INFORMAL SETTLEMENTS social marginality, obstacles to access to healthcare and basic needs for migrants, asylum seekers and refugees

SECOND EDITION FUORI CAMPO 1

TABLE INTRODUCTION 1 INTRODUCTION OF CONTENTS RECEPTION SYSTEM AND BORDERS 3 SOCIAL MARGINALIZATION 6 OCCUPIED BUILDINGS 8 FORCED EVICTIONS 10 his report is the follow up of and refugees in informal settlements, healthcare and psychological support the research contained in Fuori regardless of their legal status, was set up in the disused buildings OBSTACLES TO ACCESS THE NATIONAL HEALTH SERVICE 12 Tcampo - Asylum seekers and have less and less opportunities to where men, women and children live refugees in Italy: unofficial settlements access medical treatment. Hospital in disgraceful conditions. THE BORDERS AT COMO AND VENTIMIGLIA 14 and social marginalisation1. It is emergency services are fast becoming THE DEADLY BORDER 17 the result of constant monitoring the only gateway to the Italian In Bari and Torino, MSF has worked activities carried out in 2016 and 2017 National Health System. in buildings occupied by migrants THE BRENNER ROUTE AND TRENTINO ALTO ADIGE 18 by way of repeated field visits and and refugees, seeking to overcome In the last two years, more than their marginalisation by facilitating FRIULI-VENEZIA GIULIA 20 in collaboration with an extensive network of local associations. twenty people have died attempting access to the National Health TURIN 22 to cross the borders with France, Service. MSF volunteers work The reception system for asylum Austria and Switzerland. Migrants alongside professionals in these ROME 24 seekers and refugees, expanding suffer repeated border rejection, activities, raising awareness on the PUGLIA 30 to reach just over 180,000 places often accompanied by violence. lack of access to healthcare that as of 31 December 2017, continues The number of people stranded at marginalised migrants and refugees CIVIL SOCIETY AND CRIMINALISATION OF SOLIDARITY 32 to be based, for the most part, on the borders and living in unofficial experience. CONCLUSIONS AND RECOMMENDATIONS 34 extraordinary reception structures settlements is increasing, with limited in which services aimed at social access to basic needs and healthcare. MSF saw Italian citizens living in LIST OF INFORMAL SETTLEMENTS 36 inclusion are limited. informal settlements – as well as in Throughout Italy, volunteers and self-organised occupations – in Rome, MSF IN INFORMAL SETTLEMENTS 38 There are pockets marginalization activists are helping migrants as marginalised as their migrant MÉDECINS SANS FRONTIÈRES IN ITALY 39 in urban and rural areas across excluded from the reception system, neighbours. This is not an isolated Italy. The raise in forced evictions, supporting them to access basic case in Italy. GLOSSARY 40 combined with a lack of alternative services and care. Opposition to their housing solutions, result in work has, in some cases, resulted in The report confirms the estimate the fragmentation of informal judicial proceedings against them. indicated in the first edition of Fuori settlements, especially in urban Campo: there are at least 10,000 contexts: migrants and refugees live In 2016 and 2017, Médecins Sans people excluded from the reception in increasingly hidden locations in a Frontières (MSF) strengthened its system, including holders and state of growing fear and frustration, commitment to supporting migrants applicants of international and with progressively limited contact in unofficial settlements. In Como humanitarian protection, with with local services, including and Ventimiglia, a psychological first- limited or no access to basic needs healthcare. aid programme was implemented and medical care2. The distribution of for people in transit, together with such settlements is fragmented and Due to administrative barriers, and a Women's healthcare programme widespread throughout the country. despite the laws in force, migrants in Ventimiglia. In Rome, primary

First edition February 2018 1. Médecins Sans Frontières, April 2016. © Medici Senza Frontiere 2. This number refers to the sites monitored in the survey and cannot be considered www.msf.it a census of the total number of asylum seekers and refugees living in all the Front cover: informal settlements throughout Italy. © Alessandro Penso, Borgo Mezzanone (FG) All the photos are by A. Penso except p. 5 e 6: Giuseppe De Mola; p. 17 and 39: Giuseppe La Rosa FUORI CAMPO 2 3 1. Memorandum between Italy and Libya, signed on 2 February 2017. Cf. http://www.governo. it/sites/governoNEW.it/files/Libia.pdf RECEPTION SYSTEM AND BORDERS 2. Articulated in First Aid and Assistance Centres, First Reception Centres (formerly, CARA) and second reception centres of the SPRAR network to ordinary places and in After the peaks of 2016, 2017 saw an a first appeal5). To speed the asylum Extraordinary Reception Centres (CAS) to overall decrease in the number of be used only in cases of lack of ordinary process up, the government has places and only for limited periods of time, cf. landings – predominantly because of adopted a series of measures, such Legislative Decree no. 142/2015. containment measures implemented as establishing migration specialised 3. With the Decree from the Ministry of the following the agreement between sections within each ordinary court, Interior of 10 August 2016, the procedure Italy and Libya1 – and a parallel and abolishing the second level of to access the SPRAR projects has been increase in asylum applications. simplified. With the ‘safeguard clause’ appeal. This has led to doubts about contained in the Ministerial Directive The full implementation of the whether such lowering of the standards of 11 October 2016, the Municipalities “hotspot approach” resulted in the of legal protection for asylum seekers belonging to SPRAR are exempt from the forced registration of almost all of is constitutional, and has provoked activation of further forms of reception (CAS), whilst with the Circular issued in the migrants arriving in Italy. This criticism from associations in the August 2017, the Ministry of the Interior has contained the secondary movements sector6. provided instructions for the conversion of towards countries further North. the available places in the CAS in SPRAR Other factors are putting pressure ones. About 15% of the Municipalities in By 31 December 2017, the reception on the reception system. First is the Italy have joined to the SPRAR network. system2 had 183,681 places, a slight increasing number of asylum seekers 4. To date, 20 Territorial Commissions and increase compared to 2016. Despite of in other countries being sent back 28 additional sections are operational the government attempts to promote to Italy under the Dublin Regulation. for a total of 48 commissions. the model of the Protection System for Second is the failure of the relocation 5. ANCI, Caritas Italiana, Cittalia, Fondazione Migrantes, SPRAR in collaboration with Refugees and Asylum Seekers (SPRAR), procedure decided by the EU Council in UNHCR, Report on International Protection managed by the Municipalities3 September 2015 to transfer a number in Italy 2017. The percentage of denials on the number of asylum seekers and of asylum seekers from Italy and the number of asylum seekers who were Greece to other member States7. given accommodation was 57% in the first refugees in the SPRAR network stood half of 2017, inclusive of the 5% who were at 31,270 on the same date, just 17% of Current legislation envisages that a unreachable. With regard to the appellants the total. at first instance, 49.5% of the proceedings person gains access to the reception are still underway, whilst the remaining The chronic shortage of places in the system as soon as they apply for percentages of appeals accepted and reception centres, is due not only to asylum8. However, in practice (for rejected are equivalent. Amongst the appeals migrants who independently present presented to the Court of Appeal that have the increasing numbers of asylum received a definitive outcome (40%), seven applications, but also to the low themselves at police stations), access cases out of 10 were given protection. levels of turnover in the centres due to the system is postponed until 6. Cf. ASGI, Law no. 46 of 13 April 2017 to the time required for assessing the the asylum seekers formalise their containing proceedings on international applications. Despite the increase application by completing the C3 Form. protection, as well as for tackling illegal This results in applicants waiting for immigration. Initial interpretative in Territorial Commissions in recent reflections, https://www.asgi.it/ years4, the time elapsing between first weeks – and sometimes months – wp-content/uploads/2017/07/Scheda- applying for asylum and being notified without any form of assistance. This pratica-legge-Minniti-DEF_2.pdf of the result averages 307 days. In has been seen, for example, in police 7. 11,464 migrants have been relocated from the case of denial of protection and stations near large reception centres Italy before 31 December 2017 and 698 the lodging of an appeal, the time such as in Gorizia, Bari, Crotone and migrants are in the relocation process at Caltanissetta. present (Source: Ministry of the Interior). spent in the centres can increase to a 8. Legislative Decree no. 142/2015, Article 1.2. further 10 months (the average time EU Directive 2013/33 establishes required to achieve an outcome after the possibility to revoke the asylum

