In this episode you’ll hear from Ieva Jusionyte, an anthropologist and associate professor of international security and anthropology at the Watson Institute. In addition to teaching and research, she also has a side job – as a licensed EMT. 

In May 2015 she combined these two passions. She moved to Nogales, AZ, to study emergency responders on the US-Mexico border. For two years she studied life along this border, and worked on it as an EMT herself. 

What she found became the subject of her book, ‘Threshold: Emergency Responders on the U.S.-Mexico Border.’ In it, she explores how the US-Mexico border – as a legal boundary, an idea, and a physical space – changes emergency response, and what these changes reveal about how borders affect people who live near them. 

Learn more about and purchase Ieva’s book. 

Learn more about the Watson Institute’s other podcasts. 

SARAH BALDWIN: From the Watson Institute at Brown University, this is Trending Globally. I'm Sarah Baldwin. In May Twenty-Fifteen, Ieva Jusionyte started working as an emergency responder in Nogales, Arizona. She'd been trained as an EMT in Massachusetts and worked as one in Florida. But just barely into her first day in Nogales, her unit got a call that reminded her that this job would be a little different.

IEVA JUSIONYTE: We received a 911 dispatch that there is a woman who has injuries from falling off the border wall.

SARAH BALDWIN: Nogales is on the southern border of Arizona-- well, really the southern border of the United States. And this woman, whom we'll call Araceli, had climbed a ladder on the Mexico side of the border fence but fell coming down the US side. She fell from a height of about 24 feet-- that's like falling from the top of a two-storey house-- right onto a slab of concrete. Ieva and her team got in an ambulance and sped off to help this woman.

IEVA JUSIONYTE: We rushed to the border fence. You can't really take an ambulance all the way there. You had to run down the hill and then up this concrete slope. She had bilateral open ankle fractures, so both of her legs were visibly injured. We gave her IV fluids and morphine and then carried her to the ambulance.

SARAH BALDWIN: They were also concerned there might be a spinal injury, so Ieva's team called in a trauma alert.

IEVA JUSIONYTE: The ambulance went to a helipad, and she was flown to the trauma center in Tucson, which is the closest level one trauma center, the closest hospital.

SARAH BALDWIN: This is maybe where I should mention Ieva had a second job at the time. She's an anthropologist and an associate professor at the Watson Institute. In addition to helping people like Araceli, she was in Nogales to study the workings of emergency responders on one of the most militarized, politicized borders in the world.

It became the subject of her book Threshold: Emergency Responders on the US-Mexico Border. In it she explores how the US-Mexico border as a legal boundary, an idea, and a physical space changes the way emergencies play out in the communities around it. On this episode, what these changes tell us about how borders work or don't work in the world today.

Before we get back to Arizona and Ieva's work, you need to know a little more about her career because it's not easy to pin down. But connecting everything she does is her interest in borders and what they do to us-- something she has experienced very personally.

IEVA JUSIONYTE: I grew up in Lithuania, which is this small country in northern central Europe. And the history of Lithuania has always been between the bigger powers, regional powers, so the Russian empire and the USSR and then the German empire and western Europe. Our country's borders have shifted often.

SARAH BALDWIN: Ieva grew up during one such moment of shifting borders.

IEVA JUSIONYTE: I was also born in the nineteen-eighties, which means my country was on the other side of the Iron Curtain occupied by the USSR. And when the USSR collapsed and Lithuania became independent and finally people could go anywhere they wanted, borders disappeared. And I became interested in thinking about borders as these social constructs, as the historical legacies.

SARAH BALDWIN: In other words--

IEVA JUSIONYTE: It all started I think from having experienced a closed-in country that suddenly opened up to a borderless-- supposedly borderless world.

SARAH BALDWIN: Ieva moved from Lithuania to the US to get a PhD in anthropology. She wanted to study how borders operated, how they affect communities, and what they tell us about the world. While working on her dissertation in Cambridge, Massachusetts, Ieva took up a side job, one that she'd been interested in for a while and that might be a nice balance to the cerebral, solitary work of writing.

