“The jungle is truly the worst thing that can exist,” says Daisy Cortés, describing her experience crossing the Darién Gap with her nine-year-old daughter Daphne. “It’s a tough route—it's something you really have to experience to understand.” I met Cortés and Daphne in October at a humanitarian center in El Paraiso, Honduras. Having just crossed over the border from Nicaragua, they were on their way north to the United States. Daphne was taking advantage of a “safe space,” a resource provided by aid groups where children can draw, play games, and feel like kids for once.
Despite being a licensed nurse, Cortés didn’t earn enough to pay for the bare necessities in her hometown of Varinas, Venezuela. Facing a worsening social and economic crisis after the July elections, they decided to leave. “I want to go to another country, see if I can practice there, and at least provide a home for my daughter—something where she can say, ‘Look, my mom left this for me through so much effort.’ That’s my goal,” says Cortés.
Upon leaving Venezuela, Cortés told her daughter that the jungle would be a fun adventure. However, the journey quickly turned traumatic for the pair when they were robbed twice, first on the Panamanian side of the Darién and again in Nicaragua.
Stories like this have become a daily reality for people passing through the Darién Gap, especially as the number of children crossing continues to rise. Children now represent over 1 in 5 people traversing the Darién. But while children and their families face harrowing circumstances, life after the jungle goes on. According to psychologists, it is while transiting through Central America that children like Daphne must begin to confront the trauma of the Darién and its effects on their mental health.
Aid groups in Panama, Costa Rica, and Honduras say they are unprepared and under-resourced to adequately address the needs of children on the move, especially the growing number of non-Spanish-speaking children. As of September, 55,000 children had crossed the Darién Gap in 2024. Following months of negotiations with the Panamanian Ministry of Health, Doctors Without Borders (MSF), recently returned to the Panamanian community of Las Blancas after being dismissed in March following public calls for the Panamanian government to better protect people in the area. Reports of sexual abuse surged at the start of 2024, with MSF citing nine cases involving children reported in just one week in February.
MSF has played a fundamental role in filling gaps in humanitarian aid for individuals making the perilous crossing, especially for victims of sexual assault. In early 2024, the organization announced a sevenfold increase in patients seeking care for sexual violence, saying in a statement that the “governments’ inaction leads to [a] worsening situation.”
Two new reports published in September and October by the Pan American Health Organization (PAHO) and Refugees International highlight the shortcomings of the humanitarian response for people transiting through the Darién, particularly the lack of services available to children.
Aid groups are trying to fill the gap. Alongside treating physical needs, NGOs throughout the region provide one-on-one psychological support, safe spaces where kids can play and learn, and educational sessions for parents so they can support their children’s wellbeing in transit. The PAHO report, focused on access to health services in the Darién region, underscores that the journey can increase the risk of mental health disorders in children, such as depression, anxiety, and post-traumatic stress disorder.
According to Alejandra Angulo, a psychologist with the Hebrew Immigrant Aid Society (HIAS) who works with children in Las Blancas, most mental health disorders cannot be diagnosed in transit. “The time children spend crossing the Darién is very short and diagnosing someone in just a few days or hours is not ethical,” Angulo notes.
But symptoms do arise during the weeks or months-long journey northward, especially among teenagers who are more conscious of what's going on around them. Angulo says that in her work in Las Blancas, symptoms of post-traumatic stress are commonplace among children after they come out of the jungle.
“Parents often tell us that their children are no longer the same as when they left," says Angulo. "For instance, we have had parents who report that their children were happier and more communicative when they left their home country, but as they continue the journey, this turns into a regression and a lack of communication due to the fears they face.”
A Growing Language Barrier
People navigate Central America by buse, on foot, hitchhiking, or contracting coyotes, particularly in Nicaragua and Guatemala, often with little to no money and days without humanitarian assistance. While non-Spanish speakers can seek medical attention, NGOs are largely unable to provide mental health support in Chinese, Creole, or French—the three most common languages spoken after Spanish, according to aid groups. “In terms of mental health, there is a gap due to language barriers and cultural barriers,” says Maynar Rodríguez, an MSF psychologist working in Honduras.
Humanitarian centers remain scarce across the region as each country takes a distinct approach to the flow of people migrating. New Panamanian president José Raúl Mulino, who campaigned on closing the Darién, has reduced humanitarian assistance while fencing off parts of the jungle and initiating repatriation flights for some undocumented individuals, financed by the U.S. government.
Haitian and Chinese nationals have become two of the five main groups crossing the Darién, making mental health support for children a growing challenge for aid groups. Alongside cultural differences, language barriers mean that people are far less likely to seek services or report abuse.
