Between 1 January and 31 December 2015, an estimated 1,008,616 fled to Europe by sea. 84% of them came from refugee-producing countries, with 49% from Syria, 21% from Afghanistan and 9% from Iraq. 17% were women and 25% were children under the age of 18. MSF teams provided more than 100,000 medical consultations to refugees and migrants on its search and rescue vessels in the Mediterranean Sea, in Italy, Greece, in the Balkans and in Western Europe. Despite winter conditions and attempts to close the sea route, people have not stopped fleeing and between January and April 2016, more than 180,000 people have arrived in Europe. More than 1,200 people have died or gone missing in this same period.

For more information on arrivals, demographics and deaths, please consult the IOM and UNHCR websites.

Today's humanitarian crisis in Europe in regards to migrants and refugees is a result of a collective catastrophically failure to respond to the urgent need for assistance and protection of over a million men, women and children. The policies and actions of European governments actively contributed to the worsening of the so-called “refugee crisis” and the health and well-being of those who fled. The lack of safe and legal options for people to flee, the razor wire fences, capriciously closed borders, squalid, inhumane reception conditions and the complicated, ever changing registration procedures aggravated the already miserable conditions imposed on thousands fleeing war, poverty and oppression, serving only to make fleeing more dangerous and increasing the suffering of those on the move.

Europe’s restrictive policies put some of the world’s most vulnerable people in more danger

 causing more suffering, as they risk it all to try to bring themselves, and their families, to safety.  European countries (and transit countries) have the responsibility to ensure their policies guarantee the right to seek asylum and respect fundamental rights and human dignity. So far, The EU’s response to the crisis at and within its borders has catastrophically failed to address the urgent humanitarian and protection needs of refugees and migrants. It is now time for the EU and its member states to take stock of the last year, to invest in a coherent European reception system, and to put in place measures that will provide safe and legal channels for refugees and migrants to access the assistance and protection they are desperately seeking.

European countries are only accepting a small share of the total number of displaced

Most of the world’s displaced people live elsewhere in their home countries or in the counties surrounding their home countries, relatively few are granted asylum elsewhere. For example, twelve million Syrians have been displaced by the ongoing conflict. Eight million have fled to other parts of Syria. Four million live as refugees in the countries that surround Syria – many of these countries are now overwhelmed (one in four people living in Lebanon are now Syrian refugees). One million people have reached Europe in 2015 – that is less than 2% of the total number of European population and not an insurmountable challenge for a regional power such as European Union.

People will continue to risk their lives in the hands of smugglers as long as there are no safe alternatives

Contrary to what governments claim, the construction of fences at the EU’s external borders over the past years has only pushed people to take more risks into the hands of smugglers and into leaky, overcrowded boats on the Mediterranean. Today, there are very few safe channels that people can take to reach protection, safety and a better life.

The enforcement of migration cooperation deals between the EU and its member states with third countries is resulting in unacceptable humanitarian consequences, including high levels of violence and a sustained erosion of refugee and asylum law. The EU-Turkey deal, presented as “the” solution to the current crisis, is a perfect illustration of this dangerous approach. Unless concrete protection measures to assure equal treatment and the dignity, safety and protection of people on the move are in place, abuses of migrants and refugees will worsen with increased externalisation of border control. There is no “quick fix” to addressing the causes at the origin of migration and refugees ‘flight.

The closure of the Balkan road combined with the implementation of the EU/Turkey deal is provoking a chaotic and inhuman situation in Greece: After the closure of the Balkan road, and the signing of the cynical EU/Turkey deal, around 46,000 people are today stranded in Greece in undignified conditions. Some of them are arbitrarily detained in hotspots turned into expulsion centres, with scarce access to basic humanitarian assistance and with no access to legal information and support. Some others are abandoned in camps with no access to asylum procedures, living in tents in unhygienic conditions.  With little hope other than smugglers to access their aspirations to find protection and reach family members.

What is MSF doing to help?