200,000 180,000 160,000 140,000 120,000 200,000 100,000 150,000 80,000 100,000 60,000 50,000 40,000 0 20,000 2012 2013 2014 0 2015 2012 2013 2014 2015 2016 2017 2016 2017 First reception + LANDINGS 13,267 42,925 170,100 153,842 181,436 119,310 extraordinary places 26,500 35,562 76,683 153,602 152,411 ASYLUM 17,352 26,620 64,886 83,970 123,600 130,180 SPRAR 3,979 10,381 20,752 19,715 22,952 31,270 REQUESTS OUT OF SIGHT RECEPTION SYSTEM AND BORDERS 4 5 9. Cf. ASGI, The revocation of asylum seeker reception, June 2017. seeker the right to a place in a sanitation, and healthcare. Amongst 10. Cf., for example, the case of 18 African asylum seekers whose accommodation was reception centre, but only as a last them are migrants who have just 9 RECEPTION: FROM A RIGHT TO A PRIVILEGE revoked by the Prefect of Naples for protesting resort . In Italy, this provision, set out landed a few days previously, trying THE EUROPEAN COMMISSION’S NEW REFORM PROPOSALS against living conditions inside the centre in Legislative Decree no. 142/2015, to reach another Member State where (http://www.lasciatecientrare.it/j25/italia/ news-italia/220-comunicato-stampa-revoca- is adopted without any degree of they can apply for protection despite Between April and July 2016, the European Commission to the Member States. The risk is that a wide interpretation graduality and proportionality, accoglienza-il-20-luglio-l-udienza-per-i- the fact that they were registered in presented a package of reform proposals for the EU’s inter- could include only the bare essentials of food and accom- 12-richiedenti-asilo-del-cas-belvedere). In especially for those staying at the CAS. ‘hotspots’ under the Dublin Regulation; national protection system. It was aimed at reshaping every 2017, the TAR (Regional Administrative Court) Here, it is often used as a sanction for modation. of Liguria cancelled nine revocation orders, there are also asylum seekers whose aspect of the procedures and reception measures. people who break centre rules, from claiming that the persons concerned had reception has been withdrawn; Broad discretion is also given to Member States regarding minor disciplinary infractions to violent not been duly informed nor had been given migrants leaving the centres with The reforms propose that reception should only be acces- the establishment of a place for asylum seekers to live (such the opportunity to assert his or her reasons behaviour. These applicants are left to international protection denied, sible to people who strictly fall under the obligations impo- as in a reception centre, apartment, hotel or other recep- (https://www.a-dif.org/2017/02/17/il-tar- find alternative accommodation, often sed by the Member States. liguria-sulle-revoche-dellaccoglienza/). having appealed to the rejection or tion facility), which greatly restricts freedom of movement ending up in the unofficial settlements This is evident in the proposed reform of the Dublin Regu- 11. Agreement between the Government of the 10 not; people who hold international or within their territories. If an applicant moves away, even deprived of any form of assistance . lation, where an asylum seeker is not entitled to reception Italian Republic and the Government of the humanitarian protection but are unable temporarily, from their fixed location, they may find that re- French Republic on cooperation between the measure (with the sole exception of emergency medical Systematic checks are carried out to achieve a full social inclusion: ception is no longer guaranteed. The reform proposals lead cross-border police and customs, Chambéry, assistance) if found in a Member State other than the one 03/10/1997; Italian-Swiss bilateral agreement along the borders with Austria, France all waiting to cross a border that is to a further serious consequence for those who violate their appointed for the assessment of the application. In the pro- on the readmission of persons in irregular and Switzerland, on migrants in increasingly hard to penetrate. residence obligations: it proposes that people who do not status, 1998; Bilateral agreement between transit who are then collectively and posal for reform of the current Reception Directive, there Italy and Austria, Vienna, 7 November comply with the obligation to stay in their designated resi- summarily forced to return to Italy, Since the summer of 2016, people are numerous rules that result in the reduction or even the 1997: in the latter case, rejections also take dence, and are considered at risk of being untraceable, can place from Italy to Austria. Cf. ASGI, The on the basis of bilateral cooperation are being forced to leave the cities withdrawal of reception measures for asylum seekers, such readmission of foreign citizens to Ventimiglia: agreements. This contravenes the of Como and Ventimiglia and forcibly as when an asylum seeker fails to participate in mandatory be held in a detention centre. profiles of illegitimacy, June 2015; The Schengen agreements on freedom of relocated to the ‘hotspot’ of Taranto. integration measures. readmission of foreign citizens at the Chiasso * Cf. ASGI, The new political regulatory guidelines of the European border: profiles of illegitimacy, August movement that allow checks at internal The official reasons for this are to The reform proposal introduces a new concept in EU law: Union. The prospect of new and radical restrictions on the right to 2016; ASGI, Antenne Migranti, Fondazione borders only under exceptional and ease pressure on the borders; prevent Alexander Langer Stiftung, Along the Brenner in cases where reception is withdrawn, Member States are asylum, https://www.asgi.it/asilo-e-protezione-internazionale/ temporary circumstances, upon risks problems of public order and avoid route - Monitoring report on the situation only obliged to guarantee the asylum seeker "decent living asilo-migrazione-riforma-unione-europea-sintesi-asgi/. of migrants in Bolzano and Brenner, 2017. to public order or the security of a high concentrations of migrants giving Member State11. Such practices are standards." The draft text does not specify what is meant We thank Loredana Leo (Associazione Studi Giuridici 12. Declarations of the Undersecretary rise to public health and sanitary even imposed on the most vulnerable by "decent living standards," leaving very broad discretion sull’Immigrazione, ASGI) for the drafting of this section. for Defence, Domenico Rossi Cf. http:// emergencies12. Of the 14,576 people openmigration.org/wp-content/ groups, including unaccompanied who have been accommodated in the uploads/2016/11/stenografico-21- minors, single women with children, ottobre.pdf. The transfers were also the and pregnant women, which results hotspot of Taranto between March subject of a parliamentary debate in and October 2016, only 5,048 come January 2017, Question 4/15188, http:// in increased numbers of migrants aic.camera.it/aic/scheda.html?core=ai stranded in the border areas. When from landings. The rest are foreigners c&numero=4/15188&ramo=C&leg=17 they are not given accommodation found within Italy’s borders and taken 13. Senate of the Italian Republic, Report on into government facilities, they are to the centre to be identified13. After the identification and expulsion centres they arrive at Taranto, most migrants (January 2017) https://www.senato.it/ forced to live in unofficial settlements, application/xmanager/projects/leg17/ outdoors, and with limited access to return to the northern borders, feeding file/Cie%20rapporto%20aggiornato%20 basic provisions such as shelter, food, a nonsensical circular flow. (2%20gennaio%202017).pdf OUT OF SIGHT SOCIAL MARGINALIZATION 6 7 1. This estimate is calculated by comparing 6. Coming from Senegal (52%), Tunisia (15%), Gambia (10%), Sudan the slight increase in places in the 10 reception system in 2017 compared A tent camp was set up in S. law and agreements signed by Italy . (6%), Mali (5%), Nigeria (5%). SOCIAL MARGINALIZATION Ferdinando (RC) on 18 August 2017, to the previous year (just over 7,000) As for the Integration Plan, the Regions 7. Open from the end of October until and the number of asylum applications with up to 500 beds for seasonal 30 November. The ASP (NHS local and Municipalities are responsible presented in the same year (130,180). citrus fruit pickers. The facility was branch) of Trapani had refused to In 2017, at least 100,000 people left the exit from unofficial settlements for such interventions11. Particular 2. As foreseen by Legislative intended to house residents of a increase the opening hours of the Decree no. 18/2014. government reception centres for in urban centres, also by identifying recommendations include: i) the nearby emergency medical service. 1 nearby unofficial camp that had asylum seekers and refugees . Lacking suitable disused public buildings to be elimination of all obstacles to the 8. In collaboration with CLEDU 3. Decree of the Ministry of the been destroyed by a fire, and where Interior of 07/03/2017. a fully achieved social integration, allocated to social housing.” registration of the residence12; ii) (Clinica per i Diritti Umani - Clinic the sanitary conditions were very 4. Law no. 199/2016. they try to cross borders - less overcoming the barriers to accessing for Human Rights) in Palermo. In anticipation of SPRAR becoming the precarious5. In December, more than 5. Set up after the clashes of 2010 in Rosarno. permeable than in the past - or end the so-called ‘low threshold services’ 9. Ministry of Labour and Social Policies. only system of second reception, the 2,000 workers arrived in the area, Subject of a special agreement between The Municipality of S. Ferdinando rented up in pockets of marginality across (soup kitchens, bathrooms, overnight an industrial warehouse to increase the Plan states that CAS must homogenise forced to lodge again in the old, the Government, Regions, Autonomous Italy, in large cities (such as Rome), or emergency reception, essential Provinces and Local Autonomies at the availability of places for another 250 people. “their own services and activities unofficial settlement of plastic, zinc in the ghettos of the South (such as medical assistance); iii) the ‘housing Unified Conference of 5 November 2015. aimed at social integration with those and cardboard shacks. Puglia and Calabria regions), where first’ approach, which designates 10. Cf. United Nations Fundamental offered in the SPRAR system.” This is the population ebbs and flows in time In Campobello di Mazara (TR) the stable reception centres as the Declaration of Human Rights (Article with the peaks of seasonal agricultural a contradiction of the provisions the 3); 1951 Geneva Convention and seasonal olive harvest peaks between starting point to setting off on the path its relative Protocol (1967). work. This continuous flow of people Ministry of the Interior issued just a 13 October and November. In 2017 the of social integration ; iv) strengthening 11. With the reform of Chapter V of the includes a number of fixed points (such few months previously in its tender local institutions, coordinated by the outreach services; v) providing as Rome, the province of Caserta, the Constitution (Constitutional Law specifications for the supply of goods Prefecture, turned over a former oil linguistic and cultural mediators in no. 3/2001), social policies fell to the ghettos in Capitanata and Calabria) and services in the same centres, mill, Fontane d'Oro, for housing 250 essential public services, including jurisdiction of the Regions, the only and, on a rotating basis, seasonal work where the only activities envisaged seasonal workers. The structure has in the ‘low threshold’ and outreach entities now appointed to the legislation areas, to which the border areas have and planning of services, even in matters for social inclusion (in addition to insufficient toilets with no hot water services. been added within the last year (if you of extreme poverty. Only matters of Italian language courses) are a generic for showers. Meanwhile, in the same "determination of the essential levels cannot pass the border, you return into In the municipality of Castel Volturno14, orientation to local public services area (in Erbe Bianche), an unofficial of provisions pertaining to civil and the flux). 25,000 people are registered at the and “the organisation of leisure time settlement is present. In September social rights that must be guaranteed through recreational, sporting and civil registry, including 4,000 foreign throughout the national territory" In October 2017 the National it accommodates 300 people, and by remained under the domain of the State. 