Surviving far away from home

More than at any time in modern history, 70.8 million are now forced from home around the world. These are people who have fled extreme dangers, whether to escape relentless bombing, an invading army, gang violence, or other life-threatening circumstances.

Médecins Sans Frontières (MSF) provides medical care to refugees and displaced people all over the world. Increasingly, we see that people on the move are trying to survive not just the harrowing challenges of migration itself, but the harmful deterrence policies put in place by governments trying to keep out migrants and asylum seekers at all costs.

We are featuring stories of survival—a collection of video testimonies and first-hand accounts from people who have risked everything for a chance at safety. As an organisation working with refugees and people on the move, we know that nothing—not a wall, or even an ocean—will ever stop people who are simply trying to survive.

Click on the map below to see the global scale of the refugee crisis and MSF's response

Our teams work in conflict zones from where millions of people have been uprooted—including in Syria, Iraq, Afghanistan, South Sudan, and Democratic Republic of Congo. In Europe and across the Americas, we are providing care along some of the world’s most dangerous and deadly migration routes. And we're caring for large numbers of displaced people in the world’s leading host countries for refugees, including Pakistan, Bangladesh, Lebanon, Uganda, and Ethiopia.

Some of the richest countries in the world are abandoning their international legal obligations and longstanding commitments to protect refugees and asylum seekers. In the United States, across Europe, and around the world, refugees are increasingly not welcome. Many governments are criminalising migration, scapegoating refugees, and declaring that their countries are closed to asylum seekers. People seeking safety are being treated like criminals—and so are individuals and organisations providing lifesaving humanitarian aid.

In recent months, MSF’s lifesaving humanitarian assistance has been blocked in places like Nauru and the Mediterranean Sea as a direct result of government policies of deterrence.

Meanwhile, asylum seekers and refugees are pushed back and contained in low- and middle- income countries, where they often struggle to access the adequate care they need. Increasingly, the world’s wealthiest nations are providing financial support and other incentives to countries willing to host refugees. This is converting international aid, which should be allocated on the basis of needs, into a tool for migration control.

What often gets lost in the heated political debates around migration are the human beings whose lives have been uprooted by extreme circumstances.

All governments must uphold their shared international obligations to protect people threatened by violence and persecution. Every day, let’s stand with refugees.

In their own words

Refugees from all over the world describe how they have fled often dangerous situations at home, and their journeys in their search for a new life.

Adephine speaks in slow, hushed tones.

She tugs at her mother, Elisabeth, sliding behind her as soon as the gathering of people at this remote Médecins Sans Frontières health clinic in Tanzania swells.

A refugee camp can limit people’s movement, but it can do little to dash the hopes and aspirations of a 12-year-old girl from breaking through its dim and bleak confines.

Adephine often lets her imagination fly outside the Nduta refugee camp, in north-western Tanzania, where she has been living since January 2017, when her mother fled violence in Burundi. In a place far away from the camp, she dreams of becoming a doctor one day. As she says this, she grows in confidence, and her eyes stare you straight in the face.

In the camp, she receives lessons in English, French, basic mathematics and science, but says, with a touch of gloom, “we often get punished in the school, and I don’t like it”. It’s not only these daily chastening experiences that threaten to dampen the spirit of children like Adephine, but the grinding toil of living in a place where rationing is the norm can snuff out any lingering traces of ambition.

Adephine’s father, and her two siblings, only joined the family in the camp later, when registrations had stopped. "My husband is not registered, and so he cannot receive assistance," says Adephine’s mother, Elisabeth. “We share the food we receive among us.” A small patch of land around their modest two-room abode in the camp provides for a few green vegetables and beans. “But this is not enough,” says Elisabeth.

Over 230,000 Burundians, spread across three camps in Tanzania, will remain dependent on much-needed humanitarian assistance until longer-term solutions are found. But, for now, they desperately need support. This little-spoken crisis continues to be dismally funded, revealing major gaps in the humanitarian response. Limited food, poor living conditions and weak wastewater management are a recipe for disease outbreaks.

The Nduta refugee camp, where MSF is the main healthcare provider, recently witnessed a peak in diarrhoea cases, but MSF teams were able to swiftly respond and staunch the spread of the disease. Back in the health clinic, Adephine is playing with a strip of capsule. “When we are sick, we can have treatment”, says her mother, Elisabeth. But she wishes they had more variety in the food they received in the camp. Sitting together, Adephine, her younger sister, Rachel, and Elisabeth appear composed.

What the future holds for them remains shrouded in uncertainty. But with those dreams that take one far away, there is always that smallest of relief to take flight, even briefly, and escape the biting reality of the camp.

"You can all go home, but I cannot."

Nunahar and her husband Abdul Zoleel at the Kutupalong field hospital. Nunahar and Abdul Zoleel fled to Bangladesh after their eldest child, Irshadullah was shot dead in 2017. They currently live in a refugee camp for Rohingyas in Cox’s Bazar, Bangladesh.

"We are farmers, and today we are a family of six. Two years ago in Rakhine, the Army started arresting all the men. My son Irshadullah was twenty years old then. We were all hiding in our houses, and could not go anywhere, not even to collect food. One day the Army came to our house and started taking my 16-year-old daughter with them; my son came out of hiding to intervene. They shot him dead. We had to flee.

I am not as old as I look. Ever since I got diabetes, I started losing weight. My condition has gotten worse in the last three years. My husband and I are old, we cannot work. It would be nice to cook a big fish but that is not possible, we have no extra money. Today I am in pain. I feel dizzy and my heart is beating fast. I have an infected leg.