Central Mediterranean

MSF decided to resume its search and rescue activities between Africa and Europe, put in stand-by at the end of 2015. The first MSF search and rescue ship to be deployed this summer, the Dignity 1, set sail from the port of Valletta, Malta on 21 April with a team of 16, including experienced medical staff, on board. It has the capacity to care for 400 rescued people. The 50 metre-long vessel, will be proactively positioned in the waters north of Libya, and actively searching for boats in distress. In its first two operations Dignity I assisted 431 people. A second MSF’s boat, the Bourbon Argos, sailed off from Cyprus on 30 April, while a third MSF team will work in partnership with SOS Méditerranée to provide medical expertise on board of the Aquarius. The 68 metre-long vessel Bourbon Argos was already deployed by MSF in 2015 and rescued 9,560 assisting 12,387 of them during 52 operations while the Dignity I directly rescued 5070 people and assisted 6,312.

Aegean Sea

MSF launched rescue activities in the Aegean Sea off the island of Lesvos in collaboration with the international organisation Greenpeace. At the end of March, Greenpeace has wrapped the rescue operation on the Greek island of Lesbos and handed over to MSF team on the island who are now ready to take full charge of the operation for the longer term. In the recent weeks the numbers coming from Turkey to the island of Lesvos decreased significantly. Our teams are still monitoring the flows, ready to be deployed in case of need. Between 27 November 2015 and 23 March 2016, the MSF/Greenpeace Rescue operation assisted more than 18,117 people in 361 interventions.

Additionally, MSF operates land-based migration projects in five countries:

TUNISIA

MSF has been working with fishermen in Zarzis, Tunisia to offer training in search and rescue. Fishermen are often on the first line of the response when boats get into trouble near their fishing grounds and have been given material as well as training to assist them in their efforts. MSF has also provided training to the Tunisian and Libyan Red Crescents in dead body management.

ITALY

At least 9,200 migrants were rescued at sea by Italian and international vessels in March – four times the 2,283 rescued during March 2015. People arriving in Italy by boat are mainly from Nigeria, which has been the main country of provenience so far, Gambia, Guinea and Senegal. Due to the recent closure of the Greek/Fyrom border along the Balkan migration route, one hypothesis for the next months could be the reopening of the Albania-Apulia sea route. This change could also impact on the number of people arriving in the other southern regions, such as Sicily.

In Italy, where sea arrivals are nothing new, the reception system for newly arrived migrants and asylum seekers has been put under great strain. MSF has repeatedly highlighted the shortcomings of Italy's reception system during months of negotiations with the authorities and in a report presented to an Italian parliamentary commission last November. At the end of 2015, MSF ended its medical activities in the reception center of Pozzallo, Sicily, due to the unacceptable conditions including overcrowding and the lack of protection for vulnerable people and the impossibility for our teams to represent an added value inside an inadequate structure.

Rome: A project targeting victims of torture (VoT) within the migrant population has started at the end of October, 2015, in a temporary location in Rome. A new center in the city center, which has been built in the respect of trauma-related vulnerabilities, will be ready and operational by April 2016. 

The project offers medical rehabilitation to asylum seekers who have been victims of torture, in collaboration with an Italian organization (Medici contro la tortura), with years of experience on torture victims rehabilitation, and ASGI-Association for Law Studies on Migration, experts of legal support for migrants and asylum seekers. The main countries of origin of beneficiaries are Nigeria, Mali, Afghanistan, Ghana, Gambia and Egypt. In total, 39 people from 15 countries have received assistance in more than 340 individual consultations. A new center in the city center, which has been built in the respect of trauma-related vulnerabilities, will be ready and operational by April, 2016, and it will be able to host 30 people.

Recently, MSF decided to start an echocardiographic screening activity aimed at identifying positive cases of rheumatic heart disease within migrant population in Rome, with particular focus to specific groups of migrants living in informal sites. The project –which started one month ago-  is carried out in partnership with the National Institute for the health of migrant population and the fight against poverty –related diseases (INMP) and to the Cardiology department of the Hospital of the Tor Vergata University.

Gorizia: In the Northern city of Gorizia, at the border with Slovenia, MSF is providing medical care, shelter and first assistance for the hundreds of asylum seekers who remained excluded from the institutional reception system. Since December 2015, MSF has installed 25 containers, with a capacity to offer shelter to 96 people. Reception facilities have been sufficient to respond to the totality of the local reception needs: all the available places were assigned and there was no further space left for new comers. It is a temporary solution to provide spaces where people can be welcomed with shelter, hygiene facilities and medical screening to improve their living conditions.

