A total of 73 migrants and refugees are feared dead at sea after a boat carrying five survivors arrived last week in the Italian island of Lampedusa. Médecins Sans Frontières (MSF) provided immediate assistance to the five surviving men and woman, all from Eritrea, who were all suffering from serious health problems as a result of the journey to Italy.

“They were in a state of emotional shock,” said Licia Pera, an MSF nurse who attended to the migrants after they landed. “They were unable to walk due to strong musculoskeletal pain. Their blood pressure was low and their muscles were so weak that they could barely move. They also had burns on parts of their bodies and severe stomach pains. They were in desperate need of medical care.”

The health impact of the long and dangerous journey makes it imperative to provide immediate assistance for migrants, in the place where they first land. Transporting migrants elsewhere before giving them the assistance they need could further endanger their health.

The boat left Libya at the end of July, but after a few days it lost its course and ran out of fuel, food and water. The migrants remained adrift for many days before they were finally rescued and brought to Lampedusa, where MSF has a medical team. According to the five survivors, all the other migrants died on the journey. The survivors also told MSF that two pregnant women delivered still born babies on the boat before losing their own lives.

Last year, an estimated 30,000 migrants and asylum seekers landed on Lampedusa. By October, when MSF was forced to leave the island, the team had treated nearly 1,500 migrants. This year, in contrast, the numbers have been remarkably low.

Since MSF returned to Lampedusa in April 2009, fewer than 150 migrants have passed through the initial medical triage provided by MSF soon after their arrival. The scarce number of landings this year is worrying and MSF is concerned at what is happening to the migrants who do not arrive in Italy.

The recent episode in Lampedusa shows just how risky and tragic these journeys can be. The strategy announced by the Italian government whereby boats with migrants are returned to Libya without being allowed to land and receive medical care or request for asylum is another concern. Our patients in Lampedusa and in Malta report that in Libya they are subject to extremely harsh living conditions and inhuman treatment.

Undocumented migrants and asylum seekers trying to cross the Mediterranean Sea to Europe are escaping conflict, widespread violations of human rights and extreme poverty. In 2008, one-third of the migrants and asylum seekers who arrived in Lampedusa were from the Horn of Africa. MSF works in many of the countries of origin of these migrants and witnesses the conditions that drive them to cross the desert and the Mediterranean to reach safety and refuge in Europe.

As a result of increasingly restrictive immigration policies in European countries, migrants and asylum seekers are embarking upon ever more dangerous journeys and putting their lives at great risk.