Rabat/Madrid – A new report by Médecins Sans Frontières (MSF) outlines the impact of precarious living conditions and widespread criminal and institutional violence on the health of undocumented sub-Saharan migrants trapped in Morocco on their way to Europe. According to the report, Morocco’s transformation, as a result of increasingly stringent border controls, from a country of transit to a forced destination for migrants heightens their vulnerability. The implementation of migration policies which undermine respect for human rights is impacting on the health of this population, which includes vulnerable groups, such as victims of sexual violence or human trafficking, who are not receiving specialised care and protection from the authorities.

“The renewed cooperation efforts between Morocco and Spain which, according to these countries, are focused on the fight against cross-border crime, illegal migration and drug trafficking are having a serious impact on the physical and mental health of sub-Saharan migrants,” explains David Cantero, MSF head of mission in Morocco. “Migration policies privilege internal security criteria over respect for fundamental human rights”.

The report, Trapped at the Gates of Europe, denounces the violence which migrants are subjected to on a daily basis. Since December 2011, MSF teams have witnessed an increase in the number of police raids, during which migrants’ belongings are destroyed, and an increase in the expulsion to Algeria of those who arrested, including vulnerable groups such as pregnant women, injured people and minors. These indiscriminate raids and expulsions are part of the renewed violence used by Moroccan and Spanish security forces to dissuade migrants attempting to jump the fences  surrounding the Spanish territory of Melilla. In 2012 alone, the MSF teams in Oriental Region, which includes Nador, neighbouring Melilla, treated over 1,100 injured people.

“Since April last year, in particular, we have seen broken arms, legs, hands, and jaws as well as broken teeth and concussions, amongst others. These injuries are consistent with migrants’ accounts of having been attacked by the security forces,” explains Cantero.

One of the most urgent and significant problems outlined in the report is the sexual violence experienced, for the most part, by migrant women and girls. It is impossible to determine the exact proportions of this violence, however MSF’s medical data reveals an alarming situation. From 2010 to 2012, MSF teams treated almost 700 survivors. These women and girls require specialised care and are not receiving adequate assistance or protection from the authorities.

In addition to highlighting the increase in violence in this past year, the report also shows the difficult circumstances endured by sub-Saharan migrants, many of whom are forced to live in precarious conditions out in the open and beg in order to survive. Almost half of the 10,500 medical consultations conducted by the MSF teams between 2010 and 2012 were for pathologies related to bad living conditions. Migrants’ mental health is also affected, with patients showing symptoms of anxiety, depression and psychosomatic problems, amongst others.

Trapped at the Gates of Europe recognises the improvements in migrants’ access to healthcare services in Morocco, which have been achieved by civil society organisations and non-governmental organisations working with the Ministry of Health. This has led to a gradual decrease in MSF’s direct medical activities over the past few years. However, the question mark over the application of a new health insurance regime, the lack of mental health services and comprehensive care for survivors of sexual violence (for both migrants and Moroccans) and the existence of areas where, for fear of being expelled, migrants do not voluntarily go to health centres, are pitfalls that the Moroccan government needs to overcome.

The progress made to date, however, will be limited if migration policies continue to criminalise and marginalise sub-Saharan migrants and prioritise the focus on internal security over respect for human rights. The protection of migrants and the defence of their fundamental rights fall outside the scope of MSF’s work as a medical and humanitarian organisation and this is one of the reasons why MSF has decided to hand over its activities in Morocco this year.

MSF urges the Moroccan and Spanish governments to stop the abuses perpetrated by their security forces, comply with international and national human rights agreements and guarantee that sub-Saharan migrants are treated humanely, regardless of their legal status.

MSF has worked in Morocco since 1997. Since 2003 the organisation has focused its operations on guaranteeing access to healthcare for migrants. MSF handed over its activities in Rabat in 2012 and is currently handing over its remaining operations in Oujda and Nador.