Migration: Moving beyond crisis

Kavita Menon:

Welcome and thank you for joining us for this discussion, Migration: Moving beyond crisis. I'm Kavita Menon, editorial director for Doctors Without Borders based in New York. Some of you may know Doctors Without Borders by our French name, Médecins Sans Frontières, or MSF. Today we're talking about MSF's work with people on the move as we get ready to mark World Refugee Day this Sunday, June 20th. As a medical humanitarian organization, we now have 50 years of experience working with people forced from home, andwe are constantly adapting to meet new challenges. We'll talk today about some of the big migration trends and the individual human beings at the center of our work. Joining me today are Sergio Martín, head of mission for MSF's medical projects in Mexico. Hello, Sergio.

Sergio Martín:

Hello, Kavita. Good morning, and thanks too for this invitation.

Kavita Menon:

Very Nice to see you. Nice to see you again. Aurélie Ponthieu, coordinator for MSF's forced migration team based in Brussels. Welcome.

Aurélie Ponthieu:

Hello, everybody. Thank you very much. Nice to be here.

Kavita Menon:

Before we dive into the conversation, a few quick housekeeping notes. This discussion will run for about 45 minutes. Wherever you're joining from today, you can submit questions for our panelists. Thanks to all of you who already sent in questions via our social channels. If you're watching on Livestream, YouTube Live, Facebook Live or Twitch, you can send questions in the comment section, or the chat section and our team members will pass them on to me. We'll get to as many questions as we can, and we'll prioritize questions directly related to today's discussion. There are also live captions for this event, which you can view on a separate URL, and we're going to add that link in the chat. Let's start with you Aurélie. Tell us a bit about what you do as coordinator of MSF's force migration team?

Aurélie Ponthieu:

My team is working in department that provides support to operations everywhere in the world, in defining operational residences and advocacy strategy around migration issues. We advise our missions in the field how to position MSF, how to provide the best assistance we can, how to make sure people with access protection, and we advocate in that respect towards the different stakeholders, including government.

Kavita Menon:

What's your perspective on the so-called global refugee crisis that we see in the headlines?

Aurélie Ponthieu:

Well, every year, unfortunately, we hear that the number of forcibly displaced in the world is growing, so obviously it's a key concern. But we're dealing actually with a lot of different crises, so there's no such thing as a global crisis of displacement. We are dealing with different situations in different regions. But we also see major trends, and we can see, for example that certain policies that are trying to limit people's movements deter people from moving, of crossing borders, are replicating in different regions. We can see states getting inspired from one another, and that's a problem because we see that it's a source of suffering and humanitarian and medical needs in different regions.

A lot of challenges, but also very complex factors that push people to move sometimes for very different reason and common trends linked to natural disasters, conflict, and climate change as well. That is for sure going to increase even further the number of people that are going to be forced from their homes in the future.

Kavita Menon:

Yeah. Sergio, let's zoom in on one context, in particular, as MSF’s head of mission in Mexico. You've seen up close the impact of state policies and really charged language around the refugee crisis, or the migration crisis, and how these things make life even more difficult for people on the move. I wonder if you can talk a little bit about that. What kind of medical care does MSF provide along the migration route? What are the needs that we see?

Sergio Martín:

Yeah. We are currently working on the Americas all on the migration route from Panama to the US Mexico border. We are providing medical care basically, and mental health care. We are also on this very important and very linked to what Aurélie is doing and together with the health department, giving voice and witnessing and giving a voice to the people we work with. Right? Beyond that, we see migration as a very political issue, a very political affair. What we witness is the impact of this politicization, if I can say that, right? Of this matter. We forget, and we can see how politicians are forgetting sometimes that we are talking about people.

You can see very clearly the impact of different policies. We're talking any single excuse to harden migration policies everywhere in the world. Also in the Americas, we have seen that with new governments trying to gain votes. That has been very clear, but also with the pandemic, and using the pandemic as an excuse to harden policies. That at the end are pushing people to more violence along the road where we are working. We see many sexual violence, we see many people, many from Central America region, Honduras, El Salvador, Libyan, the places because they have no choice, because they are suffering violence, they are suffering torture, they are suffering, there are threats, see how their children are recruited by the maras [gangs] or by the criminal groups, having no choice and be forced to move within a very, very complicated and difficult route. Right?

