Ricardo Santiago, who heads MSF’s operations in southern Mexico, expects more migrants and asylum seekers like Ramírez to race to reach the border in the next month before Trump takes office.
That would mean a reversal of current trends. September saw a A minimum of four years In tension at the US border, according to government statistics. However, Santiago said he has noticed that the number of migrants is increasing again.
“The caravans are getting bigger,” Santiago told Al Jazeera. “In September and October they were made up of a few hundred people, now they are made up of thousands.”
Hundreds of people have sought medical attention from their 16-person MSF team in Santiago Niltepec since a “migrant caravan” passed through the city in November.
Perez and his family were part of the latest caravan, which Santiago estimated included 2,000 people.

Caravans began to form in 2018 as hundreds of migrants and asylum seekers huddled together for safety. The groups offered an alternative to human traffickers charging thousands of dollars for safe transportation to the US border.
Members of the November caravan estimated they walked between 30 and 40 kilometers a day – 19 to 25 miles – traveling at night to avoid the heat of the day.
Still, experts say groups often split up before reaching their destination. And the caravans, whatever their numbers, are still vulnerable to unscrupulous officials and Mexican drug cartels who use violence for bribes and extortion.
“There was a significant increase in patients who suffered violent attacks in November,” Santiago told Al Jazeera.
He explained that sometimes members of the caravan fight with each other. But the main threat comes from outside groups like cartels.
Santiago said he had heard reports of “kidnapping, extortion and attacks against young people of all ages, boys, girls, women and men who are subjected to sexual violence.”