Since the start of its humanitarian response for migrants in Libya in 2016, MSF has repeatedly been confronted with the impossibility of protecting them from harm, both inside and outside detention centres, and with the difficulty of ensuring continuity of medical care for people with the most severe physical and mental conditions, including victims of torture.
"In Libya, the majority of migrants are victims of arbitrary detention, torture and violence, including sexual violence, says Claudia Lodesani, MSF Operations manager for Libya. They have extremely limited possibilities of obtaining physical and legal protection. As a result, the deadly migration route via the Mediterranean Sea is often their only way out. We believe that safe countries, especially in the EU - which has been funding the Libyan coastguard for years and encouraging the forced return of migrants to Libya - have a duty to facilitate the evacuation of these victims of violence and to protect them on their own soil.”
Today MSF releases a report entitled Out of Libya which describes the weakness of existing protection mechanisms for people stuck in Libya. The few legal pathways to safe countries set up by the UN’s Refugee Agency (UNHCR) and the International Organization for Migration (IOM) are slow and restrictive. People of only nine nationalities can be considered for registration, access to registration is almost non-existent outside Tripoli and in detention centers, and the number of relocation slots in destination countries is very limited. Of the approximate 40,000 people registered with the UNHCR’s resettlement programme just 1,662 left Libya last year, while some 3,000 people left through the IOM’s voluntary return programme. In total, around 600,000 migrants live in Libya.
MSF’s report also presents various alternative solutions, such as those instigated by aid organisations in association with governments. In Italy, a humanitarian corridor has already been opened and is allowing the evacuation of a number of highly vulnerable people in vulnerable and in need of protection, including patients treated by MSF in Libya. Meanwhile in France, discussions are underway with the authorities to evacuate survivors of torture and violence as well as people with serious medical conditions, who would be taken care of by MSF on arrival in France. MSF calls for this type of mechanism to be duplicated in other safe countries.
"The medical care of people who are arbitrarily and indefinitely detained, or at risk of systematic violence, poses many dilemmas,” says Jérôme Tubiana, MSF advocacy manager for Libya. “Realistically, what we can do to help them in Libya is limited. To truly protect the most vulnerable people, we must first and foremost, and urgently get them out of the detention system and out of the country."
MSF is one of the few international NGOs working in Libya. Its teams provide general healthcare and psychosocial support to migrants held in detention centres and living in makeshift housing. MSF also organises the transfer of more seriously ill people to hospital and helps those who wish to do so to register for the UNHCR and IOM’s programmes to help them leave the country.