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Mediterranean Sea

Search and rescue relaunch: Questions and answers

A pneumatic boat in distress with 130 people on board was rescued by the boat Vos Prudence. © Albert Masias/MSF
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MSF has been working in the Mediterranean since 2015: we have saved thousands of people in distress there. The Mediterranean crossing is now the deadliest migration route in the world. Our teams provide first aid on board and distribute essential items.

    After a trip in disastrous conditions, people often suffer from dehydration, hypothermia and burns. Many of them have untreated chronic diseases or injuries such as diabetes. They have often experienced terrible suffering - particularly during their forced detention in Libya. Since 2015, more than 78,000 people have been rescued by MSF teams on board various rescue ships in the Mediterranean. 

    Since summer 2019, an MSF medical team has been working on the Ocean Viking, a boat operated in partnership with the SOS Méditerranée organisation in the central Mediterranean. Only since the beginning of this year, 576 people have drowned in the Central Mediterranean - and these are just the deaths recorded by the International Organization for Migration (IOM).[*]

    The mortality rate in the Mediterranean is higher than ever due to the lack of European search and rescue mechanisms at sea and the blocking of private rescue vessels.

    As long as this situation persists and people drown while trying to flee Libya, we will remain active in the sea rescue.

    We call on the EU to put an end to the criminalisation of private rescue operations and finally to take its own intervention and rescue measures in the Mediterranean. Last December, partly due to Italian political blockages, we were forced to stop our sea rescue operations with the Aquarius vessel. The movements of the rescue ship we are working on are transparent. Its position can be monitored in real time, for example on the online portal "Marine Traffic": Ocean Viking, operated in partnership with SOS Méditerranée.

    We decided to return to sea in July 2019 because search and rescue at sea is a duty, fuelled by the humanitarian need to prevent people from drowning as they try to escape the situation in Libya.

    Why has MSF launched search and rescue operations in the Mediterranean?

    As a humanitarian organisation, MSF cannot ignore the many deaths in the Mediterranean. Rescue at sea is in principle a government task, but since the EU and Italy suspended the large-scale search and rescue mission Mare Nostrum in 2014, government capacity has been insufficient. In 2019, the EU completely ended the rescue activities of Operation EUNAVFOR Med-Sophia. Rescue at sea by civil society organisations is currently the only way to prevent even more deaths.
    People crossing the Mediterranean are fleeing some of the most terrible humanitarian crises of our time, as well as violence and exploitation in the conflict zone in Libya. They take great risks and many die at sea. This is tragic and totally unacceptable.

    According to official figures, more than 15,600 people have lost their lives crossing the Central Mediterranean since 2014.

    Anyone in distress at sea must be rescued, regardless of their origin. Even once rescued, every person - whether or not they can remain in Europe - must be treated with dignity and humanity. People must be taken to a safe place and must never be brought back to countries like Libya, where their lives and safety are not guaranteed.

    How does MSF assess the situation in the Mediterranean and Libya?

    For many refugees and migrants in Libya, fleeing across the Mediterranean is the only way to escape fighting in their countries. But the EU does not offer safe evacuation routes for people fleeing extreme violence in Libya. With the end of the European maritime rescue system and the obstruction and criminalisation of private maritime rescue operations, EU Member States have made it increasingly dangerous for people to flee from Libya. Due to the targeted campaign against civilian rescue vessels, almost no rescue vessels have been put into service in recent months. However, attempts to flee Libya via the Mediterranean Sea continue on a large scale.

    The mortality rate in the Mediterranean - the number of deaths recorded in relation to the number of known crossing attempts - is higher than ever due to the lack of rescue vessels.

    Since the fighting began in Tripoli in April 2019, UNHCR and other organizations (including MSF) have called for the humanitarian evacuation of refugees and migrants from camps in Libya. But for every person who has been brought to safety since the start of the new fighting, almost four times as many people have been forcibly returned to Libya by the Libyan coast guard.