IEVA JUSIONYTE: I enrolled in an EMT school and began volunteering as a firefighter here in Cambridge, Massachusetts.

SARAH BALDWIN: But it became more than a hobby.

IEVA JUSIONYTE: I was so invested in pursuing emergency management and emergency medical services as my profession that I almost didn't become an academic.

SARAH BALDWIN: She did become an academic but--

IEVA JUSIONYTE: For a few years, I pursued both of these together. So during the days, I would be teaching courses, writing my book, writing articles, going to conferences. But then in the evenings and on the weekends, I would be volunteering in a fire department.

SARAH BALDWIN: She described it as a sort of Dr. Jekyll and Mr. Hyde situation, though I don't think that's really right since both of those vocations are good. Let's say Dr. Jekyll and Dr. Hyde. Anyhoo, one day, as she was pursuing this double life, Ieva came across an article.

IEVA JUSIONYTE: In The New York Times, about emergency services on the US-Mexico border overburdened by calls to help injured migrants. And I couldn't find anything else. Nobody else reported on this. I thought, this is so interesting. These are border towns that are clearly at the crosshairs of this immigration and security policies. But life goes on there, and people live there. And people have medical emergencies as well, and there are emergency responders who serve those communities.

SARAH BALDWIN: Ieva had found her next project.

IEVA JUSIONYTE: I wrote a proposal saying that this has clearly not been studied and this is an important subject.

SARAH BALDWIN: But before she even knew if she got the grant, she had already flown to Arizona. She made her way to Nogales, a town of 20,000 people on the US-Mexico border-- like right on the border. The main street of Nogales turns into a massive, militarized throughway into the town next to it, also named Nogales but in the state of Sonora, Mexico. Many of the town's streets dead-end at a big steel wall sticking straight out of the desert. For the next two years, this would be home.

Responding to emergencies is one of the state's most basic responsibilities, and emergencies don't follow political borders. An American citizen can have a heart attack in Mexico and vice versa. Fire and floods don't care about borders either. Ieva was going to explore this tension and see what it could tell us about the kinds of problems a militarized, politically polarizing national border creates. But before she could get into all that, she needed to find a job.

IEVA JUSIONYTE: I wrote blindly to some chiefs of fire departments, and I showed up at the doorstep of the first one that responded to my email.

SARAH BALDWIN: Luckily, due to that shortage she read about, she was hired as an EMT. And she had an in with the very people she was hoping to study as an anthropologist.

IEVA JUSIONYTE: And from then on, it's very much like a network. Who else do I talk to? Where else do I go?

SARAH BALDWIN: If this whole setup-- Jekyll and Hyde, anthropologist, and emergency medic, et cetera-- sounds confusing, don't worry. Ieva found it that way too at times.

IEVA JUSIONYTE: When the call comes in, when there is a person who is wounded, who is hurting, I am just an EMT. The anthropologist comes later when I start writing field notes or when I'm sitting at the fire station cleaning the ambulance and thinking like, what will happen next? In a way, emergency medicine is very contrary to anthropology because of the fact that you can't question the medical directives that you get.

But then you go back and you write field notes and you think about what all of that meant. And I think in my book I did struggle with that a little of trying to use my voice and my experience as an emergency medical responder but also look at the situation critically as an anthropologist. So there was a little bit of that duality I think in the book as well.

SARAH BALDWIN: We'll be living in that duality for the rest of this episode, too. That's because, as Ieva's work shows, being able to move between the specific concrete world of emergency responders and the broader questions about what borders do to us can help us see both in a new light. One of Ieva's first realizations working in Nogales was just how much movement there is between the two sides of the border. There may be two sets of laws, but actually it's just one big place.

IEVA JUSIONYTE: These communities are intricately connected. These are social ties, so they are families, multi-generational connections, but these are also pipes that carry water and carry sewage. And now there are talks of creating binational electricity grids.

