Mediterranean migration

In 2020, 10 people die or go missing trying to cross the Central Mediterranean Sea on average each week

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.

People in Libya are also often detained in detention centres, usually in horrendous conditions - and those in detention in Tripoli have been trapped in the ongoing conflict in the city, with some centres having been caught in airstrikes, with people unable to escape, and then killed or injured.


MSF returns to search and rescue with Sea-Watch

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

Since May 2015 we have provided search and rescue operations with boats in the Central Mediterranean Sea. For seven months, between December 2018 and July 2019, we had no search and rescue activities when we were forced to terminate search and rescue activities on the boat Aquarius, which we operated in partnership with SOS MEDITERRANEE. After returning to sea in July 2019, with SOS MEDITERRANEE, with the boat Ocean Viking, MSF teams now provide medical care to people rescued by the Sea-Watch 4, operated by Sea-Watch.

During our Search and Rescue operations, MSF has been shot at by the European-funded Libyan coast guard and repeatedly accused of collusion with traffickers.

There is currently very little dedicated search and rescue in the Central Mediterranean, but people are still trying to flee Libya. From January to the end of September 2020, over 23,000 people arrived in Italy, having made the journey; just over 7,200 had made it during the same period in 2019.<a href="">Italian Ministry of the Interior, Dipartimento della Pubblica sicurezza</a> These numbers don’t count the number of people who die or go missing in the attempt – over 430 in the first nine months of 2020,<a href=">International Organization for Migration, Missing Migrants project</a> an average of over 10 people a week – or who are intercepted and returned to Libya. Despite that Libya is not a place of safety, in 2020, over 8,200 people have been returned to Libya as of the end of September.<a href=">International Organization for Migration, Missing Migrants project</a>   


Why they had to flee isn't important - they're humans

Pierre-Eric was a doctor on a search and rescue boat. He describes the story of one family the boat rescued.
Ryan Rodrick Beiler/MSF

We decided to return to sea in July 2019, first with SOS MEDITERRANEE, and then with Sea-Watch, because search and rescue is a duty, fuelled by the humanitarian need to prevent people from drowning while they seek safety from Libya.

Migrants, refugees, and asylum seekers in Libya face high levels of violence, extortion, and arbitrary detention with serious consequences to their physical and mental health. For these reasons, among others, returning people rescued at sea to Libya is a clear breach of international maritime, refugee, and humanitarian law.

Criminalisation of lifesaving search and rescue

Since 2018, our search and rescue operations have encountered ever-larger obstacles, in an increasingly hostile environment, amid intense political pressure. In June 2018, Italian and Maltese authorities denied the Aquarius a safe port to disembark 629 people on board; from this point, Italian ports were effectively closed to NGO search and rescue vessels.

In both August and September the same year, the Aquarius was stripped of its flag and registration by the Gibraltar and Panama Maritime Authorities, respectively, after coming under political pressure.

Hostile attacks on Aquarius continued in November 2018, when the Italian judiciary requested the seizure of Aquarius due to spurious claims of waste mismanagement. Without a flag and registration, Aquarius was unable to continue its lifesaving mission and in December 2018, it was forced to terminate its search and rescue activities.

In 2019, the situation – both in Libya and politically in Europe – deteriorated.

Tripoli plunged into conflict, where detention centres have been surrounded by fighting and hit by airstrikes. In 2020, while conflict continues in Libya, the coronavirus COVID-19 pandemic has worsened the situation. People are still desperately trying to flee.

In Europe, standoffs over rescued people have continued; in the space of 12 months, up to July 2019, there were 21 rescue stand-offs, affecting over 2,600 vulnerable men, women and children. Ad-hoc allocation of ports of safety, with often long delays before requests for a safe port are granted, continue today.

Our ships

Over the past five years, we have operated, or been partners on, seven ships:

  • Phoenix, in partnership with Migrant Offshore Aid Station (MOAS);
  • Dignity I;
  • Bourbon Argos;
  • Prudence;
  • Aquarius, in partnership with SOS MEDITERRANEE;
  • Ocean Viking, in partnership with SOS MEDITERRANEE; and
  • Sea-Watch 4, in partnership with Sea-Watch.
Message from Ocean Viking
A message from the Ocean Viking recorded on 21 August 2019, as the ship remained stranded in the Mediterranean Sea for the 12th day since the first of four consecutive rescues, with 356 men women and children on board waiting to be allowed to disembark in a place of safety.
MSF/Hannah Wallace Bowman

Medical care

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 our boats.

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.

During these consultations our teams often hear horrific stories; many of the people we rescue are victims of torture and other forms of ill-treatment.

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 Belgium, Bosnia-Herzegovina, France, Greece, Germany, Italy, Serbia and Sweden 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.

Support centres

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 Athens, most of whom came across the seas seeking safety and protection in Europe.

A collage of Aquarius
A collage by Hong Kong illustrator Ah Leung to put different scenes of MSF's search and rescue operation into the body of the vessel itself.
Ah Leung
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