More than two-thirds of the migrants fleeing Central America’s northern triangle countries – Guatemala, Honduras and El Salvador – experienced the murder, disappearance or kidnapping of a relative before their departure, according to a new study by the medical charity Doctors Without Borders (MSF).

The MSF study said 42.5% of interviewees reported the violent death of a relative over the previous two years, while 16.2% had a relative forcibly disappeared and 9.2% had a loved one kidnapped.

The study – based on interviews with migrants and refugees at MSF medical facilities in Central America and Mexico – once again showed the despair driving migrants to abandon some the hemisphere’s poorest, most violent and most corrupt countries.

“We’re speaking of human beings, not numbers,” Sergio Martín, MSF general coordinator in Mexico, said at the study’s presentation on Tuesday. “In many cases, it’s clear that migration is the only possible way out. Staying put is not an option.”

In 45.8% of the interviews, migrants said that “exposure to violent situations” was a key reason for leaving their home country. Of those fleeing due to violence, 36.4% had become internally displaced in their countries of origin, but were eventually forced to flee.

The research was published at a time when the US border is becoming increasingly difficult to reach.

Mexico has been launched a crackdown against people trying to cross its southern frontier and deployed its newly created national guard to dismantle large groups of migrants, while the Trump administration has made the asylum process practically impossible for most applicants.

US officials are returning asylum seekers to dangerous Mexican border cities – where MSF has found many are kidnapped and preyed upon by drug cartels – under scheme known as migrant protection protocols to await their court cases. Some migrants are now being flown to Guatemala to apply for asylum in the impoverished Central American country.

“The aggressive migration policies adopted by the US and Mexico mean that more and more people are trapped in a vicious circle,” the MSF report stated. “Patients describe an increase in the predatory violence perpetuated by criminal organisations operating along the migrant route.”

Meanwhile, violence against migrants transit Mexico is escalating, the study found: 39.2% of interviewees were assaulted in the country, while 27.3% were threatened or extorted – with the actual figures likely higher than the official statistics as victims tend not to report crimes committed against them.

Nearly 6% of migrants reported witnessing a death during their time in Mexico, according to MSF. In 17.9% of those cases, it was a murder.

Members of MSF teams have themselves witnessed kidnappings outside migrant shelters.

“The physical obstacles to entering the United States are taken for granted. But what surprises [migrants] … is the violence that they experience in Mexico,” the report said.

“Coming from a country where violence is endemic, they decide to make the journey because they have no other option.”

Violence is just of a range of factors driving migration, and motives vary from region to region and country to country.

A 2019 survey from Creative Associates International found violence was the main driver of migration for 38% of Salvadorans, 18% of Hondurans and 14% of Guatemalans. In Guatemala – the main source of migrants detained at the US border with Mexico – 71% of respondents cited “economic concerns” as their main motive.

Climate change is increasingly being recognized as a driver of migration – especially from areas in Central America’s “Dry Corridor” – as is political corruption.

“Over the last 20 years in Honduras, the poverty rate hasn’t fallen beneath 60%,” said Father Germán Calix, Honduras director of the Catholic Church’s charitable arm Caritas.

“The lack of policies and actions in favor of the poor has been such that people have lost confidence that this situation can ever be reversed from Honduras.”