SARAH BALDWIN: For many people, as Ieva described, the border is more of a nuisance than anything else.

IEVA JUSIONYTE: A lot of Mexican nationals who live near the border have these border crosser cards, these long-term visas that they can come to the US to study and to work. And, really, people move back and forth across all the time.

SARAH BALDWIN: Nowhere is this interconnectedness more apparent than in how emergencies are handled.

IEVA JUSIONYTE: In most of these towns, there is at least one. There are more ports of entry, so these are-- it's like an airport security, right? Almost always some lanes are closed, and those are lanes that are used in emergency situations. So, for example, if an American citizen gets injured in Mexico or if there is a big fire and there are kids who need emergency care that is not available in Mexico and they need to be transported to US hospitals, then the ambulance or the dispatcher calls.

They open a separate lane where sometimes Mexican ambulances can cross into the US. Or if we are talking about fire trucks, they cross into the US and go fight fire through this expedited lane. So they do have to stop and sometimes have to show their identification, but it's a very, very short stop. There is also humanitarian parole that can be given to people on the Mexican side who are injured or family of the injured who can be quickly let into the country even when they don't have a visa.

SARAH BALDWIN: All of this created an impression of the border that was pretty different from what Ieva expected.

IEVA JUSIONYTE: I was very pleasantly surprised by the camaraderie in this binational partnership, brothership between emergency responders.

SARAH BALDWIN: This doesn't mean, though, that life at the border is free of dangerous risk or hardship. It's just that the dangers are not the ones that we in the United States are led to think they are. You've probably heard the idea that migrants from the Americas bring guns, drugs, and crime into the US.

IEVA JUSIONYTE: And this is what politicians do. This is what some media does as well of the threat and insecurity coming from the other side of the border. There'll be dragons and lines.

SARAH BALDWIN: But those were not the issues Ieva saw every day. Which brings us back to the woman we'll call Araceli, whom Ieva encountered on her first day as a medical responder. As you'll recall, Araceli was found on the US side of the border with two fractured ankles. Ieva's crew picked her up and brought her to a helicopter that whisked her to a trauma center in Tucson. This would become a disturbingly familiar type of dispatch for Ieva.

IEVA JUSIONYTE: I just analyzed the data that we got from the Mexican consulate in Tucson. And of over 100 cases of migrants who were injured in Twenty-Twenty and the first part of Twenty-Twenty-One there were about a third of them who were hospitalized because they had ankle fractures. If you count all kinds of leg fractures, it's about 50%. About 10% have spinal injuries and 15% have multi-system trauma, so they break more than one part of their body.

SARAH BALDWIN: This all, it should be clear, is a massive undercount since most people crossing the border this way will do anything not to get picked up and brought to a hospital in the US.

IEVA JUSIONYTE: These are just the numbers of the worst kinds of injuries where people just could not move from the place where they fell off the wall.

SARAH BALDWIN: And these injuries, both their frequency and their severity, have grown in the last few decades. More and more of the emergency responders' work has become about tending to these victims along the border itself. This started in the nineteen-nineties with a new strategy to try to limit undocumented immigration. It was called "prevention through deterrence."

IEVA JUSIONYTE: So prevention through deterrence was the centerpiece of the border patrol's strategic plan that was issued in Nineteen-Ninty-Four. The architects of this plan thought that, OK, there are so many people crossing the border without authorization because it is easy for them to do so. So let's make it difficult for them to do so. Let's deter them. Let's build the tall fences in border towns.

SARAH BALDWIN: And it wasn't just bigger fences.

IEVA JUSIONYTE: Let's put agents right there on the line, observing. Let's put surveillance cameras, ground sensors, use everything that we can so that crossing the border would be so difficult that people would be forced to travel through what the document said. It's called "hostile terrain."

SARAH BALDWIN: In most cases near where Ieva worked, this meant sending people into the Sonora Desert.

