The MS-13 and Barrio 18 gangs are famed for the creepy way they tattoo their heads and faces. That and the sheer savagery of their violence towards rivals and innocent civilians.
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While much of the world's focus has been on the chaos of the Middle East, the bloodshed wrought by gangs and the paramilitary responses of governments in Central America have been fuelling a different kind of refugee exodus.
Gangs are fighting each other for turf and against governments for political control, driving murder rates to the highest in the world in the so-called Northern Triangle countries of El Salvador, Honduras and Guatemala.
Those fleeing the violence who don't make it to the United States often end up in camps in countries such as Costa Rica, from which Malcolm Turnbull has now pledged to accept some refugees to Australia.
The longer story of these countries is one of corruption and political instability marked by civil wars and coups, but the acute problem is the growth of massive gangs on the back of the drug trade.
"The spreading wave of savagery – including beheadings, dismemberment and systematic rape – is the result of the growing involvement of the Mara Salvatrucha (MS-13) and Barrio 18 gangs in the global cocaine trade," Douglas Farah of the US National Defense University wrote in Foreign Policy magazine recently.
The US State Department estimated in 2012 that these two gangs alone had 85,000 members between them across the three Northern Triangle countries.
As a result, El Salvador's homicide rate last year was the highest in the world at 105 per 100,000 people (Australia's was 1.7 per 100,000). Guatemala and Honduras also ranked in the top five countries, excluding war zones.
The number of people fleeing violence in the triangle hit 110,00 last year - a fivefold increase on 2012. America struck a deal with Costa Rica this year to house some of the most vulnerable before their claims are processed. The Turnbull government has not said how many refugees from there it will take.
Thomas Adams from the United States Studies Centre at the University of Sydney said that profitability from the drug industry had shifted from production to transportation, empowering the Central American gangs.
"Pretty much anyone can make and grow cocaine. Getting it to the market [in the United States] is where the biggest profit is today," he said.
Experts say disruption of the more traditional narcotics networks in Mexico and Colombia has pushed the problem into Central America.
As well as drug trafficking, the gangs make money from extortion and kidnapping, taking virtual control of whole communities.
"Threats of violence and sexual assault are often tools of neighbourhood control," according to a report last year by the Woodrow Wilson Centre in Washington.
Dr Adams added: "There are stories of taxi drivers having to hand over 80 percent of their income or they'll just be killed. You see everything from localised extortion to sophisticated protection rackets and up to high-level government corruption."
The report said penetration of police forces and government institutions by organised criminals meant that "impunity for crime is extraordinarily high", with at least 95 percent of crimes going uninvestigated or unreported and therefore "disincentives to criminal activity are almost non-existent".
Over the longer term, Dr Adams said Honduras was "massively destabilised" by a 2009 military coup that Washington had "tacitly supported". All three countries have been blighted by political strife, poverty and massive inequality.
On top of providing the market for the drugs, the US is also the source of the many guns in the Northern Triangle countries. Ironically, both MS-13 and Barrio 18 formed on the streets of Los Angeles. The branches in the Northern Triangle were strengthened in part by widespread US deportations of young Central Americans who were already gang members.
Gun trafficking from the US to Central America has armed the gangs with sophisticated weapons, the Woodrow Wilson Centre report added.
The government responses in the three countries have focussed on heavy crackdowns by paramilitary police forces, none of which have been successful.
"As a broad trajectory, I don't see the endemic problems changing too much … There is enough economic interest protecting the massive maldistribution of wealth that it's hard to imagine where the change is going to come from," Dr Adams said.