    The International Organization for Migration (IOM), which is trying to record deaths in the Mediterranean with its "Missing Migrants" project, has stated that it is no longer possible to document deaths due to obstruction of private rescue at sea. At the same time, the mortality rate in the Mediterranean - the proportion of known deaths in relation to the number of known crossing attempts - is higher than ever due to the lack of rescue vessels. From January to May 2019, one in eight refugees drowned on the central Mediterranean route to Italy and Malta.

    Why is MSF returning to the Mediterranean Sea after the suspension of its previous mission in December 2018?

    We are going back to the Mediterranean Sea because people continue to drown there. That is why our efforts to save lives are necessary. Another central aspect of our work is to provide a testimony about the distress of people. That is why we publicly denounce the humanitarian consequences of the inhuman policy in the Mediterranean.
    Since the beginning of the year, 576 men, women and children have lost their lives trying to cross the central Mediterranean - and these are just the deaths recorded by the International Organization for Migration (IOM). Thousands of people are forced to return to dangerous and inhuman detention camps in Libya. This shows that the humanitarian crisis in the Mediterranean continues and that the lack of political solutions continues to cause casualties.

    What has changed since the Aquarius was forced to stop it's operations in December 2018?

    Sadly, the situation in the Mediterranean Sea and Libya has only deteriorated further since last December. EU migration policies aimed at deterring and containing vulnerable people in Libya at all costs have only worsened. These policies have resulted in the deaths of thousands of refugees, migrants and asylum seekers at sea and in Libya, while those that survive remain trapped in a cycle of abuse. 

    The most deadly migration route in the world remains the sea.

    European governments have continued to criminalise and block NGO SAR vessels, either through criminal investigations against NGOs, the staff and crew or through preventing proactive search and rescue operations to take place, leaving it in the hands of the Libyan Coastguard. During the first six months of 2019, EU governments supported the Libyan Coastguard to intercept and forcibly return over 3,685 refugees, asylum seekers and migrants to Libya. Over 1,300 people were forcibly returned in June alone. 

    With at least 426 people having already lost their lives in the Central Mediterranean already this year this remains the world’s deadliest migration route. With over 8,400 attempted crossings in the first six months of this year alone, the need for search and rescue is clear. As long as people continue to needlessly drown at sea attempting to flee Libya, and as long as the EU neglects its responsibilities, we will continue in our attempt to conduct search and rescue activities in the central Mediterranean Sea.

    Does MSF expect that after last year's experience, the 2019 sea rescue operations will also be obstructed?

    The decision to end the Aquarius ultimately came down to not being able to obtain a flag for the ship. We were forced to cease search and rescue operations with the Aquarius following a sustained two-year campaign by Italian and EU governments to stop humanitarian action at sea. Eventually, with no government coming forward to grant us a flag - coupled with a seizure order issued by the Italian judiciary - we were unable to resume our medical humanitarian action with the Aquarius. 

    Although we have a new ship which is registered with a Norwegian flag, we are under no illusions: it is going to be extremely difficult to conduct rescues given the continued efforts by Europe to block NGOs. However, we don’t see this as a good enough reason to not try. There is no reason to let people drown at sea or suffer in Libya.

    How many people have been saved by MSF so far? How many died in the Mediterranean Sea?

    The Mediterranean Sea crossing is currently the deadliest migration route in the world. More than 18,000 people have died in the Mediterranean since 2014, including 576 this year alone. Since 2015, more than 78,000 people have been saved by MSF teams.

    Why do people flee across the Mediterranean Sea?

    Since 2002, MSF has been supporting people who have fled to Europe via the Mediterranean Sea. MSF teams have long been aware of the impact of conflict, hunger and disease on people in Africa, Asia and the Middle East. The people we rescued repeatedly explain to us that they saw no other way out than to risk their lives to get to Europe.

    They flee violence, war, persecution and poverty in their countries of origin.

