Life and Death on the US-Mexico Border

As an ethnographer and an EMT, Harvard anthropologist Ieva Jusionyte has a front-line perspective on tensions at the politically fraught border between Mexico and the United States.

Image of protesters on both sides of the border fence during rally

Ieva Jusionyte has always been drawn to tensions at the border.  As a graduate student, she went right to the heart of the drug and human smuggling nexus of Puerto Iguazu, a town at the tri-border area of Brazil, Paraguay, and Argentina, to research how the media reported on crime. While there, she developed a deep interest in the experiences of firefighters and rescue workers, and later, in the US, trained to become a certified emergency medical technician, paramedic, and wildland firefighter. 

Most recently, she embedded herself at the US-Mexico border for a year, using her technical skills to help first responders on both sides of the divide. She reasoned that firefighters and EMTs would  face many of the human consequences of national security policy on a daily basis. In order to fully leverage her insights as an anthropologist, she felt she needed to participate.

In Nogales, Arizona, she volunteered as an EMT with the suburban fire department, responding to 911 calls—whether it was for a wildfire or for a critically ill or wounded person. Across the border in Nogales, Mexico, she delivered first aid to injured migrants and deportees on a bench in a soup kitchen, which also served as a humanitarian and legal center. Her forthcoming book, Threshold: Emergency and Rescue on the U.S.-Mexico Border will bring together the experiences of the first responders and residents of the local border communities, to take stock of the real-life impact of US national security measures.

Q: What drew you to the US-Mexico border?

Image of the views of the border fence east of Nogales, Arizona

A: I had come across several newspaper articles about fire departments along the US-Mexico border being burdened by calls to help unauthorized migrants who get injured trying to cross into the US. Border towns like El Paso or Nogales can handle the increased demand on their services. But there are a lot of rural areas where the taxpayer base is extremely small and cannot support a local fire department and an ambulance. From these locations it takes hours to transport a wounded border crosser from the middle of the desert to the hospital in Tucson, leaving the community without anyone to attend to other emergencies.

Over the last couple of decades, because of large numbers of unauthorized migrants crossing the border, the ambulances had been picking up the injured and taking them to hospitals. But there was no way for these first responders to get reimbursement from the federal government or, obviously, from the migrants, except if they first called the Border Patrol to take their patients into custody. 

These small communities were really conflicted and burdened and didn't know what to do. It was the blurring of immigration enforcement with emergency services which was very disturbing to me and that's what I wanted to study.

Q: Do Mexican and US emergency responders on both sides of the border work together?

A: At the border, everyday life unfolds on a binational scale. Mexican and American first responders go back and forth regularly and rely on each other to do their jobs. When it comes to saving lives, it is as if the border did not exist for them.

There was a lot of cooperation in the Nogales area, where I did most of my work. Sometimes emergency workers on both sides were family members. Nogales, Arizona, is predominantly Mexican-American with over 94 percent primary Spanish speakers, many of whom have migrated from Nogales, Mexico. For them it is one community split in half by the border wall, which is an inconvenience but does not cut the strong ties that hold the community together. As you go further north, beyond the interior Border Patrol checkpoints set up on US highways, the sentiment toward Mexico is somewhat different. The fire departments, which are predominantly white, have a more negative attitude toward Mexico and don’t work with Mexican first responders.

Q: What kinds of emergencies require joint efforts?

Image of emergency responders helping injured woman

A: Both sides go back and forth over the border to help each other, not only with structure and wildland fires but with search and rescue operations. 

Some migrants decide against climbing over the wall and try to cross under it instead, through the drainage tunnels. Although the Border Patrol installed a gate inside to prevent unauthorized migrants and drug smugglers from getting through, this gate lifts when the water pressure builds up—this happens when there is heavy rain and the water rushes downstream from Mexico to the US side. Migrants who get stuck in the tunnel when this happens are carried away by the wash. 

Mexico is uphill, upwind, and upstream from Arizona. Because of how Nogales was haphazardly built, when it starts to rain in Mexico, some streets turn into rivers, and the water overflows the drainage tunnel that goes under the US-Mexico border. There are a lot of situations when people get carried away in these washes, or arroyos, that flood the tunnels. Often these are unauthorized migrants who hope to cross the border through the tunnel unaware of the danger, but some are visitors from out of town who don't know the local topography. The powerful current sweeps them away from Mexico and carries them to the United States. So emergency responders do these binational rescue operations to find people; they begin searching the tunnel on the Mexican side and continue into the US. Sometimes they save a life, but more often they only recover a body. This happens a mile or more north of the border in US territory, where the tunnel ends. 

