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Pictured here in Mexico, 54-year-old Rosa fled gang violence in El Salvador with two of her grandchildren.

Migration crisis in the Americas

MEXICO 2016 © Christina Simons/MSF
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What is the Central American migration crisis?

Every year, hundreds of thousands of people from El Salvador, Guatemala, and Honduras flee extreme violence and poverty and head north through Mexico to find safety. The high levels of violence in the region, known as the Northern Triangle of Central America (NTCA), are comparable to that in war zones where MSF has worked for decades.

The countries of the NTCA have long been burdened by deep social inequality, political instability, and conflict—and in some cases have been further destabilized by US interventions in the region over the past 40 years. Now these countries are also contending with the rapid expansion of transnational organized crime, which has exploded over the past decade. Across this region, drug and human trafficking by criminal groups known as maras, coupled with widespread corruption and weak law enforcement, have resulted in an environment where civilians face the ever-present threat of violence.

Migrants and Refugees in Mexico shelters

The facts about the humanitarian crisis in Mexico and Central America

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Gang-related murders, kidnappings, extortion, and sexual violence are daily facts of life. “In my country, killing is ordinary—it is as easy as killing an insect with your shoe,” said one man from Honduras, who was threatened by gang members for refusing their demand for protection money, and later shot three times.

Central Americans fleeing violence often face more of the same along the migration route through Mexico. In 2020, MSF published a special report based on 480 interviews and testimonies of Central American migrants and asylum seekers, experiences of MSF staff, and medical data from more than 26,000 people helped along the migration route through Mexico during the first nine months of 2019.

Now refugees and migrants across the region are also facing the coronavirus pandemic. People on the move and in detention throughout the region are at particularly high risk of contracting the disease. The pandemic, along with other economic issues, are among the main reasons tens of thousands of people, primarily from Haiti, Cuba, and Venezuela, are risking their lives on dangerous travels routes to the north, including the Darién Gap.  


of respondents were exposed to a violent situation

during the two years prior to leaving their home country


of patients surveyed were victims

of violence while in transit through Mexico


of people traveling with children reported leaving home due to violence

How MSF is helping people on the move in Central America and at the US-Mexico border?

MSF teams have been providing medical and mental health care to migrants and refugees along the migration routes through Mexico since January 2013. Many of our patients need mental health support due to the significant stresses related to conditions in their home countries as well as on the run. Treatment for women often includes medical and psychosocial care for victims of sexual violence. Teams provide primary care as well as treatment for acute and chronic diseases whenever possible. 

From 2015 to late 2019, we have provided more than 42,000 medical consultations and more than 11,000 mental health consultations for migrants, refugees, asylum seekers, and deportees in Mexico.

In June of 2021, when more than 11,000 migrants entered Panama from Colombia, MSF teams opened programs in Bajo Chiquito—the first village that migrants reach in Panama after crossing the dangerous Darién Gap—and at the migrant reception stations in Lajas Blancas and San Vicente. By the end of the year, MSF provided medical and mental health care to more than 14,000 people who crossed to Panama. 

MSF’s direct experience on the ground points to a broader humanitarian crisis in Central America. Despite the catastrophic conditions in the region, the US and Mexico generally treat people from the Northern Triangle as economic migrants, and have focused efforts on detention and deportation rather than on providing protection and support. MSF is calling on the US and Mexico to provide humane treatment to all refugees, asylum-seekers, and migrants and to stop deportations of vulnerable people back to a dangerous region.

Desperate journey: Fleeing invisible wars in Central America

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COVID-19 impact on the Central American migration crisis

The coronavirus pandemic has compounded the risks for people on the move in Mexico and Central America. In March, MSF issued a joint statement protesting the US government's decision to block asylum proceedings and close the US-Mexico border citing the threat of the coronavirus. Turning back men, women, and children seeking refuge is not in accordance with public health guidance and will only endanger more lives. Thousands of people seeking international protection in the US have been forced to remain in Mexico, many of them living in overcrowded shelters and settlements. MSF is also calling on the US government to suspend all deportations to Latin America and the Caribbean. We are concerned that continuing deportations move people from the epicenter of the COVID-19 pandemic to countries with lower rates of transmission and weaker health systems. US policies threaten to fuel a wider public health crisis in the region. 

MSF has called on Mexican authorities to release all migrants held in detention centers and ensure testing and medical care for those suspected to be infected with the coronavirus. Visits conducted by MSF teams to various migrant detention centers in southern Mexico in 2019 found that detainees received no regular medical attention and lacked essential services such as access to water, making these facilities ideal breeding grounds for infectious diseases like COVID-19. 

MSF is providing medical and psychological care to migrants, refugees, and homeless people in Mexico City and along the migration route through Mexico. Teams are working in shelters, hostels, hotels, and community kitchens. We're also offering practical advice to staff, volunteers, visitors, and residents in these facilities on ways to prevent transmission of the virus.

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