In August 2008 Médecins Sans Frontières (MSF) started providing health care in Maltese detention centres for undocumented migrants and asylum seekers. Consultations with detainees quickly revealed how appalling living conditions and serious barriers to access health care – including mental health care – endanger the physical and mental health of the detainees. Poor hygiene standards and inadequate shelter lead to skin and respiratory infections. Men, women and children are accommodated together in overcrowded cells. Dysfunctional isolation policies cause healthy people to be detained in the same areas as people suffering from infectious diseases leading to the spread of epidemics inside the centres. The poor quality of health care available in detention has a significant and potentially long-term impact on detainees’ health.

In addition, almost fifty per cent of the people residing in the centres originate from Somalia. They have escaped a context of conflict and generalised violence and need protection but find themselves facing poor and precarious living conditions once again.

MSF provided medical consultations and psychological support in these detention centres. We have drawn the attention of the Maltese authorities to the sub-human living conditions in the centres and pressured them to instigate change. However, despite late efforts taken by the Maltese authorities to improve the conditions for receiving asylum seekers and undocumented migrants, structural problems remain. The centres are still overcrowded and unhygienic, and the systematic detention of vulnerable people continues.

Without structural changes, and given the increasing number of new arrivals in 2009, the situation is likely to deteriorate further. Such inhuman treatment is unacceptable – especially in a member state of the European Union. Urgent and fundamental change to treatment of migrants and asylum seekers in Maltese detention centres is required.