Sometimes we have seen governments, with the policy of the remain, the payments policy "Remain in Mexico", the US government was putting these people in the middle of border Mexican towns. Very dangerous, and forcing them and forcing families and women to be exposed to more violence even, right? It's not only the problem and the violence and the hardship of the road, but on top of that, the policies are also putting people in danger, and we should not forget that. I think it's more and more and already can talk more on that for sure in the world that policies are putting people in danger, really, and are part of the problem sometimes, right?

Kavita Menon:

Yeah, I think. Aurélie, what do you see from the European side in terms of European policies and the impact they're having on people's lives?

Aurélie Ponthieu:

Yeah. Unfortunately, the European policies are a source of inspiration in many other regions. We see that there's a big impact. In the last 20 years we've seen the asylum system in Europe being restricted to become almost nothing today. We are really shrinking the definition of who is a refugee, trying to put obstacles in people's ways, trying to deter them, and that's really, I mean the common denominator of these policies is deterrence. This is what comes first. It's not about protecting human lives, dignity, offering asylum. It's really the first intent is to deter people from coming. You have people that are basically all stages of these policies, and kept in miserable conditions so that they can send a message to other people that would dare to come to Europe.

We've seen these policies unfolding under our eyes in the last years. We would never have imagined that we would have such a restrictive asylum system in Europe in 2021. Every day we hear new changes, new legislations. We just released a report about the situations in Greece and the Greek islands, and we are really denouncing the model that is being put in place by the European Union, which is a deterrence model that aims at doing this very artificial triage between who deserves protection, who doesn't deserve protection. Even those who deserve protection, they are very few today. We cannot even know who deserve the protection of Europe because even Syrian refugees are supposed to ask asylum elsewhere. One of the consequences is you see a lot of human suffering and people dying on the way and suffering very miserable conditions in Europe.

Kavita Menon:

I feel even these terms of the refugee, asylum seekers, all these terms themselves have become quite politicized and even used in a pejorative way as this whole people seeking safety. We have this slogan that we use at MSF, seeking safety is not a crime. We have to remind people it is a right to seek asylum. This is an international right. There's many domestic laws also exist to protect the rights of refugees and asylum seekers. But can you explain why that matters and where we are now with the international protection regime?

Aurélie Ponthieu:

Well, it's a very important question because obviously, the definition of refugee and the one that is the most universally applied, which is the one of the 1951, a UN Geneva Convention. That is the definition of who is a refugee. Obviously, it's also a political construction. This is, of course, government's agreeing in 1951 of who they wanted to protect and who deserved the protection of the state. This definition today is inadequate. We know and in our patients everywhere we work, we see that a lot of people need protection that is not found in the Geneva Convention. You have people that and again, talking about the climate emergency, we know it's going to be even, in the gap of protection that exists in this legal framework, it's going to grow bigger.

We have people that deserve protection for many different reasons, but we'll not find it in the Geneva Convention. Instead of expanding the protection regime, instead of finding new ways to protect people, we are seeing the other way around. States actually restricting even further even what exists in the legislations. One of the big fear is that if we reopen the definition of a refugee, so someone that finds protection for because of persecution, for the race, religion, political opinions, there's many different criteria. Even to reopen that, the risk is that we will end up with something even more restrictive than what we have today. But many people are falling into the protection gap. They deserve protection, and they are not finding it at this moment.

Kavita Menon:

Yeah. It seems the crisis or the crises are getting bigger and worse to come, and states are doing less and less, and instead of rising to the occasion to rethink policies. We're trying to fill gaps where we can, but as a humanitarian organization, our mandate, it's very focused. I think that raises another issue. When we do this work, we talk a lot at MSF about the importance of témoignage, or speaking out, as quite central to our mission. But when we speak out for and with refugees, we're often accused of being too political, especially when we're talking about this in the context of the Americas and in Europe. I wonder, do you think, are we getting too political? I'm curious what your thoughts are about that criticism? Sergio, do you want to take that first?

