Frequently asked questions

Why do hundreds of thousands of people continue to make these dangerous journeys?

People often tell us they had no other option but to undertake the deadly sea crossing to Europe. They tell us they are fleeing violence, war, persecution and poverty in their home countries. Regardless of their country of origin or their reasons for trying to reach European shores, almost everyone rescued from this stretch of water has passed through Libya, where many of them have been exposed to alarming levels of violence and exploitation.

Many of those we have rescued report having directly experienced violence in Libya, while almost all report witnessing extreme violence against refugees and migrants, including beatings, sexual violence and murder. After the traumatizing experience of leaving their home countries, crossing the Sahara and surviving in Libya, there is often no way back and the dangerous sea crossing is one of the only ways to escape.

Conflict has started in Libya in April 2019, significantly increasing the risks for people’s lives. The bombing on 2 July, 2019, of the Tajoura detention centre that killed nearly 60 of the refugees and migrants trapped inside, and injured other 70 clearly shows that Libya is not a safe place.


The Central Mediterranean remains the world’s deadliest sea border, with at least 101 people reported dead or missing in June alone. Not only are European governments turning a blind eye, abandoning people for hours, days and sometimes weeks at sea without assistance, they are actively conspiring to push vulnerable people back to Libya.


According to the United Nations, Libya is not safe. Even the European Commission agrees. Yet almost 6,000 people have been intercepted and forcibly returned into a cycle of torture, abuse and arbitrary detention since the beginning of the year, as part of a bilateral agreement with Libya, funded by European member states.


As European member states brazenly exploit COVID-19 as an excuse to further curtail search and rescue activities, as well as increasingly enlisting the Libyan Coast Guard to abdicate their own responsibilities, policies of non-assistance are condemning  people to drown. Once again, it is left to NGOs to save lives at sea, and to shine a light on this criminal dereliction of duty that has become a grotesque caricature of EU migration policy.

Why are people still dying on the Mediterranean?

During the first half of 2019, 426 people have died in the attempt to reach Europe through the Central Mediterranean. These are only the officially documented deaths. In reality, we have no idea how many dinghies overloaded with terrified passengers set sail from Libya in the direction of Italy each day and how many of them sink without trace before they reach busy shipping lanes in the Mediterranean or call for help.

Efforts by the European Union to dismantle search and rescue operations, criminalise humanitarian efforts to save lives at sea, and the adoption of migration policies aimed at deterring and containing vulnerable people in Libya at all costs, only resulted in more people drowning and more people suffering or dying in the conflict-ridden Libya. Unscrupulous smuggling networks have been quick to adapt their way of operating, and the crossing by sea has only become even deadlier.

We believe that until safer alternative are provided people will continue to take these dangerous routes and risk their lives. SAR is not a solution to this crisis but it is only an emergency measure that can mitigate the number of deaths. That is why we call EU to put in place a dedicated mechanism to rescue people at sea. Priority should be given to the urgency of providing lifesaving assistance and appropriate humanitarian assistance for those who risk their life in search of safety and a better life.

Many of these people are coming from countries that are not at war. Why are they making this crossing?

The reasons why people leave their home countries are complex but once at sea on a flimsy and overcrowded inflatable dinghy, all are vulnerable and need to be rescued and brought to safety. Many people cannot swim and most are not wearing life jackets. It is an imminent life and death situation and the risk of mass drowning is always present.

People do not undertake this journey lightly, people do not risk their own lives and at times the lives of their children if there are easier options available to them. Once out of harm’s way, people should have their medical and protection needs assessed on an individual basis and not depending on their nationality of origin. Whether they are able to stay in Europe or not, everyone deserves to be treated with dignity and humanity.

Are NGO search and boats stationed in the Mediterranean actually encouraging people to risk their lives at sea?

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.

During the first 6 months of 2019, vulnerable people have tried to flee Libya in increasing numbers, with over 8,400 boarding unsafe boats to attempt the crossing in the first six months of the year – over 70% of them in May and June alone. The lack of humanitarian vessels in the central Mediterranean during this period should put to rest the unfounded allegation of our being a ‘pull factor’. 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 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, as of July 3 nearly four times as many have been forcibly returned to Libya by the Libyan Coastguard.

Humanitarian organisations carrying out search and rescue at sea are saving tens of thousands of people from drowning every year.

Humanitarian action is not the cause of this crisis but is a response to it.

Why don’t you take people back to Libya?

International law clearly states that people rescued at sea must be taken to the closest place of safety 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 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.

Are NGOs at sea helping smugglers?

All rescues in the Mediterranean are completed by MSF in full accordance with the law of the sea and the SOLAS convention and under the coordination of the recognised maritime rescue coordination centre, which is currently the Libyan Joint Rescue Coordination Centre (JRCC). Every man, woman and child rescued by MSF is met at port by Italian and EU border guards. However, 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.

As a humanitarian organization, we clarify that the purpose of our activities and efforts at sea are only and exclusively aimed at saving lives.

The reason the smugglers’ business model exists is in part because the European Union does not offer any safe and legal alternatives for refugees and migrants who are looking for safety in Europe. Addressing this would be the most effective way to stamp out smuggling networks and stop unnecessary deaths at sea.

Does MSF collaborate with FRONTEX on anti-smuggling activities?

It is not MSF’s role to police international waters or to investigate smuggling networks. We are doctors, not police and we are present on the Mediterranean to save lives.

Do MSF boats rescue people from near to the Libyan coast?

All rescues occur in international waters in the central Mediterranean between Libya, Malta, and Italy where the majority of distress events occur. We normally patrol between 24-40 nautical miles from the Libyan coast.


As per our standard operating procedure, as soon as we bring rescued people on board, they will be immediately triaged by the MSF medical team. Anybody with a temperature over 37.5 degrees Celsius will be isolated and flagged for follow-up immediately post-rescue.

In the event we have a symptomatic case, we would immediately isolate the patient in line with established protocols. While continuing to monitor their health status, we would update relevant health authorities, liaising with them at disembarkation to ensure all protective measures are in place to support the health of the patient and prevent contamination. 


As there is currently no validated Rapid Diagnostic Test (RDT) recommended for use in clinical decision-making, we are unable to test on board. However, in the absence of reliable diagnostic tests, our medical team will rely on their clinical skills and judgement to monitor for and identify symptomatic cases.


In order to ensure optimal physical distancing in the context of the COVID-19 pandemic, we do plan to try and limit the number of people rescued to below that we would normally accommodate. Nevertheless, the primary objective of our mission is to save lives. In the event of a distress case, it is our maritime responsibility to proceed with all possible haste to those in need of assistance. Ultimately, the Master of the ship will take the decision as to whether or not a rescue can be completed without posing a risk to the ship, its crew, or the people who have already been rescued, as the barer of ultimate responsibility when it comes to the safety and wellbeing of those on board.