A woman who leaves her children behind, a young woman who lost her mother to cancer. Another who leaves in pursuit of art or a job opportunity. We leave, we migrate. Living in a country that is being destroyed, deciding to leave, leaving, trying to assimilate, rebuilding without longing. We are more than 5 million people with a common trait: migration has impacted our mental health.
Text: María Laura Chang, Johanna Osorio Herrera, Héctor Villa León*
* Venezuelan migrant journalists based in Argentina, Colombia and Peru.
Migrating is more than moving from one place to another. It is leaving behind what you know, it is facing change. It is, many times, being alone, feeling that your roots have been cut off. It is adaptation, worry and calm, sadness and joy. Uncertainty. You can wake up happy one day because life looks a lot like what you had or what you dreamed of and find yourself crying in the afternoon because you are homesick, because you lost your job, because xenophobia stalks you or simply because you miss what will never come back.
We know it. We are among the 5,667,835 people who the United Nations High Commissioner for Refugees (UNHCR) says have left Venezuela to flee violence, insecurity, threats, lack of food, medicine and essential services.
Anxiety, depression and other serious mental health issues that result in inability to assimilate, that take away calm and can lead to instability, pain, addictions, violence and even death, are some of the consequences of our forced, determined and driven departure.
Adriana Caldera knew she had to leave Venezuela when her first baby died the day he was born. It was October 2016. She arrived at the hospital in labor, but there were no beds and she was asked to wait. The wait was too long. The umbilical cord was wrapped around her son’s neck. When doctors finally got to Adriana, her baby’s heart was no longer beating. That’s the moment she began to plan her departure from the country. In March 2019, in the middle of the national blackout that darkened Venezuela for more than 140 hours, Adriana packed her suitcase, guided by the flashlight of her cell phone, and left for Colombia with her husband.
AJ chose to leave because he saw no future for his dream of being an accomplished clarinet player. He saw the cultural life of Venezuela dying. He saw its university in ruins. Some days, AJ's family ate only mangoes that fell from the trees. But AJ didn’t leave because of hunger, he left because of the lack of art.
Both AJ, a native of Zulia state in western Venezuela, and Adriana, from Falcón in the northeast, were emotionally worn out. While he was a student at the university, AJ was the victim of more than 10 robberies or attempted robberies, always violent. Adriana feared being a mother in a country with a weakened health system, with hospitals without beds, supplies or personnel.
Her fear was justified. according to the Panorama of Food and Nutritional Security in Latin America and the Caribbean 2019, Venezuela ranks fourth in the region in neonatal mortality rate, with 19.8 deaths per 1,000 live births. Only Haiti, Dominica and the Dominican Republic have higher infant mortality rates.
Venezuela is the poorest country in Latin America, according to the National Survey of Living Conditions 2019-2020 which calculates that 79.3% of those living in Venezuela cannot afford basic foodstuffs. The inflation rate hit 65,000% in 2018. Although it declined in successive years to 6,500%, hunger stalked the population. The arepa, the most popular dish, became an unaffordable luxury. And it was all too common to see families scavenging in city garbage dumps for food.
The major blackout in March 2019 confirmed everyone’s worst fears. "We were warned that the country was on the verge of a collapse, but no one imagined that the situation would be so serious. The country shut down and the population was filled with enormous anguish, not only because of the absence of services, but also because of the lack of communication," explains Dr. Yorelis Acosta, clinical and social psychologist at the Center for Development and Studies of the Central University of Venezuela (CENDES).
There was despair and looting. Hopelessness reigned.
How do these crises impact the mental health of the population?
Dr. Cristal Palacios, is a clinical psychologist, researcher and founder of Psicodiáspora, a network of Venezuelan psychologists and psychiatrists living outside the country. She points to a decrease in quality of life that cannot be attributed to a single traumatic event. All the events combine to affect us as a whole and often generate chronic stress and post-traumatic stress, she says.
"We start distrusting each other. The family has withdrawn into itself because it is the only way to be protected when everything is against you," says Palacios, who describes the deterioration of social relationships as the result of experiences marked by crisis.
