Countries: Guatemala, Haiti, Panama, Venezuela (Bolivarian Republic of) Source: Médecins Sans Frontières Médecins Sans Frontières (MSF) ran a project for people migrating through Guatemala from late 2021, just before a large wave of people moved up from South America, until June 2025. For the three years and seven months we operated this project, our goal was to ease the suffering of the thousands of people seeking to reach the United States in search of better opportunities.MSF provided care to 238,808 people through this project. Up to June 2025, we offered general healthcare and psychological support to people, as well as social work and health promotion services, and access to toilets, showers, Wi-Fi, and electricity at two centres. Operations began in Tecún Umán, San Marcos in November 2021, and in Esquipulas in October 2023.MSF sent multidisciplinary teams to these locations to respond to the humanitarian emergency caused by the massive movement of people from South America, which began in 2021 and continued through 2024. According to data from different entities, including Panama’s Migration office, 2023 saw the highest number of people crossing the Darién Gap – the jungle dividing Colombia and Panama. That year, over half a million people crossed. In 2024, the number exceeded 300,000, and during the first five months of 2025,1 the count reached 2,917. In June 2025,2 it was reported that only 10 people entered at that border point.“The Darién became the barometer of mass migration,” says Jean Hereu, project coordinator. “The people who made that journey took a physically demanding route, full of dangers and risks due to the presence of criminal groups. They had to choose between making this journey in search of a better future, or staying in their home countries facing economic hardship, violence, or lack of rights — in Latin America and other parts of the world.”After entering Panama, people would start the difficult and dangerous route through Central America, to eventually reach Mexico. Once in Mexico, they tried to request asylum in the U.S. through the CBP One app, a digital system created to schedule migration appointments.However, this tool had serious limitations: it could not respond quickly to the massive demand, leaving thousands stranded and waiting in Mexico. In January, the new US administration decided to eliminate the app as part of a series of anti-migration policies.The impact of violence and vulnerability along the migration routeMost of the people migrating through Guatemala who received MSF's support were victims of different forms of violence, including physical, psychological, and sexual violence. They also suffered from respiratory problems, skin infections, body aches, and gastrointestinal illnesses caused by drinking contaminated water and having limited access to healthy food.“We treated 278 survivors of sexual violence. 94 per cent of them were women between 18 and 35 years old,” says Hereu. “We know there were many more victims, but they were afraid, ashamed, or unaware of their right to medical care because of their irregular status in another country. That’s why, in addition to offering emergency contraception and infection prevention, we also focused on providing psychological support.”Patricia, 24, contacted MSF in 2025 while returning to Venezuela. She had been on the road for nine months and had survived sexual violence while crossing the Darién.“Most men were robbed and threatened with guns to their heads,” she says. “And us, well, we were abused. That happened to me in the jungle… it was like a shock, like being sleep-deprived. I couldn’t get my strength back. What gave me the will to continue was my son and my husband, who were with me.”Most people assisted by MSF were from Venezuela. However, in 2024, others came from different regions also facing severe crises.“We assisted people from Haiti, Senegal, the Democratic Republic of Congo, Afghanistan, Angola, and South Sudan, among others – places where civil wars have left thousands of victims,” says Hereu. “It was like seeing a refugee camp, but in motion, with the added challenge of language barriers and restricted access due to their method of travel, usually in groups and guided by smugglers.”MSF staff had direct contact with families broken by violence. Women who had been assaulted, men who were forced to witness the rape of their wives, daughters, or sisters. Children who described kidnappings, robberies, and extortion along the way.In coordination with the Ministry of Health and other humanitarian organisations, MSF followed up on people needing hospitalisation or specialised care for chronic illnesses, pregnancies, or mental health conditions linked to what they had experienced or pre-existing diagnoses.The project closed after observing the impact of U.S. migration policies, which include cuts to humanitarian aid funding for services, that while independent to MSF, were linked to migration. It is important to highlight that, although the movement north has nearly stopped, hundreds of people do not see returning home as an option and remain stranded – especially in Mexico – without options and often living on the streets.MSF calls on regional authorities to respect the human rights of people on the move. We also urge the provision of dignified and humane conditions, with spaces that ensure access to healthcare, food, and well-being.