Raped and unable to access a hospital: the reality of migrant women en route to the United States

The story is not new, but it still happens. Migrant women leaving their home countries with the hope of reaching the United States. On the road: fear, hunger, violence. They come from Honduras, El Salvador, Guatemala, and must cross the 5,000 kilometers from Mexico to reach the northern border. Being raped is for some the price of the ticket. In addition to the aggression, due to their nature as irregular migrants, they are not treated in public hospitals and depend on organizations to obtain contraception or something as basic as psychological support. The NGO Doctors Without Borders identifies sexual violence on migratory routes as one of the great pending challenges in the region. Last year they handled 61 direct cases of sexual assault and more than 3,200 for consultations on sexual and reproductive health.

The first obstacle begins at the door, explains Elena Vargas, a Nicaraguan doctor who has settled in Mexico: “From there, you open your mouth, the security guard at the medical center hears that you are a foreigner and bye. Complete rejection”. Those who manage to advance meet those in charge of the archives, who must open the file and take turns, “very few are sensitized and trained enough to know that migrants also have the right to medical services.” The last step is the medical staff, where they often receive “poor, to say the least” care.

Vargas, who went into exile from Nicaragua after the 2018 protests, explains that sexual violence has become one of the most tangible problems affecting migrant women. “Early care is essential. Ideally, cases are treated in the first 72 hours, when we can prevent pregnancy —obviously any unwanted one—, and when we can also give some prophylaxis, some preventative, in the event that the attacker was HIV positive.” , Explain. However, they do not always manage to reach them before three days. In 2022, it was achieved in just five cases. This is partly because women don’t know where to turn when they are sexually assaulted. “Where do migrant women go when they have something like the flu? They know. But when is an issue as sensitive and as stigmatizing as sexual violence?” she asks.

Doctors Without Borders is in charge of helping with the medical part, from access to the necessary pills and psychological consultations, to referring them to centers where they can have access to services. Of these, there are very few. Vargas mentions that in Mexico City they only have one public reference clinic, in the Condesa neighborhood, “where they have their doors open for migrants, but it is something very exceptional.” In addition, they often accompany migrants to navigate the health system. In other cases, they resort to social workers and interpreters —for women who speak French, Portuguese or Haitian Creole— to accompany migrants in the health system. “But how many people can have access to this accompaniment? There are many migrants. We have limited resources, we need a response from the State, not that this remains in the hands of NGOs, and civil society”, he points out.

The framework varies by country. In Honduras, for example, the organization succeeded in December after many years of effort for the Ministry of Health to allow the emergency contraceptive pill to be offered to victims of sexual violence, it was the only country on the continent that had not approved it. In El Salvador, they face a system that criminalizes interruptions of pregnancy, even involuntary ones. In Nicaragua, Doctors Without Borders, like most NGOs such as the International Red Cross, were expelled from the country by the Daniel Ortega regime, leaving a healthcare vacuum that the public healthcare system cannot fill. . “In Nicaragua, abortion is prohibited in all cases, regardless of whether it is the product of sexual violence or whether the fetus comes with malformations. In addition, there is a rampant sexual abuse of girls, who are being forced to give birth when they are 11 or 12 years old”, explains the Nicaraguan doctor.

Sexual violence is just the tip of the iceberg. A report from the National Institute of Public Health, the National Autonomous University of Mexico (UNAM) and the Autonomous University of Mexico City states that 29% of migrants are victims of physical, psychological or sexual violence. Most abuses go unpunished. Fear of being repatriated and mistrust in the authorities cause only one in 10 cases to be reported, says this 2021 investigation. In total, Doctors Without Borders treated 24,600 migrants between Honduras, Guatemala and Mexico.

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