According to UNHCR, the UN refugee agency, the numbers of displaced people in Central American countries reached record levels in 2021, creating a humanitarian crisis. Almost a million people fled their homes to escape violence and a lack of opportunities in their home countries, a situation exacerbated by the COVID-19 pandemic. The new US administration had indicated that it would adopt a more compassionate attitude towards undocumented migrants and refugees arriving from the south, but it maintained its restrictive asylum policies, citing public health reasons, closed its borders and deported hundreds of thousands of people to Mexico and other countries. This, and the criminalisation of migration by regional governments, forced people to risk more dangerous routes, where they were exposed to robbery, extortion, torture, sexual aggression, rape and kidnapping. 

Our teams worked to improve access to medical and psychological care at different points along the migration route, prioritising assistance to the most vulnerable groups: children, unaccompanied minors, women travelling alone, non-Spanish-speaking people, extracontinental migrants, older adults, LGBTIQ+ people and victims of direct violence. 

The mobility of our operations enabled us to provide emergency responses to specific needs as they were detected. We sent teams to work on Mexico’s northern border, in Nuevo Laredo, Tamaulipas state, and Ciudad Acuña, Coahuila state, as well as in the south, where we assisted migrants arriving in Tapachula, Chiapas state. Our comprehensive care centre in Mexico City continued to offer medical, psychological, physiotherapy and social work care to migrants, refugees and Mexican citizens who have been victims of extreme violence.  

In September, we decided to reorient our project in Reynosa and Matamoros, Tamaulipas state, where we had been providing care for victims of violence and sexual violence since 2019, to assist thousands of migrants trapped in precarious conditions in shelters and makeshift camps. As well as medical and psychological consultations, we ran health promotion activities, offered social support and distributed drinking water and hygiene kits. 

In the second half of the year, we launched an emergency intervention in Mexico City, focused on health promotion activities, to support institutions to address the needs of huge influxes of migrants, mainly from Haiti. 

The COVID-19 health emergency has not curtailed the activities of the many armed groups and gangs operating in Guerrero state. People continue to be displaced or unable to move freely due to violence in their communities. Our teams in Guerrero worked to improve access to basic health services in these areas by running mobile clinics offering medical and psychological care, as well as social support. In January 2021, MSF expanded these activities to cover Tierra Caliente region in Michoacán state.