Mexico: An MSF psychologist shares his story about working with migrants at the border

“What they need from us, as human beings, is empathy.”

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Every day, around 30,000 migrants gather in Tapachula, a city on Mexico’s southern border. They wait in squares and parks, in exchange offices or at the Mexican Commission for Refugee Assistance to obtain transit permits and continue their journey. 

However, many migrants have experienced physical and mental trauma on their journey—in some cases extreme violence and torture. They are in urgent need of expert medical care. Miguel Gil, a psychologist with Doctors Without Borders/Médecins Sans Frontières (MSF), who has 10 years of experience working with migrants, describes the situation in this city and the challenges our teams face.

MIGRANTS EXPOSED TO VIOLENCE CUT OFF FROM HEALTHCARE

Miguel Gil is a psychologist with MSF who has 10 years of experience working with migrants. Mexico 2023 © Yesika Ocampo/MSF

Our team here is made up of six psychologists, two doctors, two social workers, a psychosocial community involvement agent, a mental health supervisor and a team leader. Initially, we visited migrant shelters and other places to identify victims of extreme violence and torture who could benefit from treatment provided at an MSF center in Mexico City. 

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A man walks through the "Senda de Vida" migrant shelter in Reynosa, Mexico, at the US southern border. Hundreds of families relocated to this shelter in May 2022 after a camp that had formed in a public plaza was evacuated and cleared away. At the time, two thousand people were living in the camp, including hundreds of children.

However, for the past year, we have also expanded our medical activities for migrants—providing wider mental health care, as well as support for victims of sexual violence. In 2022, we assisted 187 people.

Tapachula does not have sufficient capacity to assist all the people who come here. There are no basic services. Shelters run by other organizations can’t care for so many people and there is a lack of access to health care in general.

MSF is the only organization that offers specialized health care for migrants who have been victims of violence or torture.

Center for Comprehensive Care (CAI) in Mexico
An MSF team member works with children during a session at the Center for Comprehensive Care in Mexico City. Mexico 2021 © Yesika Ocampo/MSF

In the city, there are specific areas where people stay based on their nationalities. There are migrants everywhere, and they mainly live on the streets. The majority of people are Haitians and Hondurans, while the number of people from Venezuela has recently grown significantly. They tend to advance faster through small caravans to avoid arrest and deportation.

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Jean Louis in his house

Enduring extreme violence

People who suffer from extreme violence have very critical symptoms. The main ones we see are post-traumatic stress, acute depression, and anxiety. Some of our patients don’t want to continue living.

We have patients who have been victims of rape and others who have been injured by firearms. Some have been mutilated while others have witnessed the murder of family members. I can safely say that I have never cared for so many people with suicidal ideation as I have here. They make up just over seven percent of our patients.

In addition, there are other factors that aggravate these symptoms, such as the lack of access to humanitarian assistance, which also affects people emotionally.  Changes in immigration policies also have an impact on mental health, as well as uncertainty and rejection.

MSF teams witness overwhelming needs of migrants in Mexico’s northern border cities
MSF teams witness the overwhelming needs of migrants in Mexico’s northern border cities as well. 2022 © MSF/Yesika Ocampo

There are women who need prenatal monitoring but who don't have access. Hospitals do not take responsibility for surgery materials either. We have documented cases of obstetric violence. Many patients have told us that they were denied care or were not treated with respect.

When it comes to patients who have experienced torture, the most complex cases are sent to the Comprehensive Care Center in Mexico City.

There, our team made up of medical, mental health, physiotherapy, and social workers provide specialized multidisciplinary care to migrants, refugees, and Mexicans who have been victims of extreme violence and torture.

The critical need for support

I feel like I’m doing my bit: making effective referrals, achieving access for patients, and caring for their health. These are the most satisfying things for me—serving people who have been forgotten about.

I think that of the 30,000 migrants from Tapachula, five percent of them have suffered extreme violence. In my opinion, what these people need from us, as human beings, is empathy.

 

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An MSF mobile clinic assists migrants at the Honduras-Nicaragua border

The last patient I saw with suicidal ideation said to me, “I'm telling you because I see you as a father.” That really touched me.

We have to educate the local people here and help them to understand the stories of those who have suffered so much. Many of the parents, grandparents, or great-grandparents of Tapachula were once migrants, too, so perhaps they can understand the struggle.

Unfortunately, crises continue, forcing people to leave their homes and seek shelter. The violence and cruelty they experience in their own countries and on the road continues.

Over the years, since we've been carrying out the migrant care project in Mexico, the situation has not improved, it has only deteriorated. The cases of extreme violence and torture that we handle are just the tip of the iceberg.

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