3 citizens. An estimated 10,000 people Integration Plan for holders of cultural activities.” October around 1,4006. Many have in the area are unregistered, the 12. Cf. Presidential Decree no. international protection was come from CAS, women and minors Regarding housing conditions overwhelming majority of whom are 223/1989; Circular of the Ministry issued for the 2017-2018 two-year among them. The Municipality installs of the Interior no. 8/1995. 2 in seasonal agricultural work from sub-Saharan Africa, in conditions period . The Plan contains general four water points. Twenty chemical 13. Another example of good practice is the areas, the Plan recommends the of widespread irregularity regarding guidelines and fails to allocate specific toilets are delivered, but regular Self-Help Housing – where accommodation full application of the so-called working and housing contracts. Their is found in the private market and resources, merely referring to the 4 maintenance is not carried out and Law Against “Caporalato” . The housing is often not legally registered renovated with the involvement of the possibility of drawing on European after a short while the toilets are not fit management of these critical areas and very run-down. Amongst them are beneficiaries of the programmes. This funds. The Plan recommends that the to be used. Workers install their own practice provides a number of benefits, follows certain directives that are people who have left the CAS across Regions and Municipalities include showers with a water heating system. including reduction of rental costs, common to all national territories such Italy, including increasing numbers of the possibility of increasing income in their emergency housing plans On 27 October, Fontane d'Oro opens for as the appointment of Extraordinary young women from Nigeria. for the people concerned, and the “means of supporting protection migrants with a regular work contract Commissioners with a focus on creation of training sites where people holders exiting from the reception but nobody leaves the Erbe Bianche A group of local civil society are reintroduced to the workforce. the fight against crime and labour centres, and verifying the possibility informal camp. organisations15 presented a ‘Plan for 14. From last August, the Government has exploitation and on housing, the of including such in public housing Castel Volturno’ to the governing appointed a special Commissioner to setting up of large-scale temporary From October, an MSF team supports and lease support programmes” as bodies, which recommends granting programme interventions aimed at a Red Cross OPD in Erbe Bianche, the integration of migrants and the well as “programmes to accompany camps (using tents or containers). humanitarian protection to 2,000 through donation of medicines7; environmental restoration of the area. people – which is now underway runs psychosocial support activities8 15.“Comitato per il Centro Sociale” Volunteer thanks to the establishment of a and health and hygiene promotion Association and Information Desk Special Section of the Territorial for Migrants and Refugees "Diritti di activities. At the beginning of Commission in Caserta – and a Cittadinanza per tutti/e", Managing Body November, it distributed 1,000 of the municipality of Caserta SPRAR programme to facilitate social inclusion blankets and 1,000 hygiene kits. project, in collaboration with Caritas and for 1,000 people over a period of 18 the “Movimento Migranti e Rifugiati”. Refugees and asylum seekers are months, delivering literacy, vocational 16. “Reddito di Inclusione” (Inclusion Income), included amongst the recipients of courses, job placement and housing set forth by Decree Law no. 147/2017. the ‘Guidelines for the fight against through registration, the legalisation of serious adult marginalisation in leases and the maintenance of houses. Italy’9. This document states the The Plan proposes to use measures need for guaranteed access to basic set out in recent national legislation services, including healthcare, to combat poverty, such as the REI referring to international humanitarian subsidy16. OUT OF SIGHT OCCUPIED BUILDINGS 8 9 1. Cf. occupations of Eritrean refugees in Rome and Bari, Somalis in Turin and Bari, Sudanese in Turin and Rome. OCCUPIED BUILDINGS 2. Cf. occupations in Turin, Rimini, Florence, Rome and Cosenza. Health Services. This is particularly Somalia. Today, 44 people live in 3. The residents’ association gave the My family and I lived in a rented Over the last two years, the numbers of Many occupations that began outside Municipality of Bari its own self-renovation relevant in those cities where the the centre – 39 men and five women applicants and holders of international the law, were later legalised, with project. house for 18 months. We paid municipality does not provide with (both Italians and non-Italians). and humanitarian protection living in the involvement of private entities 4. Just over 60 people live in the building on Via 500 euros a month. Then my factitious residence - the one provided Three people have come from the Savoia, with 75% coming from sub-Saharan boss told me that he could no occupied buildings has increased. The and institutions (primarily the to homeless people - or where it is centres of North Africa Emergency Africa. longer keep me on, that there majority of these people have never Municipalities and Regions). Compared particularly hard to get it. Programme (ENA), 24 from CAS. Some 5. Amongst other activities, there are after was not enough work. How could entered the institutional reception to the government reception system In Turin in 2014, a building in Via are holders of a form of international school computer literacy workshops, a film system or have been expelled from it in for asylum seekers and refugees, the Madonna de la Salette was occupied or humanitarian protection; others are club for children from three to 12 years of I manage to support my wife and age, theatre workshops and sports activities. the absence of proper social inclusion. occupations promote a model based by a group of refugees who left the appealing, either the first or second two small children? Being here Occupations are self-managed by on self-management and on giving is like a miracle, it was God who reception centres under the North degree, against denial of protection the migrants and refugees, mostly residents an opportunity to remain Africa Emergency Plan. In 2015, decisions. For others, reception in helped me. When we arrived, the those where residents come from in safety until they have achieved Pastorale Migranti, Caritas and the CAS was revoked before their rooms were completely empty. the same countries of origin1, others effective social, housing and work Congregazione dei Missionari di Nostra asylum application procedures Then, little by little, we filled them are managed by right to housing independence. Signora de La Salette – as owners were concluded. Four people have a with second-hand furniture or movements; this generally concerns With regards to healthcare, limitations of the property – established an recognised condition of disability, with gifts. We did not even [have to] so-called “mixed occupations”, where were imposed under Law no. 80/2014 association with the aim of legalising 7 suffering from psychiatric disorders buy toys for my children – the migrants and refugees from different (Article 5) and confirmed under Law no. the occupation and redeveloping or psychological distress. people from the neighbourhood areas - sub-Saharan Africa, Latin 48/2017: living in occupied buildings the property, using funds from the In Bari, since 2009, about 60 gave them to us. America, Europe - coexist together does not give people the opportunity Diocese of Turin and the Compagnia refugees (mostly from Eritrea) have with a significant component of to get a formal residence and thus di San Paolo, transforming it into a lived in a former high school owned Via Savoia, Cosenza Italians2. to get registered with the National model of self-managed social housing, by the Municipality. Around forty specifically aimed at vulnerable people. are employed in a precarious or The building was renovated involving intermittent way in restaurants, the same inhabitants. Currently, 80 domestic work or as caretakers, with men live in the building, half of whom others being seasonal agricultural have a residency permit (“permesso di workers or refugees awaiting the awaiting the renewal of their residency soggiorno”) for humanitarian reasons, renewal of their residency permits. permit. Today, the settlement is and 20% for subsidiary protection. Sometimes Italian citizens in difficulty legalised, as is the former Don Milani In December 2015, the Rumori Sinistri are also living there. The building needs primary school in the district of and No Border associations signed an urgent maintenance work. In May 2014, Portapiana, owned by the Municipality, agreement with the Municipality of a memorandum of understanding for which a self-restoration project Rimini to manage a reception facility in was signed between the residents, is planned. Living alongside Italian the context of the Winter contingency the Municipality of Bari, the Puglia citizens are North Africans and 10 plan. The building, renamed Casa Region and other entities that set out holders of international protection; Don Gallo, hosted Italians and foreign a number of commitments including: altogether a population of 30 people. migrants. The two charities raised the restoration of the property, with The most recent occupations concerns about the reception model the involvement of the refugees living supported by the Prendocasa represented by a dormitory open only there, in construction works; the committee are a building in Via Savoia at night and only during the winter. Municipality of Bari to ensure the safety (from November 2016) and the Hotel They decided to keep the centre open of the building and grant the property Centrale (from December 2017). In 24 hours a day and started activities to the residents according to the these occupied premises Italians aimed at the guests' autonomy, without principle of self-management; and the coexist with foreign migrants, amongst imposing them any temporal limitation Puglia Region to provide the resources whom – in ever greater numbers – are to their permanence in the centre. The needed to finance the project. applicants and holders of international agreement expired in April 2016, but Three years after it was signed, the and humanitarian protection. At the associations continued to manage agreement has yet to be fulfilled3. the Hotel Centrale alone, 35 people the centre together with the guests in The occupation of the former Institute from sub-Saharan Africa share the complete autonomy, even financially. of Canossiane in Cosenza, promoted spaces with 12 asylum seekers who Recently, a deal was reached with by the Prendocasa committee, dates