MATAMOROS, Mexico - A smoke-filled stench fills a refugee camp just a short walk from the U.S.-Mexico border, rising from ever-burning fires and piles of human waste. Parents and children live in a sea of tents and tarps, some patched together with garbage bags. Others sleep outside in temperatures that recently dropped to freezing.
Justina, an asylum seeker who fled political persecution in Nicaragua, is struggling to keep her 8-month-old daughter healthy inside the damaged tent they share. The baby, Samantha, was diagnosed with pneumonia and recently released from a hospital with a dwindling supply of antibiotics.
"I face cold, hunger and everything because I don't have resources, and my daughter doesn't either," said Justina, who didn't want her last name used out of fear for her safety.
The camp is an outgrowth of the Trump administration's "Remain in Mexico" policy, which has sent more than 55,000 migrants, including Justina and Samantha, south of the border to wait and pursue their asylum cases.
A humanitarian crisis is worsening each day at the camp across the border from Brownsville, Texas, where a large American flag flapping in the wind is visible from more than 700 tents. As many as 2,000 immigrants are waiting for U.S. court hearings amid deteriorating medical and sanitary conditions.
Safe drinking water is scarce. People regularly line up for a half-hour to fill milk jugs and buckets with water. Some people bathe and wash their clothes in the Rio Grande, known to be contaminated with E. coli and other bacteria. They rely on donors who bring meals, or they pull fish from the river and fry them over wood fires.
Near the wooden toilets, the air smells like feces. Flies buzz around toilet paper discarded on the ground. A volunteer uses a shovel to remove waste that has pooled in front of a set of toilets.
The conditions show the health risks associated with the Remain in Mexico policy - which many have criticized for sending migrants to dangerous border towns - and how nonprofit groups are struggling to provide health care and other basic services without more support from the U.S. or Mexican governments.
Doctors Without Borders says that in three weeks in October, it did 178 consultations at the camp in Matamoros for conditions that included diarrhea, hypertension, diabetes, psychiatric conditions and asthma. More than half the patients were younger than 15.
Remain in Mexico has helped the U.S. government push down migration numbers at the southern border, a key priority of President Donald Trump. His administration said Thursday that migrant apprehensions at the U.S.-Mexico border had fallen for a fifth straight month.
Mark Morgan, acting commissioner of U.S. Customs and Border Protection, credited Trump administration programs like Remain in Mexico, officially known as the Migrant Protection Protocols, saying they had "been a gamechanger."
"MPP has absolutely been successful" from a law enforcement perspective, Morgan said.
When the U.S. and Mexico announced the program in December, Mexico agreed to provide work permits and other assistance to migrants forced to wait for U.S. court dates.
Last month, the U.S. Department of Homeland Security said it "understands" that migrants "are provided access to humanitarian care and assistance, food and housing, work permits and education." The agency says the U.S. has provided more than $17 million in grants for shelters and other housing options.
But there is dire need in Matamoros, where more than 11,000 people had been sent back through Oct. 1, according to official numbers obtained by The Associated Press.
Many migrants receive medical care at a sidewalk clinic run by Global Response Management, a small nonprofit that works in combat and disaster zones. Asylum seekers help at the clinic, including two fluent English speakers who help translate - one from Cuba, the other from Venezuela.
On the other side of the Rio Grande, there are signs that Remain in Mexico has worked as
intended.
In the Rio Grande Valley, the southernmost point of Texas and for many years the busiest section for border crossings, the Border Patrol is apprehending around 300 people daily. That's down from as many as 2,000 a day in May.
For years, large numbers of families would cross the Rio Grande by foot or in rafts. Smugglers would send families toward a few known areas and tell them to wait for Border Patrol agents to pick them up.
Now, routes near the river where agents would sometimes spot families several times a day are usually empty. The Border Patrol's central processing center and its smaller stations are holding far fewer migrants.