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Migrations. People’s health first.

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Migrations.  People’s health first.

The Lancet

The route from Central America to the USA is the most dangerous overland migration corridor in the world. A route littered with deaths, violence, diseases, kidnappings and rapes. Biden, who has largely confirmed the measures introduced by Trump on the border with Mexico, must change migration policy. The 2024 elections represent an opportunity to finally prioritize people over borders and address this explosive humanitarian crisis (1).

According to Missing Migrant Project The International Organization for Migration (IOM) said 2022 was the deadliest year on record for migrants and identified the US-Mexico border as the world‘s most dangerous overland migration route.. The dangerous journeys that migrants are forced to make expose them to a wide range of health risks. The difficulties in gathering information along these clandestine routes means that the true extent of the challenges faced by migrants rarely makes the news, while, on the other hand, the control and deterrence activities exercised by the United States aggravate the health conditions of migrants and expose the groups most vulnerable to greatest harm.

The most remote stretch of the overland route is the Darién Gap between South America and Central America, one of the most hostile environments on Earth. A research letter published in The Lancet examined all forensic cases of migrant deaths in the Darién Gap from 2018 to 2022 and found that the number of confirmed deaths (by drowning, illness, stabbing, gunshot and unknown causes) is

increased steadily each year, before spiking in 2021. Investigations by the IOM and the International Red Cross found that this trend continued into 2023 and with the addition of disappearances the total number of victims could double, underlining the difficulty of collecting of data in a harsh and lawless environment. Despite growing awareness of the risks of injury, illness, fatigue, robbery, violence and rape, more people are traveling the route than ever before; this year, more than 360,000 migrants have undertaken this perilous journey.

Of the 250,000 people who crossed the Darién Gap in 2022, more than 150,000 were from Venezuela, fleeing political persecution, extreme poverty and health care crises. In response to pressure from the U.S. government, Mexico, Costa Rica and Belize have imposed visa restrictions that effectively bar Venezuelans from legally entering and transiting their countries. The migrants are then forced to be transported clandestinely by criminal organizations across seven borders, on a 4,800 km journey to the United States. Exploitation is widespread. In Colombia, cartels work with local authorities to openly market goods and services to migrants at exorbitant prices. In Mexico, migrants waiting to legally enter the United States were attacked, extorted, robbed, and kidnapped by the same gangs they hired to smuggle them across the border from Guatemala.

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Organizations providing help and support are overwhelmed. Las Americas, a nonprofit advocacy group that offers legal assistance to asylum seekers, received 4,000 calls a day in August 2022, 70% of which referred to the need for medical assistance. All people in Mexico are guaranteed basic healthcare under the national insurance program INSABI, but residency requirements and discretionary interpretation of rights limit access for migrants. Humanitarian organizations running free clinics on both sides of the border report new arrivals experiencing traumatic infections and injuries, uncontrolled hypertension and diabetes, dehydration, cancer, high-risk pregnancies and mental health problems, all exacerbated by the stress of migration. In Mexico, where unregulated tent cities have grown outside border cities, the few government-run facilities have seen infectious disease outbreaks and maintain limited medical services. This unsustainable situation requires urgent government intervention.

The widely contested Title 42 ordinance denied migrants the right to seek asylum on US soil during the COVID-19 public health emergency and ordered border agencies to immediately deport people apprehended crossing the border illegally. The Biden administration did not defend Title 42 during the litigation that ended the program in May 2023, however it issued its own version of “Remain in Mexico”, called Circumvention of Legal Pathways rule.

This law continues to deny the right to seek asylum to those caught crossing the border illegally and criminalizes repeated attempts. The alternative legal route requires a mobile application that has been criticized for its poor accessibility and inconsistent connectivity, and often results in months-long wait times that leave people stranded just meters from accessing care, which they may have needed. desperately needed. The Biden administration recently announced measures to support hundreds of thousands of Venezuelans already in the United States, but maintains policies that penalize migrants at the border and abroad. Political polarization over immigration is overshadowing human suffering.

The Biden administration needs a health system ready to welcome those fleeing violence, hunger and exploitation. The 2024 elections they represent an opportunity for the United States to finally prioritize people over borders and address this explosive humanitarian crisis.

(1) The Lancet, Editorial of 30 September 2023, Immigration reform in the USA – health must come first, Vol. 402, p. 1107. The translation is ours, as are the title, subtitle, bold text and images.

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Biden, Circumvention of Legal Pathways rule, Darién Gap, Mexico, Migrants, Missing Migrant Project, International Organization for Migration, Remain in Mexico”, migrant health, United States, The Lancet, Title 42, Trump, Venezuela

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