    Many of them have also been victims of various forms of violence and extreme exploitation on their way to Europe, particularly in Libya. Almost all of them have witnessed or been subjected to violent attacks such as beatings, sexual violence and murder. After fleeing and experiencing traumatic experiences in Libya, there is no way back for most of them. 

    The almost total lack of safe and legal ways to seek asylum or migrate to Europe forces thousands of people to risk their lives on board unreliable boats.

    Why do people still die in the Mediterranean Sea?

    The fact that so many people are still dying trying to cross the Mediterranean into Europe is the result of both a lack of European sea rescue mechanisms and powerful incentives, such as the existence of violent conflicts in the countries of origin of these people who drive them to flee at all costs. The violence and ill-treatment suffered by refugees during their stay in Libya also leads them to flee the country and risk a dangerous crossing. Once trapped in Libya, they have virtually no other choice. Moreover, the use of the sea as a migration route is also a direct consequence of the increasingly restrictive European asylum and migration policy.

    MSF believes that without safe alternatives, people will continue to take dangerous roads and risk their lives.

    The closure of Europe's borders and the almost total absence of safe and legal ways to seek asylum or migrate to Europe force thousands of people to risk their lives on board unsuitable boats. Increased border protection, increased military intervention and the lack of European sea rescue services mean that so many people continue to drown in the Mediterranean. However, the focus continues to be on combating the effects of the leak, not on the causes of the leak.

    MSF is convinced that without safe alternatives, people will continue to be willing to take dangerous roads and risk their lives. Rescuing people at sea is not a solution to the whole situation, but an emergency measure to save people from death.

    Fewer people are arriving in Europe so surely there is less need for you to be there?

    Over 8,000 people have attempted to cross the Central Mediterranean Sea in the first six months of the year.  And during this time there have been virtually no humanitarian vessels in the area. Four hundred and twenty-six men, women and children have already died this year alone in the Central Mediterranean. And these are just the ones we know about.

    As long as people continue to die making this crossing, there is a need for search and rescue vessels.

    Isn’t it true that the presence of NGO vessels encourages people to take this dangerous sea journey?

    It is important to emphasise - and this is something that has been clearly evidenced time and time again - that people will flee for their safety regardless of whether civilian SAR vessels are operational.

    This year vulnerable people have tried to flee Libya in increasing numbers, with over 8,400 people trying to cross the Sea on unsafe boats in the first six months of the year – over 70% of them in May and June. The lack of humanitarian vessels in the central Mediterranean Sea during this period should put to rest the unfounded allegation of NGOs being a ‘pull factor’. In fact only 10% of sea arrivals this year to Italy and Malta were from NGO rescues (correct as of July 23). The reality is, even with fewer and fewer humanitarian vessels at sea, people with few alternatives will continue to undertake this deadly sea crossing, regardless of the risks. The difference now is that people are more likely to die compared to last year, according to the International Organization for Migration (IOM).

    While UNHCR and other organisations (including MSF) have called for the humanitarian evacuation of refugees and migrants from Libya since the start of the conflict in Tripoli, the reality is: for every person evacuated or resettled since the conflict started, nearly four times as many have been forcibly returned to Libya by the Libyan Coastguard.

    Several scientific studies have concluded that the existence of rescue vessels in the Central Mediterranean is not an incentive to cross:

    The real issue is not about a pull factors, but about push factors. The violence, extortion, arbitrary detention, and general sense of hopelessness, fear, and despair that migrants, refugees, and asylum seekers are confronted with in Libya are forcing them to attempt the dangerous Mediterranean crossing. 

    Doesn't such search and rescue operations make the work of smugglers easier?

    For people in distress, the use of smugglers often remains the only option, despite all the costs and dangers. Smugglers exploit people's misery. It is only a symptom of the problem, but not its cause. As long as there are no legal escape routes, there will always be smuggling activities, regardless of whether or not there are search and rescue operations. On the contrary, these traffickers take advantage of the EU's restrictive immigration policy, which does not allow legal channels to Europe, to charge for their crossings.