IEVA JUSIONYTE: It gets very hot in the summer-- more than 110, 120 degrees during the day. In the winter, during nights, especially, temperatures drop to freezing.

SARAH BALDWIN: Hostile terrain, indeed.

IEVA JUSIONYTE: Most of them have to walk for days, so they have blisters. They have severe dehydration that can lead to rhabdomyolysis, which is this very bad kidney failure-like injury. And if those people do not encounter border patrol agents, yes, they try to avoid going to the hospital. They try to-- their family members care for them.

SARAH BALDWIN: The US government hoped that thanks to this strategy--

IEVA JUSIONYTE: The word would get out and others would not come. Well, clearly, that was a failure in so many ways. People do not come to the United States without authorization just because it is easy to do so. They come here because they have more compelling reasons.

And the taller the fences, the more difficult it is for them to come here. It increases the profits of organized crime groups and smugglers that help them come across. It also increases the risks of injury and death for the people.

SARAH BALDWIN: Araceli was a victim of this strategy and also proof that it wouldn't dissuade people like her who were desperate to cross. I asked Ieva if she knew what happened to Araceli.

IEVA JUSIONYTE: I tried to follow her story. I drove-- the next day, I drove to the hospital in Tucson. But people who are admitted and who are under border patrol custody are technically arrested by border patrol as well. Therefore, public information officer couldn't tell me anything.

SARAH BALDWIN: While Ieva doesn't know what happened, it's likely that once Araceli and other people in her position are out of critical care, the border opens back up to return them to Mexico.

IEVA JUSIONYTE: Just dropped at the port of entry.

SARAH BALDWIN: There's a migrant aid center in Nogales/Sonora where Ieva spent some time volunteering trying to get a sense of what happens to people in Araceli's position.

IEVA JUSIONYTE: And that aid center, it's also like a soup kitchen. It was one of the first places they would go so they would get some breakfast and lunch. And also, I was at the medical aid station. I couldn't do much, but that's where they told me these stories about the kind of-- the falls from the wall and what kind of care they received at the hospital before they drop back off. So I never connected with Araceli, which was just one of so many people in this situation.

SARAH BALDWIN: Araceli's story highlights the disturbing duality of life on these borders. On one hand, it's a porous, dynamic, largely non-violent space for the people who live there. But at the wrong place at the wrong time, it becomes something as forbidding and binary as a massive steel wall in a desert. Maybe you could say that's the Dr. Jekyll and Mr. Hyde part of this story.

It's in many ways a reflection of our country's dueling conceptions of migration. On one hand, it's what makes us great. On the other hand, and especially recently, immigration from our southern border has been framed as a threat to America's greatness.

IEVA JUSIONYTE: Unfortunately, the US-Mexico border has become that scapegoat and also where the solutions are projected. So if we build a wall, the country will be safe, and there will be jobs for everyone, and the welfare will increase. And all of that is always a projection of fear and of threats.

SARAH BALDWIN: So much of the problem comes from the fact that decisions about the border are made by people and institutions that know nothing of life there.

IEVA JUSIONYTE: But the Department of Homeland Security always has the upper hand. And if there is a threat of drugs or terrorists coming into the country, then we clearly have to prioritize that.

SARAH BALDWIN: And those priorities lead us to higher walls and hostile territory. This affects not just emergency responders like Ieva but employers, businesses, community organizations, local governments. For example--

IEVA JUSIONYTE: Do we prioritize environmental protection? In which case, we should not be building border walls where they are obstructing the crossing of endangered species or that exacerbate floods in the area. If there was like a big chemical spill from the train or one of the factories, like what would happen if you would have to move a lot of people to one side or the other?

All those decisions to open the borders, including for firefighters who cross. Sometimes they cross in the bigger trucks or work close to the border fence on the opposite side of the border. These decisions to let them go through are federal. So local governments, local fire chiefs, local mayors can't decide for themselves. They have to call Washington, and they have to call Mexico City to sometimes resolve problems that can be dealt with so easily if they were allowed to be managed locally.

