HOME SICK: Chronic illness and longing define life in the Tijuana River valley

It swoops in late at night. It comes in like a hand. Even when the windows are closed, it creeps in.

“It comes in like a hand, and then it just settles in your house. … You’re woken out of sleep. You can’t go back to sleep. You’re gagging in your bed.”

Kelley Wojcik, Nestor resident

“It’s like a big monster comes inside your house, and it’s smelling like that and it catches you. Can I breathe?! Help me! Help!”

Ana McGrath, Wojcik’s friend and neighbor

The monster

Friends and neighbors for years, McGrath and Wojcik live off of Saturn Boulevard, not far from where the South Bay’s urban grid gives way to the sprawling Tijuana River estuary along the U.S. Mexico border. Rich in biodiversity, the estuary is home to hundreds of migratory bird species and endangered plant and animal life. 

It’s also the site of a worsening environmental crisis marked by billions of gallons of wastewater that have spilled annually over the international border in recent years, the byproduct of Tijuana’s urban and industrial growth fueled in part by U.S. trade policies.

When storms sweep the region, massive downpours collide with poor or aging wastewater infrastructure, causing sewage overflows and dragging the waste and urban runoff through Tijuana communities to the border. 

Once they cross into the estuary on the U.S. side, the pollutants sink into the river bed, float out to sea where they sweep the coast, or churn and froth into airborne particles that blow across South Bay communities.

Foul smelling gases emanate from the river and sweep across homes, seeping through cracks in doors and windows.

inewsource spent months talking to more than 100 people living and working near the Tijuana River. Many say this place — their longtime home — is making them sick. They say it enters their bodies through their pores and lungs — they can feel its mark, even if they can’t prove it.

Some say they’ve endured chronic illness for years.

Despite widespread awareness of the enduring pollution threat — from the White House to the halls of Congress to local government chambers — no comprehensive data exist on the long-term effects of exposure to the toxic gases and other airborne contaminants from these polluted flows. And until recently, when officials launched surveys and scientists raced to study the air and water, South Bay residents have been largely on their own in trying to decipher the source of their illnesses. 

Scientists and local leaders have offered air filters and advice to shelter indoors while they advocate for broader solutions.

The granddaughter of a rancher, Wojcik grew up in Nestor not far from where she now lives. She remembers the smell from as far back as her childhood, which she spent crisscrossing the river valley. All her life she’s had asthma, eczema, allergies, chronic infections and sinusitis. 

Wojcik has been keeping notes on her symptoms. In the last few years they’ve gotten worse: She developed lymphocytic colitis, or chronic diarrhea.

She says doctors have had a hard time explaining her illnesses.

“But now that I’ve started talking about the sewer to them, they’re like, this could be what we’ve been looking for this whole time,” she said. “My body does not tolerate itself anymore because … all the toxins just ruined me.”

McGrath and her husband bought a place in Nestor in 2011. About two weeks in, they were on a walk near the river when she suddenly couldn’t breathe. She started to cry desperately. Her doctor guessed she had an asthma attack, but tests came back negative. Similar episodes followed from time to time, she said, noting her lungs have gotten weaker and weaker.

Then things got worse, she said – she got pneumonia, she got tuberculosis, infections that affect the lungs.  

“I never got sick in my life,” McGrath said, adding that she wouldn’t have moved there had they known about the pollution. “Now I had everything.”

Wojcik and McGrath are not unique. And neither are their symptoms, inewsource learned from dozens of South Bay residents. Stories of chronic illness, like threads, weave their lives together.  

They wheeze, cough or can’t breathe. They get sinus infections, chronic headaches even in children. Diarrhea, nausea. They can’t sleep. Their eyes tear up and burn. Their skin erupts in infection. 

They’re tired, mentally foggy, depressed. 

For some, the symptoms are more life-threatening, as was the case for Skip Crane, a U.S. Navy and Vietnam War-era veteran. Crane frequently kayaked in the ocean off Imperial Beach until he contracted a bacterial infection that transferred to his blood stream and turned into sepsis.

And Paula Granados, a San Diego State University researcher who was hospitalized after collecting water samples in the river to test them for pathogens. She lost a kidney before her health improved.

It isn’t just humans getting sick. Their pets suffer chronic, inexplicable ailments, too, they say. 

And when residents leave the area for a prolonged period, they say their symptoms go away — more evidence that confirms their suspicions. 

Doctors at local clinics concur. They say they saw patterns and increasing symptoms among their patients as sewage overflows were occurring.  Last year alone, as sewage overflows peaked, odor nuisance complaints to the county air pollution board topped 2,000.

