How Trump's US aid freeze stymied Colombia’s immigration system

Medellin, Colombia – Fraymi Loaiza’s five-year-old daughter, Samantha, was refusing to eat.

Instead, she lay in bed with a raging fever that her mother attributed to an infection she had been battling since before the family left Venezuela in December.

Now in Medellin, Colombia, Loaiza agonised over whether to take Samantha to a local hospital.

She and her family are among the 2.8 million Venezuelan migrants and refugees who have fled to Colombia in recent years, and their immigration papers have yet to be processed.

Without those documents, Loaiza and her children are not yet enrolled in Colombia’s public health insurance programme. She worries they could be turned away at the hospital or charged a fortune for care.

"I don’t know if they’ll see her or how much they would charge me to do some tests," she told Al Jazeera.

Adding to the uncertainty was a broader geopolitical upheaval: the election of United States President Donald Trump.

Upon taking office for a second term on January 20, Trump announced a freeze on the disbursement of foreign aid.

By February 3, Colombia’s government migration agency had been forced to stop processing documents for migrants and refugees, due to the staffing cuts resulting from a lack of funding.

That left families like Loaiza’s in desperate straits, and immigration workers frustrated.

Before the freeze, Adriana Llano Medina was among the volunteers coordinating migration documents and healthcare enrolment for Venezuelan migrants and refugees, through a local nonprofit called Famicove.

Samantha and her younger sister, Clarion, made it on a list of 80 children she was slated to register. When Venezuelan kids do not have health insurance, their lives are at risk, Llano Medina told Al Jazeera.

Many hospitals will not treat undocumented kids until they are in dire need, she explained. "By the time they get to the hospital, they’re already bad."

Llano Medina remembered that, on February 3, WhatsApp messages began to pour into her phone, as dozens of teachers, parents and school psychologists begged for help. But there was nothing she could do.

"Look!" she said, showing Al Jazeera her incoming chats. "My phone can’t take any more messages."

The fate of US foreign aid is currently wrapped up in legal battles. Earlier this month, the US Supreme Court ordered the Trump administration to pay an estimated $2m for work already rendered.

But what happens to the rest of the US’s commitments abroad remains unclear.

The Trump administration has promised to review all accounts and only restore those that are "fully aligned with the foreign policy of the President of the United States".

On March 10, Secretary of State Marco Rubio announced that 83 percent of all foreign aid contracts would be cut for failing to meet that criterion.

Colombia in particular has a lot to lose in the process. It is the largest recipient of US foreign assistance in South America, with funds earmarked for protecting the Amazon rainforest, ensuring regional peace and participating in the US-led "war on drugs".

From fiscal years 2018 to 2024, the US also dedicated an estimated $697m to support Colombia as it addressed a mass influx of migrants and refugees from Venezuela. More than 7.7 million Venezuelans have fled their home country, many driven by political persecution and an economic crisis that has left essential goods scarce.

But the office responsible for distributing those funds, the US Agency for International Development (USAID), has had its workforce slashed and headquarters shuttered.

The Trump administration has framed the aid freeze and the dismantling of USAID as necessary to rein in federal spending and eliminate "waste".

However, experts say it might hamper other goals, including Trump’s aim to stamp out irregular migration into the US.

According to a January report from the Congressional Research Service, aid to countries like Colombia is designed, in part, "to prevent migrants from abandoning their initial destinations and engaging in secondary migration toward the U.S. Southwest border".

In a statement to Al Jazeera, a spokesperson for the State Department added that it is nevertheless "prioritizing efforts to curb illegal [undocumented] immigration".

"Our diplomatic relationships with other countries, particularly in the Western Hemisphere, prioritize … implementing visa requirements and creating the conditions for people to stay and build a future where they are."

As she tried to manage her daughter’s illness at home, Loaiza questioned whether their stay in Colombia had improved their situation.

"It has been frustrating. Honestly, it’s not much different from what we already lived through," she said.

Loaiza and her husband had decided to leave Venezuela for a "better quality of life" — and most urgently for improved access to healthcare.

According to Loaiza, her daughter’s life depended on it. She flashed back to a night in Acarigua, Venezuela, when she feared the little girl would die. Samantha’s respiratory infection had worsened to the point where she started having asthma-like attacks.

As she struggled to breathe, Loaiza and her husband were turned away from three public health centres due to a lack of staffing and resources.

Desperate, they spent their last dollars to buy a nebuliser to administer medicine. But at midnight, just as they got the equipment set up at home, the electricity suddenly shut off, a common occurrence in Venezuela.

"We had to stay there all night, praying to God and trying to calm her down," Loaiza recounted.

But in Colombia, getting access to medical care has continued to be a challenge. Loaiza first had to enrol Samantha in school, a requirement to apply for immigration documents.

By the time they tried to register for an immigration permit in February, the staff at the migrant services office turned them away because of the funding freeze.

"Everything was on hold," she remembers being told.

Children like Samantha are the core group currently eligible for Colombia’s temporary protection permit (PPT), since eligibility for adults was restricted in 2023.

Colombia established the PPT programme in 2021 to encourage Venezuelans to seek legal immigration status.

It was hailed as a breakthrough in addressing the migration and refugee crisis: The permits are valid until 2031 and allow Venezuelans to access Colombia’s education system, employment and other services.

Andrés Moya, a professor at the Universidad de Los Andes School of Economics, has studied the benefits of the PPT.

He found that Venezuelans with regularised immigration status had higher monthly incomes, better health and higher consumer spending. And it costs the Colombian government less to support them, compared with migrants and refugees without documents.

The upside is particularly evident with children, Moya added.

"If we invest in these children, they're going to be in a better position later on in life to contribute back, to work, to create their own businesses, to increase consumption," he said.

If not, Moya warned, families are "going to either keep migrating and increasing the crisis throughout the region, or they're going to become a burden to the system".

But since USAID stopped distributing foreign assistance, the programme that processes the special permits — called the "Visibles" project — has sputtered.

Some Visibles offices reopened on February 28 with a skeleton staff. The Colombian government has had to rehire employees with its own funds.

There were originally 171 staff processing documents nationwide before the aid freeze, according to a spokesperson for Colombia's migration agency. Now, the government hopes to keep 92.

When the sites shut down around the country last month, Llano Medina said only a single person was left on the Medellín staff — a programme coordinator — to handle high-level complaints.

She credited her informal link to that coordinator with helping to save an eight-month-old child’s life. When the Venezuelan infant contracted a high fever in late February, the coordinator managed to arrange an emergency PPT so the baby could receive hospital care.

She worried other children without documents might not get the same help in an emergency.

From 2021 until the funding freeze, Llano Medina estimated that she registered at least 1,500 kids for their PPTs. She showed Al Jazeera the three notebooks and two tablets where she writes out each child’s information and stores their pictures to fill out their paperwork.

Now, she struggles to scrape together bus fare to get to the hospital for her volunteer shift.

"It’s a commitment that I make from the heart. I like contributing because, honestly, there aren’t many people who do it for free," she said.

Llano Medina pointed to Samantha as one of the lucky ones. The five-year-old’s fever eventually broke, and within days, she felt well enough to go to school.

But her mother, Loaiza, still worries about what may happen next time they face a medical emergency. She plans to restart the PPT registration process for both Samantha and Clarion once her local migration office can rehire staff.

"What gives us hope is knowing that once the process opens up, we can finally get rid of this burden," she said. "They’ll have health insurance… and we won’t be turned away."