• Migrants crossing from northwest Colombia into Panama through the Darién forest are being robbed, assaulted, raped, even killed.
• MSF teams are providing medical and mental health care to people in Panama who have made it through forest.
• MSF calls on Panama and Colombia to establish safe migration routes between the two countries to ensure people’s safety.

Following a surge in arrivals, Médecins Sans Frontières (MSF) has begun providing medical and mental health services for migrants crossing from northwest Colombia into eastern Panama through the Darién forest. MSF is calling on Panamanian and Colombian authorities to create safe routes that protect people in transit.

“There is enormous suffering among our patients because of the journeys they are having to make,” says Raúl López, MSF’s project coordinator. “Many of them have been on the road for weeks or months and crossing the Darién forest is hard because of the long, difficult journey.”

“Added to that, we have heard terrible tales about the violence, robberies, sexual assaults and attacks people have faced,” says López. “We demand that the Colombian and Panamanian authorities guarantee protection for people in transit through their countries.”

In May 2021, MSF began activities in Bajo Chiquito, the first town migrants arrive at in Panama, and in the San Vicente and Lajas Blancas Migrant Reception Centres, after noting both an increase in the number of migrants arriving and their existing medical and mental healthcare needs. The MSF team includes doctors, nurses, psychologists and logisticians. As well as providing medical and mental health services, they are also improving the local health infrastructure.

In recent months, Panama has reported an increase in people arriving from Colombia through the Darién forest. Between January and May, more than 15,000 migrants travelled this route into Panama. In the month of May, 5,303 migrants have registered their entry, according to the Panamanian National Migration Service.

Many come from Haiti and Cuba, but there are also citizens of different French-speaking African countries, as well as Pakistanis and Yemenis. Although most are adults, there are also families with children and many women in an advanced stage of pregnancy. In May, our teams carried out 3,390 medical consultations and an average of five individual and five group mental health consultations a day.

“It’s a really tough route, both in its geography and its duration,” says López. “The walk can take between five and 10 days, depending on whether it’s the dry or rainy season.”

“We’ve been told about instances of violence and robberies, and a lack of food and water,” says López. “Our patients have seen other migrants who have not been able to carry on due to exhaustion or who have drowned in the rising rivers.”

“The health issues that we see the most are related to skin infections and lacerations in the limbs, as well as dehydration and Diarrhea,” continues López. “Children are often suffering from fever, Diarrhea and malnutrition. One of the issues that worries us the most, and which is shocking, is that many of the women we help have told us that they have been sexually assaulted en route.”

During the first 15 days of providing medical assistance in Bajo Chiquito, MSF treated 12 women who had been sexually assaulted in the previous three days. “On the first day of our project, we had five cases,” says López. “Our teams, who have years of experience on the Mexican migration route, had never seen such a large number of cases in a single day.”

Testimonies collected by our teams in Mexico, in migrant shelters where we work, show the horrors facing those that make the Darién crossing. Ana*, 45, comes from Cuba. After two years of travelling through South America, she crossed the border between Colombia and Panama.

“We went through a small path and suddenly we saw people with guns. (…) They started to search the men first. They were taking our things up the hill; shoes, money, phones. Up the hill there was another group of men, with guns,” says Ana. “Then they searched the women. Some of them were sent straight up the hill where they were raped. Some of them were raped in front of everybody, without us being able to do anything. Even me too… they abused me too.”

“That part is very difficult because there are many things,” says Ana. “They killed people, innocent people, in front of you, bleeding to death in front of you, without being able to do anything, without being able to help.”

MSF calls on the Colombian and Panamanian authorities to increase the protection of extremely vulnerable people on their journey.

“At MSF, we have been working with people in transit for many years. We have witnessed how borders, walls and administrative barriers negatively impact migrants and how they are exposed to trafficking networks that violate and exploit them,” says López. “Migrants should be able to transit between Colombia and Panama by safe routes established by the authorities, knowing that they will not be assaulted, beaten, robbed or harassed, and that they will not risk their lives or those of their loved ones on the way.”

“No one should face what our patients go through just for trying to migrate,” says López. “Migration is not a crime.”

*/*Name changed to protect privacy. Testimony was collected on 3 June at a shelter in southern Mexico.*

In Latin America, MSF has been working with migrant populations in Mexico since 2012 and currently also helps people in transit in Honduras, Guatemala, Venezuela and Colombia. The organization also runs activities for people in transit in the Mediterranean Sea, Greece, Libya and Ethiopia, among other places. In Panama, MSF collaborates with different public institutions, the Ministry of Health and other international organizations.

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