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Life on the Line: One HIV-positive Woman's Story (Essay)

Published in A & U Magazine, October, 2006

Life on the Line
One HIV-positive woman’s account of crossing the U.S.–Mexico border in search of healthcare
by John Fanestil

Last summer I worked for a week in the mountains east of San Diego, as the volunteer chaplain at a camp for people with HIV/AIDS. There I met Lourdes Sanchez (not her real name), a twenty-four-year-old Tijuana woman who laughed when I asked her where she was from.

“Yo vivo en la línea,” said Lourdes, smiling and using the Spanish slang for “border.” I live on the line.
I picked up the conversation in Spanish: “Así que vives en San Diego o Tijuana?” So do you live in San Diego or Tijuana?

“Los dos,” Lourdes said. Both. She went on to explain to me that she maintained residences in both Tijuana and San Ysidro, San Diego County’s border town.

I found the idea fascinating, and so I asked Lourdes to sit down and tell me about herself, and to explain how it came to pass that she lived on both sides of the line.

Lourdes Sanchez was born in Guadalajara, but her parents moved to Tijuana when she was six years old. “I have very few memories from Guadalajara,” she said.

Her upbringing in Tijuana was in many ways typically Mexican. The third of seven siblings, she grew up in a large and loving extended family, which celebrated with her in 1999 when she graduated from preparatoria (the Mexican equivalent of high school) and married a boy from the neighborhood, Rafael Zaragoza. The couple’s first son, Rodrigo, was born in 2000 and their second, Paulito, in 2002.

With plans for further studies she aspired to someday become a secretary—Lourdes never imagined herself moving to the United States. All that changed, though, in September 2003, when she discovered that Rafael had infected her with HIV.

Rafael had never been a very good husband, Lourdes told me, but still he was devastated to learn that he had given the virus to his wife. “I don’t know how he contracted the virus,” Lourdes said. “He never told me…who knows if even he really knew how he got it or from whom.” The way Lourdes remembers what happened next, Rafael “just gave up.” He died of AIDS in April, 2004.

Facing a moment of profound crisis, Lourdes determined that she would not just passively accept this same fate. Relieved to learn that neither Rodrigo nor Paulito were HIV-positive, she decided to fight the virus in her body.

“I believe in being here for my children,” she explained.

It did not take Lourdes long to discover that in Tijuana she would be unable to access the medical care she needed. A clinic supported by the government of the Mexican state of Baja California Norte provides services and prescriptions to some 300 people living with HIV/AIDS. The waiting list for this program is several years long—Tijuana is a city of over two million people and researchers at the University of California, San Diego, conservatively estimate Tijuana’s adult HIV-positive population at over 5,000.

With adequate medical care unavailable to her in Mexico, Lourdes made the entirely reasonable decision to establish a residence in San Ysidro, the California town that is, for practical intents and purposes, both the southern-most suburb of San Diego and the northern-most suburb of Tijuana. There she signed on with San Ysidro Health Center, a community clinic offering a range of medical, psychiatric, and social services to families affected by HIV/AIDS.

Setting herself up in the United States was a big deal for Lourdes, but it was not difficult to do. She was already the rightful owner of a “border-crossing card,” a document issued by the U.S. Immigration and Naturalization Service that grants an unlimited number of entries into the United States, provided its bearer remain within twenty-five miles of the border and stay for no more than thirty days at a time. Over seven million Mexican citizens possess a border-crossing card—also called “el pasaporte local” or the local passport.

According to Jessica Vaughan, a senior policy analyst at the Center for Immigration Studies in Washington, D.C., “the program is really no more than an expensive and fancy honor system, because land border inspectors only rarely do name-checks and even more rarely try to authenticate the identity of the card-holder.” In 2004 the Department of Homeland Security upgraded the border-crossing cards, converting them into new, high-tech “laser visas” that can be scanned using infrared technology. The Department is now aggressively pursuing plans to tighten controls on this system: Its stated goal is to submit all laser visa users to electronically-scanned fingerprint identification.

As have millions of other Mexicans, Lourdes Sanchez converted her local passport into an entirely binational way of life. (In 2004 DHS recorded 114 million laser visa entries into the United States.) She retained her apartment in Tijuana, the receipts from the rent providing ample evidence for those occasions when U.S. Border Patrol officers asked for proof of her residence in Mexico. And in the summer of 2004 she moved with a friend into a two-bedroom apartment in San Ysidro, using the utility bills to sign up with organizations like San Ysidro Health Center that offer services, irrespective of nationality, to all residents of the United States.

Lourdes became an “illegal alien,” but not in the traditional sense. In the vernacular of the Border Patrol, she became a “visa abuser.” Her older son, Rodrigo, continued to live in Tijuana with Lourdes’ mother. Her younger son, Paulito, moved with Lourdes and her friend into the San Ysidro apartment. She began to cross the border regularly—the way she talked about it made it sound like crossing the street.


Near the end of our conversation, Lourdes shared with me some big news. She had met a wonderful man from Tijuana—a man named Ivan who was close to finishing his architectural studies—and they were making plans to marry.

I asked if her fiancé knew she was HIV-positive.

“Yes, he knows,” Lourdes said, “but his family doesn’t. I told him when he first proposed that we start dating. He took it well.” Lourdes smiled.

As happy as she was about this new relationship, Lourdes also recognized that it presented her with a grand dilemma. Ivan’s architectural degree would do him no good in the United States—his friends, his family and his future were in Tijuana. Lourdes said she’d prefer that her future be in Tijuana, too.

“I consider myself a Tijuanense,” she explained, “but now I live in San Ysidro. I consider it a temporary thing—I would prefer to be over there. But I feel like if I go back to Tijuana full-time, I’ll be moving backward. I feel like I’d be going back to where I was before.” She sighed. “It’s a jumble. You take a risk to win and you only end up losing.”

The conversation continued this way for quite some time, with Lourdes weighing the costs and benefits that come with living on each side of the line. In all probability, she concluded, she would have to keep her residence in San Ysidro, no matter what happened with her life in Tijuana. She would have to do whatever it takes to retain access to the medical services available to her in the United States.

Lourdes was becoming more and more honest with me as we continued to talk. Finally she told me she was pregnant.

“See,” she said, “The doctors say I have to take medicine so that the baby won’t get the virus. And Ivan is negative so I have to be careful not to infect him.”

I looked at Lourdes and I smiled. Twenty-four-years-old, she was young and vibrant and vivacious. Literally and figuratively, she was so full of life.

As our conversation reached its end, Lourdes arrived at a final conclusion:“The real goal is to stay healthy for my family,” she said. “If I stay strong—mentally, physically, spiritually—I can last many years without going downhill, without the virus knocking me down.”

Log on to www.syhc.org/hiv.html to learn more about the HIV/AIDS services at San Ysidro Health Center.

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