Sergio Martín:

Well, I can. I think we need to be human. We are a humanitarian organization, and obviously, we are getting to debate, and we are adding to the debate on who should be a refugee and everyone that is outside that political definition at the end, right? But beyond that, we see people suffering, we see people risking their lives with no choice. Honestly, our teams in front of the people when they are taking care or when they are given a consultation, providing mental health, they are not thinking about what's the political figure of these people. We have people suffering.

I think it's important for us as an organization to push in the public space on that. We're talking about people, and it's not a matter of which level we are putting to these people. We are talking about people in need, people that have no choice, that are taking very difficult routes, that are risking their lives, and that's not for free. They are doing that to be safe. People like you or me, I'm Spanish. I'm very culturally near. I mean, I'm very near culturally of the people were treating in Mexico. I see people, I could be them. Normal families that one day they need to move because there is nothing more for them in the countryside, in El Salvador, or in Honduras.

They go to the town, they try to find a light there, but they're immersing in that violent environment. The children are absorbed by the maras, and the criminal groups and they are forced to flee. And they were, I don't know, economists, or they were people living in the countryside. I mean, you have people like us that saddle leaving each move. From our point of view, when we are providing this medical care, it really doesn't matter if they are moving because of the climate change, the hurricanes, the drought, or the violence.

They are prosecuted or not. They don't have the choice. They need a system. They need protection, whatever we are, what’s the label we're putting on it. It's very clear. I think we don't need to be political even if we are accused or not. I mean, we don't need to enter there. We're talking about human beings in need, and that's all and that's blank, and that's easy to understand.

Kavita Menon:

That's very well said. Aurélie, did you have more to add?

Aurélie Ponthieu:

No. I mean, Sergio said it all. It's about saving lives. If it has to become a political choice, then that's what needs to be done. But I don't think it's more political to talk about asylum in the US or in Europe than in Kenya or South Sudan. I think there is, of course, we're talking about borders, we're talking about state sovereignty, so it's always a very sensitive issue. But MSF has been helping refugees since we existed, it’s been 50 years now. We have not become more political. We've always done this work. What we care about is for people to be treated with dignity, to access health care, and get the protection that they duly deserve. They really do deserve. Yeah. That's what humanitarian action is about.

Kavita Menon:

That's great. Thank you. A reminder to everybody, if you're tuning in now, you can submit your questions via the chat feature, so keep them coming. We have a question from Antoinette who asks, what is it like to work with people who have been away from their home, their family, their livelihoods for so long? I wonder if either of you have any personal stories, any testimonies that stand out for you?

Aurélie Ponthieu:

There's so many.

Kavita Menon:

Do you want to start with your recent? You were in Greece recently?

Aurélie Ponthieu:

Yeah, I was in Greece a few months ago, and it's always hard because I've been following these projects that we have in the Greek islands as I was in Lesbos.

Kavita Menon:

Actually, maybe take the audience back a bit about how long people have been on the Greek islands, and what's happening there?

Aurélie Ponthieu:

I mean, these islands have been, I mean, they have a long history of refugee issues because the population themselves they were refugees once and they have seen people from Afghanistan, from Iran, from the Middle East mostly arriving since the end of the '90s, beginning of the years 2000s by small numbers. But obviously, the numbers of people have increased because for very simple reason is that the European Union have closed its external borders, that even physical fences that have been built at the Greek Turkish border, we know you have different walls everywhere, so people have been forced to arrive by sea, and that's a key concern.

Because obviously, it's still a minority of people who arrive irregularly in Europe. Most of displaced people, refugees, they are not coming to Europe. They are in the south; they are living very different lives. But that's the main focus of the policies today. These people arriving irregularly by sea because they have no other choice. Of course, the number of people have been increasing quite a lot in the last years with of course, the one million people who entered through these routes to Europe in 2015.