Since the beginning of the project, around 600  medical screenings and visits have been carried out in partnership with the IRC and the local health service. The vast majority of them travelled an average of 1 to 3 months across the Balkan route, and passed through other European countries, such as Austria, before reaching Italy. Around 9% of the asylum seekers had stigmata of traumas related to war, violence or accidents that happened in the origin country or long the migratory journey and this figure is probably underestimated.

In order to cope with patients’ needs and to provide them with legal information about asylum procedures, MSF has organised trainings with a legal actor and a specialized cultural mediator, in partnership with the national NGO Italian Council for Refugees and the legal support office from Caritas. In Udine, MSF is supporting local actors (Caritas) who provide shelter and medical assistance to migrants and asylum seekers.

The main aim of the project is to create and implement a first reception model that would include all the legal actors, who collaborate together on the different aspects of the reception. At present, we are working with local authorities to organize the handover of the center management and of medical activities, which are supposed to continue after our departure, expected for the end of June, 2016.

GREECE

MSF is providing medical care, shelter, watsan services and distributing relief items to refugees and migrants arriving in the Dodecanese Islands as well as on Lesbos, Samos and Agathonisi; in Athens and at the Idomeni border crossing to FYROM. MSF also distributed items (heating material, tents, energizing food, winter clothing, and blankets) to volunteer groups in Greece to support their actions for refugees. In 2015, Greece saw an unprecedented number of arrivals. By the end of the year, 856,723 people in total had arrived in the country and on average 10 people died every day trying to cross the sea into Europe. According to IOM, between 1 January and 31 March 2016, more than 151,104 people had arrived in Greece and around 400 people died or went missing in the Aegean sea trying to reach Europe. With the complete closure of the main Balkan migration route towards Western Europe, approximately over 50,000 people remain stranded across Greece, of which 15,000 are still in Idomeni, over 6,000 on the islands, 10,000 in Athens area and over 17,000 in the rest of mainland Greece. Currently all the reception places for asylum seekers in the country - whether in hotels, apartments, centers, abandoned buildings or camps - have reached full capacity. Since the first of March more than 27,181 people arrived in the Greek island, which means an average of 500 arrivals per day. According to UNHCR, women and children represent 62% of the arrivals.

Kos/Leros: Faced with no reception infrastructure at all in 2015, works have finally started in Kos and Leros to create hotspot structures but both centres are not fully operational so far. In Kos, MSF has established some tents - to provide extra shelter when the island is full- in the car park of an archaeological park on the island. We are also distributing blankets, water and running a medical clinic which includes access to a psychologist. MSF is not anymore in Leros, since the arrivals have been decreasing in the past weeks. In Dodecanese islands, the MSF team has been conducting vulnerability screenings to identify the most vulnerable groups like pregnant women, minors, but also people without access to basic services, providing medical consultations and mental health support. Since the beginning of January, in Kos and Leros, MSF medical teams have conducted a total 1,126 medical consultations in Kos and 1993 in Leros. In March, MSF psychologists have in the meantime conducted 27 mental health counselling sessions and 207 group sessions with 141 participants.

Lesbos: As of 30 April, almost 90,000 people have arrived to the island of Lesbos – 91% of whom came from Syria, Iraq or Afghanistan. Since July 2015, MSF has provided medical consultations, mental health support, distributed relief items and conducted water and sanitation activities in Moria camp in Lesvos. MSF has carried out 24,314 consultations in the island of Lesvos, of which 12,526 in Moria. MSF psychologists have assisted 401 people through individual sessions and have conducted 584 group sessions with 3,532 participants. Teams were also providing temporary shelter and transportation between the North and the registration centers of Moria and Kara Tepe in the South of the island. As of 13 March, MSF transported 12,952 new arrivals.  

In March, MSF has decided to suspend all its activities inside the Moria ‘hotspot’ after the EU-Turkey deal has changed the very objective of the center: from a registration center allowing people to leave the islands and find protection somewhere in Europe, it has become a pre-removal center offering insufficient guarantees for the respect of people's basic rights. The hasty declaration of Moria as a closed expulsion center has not been accompanied by the deployment of a mechanism of assistance for the people in there. This has resulted in a drop in the living standards in the camp. Overall minimum humanitarian standards in Moria are not being met and security is a concern. In addition, the lack of information and clarity of the refugee/migrants status and procedures is adding to the frustration of the population. In April, the most vulnerable cases were transferred from Moria to Kara Tepe where MSF is providing medical care in a mobile clinic.

