Central American nations had the highest per capita homicide rates in the world, mostly due to gang violence. But why has gang activity become endemic in the region? Photojournalist Donna De Cesare has been trying to answer that question since she began covering Central America during the civil wars of the 1980s, focusing especially on children and youths. She continued her photography project in Central American refugee communities in the United States in the 1990s and postwar Central America in the 2000s. In her book Unsettled/Desasosiego: Children in a World of Gangs, she documents a history of repression, violence, and trauma, in which gangs are as much a symptom as a cause of trauma.