But their observations — and their patients’ suspicions — came up against a conflicting narrative, pushed by county health and elected officials, that breathing the sewage gas, though stinky, wasn’t dangerous. 

Last year in September, after sewage overflows and outcry over the smell drove scientists to test hotspots along the river, San Diego County health officials dismissed scientists’ warnings about high levels of hydrogen sulfide in the air.

“It smells horrible, but it’s safe,” said Nora Vargas, then the chair of the county Board of Supervisors, citing the county’s own data gathered by its Hazard Incident Response Team. 

The researchers say county leaders couldn’t know that — because they weren’t measuring at the right times. And the impacts of chronic exposure to the gases over prolonged periods of time aren’t known.

In a rush to study the extent of the pollution, researchers from local universities say they’ve measured hydrogen sulfide, the common sewage gas produced from the breaking down of organic matter, at alarmingly high levels capable of causing many of the residents’ symptoms.

The levels were higher than state nuisance thresholds. At even higher concentrations, such as what a sewage treatment worker might encounter, the gas can cause death. 

But also alarming, researchers say, they’re finding evidence the airborne stench carried other threats as well: chemicals, viruses and other harmful toxins, including traces of methamphetamine and a chemical known to damage DNA.

In the absence of consensus, doctors and scientists have pushed for additional investigation and say more coordinated health care surveillance is needed to address the health impacts they are tracking.

Meanwhile, officials have distributed air filters to community members. But a pair of doctors in Imperial Beach say much more could be done to prevent exposure, such as an early warning system notifying residents when sewage has overflowed could help residents stay out of harm’s way.

Other proposed solutions have focused on infrastructure upgrades aimed at preventing or limiting the sewage overflows. 

They’ve come in part from President Donald Trump’s administration, blaming Mexico and pledging to speed up repairs on the South Bay International Wastewater Treatment Plant on the U.S. side. Upgrades are underway thanks to $650 million in federal funding approved under former President Joe Biden’s administration. But that expansion alone would not meet the demand from Tijuana’s future growth. 

Most recently the Trump administration signed a new agreement under which Mexico committed to determine the possibility of expanding its wastewater treatment facilities to account for its population growth, as well as other projects.

Local officials, including San Diego County leaders, also have rallied to add pressure this year. Supervisor Paloma Aguirre, former Imperial Beach mayor, has pushed the county to fund a study on the long-term health impacts of hydrogen sulfide exposure. Officials are also advocating for a long-term funding solution for wastewater infrastructure building and repairs.

Meanwhile, lawyers have upped the ante. Their firms are looking for residents to join lawsuits accusing the operator of mismanaging the plant and harming public health and property.

The company has blamed “unchecked flows of debris” coming from Mexico and a lack of government funding to maintain and increase the facility’s capacity.

Airborne

Residents living near the river told scientist Ben Rico where to go. 

As he and a fellow Scripps Institution of Oceanography researcher drove their car along Saturn Boulevard to where it crosses the river, they opened their windows.

“We were just hit by the most foul smell I’ve ever experienced in my life. It was hard to breathe,” Rico said.

They set up a sensor nearby in the area, now widely known as the Saturn Boulevard hotspot, whose foamy churn is visible even in a Google satellite image. Soon they began to trace levels of hydrogen sulfide that exponentially surpassed state nuisance thresholds.

They also confirmed what residents described: The numbers were spiking in the night.

Rico climbed to the top of the monitor, wearing his respirator — a wardrobe staple since he began leading a team of researchers studying the levels of toxic gases in the river valley’s air. Something caught his attention.

“I turn around and look north. Just across the street is Berry Elementary, and there are just a handful of kids playing soccer, running around, laughing, having a good time, smiling — like nothing was going on,” he said. “It was really hard to see. It was heartbreaking to see that this is just normal for them. This is every day.”

It was 7:24 a.m. on Sept. 5, 2024. His meter registered 1,268 parts per billion of hydrogen sulfide. The state nuisance threshold is 30 ppb, which can already cause symptoms.

Rico said the elevated levels were concerning because of the potential risks the children faced in being exposed to the hydrogen sulfide gas everyday.

 “Hidden in these numbers are the lived experiences of those being exposed on a daily basis.”

Berry Principal Joseph Prosapio said that on “smell days” the school follows  a rainy day schedule, keeping kids indoors. The district and the county outfitted the school with specialized air filters. Prosapio said that for some students who don’t have filters at home, school might even be a safer option.

