As 2015 drew to a close, Doctors Without Borders, known by its French acronym MSF (Médecins sans Frontières), announced it would cease activities at migrant reception centers in Italy in the new year. The move — a protest against substandard conditions and absent government attention — is the latest signal that Europe’s creaking asylum system is not improving fast enough or measurably. And yet, the stream of migrants and refugees crossing the Mediterranean flows unabated.
Aurelia Barbieri, a psychologist for MSF in Italy, often felt despair watching her patients in Sicily’s migrant reception centers try to navigate the system. “People spend their days without any activity, without the chance to work, to socialize, to learn Italian,” she tells Quartz. Sometimes the emergency center is so crowded with people sleeping on the floor, there is not space to walk, and she and other team members cannot conduct interviews to identify victims of torture or people suffering from post-traumatic stress disorder (PTSD), for example.
“How can we, as psychologists, help them to find hope, strength, and faith in the future if the life they are living is not so different from that which they have escaped?” Barbieri says.
The international humanitarian organization had been providing medical and psychological support to the local health ministry since Feb. 2015, with a team of 12, including doctors, nurses, psychologists, and cultural mediators. Their presence was small to begin with, confined to an emergency reception center in Pozzallo that processed 15,000 of the 152,000 boat arrivals last year, and a nearby secondary reception center in Ragusa.
But though MSF has frequently complained of overcrowding, unsanitary conditions and lack of adequate legal and medical services, they found the local government an unwilling partner. “We don’t share the same vision,” Sara Creta, a communications officer for MSF Italy, tells Quartz. “In general, the authorities have not expressed any will to improve reception conditions, or especially to develop a structural response.”
In Nov. 2015 the group presented a presented a report (link in English, report in Italian) to Italy’s Parliamentary Commission, highlighting cockroach infestations, overcrowding, lack of separation between men, women, and children, dirty toilets and showers without privacy, leaks and mould in sleeping areas, and poor communication with the outside world. But even this did not lead to any significant changes.
“Our team, which has been witnessing the situation for the past nine months, was going to see the same thing in the future,” says Creta. “We thought that, in terms of our medical and psychological response, it would not be effective in these conditions. So we decided to stop that activity.” The Italian interior ministry has not responded to repeated requests for comment.
Besides the poor conditions of the buildings, where people are often detained for weeks, Creta says one of the biggest challenges for MSF was trying to identify and help vulnerable people when they first arrive—like minors, victims of torture or rape, and single women in danger of being trafficked—so that they could be moved to special, protected reception centers.
“The identification of vulnerability happens in a moment when people are quite confused, just after landing,” says Creta. Amid the chaos of fingerprinting, basic medical screening, and insistent police questioning of “How old are you? Where are you from?”, many people, tired or traumatized from the trip, have difficulty communicating their problems. If they aren’t identified as vulnerable immediately, the psychologists risk losing track of them—especially minors or women who are sometimes absorbed into local trafficking rings run by members of their own nationality.
MSF’s report also decries the lack of legal information available to new arrivals, especially in situations where asylum decisions are being made on the spot. Creta says they have documented many cases of illegal “refusal of entry” decrees, arbitrarily classifying a new arrival as an “economic migrant,” and denying him or her the right to apply for asylum under EU and international law. In some cases, minors are labeled adults and told to leave the country. Since the shelters are effectively used as short-term detention centers, immigration lawyers usually cannot gain access to those inside.
MSF’s assessment of the situation is particularly discouraging because the Pozzallo emergency reception center is something of a test case for the EU’s efforts to streamline the asylum process across the region. These so-called “hot spots,” beefed up with additional border guards from the EU’s border agency, Frontex, are meant to help with faster asylum processing and relocating refugees to other EU countries.
“It is deeply troubling that MSF felt it could not continue working in the center, especially considering that Pozzallo is now an EU ‘hotspot,’”Judith Sunderland, associate director for Human Rights Watch in Europe, tells Quartz. “This speaks to long-standing and broader concerns about Italy’s often ad hoc, chaotic, and substandard system for receiving and accommodating asylum seekers.”
She points out that the refugee crisis on Italy’s shores has been going on for many years, and 2015 didn’t see a significant increase of arrivals to Italy by sea. “The numbers are high, but not unmanageable, and there is no excuse for conditions and treatment that do not respect people’s rights,” she says.
Mattia Toaldo, a policy fellow at the European Council on Foreign Relations, says the attitude in the Sicilian reception centers is part of an Italian push-back policy that began under Berlusconi more than 10 years ago—a strategy more focused on border control than protecting human rights for people fleeing danger, and one seemingly condoned by the EU. ”No one will complain if Italy pushes back more ‘economic migrants,’ the complaints are only about identification and fingerprinting of asylum claimants,” he tells Quartz.
And Toaldo wasn’t optimistic that the centers would be upgraded anytime soon, unless Italy changed its policy drastically to address the problem head on. “As long as you’ll have all these conflicts in Europe’s neighbourhood you’ll have refugees,” he says. “I don’t see a best case scenario but only different degrees of a worst case scenario depending on whether the numbers increase from 2015 and whether European solidarity continues to be weak.”