"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.