February 2023

EYE CARE FOR MEXICO/USA MIGRANTS

Project draft

INTRODUCTION
Mexico’s Institute of Ophthalmology Fundación Conde de Valenciana (HCV), a private, non-profit benefit
organization with over 47 years’ experience in visual health, servicing over 1,500 vulnerable patients from
indigenous and low-income populations a day, in five sites throughout the country and the International Centre
for Migration, Health and Development (ICMHD), a Swiss-based non-profit institution established in 1995 to
work on research, training and policy advocacy for health and migration, come together in synergy with the
World Health Organization (WHO) and the International Agency for the Prevention of Blindnes (IAPM) to give
greater access to equitable and affordable eye care, aiming to end avoidable eye loss, among migrants in Mexico
aspiring to work in the United States. Correcting refractive errors with eyeglasses, excising cataracts and
anticipating macular damage, early-on, betters migrants’ chances of working, abroad.

BACKGROUND
In 2016, the World Economic Forum’s (WEF) study "Glasses for Global Development: Closing the Visual Gap",
published the following figures:
 4.2 billion people in the world live with poor vision and require glasses.
 2.5 billion cannot afford to buy glasses.
 624 million are visually impaired or blind.
Adequate vision is essential for educational and economic opportunities, upholding personal well-being, self-
sufficiency and productivity.
According to the United Nations (UN), 1,060,707 immigrants live in Mexico (0.84% of the population). Male
immigration is higher than female; 40% come from the Northern Triangle of Central America (El Salvador,
Guatemala and Honduras). According to Mexico City’s Secretaría de Gobernación (SEGOB), migrant flow
increased by 34% in 2022. Between January and November 2022, an average of 48 illegal migrants entered the
country, every hour (388,611).
Due to their irregular status, on average, 6.4 million Mexicans have no access to health services. Of the 12
million immigrants in the United States, only 3.4 million Mexican migrants are American citizens (two out of ten,
are between 15 and 29 years old; 7.9 million are part of the United States labor force). The National Population
Council (CONAPO) and the University of California (UC) have compiled seven articles that analyze some of the
challenges and advances in the migration-health binomial: Mexico/USA:
 Mexicans are the largest group of migrants in the United States
 Mexican immigrants living in poverty are more likely to lack medical insurance
 Six out of ten Mexicans with medical insurance have public medical insurance while four have private
medical insurance
 In 2014, over 9 million (76%) Mexican immigrants presented some degree of overweight or obesity.
 An estimated 1.5 million Mexicans were diagnosed with diabetes
 Nine out of ten uninsured Mexican immigrants are not American citizens
 Five out of ten immigrants in the labor force lack medical insurance

The most frequent health problems among Central American migrants in homes and shelters at the Mexico/USA
border were respiratory diseases (40.0%) and injuries and accidents (9.7%). Only 38.8 percent of young
Mexicans in the US were reported to be in good health.
  Six out of ten young Mexicans in the US have no regular health coverage.
 Central American migrants who travel through Mexico and use homes and shelters in Mexico, are
averaged to be 29.9 years of age.
 From 2012 until the end of May 2016, the Tijuana Migrant Health Module served 11,000 repatriated
migrants.
 From 2014 until May 2016, 4 000 repatriated migrants were served at the in Matamoros Migrant Health
module.

CURRENT STATUS
The recent bilateral US/Mexico Symposium on Vision Health, held in Mexico City, outlined the lack of cohesive
efforts in a common Comprehensive Program, as the main cause for unattended visual loss immigrants in the
United States and asylum seekers at the US /Mexico border.
Diabetic retinopathy was repeatedly highlighted as one of the highest risks among Hispanic population, due to
native American genetic predisposition for diabetes. Without a Program, however, efforts have been dissipated
and funding, non-existent.

TARGET POPULATION
Immigrants
The 2020 Mexican Population and Housing Census and the 2015 National Household Survey of the National
Institute of Statistics and Geography (INEGI) estimates:
– 12% of Mexico’s national population is visually impaired (16% of them with visual loss or blind; 61% needing
eye-glasses)
The 2015 National Household Survey of the National Institute of Statistics and Geography (INEGI) estimating the
ages of people needing eyeglasses or contact lenses to be:
7.4% - children between 3 and 14 years old.
17% o- between the ages of 15 and 29.
24.7% - between the ages of 30 and 49.
57.5% - between 50 and 64 years old.
54.2% - older adults over 65 years old.
Estimates for visual aid among immigrants
Based on these official statistics estimates can be projected onto the 12,000,000 immigrants in the USA:
– 12%- (1,440,000) need visual care
– 1.9% - (230,400)- have important visual loss
– 7.3% - (878,400) –have visual impairment

Asylum seekeers
Based on reports from the USA/Mexico Border Patrol in 2022, there was an average of 200,000 asylum seekers a
month.
Estimates for visual impairment among asylum seekers
Considering a total annual estimate of 2,000,000 estimates can be projected as:
12%- (240,000) need visual care
1.9%- (38,000) have important visual loss
7.3%- (146,000) have visual impairment

ANALYSIS
Visual disability seriously impacts on people´s capacity for work. Since most immigrants are hired for labor,
visual impairment becomes a detriment, cause for job loss and potential expulsion from the country.
Genetic predisposition for diabetes is an aggravating, long-term risk among Hispanic migrants in the United
States, detrimental for health costs.
Most migrants have no health insurance (only 276,000 visually impaired are reported to have had access to
visual care services).
Most asylum seekers are in the group between 30 and 59 years of age, when major visual loss is due to
refractory errors, easily corrected with eyeglasses.
Visual care in Mexico is insufficient. According to the General Health Council in Mexico, there are only 280
medical facilities offering ophthalmological service, throughout the country. Only 131 of them are specialized
and registered in Ophthalmology (CdMX-40; BCN-20; Chihuahua-11; Guanajuato-18; Veracruz 13 and Nuevo
León 9).
Lack of health education and prevention programs has left millions with undetected diabetes. There is no risk-
awareness to allow for a culture of self-care.
Visual loss goes undetected, as it is considered to be a natural process that comes with age.

PROPOSAL
The Institute of Ophthalmology CONDE DE VALENCIANA Foundation I.A.P. has had 46 years of experience in the
visual care of impoverished patients with heightened vulnerability due to diabetes, hypertension and
malnutrition:
- 41% of its patients come from conditions of extreme poverty (Chiapas, Oaxaca, Guerrero and Veracruz);
- 59%, from conditions of poverty (Tabasco, Michoacán, Puebla, Hidalgo, Nayarit and San Luis Potosí);
- 16%, require surgical intervention.
Many of the patients are exposed to the additional risk of secondary infectious transmission among migrants
travelling from Central America to the United States (COVID 19, TB, syphilis, HIV/AIDS, cholera, zika, chikonguya,
malaria…).
Being an educational institution incorporated to the academic curricula of the Mexican National Autonomous
University (UNAM), it has invested in much of the latest state of the art technology deeply immersed in research
and investigation.

With these assets the CONDE de VALENCIANA explores potential intervention in the development of a program
for:
- Visual care among immigrants in the United States, through early impairment detection and anticipated
consular ophthalmologic service.
- Visual screening at the Mexico/US border among asylum seekers, with free eyeglasses.
- On-going preventive programs for diabetes and its complications.

Dr. Enrique Graue Dr Manuel Carballo

Presidente del Patronato Executive Director
Fundación Conde de Valenciana ICMHD