Fall 2018: Desperate journey

Fleeing invisible wars in Central America

HONDURAS 2018 © Dominic Bracco

Alert is a quarterly magazine published by Doctors Without Borders/Médecins Sans Frontières (MSF-USA) that features compelling stories and photography from our work in the field. Below is an excerpt from MSF-USA Board President John P. Lawrence's introduction to the Fall 2018 issue (Vol 19. No. 3)

How we treat migrants and refugees making the journey from Central America to the United States has become a focus of public attention in this country and abroad.

Our attention to this issue has been sharpened following the recent introduction of “zero tolerance” policies by the US administration intended to curb migration, including through the accelerated detention of migrant populations, the separation of children from their families, and the return of asylum seekers to their home countries without due legal process. The decision earlier this year by the US Attorney General to eliminate domestic abuse and gang violence as legal grounds for asylum will further endanger thousands of people facing serious threats.

While the legal and policy debates around these topics are nuanced, the medical issues are clear-cut. We provide medical care to those who need it most, regardless of their nationality or official legal status.

This issue of Alert highlights the work of our teams at Doctors Without Borders/Médecins Sans Frontières (MSF) to provide urgent medical aid to people on the move through Central America and Mexico. Many people fleeing Honduras, Guatemala, and El Salvador have been victims of both physical and psychological abuse in their native lands. They endure levels of violence comparable to what MSF teams see in the world’s worst conflict zones. They need comprehensive medical care, including supportive psychological counseling—not family separation and detention.  


Humanitarian crisis in Central America

For Central Americans forced from their homes, a history of trauma is often compounded by a pattern of continuing violence and injustice on the paths taken northward. Victimization of migrants is common—including robbery, sexual assault, and torture at the hands of smugglers, and even abuses by government officials responsible for protecting people from harm. Access to basic medical services such as prenatal care, treatment of pediatric illnesses, or management of chronic diseases is rarely available.

In this issue, we look at the work of MSF teams along the migration route, from Honduras to Mexico, and hear the stories of individuals who are making the difficult journey north. While we take pride in describing the medical services we offer, we also recognize how important it is to create more space for the voices of the patients we serve. This is an essential aspect of our commitment to bear witness and speak out about the suffering we see. Gathering first-hand testimonies from individuals at risk not only helps the public to better understand their plight, but also allows patients to provide input on what their specific medical needs are, and how well MSF may have succeeded in addressing those needs.

In this issue, we also explore the role of MSF’s advocacy efforts related to the humanitarian crisis along the corridor from Central America to the US southern border. Advocacy is ingrained in MSF’s culture. We try to influence governments and persuade the public to better address the root causes of people’s suffering. 

This year marks the third and final year of “Forced from Home,” MSF-USA’s traveling interactive exhibition raising awareness among American audiences about the medical challenges facing displaced people around the world. Led by experienced aid workers, the tours bring visitors just a little closer to the very real struggles of people fleeing violence and extreme hardship worldwide. The fall tour runs from September 9–November 11 with stops in Minneapolis, Chicago, Charlotte, Atlanta, and San Antonio. We hope to see many of you along the way. 

Finally, while this issue of Alert focuses primarily on the situation in Central America, we must remember that the displacement crisis is global. Some 68.5 million people have been driven from their homes in Syria, Afghanistan, Myanmar, Democratic Republic of Congo, and South Sudan, among many other locations where MSF works. While people crossing borders tend to receive more attention, for every single refugee who manages to escape extreme danger there are two more individuals who remain internally displaced in their home countries—often trapped in precarious circumstances.


Map: Responding to the global refugee crisis

MSF strives to meet the medical needs of those who have been uprooted, no matter the cause. Throughout our work, we respect the dignity of the people we serve, and try to strengthen their resilience. Thank you for supporting these vitally important efforts.

John P. Lawrence, MD
President, MSF-USA Board of Directors

Desperate journey
   Introduction: Fleeing invisible wars in Central America
   Part 1: Cycles of violence in Honduras
   Part 2: Tending deep wounds in Mexico

♦ Speaking out
   Pushing for action on the neglected humanitarian crisis in Central America

Map: Responding to the global refugee crisis
   A look at our projects around the globe that provide care for people on the move