backdrop of only three public hospitals serving a city of over two million residents, alongside a significant population of undocumented migrants and transient individuals, the strain on the healthcare system in Tijuana was substantial. We had patients who had been turned down care from the emergency department and were desperately in need of medical care. Social and legal considerations complicated the already complex medical presentations that ranged from massive ulcerating tumours to outbreaks of chickenpox, necrotic wounds, open fractures, and the haunting aftermath of adverse childhood events. Each case bore physical manifestations of stress and trauma, painting a vivid picture of the interconnectedness of mental, the physical manifestations, social, emotional, and spiritual wellbeing.
Through these experiences, I gained a deeper appreciation of the intricacies of health, and realised how closely intertwined various facets of wellness truly are. I saw how social determinants, such as the lack of access to water, food, and shelter reverberated through the health outcomes of the population we served.
Fridays’ clinic, operating under the auspices of an international program funded by the UN, was focused on delivering hormone therapy to transgender individuals. Delving into the intricacies of patient needs and treatment protocols for facilitating gender transition proved to be a fantastic learning journey. Many of the individuals had fled countries where they faced marginalisation and persecution due to their gender identity. Through broken Google translate conversations they shared their heartbreaking stories and gratitude to finally receive gender affirming care.
Despite the challenges, those we were able to treat served as a powerful reminder of the privilege and responsibility we hold as healthcare providers. The patients and their stories will stay with me forever. Their unwavering resilience and determination to persevere despite unimaginable hardships was nothing short of inspiring. We’d often give out donated toys to the children and their smiles and those of their parents easily brought me to tears. Even within their place of pain and uncertainty, these families still had space for joy.
As we turn off the main road, the imposing presence of the Wall begins to fade, leaving only my memory of it glazed by my unique personal experience a lingering taste of the challenges faced, and the stories shared within its shadow. The past month has elicited a mix of emotions, a curious blend of gratitude, guilt, pride, frustration, trust, and scepticism. But amidst this knot of feelings, one truth stands out: my time in Tijuana has been invaluable for personal and professional growth. It has taught me to confront discomfort head-on, to challenge my own biases, and to embrace the complexity of human experience. As I return home, I carry with me not only memories of the patients but also a renewed sense of purpose and a steadfast dedication to making a meaningful difference in this world.
Developed exclusively for medical and dental students, each year the BOQ Specialist FutureFocus grants provide students with the opportunity to undertake an elective so that their commitment to helping others can be realised. Applications for our FutureFocus grant are currently open, apply here.
You can also access funds to help undertake an overseas placement, with our Student Banking Package.
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