Armando limped into the waiting room of the support house for deported U.S. veterans in Tijuana, Mexico. We were there to evaluate him for humanitarian parole, a process by which an individual banned from the United States can appeal to return on a temporary basis for an extenuating circumstance — in Armando’s case, medical care for a disabling bone infection at a VA facility just across the border in San Diego.
Born in Mexico, Armando came to the U.S. as a child. When he came of age, he enlisted in the armed forces and served several tours of duty in Korea and Germany. During his service, he developed addictions to alcohol and opioids.
After being honorably discharged from the service, Armando returned to the U.S. A few years later, a drug charge landed him before a judge. Addiction is a common problem in the military, and courts have recently begun to offer veterans treatment instead of jail time. But instead of being offered treatment, Armando was deported to Mexico.
Once back in Mexico, things got worse. Armando was in a serious car accident that left him permanently disabled and caused chronic infections. Now he waits, living in a shack at the edge of a friend’s property with his small dog, hoping he might one day get treatment — treatment he is entitled to as a veteran — at the VA medical facility just 30 miles away.
As physicians who work with immigrants and those in the justice system, Armando’s story is both tragic and familiar.
Each year, around 8,000 noncitizens enlist in the military. In 2008, the U.S. Department of Defense estimated that more than 65,000 immigrants (noncitizens and naturalized citizens) were serving on active duty in the U.S. armed forces. That represented approximately 5 percent of all active-duty personnel. Enlisting in the military can expedite the process of becoming a citizen — but it doesn’t guarantee it.
A conviction for something as minor as drug possession can result in automatic deportation. According to a report from the ACLU of California, thousands of foreign-born veterans are now scattered across the globe following deportation. Under President Trump, thousands more face the risk of arrest and deportation.
As many as 1 in 3 veterans suffer from post-traumatic stress disorder. They struggle to keep jobs and adjust to civilian life. As a result, veterans are much more likely to become homeless and succumb to crimes of poverty.
A staggering number of veterans struggle with addiction, and the numbers seem to be climbing. Among veterans who are incarcerated, some are able to access treatment. “Deportable” veterans, however, are barred from treatment by the Bureau of Prisons while they do time. And once deported, veterans can no longer access the VA health care system, depriving them of the VA benefits to which they are entitled.
A current bill package proposed by Rep. Juan Vargas (R-Calif.) offers some steps in the right direction. If passed, this bill would fast-track the naturalization process for noncitizen veterans and would also allow veterans who have been deported to temporarily return to the U.S. to get medical care at the VA. But efforts to move this bill forward seem to have stalled.
Armando’s appeal for humanitarian parole was recently denied. Without the kind of care he could — and should — get at the nearby VA health facility, the treatable infection that is damaging his bones may someday make it impossible for him to walk.
In the absence of a strong safety net, it is no surprise that veterans get caught up in our criminal justice system. Instead of treating the wounds of war, we punish people like Armando with prison, deportation, and the loss of much-needed health care.
We owe more than a debt of gratitude to our veterans for their sacrifice. People like Armando deserve treatment and citizenship. The VA system must do more to safeguard veterans from the vulnerabilities that land them in our jails and prisons. And our lawmakers need to support initiatives that protect veterans from deportation and the loss of health care.
As a country, we can do better. We must commit to protecting those who risked everything to protect us — regardless of their citizenship status.
Lello Tesema, M.D., is a general internal medicine physician and director of population health at the Los Angeles County Correctional Health System. Stephen Merjavy, M.D., is an HIV and family medicine physician at Contra Costa Health Services in California.