are appealing against the denial of the Municipality to regularise the back to October 2013. This was the protection, in both the first and second occupation of the building and to first “mixed” residence in Cosenza: instances4. extend the activities until April 2018. amongst the inhabitants are around 20 Running alongside these housing Negotiations are still ongoing to find a Italians and 25 men from sub-Saharan projects in Cosenza are activities more stable solution. Africa, who are holders of international that aim to promote integration in Since it opened, Casa Don Gallo has and humanitarian protection. Twenty their neighbourhoods, starting with welcomed 71 people, 16 of them from places are reserved for migrants children5. SGOMBERI FORCED EVICTIONS 10 11 1. Puglia Region had found 200 places in two centres in the area. At the Public Prosecutor's Office following a one with bruising to the metatarsal- time of the eviction from 500 people complaint by the owner, Cassa Depositi phalangeal joint of the foot. were living in the Gran Ghetto. e Prestiti. The migrants remain on the Since 2013, in a building in Piazza 2. Owned by the Unipol-Sai banking streets. The indignation caused by the Indipendenza in Rome, there have been group and unused for years. We intervened after a woman eviction and the way it was carried at least 800 refugees, almost all of 3. Another eviction agreed with the resident was hit by a water jet from a out led to a public demonstration, Eritrean and Ethiopian origin. Amongst population took place on 23 March 2017 on 9 September, attended by 10,000 these are many women and children. On and concerned the Casa Don Gallo in Padua, hydrant and fell to the ground, occupied since 2013 by approximately sixty passing out. There were no people. After this, the Municipality 19 August 2017, when police cleared the refugees who had left the ENA centres. With ambulances on site at the time of committed to finding a new space to building, 200 people set up a makeshift a programme that saw the involvement, the trouble. house the activities previously run in the camp in the square. The Municipality amongst the others, of the Razzismo Stop centre. In December, an indictment was only offered temporary housing association, Caritas, Confcooperative and MSF Medical Coordinator requested for 11 activists who had tried solutions to women and minors, without Fondazione Cariparo, the refugees were 4 included in vocational courses and job to oppose the eviction, with accusations any protection for nuclear families . On grants in Padua and across the Province. For of resistance against public officials and 24 August, the police intervened again the last 15, accommodation was only found personal injuries. to clear the square, this time using in October. The open-air space at the back On two occasions, on 8 and 12 June, water hydrants. An MSF team provided of the Casa Don Gallo where they had lived following the eviction was promptly sealed a shed on Via di Vannina in the Tor assistance to 13 injured people, most off by the Municipality with a metal fence. Cervara area in Rome was evacuated. of them women. Five needed to be 4. Of the occupants of the building in Piazza Around 500 people, including minors, sent to hospital. In the following days, Indipendenza, in November 2017, 76 elderly people, pregnant women and the inhabitants of the building were people were living in hostels for women the disabled were living in the shed. again dispersed from other parts of the and other vulnerable groups, run by the The police intervened with force, using city. In mid-November, the authorities Municipality of Rome. At least a dozen armoured vehicles. The Municipality was began to allow people to recover the were still sleeping on the streets. not present. On 21 July, an MSF team belongings that had been kept inside 5. Article 11 of Law no. 48/2017 reads: “[The prefect defines] the use of force actions for visited an adjoining shed where some of the evacuated building. In January the execution of the necessary interventions, the people had moved after the eviction. 2018, for three refugees accused of according to criteria of priority that, even MSF doctors found seven people resistance to a public officials during taking into consideration the protection of with trauma, all – according to the the eviction operations of 24th August, nuclear families in situations of economic statements of the people involved – due the Prosecutor asked for two and a half and social hardship, takes account of the situation of public order and safety FORCED EVICTIONS to the nature of the eviction. Amongst years in prison. in the territorial areas concerned, of the these, four people had sought treatment In a Circular published on 1 September Legislative Decree no. 267/2000 grants for a handful of families. Amongst the another building, in Via Baracca2. This possible risks for public health and safety, at nearby hospitals on the previous days: 2017, the Minister of the Interior states of the rights of the owners of the buildings.” authority to the mayor “in relation refugees were at least 30 minors and a occupation is ongoing. one with a fracture of the orbital wall that “The protection of nuclear families Regarding the rights of the owners, it is to be to the urgent need for interventions number of pregnant women. On 11 January 2017, a fire destroyed the and the nasal septum; one with a bruise in situations of economic and social highlighted that Ruling no. 21347/2017 issued aimed at overcoming situations of 1 March 2017 saw the clearing of the shed attached to the former Aiazzone by the Court of Rome in November 2017 gives to the head and back and a wound on distress is a priority condition for the serious negligence or degradation of Gran Ghetto in Rignano Garganico (FG), furniture factory in Sesto Fiorentino, the Ministry of the Interior the responsibility the left arm; one with a bruised leg over definition of procedures regarding the the territory, of the environment and a shanty town that was home to more where a hundred Somali refugees for any damage caused to the buildings by a previous fracture of the tibia; the last execution of eviction operations5”. the occupants in case of lack of eviction. of cultural heritage, or of detriment to than 2,000 migrants and refugees in the had been camping since December cleanliness and urban liveability.” Such summer, during the peak agricultural 2014. Ali Muse died in the blaze, whilst authority, reaffirmed and strengthened season. A year previously, the governor trying to recover paperwork relating by Law no. 48/2017, is increasingly used of Puglia Region had submitted a to family reunification. The lack of to break up unofficial settlements where complaint to Bari’s District Anti-Mafia housing solutions for the refugees migrants and refugees excluded from Directorate on reduction in slavery affected by this fire forced them to I slept on the street for four months in Cagliari. Finally, police gave the institutional reception system live, in reference to the inhabitants of the occupy a building owned by Jesuit us a document and told us that we could use it to catch a ferry. using more or less forced evictions, Ghetto. This was followed by a Decree Priests. On 29 November, the building I applied for asylum in Florence. After the fire in Sesto Fiorentino almost never arranging them alongside authorising the seizure of the land on was cleared following an agreement warehouse, I ended up in this occupied building. I do not know how the resident population. This forces which the ghetto stood, and an eviction between the Municipality, local long it will last. I am really tired. them to disperse into increasingly order. About 200 migrants refused Police, Jesuit Fathers, Caritas and the S., Somalia, via Spaventa, Florence peripheral areas and ever more hidden to leave the area1. During the night inhabitants of the building themselves. locations, with more limited access to of 2 March, a fire broke out amongst A minority were transferred into the social and healthcare services, with the the shacks. Mamadou Konate and SPRAR network; the single women increasingly remote possibility of those Nouhou Doumbia, 33 and 36 years old into housing for vulnerable groups; services providing for the needs of this respectively, and both of Malian origin, others were helped into private rented vulnerable population. died in the blaze. accommodation. The police issued 30 On 6 December 2016, following an order On 12 July 2017, about 50 Somali people with travel documents to move by the mayor of Falerna (CZ) citing refugees, some of whom had been in to other EU countries, whilst six chose reasons of hygiene and sanitation, Italy for over 10 years, were evicted the option for assisted repatriation to the Residence degli Ulivi was evicted, from the ex Meyer warehouses, owned Somalia3. which, since the closure of the ENA by the Municipality of Florence. The On 8 August 2017, the Labàs centre in programme in 2013 had been hosting mayor, in his eviction order, claimed a former military barracks in Bologna, about 200 refugees from sub-Saharan the property was uninhabitable and was evicted after being occupied since Africa. The eviction saw a huge unsafe (in fact, it was in an extremely 2012. Amongst other activities the deployment of law enforcement, but poor condition). No stable housing centre offered hospitality to around 15 no municipal social workers. The City solution was proposed for the refugees migrants and refugees. The eviction did not offer any alternative housing who, supported by Movimento di was ordered following a seizure decree options apart from temporary solutions Lotta per la Casa, went on to occupy issued two years previously by the OUT OF SIGHT OBSTACLES TO ACCESS THE NATIONAL HEALTH SERVICE 12 13 1. Contributing to the drafting of this section were the Gruppi Locali Immigrazione 1 Except for Piedmont, all other regions is only assigned if the family is in Salute (GrIS -Local Migration and OBSTACLES TO ACCESS THE NATIONAL HEALTH SERVICE recognise exemption from the co-pay possession of a tax code5, or only until Health Groups) of the SIMM - Società system for medicines and healthcare the child reaches 14 years of age6. Italiana di Medicina delle Migrazioni (Italian Society of Migration Medicine) The residence registration continues to use the National Health Service. The CAS, even the small scale ones, set services for two months – at most Translators and cultural mediators of the regions Campania, Friuli-Venezia be the biggest administrative barrier result is a growing recourse to the out in recent Ministry of the Interior six - after the formalisation of an – with rare exceptions – are not Giulia, Lazio, Piedmont, Puglia and 4 asylum application, on the basis of Veneto, in addition to the organisations to registering for the National Health Temporarily Present Foreigner (STP) Decrees , is another factor in limiting employed in the NHS, either at the arbitrary difference between mentioned at the end of the report. For the Service for applicants and holders regime, which was originally set up for asylum seekers the inclusion in the administrative or medical services, unemployment (one who used to collection of materials and the analysis, of international and humanitarian undocumented migrants. Increasingly, National Health Service, considering except for on-call interventions or for we wish to thank Dr. Sara De Santis. work and has the right to payment protection. the most common way to access the they should be assigned personal specific projects with a finite timescale. 