Abstract

The Venezuelan crisis has unleashed multiple forms of sociopolitical violence against its population and created a context of unmet needs, insecurity, and human rights violations. Outward migration caused by this situation has been linked to health emergencies in neighboring countries. Venezuelan migrant and refugee women and girls (VMRWG) are among the most affected. We conducted a cross-sectional qualitative and Participatory Action Research (PAR) project to characterize the risk environments for VMRWG across migration phases, analyzing pre-departure, transit, border crossing, and resettlement risk factors for health and security through semi-structured interviews ( n = 30) and human cartographies ( n = 16). We found cross border risk and protective factors that inform cross-border health initiatives, migration policies, and human rights efforts for both the migrant and host communities. Findings and Recommendations Migratory trajectories of VMRWG from Venezuela to Colombia represent a risk environment for women and girls, connecting cross-border contexts through armed actors’ control, culturally reinforced gender roles and limited social and economic resources. Long-term sustainable migratory policies that are culturally sensitive and include a gender-approach to health should operationalize how gender roles are intimately connected to HIV risk and mental health disparities through reinforced structural factors. Such policies must address these structural factors. The public health system needs to incorporate and align with programmatic efforts implemented by international platforms (United Nations Population Fund (UNFPA), AID4AIDS, and Médecins Sans Frontières (MSF) also known as Doctors Without Borders) targeting screening for infectious diseases (including HIV and mental health disparities) in border crossings and borderlands. Sustainable policies to bridge gaps between services and populations and to decrease growing HIV cases depends on these strategies. Policies and programs of local governments (city and municipality level) addressing mental health disparities need to be expanded through peer leaders and civil society networks of care to guarantee wellbeing and quality of life after resettlement. International efforts and collaborations should capitalize on the re-opening of the border to establish inter-sectoral collaborations with Venezuelan NGOs and civil society organizations on both sides of the border to address gender-based violence, follow-up of cases, and access to services in sending and receiving communities. In order to broach gaps and tackle access barriers in resettlement communities in Colombia, services must be provided in peripheric territories and neighborhoods where some vulnerable migrants resettle. These services must rely on health sector-community collaborations. Public health sector efforts should be integrated and coordinated with family and child services on a local and national level Instituto Colombiano de Bienestar Familiar (ICBF), gender working groups, shelters, and citywide supported initiatives like the House of Women) to provide and promote access to social resources (education, jobs, and housing) for migrant women. Health promotion strategies are necessary to decrease infectious diseases and violence-related trauma among migrants across borders. These strategies can include outreach through peer leaders, civil society organization campaigns, and HIV mobile testing and counselling. These services should be delivered in a culturally sensitive manner, capitalizing on in-place cross-border networks of support. In Colombia, sustainable efforts in policy and programs have been made to provide Venezuelans with access to health care and social services with the help of inter-sectoral working groups, national laws, and border commissions. However, there is an urgent need to expand the humanitarian response and the health sector coverage to gender-based violence impacting infectious disease risk and mental health trauma in host communities. Connecting pre- and post-migration contexts in South-to-South migration is paramount. Tackling these issues can improve the protection of human rights and resettlement conditions in host communities.

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