It is safe in the camps. We can fast here, and pray. At least the Myanmar Army would not come in the night and arrest us. But Myanmar is my homeland, that’s where all ancestors are buried. You can all go home, but I cannot, we have to stay in a small hut in a camp. I dream of my home when I sleep. One day we will return to Myanmar or maybe some other country where there is peace."

"I am happy here, I can at least sleep peacefully."

Shabbir Ahmed with his son Mohammed Haroon seek medical treatment at the Kutupalong field hospital. Shabbir’s family fled to Bangladesh after his eldest son Salim was killed in 2017, and currently live in the refugee camps for Rohingya in Cox’s Bazar, Bangladesh.

"I am a farmer. As a child, I remember running into the forests to hide from the officials and locals in Rakhine state. They would take our money and produce from the farms. They would also beat us up. I am fleeing Myanmar for the third time in my life. I must have been 10 or 11 years old when we first ran away from our homes in the 1970s. Then we stayed here in Kunyapalong for two more years before we returned; we were told it would be safe to return. 

It has always been hard to live in Rakhine. The harvests would be taken away. The government would arrest the males and often we had nothing to eat. We ran away to Bangladesh a second time in 1992. Here I met my future wife, Khatija. I was 23 years old when we got married. My first-born child, Salim was born in this country. He was only forty days old when we were forcefully returned to Myanmar. 

I have often been picked up from home or the market by the Myanmar Army. They would take us into the jungles and make us carry heavy loads for 7-8 days. If I dropped the load, I would get beaten up. Life went from bad to worse more than two years ago. The government said we were all armed extremists and closed the mosque and madrassa. They stopped us from farming and curbed all cultivation. We could not earn money, people were arrested, killed and our women gang raped.

On the morning of Eid Al Azha, they killed my eldest child, Salim. He was around fifteen years old. We left our house and ran here for safety. We walked for 14 days before reaching the camp. I am happy here, I can at least sleep peacefully. My children can study. We are not allowed to go outside the camp and find work, money or new clothes. I want to return to Myanmar with full citizenship and the right to move freely."

"I was held in a detention centre in Libya. Men and women altogether in the same large room. Sometimes they would come and take one of the young girls. We prayed to God that they would be brought back. There are people here that take care of me. They come with me to the hospital for my check-ups. It is my first pregnancy. I am expecting a girl. I hope that she will be able to live in a quieter place than this. One that is more peaceful. My baby will be called Testimony.

At the end of 2016, Médecins Sans Frontières (MSF) introduced a programme aimed at facilitating the access to health for the residents of one of Italy’s largest informal settlements, the former wholesale fruit market (MOI) in Turin. Here at least one thousand of men, women and children mostly coming from sub-Saharan Africa and the Horn of Africa were living in inadequate conditions, overcrowding, no heating, and frequent disruptions in water and electricity supplies, and were faced with different economic and language barriers to access the national health care system. 

MSF operators and volunteers went into the buildings to inform the residents of MOI, about the rules and procedures related to accessing healthcare through the Italian National Health Service (SSN). When MSF started its intervention, seven out of ten did not have a healthcare card, and eight out of ten did not have a general practitioner at the time of their initial contact with the MSF.

As a result of MSF’s activity, 469 people have been assisted since the start of the project up until 31 December 2018. In 2017, an agreement was signed with the Local Healthcare Service (“Azienda Sanitaria Locale - ASL”) for the “City of Turin” to consolidate the interventions started by MSF. Two residents from the former MOI that were already involved in MSF activities, were identified as cultural mediators to facilitate the procedures regarding registration with the SSN. As a result, the time required to finalise registration, with the concurrent allocation of a general practitioner, has come down from two months to one week.

In 2018, the agreement between MSF and the healthcare local centre was extended to include the Municipality of Turin, with the intention of facilitating the registration required to access the SSN and with the additional objective of integrating regional social-healthcare services directed at the more vulnerable sections of the population.

Open My Eyes

Documentary: A refugee's journey beyond physical boundaries

Qusay Hussein landed in Austin, Texas, with absolutely no idea where he was going.

Blinded by a suicide bombing in Iraq in 2006, he was eager to try somehow to make a new life in the United States.

“I needed to go to a country that believes in me,” he says. “When people think ‘refugee,’ I’m one of them. [But] people don’t identify me, I identify myself.”

In this intimate documentary produced by MSF, Qusay shares his extraordinary journey – from struggling with the painful aftermath of the attack in Iraq, to rebuilding his life at an MSF hospital in Jordan, to reinventing himself again in the US.

After three years of reconstructive surgery and intensive rehabilitation, Qusay is now preparing for the next challenge. “Open My Eyes” is the story of one refugee – one young man among the millions of people who have surmounted unimaginable obstacles on their way to find safety.

The film reminds us of our shared humanity, and the far-reaching ripple effects of compassion and care.

"I had to find my own way to survive."

Every year, an estimated 500,000 people flee extreme violence and poverty in El Salvador, Guatemala, and Honduras and head north through Mexico – where they also risk extreme violence - to find safety. The story of Daniela, a transsexual woman from Guatemala, who had to flee her country to save her life, summarises the experiences of many of them. In this case, Daniela has been offered a second chance as a refugee.

"We faced injustice, we faced bad treatment, we faced hunger, lack of water.”

Haider fled war in Iraq, but is now stranded in Greece, waiting for Europe to find a solution.

"I don’t have the possibility to do so many things I wanted to do."

Luc fled to South Africa after violence and insecurity affected his family in Democratic Republic of Congo.

“I miss home. I miss my childhood haven. I miss the loved ones, the friends and the cousins.”

Mohammad left behind war in Syria to ensure safety, well-being and medical treatment for his family, now in Lebanon.