As transboundary sewage spills peaked, Rico and his team of scientists spent months carrying out a study of pollutants throughout the river valley. They tracked the spike in community odor complaint data and compared them to when they saw spikes in their hydrogen sulfide numbers. The correlation was striking, nearly perfect, Rico said.

The study validated the community members’ complaints and proved that the sewage deep in the river valley near residential neighborhoods was seeping into the air at significant levels, not just floating to sea in the water.

Rico’s results came out just months after a previous Scripps study that showed how industrial chemicals in coastal waters are aerosolized when water churns, such as in the spray caused by ocean waves crashing, contaminating the air people breathe.

According to the two studies, the threat to public health was more widespread than scientists previously understood.

San Diego Coastkeeper, an environmental advocacy group, identified other concerning substances in the river: heavy metals such as arsenic and lead, toxic industrial solvents such as toluene and acetone, as well as cyanide.

“We shouldn’t detect those in the river at all,” said Phillip Musegaas, Coastkeeper’s executive director. “So the fact that we’re finding a whole menu of them, a whole panoply of these toxic contaminants, is a huge concern.”

None of the treatment plants in the region are able to remove industrial chemicals from the water, he noted. 

The experiment

Advocates and doctors are calling on officials to expand monitoring of chronic health impacts on the communities they say are a living experiment in the wake of a decadeslong pollution crisis.

Meanwhile, the lack of data on long-term exposure to wastewater pollutants has mobilized doctors and scientists to gather their own. 

Dr. Vi Nguyen, a South Bay pediatrician, says she’s traced an uptick of kids coming in with respiratory issues, including multilobar pneumonias, severe lung infections uncommon in the summer. Imperial Beach and neighboring communities experience among the highest levels of asthma-related emergency room visits in the county.

Nyugen, along with more than two dozen other doctors and medical professionals, signed a letter raising concerns about health impacts of the pollution.

Doctors Kimberly and Matthew Dickson, who run South Bay Urgent Care, a small clinic in Imperial Beach, started tracking the issue on their own.

“We saw that there was a relationship. Every time there was increased flow of sewage, we could see increased flow or increased diarrhea patients,” said Kimberly Dickson. “That was kind of our ‘Aha’ moment where we went, something’s going on, we think the illness is related to the sewage.”

“That’s when we reached out to the health department and alerted them to our concerns.”

At his home near the estuary, Crane, the Vietnam veteran, carefully lowered himself into a chair at a dining table.

“At one point, there was the thought that they may have to take my left leg,” he said. “It was completely discolored from my toes all the way up to my thighs.”

Crane said he spent 60 years in South Bay waters, including playing with his kids at the beach and kayaking. Then he contracted cellulitis, a bacterial infection that began when a small cut on his neck got infected while he was out in the water. The infection spread and turned into sepsis.

His health recovered and doctors were able to save his leg, but still today — a decade later — his leg movement is impaired.

He and his wife Carol Crane have lived near the estuary for decades. But the pollution has put a damper on their quality of life. 

“We’re here to enjoy our ocean breeze, our million dollar view. So that’s a little bit on the sad side,” she said. 

Some residents reported experiencing a domino effect of health issues after moving near the river.

After decades in Germany and some years in downtown San Diego, Tony Magee moved to a flat with a balcony overlooking the estuary during the pandemic. He loves watching the birds flying over the river. “Everything is alive,” he said. “Who needs television?” 

He called his new home a “majestic opportunity that’s being devastated through this pollution that we’re consuming.”

Soon his health started to deteriorate. While some of his symptoms may be related to a recent benign tumor for which he had surgery, other symptoms predated the ailment and continue to wear away at him. Gastrointestinal issues, trouble breathing, eating, constant fatigue and skin irritation.

“Sometimes you can smell it in your skin,” Magee said, referring to the sulfur smell of sewage gases. “It’s like a part of you.”

He now has a stack of prescriptions to manage all of his conditions.

Many South Bay residents inewsource interviewed said they welcome more research to connect how they’re feeling to the air and water, which could convince people in power to see their plight as a public health emergency.

But they’re also confounded by why their complaints alone haven’t been sufficient to inspire lasting solutions. After all, generations of communities in the river valley have watched the sewage problem escalate.

Since 2018, transboundary flows have been unprecedentedly worse. Failures at the treatment plants on both sides of the border combined with intense rainstorms have led to a record 100 billion gallons of untreated wastewater spilling into the river.

The sewage spills also occur at other times, when aging infrastructure breaks down or as construction takes place in Tijuana. Now the once seasonal river flows throughout the year.

