Alhelí Calderón-Villarreal1, Brendan Terry2, Joseph Friedman3, Sara Alejandra González-Olachea4, Alfonso Chavez5, Margarita Díaz López6, Lilia Pacheco Bufanda7, Carlos Martinez8, Stephanie Elizabeth Medina Ponce9, Rebeca Cázares-Adame10, Paola Fernanda Rochin Bochm11, Georgia Kayser12, Steffanie A Strathdee13, Gabriela Muñoz Meléndez14, Seth M Holmes15, Ietza Bojorquez16, Marc Los Huertos17, Philippe Bourgois18. 1. Department of Family and Preventive Medicine, University of California, San Diego (UCSD), San Diego, CA, USA; Graduate School of Public Health, San Diego State University (SDSU), San Diego, CA, USA. Electronic address: alheli.calderon@gmail.com. 2. Pomona College, Claremont, CA, USA; Epigenetics Programme, Babraham Institute, Cambridge, UK. Electronic address: brendanterry19@gmail.com. 3. University of California, Los Angeles (UCLA), Los Angeles, CA, USA. Electronic address: joseph.robert.friedman@gmail.com. 4. Proyecto Fronterizo de Educación Ambiental A. C. (PFEA), Tijuana, Mexico. Electronic address: Saralego93@gmail.com. 5. Prevencasa A. C., Tijuana, Mexico. Electronic address: rivera.alfonso10@gmail.com. 6. Proyecto Fronterizo de Educación Ambiental A. C. (PFEA), Tijuana, Mexico. Electronic address: margarita@pfea.org. 7. Prevencasa A. C., Tijuana, Mexico. Electronic address: nutriologa.pacheco@gmail.com. 8. University of California, Berkeley (UC Berkeley), Berkeley, CA, USA; University of California, San Francisco (UCSF), San Francisco, USA. Electronic address: carlos_martinez@berkeley.edu. 9. El Colegio de La Frontera Norte (El COLEF), Tijuana, Mexico. Electronic address: s.e.medina.ponce@gmail.com. 10. Prevencasa A. C., Tijuana, Mexico. Electronic address: rebecazares@gmail.com. 11. Proyecto Fronterizo de Educación Ambiental A. C. (PFEA), Tijuana, Mexico. Electronic address: fernanda@pfea.org. 12. Herbert Wertheim School of Public Health and Human Longevity Science, UCSD, San Diego, CA, USA. Electronic address: gkayser@health.ucsd.edu. 13. Division of Infectious Diseases and Global Public Health, Department of Medicine, UCSD, San Diego, CA, USA. Electronic address: sstrathdee@health.ucsd.edu. 14. El Colegio de La Frontera Norte (El COLEF), Tijuana, Mexico. Electronic address: gmunoz@colef.mx. 15. University of Southern California, USA. Electronic address: sethmholmes@usc.edu. 16. El Colegio de La Frontera Norte (El COLEF), Tijuana, Mexico. Electronic address: ietzabch@colef.mx. 17. Pomona College, Claremont, CA, USA. Electronic address: marc.loshuertos@pomona.edu. 18. University of California, Los Angeles (UCLA), Los Angeles, CA, USA. Electronic address: pbourgois@gmail.com.
Abstract
INTRODUCTION: The US deports more Mexicans to Tijuana than any other borderland city. Returning involuntarily as members of a stigmatized underclass, many find themselves homeless and de-facto stateless. Subject to routinized police victimization, many take refuge in the Tijuana River Canal (El Bordo). Previous reports suggest Tijuana River water may be contaminated but prior studies have not accessed the health effects or contamination of the water closest to the river residents. METHODS: A binational, transdisciplinary team undertook a socio-environmental, mixed methods assessment to simultaneously characterize Tijuana River water quality with chemical testing, assess the frequency of El Bordo residents' water-related diseases, and trace water contacts with epidemiological survey methods (n = 85 adults, 18+) in 2019, and ethnographic methods in 2019-2021. Our analysis brings the structural violence framework into conversation with an environmental injustice perspective to documented how social forces drive poor health outcomes enacted through the environment. RESULTS: The Tijuana River water most proximate to its human inhabitants fails numerous water-quality standards, posing acute health risks. Escherichia coli values were ∼40,000 times the Mexican regulatory standard for directly contacted water. Skin infections (47%), dehydration (40%) and diarrhea (28%) were commonly reported among El Bordo residents. Residents are aware the water is contaminated and strive to minimize harm to their health by differentially using local water sources. Their numerous survival constraints, however, are exacerbated by routine police violence which propels residents and other people who inject drugs into involuntary contact with contaminated water. DISCUSSION: Human rights to drinking water, sanitation and hygiene are routinely violated among El Bordo inhabitants. This is exacerbated by violent policing practices that force unhoused deportees to seek refuge in waterways, and drive water contacts. Furthermore, US-Mexico 'free-trade' agreements drive rapid growth in Tijuana, restrict Mexican environmental regulation enforcement, and drive underinvestment in sewage systems and infrastructure.
