In July last year, François Andrelie had her first ultrasound examination at Salud Digna, a clinic in downtown Tijuana, Mexico, that conducts tests at popular prices. A small-built 34-year-old Haitian woman, Andrelie was in the third month of her first pregnancy at the time. When I went to visit her the next day, at a small apartment that she shares with her boyfriend and two other Haitians, she spoke of being “happy but also a bit sad.” “I live a life that I do not like,” she said. “When I was young I thought I could give everything to my son when this time came.” She would like to become a doctor, and return to Haiti, but she knows that the chances of either happening are slim.
Andrelie left her hometown, Port-au Prince, a year after a severe earthquake hit Haiti in January 2010. By the end of 2016, after living for some time in the Dominican Republic—where she received a diploma in accounting—and Brazil, Andrelie arrived in Tijuana, along with thousands of other Haitians. The town on the Mexico-United States border was in the midst of a crisis at the time: in September 2016, the Obama administration restricted the entry of Haitians to the US. These restrictions increased following the election of Donald Trump in the United States in January 2017. According to Soraya Vazquez, a lawyer and activist based in Tijuana, approximately 8,000 Haitians were stranded in Tijuana between September and December 2016. Many of them obtained a permanent work permit, aware that if they tried to cross the Mexico-United States border illegally, they would very likely be arrested and deported to Haiti. At the end of August 2017, according to data provided by the Instituto Nacional de Migración in Mexico, 1,425 Haitians remained in Tijuana and 1,224 settled in Mexicali, another city on the border.
The shelters in the city, unprepared for such large numbers, filled quickly between September and December 2016. Many evangelical churches with poor infrastructure were converted into reception centres. The city responded to the emergency by establishing a humanitarian aid committee guided by Vazquez, which aimed to organise civil society action and help migrants find permanent homes. Around the same time, Ximena Rojas and Bianca Tema, decided to help pregnant Haitian women by providing midwife services and collecting donations for medical costs through social media. Although Haitians have the option of visiting the General Hospital in Tijuana, which assists those who cannot afford health coverage, the facilities are often ill-equipped and women have complained of obstetric violence.
Monica Maldonado Millon, a paediatrician who works in the Mexican Social Security Institute, explained that the General Hospital tended to be overcrowded. “The mothers stay in rooms for twelve people, which often accommodate twenty,” she said. “No one accompanies them. We have one nurse for every six patients and a doctor for every 12. There is no prenatal control and they conduct caesareans at the drop of a hat.” Mexico has the fifth-highest number of C-section surgeries: 45 out of every 100 births, according to the latest statistics of the Secretaría de Salud (three times more than the maximum limit recommended by the WHO.)
“For us, everything began in July 2016,” Tema, a 34-year-old Mexican-American who lives in Chula Vista in San Diego county in the United States, 20 kilometres from the Mexico-US border, told me. She recalled coming across unusual traffic one day, and a friend mentioning that it was because many Haitians from the United States were on their way to Brazil and had ended up stranded in Tijuana. “I investigated a little and I found a radio reportage; immediately I thought that among those thousands of people traveling for months there had to be newborns and pregnant women,” she said. “The next day I took my prenatal backpack, crossed the border and headed to the first shelter for women, which was called Mother Assunta. That’s how I began to help these women.”
Tema was the first of her family to be born in the US. Her interest in midwifery started very early, when she had her first of five children at the age of 16. “My birth was violent, I was hospitalised throughout, and I was alone all the time,” she remembered. “Until that moment I thought I was a strong girl, but they made me feel incapable.” Rojas, who also had a child when she was 16 years old, faced similar hostility in hospitals. “I have experienced obstetric violence first-hand,” she told me. “In public hospitals in Mexico, women cannot be accompanied by anyone during childbirth, and in my case, they did not even allow my mother to stay.” Besides private customers, she runs a 40-week online course, for which she charges 20 dollars a person. Almost every day, she visits the pregnant Haitian women at a small room in Tijuana, for which her and Tema pay the rent. “When Tema and I started to follow them, we immediately learned new things. They want to be visited in groups, not alone, for example, and there is always someone who speaks Spanish better than others who helps us to translate.”
Since she knows Rojas, Millon is a strong supporter of her and Tema’s efforts to encourage respect for the mother-child relationship and the importance of breastfeeding. “I explain to families that they could also save 75,000 pesos per month but they do not care because for years, in Mexico, doctors incorrectly said that infant formula is better.” But several Mexicans are also turning to Roja and Tema. Elisa Martinez, a 34-year-old woman from Tecate, a city 50 kilometers from Tijuana, met with the midwives soon after discovering that she was pregnant. She was convinced that she did not want to visit the General Hospital because in the past she was not treated well during an emergency. She told me she had initially considered a caesarean in a private clinic. “But now that I’ve talked to Bianca and Ximena I decided: I will have a natural home birth,” she said. “The price would be the same, about $2,000, but treatment and care are not at all comparable.”