    You have been accused of communicating with migrant boats via satellite phone and even being in direct contact with people smugglers. Is this true?

    Absolutely not. The first point of contact our search and rescue teams has with people in distress is always once we have a visual on the boat. We have never had contact with people in advance of this. We never have any contact with smugglers. 

    What do you do with the boats once a rescue is over? Do you destroy them/send them back towards Libya?

    The priority is always to complete the rescue safely. Once a rescue is over, and if the conditions enable to do so (for example, if there is no other boats in distress, if the Libya Coastguard are not threatening us to leave the area immediately), the SOS MEDITERRANEE search and rescue team mark all boats as a SAR rescue. This involves spray painting the date and the word “SAR” onto the boat, as the SAR case number, if such a number has been provided by the coordinating maritime authorities. They also drop the engine if safe to do so.

    If the vessel is a rubber boat, the SAR team will slash them. While we do not have the capability to safely destroy wooden boats at sea, we notify the coordinating rescue centre in order for them to safely destroy the boat in order it cannot be used again.

    Is MSF under investigation for its SAR activities? Have you done anything illegal?

    MSF is involved in two investigations for SAR activities. One with the premise of facilitating illegal immigration (Trapani Prosecutor), which after three years is still in a preliminary phase with no direct charges against MSF. The other is centred around allegations of illicit trafficking of on-board waste (Catania Prosecutor), an accusation that had the sole objective of halting the medical-humanitarian action of the Aquarius. Since the very beginning of our operations at sea MSF has always operated in full compliance to the law, with in-port operations, including waste management, of MSF’s search and rescue vessels always following standard procedures.

    How are rescues being coordinated?

    The establishment of the Libyan Joint Rescue Coordination Centre (JRCC) has been spearheaded by the Italian authorities and acknowledged by the International Maritime Organisation (IMO) at the end of June 2018, making it the responsible coordination centre.

    European governments have put all their efforts into propping up the Libyan JRCC, however, they have repeatedly demonstrated that they do not have the capacity to fully coordinate a rescue as they do not provide rescue vessels with a place of safety for disembarkation. Additionally, they often do not answer the phone when SAR NGOs try to inform them of boats in distress, nor inform SAR NGO vessels of boats in distress, even when they are in the vicinity and offering assistance. 

    Furthermore, since the Libyan JRCC took on the responsibility for the coordination of search and rescue in the international waters between Libya and Italy, political disputes over ports of disembarkation have become a regular occurrence, leaving ships who have rescued people at sea stranded for weeks at a time. Humanitarian organisations who manage to carry out search and rescue activities have been criminalised and obstructed from ports in Italy and Malta.

    Along with the recognition of the Libyan JRCC, transfer of coordination responsibilities to the EU-supported Libyan Coast Guard has been ramped up considerably. This was despite European states [insert your home society messaging here] being fully aware of the alarming level of violence and exploitation which refugees, migrants and asylum seekers are returned to by the LCG. 

    Why do you insist on bringing people to Europe? Why can’t you take them to Libya? Why is it so dangerous to send people back to Libya?

    International law clearly states that people rescued at sea must be taken to a place of safety – which has been interpreted by UNHCR, the EU Commission and IMO has being the closest safe port – and a rescue cannot be considered complete until this happens. For rescues that take place in international waters between Libya, Italy, and Malta, the closest places of safety are Italy or Malta. Libya is not considered a safe place for disembarkation for migrants, refugees and asylum seekers, as stated by UNHCR in its guidelines on returns to Libya and most recently reiterated by The United Nations Human Rights office (OHCHR) in May 2019 and the Secretary General of the UN after his visit to Tripoli in April 2019. From our work providing medical care in Libyan detention centres, MSF know this all too well, having witnessed how people are trapped in inhumane conditions and vulnerable to abuse, often caught in the crossfire of ongoing conflict.

