The vast majority of people attempting the Mediterranean crossing pass through Libya, where they are exposed to horrific levels of violence, including kidnapping, torture and extortion.

People in Libya are also often detained in detention centres, usually in horrendous conditions.

European attempts to stem migration by strengthening national borders and bolstering detention facilities outside its borders are pushing people into smugglers hands to get them past checkpoints, across borders, through fences, out of prisons and ultimately onto boats on the Mediterranean Sea.

For those people who do make it to Europe, the challenges - and dangers faced - start again once onshore. A lack of shelter, being forced to live in unhygienic conditions or in adverse weather, treacherous border crossings, hostile authorities - in these circumstances, people become sick, injured, or struggle with mental health issues.

Instead of confronting the vicious cycle that their own policies are creating, politicians have hidden behind unfounded accusations towards NGOs and individuals who attempt to help people in dire straits.

MSF and search and rescue

Since May 2015, we have provided search and rescue capacity, or provided medical care during search and rescue operations, in the central Mediterranean Sea.

We currently run search and rescue operations on the Oyvon. The Oyvon sails under the flag of Norway.

There is currently very little dedicated search and rescue in the Central Mediterranean, but people are still trying to flee Libya. Of those who attempt to cross the Mediterranean, many are intercepted at sea and returned to Libya, despite that Libya is not a place of safety. People continue to drown or go missing during the attempt; 1,745 died or went missing in 2025. ¹

We work in search and rescue because it is a duty, fuelled by the humanitarian need to prevent people from drowning while they seek safety from Libya.

Migrants, refugees, and asylum seekers in Libya face high levels of violence, extortion, and arbitrary detention with serious consequences to their physical and mental health. For these reasons, among others, returning people rescued at sea to Libya is a clear breach of international maritime, refugee, and humanitarian law.

Criminalisation of lifesaving search and rescue

During our Search and Rescue operations, MSF has been shot at by the European-funded Libyan coast guard and repeatedly accused of collusion with traffickers.

Since 2018, our search and rescue operations had encountered ever-larger obstacles, in an increasingly hostile environment, amid intense political pressure. In June 2018, Italian and Maltese authorities denied the Aquarius a safe port to disembark 629 people on board; from this point, Italian ports were effectively closed to NGO search and rescue vessels.

In both August and September the same year, the Aquarius was stripped of its flag and registration by the Gibraltar and Panama Maritime Authorities, respectively, after coming under political pressure.

Hostile attacks on Aquarius continued in November 2018, when the Italian judiciary requested the seizure of Aquarius due to spurious claims of waste mismanagement. Without a flag and registration, Aquarius was unable to continue its lifesaving mission and in December 2018, it was forced to terminate its search and rescue activities.

In 2019, the situation – both in Libya and politically in Europe – deteriorated. Tripoli plunged into conflict, where detention centres have been surrounded by fighting and hit by airstrikes. In the space of a year to July 2019, there were 21 rescue stand-offs, affecting over 2,600 vulnerable men, women and children.

In 2020, amidst the COVID-19 pandemic, authorities in Italy would find flimsy excuses to detain search and rescue vessels, leaving almost no search and rescue capacity. In September 2020, the Sea-Watch 4 was detained and impounded by Italian authorities for a period of six months, at a moment when six other search and rescue vessels were likewise detained.

Starting in 2021, the Geo Barents was repeatedly held in detention by Italian authorities. Punitive measures and detention increased following Italy’s January 2023 issue of the Piantedosi Decree. This decree requires ships to immediately head to port after each rescue, compelling them to ignore any other distress calls at sea. The Italian authorities also assigned increasingly distant ports of disembarkation, which further undermined the capacity of the Geo Barents to save lives at sea.

Over 2023 and 2024, the Geo Barents faced multiple sanctions by the Italian authorities, imposing a total of 160 days’ detention in port. In December 2024, Italy further intensified the harshness of the sanctions, by making it easier and faster to confiscate humanitarian search and rescue vessels. This forced us to end operations with the Geo Barents.

In November 2025, we returned to search and rescue with a smaller, faster boat, the Oyvon.

Our ships

Since 2015, we have operated, or been partners on, nine ships:

• Phoenix, in partnership with Migrant Offshore Aid Station (MOAS);
• Dignity I;
• Bourbon Argos;
• Prudence;
• Aquarius, in partnership with SOS MEDITERRANEE;
• Ocean Viking, in partnership with SOS MEDITERRANEE;
• Sea-Watch 4, in partnership with Sea-Watch;
• Geo Barents; and
• Oyvon.

Medical care

Our medical teams on board treat violence-related injuries resulting from time in detention, torture and other ill-treatment, including sexual violence.

Women, especially pregnant women, receive dedicated care thanks to the presence of a midwife. Our midwives have assisted the delivery of several babies onboard our boats.

We also provide care to people with skin diseases, dehydration, hypothermia, scabies and serious injuries such as chemical burns caused by fuel mixing with sea water during the crossing. Psychological first aid is provided by trained cultural mediators.

During these consultations our teams often hear horrific stories; many of the people we rescue are victims of torture and other forms of ill-treatment.

What is MSF doing on land?

Once on land, people arriving in Europe discover the dangerous border crossings, are often beaten by authorities, and are forced to live in atrocious conditions, usually outdoors - including during winter.

In one migrant camp in Italy, a quarter of respondents to a survey said there was poor hygiene conditions in the camp. In a nearby settlement, more than one in ten said there was a lack of drinking water.

In Belgium, France, Greece, Italy, Serbia, and the United Kingdom, our teams are providing a range of services to people recently arrived in Europe, including medical and psychological support.

We also provide shelter, water, sanitation and essential relief items at reception centres, informal settlements and transit camps.

Support centres

Our teams in France identify young people, who have usually undertaken the journey unaccompanied, and offer them support through day centres for minors located in Paris, Calais and Marseille. Teams there provide respite, medical care and administrative assistance through the drop-in day centre.

MSF also ran specialised centres to respond to the needs of survivors of torture in Athens, Greece, most of whom came across the seas seeking safety and protection in Europe.