Migrants crossing through Mexico and Central America are in an unprecedented state of vulnerability. From the diverse areas of work from Doctors Without Borders (MSF) – medic, mental health, social work, and health promotion – we have been able to confirm the numerous ailments that people experience when making the dangerous journey to the United States in search of a better life. Consequently, we produced the report “Violence, desperation and abandonment on the migration route”, in which we count the abuses to the health and safety of migrants caused, to a large extent, by the conditions imposed by discriminatory immigration legislation that makes the route more difficult and risky for the migrant population.
The report highlights the medical-humanitarian impact of immigration policies and practices in Central America and Mexico, addressing the devastating consequences on the physical and mental health of migrants. This underscores the increase in the migratory flow compared to previous years, the most prevalent diseases and mental health conditions noted in consultation, the violence they face along the route and the insufficient institutional response they suffer. In addition, emphasis is placed on unmet basic needs, such as shelter, food, water and sanitation, medical needs, and violations of human rights throughout the migration experience. The urgency of a timely, adequate, and safe response to address the growing health and protection needs of migrants in the region is evident.
With more than 67,000 primary and psychosocial health consultations between Honduras, Guatemala, and Mexico in 2023, at MSF we highlight the increase in the physical and mental health needs suffered by these populations. These factors are even more worrying when noting the insufficiency in access to essential services, in a context where there is an increase in the presence of entire families, and a marked 36% increase in girls and boys under five years of age served, in comparison with 2022.
In addition to this, violence has increased considerably on the different routes. We highlight the attention to cases of violence, notably sexual violence, one of the most atrocious forms of violence faced by migrants in Central America and Mexico. In 2023, we assisted 232 survivors of sexual violence, which constitutes a medical emergency that requires priority and comprehensive care. Of them, only 10% were treated within 72 hours after the event, a period that is vital for the prevention of sexually transmitted diseases and other health problems. Knowing that the figures do not fully reflect reality, and that cases are under-reported, the lack of timely medical attention is worrying. Cases of violence radically affect these especially vulnerable populations in their physical and emotional conditions. It is even more regrettable to note that many of these people flee their countries due to violence only to encounter other cases of violence and suffering on their way, encouraged by the hope of a better future.
These factors, in addition to physical and emotional fatigue, show the negative impact of the migratory experience on the mental health of migrants. Of the almost 3,800 mental health services in Honduras, Guatemala and Mexico, 48% have had acute stress as the main diagnosis, followed by cases of depression (12%), anxiety (11%), post-traumatic stress disorder (8%), among others. The stress of facing the route in an irregular situation and the conditions in which they find themselves in these contexts contribute to exposure, often prolonged, to high levels of stress. In more than half of the initial mental health consultations, violence has appeared as the main category of precipitating factor of emotional affectation, followed by the separation or loss of a family member (32%) and some medical condition ( 7%).
In terms of physical health, the report emphasizes the respiratory and gastrointestinal diseases that affect migrants throughout their journeys, but especially in Honduras and Guatemala. Then, it details with concern the gaps in care for chronic diseases, which need continuity in their treatment, as well as follow-up to avoid a deterioration in the condition, decompensation, and death. Migrants with these conditions usually seek more care in Mexican territory, particularly in cities bordering the United States. Along these lines, there have been three times more consultations for hypertension and two times more consultations for diabetes in Mexico than in Honduras and Guatemala.
Finally, at MSF we make urgent calls to improve the medical-humanitarian response in the region with the aim of addressing the growing health and protection needs. MSF calls for better security management, the guarantee of access without discrimination, racism and xenophobia to essential services for migrants, in addition to eradicating impunity in cases of violence, sexual violence and human trafficking against them.