    Many of the people we have rescued recount horrific stories of violence, torture, extortion, sexual violence and forced labour in Libya, as well as arbitrary detention in inhumane conditions. We know that migrants, refugees and asylum-seekers experience alarming levels of violence and exploitation in the country. Under NO circumstance should refugees, asylum seekers and migrants be returned to Libya.

    If people can’t be returned to Libya, why not Tunisia or another North Africa country?

    A rescue at sea is not complete until all those on board are disembarked in a place of safety. This means a location where rescue operations are considered to terminate and where the survivors’ safety of life is not threatened, where their basic human needs can be met and from which transportation arrangements can be made for the survivors’ next destination or final destination. This also takes into account the protection of their fundamental rights in compliance with the principle of non-refoulement.

    In order to assess whether a place is a safe place of disembarkation, MSF will take into account guidance by UNHCR and other UN entities and consider a number of criteria, including: 

    • Whether there is a functioning asylum system 
    • Mandatory detention of migrants, refugees and asylum seekers and risk of indefinite detention 
    • Judicial guarantees, including possibility to challenge the detention
    • Conditions of detention
    • Risk of torture and other ill-treatment, as well as risk to life
    • Risk of further transfer and indirect refoulement (chain refoulement)
    • Risk of other serious human rights violations (such as arbitrary detention, arbitrary deportation etc) 

    To our knowledge, at present Tunisia as well as any other North African country, do not offer these minimum safeguards. This was most recently exemplified by the few cases of people rescued at sea that were eventually disembarked in Tunisia. Should the Ocean Viking be instructed to disembark in Tunisia, we would request guarantees that these minimum safeguards are met. If Tunisia were to meet these criteria, in law and in practice, then it could be considered as a place of safety. 

    If people are fleeing poverty and violence in their home country – shouldn’t MSF be using your resources there to alleviate the situation instead of doing search and rescue?

    We want to do both. The people crossing the Mediterranean are the same population we are treating in our projects in Sub-Saharan Africa, the Middle East and Asia. We will not abandon them when they are fleeing and even more vulnerable. 

    MSF works in around 70 countries around the world providing lifesaving medical care and humanitarian aid. We are present in the crises that force people to flee, along the migration routes and in countries where they arrive. 

    Who are the people attempting the crossing?

    Over the course of nearly three years of operations on board the Aquarius, we rescued people from over 35 countries, of which many had international protection needs and extra vulnerabilities such as unaccompanied minors, single women, pregnant women, people with disabilities, severe medical cases and victims of torture, sexual violence, human trafficking and/or a shipwreck.
    In 2018, the majority of people rescued were men – 81% in 2018, with 19% female. Of all those rescued 23% were under the age of 18 years old.

    Almost of all rescued people have transited via Libya. They tell our teams about the abuse they have suffered at the hands of smugglers, armed groups and private individuals. The abuses reported include being subjected to violence (including sexual violence), torture and other forms of ill-treatment, financial exploitation and forced labour.

    Why do many people come from countries where there is no war?

    The reasons why people leave their country are very complex. However, no one risks their life, and sometimes that of their children, if they can imagine a futur in their country. Many people on the boats can't swim and don't have life jackets, so they risk their lives. 

    Wouldn't it be better for people to stay in their region?

    It is not MSF's responsibility to define the admission criteria for migrants or refugees. This is the task of governments and UNHCR. However, we would like to point out that nearly two thirds of those fleeing are internally displaced and that 85% of the world's refugees in 2017 lived in poor countries. Most refugees live in countries neighbouring their countries of origin, such as Turkey, Pakistan, Uganda, Lebanon or Sudan. According to UNHCR, one in six people living in Lebanon is a person who has fled their country of origin. Less than 1% of people fleeing worldwide have applied for asylum in the EU (from 2018 on).

    Does MSF have expertise in maritime search and rescue operations?

    We are aware that rescue operations for people in overcrowded boats can take a dangerous turn. That is why we attach great importance to the deployment of highly trained rescue and navigation teams. We operate the Ocean Viking in cooperation with the European NGO SOS Méditerranée.