Dr. Acosta describes a "traumatic-catastrophic" event that has psychosocial impact at the individual and social levels in her article Psychosocial Suffering in the 21st Century: Venezuela and the Revolution. "Living for long periods of time in violent situations can increase the likelihood of psychological disorders, cause them to become persistent and even project them from one generation to another,” she says.
All this suggests that when we face adverse conditions, full of fear and anguish caused by not having our needs met, we can normalize all these failures, but internally, the emotional issues accumulate. “They are internalized both at a neurological and cognitive-emotional level and eventually result in these post-traumatic stress symptoms,” notes Dr. Acosta.
These symptoms lead us to live anchored to moments in the past. They surpass our emotional management capacities, says Dr. Palacios. In the case of migrants from Venezuela, these are not necessarily singular situations, but are caused by the accumulation of stressful events experienced in the country that lead to hypervigilance, difficulty sleeping or eating, invasive thoughts or flashbacks, and difficulty releasing memories of Venezuela. It sometimes means avoiding people who do not want to hear anything more about the country, but who in reality have not been able to disconnect because they are still anchored to the experiences that marked them.
"Past events build into a big event that makes our daily lives difficult," says Dr. Constanza Armas, a psychologist and migration specialist.
The Venezuelan Violence Observatory (OVV) carried out a study from October 2019 to March 2020 to determine the impact of the crisis on suicides. Although there are no official figures, the research contrasted data from the World Health Organization (WHO) and institutions such as the Health Corporation (Corposalud) of some states of the country.
"The suicide rate between October 2019 and March 2020 may have been fluctuating between 9.3 and 9.7 suicides per 100,000 residents. According to the latest official figures recorded by the Venezuelan government, the rate stood at 3 suicides per 100,000 in the same period. We saw an increase of more than double. That coincides with the reality we are living," says Gustavo Paez, coordinator of OVV in the city of Merida and in charge of the project.
El Activista de DD.HH del Zulia Alejandro Jesús Urdaneta, se suicidó la tarde de ayer luego de postear en sus historias un texto corto que expresaba "Los Quiero a todos, espero sean felices". Se desconoce hasta el momento los motivos que lo habrían llevado a cometer suicidio.👇 pic.twitter.com/EaYrLwtvLF
— Bertilio Pérez Chávez. (@BertilioPerezCH) April 15, 2021
OVV has been monitoring suicides in Venezuela for the past three years through police and media reports. Covid-19 made the situation worse in 2020, when there was a 150% increase between April and May. "People began to be afraid of becoming infected, of dying, of running out of economic resources. Companies and institutions closed, savings were spent and that could have increased suicides," says Paez.
In 2021, the figures do not show an improvement. In the first four months of this year, 108 suicides have been reported nationwide, almost 40% of the total for 2020 when there were 281 suicides.
Researchers point to a direct correlation between the Venezuelan crisis and the pandemic. "The pandemic has been going on for more than a year. The bus fleet is functioning at 7%. You cannot lead a normal life. There are months when the number of power outages go down, but there are other months when the outages are 8, 10, 12, 15 hours or more. There is no consistent supply of domestic gas. Health care is nonexistent. Getting sick in the country is a luxury, you almost have to be a millionaire,” Paez says.
At the same time, there has been an increase in crime. According to the latest OVV figures, 11,891 people died violent deaths in 2020.
The massive Venezuelan migration has created a pioneer generation of migrants. In its recent history, Venezuela has always been a receiving country, never a sending country. In the late forties and early fifties, Venezuela received Spanish, Italian and Portuguese immigrants fleeing the post-war crisis. Later, in the seventies, the rise in oil prices favored immigration again, this time from Central and South America. There was no culture of emigration, explains Dr. Armas.
That was the case of Mariela Inojosa, a journalist and native of the coast of Vargas state. Together with her husband, Inojosa emigrated to Uruguay in 2019 after more than two years of planning. Her sister along with her brother-in-law and their mother had emigrated earlier to Peru. After fleeing to Uruguay, Inojosa and her sister were reunited in that country and their mother was left alone in Peru. Before the crisis in Venezuela, none of the family members had been migrants.
