Deepening political instability, social inequality, and economic strife has led to increased gang violence and poverty in counties such as Guatemala, Honduras, and El Salvador. As a result, the Northern Triangle has witnessed a sharp spike in the number of people fleeing their countries and arriving at the U.S./Mexico border to seek asylum. Many asylum seekers are escaping gang violence, threats, extortion, recruitment into gangs or prostitutions, as well as sexual and gender-based violence (SGBV). UNHCR reports that there is now a total of 387,000 refugees and asylum-seekers from El Salvador, Guatemala and Honduras – a figure that has been climbing at an annual rate of 24%.
The health needs of Central American migrants and refugees, both while in transit and upon arriving at the U.S/Mexico boarder are significant. Access to basic medical services such as prenatal care, treatment of pediatric illnesses, or management of chronic diseases is rarely available. Furthermore, mental health is a growing and especially acute issue for Central American refugees, especially in light of the fact that many of the asylum-seekers are children or teens who have witnessed severe violence in the early stages of their life. Compounded with recent policies at the U.S. border that forcefully separated children from their parents, the CDC warns that around half of all refugees have risk factors for PTSD.
At least seven children have now died while in U.S. government custody at the border. The lack of continuous medical care, especially pediatric care, being provided to those being held in detention centers at the border is an issue that continues to go unresolved. Health care providers cite a lack of transparency and communication as barriers to ensuring children and other asylum seekers are getting adequate, ongoing treatment.