Since then, very, very restrictive policies put in place with people now being contained in very bad camps on these islands, waiting to be either returned or to get this very challenging access to an asylum procedures, which has really reduced as I was saying. It's very hard because we see, each time I go back there, I see things getting worse. I see the treatment of people getting worse, and people really losing hope. Its families, its children. There's many, many children. It's a lot of people who have fled war and destruction. The harm that is being done to them in these places isn't acceptable. That's the most revolting thing. It's that it's not just because they flee war that they are in this situation. It's they are put in the situation by the government that wants to deter them from coming. It's really punishment.

That's the new normal. It's normalized, nobody's questioning it, and we see people, we see children self-harming. We have hundreds of people, of children with very, very severe mental health distress. Even some attempted suicide as young as 10 years old, so it's really, it's heartbreaking when you talk to these people. Yeah. States have taken away their hope and their life and what makes them able to survive, basically. Yes, there's plenty of stories, and it's really heartbreaking.

Kavita Menon:

Yeah. We've done a lot of documentation reporting on the mental health crisis, right? That just keeps getting worse. I think, Sergio, you also see the mental health issues in Mexico, quite acutely. Can you talk a little bit about that?

Sergio Martín:

Yeah, definitely. In Mexico City, we have a center for victims of extreme violence and torture. 95% of our users still today, they're migrants basically. A lot of them have suffered torture or have suffered these extreme violence already in their places of origin. They try to move to a better life, or they try to go to the US, and they end up by having and receiving more violence along the road. A number of them, they finish in our center, and we have annalistic approach there. They stay with us for months. We try to give them the tools to leave.

In fact, about suicide as she was talking earlier, I mean, we have 90 to 94% of our patients have tried to, so it's really a hard life, and it's really very hard situations. I mean, it's very hard for our colleagues to work there too because you are listening very hard stories and you're working in a very, very... I mean, it's human misery. It's really the extreme of this work, and it's very hard to work with people that have been so affected on the physical side, a lot of times also, but on the mental health side, right? One of the criteria to enter the center is having less functionality. We're talking about people that cannot live a normal life as a consequence of the violence they have suffered.

When we link that to decent indication you may have with these people, I remember a family, in Nuevo Laredo that was during the MPP time, the Migrant Protection Protocol. The “Remain in Mexico” time, right? We had a patient. The family, they were kidnapped basically in the border with Texas. After the man was forced to work with the organized crime, trying to buy their freedom, whatever, finally they arrived. I mean, they managed to be free. They crossed to the US, and the US authorities, they were asking for asylum. They were already fleeing violence from their place of origin and having a 3,000 mile trip, very hard two, three months to arrive to the border.

Then the US border authorities, they put them and they send them back 500 meters of the house where they were kept while kidnapped by the organized crime. That was an example of everything for me. It was an example of a normal family we could be identified with. They had a normal life, everything crumble because of a violent environment around them. They need to move, they move. They have a violent road, they arrive to a place, they have a huge shock too, with this kidnapping and everything. When they think they are in a safe place, and they do. They are in a safe place, and they have the right. They are asking for asylum; they're asking for protection.

What they receive, they receive a detention of two three days and send them back to the same place they have suffered all this violence that is not their home, even. They are not even Mexicans. I think honestly, sometimes we don't realize what a migration policy is having as an impact. Again, and I think we should push again to put the human being and to talk about human stories, because we are talking about that. We're talking about that, we are talking here, right?

Kavita Menon:

Yeah, exactly. That's a devastating story. I do think it captures so many of the different strands, and you really see how this affects, you know, this one family. We're getting a question from the Livestream that brings up, you mentioned the involvement of criminal gangs. When Yope, I'm not sure if I'm pronouncing your name correctly, so apologies, asks that some people say that by helping refugees, humanitarian organizations are also supporting human trafficking organizations in the US and in Europe. How do you prevent this trafficking, is the question. How do we navigate that?

