MSF CANADA MAGAZINE | Digital Edition | Summer 2017

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not beyond reach: mexico

Children in the migrant shelter in Tenosique. Almost 13 per cent of the migrant children under 11 years old surveyed by MSF medical teams were registered as travelling through Mexico unaccompanied. Photo: © Marta Soszynska/MSF







By Stephen Cornish


I am from San Pedro Sula, I had a mechanical workshop there. Gangs wanted me to pay them for ‘protection’, but I refused ... First they told me that if I stayed without paying, they would take my blood and that of my children. Last year they shot me three times in the head; you can see the scars. But what hurts most is that I cannot live in my own country; to be afraid every day that they would kill me or do something to my wife or my children. It hurts to have to live like a criminal, fleeing all the time.”


These words were spoken by a 30-year-old father from Honduras during an interview with Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams in Mexico. He is one of the estimated 300,000 people who leave El Salvador, Honduras and Guatemala every year, and his story underscores the reality that many of the people travelling north through Mexico are fleeing levels of violence in their home countries similar to those experienced in war zones such as Afghanistan or Yemen. In many cases, people are forced to make an impossible decision between remaining at home and trying to survive the brutality of local gangs, or risking their lives attempting the dangerous journey north.









Unfortunately, the violence migrants are likely to encounter along their journeys through Mexico can be equally ruthless. Kidnapping, extortion, rape and assault — as well as torture and murder — are among the threats people repeatedly face along the way. Those risks have been made verifiably worse by the increasingly harsh border-control measures implemented in recent years to stem the flow of people north into Mexico and onward into the United States. Since the launch in 2014 of Plan Frontera Sur, a Mexican crackdown on border security funded in part by the U.S., migrants have been caught in a double bind: they have been driven further down into underground routes operated with impunity by organized crime, but are also more likely to remain trapped there, unable to escape north or return home.


A recent MSF report, “Forced to Flee from the Northern Triangle of Central America,” draws upon data collected by medical teams providing care to migrants and refugees travelling the underground network through Mexico in the last three years. MSF delivers basic medical assistance and mental-health consultations at various points along this route, and also opened a rehabilitation centre in Mexico City for victims of torture, who often require comprehensive care such as surgery and neurology to recover basic functionality.


Of the 467 people MSF teams surveyed, more than 68 per cent reported being a victim of violence while travelling north through Mexico, and more than a tenth experienced at least three violent events. Nearly one third of female respondents had been sexually abused. One quarter of the medical consultations in MSF’s migrant programs were the result of intentional trauma carried out by both gangs and Mexican security forces.

'First they told me that if I stayed without paying, they would take my blood and that of my children. Last year they shot me three times in the head'

It’s not only people in physically remote areas who can be difficult for Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams to reach. Along Mexico’s notorious migration corridor, people fleeing violence in El Salvador, Guatemala and Honduras often encounter abuse, extortion and brutality at the hands of criminal networks, but don’t seek medical care in order to avoid capture and deportation.



Contrary to widely held characterizations of those seeking to cross Mexico into the U.S. as economic migrants, nearly 40 per cent of respondents cited direct attacks and threats of violence to themselves in their home countries as the reasons for their journeys. Almost half had a relative who died from violence in the past two years; for Salvadorans alone, the proportion was 56 per cent.


Hidden behind these clinical numbers is the level of depravity faced by the victims of this violence: mutilation inflicted in order to reveal family phone numbers to be used in extortion, grotesque murders performed as “exemplary violence” to terrorize others. The MSF report calls this a “hidden humanitarian crisis at America’s back door” — but it is a crisis with direct links to border protection measures taken by migration destination countries, and it raises critical questions about how we in places like the U.S. and Canada should approach the arrival of refugees from places like Mexico and Central America.


In terms of rhetoric and action, the focus of most of the North American discussion around this issue has been defensive: how to secure our borders, and how to deter and prevent unwanted numbers of people from accessing our territories. But fortifying our borders also has a human impact on those seeking not just opportunity, but basic safety and security for themselves and their families. These people have the internationally recognized right to flee unsustainable levels of violence, conflict and persecution in their home countries, and to seek asylum. States have responsibilities and humanitarian obligations, in particular to refugees fleeing violence and war-like conditions — including from places such as Honduras, El Salvador and Guatemala that we don’t usually think of in that way.

Forced to Flee: Humanitarian Crisis in Central America's

Northern Triangle

Even the most forceful deterrence policies — from interdiction measures and deportations to actual physical walls — will not stop people from seeking safety or survival. But they do cause desperate refugees and asylum seekers to fall into ever more vicious and violent underground migration networks. As a result, they are unable to seek medical care, even though they find themselves at greater risk of trauma, abuse and possibly death.


All people have a right to escape their circumstances in search of security, and their ability to do so is protected under international refugee law. That applies to families fleeing violence in Central America as much as it does those fleeing war in Syria or elsewhere. And while the countries in which they seek refuge are not required to grant asylum to everyone who arrives on their territories, they have a responsibility to review every case and to ensure that no one is sent back to where they will experience persecution or torture.


As explained by the young father from Honduras, “It hurts to live like a criminal, fleeing all the time. Most people do not want to uproot everything they have ever known and endure terrible risks for the chance to struggle in a new country.”


Many feel they have no other choice. More than just our respect and compassion, they deserve to be treated according to the same standards as all refugees from conflict and violence around the world. Our responsibility is to defend and uphold those standards, wherever and whenever they apply.



Stephen Cornish is Executive Director of Doctors Without Borders/Médecins Sans Frontières (MSF) Canada


A longer version of this article was originally published online by iPolitics in May 2017.


In this Issue

from the executive director


not beyond reach: mexico

supporter stories

about dispatches

‘It doesn’t take a lot to give back a little’

How a Newfoundland community's soccer tournament helped make a difference for MSF.

The MSF Canada magazine

Stories and updates about MSF's lifesaving work, as seen through the eyes of our staff, patients and donors.