Noelis Guaregua, who is eight months pregnant, wasn’t receiving prenatal care at the city-run migrant shelter where she’s staying, so she set out on a mile-long walk in freezing temperatures to a police station where she’d heard she could find food and medicine.
Originally from Anzoágueti, Venezuela, the 31-year-old had traveled for over two months with her family to get to the United States. She arrived at the city’s shelter on the Lower West Side last Tuesday.
“I didn’t see any medical services. They didn’t give me anything,” she said in Spanish about the shelter. “Servicios médicos, no vi. No me dieron nada.”
Mutual aid networks and free and charitable organizations have stepped up to provide health needs to migrants who are sleeping on the floor at police stations and waiting for space in one of the 26 brick-and-mortar shelters around the city.
But it is not uncommon for migrants to turn — or, in some cases, return — to police stations looking for basic medical resources, as necessities in shelters can be sparse or nonexistent. It’s not dissimilar from what migrants faced in their countries of origin.
Ahead of Chicago’s brutal winter, the city has committed to “decompressing,” or moving out migrants from police stations into shelters and churches. Still, almost 600 migrants are sleeping outside or on the lobbies of precincts across the city, waiting for placement. And with migrants repeatedly returning to police stations, advocates are concerned about whether the care provided at shelters is adequate or enough.
The Night Ministry
Stephan Koruba, a bilingual family nurse practitioner and clinical supervisor for the Night Ministry’s mobile health outreach program, pulled up at the Deering District (9th) police station in Bridgeport last Wednesday in a large white van with blue lettering. A mobile clinic from Lurie Children’s Hospital was already at the station, providing health screenings to migrant kids.
Koruba goes to police stations every week to do triage, or preliminary assessments of the dozens of migrants in need of varying degrees of medical assistance.
The Night Ministry, which gives essential services and resources to Chicagoans struggling with substance use disorder, homelessness or poverty, is one of several volunteer groups providing screenings and urgent care services at police stations. The organization coordinates with the Chicago Department of Public Health to find out what station has the largest population.
During a two-hour shift at the station, Koruba saw over a dozen migrant patients with various health problems, ranging from infections and coughs to chronic issues like high blood pressure or asthma.
Koruba pulled out a clipboard from his van and walked up to a group of migrants who stood outside in the cold, eating donated fried chicken off Styrofoam plates.
Juan Garlindo, 30, had a large abscess on his neck. He bent over so Koruba could inspect it. Koruba spoke to Garlindo carefully.
“Do you have allergies? ¿Tienes alergias?” Koruba asked, before explaining the treatment for the man’s infection and giving him antibiotics.
Koruba said triage is quicker and easier because it’s a very basic medical screening, instead of complex treatment. All he needs is a migrant’s name, birthday and condition, and he can get them assistance in the form of medication, supplies or a referral. Police will call an ambulance if their medical conditions are more severe.
Migrants’ immunity is often weakened from their strenuous journeys walking to get here. In an average week, said Koruba, police make about 50 to 60 ambulance calls across all districts.
A dire situation
Health experts note that a lack of medical resources is not a new phenomenon for the migrants who come to Chicago, mostly from Venezuela. The South American country is struggling under a strict authoritarian regime and a plummeting economy partly caused by U.S.-imposed economic sanctions.
Venezuela’s strong and robust health system has declined slowly for the past decade, said Daniela Rodriguez, a scientist at Johns Hopkins Bloomberg School of Public Health who studies how politics and public health affect vulnerable communities around the world.
“The health system is in a very, very dire situation,” she said. “There are still some services that are provided, but the access to services is deeply connected to your ability to pay out of pocket.”
According to Rodriguez, there is little understanding about the health situation in Venezuela because the country’s government has released no public data.
But there has been a massive migration of the health workforce out of Venezuela, so there aren’t as many providers who are fully trained to deliver services. The supply chain is dysfunctional, she said.
Some Venezuelans are behind on their vaccines as a result. Often, those who need more serious operations have to bring in their own supplies: gauze, saline solution, surgical staples.
Rodriguez said Chicago has the resources to provide better health care to migrants.
“A receiving government has an obligation to provide services … to help people stay healthy regardless of how they came to reside in the country,” she said, referring to the buses sent to Chicago from southern border cities.
Many of the migrants who gathered at the station in Bridgeport said they had received free bus tickets from the border city of El Paso, Texas.
Medical resources at shelters
The group of migrants Wednesday morning came from the shelter nearby, looking for basic resources they hadn’t been able to find at the shelter.
To be sure, the need inside city shelters is high. As of Friday, over 13,000 migrants were staying in more than two dozen abandoned buildings around the city, many sleeping on cots crammed next to each other.
Heartland Alliance Health and Lawndale Christian Health Center send teams of providers to city shelters once or twice weekly, according to a spokesperson for the city’s Department of Public Health. They provide on-site screenings, infection prevention and behavioral health services.
Since August 2022, Cook County Health — the lead medical provider as part of Chicago’s response to migrants arriving on buses from the border — has served nearly 17,000 migrants, with over 70,000 visits, according to spokesperson Alexandra Normington. Cook County Health provides transport to and from shelters and largely covers cost of care.
