Since February 2017, Médecins Sans Frontières (MSF) has expanded its activities in the city of Reynosa, in the northern border state of Tamaulipas, Mexico. Its aim is to provide direct medical, psychological and social care to communities in one of the country’s most troubled areas.

These activities are in addition to MSF’s work at Reynosa General Hospital, where it has provided free, confidential mental health consultations and staff training for nearly two years.

MSF started working in the Pedro José Méndez neighbourhood in early 2017. A team composed of a doctor, a nurse and a psychologist offers comprehensive healthcare at a general medicine clinic, and refers patients to other health facilities in the city if necessary.

It is one of many neighbourhoods across the city to have witnessed episodes of violence in recent years.

“The medical team is focusing on providing mental healthcare for victims of physical or sexual violence”, said Dr Marcelo Fernández, MSF medical coordinator in Mexico.

Anyone who attends the clinic for a medical or psychological consultation with the MSF team is asked to fill in a questionnaire related to violence.

“Of every four patients we assist, one has been a victim of some type of violence”, said Dr Fernández.

In addition, the stress of living in the volatile city over the past decade has affected the mental health of many residents.

“We have detected very significant psychiatric disorders in recent months,” said Dr Fernández. “We see people suffering from isolation and phobias – people who are afraid to go out. When they do go out, they take very precise routes”.

In the week that follows each outbreak of violence, the clinic is empty.

“Patients only come if they have an illness that requires urgent attention,” said Dr Fernández, who has observed that public life is diminishing.

MSF also operates mobile clinics to provide care at two shelters for migrants and deportees from the United States.

“The goal was to get closer to the community and provide direct care for victims of any type of issue”, said Dr Fernández. “In the shelters, we provide mental healthcare, mostly for Mexican citizens deported from the United States.”

A significant part of MSF’s work in Reynosa consists of giving medical care to victims of sexual violence. Dr Fernández observes that numbers of cases of sexual violence are increasing.

"We provide a medical kit for sexually transmitted infections, which includes antiretroviral and antibiotic treatments,” he said.

Victims of sexual violence are also given mental healthcare consultations.

“But it’s still a taboo subject – people are afraid of both filing a complaint and attending a hospital,” explained Dr Fernández.

“There are no precise figures but we have seen at least 10 victims at various health institutes and at MSF services in recent months.”