Mexico: “What they need from us, as human beings, is empathy”
Every day, around 30,000 migrants gather in Tapachula, a city at Mexico’s southern border. They are a ‘floating population’.
Here, thousands of people come through this entry point in the south of the country, just as many others leave for the northern border. They wait in squares and parks, in exchange offices or at the Mexican Commission for Refugee Assistance to obtain transit permits and continue their journey.
However, many migrants have experienced physical and mental trauma on their journey – in some cases extreme violence and torture. They are in urgent need of expert medical care.
Miguel Gil, a psychologist with Médecins Sans Frontières / Doctors Without Borders (MSF), who has 10 years of experience working with migrants, describes the situation in this city and the challenges our teams face.
Our team here is made up of six psychologists, two doctors, two social workers, a psychosocial community involvement agent, a mental health supervisor and a team leader.
Initially, we visited migrant shelters and other places to identify victims of extreme violence and torture who could benefit from treatment provided at an MSF centre in Mexico City.
However, for the past year, we have also expanded our medical activities for migrants – providing wider mental health care, as well as support for victims of sexual violence. In 2022, we assisted 187 people.
“I can safely say that I have never cared for so many people with suicidal ideation as I have here”
Tapachula does not have sufficient capacity to assist the people here. There are no spaces or basic services. There are shelters run by other organisations, but they aren’t able to care for so many people and there is a lack of access to healthcare in general.
We are the only organisation that offers specialised healthcare for migrants who have been victims of violence or torture.
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In the city, there are specific areas where people stay based on their nationalities. There are migrants everywhere here, and they mainly live on the streets.
The majority of people are Haitians and Hondurans, while the number of people from Venezuela has recently grown significantly. They tend to advance faster through small caravans to avoid arrest and deportation.
People who suffer from extreme violence have very critical symptoms. The main ones we see are post-traumatic stress, acute depression and anxiety. Some of our patients don’t want to continue living.
We have patients who have been victims of rape and others who have been injured by firearms. Some have been mutilated while others have witnessed the murder of family members.
To give some scale to the level of severity of the symptoms we see; I can safely say that I have never cared for so many people with suicidal ideation as I have here. They make up just over seven percent of our patients.
In addition, there are other factors that aggravate these symptoms, such as the lack of access to humanitarian assistance, which also affects people emotionally.
Changes in immigration policies also have an impact on mental health, as well as uncertainty and rejection.
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Access to healthcare for migrants is not guaranteed – much less when it’s mental health. It is still very restricted in health centres and migrants are sometimes discriminated against.
The reality is that there are certain services or medicines that are denied to specific people because they are migrants.
“The cases of extreme violence and torture that we handle are just the tip of the iceberg”
We have cases of psychiatric patients who are at risk, and access to public healthcare for them does not exist. This lack of specialised care also applies to local people. The only psychiatric hospital is in Tuxtla Gutiérrez – more than four hours from here.
There are women who need prenatal monitoring but who don't have access. Hospitals do not take responsibility for surgery materials either. We have documented cases of obstetric violence. Many patients have told us that they were denied care or were not treated with respect.
When it comes to patients who have experienced torture, the most complex cases are sent to the Comprehensive Care Centre in Mexico City.
There, our team made up of medical, mental health, physiotherapy, and social workers provide specialised multidisciplinary care to migrants, refugees, and Mexicans who have been victims of extreme violence and torture.
An important project
I feel like I’m doing my bit. Managing to make effective referrals, achieving access for patients and guaranteeing their health – these are the most satisfying things for me. Serving people who have been forgotten about.
I think that of the 30,000 migrants from Tapachula, five percent of them have suffered extreme violence. In my opinion, what these people need from us, as human beings, is empathy.
The last patient I saw with suicidal ideation said to me, “I'm telling you because I see you as a father.” That really touched me.
We have to educate the local people here and help them to understand the stories of those who have suffered so much. Many of the parents, grandparents or great-grandparents of Tapachula were once migrants, too, so perhaps they can understand their struggle.
Unfortunately, crises continue, forcing people to leave their homes and seek shelter. The violence and cruelty they experience in their own countries and on the road continues.
Over the years, since we've been carrying out the migrant care project in Mexico, the situation has not improved, it has only deteriorated. The cases of extreme violence and torture that we handle are just the tip of the iceberg.
MSF, refugees and displaced people
An unprecedented 89.3 million people around the world have been forced from their homes – around one in every 88 people.
The reasons vary, but violence and conflict; natural disasters; or extreme weather events can all mean that it is no longer safe to stay where you are.
An estimated 27.1 million of these displaced people are refugees: people who have had to travel to a new country to find safety. Worldwide, over half of all refugees are under the age of 18.