Episodes of violence suffered by migrants transiting through Libya: a cross-sectional study in "Médecins du Monde's" reception and healthcare centre in Seine-Saint-Denis, France

Introduction

The Central Mediterranean Route, passing through Libya, is one of the most dangerous for migrants. Episodes of violence have been documented but have not been accurately quantified. The objective of the study was to estimate the prevalence of episodes of violence suffered in Libya by migrants consulting the Médecins du Monde reception and healthcare centre in Seine-Saint-Denis (Ile-de-France).

Methodology

A monocentric cross-sectional study was conducted from February to May 2019 including migrants over the age of 18 years who had passed through Libya and arrived in Europe from 2017. The presence of emotional distress was considered as exclusion criterion. The proportion, frequency and factors associated to physical, deprivation and sexual violence in Libya were estimated through a bespoke questionnaire, as well as healthcare access in Libya and psychosocial support needs.

Results

Ninety eight people were recruited and 72 were interviewed (17 refused to participate and 9 were excluded). 76.4% were men, with a mean age of 31.9 years, 76.4% had low educational level, 66.7% came from Ivory Coast and 59.7% had left their country for security reasons. The median length of stay in Libya was 180 days. The overall proportion of participants having suffered from violence was 96.4% among men and 88.2% among women. The prevalence of physical, deprivation and sexual violence for men and women were 94.2, 81.7 and 18% and 80.0, 86.7 and 53.3%, respectively. Access to healthcare in Libya was 2.8 and 63.9% of participants were oriented to psychosocial support after the interview.

Conclusions

The vast majority of migrants reported having been victims of violence during their transit through Libya. Women were at particular risk of sexual violence. Access to health care in Libya was almost non-existent. Psychosocial support for this population is urgent.

Episodes of violence suffered by migrants transiting Libya, Italy and France

Background

The Central Mediterranean is one of the most dangerous migration routes from Africa. Violence perpetrated to migrants in Libya and host countries has been documented but not rigorously quantified. The objective of the study was to estimate the prevalence of violence suffered in Libya, Italy and France by migrants consulting Médecins du Monde programs.

Methods

Monocentric cross-sectional study. Inclusion criteria: migrants over 18 years old, transiting through Libya, arrived in Europe from 2017 and consulting in Saint Denis Health Center. Exclusion criteria: psycotraumatic manifestations. A sample size of 72 individuals was calculated. An ad-hoc questionnaire was created through Kobo Collect. Proportion and frequency of physical, privation and sexual violence, as well as health care and shelter access were measured in each country.

Results

95 individuals were recruited and 72 were interviewed (16 refused 7 were excluded) from February to April 2019. 76.3% were men, mean age was 31.6 years, 76.4% had low educational level, 66.7% were from Ivory Coast and 58.3% left their country for security reasons. In Libya, length of stay was 180 days, global proportion of individuals suffering from violence (GPISV) was 98.1% for men and 88.2% for women. Prevalence of physical, privation and sexual violence was 94.1%, 84.3% and 17.6% for men, and 85.7%, 93.3% and 60.0% for women. Health care access in Libya was inexistent. In Italy, GPISV was 31.8% for men and 28.5% for women. Health care access was 41.4%. In France, GPISV was 20.0% for men and 12.5% for women and shelter access was 44.3%. 60.3% of the participants reported need of psychological support.

Conclusions

The vast majority of migrants testify suffering from direct violence during migration, specially dramatic in Libya. Women have a particular risk of sexual violence. In Europe, the main problems are the lack of health care access in Italy and precarious living conditions in France. Mental health support is urgent.

Key messages

The vast majority of migrants testify suffering from direct violence during migration, specially dramatic in Libya. In Europe, the main problems are related to lack of health care access in Italy and the precarious living conditions in France. Mental health support is urgent.