An undercurrent of fear in Baltimore's immigrant communities

On Sunday Feb. 12, hundreds of Latino, African-American, white and Asian neighbors marched in Highlandtown to Patterson Park chanting "No hate, no fear, immigrants are welcome here!" Despite this moment of great solidarity, there was an undercurrent of fear among the undocumented immigrant community, and in the days that followed, these fears were evident in our clinical practice.

On Monday, the Honduran mother of an American child came to the clinic to request that her daughter no longer get food stamps because she was afraid that the information she provided for eligibility could be used by authorities to deport her.

On Tuesday, our case managers reported that they were overwhelmed by the number of requests from immigrant parents for notarized letters attesting to their guardianship of their children in case of deportation.

On Wednesday, our outreach health navigator reported that the places where she usually meets community members for health promotion activities were deserted. One of our patients, a father of two American children, told us that early that morning he went as usual to the Home Depot looking for construction work, but instead spent several hours hiding behind a crate waiting for the "coast to clear" of ICE agents.

On Thursday, as many local businesses, including prominent restaurants, closed in support of "A day without immigrants," a Honduran man was detained by ICE at the Walgreens on Eastern Avenue where many of our patients fill their medication prescriptions. We had to scramble to contact our patients and change their pharmacy of choice to a safer option within Bayview Hospital.

On Friday, a patient called because he was running out of life-saving medications but was afraid to leave his apartment because ICE was in the neighborhood.

We are physicians at Hopkins and do not mean to be alarmists. The deliberate (and slow) academic pace that we are familiar with, however, seems inadequate in such times. Of course, we will collect data to analyze the impact of the current political environment on trends in health care utilization and health outcomes among immigrants. That's important work that will take time. But in the short term, we have been forced to respond quickly.

We have relied heavily on many wonderful organizations in Baltimore — such as Casa de Maryland, Esperanza Center and religious communities — to coordinate services, particularly in critical areas that are not our expertise, such as legal advice and political advocacy. We are especially appreciative of the clear and consistent messages from our Mayor Catherine Pugh, City Councilman Zeke Cohen and Police Commissioner Kevin Davis welcoming immigrants in Baltimore and reassuring our community that the city police department is distinct from ICE and does not enforce federal immigration laws. We know that our communities are safer and healthier when police and government entities are trusted partners.

But we cannot deny the chilling effect that the ICE presence is having among Baltimore immigrants, and we expect it to worsen now that the Trump administration has outlined a tougher stance toward the deportation of undocumented immigrants. No one benefits when American children are deprived from benefits — including health care, education and social services — because of their parents' fear of deportation. The sad reality, however, is that these children have even more to lose if they are separated from the love and stability that their parents provide.

In these uncertain times, we welcome your suggestions about how we, as physicians, can effectively respond to the needs of our patients and community. We need all the help we can get.

Dr. Kathleen R. Page (kpage2@jhmi.edu) is an associate professor at Johns Hopkins University School of Medicine and co-director of of Centro SOL. Contributors to this piece inlcude: Dr. Sarah Polk, an assistant professor at Johns Hopkins University School of Medicine and co-director of Centro SOL; Dr. Barbara Cook, director The Access Partnership at Johns Hopkins University; and Dr. Kathryn Kline, an instructor at Johns Hopkins University and the medical director of the Esperanza Clinic.

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