Blurred Borders - International Community Foundation

CHAPTER VII HEALTH & HUMAN SERVICES:
BUILDING HEALTHY BINATIONAL COMMUNITIES THROUGH
CROSS-BORDER COOPERATION
In 2003, many headlines reminded the residents of the San Diego-Tijuana region that sharing
the border meant sharing many health issues. In March, the Centers for Disease Control and
Prevention (CDC) released findings that showed that foreign-born population accounted for
51% of tuberculosis (TB) cases in the United States. Of these cases, Mexicans accounted for
23%. While these figures are startling, equally, if not more, powerful was the response of John
L. Kirkwood, President and CEO of the American Lung Association: “We share a border, we
share the TB problem and we share the responsibility for helping the people involved.” 220
Reflecting this cooperative spirit, a pilot program is underway in the US-Mexico border region
to improve treatment completion by TB patients who cross the border. 221 San Diego and
Tijuana are one of the two groups of sister cities to take part in this innovative and muchneeded
program. 222
Although it is evident that cross-national cooperation is critical in addressing many health issues
along the U.S.-Mexico border, health advocates and officials from both Mexico and US are often
caught in a dilemma. They need to address health concerns for their citizens, and disseminate
information about the sources of potential health hazards and risks. But they also need to
maintain a cordial and cooperative relationship with their partners on the other side of the
border. The difficulty of balancing these needs is evident from other headlines on health issues
from 2003: Mexican health officials warned Mexicans of the impact of possible bioterrorism and
the spread of SARS and West Nile Virus from US to Mexico, 223 while the outbreak of hepatitis
A created a controversy between US and Mexican officials, as US health officials believed the
source was green onions harvested in Baja California. 224
This chapter will demonstrate how the San Diego and Tijuana health and human service issues
and infrastructures are tied together. Infectious diseases, such as TB, hepatitis, dengue, and
HIV/AIDS, cross borders freely. While medical facilities in San Diego may offer specialized
services unavailable in Tijuana, Tijuana may offer culturally competent services unavailable in San
Diego. If we can realize how inter-connected our health issues are, as well as how
interdependent we already are for culturally-competent health care, prescription drugs, and
affordable medical services, we can leverage this knowledge to improve cross-border
cooperation and strengthen the linkages that benefit all of us. The closer we (governments,
220
American Lung Association press release on March 27, 2003, available at
http://www.lungusa.org/press/lung_dis/dis_032703.html (last accessed 1/13/04)
221
As detailed later, the focus on border crossers stems from the concern that this population tends to develop
drug-resistant TB due to incomplete treatment.
222
The other group is El Paso, Texas, Las Cruces, New Mexico, and Ciudad Juarez, Chihuahua.
223
See, for example, Frontera Norte Sur (online publication), June 18, 2003.
224
See, for example, Diane Lindquist and Sandra Dibble,“Clues, but no smoking guns,” San Diego Union Tribune,
December 15, 2003.
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