More than 2,000 migrants have died in 2017 attempting to cross the Mediterranean Sea into Europe, making this migration route one of the deadliest in the world. In 2016, 5,143 migrants died or went missing in the Mediterranean sea. Migrants recount stories of sexual abuse, exploitation and extortion throughout their journey to Europe. Yet, despite the challenges, a total of 145,355 migrants and refugees arrived in Europe by sea between 1 January and 15 October 2017, the International Organization for Migration reported. The main migration route into Europe is currently between Libya and Italy. In an effort to curb down migration, EU leaders contributed $215 million in 2017 to Libya’s Government of National Accord, the product of UN-brokered peace talks that were concluded in 2015. Around 18,477 migrants have been rescued or intercepted in Libyan waters so far this year. They are then detained in formal and informal detention centers operated by Libya’s Department for Combatting Illegal Migration (DCIM). It is estimated that DCIM runs 28 detention facilities. It is also reported that thousands of migrants and refugees are currently held captive by smugglers in Libya.

Migrants held in detention facilities have no access to a judicial process or accountability for the abuse they face. In May 2017, the UN described conditions inside the refugee detention centers as “inhumane.” In a January 2017 joint communication, the European Commission and the High Representative of the EU for Foreign Affairs and Security Policy stated migrants are held in “unacceptable” conditions that “fall short of international standards.” According to Doctors Without Borders (MSF), hundreds of migrants receive treatment every month for diseases contracted as a result of dire conditions inside detention centers, including respiratory tract infections, acute watery diarrhea, skin diseases and urinary tract infections. Cases of weight loss and malnutrition were also reported. In addition to being held in unsanitary conditions, detention officers often subject migrants to physical abuse.

A report by the Office of the United Nations High Commissioner for Human Rights and the UN Support Mission in Libya documents widespread torture and maltreatment inside government-controlled detention facilities. Medics have reported attending to trauma-related injuries and patients with gunshot wounds or broken bones. Ali, a 17-year-old Gambian boy, said that guards inside the facility where he was detained “finish off” sick detainees. Ali was beaten by facility guards and forced to bury another detainee who died due to poor health.

UN agencies and humanitarian organizations do not have unhindered access to migration detention centers. Additionally, the lack of formal registration for the detainees makes it difficult for international aid organizations and UN agencies to keep records of migrants’ whereabouts. The transfer of detainees between detention centers, some of which are undisclosed, further obstructs the delivery of life-saving care.

Under the Mandela Rules relating to treatment in detention, states must strive to provide health care to detainees of equal quality to that provided to the rest of the population. Also, as a party to the International Covenant on Economic, Social and Cultural Rights, Libya has an obligation to guarantee the right of everyone, especially migrants and refugees, to the “enjoyment of the highest attainable standard of physical and mental health.” This includes medical services, sanitation, adequate food and decent housing. Defenders for Medical Impartiality calls on EU member states to pressure Libyan authorities into finding alternatives to detention. In the meantime, Libya’s government should grant representatives of aid organizations and UN agencies unhindered access to its formal and informal migrant detention facilities.