Sergio Martín:

I can maybe go first Aurélie. I think it's criminalization that is feeding really the human trafficking, right? It's very clear on the road. We are working from Panama to Mexico now under the US border, in fact. You can see very clearly those countries that are allowing people to move and to cross them, people doesn't need to do hide. Doesn't need to go to the forest. They can take a bus. They have much less problems with violence and there is no these criminal organizations trafficking them. There is no need for that. There is not a market for that, if you want to put this in economical terms, right? In Mexico, they need to hide. They cross from what? I mean, Honduras, El Salvadorians, they can move freely in Guatemala. That's fine until they arrive to the border.

We have a program near the border with Mexico in Guatemala. We have women come in and asking for antiretroviral prevention for pregnancy. I mean, they know they are going to [be] rape[d]. They know. Once they enter Mexico. The only changing factor is this freedom to move. Mexican government is will deport them if they are detained, so will prosecute them and this is pushing them to I mean, they are criminalized, if you want to say like that. They are pushed to the bush, they are exposed to violence, and then it's the whole market created on them, right? To traffic them.

Basically, we can see things the other way around, and migration policies are really feeding these criminal gangs. When you are working in the border in the northern Mexican border, as a coyote [person who smuggles immigrants]. Suddenly the pandemic came, and less people were moving, and your business were down. I'm sorry, I'm very blunt. I mean, it's like that, right? You are having less people crossing but the United States with the excuse of the pandemic to avoid to spread the virus in the United States. They're sending back people even if they are not Mexican. People are sent back to Mexico.

Well, this is also putting at risk Mexican side that's clear. But in fact, coyotes, they're taking the same people once again because they're just sent back, so they have more markets. When you are on the ground, you have the perception that it is the other way around, and really that migration policies and hardening migration policies each time they're hardening it, they are feeding more and more the criminal business on that. It's very clear on the ground. You can see the other way around. I think we need to, and we should push for safest roads. We should push for those needing protection to have them, regardless the label you're putting on them, as we were mentioning before. This is very clear. I have the impression that they are just an excuse sometimes, these human trafficking gangs, right? That we are taking them on this.

Kavita Menon:

Well, yeah. I mean, we say these harsh migration policies are driving migration underground and really enriching these smuggling networks. I think we also see this in Europe. I'm curious Aurélie, I mean, this is again one of our most controversial activities, probably are our search and rescue operations in the Mediterranean Sea since first launching in 2015. We’ve sent medical teams on board, seven rescue ships, and have provided lifesaving assistance to more than 81,000 people. But why are we even doing this work?

Aurélie Ponthieu:

Yes. It's a good question because it's becoming so difficult to rescue people at sea. Knowing that search and rescue is a legal obligation, it's the obligation of all ship masters and to think how difficult it has become just to be able to rescue people at sea in the Mediterranean Sea that will drown either way, so I mean, if we don't rescue them, they are for sure not reaching destination. We have a ship at the moment actually, that has rescued several hundred people and that is waiting from a place to disembark. States are refusing to allow this disembarkation which is also a legal obligation. People that are rescued at sea needs to be brought to a place of safety by law. It's international maritime law.

As MSF, we continue, despite all odds, and despite the fact that we are also talking about human trafficking, we are accused of working with human traffickers, and we are criminalized as we speak. In Italy, for example, we have legal proceedings against our organization and our members for this specific activity of rescuing people at sea. Despite that, we have to continue because every year we have hundreds of people who drown or go missing. If we talk about the route between Libya and Italy, we are actually talking about people fleeing human traffickers. People that are escaping torture, ill treatment, slavery, and that are put back in these detention centers as soon as they are intercepted and brought on ships of the Libyan coast guards that are funded by Europe.

We are accused of being the traffickers when Europe is putting people back in the hands of people. Something very important, and I completely agree with what Sergio was saying, that people will come back. They will try again. I've met many people who have been pushed back at all borders. At the Hungarian border, the Syrian borders, both borders, Greece borders. They will try again because they have no other choice. They try 15 times sometimes. I've met people who have been pushed back 15 times and sometimes very violently. Indeed, the problem is the lack of safe and legal passage. We need safe and legal avenues so that smugglers and human traffickers are out of business. That's the only way.

