Meeting asylum seekers’ healthcare needs with compassion

Healthcare is a human right. As the home of the nation’s largest municipal healthcare system, New York City works to honor and uplift that right every day.

In our city, which has provided services to more than 180,000 asylum seekers who have arrived here since spring 2022, we’ve seen firsthand the consequences of prior failures to meet their healthcare needs. For many asylum seekers, the care we provide is the first they have ever received. Our mission is to change that harsh reality. We want asylum seekers to have accessible, high-quality care wherever they go. We humbly offer our experience as a road map for others who share this vision, and we are optimistic that we can collaborate with colleagues around the country to meet this population’s healthcare needs together.

Related: Komal Bajaj, NYC Health + Hospitals, talks health equity

I am a primary care doctor at NYC Health + Hospitals and lead the city’s humanitarian centers and Arrival Center, which provides medical care to all asylum seekers upon entry as well as placement in shelters. Thousands arrive in difficult situations, including families with young children and pregnant people who arrive unannounced on buses from the southern border. Many are unprepared to find themselves here. When they arrive at our doorstep, they are often recovering from wounds or illness as well as malnourished, confused or scared.

One young boy arrived by chartered bus from Texas after having his anti-epileptic medicine seized at the border by U.S. Customs and Border Protection officers. Deprived of his medication and with no access to more, he suffered a near-fatal seizure just moments after he arrived at the Port Authority Bus Terminal. It is not uncommon for people to arrive in NYC late in their pregnancies after not being able to access basic obstetric care at the border or during the transnational bus ride to New York. My team transported a woman in labor directly from a chartered bus to the NYC hospital where she delivered her baby moments later. We see unvaccinated children every day, who have never had access to vaccines for preventable diseases like measles and chickenpox in their home countries or since crossing the border.

It shouldn’t be this way, and it doesn’t have to be. 

In NYC, we created a coordinated system of medical care that begins at the front door of our shelter system and extends to our public hospital system and other federally qualified health centers. We opened the city’s Arrival Center in May 2023 to provide organized and responsive services as soon as people arrive. First, staff provide screenings for communicable diseases including active tuberculosis, COVID-19 and chickenpox. Urgent care is available for medical needs such as pregnancy or chronic disease management. Then, based on our experience treating people who have endured significant trauma on their journeys, everyone older than 12 is screened for depression, with social workers on site for those who need immediate care. Finally, we have administered over 60,000 doses of vaccines, predominantly to children, at our Arrival Center and humanitarian centers.

After new arrivals have had their urgent healthcare needs addressed, they meet with our case workers to make plans to complete their journeys or get placed into temporary shelter. Since the Arrival Center first opened its doors, we have provided this care to more than 120,000 individuals.

We also offer continued care within the public hospital system. We have handled nearly 100,000 visits in our system and identified common needs ranging from obstetric care to dental care, allowing us to augment staff to increase capacity. More than 600 asylum seekers have given birth to healthy babies in our system and over 16,000 people have applied for health insurance to establish life-changing healthcare relationships with their new primary care doctors. 

We are proud of the work we’ve done, but New York and other large cities facing similar challenges, such as Chicago, Los Angeles and Denver, cannot do this alone. Treating healthcare as a human right starts at the border, where asylum seekers should be able to access basic care like prenatal services and vaccinations.

When new arrivals come to our cities, there is a critical need to provide healthcare — from urgent care prior to shelter to mental health services, given the traumatic journey they have been through. We have found that it is effective to provide this immediate access to care upfront at our Arrival Center, where shelter placements are offered, and recommend that this be federally supported. Finally, asylum seekers will have ongoing healthcare needs. Planning ahead for key services such as obstetrics and primary care will help cities’ hospital systems keep up with the needs of this new population.

Together, we have an opportunity to turn this humanitarian crisis into something positive — and show the world that we are not only a strong country but a compassionate one.

Dr. Ted Long is a primary care doctor and senior vice president of ambulatory care and population health at NYC Health + Hospitals. He is also the leader of the New York City’s Arrival Center and 15 humanitarian centers currently housing approximately 25,000 asylum seekers.