2. Circular of the Ministry of the Interior general practitioners as for the Italian exemption) and joblessness (someone This lack is particularly serious in no. 5/2017, in application of the Following recent government National Health Service is via hospital who has never worked before). A emergency departments. citizens. direct access services, such as primary Legislative Decree no. 13/2017. measures, residence registration judgement from Rome Court, 1 Section healthcare services, first aid, woman 3. Article 5, Law no. 80/2014. is revoked with immediate effect In some cities, people who want to More and more primary healthcare 17/2/2017 – recalling the Law no. clinics, mental health centres and 2 4. Decree of 07/03/2017. For any CAS with upon leaving the reception centres . submit an asylum application at a services for migrants without a 150/2015 and the Labour Ministry’s addictions centres. fewer than 50 places, a 24-hour nurse is Declaring residence at occupied police station must present a medical residency permit are delegated to communication 5090 of 4/4/2016 – Finally, very serious critical issues expected, seven days a week, and a doctor 3 for six hours a day on six days of the week. premises is not allowed , whilst the certificate. This increases the waiting private humanitarian organizations. clarify that the exemption should be concern mental health services. 5. Cf. Region of Campania. issuance of a fictitious residence, as time for entry into the reception In general, these services do not extended for the whole period of time In addition to the lack of cultural the homeless are allowed to do, does system, condemning the applicants to issue a STP code when they are in which the asylum seeker or the 6. In all these cases, in contravention of mediators (whose presence is judged the provisions of the State, Regions not occur in any Municipality and extended periods of time without any treating a patient (who is forced to refugee is unemployed, calling off the to be even counterproductive for the would involve complex procedures aforementioned difference between and Autonomous Provinces Agreement assistance. obtain it from the health registry purpose of taking care of the patient, of 20 December 2012; Law no. 176/1991 unemployment and joblessness. even if it were to. Moreover, for before returning to the service for as in Udine and Bolzano) there are “Ratification and implementation of the migrants and refugees forced to move Notably increasingly more asylum prescriptions). In addition, they cannot Convention on the Rights of the Child”, There are strict limitations on assigning significant shortcomings in the skills across Italy because of job insecurity seekers use the STP code after filing Article 35, paragraph 3, letter b. issue prescriptions under the local a paediatrician to children without of ethno-psychiatry and a lack of – for example, those employed in their asylum request (C3 form). This healthcare authority, and therefore 7. An ID document is requested. residency permits. Many regions use continuity of care for people with seasonal agricultural work – if their happens mainly to people hosted in are forced to provide prescriptions for 8. The certificate about the lack of any income the STP regime whereby a paediatrician psychiatric disorders. temporary workplace does not tally the first reception centres and in the drugs or specialised services at full is systematically omitted and consequently with their registered residence or extraordinary reception centres. price. The result, again, is a separate the payment exemption is not applied. domicile, it is impossible for them to healthcare system for migrants. 9. Sometimes an ID document is required. The provision of medical services in Renewal is permitted only once. 10. In Gorizia, there is a primary healthcare clinic run by the Red Cross with the occasional presence of a General Practitioner from the Local Health Authority. Patients are sent to the health administrative office for the issuing of the STP code. 11. In the clinic, within the premises of the Local Health Authority, volunteer doctors from Caritas work the presence Registration to the to Registration NHS in the absence of residence registration: residence fictitious the to Registration NHS during permit renewal of staying C3 form health Post assistance in first centres reception and CAS Criticalies in issuing the STP code dedicated Public STP OPDs Issue of PSTP code at public dedicated STP OPDs Issue of STP code at woman clinics Issue of STP code at hospital emergency dpt. Pediatrician for undocumented minors Linguistic-cultural mediators at serviceshealthcare of linguistic-cultural mediators. The various ser- clinic is open at least two days a week. Bolzano NO NHS NHS NO 1 YES NO YES NO vices, on call 12. The OPD is run by volunteer doctors inside Pediatricians the St. Paolo Hospital. In Lombardy, there CALABRIA YES STP STP NO 2 YES NO YES at woman NO are 13 dedicated STP clinics managed by Cosenza clinics private humanitarian organizations. Cf. Pediatricians Current Italian legislation on healthcare CALABRIA YES STP STP NO 1 YES NO YES at woman NO for undocumented migrants and the Reggio Calabria clinics current application of this legislation at a regional level, Naga Milano in FVG NHS YES7 010 /// NO YES collaboration with SIMM, June 2016. Gorizia 13. Two others have been closed. FVG various YES NHS NHS NO 111 YES NO NO YES 14. In 2016, linguistic-cultural mediators Pordenone services were present in the women clinics, LAZIO as part of a project that was not YES STP NO (online) 0 /// NO Roma Munic.4 refinanced upon expiration. LAZIO YES STP NO (online) 2 YES NO Roma Munic. 5 LIGURIA NO NHS NHS NO 0 /// YES YES NO NO Ventimiglia LOMBARDIA NO STP STP YES8 0 /// NO not always NO NO Como LOMBARDIA various STP NHS YES9 112 Not all Not all YES Milano services at woman cli- PIEMONTE with tax YES NHS NHS NO 213 YES NO NO nics & various Torino code only services PUGLIA YES STP STP NO /// /// NO YES YES NO14 Bari OUT OF SIGHT THE BORDERS AT COMO AND VENTIMIGLIA 14 15

1. Harmful borders, Médecins Sans THE BORDERS AT COMO AND VENTIMIGLIA for the most vulnerable, women and municipal council sealed off the only Frontières, January 2018. minors, who were left unprotected in water point available to those staying 2. Cfr. ASGI, The readmission of foreign citizens mixed and unsegregated living spaces. at the car park. In December, the to Ventimiglia: profiles of illegitimacy, Of the 287 adults that MSF In Como, between July and September Val Mulini migrants were transferred June 2015, and The readmission of foreign interviewed in Ventimiglia between On 4 February 2017, MSF staff in Ventimiglia assisted a woman 2016, up to 300 migrants, mainly from to sheltered facilities included in citizens at the Chiasso border: profiles of Eritrea, were gathering in the park in the Winter Contingency Plan. The illegitimacy, August 2016; STAMP, Hotspot 28 August and 14 September 2017, who was over 36-weeks pregnant. She claimed to have been leaks: a dossier on the Taranto border, 2017, 131 said they had tried to cross the forcibly taken by the French police from a hospital in Nice and front of San Giovanni railway station, as Municipality, in order to prevent https://www.unponteper.it/wp-content/ French border, of whom 90 tried returned to the Italian border. it was impossible to cross the border. access to the car park once and for uploads/2017/07/DOSSIER-stamp.pdf. The all, installed metal grids mounted on criteria for the selection of migrants to between one and three times; 25 Two Eritrean women, who arrived at the MSF clinic on 26 July Access to basic needs – shelter from between four and seven times; whilst the elements, food, washing and toilet concrete Jersey barriers and, above be transferred to Taranto are not clear. eight people had attempted to cross 2017, reported having been stopped after crossing the border facilities – was limited, and provided the grids, rolls of barbed wire14. 3. In July 2017, a peak of almost 9 600 people were registered. more than 12 times. 23.6% of those along with 120 others, and subjected to verbal abuse by the almost exclusively by local volunteers . French police. The women were forced to return to Italy after an Healthcare was provided by volunteer MSF intervention 4. In March 2017, citizens from Morocco, who tried to cross the border also Algeria, Tunisia, Libya and Egypt declared that they had suffered at entire day without eating or drinking – one had evident difficulty doctors and nurses, coordinated by the In October 2016, MSF launched were systematically prevented least one act of violence committed in walking. Red Cross, in a mobile clinic in front of programmes in Como, and from accessing the centre. 1 the station. All throughout Como, the by Italian or French men in uniform . MSF Coordinator in Ventimiglia subsequently in Ventimiglia, to support 5. Lunch is distributed by the local Caritas Closure of the borders between Italy STP regime – which would have allowed migrants stranded at the borders, (the charitable arm of the Italian Bishops and France and Switzerland resulted migrants in transit to have regular with the aim of facilitating access to Conference) and dinner by French access to the National Health System volunteers. Of the 150 migrants interviewed in a growth in the number of people local healthcare services, providing in August 2017 for the study, In Dangerous who remained stranded for days, by local volunteers using their own hotspot in Taranto. in accordance with current legislation psychological first aid (PFA)15 and – in Transit: filling information gaps relating and sometimes weeks, in the areas resources. Migrants who were refused Since July 2017, underage migrants – is not in place. Ventimiglia – assisting with women’s to refugees and displaced people in close to the two borders, in formal entry to the Red Cross centre4, and are also allowed in the Red Cross In September 2016, the Prefecture reproductive health. This latter Ventimiglia, Italy, Refugee Rights Data reception centres or in unofficial open- particularly children between the ages camp (available places: 54). In the opened a reception centre close to Project, 2017, 82% said they did not have intervention was carried out between sufficient drinking water and in some air settlements, with no or limited of 14 and 18 who could not gain access same period, a service to support the the city cemetery, requesting that all November 