Poverty and Immigration, a pediatrician's perspective

One of the pediatric patients who visited us in the clinic this week was a sweet, healthy 4-year-old.  He was brought in by his grandpa.  I don’t see too many toddlers in my clinic in Colorado who are accompanied by their grandpa, which prompted me to ask more questions about his living arrangements.  This little boy is being raised by his maternal grandparents.  Grandpa shared that when his daughter was 17, she became pregnant.  The father of the baby was a much older man.  He came to their home and convinced the family he was honorable and would take care of her and the baby.   After the baby was born the grandparents found their daughter and grandson were essentially being trafficked by this man.  There were 5 other women and their children living with them.  The grandparents were able to get their daughter and infant grandson out of that situation and back home with them.   Not long after the grandpa had some health issues, making him unable to work, so the young mother made the difficult decision to head north. Someone needed to make money to support the family.  Thankfully she successfully immigrated to the USA and is sending money down to support her parents and toddler son.   Let’s hope ICE doesn’t find her.   This is the typical story of most immigrants.  Life circumstances become so unbearable that they seek out a better life for their family.   

People immigrate for so many reasons.  Sometimes things like war or local conflicts push people away.  Climate change is certainly playing a part.  The last few years I can see the effects of climate change in Guatemala.  Corrupt governments that don’t support systems that allow for people to raise families in economically stable and safe communities are probably one of the biggest drivers of migration.  Once you have seen what extreme poverty looks like and the challenges it brings, it is not hard at all to see why someone would make the very difficult choice to leave everything they know in search of a better life.  I can honestly say that I would be honored to have any of the patients we saw this week in clinic as my neighbors.  

Even the trip north itself is incredibly dangerous.  Earlier in the week there was a father of 3 children who came to clinic.  Several months ago he went north to better provide for his children.  In Mexico he fell out of the bed of a pick up truck and severely injured his right arm. He is now an amputee and back in Guatemala with his family, unable to find work so he cannot provide for them at all.   

Each time in our debriefs as I was listening to these stories of poverty necessitating these drastic upending of lives, I found myself thinking about Gustavo Gutierrez - a Peruvian priest and founder of liberation theology, who died last fall.  When my husband, Chris, was getting his PhD at Notre Dame, he had the privilege of having Gustavo as one of his theology professors.  Our family got to know Gustavo well those years and were honored that he came to our home a few times to say  mass for “house church.”  Our daughter Grace was an infant at that time. Gustavo adored her and she was fascinated by him.  Gustavo was a tiny Peruvian.  Think Yoda in human form. Gutierrez wrote about the preferential option for the poor.  It is a key principle in Catholic social teaching that emphasizes the moral priority of addressing the needs of the poor and marginalized.  It means prioritizing the well being of those most vulnerable, not just through charity, but through systemic changes to address the root causes of poverty and marginalization. 

Fr Gustavo Gutiérrez, our daughter Grace, my husband, Chris 2004

Poverty is not accidental but the result of structural and historical events that systematically makes it impossible for those at the very bottom to get out.  To quote Martin Luther King, Jr ,”It’s alright to tell a man to lift himself by his own bootstraps, but it is cruel jest to say to a bootless man that he ought to lift himself by his own bootstraps.”  Our community in Guatemala is bootless.  The only way to confront poverty is to remember we live in one world, not three.   Guatemala, and places around the world like it, is not “the third world.”  There really is only one world and we are all connected.

In recent years, it has been a welcome relief to have had Pope Francis stand firmly against the mass deportation of human beings around the world during his pontificate.  He was a vocal critic of the demonization of the other that is the root of right wing immigration policies around the globe.  Pope Francis will be dearly missed.  I wrote to the students shortly after his death that I suspected we would actually be in Guatemala during the conclave.  So when the white smoke appeared on Thursday morning while we were in clinic, we were happy to learn that Pope Leo XIV was chosen.  From what we are learning in these early days of his pontificate he also appears to be a strong advocate for refugees and immigrants.  I suspect his decades of serving the marginalized in Peru has shaped his conviction on this from real world experience.  

When our politics focus on demonizing the other and making us fear the other, we start to see them as less than human.  I can tell you that a 17-year-old new trafficked mom is fully human and is only doing what any mother would do for her child. Today is Mother’s Day in the US - it was yesterday in Guatemala.   On these special days I find myself honored to have met this little 4-year-old boy who is so loved by his mother  she went north to find work so she could support him. I hope our world can come together to solve the problems that forced her to have to leave her community in the first place. 

Lauri Pramuk, MD

One of the many special moms I saw this week. Deysi shows up every day for her wonderful boy

Another incredible mom I was able to see again this week.  Luz loves Sebastian so tenderly