In addition to rescues from the wash, emergency responders go out in the desert to find people who are lost and who don’t even know which side of the border they are on when they call 911.

Q: After working for a year in this region, you conclude in your forthcoming book that the border wall is being used as a weapon. Can you explain this? 

A: The whole focus of my work is actually how the terrain is being weaponized to enforce US immigration policies. The major component of course is the border wall, which the US calls “tactical infrastructure.” 

In 1994, the US Border Patrol created a strategic plan based on the concept of “prevention through deterrence.” The idea was to make the transit corridors in major urban areas, like Nogales, Tijuana-San Diego, or Ciudad Juárez-El Paso extremely difficult to cross. They militarized the towns by increasing the length and the height of the fence, bringing in a lot of agents, building surveillance and lighting systems, and really concentrating all the border enforcement there so that the only option would be for migrants to go through remote desert terrain in Arizona or California, or cross the Rio Grande in Texas, which is very dangerous. It’s written in the plan that violence and injuries would increase, and that would deter people from coming. Well, the Border Patrol was wrong: they didn’t stop coming. 

Q: You write that using the desert became part of the deterrence strategy as well.

Image of Normandy anti-vehicle barriers along border

A: Migrants became much more vulnerable after the strategic plan was implemented, for a number of reasons. The prices for “coyotes,” or guides, increased in the desert areas—in part because they have to go further around the wall, so it takes longer, and migrants are often forced to carry drugs. And, of course, migrants have to climb higher to get over the walls in the urban areas. The further away you go from these areas, there is nothing but desert with mountains and steep ravines. The international boundary there is marked by a four-strand barbed wire fence and Normandy barriers, which are crisscrossed beams that stop vehicles, yet people can cross there very easily. But it is so far away from settled areas that the natural environment will kill you if you are unprepared. It’s impossible to carry enough water for that kind of journey. Unable to call for help, migrants are also often assaulted; women are frequently raped. Many people do make it across, however, and that’s why they keep coming. 

Q: What are the most common types of injuries you saw?

A: I've met migrants in the desert who got lost and were trying to find the Border Patrol because they wanted to live. When the smugglers take them across they are told it's a few hours to Phoenix, when it actually takes three to five days just to reach Tucson. They don't have maps and there’s no cell phone signal. The people that I've met were very, very dehydrated. Such dehydration can lead to heat stroke, or hyperthermia. More often it results in kidney failure. People who walk in the desert usually have blisters that make it difficult to carry on with the journey. In winter, with temperatures at night falling to below freezing, dehydration makes migrants susceptible to hypothermia. There are snake bites, too, but those are rare. In the desert, most people die due to exposure to extreme heat. But sometimes it is hard to tell; by the time they are finally found, they are reduced to skeletal remains.  

Q: Was it challenging to switch hats, from ethnographer to EMT?

Image of Ieva Jusionyte with two Mexican firefighters

A: The Border Patrol who finds migrants in bad shape, instead of taking them into a holding cell, can call a local ambulance to pick them up. So, when I was doing fieldwork with the Arivaca Fire Department, we went out there, usually to remote locations along desert roads, to meet with the Border Patrol. It takes an hour and a half, sometimes more, to get to the closest hospital from out in the desert. I was not volunteering as an EMT in Arivaca, I was doing my work as an ethnographer, but when we went on calls I helped with what I could—sometimes translating between a Spanish-speaking migrant and an English-speaking paramedic, other times doing chest compressions. Under these circumstances, everybody in the ambulance has to do something, and fortunately I had some useful skills. 

Q: How do people breach the wall in the urban areas?

A: Most people pay for a trip “up the ladder” on the Mexican side. Then they need to slide down on the other side and it's quite high, twenty-plus feet. 

YouTube is full of videos of drug smugglers with backpacks who slide down very efficiently. But some people climb up and then see that it's too far to the ground and become afraid to slide. There have been cases where—because the migrants have already paid for the service, or it will be paid by the family members only if the person ends up on the US side of the border—that they are forcibly pushed down. So, some of the people picked up in Nogales were injured because they were pushed. They usually have leg or ankle fractures, and because of the height of the fall injuries to the spine are also likely. I interviewed a trauma surgeon who has treated many migrants injured by the border fence. But not everyone survives. There were some that landed on their heads and died instantly. 

Quotation about border crosser dangers from Ieva Jusionyte

Q: How has the back-and-forth movement of Mexican migrants changed in the past two decades?

A: It became more difficult to cross in the mid 1990s, and even more so after 9/11. In 2006, the Secure Fence Act mandated the building of essentially what we have now, 700 miles of border fence, which includes both pedestrian and anti-vehicle barriers. 

