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Journal Article

Citation

Lancet T. Lancet 2023; 402(10408): e1107.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/S0140-6736(23)02185-2

PMID

37777322

Abstract

The International Organization for Migration's (IOM) Missing Migrant Project found that 2022 was the deadliest year on record for migrants and identified the USA-Mexico border as the most dangerous overland migration route in the world. The perilous journeys migrants are forced to make expose them to a vast array of health risks. Difficulties in reporting along these clandestine routes mean that the true scale of the challenges migrants experience rarely makes headlines, but the USA's consistent focus on deterrence exacerbates the complex health demands of migration and needlessly exposes vulnerable populations to greater harm.

The most remote stretch of the overland route is the Darién Gap between South America and central America, one of the most hostile environments on Earth. A research letter published in The Lancet reviewed all forensic cases of migrant deaths in the Darién Gap from 2018 to 2022 and found the number of confirmed deaths--from drowning, illness, stabbing, gunshot, and unknown causes--steadily rose each year before spiking in 2021. Investigations by IOM and the International Red Cross found that this trend continued into 2023 and that adding disappearances could double these totals, underscoring the difficulty of data collection in a rugged lawless environment. Despite growing awareness of the risks of injury, illness, exhaustion, robbery, violence, and rape, more people are crossing than ever before; over 360 000 migrants have made the treacherous journey so far this year.

Of the 250 000 people who crossed the Darién Gap in 2022, more than 150 000 came from Venezuela, fleeing political persecution, extreme poverty, and a public health crisis. Responding to pressure from the US Government, Mexico, Costa Rica, and Belize imposed visa restrictions which effectively prohibit Venezuelans from lawfully entering and transiting their countries. Migrants are thus forced to arrange to be smuggled by criminal organisations over seven borders across the 4800 km journey to the USA. Exploitation is rife. In Colombia, cartels partner with local authorities to openly market goods and services to migrants at exorbitant prices. In Mexico, migrants awaiting lawful entry to the USA have been assaulted, extorted, robbed, and kidnapped by the same gangs they hired to smuggle them over the border from Guatemala...


Language: en

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