Doctors Without Borders/Médecins Sans Frontières (MSF) is sounding the alarm about dire living conditions for migrants arriving in the town of Danlí, on Honduras’s southern border with Nicaragua. More than 18,300 migrants crossed the border into Danlí in the last week, according to the National Institute of Migration (INM)—a new record. MSF calls on authorities and other organizations to urgently increase the humanitarian response in the region; improve water, sanitation, and living conditions; and ensure safe and dignified pathways for people to seek safety.
In Danlí, MSF teams are treating growing numbers of people, particularly children, for health problems related to overcrowded, unsanitary living conditions and a lack of clean drinking water, including acute diarrhea. “In recent weeks, a significant number of children who come to our mobile units for gastrointestinal infections are dehydrated, [a symptom of diarrhea] which in the most severe cases could be life-threatening,” said MSF doctor Luis Montenegro.
From January to August 2023, MSF provided at least 8,000 mental health consultations and more than 15,478 medical consultations. The primary issues affecting patients include acute diarrheal diseases, upper respiratory tract infections, skin conditions, and trauma. Our teams also provide mental health support, social assistance (such as referring people to other aid services), and health promotion.
Historic migration across Honduras’s southern border
According to INM, more than 257,885 migrants have entered the country irregularly in 2023—double the number of arrivals in 2022. But this increase in migration has not been matched by an increase in services for migrants, which has serious medical and humanitarian consequences for people on the move.
When people arrive in Danlí, they receive a transit permit that allows them to travel through Honduran territory for five days. However, many need to stay longer and earn money to continue their journey north. Hundreds of people waiting to earn enough to leave Honduras have gathered in a makeshift camp at the Mother's Monument, a small park in the city.
“People mostly sleep in conditions that worsen their fragile health and increase their susceptibility to infection,” said Dr. Montenegro. “They don’t have spaces to shower or wash their hands.” There are no free toilets in the area either, and the $1 fee to use public restrooms is more than many people can afford.
"We arrived in Honduras five days ago and have been sleeping here in both rain and [heat],” said Nanmalys, a migrant from Venezuela who has been sheltering in a tent in one of the makeshift camps in the city. “Our special transit permit has already expired, and we haven’t been able to leave because we have run out of money. In Nicaragua, armed people approached us and said that if we didn’t pay [them], we couldn’t cross the border. We just want to keep moving. The faster everything goes, the less our children suffer.”
Contaminated food and water cause illness
MSF provides medical care next to INM facilities in Danlí, where people register and wait to receive their transit permits. “In the clinic’s waiting room, you can hear children crying and many people asking for clean water,” said Dr. Montenegro. “Dehydration and malnutrition are clearly due to the increase in diarrhea cases.”
Without reliable access to safe drinking water, people often have no choice but to use untreated water from nearby rivers. And without the means to cook they are also at risk of illness from consuming contaminated food. “On top of precarious living conditions, these are the likely causes of gastrointestinal infections in these patients,” said Dr. Montenegro.
Surviving one horror to face the next
Most people who arrive in Danlí have already survived the dangerous journey through the Darién Gap, a treacherous stretch of jungle that connects Colombia and Panama. In addition to dehydration and often severe injuries from traversing the rough terrain, people traveling through the Darién frequently witness or experience horrors including deaths, robberies, and sexual assault.
“It’s really tough to cross the jungle, but it’s worse to come out of it and to find an even more inhumane situation,” said Rosa Idalia, a migrant in Danlí. “There are people sleeping in the trash.” Rosa is traveling with a doll to remind her of her two-year-old granddaughter in Peru. “I kiss her every day, hug her when times are hard, and I focus on our dreams—where I’m getting to. I always think of her and even more so when I turned 62 in the jungle.”
Daviler is from Venezuela. His one-year-old daughter has been suffering for more than five days with acute diarrhea and a high fever. "She got sick in the jungle, and we ran out of money because they took everything from us in other countries,” said Daviler. “We've been in Honduras for more than three days. My wife suffers from severe headaches, and at night she wakes up because she dreams that she's still in the jungle—still in the river."
Authorities in the region must ensure dignified passage for migrants and provide medical care and rest areas for vulnerable people on the move. The desperate needs of migrants are only increasing, and the response remains shamefully inadequate.