The vast majority of people attempting the Mediterranean crossing pass through Libya, where they are exposed to horrific levels of violence, including kidnapping, torture and extortion.
European attempts to stem migration by strengthening national borders and bolstering detention facilities outside its borders are pushing people into smugglers hands to get them past checkpoints, across borders, through fences, out of prisons and ultimately onto boats on the Mediterranean Sea.
For those people who do make it to Europe, the challenges - and dangers faced - start again once onshore. A lack of shelter, being forced to live in unhygienic conditions or in adverse weather, treacherous border crossings, hostile authorities - in these circumstances, people become sick, injured, or struggle with mental health issues.
Instead of confronting the vicious cycle that their own policies are creating, politicians have hidden behind unfounded accusations towards NGOs and individuals who attempt to help people in dire straits.
MSF and search and rescue
We currently provide medical care in the Central Mediterranean on board the search and rescue boat Aquarius which is run by SOS MEDITERRANEE.
During its Search and Rescue operations, MSF has been shot at by the European-funded Libyan coast guard and repeatedly accused of collusion with traffickers.
On three occasions in 2017 our team onboard Aquarius witnessed refugees and migrants aboard unseaworthy vessels being intercepted by the Libyan Coastguard in international waters as EU military assets at the scene looked on.
On 31 October, 24 November and 8 December 2017, Aquarius was instructed to standby and was forced to watch as hundreds of people were pushed back to Libya by the Libyan Coastguard.
Over the past three years, we have operated, or been partners on, five ships:
- Phoenix, in partnership with Migrant Offshore Aid Station (MOAS);
- Dignity I;
- Bourbon Argos;
- Prudence; and
- Aquarius, in partnership with SOS MEDITERRANEE.
Where we operate
Aquarius operates in international waters, around 12 to 25 nautical miles (22 to 28 kilometres) from the Libyan coast where the largest number of distress situations arise.
As an exception, and when requested or authorised by the Maritime Rescue Coordination Centre (MRCC), we occasionally enter Libyan Territorial Waters (less than 12 nautical miles) when there is a vessel known to be in distress and with all the necessary authority permissions.
Our medical teams on board treat violence-related injuries resulting from time in detention, torture and other ill-treatment, including sexual violence.
Women, especially pregnant women, receive dedicated care thanks to the presence of a midwife. Our midwives have assisted the delivery of several babies onboard.
We also provide care to people with skin diseases, dehydration, hypothermia, scabies and serious injuries such as chemical burns caused by fuel mixing with sea water during the crossing.
Psychological first aid is provided by trained cultural mediators and follow-up with more dedicated mental health care can either be provided on the boat or onshore.
During all these consultations our teams hear horrific stories; many of the people we rescue are victims of torture and other forms of ill-treatment.
In 2017, we launched a website in English, Spanish, French and Italian dedicated to our search and rescue operations. It provides answers to frequently asked questions and features an interactive map.
What is MSF doing on land?
Once on land, people arriving in Europe discover the dangerous border crossings, are often beaten by authorities, and are forced to live in atrocious conditions, usually outdoors - including during winter.
In one migrant camp in Italy, a quarter of respondents to a survey said there was poor hygiene conditions in the camp. In a nearby settlement, more than one in ten said there was a lack of drinking water.
I’m sleeping under the bridge with other people. I have no money and no way of communicating with my family. I’m really tired. Nobody takes care of us, nobody asks me how I’m feeling or how I’m living.Migrant living in Roja River settlement, northern Italy
In France, Italy, Greece, Serbia, Sweden, Belgium, and Germany our teams have provided or are providing a range of services including medical and psychological support.
We also provide shelter, water, sanitation and essential relief items at reception centres, informal settlements and transit camps.
Our teams in France identify young people, who have usually undertaken the journey unaccompanied, and offer them support through a day centre for minors in Paris. Teams there provide respite, medical care and administrative assistance through the drop-in day centre.
MSF also runs specialised centres for the rehabilitation of survivors of torture in Greece and Athens most of whom came across the seas seeking safety and protection in Europe.