Inexperience makes pulling up roots much more difficult. The process of assimilation and the famous "starting from scratch" is more difficult for us than for second and third generation migrants who weave support networks or are accustomed to a history of exodus through family and community experiences that help build a migrant culture.
Mariela lost her mother to Covid-19 in April 2021. She was unable to say goodbye. "I went three years without seeing my mother because of migration, in this huge humanitarian crisis. Knowing that I will never see her again has been the hardest thing to deal with since I emigrated. Migration is, in every sense, a loss. I feel that I not only lost my mother, I also lost my country.”
Escaping is as difficult as reaching a new destination. You have to learn to live again. Adriana Rivas, 36 years old and pregnant, left Venezuela with her husband. The stress of the trip led to bleeding as soon as she crossed the border. Although she was worried about the baby's health, her goal was clear. She continued her journey by land. First through Colombia, then Ecuador and Peru. Along the way, she was able to receive medical attention. Even though the recommendation was to rest, the couple did not stop until they reached their destination, Chile, where the bleeding finally stopped.
Those who migrate risk being subjected to abuses during their journey, such as the demand for payment, confiscation of belongings or destruction of documents; travel through unauthorized points known as "trochas"; risk of violence and sexual abuse, theft or limited availability of economic resources, says Ligia Bolívar, in her report Mental Health of Venezuelans in a Situation of Mobility.
Bryant González, a 31-year-old amateur astronomer from Caracas, arrived in Cúcuta after spending all his money on the ticket to the border. There, he offered to give classes to children in a local school in exchange for lodging and daily wages. After the five-day agreement ended, he sent a similar proposal to another school in Bucaramanga, which accepted, but only offered food. Bryant could only afford the fare to Pamplona. To get to Bucaramanga, he had to walked and hitchhiked the 37 miles between the two cities, spending the night at gas stations. Two weeks later, his odyssey would be repeated, this time to travel the 310 miles that separate Bucaramanga from Bogota.
The challenge of relocation is followed by culture shock, xenophobia, the absence of support networks, the requirement of various documents, changes in laws, frustrated expectations, job discrimination, mistreatment and violence, says Bolivar's report.
"My routine was to work, eat, sleep and cry. It was an endless cycle. I felt adrift," recalls Alba Solórzano, a young woman from Aragua state.
Another young woman in New York recalls that she began to feel that she did not belong anywhere. "Being alone in an immigration process, without residency, not knowing if tomorrow you have to depart and leave everything again, with fears and uncertainty, not being sure of being able to deal with another language, other cultures, feeling the anguish of moving forward and having the burden of helping your family economically.”
"My former boss called me 'famished.' I had been eating rice and lentils for a year. I know what it's like to go hungry, but to be called such an ugly name hurts... a lot," recalls another young Venezuelan woman living in Buenos Aires.
These experiences were shared in a survey conducted through social networks with migrants from Venezuela by Historias sin Fronteras between April 27 and May 9, 2021. Of the 183 who participated, 90% (164) considered that they had experienced anxiety, sadness or depression during their migration process. The predominant emotions of those consulted were sadness (16%), anxiety, anguish, uncertainty (14%), calm (13.6%) and joy (8.7%).
Results of the test
This range of emotions goes from the tranquility felt by Adriana Caldera when she was able to give birth to her second baby in Colombia, far from the nightmare of Venezuelan hospital, to the panic attacks experienced by Bryant who during his travels through Latin America feared dying far from home. It’s present in the case of Felix, who spent a year without leaving his new home in Ecuador because he didn’t have an identity document that would allow him to attend classes at the university or look for a job and in the emotional crisis faced by AJ, who had to be admitted to a psychiatric hospital after having suicidal thoughts.
