In mid-summer, Evelia Sáenz started a 25-mile journey that she hoped would save her husband's life: it was time to cross from the United States to Mexico.
"I was quite scared, I'm not going to hide it," Sáenz told Noticias Telemundo and NBC News about her husband's delicate health situation.
Her husband had contracted COVID-19 and was having difficulty breathing, but the Texan family has little income and does not have health insurance. So the best bet was to look for medicine on the Mexican side, across the border from their home in Texas.
In the following weeks, Sáenz and her daughter also became infected; it was in Mexico where they were able to pay for a doctor's visit. The father, mother and daughter recovered, although they are still dealing with some lingering effects of the virus.
"The consultation costs $25" and the drugs "are cheaper in Mexico," Sáenz said before a medical follow-up Tamaulipas. In Texas, a doctor visit without insurance could cost up to $100, according to some estimates.
When the income is barely enough to live week to week and when there is no health insurance, going to the doctor is not an option for many families. The concern is greater during the pandemic, which has impacted the economy and has led both countries to partially close their border.
This is the reality for a large part of the population in places like Texas' Rio Grande Valley, where more than a third of residents are not insured, there are few hospitals and many suffer from diseases like diabetes and hypertension that makes people more vulnerable to getting coronavirus' effects.
"We have all, and I hate to use clichés, but we have all the parameters for a perfect storm," said Dr. Ivan Melendez, a family medicine specialist in the city of McAllen. "Poverty, diabetes, hypertension, multigenerational families...We were perfect for this, for this to spread the way it did."
In the four counties of Rio Grande Valley, more than 55,000 cases of coronavirus have been registered, according to local authorities.
Several people, like Sáenz, have found a solution: cross the border to Mexico.
Health tourism in the time of COVID-19
Medical tourism to Mexican border cities has been common for years, since treatment in the U.S. can cost more than twice than it does in Mexico and medicines can be up to 10 times more expensive in the U.S.
The organization Patients Beyond Borders, which promotes medical tourism, estimates that in medical centers in Mexico it is possible to save from 40% to 65% on a treatment compared to the U.S., and they tout the quality of medical care as usually "first class."
Between one and 2.5 million tourists make the crossing each year, according to Patients Beyond Borders and tourism authorities for the Mexican border state of Baja California.
It is both a resource for Americans and low-income valley dwellers and an important source of money for cities on the south side of the Rio Grande, such as Nuevo Progreso, Monterrey and Tijuana.
The latter is among the top three world destinations for medical tourism. Revenues there reached $1.2 billion in 2019, according to state data, which includes fees for doctors or pharmacies and also hotel lodging for patients.
The greatest demand is usually for dental services, plastic surgery, and bariatric operations (such as a bypass for weight loss).
The pandemic significantly impacted medical tourism in the first months of the year, but in recent weeks surgical interventions and hospital services that don't have to do with COVID-19 have begun to increase, according to the Baja California Medical Cluster located in Tijuana.
Medical personnel wear personal protective equipment and there are new protocols for American medical tourists.
At least 10 days before a scheduled consultation or surgery, patients must undergo a PCR-type coronavirus test, and when they arrive in Tijuana they are sometimes also given a rapid antibody test to rule out infections, according to Ricardo Vega, president of the Baja Health Cluster, who was interviewed in the newspaper El Sol de Tijuana.
"What is reviving the economy comes from health tourism," he said. "Hotels, restaurants, pharmacies, laboratories, are also being reactivated by health tourism."
Seeking help in Texas
Elvira Espino, who does not have health insurance and was infected with coronavirus shortly after her father died from the disease, told Noticias Telemundo that she normally goes to the Mexican side to buy medicines at a good price, but this time she found help on the U.S. side.
Telemundo and NBC News accompanied her to a clinic in McAllen, Texas, where free tests for COVID-19 are performed regardless of whether the person is insured or their immigration status.
“That's what we are here for, to help. One of the biggest barriers we have is that many people are intimidated by seeing so much paperwork," said Marisol Resendez, executive director of the clinic, El Milagro, which means The Miracle. "We have people who help patients navigate this entire health system."
They have plans to put mobile units in remote parts of the Rio Grande Valley to serve communities where there are no hospitals.
Meanwhile, families like the Saénz and Espinos know that a possibility to access medical help when they cannot get it in the U.S. is 25 miles away, across the U.S. border.
This report is part of the new collaboration “NBC News and Noticias Telemundo Report,” which showcases both networks' stories in English and Spanish.