Prior to this time, a lot of migrants would come to the US to work temporarily just for one agricultural season or perhaps a couple of years in construction or service industry and then take their earnings back to their hometown, build a house, and live there with their families. When they needed more money, perhaps to pay medical bills or to send a child to school, they would return, knowing that US employers were eagerly waiting for cheap migrant labor, and so on and so forth. It was cyclical migration. But many of those people are now stuck here, on the US side, and not going back because they fear that with security buildup they would never be able to return to the US for another labor season. They stay here, send money back, and, when they can, save enough to pay a coyote to bring their spouse or their children to live with them here. I’ve seen many women crossing the border, sometimes with small children, while it used to be primarily young men coming for work. 

Q: Besides work, what are the other reasons for wanting to cross into the US?

A: Not all those who are trying to cross the border are coming to the US for economic reasons, and many no longer come from Mexico. In the last few years, we’ve seen many people from Guatemala, El Salvador, and Honduras, fleeing violence and crime. Some of them are asking for asylum, which means that instead of crossing the border illegally, they present themselves to the Border Patrol and wait for their case to be heard at the court. 

Patterns of mobility change depending on political circumstances, too. In the last few years, since the US government began funding Mexican law enforcement to stop migrants from Central America even reaching the US-Mexico border (it’s called Plan Frontera Sur, or the Southern Border Initiative), more of them are caught in southern Mexico, on the border with Guatemala. Both the economic crisis and, later, the anti-immigrant rhetoric in the US discouraged some potential migrants. And many of those already in the US have been deported. Migration fluctuates. Recent data show that there are now more Mexicans leaving the US than coming here. But I’ve always been skeptical about statistics since they are notoriously ineffective at estimating activities, such as unauthorized migration, which depends on avoiding being seen and known by the state.

Q: Would you advocate just taking the border away? What would happen?

Image of Ieva Jusionyte formal photo

A: You don't need a wall or a fence on the border. People have no urge to leave their homeland, to risk their lives in order to live on the margins of society in a foreign country. If given a choice many would prefer to stay in their community. If they could get a temporary work permit, it would enable them to go for a short time and then return home, as long as movement is possible, much like between the countries in the European Union and the US and Canada. A militarized border like we have with Mexico indicates that there are severe structural inequalities between both sides. I’m not saying the US is responsible for making the world a nicer place so that migrants wouldn’t want to come here, but its foreign policy has had a lot to do with making life in Mexico and Central America difficult and pushing people to migrate north. 

Q: What would the ideal border look like?

A: To me, the ideal border is one that exists only on a map, maybe with a few historic monuments along the jurisdictional line, recognizing how it came to be. Immigration and customs officers at the official border crossings or elsewhere could handle paperwork, but there would be no need for a fence or a wall, for Border Patrol catching people in the desert, for surveillance cameras and drones, for detention centers.

I don't think we need borders. They are symptoms of other political and economic problems that our society faces, and further militarizing them not only fails to stop people from coming across, but it does nothing to address those other issues. Today that sounds radical, but the US-Mexico border was porous for most of the past century; and now, as I argue in my book, it is an instrument of state violence.

Image of an artist painting the porous border fence blue to match the sky

Michelle Nicholasen, Communications Specialist, Weatherhead Center for International Affairs

Weatherhead Center Faculty Associate Ieva Jusionyte is an assistant professor of anthropology and of social studies at Harvard University. Her forthcoming book, Threshold: Emergency Responders on the US-Mexico Border, delves into how space and terrain at the US-Mexico border is being weaponized to enforce US immigration policies. She received a 2017–2018 Weatherhead Center grant that supported an author’s workshop on her forthcoming book.


  1. Protesters on both sides of the border fence during a binational rally against border militarization organized by SOA Watch in Nogales, Sonora and Nogales, Arizona, on October 8, 2016.
  2. Views of the border fence east of Nogales, Arizona. 
  3. Emergency responders help an injured woman who fell off the border fence in Nogales, Arizona. May 2015.
  4. Normandy anti-vehicle barriers and four-strand barbed wire fence along the US-Mexico border between Nogales and Sasabe. 
  5. Jusionyte with two Mexican firefighters during the Day of the Virgin of Guadalupe celebrations in Nogales, Sonora, on December 12, 2015.  
  6. Ieva Jusionyte. Photo credit: © Brown Dog Studio
  7. Artist Ana Teresa Fernández paints the border fence blue, to merge with the sky, during an installation “Borrando la frontera” (Erasing the Border) in Nogales, Sonora. October 2015.

Photo credits: All photos by Ieva Jusionyte unless otherwise noted