Colombia, which has received 1,742,927 Venezuelans, making it the South American country with the largest number of migrants, has seen a huge increase in mental health cases. The Ministry of Health of Colombia reports the number of migrants from Venezuela who have received a diagnosis of mental and behavioral disorders surged from 302 people in 2017 to 7,452 people in 2020, an increase of 2,467.55% in four years. The number of Venezuelan migrants who received treatment rose from 1,102 to 16,813 in the same period.
Health services in Colombia
Budget allocated to health/mental health in Colombia
(Billions of pesos)
Research conducted by Profamilia in 2019 in five states in Colombia on the mental health of the Venezuelan migrant and refugee population revealed that anxiety was the main reason migrants from Venezuela sought mental health services.
A similar situation exists in Peru, which had received 1,049,970 migrants by July 2021. There, the Universidad del Pacífico (UP) carried out research in 2019 and 2020 that consisted of surveying 800 Venezuelans in Tumbes, a border city. "The study measured the challenges and difficulties they encountered, the reasons why they chose Peru, and we had a section for mental health in which we asked if they had experienced symptoms of depression or anxiety," says Marta Luzes, analyst and researcher at UP.
The first study took place between the months of April and August 2019 when there was a change in migration policy and the humanitarian visa became a requirement to enter Peru. "This increased undocumented migration and the levels of anxiety and depression increased,” Luzes says.
During that period, long lines of migrants could be seen trying to enter the country, waiting for their humanitarian visa to be approved, or waiting to speak with an official of the Refugee Commission to request international protection in the country. "Migrants were led to cross without documents, because they did not have passports and the humanitarian visa took time to be processed," says Luzes.
This was the case of Christian Maestre, who emigrated with his entire family and had to spend more than 12 hours in the middle of the South American winter in a line at Rumichaca, at the Colombia-Ecuador border, to enter the country. When he approached the access site, he found that there were two lines: one for foreigners of other nationalities and a longer one for Venezuelans.
"I suppose some people have it worse, but a five-day trip was a calamity. Although you can meet people and have a logbook, that doesn't prepare you for unpleasant circumstances along the way," he says.
"Two out of every three Venezuelan migrants in Colombia have their mental health affected," says Andrés Cubillos, a professor at the Institute of Public Health of the Pontifical Xavierian University with more than 15 years of experience in social policy, migration and public and mental health. "Migration in the case of Venezuela is done more by families than individuals, which affects the mental health of people even more because many people cannot protect the living conditions of their environment", explains Cubillos who is collaborating with the University of Central Florida on a research project on the subject.
Symptoms of mental disorder are not always emotional. Cubillos explains that sometimes physical symptoms can be an indication of mental health issues. "Back pain, headache, neck pain, difficulty sleeping are signs that have been poorly studied because health care is based on the physical aspect," he says.
That is the case of Felix, a young man from the Andean city of Merida, who arrived in Ecuador at the age of 18 with the good fortune of being able to live with his parents. From the moment he set foot in Quito, Felix says he started to feel severe back pain, which have not stopped. "Now I understand that physical problems are derived from psychological ones," he says. He also acknowledges experiencing anxiety and having several depression episodes during his migration process. He has received psychological care as a university student, but he is eager to start working to be able to pay for better services.
"Our research indicates that the symptoms are increasing and are not only present during the migration process, but are exacerbated once migrants arrive in the country, due to rejection, discrimination and xenophobia," says Cubillos. On the other hand, he believes that the lack of adequate public policies to help the migrant population affects them much more. "We don't even have first aid in mental health. I know that in hospitals in Cúcuta the services are minimal. They keep the person who arrives for about two days and then the person has to continue on their way".
"I have periods where I don't want to get out of bed. I don't want to talk to anyone,” says a 21-year-old young woman from Maracaibo who now lives in Chile. “I overthink things and situations. I am constantly hungry, but I also have a lack of appetite, insomnia and somnolence, stress attacks and migraines.”
For Luz Ángela Rojas-Bernal, psychiatrist and professor of the Faculty of Health at the South Colombian University, deficient mental health care depends on three factors: stigmatization of mental illnesses, lack of political will and lack of monetary and human resources. "Although there are studies on the prevalence of mental disorders in these [migrant] populations, many remain on paper, because there is not enough political support to turn them into public policies. The mental health law [in Colombia] says very beautiful things that are very well written, but in practice they do not happen.” Dr. Rojas-Bernal also says the distribution of psychologists and psychiatrists is not equitable in terms of demographic density or needs.
