Extracontinental migration through Latin America is not a new phenomenon, but it is becoming increasingly common. The echoes of hunger, armed conflicts, violence, and disease from all corners of the world are felt more strongly in migrant camps throughout the continent. While Europe's restrictive policies lead to deaths in the Mediterranean—where over 30,000 people have drowned or disappeared in the past 10 years—torture persists in North Africa, and illegal detentions occur at international borders. As a result, people have been forced to seek new routes to seek safety, which are more dangerous and much longer.
In response, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are providing primary health care, mental health support, social services, health promotion, and intercultural mediation along the migration route through Latin America.
Mbala’s* journey, like that of thousands of people from Africa or Asia, was triggered by violence—a factor that follows migrants nearly everywhere they go. Along the 7,900 miles separating his home country, Democratic Republic of Congo (DRC), from Mexico, he has encountered people willing to use violence in all its forms to exploit the most vulnerable.
"I didn’t want to leave," he says, "but I had no choice after they killed my father. The persecution, the fear—it was unbearable." Mbala’s father, who was a political advisor to another relative, lost a local election last year and was murdered in front of him. As a politically persecuted person, Mbala knew—even while still grieving—that a peaceful future in his country was impossible.
"I thought about going to France, but I don’t know how to swim and was terrified of drowning in the [Mediterranean] Sea," he explains. "I had no choice but to escape to the United States." The decision that would change his and his family’s life was made in 2016, but they did not reach the Americas until 2023.
In Mexico, the number of extracontinental migrants from Africa or Asia encountering authorities irregularly has skyrocketed. While there were 17,044 cases in 2022, this figure jumped to 92,163 in 2023 and 88,956 in 2024, according to Mexico’s Migration Policy Unit. This marks a 440 percent increase from 2022 to 2023, followed by a 3.4 percent decrease in 2024, indicating that extracontinental migration is now a significant demographic factor along the migration route. But the journey takes extracontinental migrants years to complete, whereas it takes Latin American migrants only months.
On Foot: Traversing the Most Perilous Route to Reach Safety
A comic written and illustrated by Hugo Gonzalez for Doctors Without Borders.
Unique barriers for extracontinental migrants
Israel Reséndiz, coordinator of mobile medical activities for MSF in Mexico City, explains that language barriers, the long journey, and discrimination make the extracontinental migration route uniquely challenging.
"Accessing this population is one of the biggest challenges, but not the only one," Reséndiz says. "In previous months or years, even though people from Asia or Africa were crossing through Mexico City, they were rarely seen, using routes that were difficult for us to reach. Now, more and more groups of 20 or 30 people are appearing—coming from Bangladesh, Mauritania, DRC, or Afghanistan, for example. And once we find them, mediation and translation are not always straightforward."
The fear of seeking any form of assistance—after experiencing systematic discrimination and violence—keeps many from accessing available services. "Even if they haven’t experienced direct violence, we can still talk about post-traumatic stress because the journey itself is traumatic," says Reséndiz, who is also a psychologist. "Now, if you add the conditions they are fleeing from—not just for extracontinental migrants, but for all those we assist—of whom 69 percent report experiencing some form of violence—the consequences can be severe."
"This is the worst thing I’ve ever done in my life"
At one corner of the camp, next to a playground where children chase each other, speaking the universal language of childhood—play—Djanina and her husband Paul wash clothes, exhausted.
"I’m from the Congo [DRC], and she’s from Angola," Paul says. "We met after I fled the war, but Congolese people are treated very badly in Angola, so her family never approved of our marriage." Death threats, beatings, and social exclusion led Paul and Djanina to take the migration route.
Djanina’s voice breaks as she recalls their journey: "This is the worst thing I’ve ever done in my life. What can I say, my friend?"
They left Angola for Brazil, hoping to escape the beatings and death threats that had become their daily reality. But what they found in Latin America was even worse.
Paul left Angola in 2011, and after 11 years of working various jobs, he finally saved enough in 2022 for Djanina to join him in Brazil. There, criminal gangs in the favelas continued the harassment they had fled in Angola. Left with no other option, they embarked on the journey once again, traveling through Bolivia, Peru, and Ecuador. Upon reaching Tumbes, Ecuador, they were detained alongside a Venezuelan family.
Paul translates to French as Djanina, crying, speaks in Portuguese. "They kidnapped us. They locked us in a house in the mountains—men wearing ski masks. 'Money, money, dollars, dollars!’ they shouted. Then they took everything from us and separated the women."
Djanina cannot continue. Paul, also in tears, explains that they stripped her and searched for money in her private areas. This was before they even crossed the Darién Gap, before they endured kidnappings and beatings in Central America and southern Mexico, where Djanina would survive yet another episode of sexual violence.
"Providing care to survivors of sexual violence is a crucial part of our work along the migration route," says José Antonio Silva, MSF project coordinator in Mexico City. "In 2024, we treated over 145 cases—nearly double the previous year. For extracontinental migrants, criminal groups and authorities take advantage of their vulnerability, especially due to language barriers and the lack of support networks. This significantly increases their risk of suffering extreme violence along the route."
"In our Mexico City project in 2024," Silva continues, "we treated 83 extracontinental patients from at least 17 different nationalities, ranging from Angola and the Congo to Mali, Morocco, Afghanistan, and China. It’s a small proportion compared to Latin American migrants, but when you factor in the severe lack of access to basic health care, mental health services, and survival resources, many of them come to us in extremely deteriorated conditions."
Hope amid hardship
In a shaded corner of the camp, beneath a yellow tarp, Luísa holds the hand of her 10-year-old son Manuel. She says that throughout their journey, they have been protected by a higher power. Since leaving Angola, they have lost many material things but not hope. Luísa, a single mother of four, has made it from Angola to Brazil, through the Darién Gap, Honduras, Guatemala, and southern Mexico.
When asked how she managed this journey alone with her children, she answers: "I don’t know. Everyone has their luck. We were lucky to make it this far. This is the suffering of walking, walking, of the water... You arrive somewhere and there is no more food, but you must have strength in life."
On January 20, the Trump administration eliminated the CBP One mobile app, canceling all pending appointments and shattering the last hope of asylum seekers like Mbala, Luísa, Paul, and Djanina. Now, stranded and with no alternative, they wait—hoping, against all odds, that Mexico will be more benevolent than the rest of their journey.
*Names have been changed to protect identities.
About our work in Latin America
MSF provides primary health care, mental health support, social work, health promotion, and intercultural mediation along the migration route in Latin America, with service points in Colombia, Guatemala, Honduras, Mexico, and Panama. Given changes in migration policies affecting vulnerable people on the move, we call for respect for the right to seek asylum and the establishment of protection mechanisms to safeguard their health, safety, and human dignity.
