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20 Jun 18 21 Jun 18

World Refugee Day: Mexico not safe for thousands of migrants fleeing violence in Central America

Migrants and refugees fleeing danger in Central America are trapped and exposed to more violence in Mexico due to ever tighter and more callous US border control policies, said Médecins Sans Frontières/Doctors Without Borders (MSF) today on World Refugee Day.

The violence in Honduras, Guatemala and El Salvador continues to force thousands of people to head north in search of refuge, even as the Trump administration imposes cruel practices intended to deter them from seeking asylum. Last week, US Attorney General Jeff Sessions ruled that people submitting claims related to domestic violence or gang violence will not qualify for asylum—a decision that effectively closes the door to many Central Americans fleeing for their lives. In recent weeks, authorities have stepped up criminal prosecutions of people attempting to cross the border, going so far as to forcibly separate children from their families.

Mexico is effectively becoming a final destination for thousands of vulnerable refugees and migrants, left exposed to further violence by criminal gangs who prey on them.

"We are seeing a population that is increasingly trapped in Mexico. They can't return to the countries they escaped from for fear of violence. And now they can't find safety in the US as the administration punishes those who try to cross the border with increasingly harsh and cruel measures,” says Marc Bosch, MSF's Operations Manager for Latin America. “We are alarmed by the terrible policy of separating children from their parents. This will be compounded by the recent US decision not to accept gang violence or sexual violence as the basis for asylum claims,” adds Bosch.

Initial talks between the US and Mexican governments in May considered the possibility of converting Mexico into a “safe third country”. This would force asylum seekers to apply in Mexico, preventing them from reaching the US to demand refuge.

Mexico is not a safe country for people fleeing violence in the Northern Triangle of Central America (NTCA)

More than 20,000 migrants or refugees are kidnapped in NTCA every year, according official sources (CNDH). Sixty-eight percent of the migrants and refugees interviewed by MSF in places along the transit route in Mexico had been exposed to violence. Nearly one-third of the women surveyed were sexually abused. Central American gangs are operating in the south of Mexico and are responsible of some of the attacks against migrants.

MSF medical data shows that one-fourth of our medical consultations for migrants and refugees in Mexico are related to injuries from intentional violence. Ninety percent of our mental health consultations are related to violence. Our patients are suffering from anxiety, depression, and post-traumatic stress disorder (PTSD), among other conditions, which have severe consequences on their ability to function. Women, children, and members of the Lesbian-Gay-Bisexual-Transgender-Queer (LGBTQ) community are more vulnerable to certain types of violence and require specific protection measures that are not effectively in place in Mexico.

US and Mexico must meet its responsibilities towards populations fleeing violence

According to official figures from the United Nations Refugee Agency, 108,500 people from the NTCA applied for asylum in the US in 2017, while only 8,700 chose to carry out this process in Mexico. Staying in Mexico is not a viable alternative for many people who fear the violence of criminal organizations there. The deadlock is particularly brutal for minors, whether traveling alone or accompanied.

"Mexico should be able to guarantee protection, healthcare and safe passage to migrants and refugees. The US also needs to fulfil its international responsibilities and recognize the status of asylum-seekers and refugees. The US continues to have an essential role play in addressing this humanitarian crisis,” says Bosch.

In 2017, the scale of the crisis led MSF to publish a report: Forced to flee the Northern Triangle of Central America: A forgotten humanitarian crisis. The situation is now getting worse, causing greater suffering to a population that has been subjected to tremendous violence in their countries of origin and in their transit through Mexico. Now they must also endure an unprecedented level of institutional violence from the US, where they are not only prevented from claiming the protection they need but facing additional threats. People seeking safety, and their children, are being detained under inhumane conditions and face the risk of deportation, in violation of the principle of non-refoulement.

MSF provides medical and mental health care to migrants and refugees from Honduras, Guatemala and El Salvador moving along the transit routes through Mexico. We work in migrant shelters and mobile clinics along the railway lines and in three locations on the migrant routes (in Tenosique, Coatzacoalcos and Reynosa). We also run a comprehensive care centre for victims of extreme violence in Mexico City. This centre opened in 2016 in response to the medical and humanitarian needs of people in transit.