Since the beginning of January, MSF medical teams have conducted 9,667 medical consultations. MSF psychologists have assisted 160 people through individual sessions and have conducted 172 groups sessions with 807 participants. In the north of the island, MSF is still running rescue activities. In Mantamados, MSF has established a transit camp for arrivals to the north of the island where we provide shelter, medical activities if needed, a children’s play area and ‘safe space for mothers’ and where people receive food, water and blankets.

Idomeni: Due to the complete closure of the Balkan route over the last month, thousands of migrants and refugees are trapped at Idomeni, on Greece's border with FYROM (Former Yugoslav Republic of Macedonia). MSF is running a medical clinic and soon opening a second, distributing relief items, providing shelter and water and sanitation. Idomeni camp is only a transit camp and has not been planned to host so many people for such an extended period of time. A count of all tents by MSF revealed the real figure of people is between 15,000 – 17,000, so much more than official figures (of about 11.000). It is a huge challenge to cope with the massive increase of people in Idomeni and respond to their needs. A team of MSF logisticians has helped to increase the capacity of the camp. The camp now has an estimated shelter capacity to 2,500 - 3,000 people. So the majority of people sleep in camping tents on the ground, a completely unacceptable shelter for people over a long period of time.  Around 2,000 refugees and migrants are also staying at the gas (EKO-station) station less than 20km from the camp. MSF has established nine 45sqm heated tents at the service station, ran a clinic at the site, set up temporary toilets and distributed blankets, food and water. MSF also has a mobile clinic that serves people who are not staying in Idomeni and the EKO-station, but live in other un-official camps in the area.

Over the past 4 months, our medical teams have treated an increasing number of patients for injuries consistent with violent behaviour and reporting having been beaten by FYROM police, while caught crossing illegally into FYROM. From 1 to 28 March 2016, MSF medical teams conducted over 7,000 medical consultations between Idomeni Transit Camp and the EKO Gas Station. The main morbidities are respiratory tract infections (associated with inadequate shelter) and gastrointestinal pathologies (associated with inadequate access to hygiene facilities).  While the main morbidities we are treating in Idomeni camp have not changed in recent weeks, our teams have noted a marked increase in severely vulnerable people seeking medical attention. The number of young children, expecting mothers in their final stages of pregnancy, people with severe physical or mental disabilities and chronic illnesses has increased, with most requiring medical treatment. Since beginning of January, MSF psychologists have conducted 221 individuals sessions and 254 group sessions with a total of 2,960 participants.

Samos: Samos is the third most important island after Lesbos and Chios where refugees land when they cross over from Turkey. In 2016 over 11,000 people arrived on the island so far. An MSF team is providing first aid to refugees when they land. In February, following the announcement of Samos camp becoming a Hotspot and the centralization of all registration process in the camp, the accommodation capacity in Samos has decreased with the progressive closure of any accommodation capacity in the Port of Samos that was before hosting around 500 refugees. On 20 March, the hotspot was turned into a detention center following the agreement between EU and Turkey. Today, the total capacity for accommodation in the camps remains at 280 when more than 900 people are staying inside the camp. 2 places tents have been placed everywhere inside the camp up to a point that there is no more space to put any single more. In April, some shortages of water have been experienced in the camp. During a week, the authorities guarding the camp have even forbidden volunteers to provide tents to refugees who had to sleep out door with no protection at all.

Agathonisi: In the island of Agathonisi, close to Samos, MSF team is welcoming new arrivals, providing medical care and shelter to refugees when they land. In 2016 over 1,200 people arrived in Agathonisi so far. 

Korinthos: In order to provide medical care to the most vulnerable people arriving in Greece, in February, MSF started providing medical care in the Korinthos detention center, where 369 people were present. The MSF medical team is going to Korinthos twice a week to provide medical consultations in the detention centre. The centre has now about 500 people, majority Pakistanis.

Athens: In Athens, MSF launched in October 2014 a project offering medical rehabilitation migrants and asylum seekers who have suffered systematic violence in their country of origin, during their journey or in Greece. The MSF team, in cooperation with two local partners: BABEL mental health day center and Greek Council for Refugees, offers medical assistance, including psychiatric care and physiotherapy, psychological, social and legal support aiming at the rehabilitation of victims of violence. 164 people from 33 countries have received assistance in more than 2,500 individual consultations. The project is in the process of being re-launched with increased capacity for outreach in the urban setting in response to the increased needs resulting from the changing context: more and more migrants and refugees spend longer periods in Athens as access to the “Balkans route” is being closed.