2016 and July 2017 in an cases, they had to drink water from the access to basic needs. To reduce such to Gianchette parish church nor to the migrants in Ventimiglia, particularly migrants camping in the San Giovanni outpatient set-up inside the Gianchette river. In July 2017, the authorities sealed concentrations of people, the practice Red Cross centre, were forced on the those excluded from the Red Cross park transfer there. In this centre, run parish church, where the following off the only access point to drinking water of forcibly transferring migrants from streets for the entirety of their stay in centre, was set up7. The space – called by the Red Cross, men, women and activities were carried out: general in the area, which had been opened by the areas of Como and Ventimiglia Ventimiglia, sleeping near the railway “Eufemia” – offers social and legal children (even unaccompanied minors) some activists. The only basic medical obstetric screening; pregnancy testing; service is a clinic located on the Caritas to the hotspot centres in Southern station or under the overpass at the assistance and other basic services are housed in unsegregated conditions, pre- and post-natal consultations; premises, which is open two mornings a Italy, in particular to Taranto, has mouth of the Roja, with limited or no such as the distribution of clothing whilst they are awaiting access to the treatment of simple infections16; week thanks to the presence of volunteer been established. Of the same sample access to basic needs such as food, and shoes, mobile phone charging and asylum procedure10 or their request for information on the prevention of doctors. Other volunteer doctors worked interviewed by MSF in Ventimiglia, water and healthcare5. the use of computers. More than 100 protection in Italy is being processed. sexually transmitted diseases, family at the Gianchette parish church. There more than 17% said they had been people rely on these services daily, 11 is a basic primary healthcare clinic in On 23 June 2017, an order from the Migrants unable to access the centre , planning, pregnancy and prevention of the Red Cross centre run by the Local transferred to Taranto, 26 of whom mayor of Ventimiglia authorised the which are opposed by the institutions including many unaccompanied minors mother-to-child transmission of viral Health Authority. The nearest hospital were transferred once, 18 people two extraordinary clearing of the Roja because they are considered an caught by the Swiss authorities trying diseases; and the referral of victims of is Bordighera, which is not reachable or three times, and four people three riverbed6. The people camping there incentive for migrants to stay in the city to cross the border, were housed for violence or trafficking to competent on foot from the banks of the Roja. 8 to five times2. – between 300 and 400, including without using the Red Cross centre . months in the San Martino church in services and authorities. 6. http://www.medicisenzafrontiere.it/ In Ventimiglia, large numbers of many children – were told to move Throughout 2017, the number of the district of Rebbio, having been In the first seven months of 2017, notizie/news/ventimiglia-un-centinaio- migrants were first stranded due to the away, “being sure to take any personal migrants at the mouth of the Roja di-migranti-dispersi-al-confine- tracked down and taken to the church Gianchette church hosted more than dopo-ordinanza-del-comune. closure of the border in the summer of belongings”. Many migrants headed river, living in inhumane conditions, by night patrols organised by local 1,060 women, with 226 (21%) being 7. The service is managed by the 2015. At the end of 2016, the reception to the border with France, choosing to has rarely been less than 50 people, volunteers. Until 4 May 2017, when under the age of 15 years. Of the 435 associations Iris from Bergamo, Popoli centre managed by the Italian Red travel through the mountains. At the with peaks of 400 men, women and it was forced to end its reception women consulted by MSF, 79 (19%) in Arte from Sanremo and Melting Cross was reopened (for male adults end of what amounted to a manhunt children. On 4 August, all inhabitants activities12, the church hosted more were pregnant. To give them access Pot Europa project from Padua. only) with a maximum capacity of 500 using helicopters and dogs, the French of the Gianchette parish church were than 1,300 people. to better healthcare, a memorandum 8. http://www.sanremonews.it/2017/07/15/ 3 people . This centre was previously police tracked down 200 people and transferred to the Red Cross camp. In Migrants excluded from the Red Cross of understanding was signed with leggi-notizia/argomenti/cronaca/ articolo/ventimiglia-il-sindaco-sullinfo- located near the railway station and handed them over to their Italian a letter to the Prefect of Imperia, MSF centre and other Como dormitories the Ventimiglia woman clinic, expressed concerns about the unsafe point-delle-gianchette-qualcuno-rema- is now situated at the mouth of the colleagues. These migrants were gathered in various sites around the providing patients with gynaecological contro-e-vuole-mantenere-i-m.html. river Roja, about four kilometres from transferred from Ponte San Luigi to the conditions in the camp, in particular city, in particular on the ground floor examinations, ultrasounds, routine 9. Dinner was distributed by dozens of the town. Originally intended as a of the unused Val Mulini covered examinations and check of the results volunteers on the premises of a parish short-term transit camp for migrants carpark. From May to November, there within a maximum of two days, in church, and lunch served in the San travelling to France (regardless of was a constant presence of several consideration of the short time of Giovanni park by volunteers of the Swiss organisation Firdaus. Red Cross whether they had a residency permit), dozen people13, amongst whom were women's permanence in the town. All the centre’s function changed in installed a shower block and chemical increasing numbers of migrants of these services are provided through toilets in the space in front of the San March 2017. To gain access now, it is sub-Saharan origin leaving reception the STP regime. 13 women have been Giovanni railway station. On at least necessary to provide fingerprints to the centres throughout Italy, with or identified as survivors of sexual abuses, one occasion, in September 2016, police police officers permanently present in in riot gear prevented the installation without a form of international or among them five were pregnant as a of tents by volunteers and activists. the centre, and to present a request for humanitarian protection. To avoid consequence of the violence suffered. 10. Since May 2017, migrants have been protection in Italy (or having already an evictions by the Municipality, migrants asylum procedure ongoing in Italy). transferred to the Red Cross centre supported by volunteers avoided In Ventimiglia, PFA activities were directly upon disembarkment. Families, women and children under 14 putting up tents until November, carried out both in the Red Cross (mostly from Eritrea), in the absence of instead, sleeping out in the open. In camp and the unofficial check of the other reception facilities, were housed the early morning light, they left the results within a maximum of two days, in the San Giuseppe parish church in area, after cleaning it up with the in consideration of the short time of the Gianchette district and assisted help of volunteers. In August, the new women's permanence in the town. All 13.

OUT OF SIGHT FUORIROTTA CAMPO DEL BRENNERO E BOLZANO 16 1717 11. Many arrived from Milan or upon being rejected by the Swiss police PFA I COMO A IMIIA A at the border, remaining on the street because they reached the Red Cross centre after closing time. Symptoms of adaptation 12. The church has been the subject of numerous inspections by the police Anxiety symptoms Ventimiglia and the Local Health Authority. Como 13. Peaks of more than 100 people Anxiety symptoms were recorded in July 2017. 14. http://www.laprovinciadicomo.it/ Anxiety symptoms stories/como-citta/como-in-val-mulini- recinzioni-anti-migranti_1264629_11/. Symptomatic problems 15. PFA – Psychological First Aid – consists of: providing information to facilitate Others orientation to the area and access to health care and basic services; evaluating 0% 10% 20% 30% 40% 50% 60% the general psychological conditions of the person; achieving early detection of symptoms of mental distress and providing support through individual and group sessions; identifying vulnerable Sexual violence 2% Sexual violence people and directing them to the with pregnancy specific territorial services (victims of Sexually transmitted 1% sexual violence/trafficking, patients in infections psychiatric distress); providing emotional 3% Urinary tract Other 10% support and psycho-education in relation infections to traumas suffered in countries of 3% origin and during the journey to Italy. 16. Often caused by the critical hygienic Vaginitis 7% conditions during the trip. Women health consultations in Pregnancy 17% Ventimiglia Good health Nov. 2016 57% Jul. 2017

these services are provided through and cultural mediators provided the STP regime. 13 women have been psychosocial support to more than 500 identified as survivors of sexual abuses, people (including 200 women and 41 among them five were pregnant as a minors) in the Red Cross centre and THE DEADLY BORDER consequence of the violence suffered. Rebbio parish church. In 229 cases, where migrants concentrated, such the need for individual and follow-up as Gianchette church, on the banks sessions emerged. Since the end of 2016, at least 22 old of Eritrean origin, lost her life on line. On 16 November, Rawda, a young of the Roja and the railway station. Both in Ventimiglia and in Como, people have died trying to cross the the A10 motorway, hit by a truck. A Ethiopian woman who had only been Between January and August 2017, a the majority of cases of PTSD (Post- border to reach France, Switzerland or few days later, on 21 October, another in Italy for a few days, was struck by team made up of a psychologist and Traumatic Stress Disorder) are due to Austria. migrant was killed by a car on the same a train near Avio. After the difficult cultural mediators offered PFA to 2,452 trauma suffered in Libya and during the road. In 2017, three migrants were hit identification process, her body was people, 777 in individual sessions journey to reach Italy. These symptoms Fifteen alone died on the frontier by trains whilst attempting to cross repatriated thanks to money raised and 1,675 in group sessions. One-fifth have been exacerbated by the extreme between Italy and France. Alfatehe- the border, and three others were by activists and private citizens in the showed problems related to mental insecurity regarding patients’ present Ahmed Bachire, a 17-year-old from electrocuted along the tracks. area. A few