Everyone Who Is Gone Is Here: The United States, Central America, and the Making of a Crisis

Using “brash executive action, relentless politics, and bureaucratic sleight of hand” (430), Trump achieved his campaign promise of curbing immigration. At the start of 2020, MPP was still in effect. Nearly 64,000 asylum seekers were enrolled and just 517 had received some kind of legal relief. Many abandoned their cases, and many were murdered, raped, and kidnapped while waiting in Mexico.

While MPP successfully kept the majority out of the county, Stephen Miller still dreamed “of closing the border entirely to asylum seekers” (431). To do so, he took advantage of the “obscure” Title 42 in the 1944 Public Health Service Act, which stated the government could close the border during a public health emergency involving communicable diseases, with the authorization of the Center for Disease Control and Prevention.

In March 2020, the head of the Division of Global Migration and Quarantine in the CDC initially refused to sign the order. COVID-19 was already spreading rapidly in the US, and there was no evidence that admitting asylum seekers would worsen the situation. After pressure from Vice President Mike Pence, the CDC eventually caved. The US government used Title 42 as an excuse to force all asylum seekers into Mexico and tighten restrictions on other kinds of visas. Without income from visa applications, Citizenship and Immigration Services was left with a $1 billion budget shortfall.

By the end of March, Guatemala had registered 35 cases of COVID-19. The country had only two large hospitals, and the president worked hard to preemptively contain the virus. On March 28th, an infected deportee arrived from the United States and became known as Patient 36. A week later, another deportee tested positive. The United States refused to stop deportation flights to Guatemala and other countries in the region with “fragile health care systems, scant hospital space, and a dearth of ventilators” (433). In the 1990s and 2000s, deportations caused gang violence to spread “like a virus” in Central America. Now, the same was happening with COVID-19.

By mid-April, more than half of the deportees arriving in Guatemala were infected, and the Guatemalan government estimated that 20% of the country’s total cases were recorded in deportees who arrived from the United States. COVID was rampant in ICE detention centers, where “[t]esting was virtually nonexistent” (434) and detainees couldn’t comply with social distancing recommendations.

In November 2020, Joe Biden was elected president, and Juan texted Blitzer to congratulate him. Although he was intensely political and lived a life defined by activism, Juan spent very little time complaining about “demagogues and strongmen” like Trump and the Salvadorian president Bukele. Instead, Juan dedicated his life to his conviction “that medical care was a human right and should be free” (436). He served two FMLN presidents and improved the quantity and quality of clinics in his area.

However, by 2019, the leftist party that he had seen rise after the civil war had largely failed. The former president, Mauricio Funes, was living in exile after being convicted on a number of corruption charges. In the new president, Juan “saw the past dressed up as the future” (439), and he was suspicious of Bukele’s charisma and “soaring promises.” Nevertheless, his win in 2019 was widely celebrated as a “new national beginning” (349).

Eddie, meanwhile, supported Bukele. He was living a middle-class life with his family in San Salvador, growing Cool English and starting a new media outlet called Salvy Life, meant to share “dynamic, engaging stories about El Salvador” (440) and rebrand the country for foreigners and locals alike. After many years, Eddie finally saw a future for himself in his home country. He no longer felt stuck “in limbo.”

After his inauguration in January 2021, President Biden assembled a task force to work on unifying families that had been separated during Trump’s zero tolerance policy. Keldy qualified for a new humanitarian visa and was scheduled to cross the border into El Paso at 8 AM on May 4th. Keldy’s niece helped her arrange her journey to Philadelphia to surprise her sons.

In Philadelphia, her family gathered with a news crew they believed wanted to collect interviews about Keldy’s legal case to get support from the president. After a moment of shocked silence, Keldy’s family rushed to her, and “the house filled with the sound of Keldy and her three children wailing” (446).

During the Trump administration, the government used MPP and Title 42 to hide the reality of the asylum crisis at the Southern border. As Biden attempted to manage the crisis and brought it back into view, he was immediately accused of worsening the problem. He kept Title 42 in place but made an exception for unaccompanied minors. This meant that the number of children in US custody rose significantly, and Biden was forced to reopen some of the shelters that were used during the Trump administration, leading to accusations of caging children.

As vice president, Biden made a number of visits to Central America, engaging in talks to reduce corruption, increase security, and stimulate economic growth in the region. As president, he tried to send Kamala Harris to do the same, but a history “of American interventionism, followed by […] indifference, made old allies suspect and new ones impossible to find” (449).

By March 2022, Lucrecia Hernández Mack was a leftist congresswoman living in Guatemala City, working a few blocks from the street where her mother was murdered. Her party held seven seats in the conservative-dominated Assembly, and they were engaged primarily in a “series of fights that [they] could draw out but never win” (452), constantly coming up against the uncontrolled corruption that ran the county. Nevertheless, Lucrecia was glad of the opportunity to “engage on the ground level” (454) and knew that fighting was her only option. She was diagnosed with cervical cancer in 2020, and the disease had returned, but Lucrecia wasn’t afraid of dying.

Throughout 2021, the Biden administration was participating in settlement talks with the ACLU to provide financial compensation and legal relief to families that had been separated at the border. However, in December, the administration abruptly withdrew from the negotiations. The Wall Street Journal reported that the government was considering giving each family member $450,000, and the settlement suddenly became too great of a political liability.

Title 42 remained in effect until the spring of 2023, when the COVID-19 public health emergency ended. The policy had the effect of keeping immigration out of the news, but it remained “an ad hoc approach of expelling as many migrants as [the government] could” (457) instead of repairing the asylum system. It came in handy when, for example, 30,000 Haitian refugees arrived at the border in the fall of 2021. They set up camp under the Del Rio International Bridge, and Border Patrol officers patrolled the banks on horseback brandishing whips. Biden later claimed these officers were “beyond an embarrassment,” but Title 42 allowed the president to easily deport the migrants without considering their asylum cases.

When it was finally time to end Title 42, a team assembled to develop a new plan. One of their first ideas was to deny asylum to anyone who had passed through another country on their way to the US.

Juan and Blitzer met for the first time in 2022 after speaking by phone for two full years. The Salvadorian government was in the middle of a state of exception to tackle gang violence. Many innocent people were being swept up in the arrests, but the public overwhelmingly supported the crackdown. The state of exception was renewed month after month, and the vice president insisted it wasn’t “strange” because the government had done the same during the civil war.

Juan was now 70 years old and preparing to sell the home that had been in his family since 1824. As they drank horchata together in opposing hammocks, he told Blitzer that a “constant” of his career in medicine was the reality “that people want to talk” (464). He said that his patient’s symptoms were “only half of it” (464).