MSF started mobile clinics in Elliniko camp (around 4,000 people) in Athens (medical and mental health consultation). Next week, the team will start mobile clinic in Skaramangas camp in Athens (2,200 people) and will open a clinic in Athens center to provide medical and psychological care to migrants and Greek population (focus on girls and women).

Due to the complete border closure of the Balkan route over the last month, a growing number of refugees are stranded in Athens. About 14,000 people are now blocked in the Greek capital and its surroundings, while the accommodation capacities are very limited, even if new hosting sites are in the process of being opened in Athens and in other places around the country. In the premises of Eliniko old Airport and Olympic complex, which turned into a hospitality camp for migrants, more than 4,100 people are sleeping in appalling conditions. People are gradually transferred from Piraeus Port to other locations. Around 4,700 people are installed in the terminal waiting areas of the port or sleeping in small tents set up outside. MSF is providing medical activities and will soon start up with mental health and supporting food and blankets distribution in the transit centre set up in the port area where the registration office is located. Moreover, MSF has been providing outpatient medical consultations at the Eleonas Hospitality Centre for Refugees, which is hosting 1,500 asylum seekers, mostly from vulnerable groups. The medical team consisting of one medical doctor, one nurse, one Arabic translator and one Farsi translator is present every day including weekends.  Victoria square in the centre of Athens has become an unofficial meeting place for migrants of all nationalities. On 12 February, MSF started providing outpatient medical consultations in a facility next to Victoria Square, where an NGO welcomes and provides social activities to women and children.

SERBIA

Since late 2014, MSF teams have been present at both entry and exit points in Serbia offering medical services, mental health support and distributing NFIs to people transiting through Serbia, onwards towards Croatia and Hungarian borders. Since January 2016 MSF has re-started activities in Belgrade. While the flow of refugees through the Balkan route was already restricted to small groups of Syrians and Iraqis, the new measures have effectively blocked the legal passage of refugees of all nationalities. The restrictions on the Balkan route have pushed more people towards criminal networks and irregular routes exposing them to kidnappings for ransom and additional violence and abuses. Since November, our medical teams in Serbia have seen an increase in cases of violence by smugglers and authorities at the border but also inside transiting countries. Civilian vigilante groups have also started to arrest and mistreat migrants and refugees, notably along Bulgarian borders. Many people are showing signs of confusion and frustration, as they are uncertain about their fate and about the rationale behind border closures to any onward passages along the route.

From 1 January until 24 April, MSF teams provided 5,800 consultations in Presevo. From 1 January until 24 April, MSF teams provided 4,073 medical consultations in Belgrade. MSF psychologists have supported more than 566 people through individual sessions and conducted more than 619 group sessions with 3,154  participants.

Belgrade: After the implementation of the first restrictions to the “Balkan route” in November, MSF saw an increase in the number of people staying again in Belgrade parks, sleeping in the street or at train station with low temperatures and lack of support at night (shelter, food, medical, legal). Since 20 March MSF has a fully equipped Mobile clinic in a truck at the park close to the main train station.

MSF started activities in Belgrade with a mobile clinic during the night in the park next to the train station and at Krnjaca asylum camp, a collection of barracks-like huts half an hour’s drive from central Belgrade. These are home to families, elderly and refugees who are not able to cross into Croatia or Hungary and are stranded in Serbia. MSF is providing primary health care and distributing NFIs. In addition MSF has been advocating for shelter and protection solutions for this vulnerable population, this is also a population that often has tried to pass to Croatia and has been denied access on the train or has been pushed back by police. Although MSF has not witnessed these events and can’t identify perpetrators, we have treated cases consistent with the stories told by our patients – coming from Bulgaria or Macedonia.

Presevo: In Presevo, where the registration center is located, hundreds of people were walking through the border in a dirt road which was often muddy. Since the new border control measures have effectively blocked the passage of refugees, the Refugee Aid point (RAP) in Miratovac has been closed.  MSF teams is present at entry points in Serbia around Miratovac to ensure medical assistance. Numbers of people passing from the Macedonian border have decreased dramatically after the EU-Turkey deal.