Kavita Menon:

Yeah. I always think of that famous poem by Warsan Shire. No one leaves home unless home is the mouth of a shark, and I think that really captures for me the extreme situations that people are in. We are seeing more and more even transcontinental migration, especially to the Americas. Sergio, you mentioned a few times what the new work in Panama and along the border. Can you talk a little bit about the changing patterns of migration that you're seeing?

Sergio Martín:

Well, it's a road that is increasingly used. In fact, we are working in Panama, in the border with Colombia. You have the Darien rain forests. It's very exotic place. They are discovering new species of animals constantly there. It's one of these unexplored places in the world, and people are taking seven to 10 days to cross it. We are working on the Panama side after they cross from Colombia. Main nationality we see today is Haiti, after Cubans. After that, the third one is from Nepal. They're Nepalese crossing there. We have Afghans, Palestinians, Burkina Faso, Cameroon. You have people around the world trying to reach the United States, crossing a very dangerous rain forest in Panama which is still 5,000 miles to the US border. It's amazing. It's incredible, and it's really sad.

It's very dangerous to cross these forests. You have a lot of natural dangers. They are suffering. I mean, hunger, lack of water. You have this rain almost the all year round, and a lot of people have drowned because you have some very sudden waters coming with the rains. We have terrible témoignage, terrible stories explained by people who have seen how, well they have been raped and after they have witnessed how some companions were killed in front of them. There is no law obviously in this rainforest. There are seven, 10 days between Colombia and Panama with no law at all.

You have some people bringing on some guides, obviously paid to cross people through the forest. But life is, just I mean, there's no pride. I mean, you're nothing in the middle of that forest. We have very terrible, terrible stories. We have seen so many sexual violence in this place, as in the rest of Mexico, which is already very, very violent for the rest of the year. It's incredible the number of violent events happening in this tiny, tiny portion of the road. As you were mentioning Kavita, this is somebody from Gaza trying to reach the US in the middle of, we're almost in South America, in the Panama rain forest. It's just amazing thinking that if you arrive there, it's because of your choice. This is, I mean it’s unbelievable, it's just too risky, too dangerous, and incredible what we are witnessing today. This road is more and more used.

Kavita Menon:

Yeah, well, it's horrific to think about that odyssey, and then what lies at the other side after all of that. I'm curious to reflect. This is our 50th anniversary of MSF. We've done this work for decades. We've seen some of the changes in migration. What are some of the things that we've learned? Some of the experience that we've gained in our response to the needs of migrants and refugees? How have these lessons informed more recent interventions? This is a question from Michael on the chat.

Aurélie Ponthieu:

Yeah. We learned a lot, because we had to adapt quite a lot while still keeping the same expertise to respond to the old challenges. We see today, of course, that refugee camps are still places where unfortunately assistance is too limited, where people have no prospects where they are staying even longer than before. We have more and more protracted refugee crises. We need to continue as MSF to be able to respond to this form of displacement. We see new camps appearing and mostly camps that look like prison. I've talked about Lesbos. But we see that more and more. Camps are becoming really like detention centers and prisons unfortunately, for asylum seekers and refugees.

We had to learn more and more to respond in detention settings, which is very complicated intervention because it requires to really know your place, what impact you can have, to have a team that are prepared to work in detention and detention like by conditions. It’s very, very tricky. While not promoting the system, not being complicit in the detention system, it is quite challenging. We've developed quite a lot of expertise in different places in the world working in these conditions. Then we had to adapt to what Sergio was explaining. People in transit, people that have not arrived yet, that are stranded at borders. Then rescue. People that need to be rescued because they are at the most dangerous borders. We can imagine in the middle of the sea, in the middle of the forest.

We had to develop quite a lot of experience, expertise, sorry, in responding to all forms of violence, including ill treatment and tortures. We have developed expertise on that. We really had to diversify the type of assistance we provide, while keeping the old school emergency response that you can still have in different countries when you have a sudden influx of refugees across the border in DRC, in the Democratic Republic of Congo, or in South Sudan, or in our internally displaced people, which are also the most common form of displacement in the world today. Yeah, it's many challenges, but it's also important that we respond to all forms of displacement, and not only in the south, but also in the north, in Europe, in the US, in other countries where we see very, very severe needs as well.

