Militarised Polish-Belarus border Kozie Borki natural park

Bridging the Gap: Addressing Health Needs of Migrants in Europe through Operational Research

On Monday, June 24, 2024

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In the face of the multifaceted humanitarian crisis surrounding migrants' health and well-being, Médecins Sans Frontières (MSF) has long been at the forefront of providing humanitarian medical assistance. However, challenges persist, and the need for evidence-based interventions has never been more pressing. This is where Operational Research (OR) steps in, playing a crucial role in filling the evidence gaps. In the context of MSF's work with migrants, OR provides invaluable insights into health interventions, the impact of policy decisions, and best practices.

Already in 2015-2018, MSF’s Operational Research contributed to the analysis and documentation of the medical and psychological conditions of populations on the move seeking asylum in Europe, shedding light on the risks of protracted violence at the borders, and on the compounded health risks of an extremely vulnerable population. The publication of those analysis contributed to the generation of evidence on a subject that was still little investigated at the time, and supported MSF’s advocacy initiatives in different fora. 

Recognizing the need for adapted approaches to providing health care to migrants, LuxOR (MSF Luxembourg Operational Research Unit) and staff from MSF migration projects in Europe held a joint workshop in November 2023. By reflecting on the needs and policy environments of the countries MSF works in, the two teams identified priority research areas and aligned them with MSF’s advocacy objectives. Research proposals include understanding and mitigating psychological risks among intercultural mediators in countries of first arrival in Europe, improving responses to health emergencies in terrains like the Poland-Belarus forest border region, and assessing the effectiveness of targeted environmental interventions for managing scabies in open migration settings in Belgium.

Situation at the Polish Border

Militarised Polish-Belarus border Kozie Borki natural park

In early May, Operational Research Advisor Sylvia Lim visited Poland to follow up on research proposals from the Polish-Belarusian border project staff. Working near the border, MSF provides medical assistance to migrants travelling on foot through the Bialowieza (“White Tower”) Forest, a difficult-to-access, swampy woodland. This area features one of the last primeval forests of Europe, and a 5.5-meter-high wall equipped with razor wires and electronic surveillance separates the two countries. MSF paramedics work with a local organization to respond to migrants experiencing exhaustion and gastrointestinal distress from drinking surface water, and treat traumatic wounds and exposure injuries in the forest and at the wall. The interventions in the forest are physically demanding and dangerous, due to the terrain, climate conditions and the security context. Added to the mix, both migrants and MSF staff face increasing military scrutiny on the Polish side.This was immediately apparent during Sylvia’s visit to the project, where she was stopped twice by military personnel along with other MSF colleagues in ad hoc checkpoints.

“My Polish colleagues translated for me and said they were looking for migrants,” she said. 

Sylvia Lim, Operational Research Advisor


During her visit, Sylvia got to see what the paramedics were doing, and heard a lot about the challenges that the migrants faced during their journeys. She collaborated with the Polish project team to refine research objectives in light of what the paramedics are observing among the people they treat. The documentation of injuries, traumas and experiences of people on the move are crucial in questions related to how MSF can provide care, and the extent of care that can be delivered in such a restricted context. “Their work is not easy, and I get the sense that they have to make a lot of decisions about the kind of treatment they can provide especially when patients declined to be referred to a hospital,” she said. “They sometimes spend up to six to eight hours in the forest to make sure that the patients are stabilized before they can leave.” 

Moving Forward

Operational Research serves as a vital tool in addressing the complex health needs of migrants. The workshop organized by LuxOR and MSF migration projects in Europe exemplifies the commitment to leveraging OR to inform medical, operational, and advocacy objectives. As these initiatives progress, LuxOR is committed to sharing updates on the broader research portfolio and eventual findings to enhance medical response and amplify the voices and testimonies of MSF’s frontline staff and patients.

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