It has been five years since the EU-Turkey Deal came into force. Not only did it signify a tipping point in fortifying Europe’s external border, but it has also resulted in the normalization of structural violence in EU migration policies. 

The Deal’s premise was that men, women, and children seeking safety in Europe could be screened in five hotspots on the Greek Islands and quickly deported to Turkey. EU leaders claimed only a few were to be deemed ‘real’ asylum seekers who can apply for protection in Greece. However, in reality, most of those that arrive in Greece are vulnerable. The majority come from countries such as Afghanistan, Syria, Somalia, DRC, and Palestine, and one out of four people are children.

Meanwhile, to prevent the flow of migrants to Greece, the EU pledged 6 billion euros to Turkey to control the border and contain more than 3.6 million Syrian refugees. This cynical Deal’s primary objective was to prevent migrants and asylum seekers from reaching Europe’s shores and has transformed the ‘hotspots’ on the Greek Islands from reception centers into open-air detention camps.

At the time, MSF decided to no longer take EU funding to oppose this damaging deterrence policy, intensifying attempts to push people away from European shores and trading of humanitarian aid for border control. We also suspended our operations inside the Moria hotspot on Lesvos as we did not want to be complicit in the mass deportation and potential refoulment of asylum seekers and refugees. We stayed on the Greek Island to provide medical and mental health assistance on Lesvos, Samos, and Chios and advocate against the harmful human and humanitarian consequences. We called for the EU to re-examine their approach in light of the escalation of suffering these policies would create and the damaging effect on the meaning of asylum in Europe.

Sadly, as every new winter passed or a new emergency, death, or fire occurred on the islands, EU leaders’ unwavering commitment to the Deal was prioritized over humanity. No mass expulsions have happened, as human rights still apply. Instead, people remained trapped indefinitely in overcrowded and inhumane conditions as they waited for international protection. Currently, there nearly 15,000 people seeking asylum trapped on the Greek island.  

Over the past five years, MSF has regularly highlighted the structural violence and human cost of this Deal on people in the EU-supported hotspots (also known as reception and identification centers). MSF doctors treat people who have become sick from living in tents in hazardous conditions, and we continue to document the health consequence of containment. In 2017, we highlighted the mental health emergency on Lesvos and Samos. In 2018, we raised the alarm concerning the rise of severe mental health symptoms amongst children, including suicide and self-harming in young children. We have spoken out against how health care has become co-opted by the border procedure or repeatedly neglected by the authorities while NGOs and volunteers have stepped in to ensure access to essential services from primary healthcare to managing chronic conditions and vaccinations. We also worked with solidarity movements on the island to support alternatives to this harmful system and partner with legal aid organizations to prevent deportation, detention and facilitate access to asylum for our patients.

Let’s be clear, none of this is an unintended consequence nor an issue of lack of capacity or resources: the hotspot conditions are supposed to be a deterrent to those still thinking of attempting the journey.

Hostility and increased xenophobia from authorities and fractions within local communities have escalated in recent years. The Greek Government has escalated violent tactics at both sea and land borders and introduced more administrative measures to shirk humanitarian space. NGOs such as Lesvos Solidarity was forced to close alternative shelters such as PIPKA due to administrative fines and the criminalization of their activities. In February last year, tensions on the island boiled overfter authorities announced new restrictive centers (known as multi-purpose RICs) on the Greek islands, which led to riots, roadblocks, arson, and xenophobic attacks on asylum seekers and those providing them assistance.

The COVID-19 pandemic should have been the final straw to abandon cramped hotspots. Instead, the pandemic amplified and deepened the existing exclusion of migrants. Asylum seekers were subjected to a chaotic COVID-19 outbreak response and harsh lockdowns in poor living conditions, little to no access to water, hygiene, or essential services. Measures taken have dangerously conflated public health and migration control agendas.

In September 2020, the notorious Moria hotspot came burning down in a destructive and symbolic moment. EU leaders promised ‘no more Morias’ while ignoring similar camps on Samos, Kos, Chios, and Leros. From the ashes of Moria has emerged a new camp that replicates many of the worse elements of the Moria hotspot, which continues to be the blueprint for the new multi-purpose RICs, a more restrictive version of the hotspot.

Despite all the harm inflicted, EU leaders remain committed to this Deal. Last week, the European Commission announced its plans to re-negotiate the Deal’s renewal with Turkish authorities. So-called new proposal in the EU Migration PACT further the insidious normalization of the Deal, focusing on containing and screening migrants at EU external borders and returns. These proposals will make it harder to reach migrants, further make their suffering invisible, and isolate the most vulnerable.

So, what does this mean for MSF and other actors trying to assist migrants? We must be bolder in our fight for humanitarian space and challenge these policies by providing alternative forms of care, protection, and assistance. We must continue to chip away at these systems by advocating for people to be relocated, disrupt the status quo through public and legal challenges, and our action should be in solidarity with people seeking asylum, especially those hardest to reach.

Whether within the EU or outside, systems of containment never work in the long term; however, they erode migrant and refugee rights along the way. The EU-Turkey Deal has always been a dangerous experiment, which has allowed the EU to test how close to the edge they can go. It has demonstrated that the inevitable human cost is a price EU member states are willing to accept if it means creating the illusion that migration can be stopped. They continue to sign off on chaos and despair.

Reem Mussa – Humanitarian Advisor on Forced Migration

This article expresses the opinion of the author and does not necessarily reflect the position of MSF.

Photo © Anna Pantelia/ MSF, 2018