Health Needs in Migrant and Refugee Communities

Lack of access to health care, trauma, and poor living conditions all contribute to public health concerns of migrant populations.

The Patrons of Veracruz provide food for migrants traveling across Mexico. Giacomo Bruno. CC BY-NC-ND 4.0.

 Over the years of the Trump Administration, stories of maltreatment of migrants either at the border, or well-established in country, keep surfacing. This pattern is mirrored in other countries around the world, often with a large anti-immigration rhetoric. In the US, this has stemmed from a dislike and distrust of illegal immigrants but often spreads to legal migrants and refugees as well, at a huge health cost to those trying to enter.

 Trump’s policies to reduce numbers crossing the Mexican border include a, now revoked, policy to separate children from their families and a Remain in Mexico policy that prevents migrants from entering the US while waiting for asylum cases. With this policy over 50,000 migrants have been sent to wait in Mexico. They now live in overcrowded camps with limited access to health care. NGOs struggle to keep up with increasing numbers and problems such as clean water and waste management. US policies are supposed to allow children and those ill or pregnant to remain in the States, but this policy is often ignored.

Once in the US, it is still difficult to access care. Detention centers are overcrowded and trauma from being separated from family can lead to many mental health issues. Migrants are not covered by government programs and have to seek health care through out-of-pocket costs or community health and non-profit organizations. Language and fear limit many from getting care when something might be wrong. Poor migrant working conditions and food insecurity have lasting impacts on migrant health once in the country.

 Australia has had similar policies to deter migrants by sending them to wait for asylum on nearby pacific islands where resources are lacking. In 2018, there were almost 1500 detained in Nauru and Papua New Guinea. Health organizations working on the islands found a massive mental health crisis with one third of the 208 people treated on Nauru having attempted suicide. It was found that in the 2017-2018 financial year, the Australian government spent over $320,000 fighting medical transfer requests.

 The US and Australia have showcased how inhumane policies surrounding immigration comes at a great health cost. But the majority of refugees and migrants, aren’t in the US and Australia, they are in countries neighboring conflict. In fact, 86% of migrants are in developing countries. Jordan has been extremely generous with accepting refugees from neighboring countries but a large influx during the Syrian Civil War is straining Jordan’s ability to provide. In 2018, they had to increase the cost of medical treatment for refugees, which before 2014 was free, now leaving most refugees unable to cover basic health costs.

 The World Health Organization is working to try to make sure migrant health needs are met but with 258 million international migrants, 68 million of which are refugees, it is not an easy job. 

DEVIN O’DONNELL’s interest in travel was cemented by a multi-month trip to East Africa when she was 19. Since then, she has continued to have immersive experiences on multiple continents. Devin has written for a start-up news site and graduated from the University of Michigan with a degree in Neuroscience.

A Crisis of Violence Pushes Honduran Women to the U.S. Border

For women facing rampant femicide and rape in Honduras, the risks of a treacherous trip across the border are minor compared to the dangers of remaining at home.

High rates of violence against women in Honduras has been attributed to a culture of machismo. Paul Lowry via Wikimedia Commons. CC BY-SA 2.0

Yo no quiero ser violada.


I do not want to be raped.

So read the signs plastered across walls and doors in the cities of Honduras. Simple black lettering is inscribed beneath a pair of thickly lashed eyes, with the eyebrows above turned downwards in an expression of anger—or, more accurately, indignation—at the dangerous injustices Honduran women face every day.

Honduras has been called the most dangerous place on Earth to be a woman, and with good reason: As of 2015, the Central American nation ranked alongside war-torn countries like Syria and Afghanistan for the highest rates of violent deaths among women. Although the overall murder rate of Honduras, which has long been wracked by drug- and gang-related violence, has declined in recent years, murder remains the second-leading cause of death for women of childbearing age.

In 2014, a high-profile “femicide”—the murder of a woman because she is a woman—rocked the nation and brought its murder rates into the international spotlight. Nineteen-year-old Miss Honduras winner Maria Jose Alvarado, just days from departing for London to compete for the title of Miss World, was brutally murdered and buried in a shallow grave in a riverbank. Authorities surmised that her sister’s boyfriend, 32-year-old Plutarco Ruiz, shot his girlfriend, Sofia Trinidad, before opening fire on Maria Jose as she attempted to flee. The ensuing investigation yielded the sisters’ bodies within a week, but their mother, Teresa Muñoz, believed it would not have happened at all if Maria Jose had not been famous: “Here in Honduras, women aren’t worth anything,” she told ABC News.

