Brussels - Asylum seekers and undocumented migrants are bearing the brunt of increasingly restrictive policies which take a toll on their physical and mental health. Escaping conflict, deprivation or widespread violations of human rights, they endure long and dangerous journeys to Europe. Yet when they finally reach Europe, many face prolonged detention, appalling living conditions and a lack of access to healthcare.

Others remain trapped outside Europe or are intercepted and sent back to countries where their health and lives may be at risk. Ahead of International Migrants Day, the international humanitarian organisation Médecins Sans Frontières (MSF) urges policy makers across Europe to respect the life and dignity of migrants and asylum seekers and improve their access to basic services, including shelter and healthcare.

MSF teams assist migrants and asylum seekers at different stages of their journey. In countries of origin such as Somalia, Afghanistan, Democratic Republic of Congo and Nigeria, MSF treats the medical consequences of violence and deprivation. In Morocco, Greece, Malta, Italy and France, MSF teams provide medical and psychological care to those who survived the journey: many migrants and asylum seekers endure dangerous desert and sea crossings, are subjected to violence and abuse, are imprisoned and exploited or fall victim to smugglers and traffickers. Unaccompanied minors and women, many of them pregnant, are increasingly among those making the journey.

Border control policies implemented by the European Union (EU) or individual member states leave many undocumented migrants and asylum seekers trapped on the outskirts of Europe for long periods of time or force them back to the places where they come from. In Morocco, migrant and asylum seekers trying to enter the EU often live in poor and degrading conditions and are victims of violence and exploitation. Between 2003 and 2009, MSF teams in Morocco attended to 4,000 cases of violence. In Italy, MSF was forced to withdraw its team from Lampedusa following the sharp decrease of migrants and asylum seekers reaching the island. Since the Italian government implemented tougher policies earlier this year, boats with migrants and asylum seekers are reportedly being intercepted at sea and sent back to Libya, exposing people once again to violence endured while trying to reach Europe.

Those who make it to Europe often face systematic and prolonged detention in appalling conditions. Despite the serious impact this has on physical and mental health, access to healthcare is limited and psychological support often nonexistent. In Greece and Malta, MSF’s work in detention centres for undocumented migrants and asylum seekers has revealed high rates of depression, anxiety and Post Traumatic Stress Disorder. “In the detention centres we find overcrowding and horrible hygiene conditions. Also, being detained without actually having committed any crime and the uncertainty for their future is incredibly frustrating,” said Christos Papaioannou, MSF field coordinator in Greece.

When detention is over, the outlook is bleak for many and access to healthcare remains uncertain. Even when healthcare is available, language barriers, lack of information and fear of being reported stop migrants from seeking help. In France, MSF provides psychological support to mostly unrecognised asylum seekers. Many suffer from severe psychological disorders as a result of violence or persecution at home, the arduous journey and the lack of shelter in France. Since 2007, MSF has provided more than 7,000 consultations in Paris - half of these involved psychological care.

“Our experience working at different stages of their journey gives us an insight into their prolonged suffering. These are vulnerable people who go through a very difficult journey where they often face violence and abuse. When they finally reach Europe, hoping it to be the end of a series of traumatic events, they are greeted with detention, horrible living conditions, limited access to healthcare and exclusion from society. It is paramount that migration policies in Europe respect the life and dignity of these individuals and improve their access to medical care, including psychological support,” said Liesbeth Schockaert, MSF’s humanitarian affairs advisor.