Migrants who arrive in Chicago by the hundreds are often fleeing countries with violence, crime and poverty. They’ve traveled thousands of miles across rivers, mountains and jungles. They will pull up videos on their phones of dead bodies they’ve had to step over on the way — people who couldn’t make the arduous trip, sometimes close friends or family members.
Working at a shelter can be hard, said Patricia Aguirre, outpatient services therapist for Lurie Children’s Hospital. Aguirre is a trainer for the “Reimagining Mental Health Supports for Migrant Arrivals” Initiative, led by the Coalition for Immigrant Mental Health. Aguirre also provides ongoing consultation twice a month for one hour with contracted employees and community-based organizations.
She said staffing a migrant shelter is “similar to any people-driven job” in which there can be high levels of “vicarious trauma and burn out” without adequate organizational supports, reasonable schedules and the regular practice of self-care strategies. This can affect a caregiver’s ability to provide the best and most consistent care.
Migrants have often told the Tribune they aren’t always happy with the care and resources they receive in shelters. And mutual aid volunteers have expressed their frustration about not being allowed inside city-run shelters to augment the health resources provided there.
Jenny Kelly, a volunteer at the Austin District (15th) police station, said when she tried to deliver antibiotics to a migrant family who had been moved to a city shelter on the Near West Side in October, she wasn’t allowed inside.
The family’s 6-month-old baby was sick with a high fever, and Kelly took the child to a clinic in Austin to get antibiotics. Kelly tried to drop the medicine off with the mom.
“They won’t let you in. They won’t help you. They refused to give it to the mom for a long time,” Kelly said. “She had to go and basically fight with them to get the antibiotic.”
Kelly said the city is not taking care of migrants’ basic necessities.
“The children, babies, are not getting what they need,” she said. “(Volunteers) are supplementing all of this,” she said. “I feel like they’re treating (migrants) like they’re in a prison system.”
Income disparity
At the police station in Bridgeport, the crowd of migrants huddled around Koruba as trash covered the ground from weeks of people living in tents outside the station. The remnants: hand warmers, discarded cartons of milk, tattered blankets and cigarette butts, a wooden chair without a seat, a plastic shoe.
Jose Garcia, 28, from Maracay, Venezuela, shivered and lifted his leg up and pulled down his sock so Koruba could see the inflamed cut on the top of his foot.
“I have a wound here that happened in Mexico, catching the train,” he said in Spanish, pointing to a series of scabs that dotted his leg. “Tengo una herida aquí que fue en México, agarrando el tren.”
“It is very inflamed. I have a lot of pain,” he said.
Koruba handed him a plastic bag of cotton, surgical scrub and bandages.
“I pray to God the inflammation won’t spread to the rest of my body,” Garcia said.
Garcia worked in housekeeping in Venezuela, he said. He used to earn $8 a week in his country of origin, he said, which was not enough to buy food.
In Venezuela, a large income disparity directly affects migrants’ ability to get health resources, said Adrienne Pine, an anthropologist and professor at California Institute of Integral Studies.
“The people who are part of the dollar economy can get almost whatever they want. But the people who are poor or the people who live in rural areas, don’t have access to any of it,” she said. “Pain medications. Aspirin. Tylenol. Things like that … They can’t afford them.”
Similarly, in Chicago, many migrants — who can’t work legally — return from the emergency department with a prescription but have no money to buy medicine, said Koruba.
Ruben Dario Reyes, 59, looked proudly at his 7-year-old granddaughter, Charro, and 9-year-old grandson, Mauricio. Reyes had also walked to the police station with his family from the city shelter nearby, hearing there were resources.
“Look, my grandkids,” he said. “Mira, mis nietos.”
He had hemorrhoids, and Koruba gave him ointment. He had never been diagnosed.
He mumbled his words and walked with a slight limp, remembering the jungle he crossed through to make it to the cold police station.
“The jungle. The jungle,” he repeated to himself. “La selva. La selva.”
Though he was in his 50s, he said he felt more like 90.
A car pulled up to the station and migrants rushed over to it. A woman pulled out a white trash bag with clothes to donate and distributed them quickly. The group immediately dispersed.
Without care for months
Koruba worked quickly, tallying the number of people he helped and writing down the medication he gave them from the plastic container he kept in the back of his van: A 5-year-old swaddled in jackets had a vaginal infection, a mother with a deep cough, a woman with heavy mucus in her throat, a man with increased heart palpitations.
He opened up the container and dished out pills.
Guaregua, the pregnant migrant in need of vitamins, watched a woman carry a baby in a light brown jumpsuit. She smiled.
She said she was hoping for a boy and wanted to name him Liam.
Koruba handed her the prenatals. He called the city Department of Public Health so it could inform the shelter of her prenatal needs. She and her family sat on chairs by the station in the sun for a few more minutes before leaving.
“They’re just a sliver of the population,” Koruba said, about the migrants he’s been helping at stations. “But it’s people who haven’t had care in months, living in proximity.”
At first, the Night Ministry would help out 50 or so people at police stations, said Koruba. Now, that number can be in the hundreds.
He said he wanted to help out more days of the week, but he felt the burnout was too much.
“Good luck with everything,” he said to each migrant he treated. “Buena suerte con todo.”
