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Border & Immigration

A tragic milestone: San Diego region reaches new high in border wall injuries

UC San Diego Health hospitals are on pace this year to care for more than 360 people who were injured after falling from the San Diego border wall — a new record.

It will be the fourth straight year that the hospital system has set a new record for border wall injuries, a trend that started in 2019 when the Trump administration increased the height of the wall from 17 feet to 30 feet.

“In 2018 we had less than a dozen patients falling off the wall with serious injuries, now it’s at least two a day,” said Dr. Jay Doucet, head of the trauma unit at the UC San Diego Medical Center in Hillcrest.


All told, more than 1,000 migrants have been hospitalized and 23 have died, according to UC San Diego Health records.

The human body is not built to withstand a 30-foot drop. The impact shatters bones and fractures spines. It punctures internal organs and shuts off brain function.

Doucet and other trauma doctors are sounding the alarm on what they describe as a public health crisis. They’ve collated data with doctors along the Texas and Arizona borders and spoken to elected officials at all levels of government.

Injuries doctors see from border fall patients are similar to ones normally associated with high-impact car crashes.

“We are seeing everything,” Doucet said. “Severe brain injuries, pelvic fractures, patients with contusions all over their body.”


New trends and financial toll

The UC San Diego Health records show that more women are being hospitalized from border falls. In 2019, less than a quarter of admissions were women. So far in 2023, almost half of the fall patients have been women, including more than 20 who were pregnant. Some of those women lost their babies to miscarriage, Doucet said.

Two thirds of the patients are Mexican nationals, he added. The other third includes people from all over the world.

Long-term treatment is particularly difficult. These patients are underinsured and reluctant to seek medical care for fear of being detained.

“There is no follow up,” Doucet said. “Once they leave the hospital, we don’t see them again very often. They typically keep moving.”

The impact of the increase in border fall injuries and deaths goes far beyond the migrant population. Records show the median cost per patient is nearly $300,000 and almost entirely covered with taxpayer dollars. Most of those costs are paid for by the state’s Medi-Cal system.

U.S. Customs and Border Protection (CBP) only covers medical expenses if a patient is in custody when they are discharged from the hospital. Records show CBP covered most medical expenses in 2018 and 2019.

However, federal agents began leaving patients in the hospital around 2020. Around the same time, Medi-Cal expansion provided more coverage to undocumented immigrants.

Then there is the impact on overall hospital patient population. These cases require highly trained specialists, like spine surgeons, who are already overburdened with patients.

“There are very few spine surgeons available in San Diego,” Doucet said. “And the waiting time for all patients, not just border fall patients, is now twice as long as the national average to get their fractures fixed.”

Also, the issue is the crisis is not limited to the San Diego border region. The UC San Diego physicians are collaborating with their counterparts in Texas and Arizona, where there have been similar increases in deaths and hospitalizations because of the higher walls.

Lack of political will

In addition to their work in hospitals, the physicians are working to raise awareness on Capitol Hill. Dr. Alexander Tenorio, a neurological surgery resident at UC San Diego Health, was an expert witness to Congress during a Homeland Security Committee hearing in July.

“Ultimately, these raised border walls have resulted in a record number of traumatic injuries, increased severity and mortality, and increased economic burden to our hospital systems,” he told a bipartisan group of representatives.

Tenorio said from a political perspective border wall injuries and deaths are as polarizing as gun violence, another public health crisis that federal lawmakers have largely failed to address. But increased advocacy on gun violence prevention, particularly from a generation of Americans who grew up with school shootings, has had an impact.

Tenorio pointed to the newly formed White House Office of Gun Violence Prevention as an example.

“I’m hoping that at some point there’s a similar response where we do start seeing some action from our elected officials to acknowledge this humanitarian crisis and move toward addressing it,” he said.

One major obstacle to tackling this issue is lack of political will, Doucet said. Individual representatives are concerned about the rising number of deaths and injuries — but collectively, nothing is being done.

“It’s obvious when talking to representatives that it’s a radioactive issue,” he said. “Nobody wants to talk about the wall. The increase in injuries has occurred through two different administrations and neither of them want to talk about this.”

Rep. Juan Vargas, who represents San Diego's border region, did not respond to an interview request.

President Joe Biden campaigned on a more humane approach to border enforcement. However, the administration’s actions have not always matched the president’s rhetoric. For example, the Department of Homeland Security is currently expanding the 30-foot wall along Friendship Park.