Peru: Venezuelan migrants struggle to survive

Venezuelan Migrants in Peru — An MSF doctor examines a baby at the MSF health post in Aguas Verdes, near Peru’s border with Ecuador.

Four days a week, MSF staff see patients near a bus terminal in Lima's Fiori neighborhood, where many migrants arrive in the city. Migrants have a broad array of health needs, including for primary health care, sexual and reproductive health care, mental health care, emergency referrals to hospitals and treatment for chronic diseases.

"As a doctor, what worries me is the number of patients who arrive with chronic diseases such as hypertension and diabetes," Salas says. "They have run out of their medications and do not have the means to purchase more."

Venezuelan migrants arrive in Peru

All photographs by Max Cabello Orcasitas

A Venezuelan couple hug their daughter in Plaza Lima Norte in Lima, Peru’s capital. Thousands of Venezuelan migrants enter Peru every week after making the 2,000-mile trip from their home country. Venezuela continues to suffer from a severe economic and political crisis; more than 6 million people have left their homes since 2014.

A Venezuelan migrant holds his daughter as he looks out on the Tumbes River in Tumbes city, 14 miles from the Peru-Ecuador border. 2022 © Max Cabello Orcasitas

Also in Tumbes, a family tries to get some rest on the street. Like many newly arrived Venezuelan migrants, they must sleep outdoors because they do not have enough money to pay for lodging.

A Venezuelan woman rests during a medical consultation at the MSF health post located in Aguas Verdes, close to the Peru-Ecuador border. MSF staff at the health posts see many pregnant women who have not had access to contraception or prenatal care.

A woman and her children head towards a transport stop in Aguas Verdes. There, migrants often get rides in vans and cars going to Tumbes.

An MSF doctor tends to an Ecuadorian migrant at the MSF health post in Lima. MSF staff provide initial medical consultations and basic treatment that migrants have not been able to access before or during their journey. Peru 2022 © Max Cabello Orcasitas

An MSF staff member provides food and fruit juice to newly arrived Venezuelan migrants at the MSF health post in Aguas Verdes.

A Venezuelan migrant holds his two-year-old son while the child is examined by an MSF doctor at a health post in an area known as Gasolinera because it's located by a gas station not far from the Peru-Ecuador border. Children are screened for health conditions and are given routine vaccinations

All photographs by Max Cabello Orcasitas

In Tumbes and in Lima, MSF staff provide initial medical consultations and basic treatment that migrants have not been able to access before or during their journey, such as iron supplements for children who are anemic, or folic acid for pregnant women. Then, MSF staff help patients to register for services in the Peruvian health system which can be very difficult for migrants to access. All pregnant women and children under five are entitled to free public health care in Peru, yet health workers still require documents that migrants do not have, such as a proof of residence.

"If a woman is in labor, a health center will take her if she has documents, but if she doesn't have documents, they will not take her, unless it is an emergency," explains Yohana Arevalo-Polack, MSF health promotion supervisor in Tumbes.

The COVID-19 pandemic has increased the hardships that migrants face. Peru officially closed its borders in March 2020 and has only recently reopened them. While Venezuelan migrants could previously register upon arrival and apply for a humanitarian visa, they can no longer do so, making it more difficult to obtain employment or register for essential services.

Crossing the border from Ecuador typically takes more than four hours on foot, in hot conditions. Many people arrive in Peru exhausted and dehydrated.

In addition to basic medical care, MSF staff in Tumbes provide food and water, COVID-19 vaccinations, psychological first aid and a phone number for MSF's clinic in Lima. A social worker helps identify other social services that may be available, both in Tumbes and in Lima.

Many do not stay long in Tumbes, working informally by washing cars or doing other tasks, to earn money for a bus ride to the capital city or beyond. Others walk or hitch rides on passing trucks, sometimes by climbing on the back. In Tumbes, migrants have repeatedly been injured in accidental falls from moving vehicles, MSF staff have found.

Violence against migrants is all too common, especially in border areas. Multiple people have reported to MSF that they were threatened and robbed by groups of armed men near the border between Ecuador and Peru. A 50-year-old woman traveling with her sons aged 24 and 25 gave the following account:

She stated she had just been robbed, after having taken a motorcycle taxi very close to the border with Ecuador, in Peruvian territory. The motorcycle taxi took approximately 30 minutes to reach an unknown destination, where they were ambushed by a group of three people. They threatened to take the life of her younger son and took all their belongings. They were told that if they denounced the robbers, their complaint would not move forward because theft is customary in this zone.

In Tumbes, MSF staff are sometimes the first to greet migrants as they cross and offer psychological first aid, among other support.

"We have seen much frustration, much anxiety, because they come with such hopes, and the first thing they experience is robbery or other types of violence," Arevalo-Polack says.