Humanitarian groups say thousands of Central American families waiting in Mexico for US asylum hearings face unstable living conditions at best and life-threatening ones at worst.
This week Doctors Without Borders issued a report that said criminal groups in Mexico repeatedly target those waiting for kidnapping and extortion.
In October, three-quarters of its patients in Nuevo Laredo, Mexico across the border from Laredo, Texas reported that they'd been kidnapped recently.
"They are at the mercy of human trafficking networks and criminal organizations," said spokesman Sergio Martin. "This all has serious consequences for their physical and mental health."
Grand Rapids, Michigan-based Bethany Christian Services recently sent a team to evaluate conditions for children and families waiting in Ciudad Juarez, across the border from El Paso. Kristi Gleason, vice president of global programs, said there are not enough resources for these immigrants.
"The conditions there are dire. Families are needing food and water and heaters. It was really, really cold when we were there," said Gleason.
It's why some families have begun to send their children alone across the border, so they won't have to wait in Mexico.
On Tuesday the acting commissioner of the US Customs and Border Protection, Mark Morgan, challenged the findings about kidnappings from the Doctors Without Border report. "That's not what we're hearing and that's not what we're seeing," he said.
Morgan said the US is working with the Mexican government to encourage waiting families to find shelters instead of the makeshift tent cities that have popped up along the border points where the US is returning asylum seekers.
It's also pressuring Guatemala, El Salvador, and Honduras to step up efforts to deter their people from migrating north.
The US began the practice of returning waiting families to Mexico last year in response to a new Trump administration policy known widely as "Remain in Mexico."
Bethany is urging the administration to rescind the policy.
For now, Gleason said Bethany will support teachers living in the shelters that want to help provide educational programs to children. It's also providing trauma training to social workers there.
And, Bethany is considering replicating a program already in place in Colombia that serves Venezuelan refugee families. It provides basic services to meet immediate needs.
"We serve children and families coming across with things like water and food and a safe place to rest - some education opportunities and learning opportunities for kids but also a lot of mental health and psychosocial support," said Gleason.
Gleason said it's difficult to plan for 2020, not knowing how long immigrant families will need to continue to wait for their court dates and how many more will arrive.
"We're seeing a lot of families not win their asylum cases. So they're waiting in limbo for either another court date or an appeal or to decide what do next," she said.