Mexico: “One in four patients has experienced violence”

Doctors Without Borders/Médecins Sans Frontières (MSF) began expanding its medical and psychological response to violence in the city of Reynosa, in the northern border state of Tamaulipas, in February 2017. MSF’s goal is to provide direct medical and mental health care and social assistance to communities in one of Mexico’s most troubled areas. Teams have been providing free, confidential mental health consultations and staff training at Reynosa General Hospital for nearly two years.

MSF started working in the Pedro José Méndez neighborhood in Reynosa in early 2017. Today, a team comprised of a doctor, a nurse, and a psychologist offers comprehensive health care at a general medicine clinic and refers patients to other health facilities in the city if necessary. Pedro José Méndez is one of many neighborhoods across the city that have experienced increasingly frequent episodes of violence in recent years.

“The medical team is focusing on providing mental health care for victims of physical or sexual violence,” said Dr. Marcelo Fernández, MSF medical coordinator in Mexico. Any patient visiting the clinic for a medical or psychological consultation is asked to fill out a questionnaire related to violence. According to Dr. Fernández, “For every four patients we assist, one has been a victim of some type of violence.”

Furthermore, the stress of living in the volatile city over the past decade has had a large impact on the mental health of many residents. “We have detected very significant psychiatric disorders in recent months,” explained Dr. Fernández. “We see people suffering from isolation and phobias—people who are afraid to go out. When they do go out, they take very precise routes.” In weeks that follow an outbreak of violence, the clinic is often empty. “Patients only come if they have an illness that requires urgent attention,” said Dr. Fernández, who also observed that public life is diminishing.

MSF also operates mobile clinics to provide care at two shelters for migrants and deportees from the United States. “The goal was to get closer to the community and provide direct care for victims of any type of issue. In the shelters, we provide mental health care, mostly for Mexican citizens deported from the United States,” said Dr Fernández.

A significant part of MSF’s work in Reynosa consists of providing medical care to victims of sexual violence. Dr. Fernández observed that the numbers of sexual violence cases are increasing. "We provide a medical kit for sexually transmitted infections, which includes antiretroviral and antibiotic treatments,” he said. Victims of sexual violence are also given mental health care consultations. “But it’s still a taboo subject—people are afraid of both filing a complaint and attending a hospital. There are no precise figures, but we have seen at least 10 victims at various health institutions and at MSF services in recent months.”


Christina Simons/MSF