In Europe, migration controls have been extended far beyond the continental borders. People in need are often met with punitive border policies, ‘contained’ in countries en route and deterred from seeking asylum on European soil. Policies can criminalise migrant status or deny refugees and migrants access to medical care and protection measures that would ensure their safety; and dignity. Misleadingly, European states have co-opted the language of humanitarianism to justify these restrictive measures, claiming to save lives by deterring migrants from undertaking risky journeys. This ignores the dangers people face in their countries of origin that force them to leave their homes, and those they encounter in transit. 

Furthermore, the lack of safe and legal alternatives means that people’s only chance of reaching safety is to attempt a dangerous journey to Europe. They are left at the mercy of a criminal underworld who run the smuggling routes.  

‘Contained’ out of sight in Libya 

The majority of people attempting to reach Europe by crossing the Central Mediterranean pass through Libya, where they are exposed to horrific violence, kidnapping, torture and extortion. Despite the reality on the ground, and the fact that Libya is a country in active conflict, the main objective for European states remains the containment of migrants and refugees there, at any cost.  

While claiming success in migration management, European states have implemented brutal containment and push-back policies. They have dismantled search and rescue capacities at sea, while sponsoring the Libyan coastguard to intercept refugees and migrants in international waters and forcibly return them to Libya, in violation of international law. To stem the flow of arrivals, they have made deals with militia groups in the country, despite their links with criminal and smuggling networks. As a result, the trafficking, abduction, detention and extortion of migrants and refugees continues. The chance of drowning in the Mediterranean while attempting to reach Europe has only increased.   

In 2019, MSF resumed our lifesaving search and rescue work in the Central Mediterranean and rescued 1,373 people in distress at sea.

Trapped on the Greek islands 

Back in 2016, the EU and Turkey signed an agreement in which Turkey would prevent asylum seekers and migrants from reaching the EU in exchange for €6 billion in assistance for refugees in Turkey and other incentives. At the time, MSF warned of the likely humanitarian consequences of such a deal, highlighting that it undermined the right to asylum. In protest, we stopped accepting funds from the EU and its member states. Rather than acknowledging the flaws in the entire logic of this EU-Turkey deal and its humanitarian cost, European leaders continue to call it a success and ask the Greek authorities to implement it more forcefully. 

For those refugees and migrants now trapped in deplorable living conditions on the Greek islands, the situation has become a chronic emergency. The situation exposes just how far Europe is willing to go in denying basic values of humanity and dignity to people in need of protection. 

MSF teams have treated people whose health is suffering as a consequence of these policies, feeling compelled to do work that European and Greek authorities have refused to do. But the work that we can do is limited because, after treating patients, medics must send them back to the same conditions that made them ill.  

Stranded at borders in the Balkans 

In 2019, thousands of migrants and refugees attempted to cross the Balkans in the hope of reaching other European destinations but were violently pushed back. Stranded, many live in informal settlements and abandoned buildings in border areas.  

In Serbia, MSF ran a clinic for migrants and refugees in the capital Belgrade and carried out outreach activities in informal settlements for people living outside Serbian reception centres. In Bosnia, we provided medical care in collaboration with the medical authorities to people living both inside and outside the official camps. Most of the conditions we treated – such as skin diseases, and respiratory tract infections – were linked to poor living conditions.  

Unable to access protection 

In France, many asylum seekers, migrants and recognised refugees are forced to live in squalid camps or on the streets, caught up in an endless cycle of having belongings confiscated, temporary evacuation and police harassment. Of particular concern are unaccompanied minors, often teenagers who arrive in France traumatised by violence suffered on their journeys. They face difficulties even registering for the protection to which they are entitled. Hundreds of young migrants and asylum seekers across France are being forced to sleep rough because of the state’s failure to provide them with accommodation, despite having a legal obligation to do so. 

MSF continues to assist young, unaccompanied migrants. We offer respite and care, and facilitate access to legal support and medical, social, psychological, and administrative services in partnership with other organisations in an MSF-run centre in Pantin, a suburb of Paris. A total of 734 minors benefited from these services in 2019.  

Let humanity prevail 

Europe must fundamentally change its approach to migration and asylum. No political reasoning can ever justify measures that deliberately and consciously inflict harm. The devastating consequences of these policies cannot be ignored and should not be normalised. This is not an acceptable price to pay to keep as many people as possible out of Europe.  

In the current political climate, refugees, migrants and asylum seekers are considered by many to be less than human. Respect for human life as a fundamental humanitarian value seems to have become an act of defiance. At MSF, we stand firmly in solidarity with people on the move and know that many citizens of Europe stand with us, whether as individuals, healthcare professionals, members of civil society organisations or representatives of local authorities.