Sid: In Sid, MSF was operating 20/7 inside a transit center next to the train station. Since the new border control measures have effectively blocked the passage of refugees, around 280 people were stranded for at least 3 weeks. MSF has also set up 8 large heated tents with a capacity to shelter more than 2,000 people from the cold. Activities were handed over 20 March 2016 as the camp population had fallen and the needs were met by other actors.

Subotica: Increasing numbers of people are attempting to enter Hungary from Serbia and are waiting outdoors in 3-4 sites close to the border crossing without access to basic needs. MSF has assisted this population since 1 April with 1,200 medical consultations. MSF has also donated 1,832 blankets, 770 hygiene kits and 720 half liter bottles of water as well as other items to help people. MSF also has provided basic waste collection at the sites contributed to refer medical cases to protection actors when needed and is lobbying for increased access to shelter, sanitation and hygiene facilities. 

Former Yugoslav Republic of Macedonia

Due to stricter conditions of entry for refugees of all nationalities travelling along the Balkan route more refugees are finding themselves returned to FYROM (Former Yugoslav Republic of Macedonia). Reports of violence in FYROM have been brought to the attention of the relevant authorities. FYROM is also undergoing political unrest with demonstrations on the streets of the capital.

FRANCE

Grande Synthe:  In collaboration with the Grande Synthe municipal authorities and various partner organisations, MSF opened a migrant camp with 300 wooden shelters equipped with a fuel stove and 6 sanitary blocks.  By mid-march, nearly 1,500 migrants were settled in the new camp named “Liniere”.  According to the latest figures gathered by the police (Police au Frontiere), the camps population has decreased to 1,101 as of the end of April.

MSF contributed 2.6 million euros of its own funds to cover the construction costs. The Liniere camp is managed by UTOPIA 56, an association hired and funded by the local council. The French Office for Immigrant and Integration (OFII) began working in the camp since the beginning of April.  To date, 24 migrants have been moved to reception and orientation centers (CAO), 2 voluntary returns have taken place, and 2 unaccompanied minors have been put under protection. MSF is working with Medecins du Monde, Gynécologues Sans Frontières and the French Red Cross to provide basic medical care in an OPD in the camp.  Additionally, psychological support services, physical therapy and women health services are also provided.  From January 1 to March 31 MSF teams conducted 1,217 medical consultations. On average, MSF and the French Red Cross conduct 48 psychological consultations per month. 

Between 16 February to 17 March, MSF prepared and supervised a measles vaccination campaign that was implemented by partner organizations MDM and EPRUS.  529 people were vaccinated in the camp and in four other small migrant sites in surrounding areas.

Calais: Despite the Government’s efforts to reduce the numbers of refugees living in the slum at Calais, more than 4,900 refugees continue to live in the Jungle.  In the medium term, French authorities want individual migrants wishing to remain in Calais to move in to the ‘Temporary Reception Centre’ they've constructed (white shipping container camp).  Families and children can stay in the Jules Ferry Centre and others can move to Reception Centres elsewhere in France, where they are then able to apply for asylum.  Among them, there are 294 unaccompanied minors. During the destruction and evacuation of the southern part of the slum on 29 February, MSF mobilized a small medical clinic in the southern part of the camp in order to provide medical care to the wounded. The French authorities have made past threats to dismantle and evict the northern part of the camp, but today local authorities are slowly making investments in water and sanitation services.  Despite their efforts, living conditions in this area have worsened due to overcrowding which has led to increased tensions between migrants. Water and sanitation facilities remain a major concern as well.  Migrants who have been evicted from the southern Jungle are setting up smaller camps (with a few dozen to several hundred people) throughout the north of France.  MSF is working on a logistical strategy (water and sanitation facilities) to support these migrants now living in mini sites outside of the Jungle.

MSF is increasing its support for the most vulnerable groups within the Jungle: women, unaccompanied minors and migrants demonstrating psychological problems. As of 1 March, MSF handed over its medical activities to the local hospital in Calais.  Between November 2015 and February 2016: 8,416 medical consultations were provided (25% for respiratory infections and 20% for scabies, many patients aged 15-18 years). There were also 54 consultations for “non-accident related violence”.  MSF continues to monitor and document cases of violence, particularly police violence.