Crossing New Borders—Investigating CKDnT in Texas

The temperature read 95 degrees Fahrenheit at 8:29 pm as we rolled through Del Rio, Texas. A small group of La Isla Network members and partners had spent the last few days in Austin, meeting with researchers and clinicians about the presence of CKDnT. Now we were on our way towards the Mexican border. It’s an anxiety ridden time for many in Southern Texas, with political will centered on anti-immigration and the deportation of undocumented workers. We were traveling into unfamiliar territory, even though we were in our own country. Our partner Del Garcia, with Migrant Clinicians Network, guided us through this hazy landscape as we took meetings with clinicians, local activists and members of several Mexican consulates. The stories we heard were bleak: border patrol agents cruising consulate parking lots looking to arrest “illegals,” people with CKD on dialysis in ICE detention centers waiting to be deported, and the uncertainty of care for patients returning to Mexico.

One of the main issues with CKDnT is that it almost exclusively affects people of very vulnerable populations, namely agricultural workers in Central America and South Asia, and as evidence points to, many other parts of the world. What is unique about Texas, is the added vulnerability of being undocumented that many young men face. This means that people who are already at high risk of developing CKDnT due to strenuous working conditions in agriculture or construction, may not seek healthcare for fear of being registered in the system. Once registered, they may be reported and deported without receiving treatment. For many, just the possibility of losing their job is enough to discourage seeking care. One agent from OSHA who met with us and wished to remain anonymous claims that 24 men have died in the San Antonio district in the past 8 months, mainly due to safety failures in construction and lack of training, which men forgo to not miss work, or because their bosses don’t allow them to miss work for training. While the d