In 2013, the year before Maria Jose’s violent death, statistics showed that 636 women were murdered during the year, one every 13.8 hours. Most victims lived in urban areas, particularly San Pedro Sula and the Central District—in fact, 40 percent of all murders of women could be traced to those two areas. Nearly half of all women targeted annually were young, with the 20–24 age range being the most at risk. And murder is far from the only danger facing Honduran women. Rape, assault, and domestic violence are also rampant, and perpetrators enjoy near-total impunity: In 2014, the UN found that 95 percent of sexual violence and femicide cases were never investigated.

San Pedro Sula, a city with high rates of femicide. Gervaldez. CC BY-SA 4.0, CC BY-SA 3.0, CC BY-SA 2.5, CC BY-SA 2.0, CC BY-SA 1.0

Honduras’ shocking levels of violence against women can be traced in part to harmful attitudes bubbling below the surface. Suyapa Martínez, a local feminist and co-director of the Center for Women’s Studies—Honduras, points to “machismo,” a Spanish term describing a society built by men “who consider themselves to be the owners of women’s bodies.” In such a society, women have historically lacked political power: Only about half of Honduran women work outside the home, and when they do, they earn just half of what their male colleagues bring in.

Meanwhile, those ostensibly tasked with protecting all Honduran citizens—women included—have done little to mitigate the crisis. A 2015 report from the UN special rapporteur on violence against women concluded that the administration has paid “minimal attention” to gender empowerment and implemented only “ineffective measures” to address social reform. And in many cases, the government inflames the problem by limiting women’s options after sexual violence: Emergency contraception is completely banned, as is abortion, even in the case of rape, incest, or threat to the mother’s life. Women who seek abortion can receive a prison sentence of up to six years. These strict rules stem from the stranglehold of the Catholic and Evangelical churches, who have resisted even minor liberalizations to legislation—even after the UN joined with other human rights groups in 2017 to call for the allowance of abortion in cases of rape, incest, or possibility fatality. To make matters worse, the government is expected to decrease the penalty for violence against women later this year to between one and four years in prison.

Trapped in a repressive society and seeing little hope for a safer future, huge influxes of women and children have embarked on the treacherous journey to America’s southern border. In what the UN has called an “invisible refugee crisis,” women from the Northern Triangle—which includes Honduras, El Salvador, and Guatemala—have been fleeing in droves, with more than half listing violence as their reason for requesting entry to the United States. Lori Adams, director of the U.S.-based Immigration Intervention Project at Sanctuary for Families, told Politico, “Women are leaving with no other option but to flee north, even knowing that the journey itself might be life-threatening, but knowing it’s a near certainty that they will be killed if they remain.”

Migration office in Honduras. KriKri01. CC BY-NC-ND 2.0


Yet even if women survive the trek north, their hopes are often dashed when they reach the border. According to researchers at Syracuse University, the percentage of asylum applicants denied by U.S. immigration courts has been increasing since 2012, reaching 65 percent in 2018. That year, prospects for Hondurans were particularly grim, with judges granting just 21 percent of asylum cases. And as of mid-August, new policies from the Trump administration will privilege green-card applicants—immigrants aiming to become naturalized citizens—who are educated and monied while denying those who are considered likely to rely on government welfare programs. Given the financial dynamics of Latin America, the new rule will almost certainly affect Honduran women seeking safety in the United States. Dario Aguirre, a Denver-based immigration lawyer, told the New York Times that Trump’s policy gives officers carte blanche to deny green cards to many working-class immigrants from less developed countries, such as El Salvador, Guatemala and Honduras. Thus, another option is ripped from the hands of already desperate Honduran women—and until the U.S. government or Honduran officials enact substantive change, their eyes will stay wide open like the posters on the walls, watching keenly for danger.






TALYA PHELPS hails from the wilds of upstate New York, but dreams of exploring the globe. As former editor-in-chief at the student newspaper of her alma mater, Vassar College, and the daughter of a journalist, she hopes to follow her passion for writing and editing for many years to come. Contact her if you're looking for a spirited debate on the merits of the em dash vs. the hyphen.