In Colombia, only 1.63% of the national health budget was allocated to mental health care in 2017. That decreased to 0.3% of the budget in 2020. In Peru, which has the second highest number of Venezuelan migrants, only 0.5% of the budget was allocated to mental health in 2020, according to the Economic Transparency portal.
Budget allocated to mental health in Colombia and Peru
"I have complicated feelings about Venezuela. Sometimes I don't want to know anything about the country. I feel a strong rejection. But my brother, my grandmother and my uncles and aunts are still there," says Victor Reinosa, a social communicator who lives in the city of Buenos Aires.
"Migration implies renouncing your life, goodbyes. What we call migratory grief, is a totally different grief from the one we associate with the death of a loved one," explains Dr. Acosta, the clinical and social psychologist at CENDES.
"This grief refers to the uprooting of the family, to changes in identity, it stimulates feelings of ambivalence. You can have a positive expectation because you are going to look for a new way of life or you can also feel sadness because you are leaving your family, your memories, your history," Dr. Acosta says.
"It's like getting divorced while in love,” says 41-year-old César Soledad, who now lives in Chile. “Your country is causing you pain, you miss your people and you suffer for those who live there.”
For Andres Vale the situation is more extreme because the divorce from Venezuela is total. "I feel like I hate it and that doesn't allow me to feel that I fit in the new place I live," says the 23-year-old who now lives in Ecuador.
It is a grief that begins even before leaving, according to Dr. Armas, the psychologist and migration specialist. "They arrive in the host country having lost everything they built in Venezuela and that loss represents grief. But that grief had already been developing before leaving Venezuela, because there they began to lose their status, their networks and their possibilities of development because of the crisis, and they already knew that discourse associated with the loss, but it is exacerbated.”
Adriana Rivas went from a successful career in entertainment journalism, from being a public relations person and doing press for important artistic groups, to selling bananas in order to make a living, feed her children and save to be able to migrate.
Migrants may face barriers in their adaptation process because they need to develop skills and strengths such as perseverance, emotional strength and openness to change, says Dr. Acosta. "You need to put aside your history, assimilate, be grateful and have the ability to start from scratch and if you don't have plans or emotional, psychological and economic support networks, this process can generate emotional disorders," she says.
In addition, she says that not having a legal residency documents can trigger anxiety about the future or the migrant's stay in the country.
That’s what happened to Christian Maestre from Monagas, in the northeastern region of Venezuela, who in 2018, when he was already living in Arequipa in southern Peru, had to get his police record in order to get legal residency documents. But because of a data error, he was told that for a second time the $20 processing fee. Broke and frustrated, Christian felt like his heart was going to explode. "I asked a neighbor to help me. She took the money out of her pocket to request the voucher with the correct information from the bank and I was able to finish the process.”
"To exist, to have an identity, is to be visible and visibility promotes mental health," concludes Dr. Armas.
Being locked up at home worsened the already damaged relationship AJ had with his partner and the violence began to escalate until it became unbearable. This became apparent after he attended a virtual group workshop on gender violence organized by Alianza por Venezuela during the pandemic. When the psychologists heard about it, they suggested that he seek professional help immediately because being exposed to psychological violence aggravated depression and suicidal thoughts began to emerge.
That is how AJ ended up at the Psychiatric Department of the Central Hospital of San Isidro, where it didn't matter that the word "foreigner" appeared in red letters on his ID card, because in Argentina the migration law is clear. Article 6 states that immigrants and their families are guaranteed equal access to the same protection, support and rights as nationals.
Despite this, AJ was forced to remain in detention for an entire weekend without being able to tell anyone of his whereabouts. "They didn't respect my non-binary trans gender identity," he recalls. AJ spent two days listening to other inmates banging on walls and screaming nonsense. The fear only passed when he was able to leave, beginning a process that is improving with medication and periodic therapy.