days later, Abel Temesgen, health; seven cases (one identified at and future conditions. Sudan, drowned in June 2017 whilst a 17-year-old, died whilst trying to get the Red Cross centre and six outside) Throughout the duration of MSF’s cleaning his shoes in the waters of the Different frontier, similar stories. In on a freight train to reach his brother were referred to the Ventimiglia mental programme, basic training activities Roja, the same river in which another Como, on 27 February 2017, Diakitè in Germany, and an unknown man health centre. have been carried out for volunteers migrant had lost his life seven months Yousuf tried to cross the border hidden and woman were crushed whilst the To cope with the deplorable hygiene supporting migrants in the two areas, previously, whose body has never on the roof of a Tilo train but died truck they were travelling in was being and sanitary conditions of the informal in particular regarding access to local been found. Many have lost their lives electrocuted upon a sudden change in unloaded. In October 2017, the corpse settlements and in the absence of action healthcare services, health and hygiene along the so-called death pass, used the cable tension. A few days later near of Abbas, a 19-year-old boy from the from the responsible institutions, MSF promotion and basic psychological in the past by fleeing Jews, partisans Chiasso, the same fate befell a young Gambia, was found at Bolzano station. installed two chemical toilets near support for migrants and for the man of Malian origin. and smugglers. This is what happened According to a police investigation, the Ventimiglia railway station (from 18 March volunteers themselves. to two nameless youths, found in young man was walking on the tracks to 31 May 2017) and camping showers MSF has also supported, and still Some of the victims had previously March 2016 along the Grimaldi trail. on the Roja riverbed, pushing for the supports volunteers at Rebbio parish received support from the MSF team heading south, waiting for a train to installation of sanitary facilities inside church in Como, in Gianchette In September, another young man of working in Como and Ventimiglia areas. climb on to when he was struck. On Gianchette parish church and along the parish church and Eufemia centre in African origin died when he fell from Christmas Eve, another migrant died banks of the river, plus the opening of Ventimiglia through the donation of a viaduct on the A8 motorway, whilst In the North East of Italy, since in Brenner on the roof of a freight car a water point. Authorisation for such materials distributed by the volunteers trying to escape from the border November 2016, five people have lost heading for Austria. The convoy had operations has never been granted. themselves to passing migrants, police. Milet Tesfamariam, a 17-year- their lives along the Brenner railway departed from Verona station. In Como from January to August 2017, particularly hygiene kits, blankets and a team comprised of a psychologist sleeping bags. OUT OF SIGHT THE BRENNER ROUTE AND TRENTINO ALTO ADIGE 18 19 1. Pakistanis, Afghans, Syrians, Iraqis. 2. Coming mostly from sub-Saharan Africa. THE BRENNER ROUTE AND TRENTINO ALTO ADIGE 3. At Brenner station, up to July 2017, there was an average of between 10 and 20 people per day. Non-systematic checks are carried out on trains departing from Verona station to As a result of borders being closed, to a place in a reception facility due on 6 October, Abdullah fell from Brenner by mixed patrols made up of German, the number of migrants who remain to the effects of the “Critelli Circular”, his wheelchair, resulting in multiple Austrian and Italian police officers. Since stranded in Bolzano is growing. issued by the Province of Bolzano in fractures to the lower limbs. He died November, the trilateral police collaboration has also extended to checks of freight trains. These are migrants trying to leave for September 20166. According to this two days later from complications. 4. They are mostly minors from sub-Saharan another European State immediately provision, reception is to be denied Migrants excluded from reception live Africa leaving the reception centres, but also after disembarking; coming from to all those who have been in other in extremely precarious conditions in Somalis, Pakistanis, Afghans, Bangladeshis the Balkan route1; exiting reception foreign states, or other Italian regions, who have just arrived in Italy via a number Bolzano, sleeping along the banks of centres throughout Italy at the end of where there was an opportunity to of routes and who plan to continue towards the river and under bridges. In order northern Europe. Many minors remain the asylum process or with a decree seek asylum. Hence, reception can be invisible to the institutions; others, due to the 2 to preserve the decorum of the city, revoking reception ; and coming from granted only when there are serious lack of places in the reception centres, are municipal workers continually turn other EU states, in particular from reasons (such as health), but only for placed in adult facilities or simply remain on them out from where they are resting, the street. Austria and Germany where their a maximum of three days. In the case requisitioning their personal effects, request for protection was denied, of nuclear families, adult males are 5. The so-called ‘out-of-quota’. 1,650 people and often enclosing the areas with have been assigned to Alto Adige according with the intention of submitting a new excluded from reception. All this is gratings to prevent their return9. to the system of ‘ministerial quotas’ and asylum application in Italy. on the basis of the arbitrary rule that accommodated in the CAS centres in June migrants should apply for asylum in Migrants are assisted by volunteer 2017. The Province has so far refused to join Migrants without valid residency the SPRAR system. the first safe destination they arrive in7. groups, such as Antenne Migranti and permits or travel documents who are 6. In Alto Adige, the Province manages the SOS Bozen. MSF supports them with heading to Austria by train, are forced On 8 October, Abdullah – a 13-year-old reception of applicants and holders of donations of hygiene kits, sleeping by the Italian police to alight before Kurdish-Iraqi boy affected by muscular international protection, in accordance with 3 bags and blankets that are distributed the Government Commissioner. reaching Brenner . If they manage to dystrophy – died in Bolzano8. Together to people on the street, in the hope domicile in order to proceed with the people who are not resident in the 7. In the national laws, there is no geographical cross the border, they are pushed back with his family, consisting of his that they will not be lost as a result of formalisation of their application. This Province (for those who are resident nor temporal constraint regarding the place over by the Austrian police. They are parents and three brothers aged six, 10 in which to apply for asylum and to ask for the requisitions. limits access to the asylum procedure. the period is renewable for a further often repelled summarily, without any and 12 years old, Abdullah had come a reception centre place. Any regional or The number of those who are unable 30 days in winter). This not only has provincial provision that denotes a place as opportunity to express their intention from Sweden one week previously, Following the closure of the Brenner to request asylum. Such rejections also to enter the reception system today forced asylum seekers to live in more being safe without such being disciplined following the rejection of their request border, and because of the Critelli by a national law is completely devoid of take place in the opposite direction, is around 70 people. The situation and more precarious places, but also for international protection. At circular, in the Autonomous Province of is also critical due to the scarcity of hampered the formalisation of their any legal value. In the first half of 2017, 50% from Italy to Austria. Amongst the of those out-of-quota comprised families. Bolzano police station, the family had Trento, there has been an increase in places in low-threshold dormitories international protection application, Reception was often guaranteed with migrants repelled and stranded at the expressed their intention to present the number of asylum seekers coming border, there are many unaccompanied and to the new municipal regulation since the address of the dormitories temporary accommodation in hotels for an asylum request on 3 October, but autonomously and by land to the city. limiting the right of access to these is normally used also to formalise the vulnerable people, such as single women, minors4. reception was denied under the Critelli Migrants cannot access the reception places to only 30 days a year for same application. single women with underage children and people with physical/psychological Asylum seekers arriving independently Circular. After spending their nights in system until they are able to formalise vulnerability. Many families refused to in Bolzano (outside the transfers the park near the train station, in the their request for international stay in a hotel because they would have arranged by the Ministry of the Interior atrium of the Evangelical church and protection. The Police in Trento to be split up – the husbands being soon after the landing ) have no right in hotel rooms paid for by volunteers, require migrants to have a formal denied a place. Several families housed in hotels had members with significant From 2015 I was given accommodation for about one year at health problems (paralysis, autism) and the Ex Lemayr reception centre and for three months in the Ex psychological problems (trauma, depression). Formalisation of the request for protection at Alimarket centre. Here, they accused me of having been involved the police station in Bolzano can take up to in a fight and I lost the right to reception. But it was not true. I two months. have been living on the streets for five months. At first, I slept on 8. Cf. http://www.medicisenzafrontiere. the banks of the river. The police came along and threw my tent it/notizie/news/bolzano- %E2%80%9Cpersone-vulnerabili-escluse- into the water, then cut down all the bushes along the banks so dall%E2%80%99accoglienza-costrette- that no-one could sleep there anymore. I moved under a bridge. condizioni-indegne%E2%80%9D. Again, the police came along and kicked us out, closing the 9. By way of example, on 29 and 30 November, two evictions took place in different area with a grate. I have lived under this other bridge for three locations (bridges) in the city that led months. In the morning, I wake up and tidy everything up then I to the removal of blankets, sleeping bags, backpacks, mattresses and kitchen go to work. I collect apples, I have a regular work contract. utensils of four Iraqi asylum seekers, four H., Pakistan, Bolzano Afghan and seven Pakistani applicants.