SARAH BALDWIN: The most basic human response, to rush in and help in an emergency, often gets hung up by people thousands of miles away. Thankfully, there's an emergency responder with a singular view of the situation, who's helping people see things a little more clearly. Before ending our conversation, I asked Ieva about her next project. Unsurprisingly, it's one that would not be for the faint of heart.

IEVA JUSIONYTE: "Exit Wounds" is about the role that American firearms play in violence and crime in Mexico. In a way, my previous work has to do with migrants and migrant injuries, people who are going northbound. But there is much less attention being paid to what is going southbound and what makes these people flee parts of Mexico, parts of Central America, where extortion and violent crime and recruitment to gangs make people sometimes no other option than to pack and head towards the border.

SARAH BALDWIN: While narratives in the US often frame danger as coming from Mexico into the US, so much of the danger flows in the other direction.

IEVA JUSIONYTE: The laws in Mexico are quite restrictive. People can have firearms but of very limited calibers and barely few firearms, and they have to get recommendation letters basically to get them, whereas in the US, no. And especially in Texas and Arizona, there are these gun stores that sell military-style firearms that go to Mexico. According to ATF data, over 70% of firearms that are recovered in crime scenes in Mexico have been sold in the US.

SARAH BALDWIN: It's a slight departure from Ieva's other projects in the sense that it doesn't come from an overlapping career. As an arms dealer say, she's not even an arm owner.

IEVA JUSIONYTE: I couldn't tell you the difference between a caliber 22 and a 223. I had no knowledge of guns. So to undertake this project, of course, I had to learn a lot. I took gun safety courses. I learned to shoot. I don't think this is anywhere close to what I did as a journalist, to what I did as emergency medical responder. I am not that embedded and embodied in this research both because the subject is somewhat appalling and scary to me.

Although there are some quite beautiful firearms and I came to appreciate them, it is still very difficult topic and difficult object to study. And I-- of course, as an anthropologist, as an ethnographer, you get attached to the people you work with whoever those people are even when they are gun users. But that does not necessarily translate into my love for guns.

SARAH BALDWIN: So it required a different kind of field work.

IEVA JUSIONYTE: I do spend a lot of time with various communities along this gun trafficking chain. One of them is gun owners in Mexico, so gun owners who go to shooting clubs and who go hunting, but they buy illegal weapons from the US. Sometimes they bring it themselves. Sometimes they pay smugglers to get those weapons from the US because Mexican market is not sufficient for them.

I am also working with people who have spent time in prisons in Mexico for crimes, including illegal firearm possession, and who works for organized crime groups.

SARAH BALDWIN: Like Ieva's work on the border, this research seems to be born out of a sense that important policies and laws are being made using outdated, inaccurate framing of the problems. Whether we need to be thinking more locally in the case of Nogales, or more internationally as in the case of the arms trade.

IEVA JUSIONYTE: We can't think about gun violence or issues of security just in the US and in Mexico. This is a binational issue that has to be addressed binationally by the governments talking to each other, law enforcement, criminal justice institutions cooperating but also perhaps even thinking further ahead at the level of laws. Every country can have their own laws, but it is this discrepancy of what is legal in the US and legal in Mexico that makes gun trafficking so profitable and such a big problem.

So how can we think about gun laws binationally or transnationally? As an anthropologist, you don't take anything for granted, and you don't take borders for granted as well.

SARAH BALDWIN: Ieva, thank you so much for talking to Trending Globally today. It's been fascinating.

IEVA JUSIONYTE: Sarah, it has been my pleasure. Thank you so much for having me.

SARAH BALDWIN: This episode was produced by Dan Richards and Kate Dario. Our theme music is by Henry Bloomfield. Additional music by the Blue Dot Sessions. And if you haven't already, you can subscribe to Trending Globally wherever you listen to podcasts. We'll be back in two weeks. Thanks for listening.

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