    The Ocean Viking, a 69-metre long ship, can accommodate more than 200 people. There are nine of our employees on board. The 13 members of the SOS Méditerranée team are responsible for the rescues. In addition, there is a crew of nine people on board, who are employed by the ship's shipping company. The ship is specially equipped to provide medical assistance and has a clinic where people can be treated according to their state of health. 

    What type of medical assistance is provided on board?

    During search and rescue operations, MSF teams mainly deal with people suffering from limb fractures, dehydration, hypothermia or severe burns, the latter caused by contact with a mixture of gasoline and seawater in makeshift boats. Other common illnesses encountered on board are diarrhea, seasickness, scabies and other skin infections. Due to the high number of pregnant women, there is always a midwife on board.

    Our teams are seeing signs of torture and abuse among many of the people being rescued. Many of them have untreated injuries. However, chronic diseases such as tuberculosis require treatment. Because many of them have had traumatic experiences, our teams also provide initial psychological assistance on board and refer affected people to the institutions of the Ministry of Health of the receiving country or to other actors for further treatment.

    What does MSF mean by proactive search and rescue operations?

    The EU has the responsibility to take appropriate and proactive measures to save lives in the Mediterranean. But today, private aid organisations are the only ones proactively seeking out boats in distress. If the EU took on this task, NGOs would no longer have to intervene.

    MSF therefore calls on the EU to set up a search and rescue mechanism to actively search for ships in distress. In addition, rescued persons must be treated humanely, adequately housed and medically treated upon arrival.

    What does MSF mean by safe and legal routes?

    By safe passage we mean that people’s right to flee and seek protection abroad should be respected. We defend the right of everyone to be treated humanely no matter why they chose to leave their home country. 

    Evacuation and resettlement schemes, family reunification, issuing of humanitarian visas, lifting of visa restrictions, and providing work or study permits are a few examples of safe and legal routes.

    Why is MSF involved in an area of the European policy competence?

    MSF is a humanitarian aid organisation and acts according to the principles of medical ethics. We cannot therefore ignore the situation in the Mediterranean. We feel obliged to those in need who threaten to drown in the Mediterranean. Preventing their drowning is above all the role of politicians. We call on the EU to implement a humane asylum policy and to carry out rescue operations at sea, regardless of what opinions people may have on the subject. 

    But surely the European refugee crisis must be stopped? Europe cannot take in anymore people!

    Europe needs to put the so called “European refugee crisis” into perspective. It is not a migrant crisis but a political crisis. In fact, the number of arrivals in Europe are currently at the lowest levels in years. 

    Meanwhile, when European politicians talk about the high numbers refugees and migrants coming to Europe, the reality is they are just a fraction of the displaced people around the world. In 2018, 139,300 refugees and migrants arrived in Europe, the lowest number in five years. 

    There are currently 70.8 million people who have been forced from home worldwide . 41.3 million who are internally displaced and 25.9 million who are refugees and 3.5 million who are asylum seekers. 

    85% of these people are being hosted in developing countries, with nearly 60% of the forcibly displaced in South Sudan, Afghanistan and Syria. Ultimately countries such as Turkey, Uganda, Pakistan, Lebanon and Iran are the ones hosting the most refugees – not Europe. 

    If the numbers of arrivals have dropped, then doesn’t this show the success of the EU migration policies?

    If the measure of success is the deaths of thousands of refugee and migrants who drowned in the Mediterranean and the ongoing suffering of those trapped in Libya, then yes. If success means to sacrifice the lives of vulnerable men, women and children in distress at sea, with the sole objective of dissuading others in similar situation from seeking safe haven in Europe, then yes this could be considered a success.

    As a humanitarian medical organisation we measure success in terms of humanity. The current situation only shows that by implementing migration policies aimed at deterring and containing people in Libya at all costs, European Governments have knowingly caused thousands of deaths and suffering of tens of thousands of vulnerable men, women and children. We don’t consider this a success.