In conflict zones, MSF does not take sides. We provide medical care based on needs alone.
“What I see today is what I saw in 1991: desperate people who fled their war-torn country only to end up in a camp where living conditions are below what is humanly dignified.”
Refugees and IDPs: Latest MSF Updates
- Safe Passage: An Open Letter to U.S. President Barack Obama & Congressional Leaders
- MSF Reinforces Activities in Serbia After Hungary Border Closure
- MSF Rescues 1,658 People in the Mediterranean in One Day
- The Fear that Follows Them: Providing Mental Health Care for Refugees in Chad
Nearly 60 million people are currently fleeing conflict or persecution around the world. Due to their race, religion, or nationality, these people’s homes are no longer safe places to live and their governments no longer provide them with protection.
Doctors Without Borders/Médecins Sans Frontières (MSF) works around the world to provide refugees and internally displaced people (IDPs) with everything they need from psychological care to lifesaving nutrition. We set up hospitals in refugee camps, we help women give birth safely, we vaccinate children to prevent epidemics, and we provide access to safe drinking water.
Lives continue to be lost at sea, in the back of trucks, and in make shift camps where people live in unacceptable conditions in the heart of the European Union. No matter the obstacles, people will continue to come as they have no other choice... Read More
Learn More About MSF's Search and Rescue Operations for Migrants and Refugees in the Mediterranean Sea
MSF has been working with fishermen in Zarzis, Tunisia, to offer training in search and rescue. Because fishermen are often the first line of response when boats encounter trouble near their fishing grounds, they have been given material as well as training to assist in their efforts. MSF has also provided training to the Tunisian and Libyan Red Crescents in dead body management.
MSF is working in the first reception center in Pozzallo (Ragusa Province, Sicily) in collaboration with the Local Ministry of Health to provide medical services to migrants, asylum seekers, and refugees upon arrival and during their stay in the center. MSF has also started to provide psychological first aid to survivors of traumatic events during the sea journey, for example, those who have experienced shipwrecks. A team composed of cultural mediators and a psychologist is ready to be deployed to different landing ports in Italy within 72 hours after receiving alerts. So far, the team has intervened at twelve different landings, in the Italian ports of Palermo, Augusta, Pozzallo, Catania, and Lampedusa, with the aim of providing practical and material assistance, to alleviate concerns, and to help the survivors face the first moments immediately after landing.
MSF also provides mental health care support to people living in reception centers in Ragusa Province, Sicily. During the first seven months of 2015, the team met more than 353 people in group sessions, visited 238 people, and provided psychological care to 109 asylum seekers, for a total of 600 consultations. Nearly half of the people who have benefited from psychological support have been through traumatic experiences related to their journey, including imprisonment and physical and psychological violence. Most are male, between 19 and 30 years old, coming from Nigeria, Mali, Gambia, or Senegal.
From January to September 1, 2015, the MSF team in Pozzallo provided medical screenings to 9,376 people on arrival, before they entered the primary reception center. Within the primary reception center, MSF has provided consultations to 4,160 people.
Since mid-July MSF has also been providing mental health support to people in transit in Rome. Up to August 30, the team provided psychological and emotional support to 538 people as well as support for basic needs and information to 1,754 people. MSF teams are working mainly in the Baobab Center (run by volunteers) and in the Tiburtina area, behind on of Rome's train stations.
MSF is providing medical care and distributing relief items to refugees and migrants arriving in the Dodecanese Islands as well as on Lesbos, in Athens, and at the Idomeni border crossing to Macedonia.
Since the beginning of this year, MSF teams in Greece have witnessed a marked increase of arrivals in the Greek islands. By September 23, 357,065 people had arrived in the Greek islands this year, with a 295 percent increase in the first eight months compared to the same period last year (according to UNHCR figures). In August alone, more than 107,843 people arrived, which is more than the total number of arrivals in all of 2014 (43,500). The majority have come from Syria, Afghanistan, or Iraq.
The Greek central authorities have yet to show any initiative to organize long-term reception in the islands in accordance with EU standards. Their only actions so far have been to increase the presence of riot police on the islands and organize short-term emergency evacuations (from Kos in August and from Lesbos in September) to relieve the pressure on the islands, with no vulnerability screening or provision of medical services.
MSF calls for the Greek authorities to meet their obligations and commit to reception by providing and managing spaces in all Greek islands where people can be welcomed with shelter, food, hygiene facilities, and medical screening. This is all the more urgent as the flow of people arriving will not stop in the winter but living conditions for them will become even harsher.
Kos and the Dodecanese
There is no reception system in place to deal with the number of arrivals. This has been particularly evident last week in Kos, when, on August 10, local authorities locked between 1,000–2,000 Syrians (including women and children) inside the local stadium without food, water, or protection from the sun in order to attempt to process the backlog of registration papers. The authorities used stun grenades, tear gas, and fire hoses to subdue the crowd, who became agitated due to the conditions inside the stadium and a lack of communication from the authorities.
The MSF team has been conducting vulnerability screenings to identify the most vulnerable groups like pregnant women and minors, and providing medical consultations, including psychosocial consultations across the island and at the Captain Elias Hotel, a dilapidated building where people are directed to stay while awaiting their registration papers. On September 10, authorities announced that Captain Elias will be shut down, meaning that there is no shelter whatsoever offered for the refugees arriving on the island. In the last few weeks, Greek authorities have organized ferry transport from the Dodecanese islands and Lesbos to Athens, which has helped reduce the high number of people in the islands.
From mid-March to August 31, 2015, MSF carried out 4,455 consultations and distributed more than 9,000 non-food items such as soap, combs, toothbrushes, towels, and more than 2,400 sleeping bags and survival blankets. As of June 15, MSF is also running mobile clinics around the Dodecanese islands through a boat that will visit smaller island locations where people arrive from Turkey. Up to August 31, 979 consultations had been carried out through this mobile clinic.
MSF is also carrying out mental health support on Kos and neighboring islands. Up to August 31, 1,804 people had benefitted from group consultations, in addition to 61 individual consultations.
An MSF emergency response team has arrived in Lesbos, one of the two islands in Greece that has organized reception facilities, but where the system is on the edge of collapse. MSF is providing medical consultations, cleaning services, and relief items and is working on improving water and sanitation in the Kara Tepe and Moria camps. MSF has already begun providing bus transportation so new arrivals do not need to walk the 43-mile distance from arrival points on the north coast to the registration center in Mitilini.
Greek authorities have yet to identify an additional suitable space for the existing reception center and Kara Tepe camp where people can be offered shelter, food, hygiene facilities, and medical screening. As long as this is not done, in the face of chronic mismanagement by authorities, it is likely that the island will continue to go from crisis situation to crisis situation.
In Idomeni, close to the border with FYROM (Former Yugoslav Republic of Macedonia), MSF is running mobile clinics and distributing relief items for those who first arrive in Greece and continue crossing the Balkans to go to northern Europe. From April 3 to August 31, MSF provided primary health care to 4,060 people and referred 53 to local hospitals. Another 3,906 people participated in individual and group mental health consultations. The teams also distributed 7,918 relief items such as hygiene products, energy food, blankets, and socks.
With winter approaching and taking into account the high possibility of FYROM closing the border at any moment, effectively leaving people stranded in a no-man’s-land, MSF installed four shelters, each with a capacity for 160 people, two tents for medical activities, 40 latrines, 30 showers, and 10 water taps.
In Athens, MSF launched a project offering medical rehabilitation to asylum seekers and migrants who have been victims of torture in October 2014, in collaboration with two Greek organizations (the Greek Council for Refugees and Syneirmos/Babel). So far, the MSF team has received a total of 140 patients.
MSF teams have been providing medical and mental health care and distributing relief items such as hygiene kits, food, survival items, tents, blankets, and raincoats to people crossing through Serbia since late 2014.
The team has a mobile strategy, moving according to the routes that people are taking to cross the country. Until last week MSF's three mobile teams, which each include a doctor, nurse, and translators, were working on the Subotica crossing point with the Hungarian border, in the capital Belgrade, in and around the asylum centers, at the Bulgarian border and on the border with the Former Yugoslavian Republic of Macedonia (FYROM) in Presevo, Miratovac, and Bujanovac. After the border with Hungary closed and the migration route changed with the majority of people bypassing Belgrade going straight to the border with Croatia, the teams started to focus on the crossing points with Croatia at Sid and Bapska. They continue to work at the Macedonian border, which remains the major entry point into Serbia.
The teams report seeing a large number of pregnant women, from very early to very late stages. They meet babies who have been born during the journey. There are also elderly people and a large number of very young children traveling and each day the teams see at least one person in a wheelchair.
Over the past two months the number of consultations has risen sharply, with the teams treating 2,856 people in August and 3,485 in September, compared to 621 consultations in May. The total number of consultations since April is 10,464. The main medical needs are treatment for respiratory illnesses and injuries sustained on the journey, including blisters and body pains. With winter approaching, bringing rain and lower temperatures, MSF is also treating people for common colds. As a direct result of the poor living conditions that people face, MSF teams in Presevo have also seen cases of scabies.
There are major needs for shelter in Serbia, and on nights in the past week up to 2,000 people have been sleeping outside without shelter.
MSF is working in Croatia, in a transit camp near the border with Serbia (about 15 kilometers from Tovarnik) where refugees spend about a day before being transferred to Hungary. In the camp, which hosts around 5,000 people daily, MSF has opened up a clinic. Given the unpredictability of the opening and closing of borders between Serbia and Croatia, MSF has had to deploy mobile clinics to be able to rapidly assist refugees at the different crossing points.
A team arrived September 10 in Calais, at the so-called "Jungle" site, where around 4,000 refugees are living in dire conditions, despite the efforts of nonprofit organizations and local charitable initiatives. Calais is located near the Channel Tunnel linking France and the United Kingdom and for several years migrants have been trying to reach the UK on trucks via this route.
A former garbage dump, one quarter of the site has flooded after recent rains. An MSF doctor and nurse are helping a Médecins du Monde team provide medical consultations. MSF is also doing water and sanitation repair work and on September 21 launched a large clean-up campaign to gather the trash and set up a system for collecting and managing it.
There are currently more than 15 million refugees around the world.
IDPs are not defined as refugees because they have not fled their home country.
There are currently around 26 million IDPs in 52 countries around the world.
Almost half of the world’s IDPs are fleeing conflicts in just three countries.
Refugees are protected under international law.
The United Nations refugee agency (UNHCR) is responsible for ensuring that refugees have the right to seek asylum, to receive assistance—food, shelter, medical care—to protection from violence, and to bringing about a lasting solution to their situation.
However, some policies are designed to deter refugees from seeking asylum: policies that condone inadequate processing or simply turn refugees away.
As well as providing health care and sanitation for refugees, we believe it is equally important to speak out about these policies.
The Largest Camp in the World
When countries do provide shelter, refugees are often forced to face the health impacts of living in unsanitary camps. With a population of 460,000, Dadaab refugee camp in Kenya is recognized as the largest in the world, and one of the most dangerous.
Today, Dadaab is no longer a refuge. As more people arrive from war-torn Somalia, the overcrowded camps are becoming permanent homes where people face rolling nutritional crises and outbreaks of diseases such as measles and cholera.
Abubakar Mohamed Mahamud, MSF’s deputy field coordinator, has worked in Dadaab for more than 20 years. “The crisis in Somalia is not going to end soon,” he says. “History is repeating itself and this is a never-ending problem.”
“What I see today is what I saw in 1991: desperate people who fled their war-torn country, leaving everything behind, only to end up in a camp where living conditions are below what is humanly dignified.”
Following the drought in the Horn of Africa in 2011, a surge of people fled Somalia in search of safety, food, and medical care, aggravating the already dire situation for refugees in Dadaab.
Inside Dagahaley, one of Dadaab’s five camps, MSF teams tripled capacity by setting up an emergency nutrition center with more than 200 beds while maintaining a 100-bed hospital for maternal care, pediatrics, emergencies, and general medical assistance.
Internally Displaced People
While IDPs often flee their homes for similar reasons to refugees (armed conflict, human rights violations, natural disasters) technically, they are not refugees. IDPs have not crossed an international border to find refuge and therefore remain legally under the protection of their own government, even though that government is often the cause of their flight.
Today, there are 26 million IDPs in 52 countries around the world. Almost half are fleeing conflicts in just three countries: Sudan, Colombia, and Iraq; and around three quarters of all IDPs are women and children.
Despite international law calling for the protection of civilians in conflict, women and children are often deliberately targeted by belligerents as part of their strategy.
And, while programs exist to provide surgical and other care to these victims, the vast majority will not receive the care they need because they live in regions where the healthcare system has collapsed and where it is too dangerous for independent aid agencies to operate.