The situation for migrants in Mexico's northern border cities is sharply deteriorating as expulsions under Title 42 continue and hundreds of people arrive from the south each day seeking safety in the United States of America (US). The response from local authorities in the cities of Nuevo Laredo, Piedras Negras, Ciudad Acuña, Reynosa and Matamoros are inadequate, leaving thousands of people without access to basic services or safe shelter.

As one of the few organisations providing medical and mental healthcare in these cities, Médecins Sans Frontières (MSF) teams are overwhelmed by the growing needs of people arriving. Authorities at all levels and other humanitarian assistance organisations must expand their services to ensure dignified conditions for both the migrant and internally displaced communities in Mexico’s northern border cities.

In Piedras Negras and Ciudad Acuña, migrant shelters and reception centres are closed, and people do not have access to basic shelter, such as tents.

In Nuevo Laredo, an MSF mobile team has been providing humanitarian assistance to people from Haiti and Central America, as well as to internally displaced people fleeing violence in different parts of Mexico. More than 3,000 people remain in shelters and makeshift camps, living in unsanitary and unsafe conditions.

"Most are families with small children sleeping on the floor, exposed to the rain and high temperatures,” says Pavel Goytia, head of MSF's medical team in Nuevo Laredo. “The 10 shelters in the city are at maximum capacity and hundreds of people continue to arrive. Many of the shelters are makeshift spaces that lack basic services, mattresses, food, drinking water, protection from the elements, toilets, showers, and proper waste management."

"I have been here for a week in Nuevo Laredo,” says Esaia Jorince, 27, who fled Haiti three years ago after his family was murdered. “The situation here is very bad, I don't have money to buy anything to eat and I don’t have anywhere to sleep. It has been raining. In the shelter where we are staying there is a lot of water, I am sleeping on the floor—that is complicated for me and for my illnesses.”

“I start crying because I have pains and I feel very bad, sometimes I want to die." Jorince lived in Brazil but had to leave due to lack of employment. He hopes to get asylum in the US.

A similar situation is unfolding in Reynosa. The last remaining inhabitants of the Plaza de la Republica, a makeshift camp in the city, were evicted at the beginning of May.

"The number of migrants in the city has increased in recent weeks and there is a severe lack of housing, food, and health services to assist them,” says Anayeli Flores, MSF's humanitarian affairs officer in Reynosa. “There is no space in the shelters and many people are living on the streets enduring very high temperatures.”

MSF’s medical teams have treated many people for symptoms related to poor living conditions such as respiratory conditions, gastrointestinal diseases, and skin, kidney, and gynaecological infections.

MSF’s mental health teams also care for people who are experiencing symptoms related to post-traumatic stress disorder, anxiety, grief, and depression resulting from their experiences in their countries and along their migration route.

“When I [crossed] to the US, I was alone because we could only pay for my crossing,” says Yenth, who fled Honduras and entered Mexico in January 2021. “On the other side they stopped me. I was never seen by a doctor; they did not give me any information. The next day [the US authorities] sent me to Reynosa. They didn't care that I was pregnant. [In Reynosa] I was raped.”

MSF calls on authorities at all levels and other international humanitarian assistance organisations present in the region to increase their efforts to ensure dignified conditions for both the migrant and displaced communities along the northern border.

There is an urgent need to expand humanitarian activities to prevent the deterioration of people’s health and alleviate the suffering of people living in poor conditions.