Responding to COVID-19 in Mexico, Honduras, and El Salvador

An emergency situation in Honduras

In mid-March, the Honduran government declared an emergency situation, limiting people’s freedoms and movements. The Cortes department, in the north of the country, is the worst affected region, responsible for approximately 31 percent of confirmed COVID-19 patients.

Basic health care neglected in El Salvador

El Salvador put in place a similar response to Honduras, with many parts of the country in lockdown since mid-March. As of September 14, El Salvador has reported 27,009 COVID-19 cases and 788 deaths. The capital, San Salvador, is the epicenter of the outbreak. Health centers and hospitals have suspended outpatient consultations. This has left treatment for patients with chronic illnesses, those in need of family planning services, prenatal and postnatal consultations, and mental health support, and community activities neglected—specifically in areas where people have historically been affected by violence. There is a clear lack of access to basic health care services. The Ministry of Health has reported an increase in teenage pregnancies. Almost 3,000 teenage pregnancies were reported during the lockdown. As of  August 21, there was a 13-day decrease in COVID-19 cases.

Providing care through mobile teams and clinics

MSF COVID-19 mobile teams are working in different parts of Mexico to establish biosafety protocols (such as IPC and water and sanitation management) in COVID-19 hospitals, community hospitals and health centers. These protocols will help to guarantee the safety of health care staff and patients. The team has worked in Mexico city and Guerrero and Oaxaca states, and is now working in Tabasco state.

In El Salvador, MSF ambulance services dedicated to transporting COVID-19 patients have continued to operate in order to alleviate the workload of the public emergency system. MSF continues to run mobile clinics in communities affected by violence in San Salvador and Soyapango. MSF is also undertaking COVID-19 prevention and health promotion activities and is providing mental health care at an isolation center for people who have been deported from Mexico and the US. Our teams are also evaluating other centers and shelters for possible interventions.

Treating patients in COVID-19 centers

In Matamoros and Reynosa, near Mexico’s northern border, MSF is caring for mild to severe patients in two COVID-19 centers installed in each city campus of the state university. Both centers have space for 20 severe patients who require concentrated oxygen and have isolation areas for mild and suspected COVID-19 patients who do not have a place to isolate themselves. These patients could be migrants, returnees, people without a home, or people who do not have enough space in their houses to isolate from their families. The centers have established a comprehensive health care system where patients can receive medical and psychosocial care services.

In Tegucigalpa, the Honduran capital, MSF has opened a treatment clinic for patients with severe COVID-19 symptoms at the National University sports facility. The objective of this project is to prevent hospitals in the metropolitan health system from becoming overcrowded and to care for patients in a comprehensive way, including mental health care, social work, and health promotion services.

Preventing infection in migrant shelters

Asylum seekers and migrants face a worsening situation during the COVID-19 pandemic due to the uncertainty of the asylum-seeking process, stigma against migrants and asylum seekers, and heightened health risks due to unhygienic conditions and lack of space in shelters. In Nuevo Laredo, northern Mexico, MSF is assessing all migrant shelters where more than 200 people are isolating and implementing relevant IPC measures. We also provide basic health care and psychosocial support to shelter residents, staff, and occasionally to members of the surrounding communities.

Providing care along the migration route

A multidisciplinary COVID-19 intervention team including a health promoter, psychologist, logistician, water and sanitation manager, and IPC manager, was formed to provide technical support and IPC training in migrant shelters along the Mexican migration route. This team is also providing psychosocial support to migrants and staff who are suspected or confirmed to have been in contact with someone with COVID-19.

In Matamoros, MSF is caring for asylum seekers in a makeshift camp that was formed in 2019 when thousands of people were left stranded at the US-Mexico border due to the Migration Protection Protocols (MPP)—a US policy which forces people seeking asylum in the US back to Mexico to await their asylum proceedings. MSF has a comprehensive health care team that provides health promotion to people in the camp, including COVID-19 prevention tips, and a medical team that has established a triage system to detect possible COVID-19 cases.

Mental health care hotlines

MSF has also set up a hotline and WhatsApp number so that MSF psychologists can provide psychological care remotely to migrants and refugees across the country, and to people isolated by violence in Guerrero.

In Tegucigalpa and Choloma, Honduras, MSF has set up two mental health phone lines for survivors of violence and sexual violence. Recently, MSF psychologists have reported an increase in mental health consultations.