INTRODUCTION: The US deports more Mexicans to Tijuana than any other borderland city. Returning involuntarily as members of a stigmatized underclass, many find themselves homeless and de-facto stateless. Subject to routinized police victimization, many take refuge in the Tijuana River Canal (El Bordo). Previous reports suggest Tijuana River water may be contaminated but prior studies have not accessed the health effects or contamination of the water closest to the river residents. METHODS: A binational, transdisciplinary team undertook a socio-environmental, mixed methods assessment to simultaneously characterize Tijuana River water quality with chemical testing, assess the frequency of El Bordo residents' water-related diseases, and trace water contacts with epidemiological survey methods (n = 85 adults, 18+) in 2019, and ethnographic methods in 2019-2021. Our analysis brings the structural violence framework into conversation with an environmental injustice perspective to documented how social forces drive poor health outcomes enacted through the environment. RESULTS: The Tijuana River water most proximate to its human inhabitants fails numerous water-quality standards, posing acute health risks. Escherichia coli values were ∼40,000 times the Mexican regulatory standard for directly contacted water. Skin infections (47%), dehydration (40%) and diarrhea (28%) were commonly reported among El Bordo residents. Residents are aware the water is contaminated and strive to minimize harm to their health by differentially using local water sources. Their numerous survival constraints, however, are exacerbated by routine police violence which propels residents and other people who inject drugs into involuntary contact with contaminated water. DISCUSSION: Human rights to drinking water, sanitation and hygiene are routinely violated among El Bordo inhabitants. This is exacerbated by violent policing practices that force unhoused deportees to seek refuge in waterways, and drive water contacts. Furthermore, US-Mexico 'free-trade' agreements drive rapid growth in Tijuana, restrict Mexican environmental regulation enforcement, and drive underinvestment in sewage systems and infrastructure.
Authors: Miguel Pinedo; José Luis Burgos; Angela M Robertson; Alicia Vera; Remedios Lozada; Victoria D Ojeda Journal: Glob Public Health Date: 2014-03-21
Authors: Shira M Goldenberg; Steffanie A Strathdee; Manuel Gallardo; Tim Rhodes; Karla D Wagner; Thomas L Patterson Journal: Soc Sci Med Date: 2011-03-03 Impact factor: 4.634
Authors: Jennifer Syvertsen; Robin A Pollini; Remedios Lozada; Alicia Vera; Gudelia Rangel; Steffanie A Strathdee Journal: Int J Drug Policy Date: 2010-08-25
Authors: Carlos Martinez; Lauren Carruth; Hannah Janeway; Lahra Smith; Katharine M Donato; Carlos Piñones-Rivera; James Quesada; Seth M Holmes Journal: AMA J Ethics Date: 2022-04-01
Authors: Matthew E Verbyla; Jose S Calderon; Shawn Flanigan; Mireille Garcia; Rick Gersberg; Alicia M Kinoshita; Natalie Mladenov; Federick Pinongcos; Megan Welsh Journal: Environ Eng Sci Date: 2021-05-24 Impact factor: 1.907
Authors: Pieter Baker; Jaime Arredondo; Annick Borquez; Erika Clairgue; Maria L Mittal; Mario Morales; Teresita Rocha-Jimenez; Richard Garfein; Eyal Oren; Eileen Pitpitan; Steffanie A Strathdee; Leo Beletsky; Javier A Cepeda Journal: Harm Reduct J Date: 2021-07-26
Authors: Joseph Friedman; George Karandinos; Laurie Kain Hart; Fernando Montero Castrillo; Nicholas Graetz; Philippe Bourgois Journal: PLoS One Date: 2019-11-21 Impact factor: 3.240