The epidemic of violence and the deterioration of economic and social conditions in the Central American countries of El Salvador, Honduras and Guatemala have forced large numbers of people to head north to Mexico and the United States in search of safety and security. Every year, hundreds of thousands of people continue to be forced to flee to escape death threats, physical assault, sexual violence and confinementMany people living in gang-controlled territory in Central America are effectively confined to their homes or neighborhoods, with severe limitations on their freedom of movement..

Increased displacement across the region coupled with sharply reduced options for international protection have created a humanitarian crisis that demands a coordinated humanitarian response. Governments in the region must place the well-being of individuals at the centre of their migration policies.

With this report, MSF seeks to expose the devastating effects that the criminalisation of migration is having on people fleeing violence and poverty in the NTCA. Seeking safety is not a crime. Over the course of seven years providing medical aid to people along the migration route, we have witnessed terrible suffering as well as extraordinary resilience among our patients.

People affected by violence and extreme poverty in Central America, irrespective of their legal status or the country in which they find themselves, must have access to medical care, protection and humanitarian assistance.