Kavita Menon:

Yeah. You made this important point earlier, too, about how most migration is not south to north or east to west. It's people tend to be internally displaced or to move just to in within the region. There is a misperception, especially in the United States and in Europe about even the nature of the global picture.

Aurélie Ponthieu:

It's dangerous because this perception erodes the rights of all refugees. It's really, really dangerous, this misperception.

Kavita Menon:

Looking ahead, there are some people who have asked about MSF's response to climate migrants and this threat of even more massive displacement going forward. How are we prepared to respond?

Aurélie Ponthieu:

Well, I think it's a key challenge, and I don't think we have yet the full understanding of how climate change is already affecting how people are moving today, because also people, they don't know how to explain. When you lose everything, you don't say, "Oh, I fled because of climate change." That's not how people phrase the reasons that push them to cross borders. But for sure, I mean, a lot of the advocacy we're doing for states to actually extend protection rather than restrict it for better responses at border, for more humane migration policies. This is also in light of the challenge ahead, which is, it's important that we look at the evidence, that we look at the fact it’s not, that we should not accept that this is the way forward. That there's no other way.

Because first, this is not working in terms of reducing migration flows. This deterrence approach, this containment policies, the externalization of borders to other countries, things we've seen in many different regions, there is another way. We know that if states are not prepared to host more people that are displaced by many different factors, then we are going to continue seeing crises at borders like we do, and we're going to see more situations of despair and more needs. Yeah.

Kavita Menon:

Yeah. Coming back to this idea. I mean, there are often multiple and overlapping factors, and I think that nature of mixed migration, multiple push factors, we see that a lot in the Americas as well. These are not future threats. This is, things that are happening right now. I think, Sergio, you've seen when you've interviewed people who are coming, making the journey north from Honduras, there are multiple factors. Cycles of drought, flooding, hurricanes, as well as violence, poverty. There's so many different things happening, right?

Sergio Martín:

Yeah. I mean, as Aurélie was mentioning, people sometimes, well, we have difficulties just explaining why we left, and that's very clear. Everything is having an influence obviously. We have two hurricanes in Honduras in the past months, and you see that there are a lot of people, tens of thousands, they lost everything. When they are in a very fragile balance already, if you have a changing factor, that will force you to move, and this can be mixed and overlapping factors that you were mentioning, like violence and economic factors, or the drought or the hurricane, right? Everything is mixed. The fact is that you don't have the choice, you need to move.

When you see all these people taking these dangerous paths in Europe, the Mediterranean, or the Americas, I mean, you have no change. You will do the same Kavita or me Sergio, or whoever, in that situation. You will try to have a better life for your family or a life, if your life is threatened. That's clear. I think, at the same time that I don't think we should, as an organization, put the focus into label if someone is refugee or has the right to be refugee or not.

I don't think we need to be distressed or to stress too about the reasons of moving or taking that. But when we see and regardless the people we see, they have very little choice or no choice but to move, and this should be the center of our approach, I think. As human beings, not only as humanitarian organization. This day that we are commemorating, celebrating next Sunday, again, it's the perfect day to remember that. Right? We're talking about people and we don't need to label them, that's suffering and human suffering at the end, right?

Kavita Menon:

Yeah. That's absolutely... We're coming up to time, and I think that, that's actually where we should start, and where we should end. Is really coming back to these people. We see medical needs and we address them, and that's what it comes down to. I want to thank everybody. Thank you, Aurélie, and thank you Sergio for your time. This has been a really fascinating conversation. It's very stark to be confronted with the needs, but it's also I think, reassuring to know what can be done. We can respond, we can do better, and we must. I thank you all for joining us. Apologies if we didn't get to your question, but please stay in touch and stay connected with MSF. You can email the team at [email protected]. For more information, you can always visit our website which is Doctorswithoutborders.org. You can also follow us on Facebook, Twitter, Instagram and beyond. Take good care, and goodbye. Thank you again.

Sergio Martín:

Thank you.

Kavita Menon:

Be well.