Rapid growth in the Tijuana River Valley is driving the environmental and public health threats. 

In the last 100 years, the region’s population has grown from 1,000 to nearly 2.2 million, supporting $80 billion in cross-border commerce annually, according to some estimates.

Economic policies such as the North American Free Trade Agreement, or NAFTA, have reshaped the U.S.-Mexico borderlands, generating billions of dollars of revenue that have benefited the U.S. economy and transformed the labor market in Mexico. Just south of the border in Tijuana, factories known as maquiladoras have cropped up to feed consumer demands for goods.

At its simplest, the sewage crisis is a math problem. 

Tijuana produces roughly 70 million gallons of wastewater each day. Treatment plants on both sides of the border combined are able to process about two-thirds of that amount — when the infrastructure is working. Meanwhile Tijuana continues to grow. Estimates predict the city will produce over 40% more wastewater by 2050. 

South Bay residents have grown accustomed, albeit indignant, to contaminated waters in their community. The beaches of the Tijuana Slough, an area near the mouth of the river, have now been closed for nearly all of the last 1,400 days.

Like many people, Andrew Cobarrubia, a Chula Vista resident, has been fishing off the Imperial Beach Pier since he was 12 years old. But he doesn’t eat his catch anymore.

“The fish are contaminated … so we just throw them back.”

Dollars and sense

Scientists are trying to understand the scope of the contamination so they can evaluate what the health impacts could be. Both goals seem more urgent to define than ever.

“Our community has been saying it for years, and they were ignored,” Kimberly Dickson said.

The county’s water quality test results usually arrive late, after residents have been exposed, Matthew Dickson said, adding that a warning system that notifies residents immediately when a transboundary spill has occurred could give them a chance to reduce their exposure.

A couple years ago, the Dicksons got sick from E. coli after walking their dog on the beach in Coronado. When they arrived, there were no signs up warning of any contamination, Matthew Dickson said. But the next day when they were sick, they saw the tests results online and the warning had gone up.

The couple has also begun working with the U.S. Navy on more precise testing to understand what contaminants specifically are causing illness. They are now testing for what organisms are present in patients’ fecal matter, the Dicksons said.

Some researchers have themselves fallen ill trying to gather data.

SDSU public health researcher Paula Stigler Granados spent months in the river running tests, clad in protective clothing and a respirator. Several of her students were getting sick with gastrointestinal and respiratory illnesses, rashes and headaches, and more, she said. Then she came down with an antibiotic resistant E. coli, which is something that she had been finding in her tests. It seemed she had recovered, but she fell ill again.

“It was wild how sick I got so fast,” Granados said. “I ended up again with this infection that went to my kidneys, and I was in the hospital. Within five days after I started to get symptoms, I was in full blown sepsis, and I had to spend a week in the hospital.” 

She lost a kidney. She says she can’t say for sure that the river contamination led to her infection, but it seems likely: 

“Was it the river? Was it not the river? I haven’t been sick like that ever. … There’s no reason why I would have any sort of antibiotic resistant infection in my body.” 

Decades of advocacy have yielded promises from the federal government, which owns the international wastewater treatment plant just north of the border, to do something to address the sewage crisis. But the pollution has long outpaced infrastructure solutions.

In early December, activists gathered in Imperial Beach to ask the California Coastal Commission to demand that the Trump administration create permanent funding structures not only for the buildout of wastewater infrastructure, but for its future upkeep.

Other solutions that have been floated include diverting the river so that more of the water can be treated. 

But those proposals are on wish lists — not anywhere close to being realized. Some have been on the table for a long time.

While they wait, some South Bay residents have found a new ally in the attorneys and law firms building personal injury cases against the federal government and Veolia, the international company running the wastewater treatment plant on the border.

Attorney Jim Frantz says that he has close to 2,000 clients they’re working with in the case. His firm has been calculating the financial damages for loss in property value as well as for health damages it has yet to calculate. He says that for one person with serious, permanent health issues, damages could run in the millions of dollars.

“There has to be some real teeth on the accountability side of things,” Frantz said.

For many of the residents inewsource interviewed, money is beside the issue. Some told inewsource that if it would help solve the problem, they would put that money back toward a solution.

“The only thing that brings us together is the attorney, and that’s for monetary value,” said Magee, who joined the Frantz lawsuit.

Magee said he wants to see the end of the pollution causing residents’ health concerns.

“The best medicine is preventive medicine, and what they’re waiting on is this devastation to happen — that doesn’t make dollars nor sense.”