“On the ground, I don't think any organization has someone who speaks a language other than Spanish, although there may be one or two colleagues who speak English,” says Angulo from HIAS. “There is no one on the ground who can provide a service in Portuguese, French, or Creole. This is a challenge and a limitation that I think all organizations have.” The PAHO report similarly concluded that there is “a need for translators, especially for the Chinese and Haitian populations.”
The governments of Panama and Costa Rica have responded with similar strategies, establishing government-funded attention centers that provide medical services to people in transit. Both countries also offer buses that transport people across their territory, for a fee ranging from $30 to $60.
Sometimes, Children Just Need to Play
With the United States as the primary destination, most families on the move have no intention of stopping until they arrive. This makes providing mental health services even more complicated, often leaving psychologists very little time to assess needs and provide care to children.
In Panama and Costa Rica, MSF and HIAS offer a therapeutic space for children and regularly diagnose young people with, anxiety, depression, and bipolar disorder. “We explore the symptoms the child is experiencing at that moment,” says Rodríguez. “In some cases, we take a direct approach with the child, addressing issues related to their emotions and fears.”
Some NGOs have recently begun to share records across borders and organizations to allow for follow-up treatment in transit. However, cross-border information sharing is not a strategy used by all NGOs operating in the area, forcing people to relay their stories and symptoms multiple times before receiving proper treatment. Caitlyn Yates, coauthor of the Refugees International report, says this is an unavoidable reality of providing services to people on the move. She also emphasizes the need for improved translation and health screenings to take full advantage of the short time people have. One of Refugees International’s primary recommendations is that governments and NGOs implement mandatory health screenings for children in Panama and Costa Rica.
Yates, who spent six months living and researching in the Darién, views the current response as wholly insufficient to address the needs of individuals transiting through the region. For many children, however, a 30-minute session with a psychologist may not be the best course of action while they are still on the move.
“I wouldn't use that as a chance to dig into the health and trauma specifically,” says Alejandra Salazar, a Colombian researcher and psychologist specializing in family migration. “Rather, I'd provide points of safety. Trauma comes from the feeling of insecurity. So if NGOs can instead provide spaces along the journey where kids are 100% ercent safe, that is often the best approach.”
Nor do all people come with shared ideas about mental health. Psychologists said that parents sometimes refuse mental health services for their children for cultural or religious reasons, and due to stigmas attached to discussing issues of mental health.
Salazar found in her research that the best thing for children’s mental health in this context is simply to allow them to be children. “Children need to play. They need to have toys. They need to kick a ball around.” Several organizations, including UNICEF, MSF, and HIAS, have created “safe spaces” at attention centers in Central America where children can play, draw, and interact with other kids.
Rodríguez recalls a tender moment in one of these spaces. “Even though the children did not speak the same language, some Afghan children came to the game table and played together” with Spanish speaking children. “Children are the same everywhere,” adds Rodríguez, and these opportunities make a positive contribution to their mental health.
A safe space to do some painting was exactly what Daphne needed after several weeks of long bus trips, sleeping on the ground, and eating very little food. Her mother said she was conscious of the fact that her daughter was not at school and missing her friends back home. The moments of sanctuary were beneficial for both Cortés and Daphne, giving mother and child an opportunity to relieve stress. According to psychologists, parents like Cortés play the most important role in the wellbeing of their children while navigating the uncertainty of migration.
“One thing parents can do is talk about the experiences they have had,” says Rodríguez, adding that people who endure trauma in transit often repress their experiences, which can lead to mental health disorders in the future. Instead, allowing children to share their experiences can “help reduce nightmares or the memories of the traumatic events the children have experienced along the route.”
Psychologists have also observed that the parent-child role is sometimes reversed during migration, especially for adolescents who have to care for younger siblings or look after their parents. This is also a mental health concern that merits further research and attention.
Currently, psychoeducational services for individuals transiting through the Darién are ad hoc, if they exist at all. Rodríguez says that more needs to be done to provide parents with the tools to have these conversations with their children and build healthy habits for their collective wellbeing.
Alongside the role of parents and caregivers, any major psychological work must happen in the host country. “If a child who passes through the Darién fails to adapt or does not receive mental health support upon arriving in the host country, we are likely to have a child with various issues, be they anxiety-related, depression-related, or even antisocial issues,” observes Angulo from HIAS.
Despite the promise of the incoming Trump administration of mass deportations and border closures, humanitarian experts don’t expect a major decrease in migration through Central America and the Darién in the near future. It is therefore imperative that governments and aid groups move to implement the recommendations made by PAHO and Refugees International to ensure the basic human rights of people on the move, especially children. This includes offering safe, government-funded bus routes, increasing funding and services at humanitarian centers, providing bilingual staff, and tailoring services to people from different cultural and religious backgrounds.
Timothy O’Farrell is a photojournalist based in Bogotá focused on migration in Latin America.
