The Impact of Violence on the Right to Health for Displaced Persons in the North of Central America and Mexico

People living in the North of Central America (NCA) face significant barriers to accessing fundamental rights such as the right to health, in turn triggering both internal and cross-border displacement in the region. Access to healthcare is highly impacted by the ongoing situation of generalised violence, especially as the presence of criminal groups exacerbate existing barriers to health services. Territorial control and the imposition of invisible borders between communities, and a lack of trust in authorities, are among the main reasons preventing people from accessing basic health services, and also affect the work of healthcare providers.

However, fleeing to another place does not guarantee effective access to timely and adequate healthcare; both internally displaced people, as well as migrants and refugees, face similar barriers after displacement, either due to their nationality, lack of residency or migration papers, or due to the historical structural deficiencies in healthcare systems across the region. This snapshot looks at the right to health in the NCA and Mexico, at how generalized violence can cause health problems that force people to become displaced, and how displaced people continue to face barriers to accessing healthcare on the migration route and in host countries.

The snapshot also reviews how the state responses to Covid-19 across the region have increased the vulnerability of displaced persons. Border closures, reduced response capacities (of both governments and civil society organisations), as well as the indefinite suspension of asylum and refugee status determination procedures, have further deteriorated the physical and mental health of displaced people.

Key messages

1. Generalised violence in the North of Central America has direct impacts on the health of the affected people, especially women 1 and children.

2. Fragile public health systems, which often do not provide services in areas with high levels of violence, as well territorial control imposed by criminal groups in the North of Central America and Mexico, impact access to healthcare for people on the move.

3. Criminal groups, such as gangs, restrict physical access to healthcare services, as well as the access of healthcare workers 3 to communities.

4. Forced displacement and irregular migration affect the physical, mental and emotional health of displaced people.

5. People on the move are not able to effectively access healthcare on the migration route, as they often avoid travelling through urban areas where most services are provided. Humanitarian organisations are often the only actors providing healthcare 5 services at border crossings.