During the pandemic, the vulnerabilities present throughout the migration cycle have increased, as have the risks of job loss, lack of prompt access to documentation, poor housing conditions and the stigmatization of returnees in their communities of origin, says the study titled The effects of COVID 19: an opportunity to reaffirm the centrality of the human rights of migrants in sustainable development, by the Economic Commission for Latin America and the Caribbean (ECLAC).
For Alba Solorzano, a 23-year-old psychologist who now lives in Spain, the pandemic hit her especially hard. "I was living under house arrest," she recounts. "The coexistence in the place where I lived was horrible. Our landlady was a neurotic woman who did not let us leave the room where we were and that was only the room with a bathroom and kitchen."
Jeanferich Ontiveros says from Chile, "The pandemic left me unemployed for five months. Not having money, work or food, unleashed a kind of nervous breakdown. Those five months have been the worst since my migration began. I was about to go to a health facility to see if somehow someone could help me with the nervous breakdown, or at least give me a diagnosis of what was happening to me. But the fear of contracting the coronavirus in a hospital made me avoid visiting a doctor.”
Colombian psychiatrist Luz Rojas has observed that, "With the pandemic, mental health problems have been exacerbated. I have treated people who had no symptoms or who had been able to control them and when the pandemic arrived, the tendency to suffer from anxiety disorders, depression and sleep disorders increased," she says.
The University of the Pacific in Peru conducted research in April 2020 on the links between work and the mental health of migrants during the pandemic. Some 46% of the migrants surveyed showed signs of anxiety and 35% showed signs of depression. The results show that the employment rate has a direct impact on psychological disorders, according to UP analyst Luzes. "As employability goes down, the mental health condition worsens."
For Víctor Reinosa, even before Covid-19 it was hard to get a job in his field. "I had worked in radio, television, press and arriving here and work as a cook, delivery, I worked in a kiosk. It was quite hard.”
The situation improved, but not for long. "I quit a job for an interesting proposal that I really liked. But I got sick and lost that job." From that moment on, Victor felt like he was in a void. "I didn't want to get out of bed." Then, through a friend, he was able to find a new job in his area and everything got better again. "It's complicated to be alone in a country. You don't have anyone to support you. It's not like in your country that if you don't have a job for a month you go to your mother's house and you don't worry about the rent," he says.
Dr. Palacios explains that for migrants, the pandemic generated a regressive process: many of the gains they had made vanished due to the economic difficulties that resulted from measures to contain the coronavirus.
This rekindles migratory grief and increases vulnerability. Many people who had left this survival zone and were beginning to make gains had to struggle to survive again. "It is a loss of the degree of freedom that we had gained and to that loss is added the loss of health and of loved ones who die because of the coronavirus," says Dr. Palacios.
Resilience is the capacity of people to face obstacles and become stronger. "It does not avoid exposure to the adverse event. But allows understanding adversity as a learning process, facing the situation and through personal strength, protecting integrity and forging a new behavior, resisting the disaster and rebuilding on the adverse factors," states the study Resilience and Coping Strategies in Venezuelan Immigrants of the Central University of Ecuador.
Migrants are exposed to many different risk factors. On a personal level, migrants face mental or physical health problems, inadequate communication strategies, lack of assertiveness, substance abuse and alcoholism, poor impulse control, isolation. On the family level, death of family members, lack of social networks, poverty, lack of money, abrupt moves, migration, deportation or repatriation, discrimination. All this affects our ability to resist. But even so, it is possible to overcome it.
For us, talking about resilience implies taking a trip back several years. When we were in Venezuela and we were practicing journalism and had to circumvent the censorship of an authoritarian regime to inform the communities. Despite the difficulties, we did it.
When we had to live in our native cities and find ways to afford the expenses of being in a country with the highest inflation in the world, we always found a way to succeed. Even if it cost our youth, our dreams.
