Although Europe’s so-called ‘migration crisis’ is often presented as something new, the movement of people across the Mediterranean to Europe is not. MSF has been providing assistance to people crossing the Mediterranean to Europe since the autumn of 2002, when an MSF team started working in Lampedusa reception centre, providing new arrivals with medical care. Since then we have been assisting people in Greece and Italy and at multiple points along the route.

The work of MSF includes providing first assistance, medical and psychological support, shelter, water, sanitation and essential relief items at reception centres and transit camps, as well as providing food and clothing. But it also, inevitably, involves listening to the stories of those we meet, hearing about the reasons why they left their homes and families, what happened to them on their journey, why they felt that had no choice other than to move on and how they sustained the physical and psychological injuries we try to heal.

The year 2015 was a particularly difficult one. MSF was challenged to respond to an unparalleled flow of people seeking protection in Europe. We were at the receiving end of a policy-made crisis. We set up mobile clinics and shelters at the European borders, in Greece, Italy, Serbia and Croatia. In the absence of safe and legal routes available to those fleeing violence, human rights violations and wars, we launched search and rescue operations to save the lives of those forced to take to the sea.

The stories were heard resonate strongly with those reported in this book. Most did not choose to leave their countries of origin, rather they fled bombing, detention, torture and destitution. For many, the migration journey over land and sea was the main cause of illness and suffering regardless of the trajectory they had been forced to take. This book provides a deep understanding of the complexity of these trajectories, bearing witness to the violence and neglect that runs through the experiences of those on the move.

In so doing, this book exposes the misguided and politically motivated assumptions that dominated Europe’s response in 2015 and 2016. These assumptions continue to shape the direction of policy even today. Misconceptions, arbitrary categorisation and the politically convenient labelling of the people reaching Europe frame, often in a skewed way, the focus and direction of that response.