MSF first worked in Libya in 2011 during the ‘Arab Spring’ and the subsequent civil war, to provide assistance to people affected by the conflict, at the height of the fighting. In 2016, MSF decided to focus its operations in Libya on the situation faced by migrants and began working in government-run detention centres where migrants are arbitrarily and indefinitely detained, providing detainees with basic healthcare and psychosocial support. Currently working in detention centres in Tripoli, MSF also works with migrant populations living outside detention mainly in Tripoli, Zuwara, Misrata and Beni Walid. In Zuwara, mobile clinics provide medical and social services to migrant communities. In Beni Walid, our teams offer general healthcare and facilitate medical referrals to migrants who are victims of torture and trafficking. MSF provides technical support to Libya’s National Tuberculosis Programme, run by the National Centre for Disease Control (NCDC), and has been operating a tuberculosis unit in Misrata – the only facility with these characteristics in the whole Western and Central regions.
MSF also carries out Search and Rescue (SAR) operations in the Mediterranean Sea, which is actually one of the few options for migrants and refugees willing to leave Libya.

Since the start of MSF’s migration projects in Libya in 2016, we have repeatedly faced the same challenges: the impossibility of protecting migrants inside Libya, of ensuring continuity of care for serious physical and mental conditions, and of rehabilitating victims of torture. Whether inside or outside detention centres, MSF medical teams encounter migrants who are victims of and at immediate risk of trafficking, torture, sexual violence, extortion and violence more generally. With no safe options inside Libya, this portion of the overall migrant and refugee population can only achieve safety and security by leaving Libya.

The “Out of Libya” report aims to provide an overview of existing legal pathways out of Libya and MSF’s experience at referring cases via those mechanisms. It attempts to address the main challenges encountered, mostly hailing from third countries’ unwillingness and UN agencies’ inability to fully abide with their protection mandate and obligations. As a result, MSF is proposing to develop alternative pathways for particularly vulnerable migrants. This model can rely on government, NGO or community support in third countries to provide protection to survivors of trafficking and torture who face continuing risks in Libya.

In this advocacy report, MSF makes recommendations to third countries of asylum, to International Organization for Migration (IOM), the African Union and its member states, to the UNHCR, the European Union and its member states and to the Libyan authorities.

In the coming weeks some MSF patients are likely to be evacuated through a humanitarian corridor in Italy, including a dozen survivors of torture who will be received by MSF in Italy, ensuring continuity of care.