In the days before boarding the plane or bus, we packed our belongings to take to a new country and, with tears in our eyes, we said goodbye to our families. Johanna went to Colombia where her parents' nationality made entry easier; Hector headed to Peru because he had read that economic conditions were promising; and Maria Laura traveled to the south, to Argentina, where she arrived with the idea of studying a master's degree and practicing journalism.
Adriana, Mariela, Victor, Christian, Alba, AJ, and the other people whose stories appear here, are also us. Migrating is a process that, even with the most favorable conditions, involves uprooting, changes, adaptation, new cultures and assimilation.
Facing a hostile environment with the loss of both their jobs during the pandemic, Adriana Rivas and her husband moved to Santiago, Chile, from Valparaíso, and started a gastronomic business. They achieved economic, labor and family stability for the first time since their migration began.
Adriana Caldera started a dessert store that she runs from home and has recently added Venezuelan dishes to her menu. It has been a success. When everything seems to fail, having a place with familiar flavors can take you back home for a little while and to the unmistakable feeling that despite the distance we still belong to the place we love.
"Our vulnerability and strength has to do with the interruption of our life story," explains Dr. Armas. "A forced migration increases the probability of triggering disorders because there is no adequate preparation. Another differentiating aspect is the idea of not returning. We have lost the country we knew and it hurts."
Will we ever return to Venezuela? This is the question that many of us ask ourselves but that few of us dare to say out loud. To migrate is not to dwell on the past or obsess about the future. It is nourishing ourselves with the present, no matter how hard it may be.
While most migrants are exposed to multiple situations that affect their physical and mental health, some are even more vulnerable. By December 2020, according to Unicef, at least 1.9 million of those who had left Venezuela were children and adolescents.
In Colombia, children and adolescents are defenselessness due to the lack of public migration policies in Venezuela and the capacity overload on the Colombian side. "Minors have many difficulties in legalizing their immigration status and documentation, which curtails their access to social protection, health care, early childhood development and education," highlights the study Migrant Children, which also states that 46% of minors are excluded from the Colombian education system, mainly due to lack of documents.
Not only do they experience difficulties in adapting to their new country. Ligia Bolívar details in her report Mental Health of Venezuelans in a Situation of Mobility that, according to studies in Peru, the impact of migration can lead to other less evident, regressive behaviors. “They start to wet their bed again, to suck their thumb, they start to behave in ways that they had already overcome in terms of their development because they are normal stress responses in which they try to react in the way they reacted before when they felt more protected,” explains the research.
Women also suffer medical issues during their migration process. "More than half of the care demanded by the Venezuelan population is from women," says Cubillos, mostly related to reproductive health issues. According to the latest report of the R4V Platform, about 35% of migrants are women, while 15.3% are children and adolescents.
On the other hand, the risks and situations inherent to migration have been compounded by isolation during the Covid-19 pandemic. "The conditions that have been established in the context of the pandemic have led to an increase in gender violence and domestic violence, and this has also affected Venezuelan migrant women and girls," adds Bolívar.
People belonging to the LGBTIQ community are also at risk of suffering violence and in the case of AJ, who identifies as a non-binary person, it was precisely this situation that led to his suffering. "With the person who was my partner I suffered physical, emotional, psychological violence. I first sought psychological care, but then it had to be psychiatric. The situation worsened with the pandemic," AJ says.
Migrant victims of gender violence, often due to the lack of support circles in their receiving countries or ignorance, have sought help from Venezuelan Civil Society, which has remotely tried to support them in these difficult scenarios. This is what Diyuly Chourio, a women's rights advocate, says in her research Violented in Quarantine. She has received calls for help from Venezuelan women in Colombia, Panama, Chile, Argentina and Ecuador. In most cases she referred them to advocates in those countries.
The Inter-American Development Bank, in its report Migration from a Gender Perspective: Operational Ideas for its Integration into Development Projects, recommends that governments establish migration policies with a gender perspective that guarantee access to the local labor market, legislation on gender-based violence that protects them regardless of their migratory status, and family reunification policies, among other measures.
Although there are deficiencies in the regional health systems, there are organizations and groups that have been responsible for leading efforts to assist migrants:
