Providing assistance to migrants and refugees in Libya

27 Jun 2017
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Jean-Guy Vataux, head of mission in Libya, speaks about the work of MSF teams in the country in order to provide assistance to migrants, refugees and asylum seekers. During their time in Libya, most of them found themselves robbed, under the control of criminal networks, abused, jailed, beaten up, tortured and some die. How can a medical humanitarian organization such as MSF help them? Since July 2016, MSF has been providing lifesaving and primary healthcare to refugees and migrants detained in Tripoli[1]. Early 2017, a new project opened to assist migrants, refugees and asylum-seekers in Misrata area – its activities are now expanding.

  1. MSF provides medical and humanitarian aid inside detention centres in Misrata. How is it going? What is the situation there?

In and around Misrata, the teams started activities few months ago in 3 detention centres, formally under the authority of the Directorate for Combatting Illegal Migration (DCIM).

The number of detainees varies from a week to another. They have been stopped at sea by the Libyan coastguards, arrested in towns, at a checkpoint, etc. Some arrive here after being transferred from other detention centers in Tripoli. We sometimes met in detention people who used to live and work in Libya for years. Being tested positive for hepatitis C is enough to send a migrant who moved to Libya with his family to jail.

MSF teams have started to provide medical consultations inside the detention centres. The majority of health issues affecting the patients we see are directly linked to the detention conditions and the violence that marks their journey: skin diseases, scabies, diarrhea, respiratory infections, muscular pain, wounds, but also psychosomatic disorders. MSF provides referrals to secondary and specialized care for those who need it, such as patients with fracture. Hygiene and non-food items kits are distributed to the detention centres.

While it is possible to marginally improve the material detention conditions, let us not lose sight of the core issue: people are jailed, theoretically awaiting for expulsion, following an opaque process which denies their basic rights.

  1. According to IOM, about 7 100 people are detained in the 27 detention centers officially operated by the DCIM, mostly in Tripoli[2]. What about other migrants, refugees and asylum-seekers in the country? Can you tell us more about them?

OIM identified over 380 000 migrants currently in Libya. Indeed people held in detention centres under the authority of the DCIM only account for a relatively small part of the total migrant and refugee population in Libya.

Some came to work in Libya, which once was an economic Eldorado for nationals from neighboring countries. Others either work to try secure funding for the Mediterranean crossing, working under conditions that fell within the scope of forced labour and interrupted by periods of detention, or are at the very beginning of their journey across Libya.

The journey through the Libyan desert and the stays in the « unofficial » centers, meaning the connection houses and warehouses run by criminal networks, are described as an excruciating experience by those who survived it. It remains a blind spot for us.

In 2016, about 5 000 people drowned in the Mediterranean, and in 2017 the toll is already estimated at 2 000 people as of June[3]. But how many die before reaching the coast and embarking on boats? There is every reason to believe that this is a silent hecatomb.

  1. What is MSF trying to do to assist them ?

We opened this month an out-patient clinic in Misrata town to reach out to migrants and refugees who live and work here under various conditions, in order to better understand their challenges and provide free and confidential healthcare. The respect of medical confidentiality is key in such context where developing certain diseases can be grounds for detention and expulsion. Beside, we continue our activities in the detention centres.

Then, how to be alongside people in the worst moments of their migration journey? So far, we do not have an answer, we continue to attempt negotiate access to people on the road upstream of the coastal cities. We will see what kind of working space we are able to negotiate or not. The risk of failure is significant. There are certainly other operational models we have to develop, to devise. Our team regularly go south of Misrata, where the corpses of those who are referred to as “migrants” flock to the local morgue. Reportedly about ten a week. In my opinion, we could at least do more to restore the dignity of these anonymous wrecked.

Working in Libya since 2011, MSF supports the Libyan health system which has been impacted by the renewed war and the ensuing economic recession. Health structures struggle with shortages of medicines and staff. MSF responds with donations to public health structures, including in the fields of infection control and emergency rooms departments. We remain committed to respond to the consequences of conflict when needed, for instance by assisting populations displaced by the fighting in Benghazi where we also provide pediatric, gynecological and obstetrical care, and mental health services to children and families affected by the conflict.