Voice from the field: “It’s challenging for the team to listen to so many violent stories told by migrants and refugees in Mexico”

Madeleine Walder has been the field coordinator for MSF projects with migrants and refugees in Mexico for the last nine months.

Why are so many Central Americans fleeing their countries?

Forced recruitment by criminal gangs (usually of teenage boys), direct threats against their family or themselves, family members killed, family members tortured, attacked or abused, extortion by criminal gangs, death threats, threat of sexual violence against young women by gangs (who select young women to be their ´girlfriends’, essentially a sexual slave for the gang members), domestic violence…They are also looking for economic opportunities as there is no work in their country. In some cases, extortion has reached such a level that they cannot survive on the profits of their business. Some people are looking for missing family members who have already travelled north.

What do they face when they travel through Mexico? What dangers do they face?

Mainly they are very vulnerable to physical violence by criminal gangs, petty criminals and authorities. Sexual abuse and violations are, unfortunately, also routinely reported (both for male and female migrants.  Gang rape is also reported)

Some of them describe being kidnapped.  During these kidnappings migrants are usually tortured, beaten, sexually abused, raped or forced to work, while their kidnappers extort their families for money. Extortion by criminal gangs, authorities and petty criminals—who charge money to allow migrants to  board and de-board trains and cross unofficial checkpoints—are also quite normal.

When they come to us for medical assistance, they usually have symptoms of hunger, dehydration, skin infections, fatigue, acute stress, anxiety and depression due to difficult conditions faced during the journey). We have also treated injuries sustained from travelling on top of the train (damage to body parts while boarding or getting off; some migrants fall off the train and some have lost limbs in the process) and, of course, injuries from violent incidents.

What humanitarian aid is MSF providing to migrants and refugees?

MSF provides comprehensive primary level care to migrants at two shelters in the South of Mexico (Tenosique and Coatzacoalcos, with psychologists, a doctor and social worker. We provide mental health care, medical care (primary level attention) and social support (guidance, information on the migrant route and legal rights, referrals to second and third level medical and mental health service providers). We also provide medical and psychosocial services in Reynosa, located in the extreme north of the country for migrants and refugees, as well as for those who have recently been deported from the US.

What would be the profile of migrants and refugees?

The large majority of migrants that we see in migrant shelters are males between 15 and 40, the majority are from Honduras, followed by El Salvador and Guatemala. Recently, though, we have seen a noticeable increase of about 20% in women, children, unaccompanied minors and complete families.

What is the reason for this situation? What other things have changed in relation to your arrival at the project and now that you are leaving?

When I arrived, last September, the migrant flow was quite low but since the end of 2017, the migrant flow has steadily increased, almost doubling in the first quarter of 2018 compared to the last quarter of 2017. This is likely due to the continued need for migrants to flee their countries due to high levels of violence.

What challenges does MSF staff encounter in providing this care?

Challenges include access to persons migrating: it is estimated that only 20% of migrants pass through migrant shelters, and as such many people are travelling but not accessing MSF services. The types of cases we see are challenging in terms of stress and emotion: the team listens to stories that can be quite upsetting regarding the violence lived by the migrant. The Mexican context is very unique for MSF because the population is constantly moving, making it a challenging target population to work with, and challenging to measure impact.  

Since 2012 MSF has been providing medical care and mental health care in Mexico to migrants and refugees from Honduras, Guatemala and El Salvador moving along the migratory route through Mexico. MSF has adapted its intervention strategy as the crisis has progressed and changed; from the work carried out in migrant shelters and mobile clinics along the railway lines, to the work established in several locations on the migrants' route (in Tenosique, Coatzacoalcos and Reynosa), as well as a Comprehensive Care Center for victims of extreme violence in Mexico City. This center opened in 2016 as the latest strategy to respond to the medical and humanitarian needs of people in transit.

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