Thousands of migrants and asylum seekers are living in detention or in open centres in Malta, and conditions can be very hard. Unwelcoming measures are affecting migrants’ health. In 2008, Médecins Sans Frontières set up a programme to provide medical and psychological care in the detention centres to which all new arrivals were sent. There have been improvements in making healthcare available to migrants over the past two years, but access remains difficult for those without official permission to stay in the country, particularly those whose asylum applications have been rejected.

Medical care in detention centres

From August 2008 until October 2010, Médecins Sans Frontières ran medical activities in Safi, Lyster Barracks and Takandja detention centres. In Safi and Lyster Barracks, appalling living conditions and poor access to healthcare contributed to the deteriorating physical and mental health of detainees.
Many migrants have experienced multiple psychological traumas relating to violence, including sexual violence. These may have occurred in their country of origin, on their journey to Europe or upon arrival in Europe.  Poor living conditions, a precarious social situation and a lack of future prospects exacerbate the effects of mental trauma and many people have difficulty coping.

In 2009, Médecins Sans Frontières suspended its work in the detention centres as the poor conditions in the centres were compromising the effectiveness of its medical care. We resumed work in Takandja between June 2009 and October 2010, screening new arrivals and carrying out consultations. In total, from 2008 until 2010, our staff held more than 4,670 medical consultations and 724 psychological consultations in the detention centres, and almost 3,000 people participated in health or hygiene promotion workshops.

Working in open centres

Until June 2010, our medical teams worked at a clinic located at Hal Far, in southern Malta, holding more than 2,150 medical and 727 mental health consultations between August 2008 and June 2010 for migrants and asylum seekers who had been moved from detention to open centres. Health promotion teams held 165 workshops on hygiene and other topics both on site and at the open centres.

By the second half of 2010, fewer arrivals and an improvement in healthcare provision for asylum seekers and migrants meant that the emergency phase was over. We focused our energy on the creation of a sustainable network that would be able to provide mental health support on a long-term basis.

Cultural mediation

Cultural mediators facilitate communication between patients and health staff by removing many barriers of language and culture. Médecins Sans Frontières successfully advocated for and initiated the provision of cultural mediation services, assisting almost 7,700 consultations in this way. In 2010 the national health authorities employed five cultural mediators to assist in the provision of care at health centres, four positions were opened in Mater Dei hospital, the largest public hospital, and plans were made to create positions at Mount Carmel hospital.