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Ref: Arizona county reaches out to immigrant population for bioterror preparedness

AZ Central

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Migrants weak link in facing bioterror



County seeks ways to reach out to them
Daniel González
The Arizona Republic
May. 19, 2007 12:00 AM
Maricopa County health officials are devising a strategy to gain the trust of illegal immigrants in the event of a
bioterrorism attack, putting them at odds with other county agencies trying to crack down on immigration violations.
A year after the county received a poor grade for its bioterrorism-preparedness plan, it is at the forefront of the issue
nationwide as communities scramble to meet federal mandates. To contain a bioterrorism attack, county health officials
would have just 48 hours to get lifesaving medicine to every man, woman and child - more than 4 million people in all -
or risk massive death.
But health officials worry that stepped-up immigration enforcement could make many illegal immigrants reluctant to go
to government-sponsored distribution centers to receive the drugs. Without treatment, the immigrants risk illness or
death, and they could spread certain diseases to others.
"They are going to rank as among the hardest-to-reach populations," said Mark Hart, the health department's special-
populations coordinator. "It is a twofold challenge: finding and informing them, and then getting them to come."
Maricopa County has received nearly $1.3 millionunder a Centers for Disease Control and Prevention program to help
cities increase their ability to deliver medicine and supplies during a large-scale public health emergency. More than
70communities nationwide have received funding.
In April 2006, the CDC gave the county a "red" rating, the lowest possible, for its bioterrorism-preparedness plan, in
part because officials hadn't addressed how they would reach the entire community.
That prompted health officials to study how to reach the Valley's diverse population, including illegal immigrants, Hart
said.
The planning has taken on greater urgency with the Feb. 3 Super Bowl XLII in Glendale just around the corner. Today,
health officials plan to conduct their first bioterrorism drill, at Cactus Shadows High School in Cave Creek. The drill will
test the county's ability to distribute antibiotics in the event of an anthrax attack.
Immigrants targeted
Since 1999, the federal government has provided money to public health departments to plan for a bioterrorism attack.
The funding skyrocketed after the Sept. 11, 2001, terrorist attacks and the anthrax-tainted letters sent to lawmakers
afterward.
So far, $5 billion has been dispersed, said Donna Knutson, a senior adviser at the CDC.
Atlanta health officials decided to target illegal immigrants because the population is so large. With about 500,000,
Arizona proportionately has the largest undocumented population of any state, according to the Pew Hispanic Center.
Migrants weak link in facing bioterror 5/24/07
The majority of illegal immigrants are believed to live in Maricopa County, the 13th-largest metropolitan area in the
country.
Public health departments around the country recognize that many residents may be hard to reach, but it's unusual to
target illegal immigrants. There are an estimated 11 million to 12 million nationwide.
In California, which has 2.5 million illegal immigrants, public health departments have created plans that would use
several languages to alert residents of an attack.
The messages would also assure residents that they could receive services regardless of immigration status and
without fear of being turned over to immigration authorities, said Jonathan Freedman, a program director at the Los
Angeles County Department of Public Health. About one-third of the county's 10 million residents are foreign-born, he
said.
Controversy expected
Maricopa County health officials want to go a step further.
To get the message out and persuade illegal immigrants to come forward in the event of an attack, health officials are
identifying people who are trusted in the community, including priests, church pastors and community leaders.
"It's going to have to be a grass-roots movement," Hart said. "The bottom line is building trust."
Health officials are concerned the plan could cause controversy.
"I think in this political climate, whenever you talk about undocumented immigrants, there is bound to be controversy,"
said Dr. Bob England, director of the county's Department of Public Health.
In 2004, Arizona voters passed Proposition 200, which requires state officials to report illegal immigrants who attempt to
apply for certain public benefits. The law exempts public health services, but it could still create confusion and fear
during an attack, England said.
What's more, the plan could be seen as putting health officials at odds with Sheriff Joe Arpaio and County Attorney
Andrew Thomas.Arpaio recently began using deputies trained as immigration agents to arrest illegal immigrants.
For more than a year, Thomas has been prosecuting illegal immigrants with felony conspiracy charges whenever they
are caught with smugglers.
At the same time, federal officials have stepped up enforcement of immigrations laws, resulting in the arrest of scores
of illegal immigrants in the Phoenix area.
But England said a bioterrorism attack should not be looked at through a law enforcement lens.
Preventing deaths and keeping people from spreading a disease like smallpox would depend on reaching everybody,
regardless of immigration status, England said.
"But there is also simple human decency," he said. "When you are talking about preventing a serious disease, why in
heaven's sake would you screen out people who are here and who may have been exposed?"

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