In the political tug-of-war over Europe’s migration policy, all eyes are on the Mediterranean region, with rescue boats being denied safe port and living conditions in overcrowded refugee camps remaining inhumane. But the crisis of safe passage has long reached the very heart of Europe: In Brussels, several hundred migrants transiting Belgium are blocked on their journey and have no permanent place to stay.
Since October 2017, MSF has been supporting the humanitarian Hub in Brussels, offering specialized mental health care for migrants in transit. The hub also provides general medical assistance, legal support, second-hand clothing, a long distance call service and electricity to charge phones.
In June 2018, a small team of research and advocacy specialists with MSF’s Operational Centre in Brussels started conducting in-depth interviews with migrants at the Hub. Umberto Pellecchia, an Anthropologist with MSF’s Operational Research Unit LuxOR, explains how MSF is looking to better understand migrants’ personal stories, and why conducting impartial research on a politically charged subject is challenging.
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Up to 200 migrants visit the humanitarian hub in Brussels every day, where MSF psychologists and cultural mediators provide mental health care. © Bruno De Cock/MSF
Who are the migrants coming to the Hub at Brussels’ Gare du Nord and what are their needs?
About 200 migrants visit the hub every day, and most have a long and hazardous journey behind them. They left or fled their homes in Central or Northern Africa, the Middle East or Central Asia, and reached Europe crossing the Mediterranean Sea or travelling by land. Only a few have applied for asylum after reaching Europe, and a majority do not have any documents and are looking to leave Belgium to travel towards England or Northern Europe.
In Brussels, they are forced to sleep in parks or tunnels, and are often chased away from the areas around the Hub by police and security forces. For them, the mediatized political debate on migrants’ movements within Europe is a very real and harsh life on the streets, with no protection, and little hope to reach their destination.
The hub offers them a basic set of urgently needed goods and services: Warm clothes during winter, legal support for their travel permits or asylum documents, as well as medical care, psychosocial support and social assistance.
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MSF psychologist Xavier Guillemin in consultation with a patient from Afghanistan. © Bruno De Cock/MSF
Why is MSF focusing on providing mental health care?
The Hub is run in partnership with several NGOs, each bringing their expertise and resources to the project. MSF is experienced in providing psychological and mental health support for migrants and refugees, and has successfully run similar centers in Paris or Belgrade, as well as mental health projects in destination countries like Sweden and Belgium.
The focus on psycho-social support is important because physical and mental health need to be addressed together. A constant state of alert, or fear of deportation, for example, can intensify anxiety and pre-existing traumas as much as unsanitary living conditions or unattended physical injuries. Nearly 600 mental health consultations were held over the past months.
Many of our patients show similar symptoms of distress to the ones our teams report from the refugee camps in Greece or the Balkans or from migrants rescued from Libyan prisons and at sea. It is alarming how their stay in Brussels does not lessen, but exacerbates this suffering.
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Christoph Godderis of MSF’s Analysis Department during an interview at the HUB. The findings will be used in a report on migrants’ living conditions in Brussels. © Bruno De Cock/MSF
What is your focus and objective when interviewing migrants at the Hub?
We are looking to understand the background and profiles of migrants receiving psychosocial support at the Hub. Where do they come from, which routes did they take, and what were their migration plans?
Listening to peoples’ stories has a medical background and helps improve our services: there is a link between migrants’ experiences and the medical and mental health issues they face. Being detained in a prison or camp and remaining stuck along the route creates similar symptoms that reinforce each other.
Understanding the stories behind migration patterns also allows us to advocate for change with local authorities and society. Our research provides the scientific framework for a report on the unsafe environments and a possible lack of services for migrants.
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Xavier Guillemin (MSF psychologist) in consultation at the humanitarian hub. © MDM
You are working with mixed methods, using both quantitative analysis and qualitative interviews. Why this dual approach?
The quantitative data tells us the age, nationality or travelled route of our patients, and where they witness most episodes of violence. The qualitative interviews then reveal the personal stories behind these figures and events. This gives us a concrete understanding of the obstacles and suffering migrants face, and what they perceive as violence or harassment in the reception system.
But qualitative research is not just about unearthing personal tragedies in the name of better programmes or scientific publication. In the context of migration, the analysis really has to go beyond encoding the many forms of violence into some statistical figures or horror stories.
What qualitative research offers is a critical and differentiated perspective into the political, socio-economic, and personal dynamics that shape individual and collective behaviour. We hear how violence affects migrants’ everyday life, how they take decisions and build resilience, and what their vision of the future is. Each story sheds a different light at the many shades of structural violence in an unequal reception system that tends to treat migrants as unwanted intruders or criminals.
What are the challenges of conducting research in this dynamic and politically charged setting?
A lot of migrants visit the Hub for a limited time only, and many get constantly questioned by medical professionals, legal advisors and security forces. We therefore have to be highly flexible, make sure our questions are not misperceived, and do not cause any additional trauma.
The bigger challenge, however, is indeed an ethical and political one: As researchers, we strictly uphold the principles of impartial critical analysis. It requires both discipline and constant self-reflexivity to ensure our own views political views are not distorting our findings.
Still, the stories we record and analyse highlight a man-made humanitarian crisis right on our doorstep, and they put our European migration politics into a dim light. As a humanitarian organisation, MSF can and should speak out. This is why our research will be complemented by an advocacy report we plan to share with Belgian authorities, the EU, and the public.
*Header picture: Xavier Guillemin (MSF psychologist) and an Arabic cultural mediator for MSF during a counselling chat with a migrant from Sudan. © Bruno De Cock/MSF