I slept on the street near the Caritas soup kitchen. They came along and chased everyone away, then fenced off the area with a grate. I would never have left Libya. But there two friends of mine were killed in cold blood in a detention centre, when bread was being handed out. I was also there – they hit me in the face with the butt of a rifle. Do you see my incisors are loose? I reckon that the day they open the borders, no black person will remain in Italy. M., Senegal, Bolzano OUT OF SIGHT FRIULI-VENEZIA GIULIA 20 21 1. At the end of November 2017, 966 asylum seekers and refugees were hosted in Trieste (90 in the SPRAR); 617 in Udine (49 in the area, they provided shelter to asylum SPRAR); 295 in Gorizia (corresponding to FRIULI-VENEZIA GIULIA seekers who had spent months staying 0.85% of the resident population, zero in the SPRAR); 405 in Pordenone (0.79% of in the city parks and bushland on the the resident population, 16 in the SPRAR). banks of the Isonzo river (the so- Throughout 2016 and 2017, the arrival having a document attesting the place 5 2. In November, the mayor of Gorizia, Rodolfo called Jungle) . Containers have been Ziberna, in referring to the supportive action of asylum seekers – mainly Pakistanis where they are living is also increasing. transformed into a first reception of the volunteers, said: “As long as it is known – from other EU Member States and In Trieste, there is a constant presence centre. that in Gorizia, there are those who feed a smaller number of people from of dozens of people waiting to access everyone outside the regulations of structured Since December 2016, the basement- the Balkan Route continued across the asylum procedure, seeking shelter level spaces of the San Giuseppe reception every day, it is clear that more and 1 more will continue to come here”. See https:// the region of Friuli-Venezia Giulia . in disused silos near the railway centre have become a refuge for www.avvenire.it/attualita/pagine/gorizia-il- Formalisation of an asylum application, station. Applicants are able to access a hundred asylum seekers who prefetto-chiude-la-galleria-della-vergogna. along with simultaneous access to the primary services provided for homeless remained excluded from institutional 3. In November, around 70 people were reception system, is not immediate, people, but access to care is greatly registered, all men aged between 20 and reception facilities. The space has 30 years, of Afghan, Pakistani and – to a and people are forced to stay on the limited because there is a lack of been renamed the Bunker. For months, lesser but increasing extent – Gambian and streets for weeks, without a dignified information available regarding local it has been witnessed the paradoxical Ghanaian origin. These are refugees at the shelter and with limited access to healthcare services. situation whereby the services end of the reception period (85%); asylum primary services. This is a deliberate In Udine, migrants who are not in seekers whose reception has been revoked guaranteed to asylum seekers inside (4%); migrants who are renewing their policy by the municipal administration, reception facilities sleep in small the containers were denied to those residency permit, a procedure that requires to prevent what they call a “pull factor” groups in a range of places in the who lived under them – even though 2 3 an average waiting time of one month in and to deter other unwanted arrivals . city to avoid evictions by the police . they had the same legal status and the Udine (7%). Monitoring was undertaken by Amongst the migrants living outside Basic necessities, including hygiene same geographical origin as the first the Ospiti in Arrivo association of Udine. of reception facilities, the number of kits and sleeping bags donated by 4. The same organization runs regularely group. The invisible people inside the distributions in Gorizia and Pordenone. people leaving the centres at the end MSF, are distributed by the Ospiti in Bunker depended on Caritas and other In Pordenone, there has been a The Municipality, which cannot 5. Throughout the project, MSF accommodated of the asylum procedure is on the rise, Arrivo association at the Misskappa in local volunteers for all their primary constant presence of more than fifty intervene directly due to it being a 598 asylum seekers overall and – in whether they are in possession of a Udine, a non-residential centre where services. This was the situation until people living outside of the reception private building, requested the owner collaboration with the Italian Red Cross residency permit or not. This is also migrants out of reception facilities can they were evicted on 20 May. system since autumn 20166. They are to immediately make the shed safe, and Local Health Authority – provided 4 true for those whose reception has also take Italian language courses . After a further clearing of Valletta forced to wait up to 60 days before resulting in the entrances of the shed medical treatment to around 800 people. been revoked before the end of the In Gorizia in mid-2016, MSF transferred 6. The same geographical origin and park and around 10 days of camping being able to formalise their asylum being walled shut. the same legal status as those procedure. Meanwhile, the number of the management of the housing out in front of the Prefecture, the request, due to a procedure where The applicants slept in ditches in excluded from reception in Gorizia. migrants who do not manage to renew modules set up in December 2015 to asylum seekers out of the reception even a mandatory medical screening front of the Monti barracks, under their residency permits due to not the Prefecture. In the San Giuseppe system found shelter (from 10 contributes to lengthening time spent the Concordia theatre, on the stairs August) in another place in the city, on the street. of the fire escape of the sports hall, the Bombi Gallery. The applicants In April 2017, an unofficial settlement subject to perpetual harassment arrived with their luggage in the located in an underground car park, from private vigilantes paid by the I arrived in Italy after a year-long journey. As soon as I reached Udine, I broke my arm. evening then left early in the morning, unofficially called “Bronx”, was evicted. Municipality who evict them forcibly, I went to the police station in Gorizia to present my asylum application on 4 September not before having carefully cleaned In May, the local Red Cross proposed night and day, seizing personal effects, up the place so as not to break the the creation of a dormitory with 24 including sleeping bags donated by 2017. From there, they sent me to the Monti barracks for a medical certificate. When I rules of urban decorum and to avert beds in the industrial area. Although MSF, which were taken away and never returned to the police station with the certificate, they gave me a new appointment for 6 a new forced removal. Volunteers the project would not result in any returned. The volunteers themselves November. Showing them the cast on my arm and repeating that, in such a state, I could from local associations helped costs for the municipal administration, are subject to continuous attacks, even not sleep on the street all that time proved to be useless. them by distributing food, blankets the latter opposed it. In September, by institutional figures, being publicly H., Pakistan, Pordenone and sleeping bags. At the end of people out of the reception system defined as traffickers and accused of September, during the four days of moved to an abandoned industrial incentivising new arrivals with their the Gusti di Frontiera, one of the warehouse, with rubble for a floor. supportive actions. most important tourist events of the year organised by the Municipality of Gorizia, the asylum seekers were allowed to stay in a reception facility, only to find themselves back on the Police station: Access to asylum procedure, Pordenone intention to submit street the day after the festivities asylum request Monti Barracks: ended. The gallery was vacated on 24 medical examination + Police station: November, “sanitised” and then closed vaccines at both ends with iron gratings. fingerprinting index finger Police In December, MSF donated a heated station: tent to the local Caritas, to provide fingerprinting temporary shelter for at least other fingers Police sixty people. The first entries were station: 20-25 days C3 filling Monti registered on 13 December 2017. The Barracks: structure, however, immediately reception proved to be insufficient for coping with the new arrivals, and Caritas had to make another temporary dormitory + 10-20 days available. OUT OF SIGHT TURIN 22 23 1. Corpo Nazionale Soccorso Alpino e Speleologico (The National Alpine jobs, the Committee instead proposes use of public healthcare services, Mountain and Cave Rescue Corps). TURIN investing in stable low-cost housing vaccinations, women's and children's 2. According to the team in charge of solutions, community housing, and health), through focus groups. carrying out the project, in June 2017 there were 745 people living at the MOI, 2 salvaging unused public properties, all In August 2016, around thirty people connects to the Val di Susa and the voluntary transfer of residents through 40 of whom were women. Judging from with strong institutional support and Some inhabitants of the MOI, after a MSF direct observation and a census from Pakistan, mostly waiting to access Vallée de la Clarée. This route saw a personalised projects aimed at social significant increase in the summer of inclusion, work and housing. The coordination. That is the model already period of training, are now supporting carried out in 2015 by the "Comitato di the asylum process, were evicted from successfully tested in the occupation MSF volunteers as linguistic facilitators Solidarietà Rifugiati e Migranti" association 2017. The flow did not stop with the ‘MOI: Migrants, an Opportunity for which indicated the number of people Turin’s Stura park and transferred to 3 in Via Madonna de la Salette: self- and cultural mediators in the arrival of winter snow, with a dozen Inclusion ’ project has to be undertaken present as being 1,200, the team's figure the Settimo Torinese first reception restoration and permanence without 8 migrants still in transit every day, in a number of phases that would be programme’s activities . appears to be an underestimation. centre. They had been camping in time limitations for inhabitants who From 1 January to 30 November 2017, many having to be rescued, in freezing implemented by 2020. There would be 3. The original acronym refers to the the bushes on the banks of the river contribute to living expenses and give a total of 218 people – mainly from conditions, by the CNSAS of Piedmont1. work placements for 500 people and Mercato Ortofrutticolo all’Ingrosso – the inside makeshift shelters, without up their places as soon as they are fully sub-Saharan Africa (Mali, Nigeria, Wholesale Fruit and Vegetable Market. When they manage to intercept them, housing for 640, alongside vocational any assistance, for months. It was a independent. Ghana) and Somalia – received 4. For four months, renewable, at shipyards similar settlement, in terms of number, the French Gendarmerie push them training courses, fixed-term work outside Piedmont, with six months housing 4 5 support from MSF, including nine nationality and type of legal status of back to the Italian side of the border, contracts and housing . minors and 32 women (15%). support (195); in addition, work placements MSF’s activities in the metropolitan area of Turin (133). migrants, to the one present the year which is kilometres away from the More than six million euros were Of the slightly less than 90% of users previously in the archaeological park of nearest inhabited centres. allocated for the project, 46% for 5. Twelve months in the metropolitan area in the Ex MOI in possession of a regular residency of Turin in premises owned by the project Porta Palatina, near the Palazzo Reale. housing support and 47% to help get permit upon first access, only 39.4% 6 Since September 2016, MSF has been partners and managed by social housing To the unofficial settlements of Via people into work . Ex MOI Olympic Village working in the MOI, alongside about were registered in the National associations and cooperatives (369); in Giordano Bruno, Via Madonna de la Some of the residents of the MOI, and Health Service and only 18.4% were addition, provided with housing in the In May 2017, a memorandum of the Refugee and Migrant Solidarity twenty volunteers from the local first two renovated buildings (60). Salette, Via Bologna (of Sudanese Turin group7, coordinated by a project assigned to a family doctor. refugees) and Corso Chieri (of Somali understanding was signed between Committee based there, oppose the In the same period, 236 people 6. The main sponsor is the manager. Compagnia di San Paolo. refugees), another has to be added on the City of Turin, the Metropolitan City, general approach of the project. They accessed the information desk, and Prefecture, the Piedmont Region, the are particularly concerned about The general objective is to promote 7. Assisted by volunteers from Corso Ciriè, where Italians are living 141 people were accompanied to local the National Civil Service. together with few dozens of people Diocese of Turin and Compagnia di San the temporary nature - six to twelve residents’ access to local public services. 8. Coming from Somalia and sub-Saharan coming mainly from sub-Saharan Paolo, with the aim of freeing the four months - of both work placement healthcare services through: In November, an agreement was Africa, French and English-speaking. on-site information desk Africa. buildings of the former Olympic village and housing, already experienced • reached between MSF and the Local 9. MSF funds only will be used for the In 2015, a new route opened for in Via Giordano Bruno (Ex MOI), which in the past institutional assistance about services, regulations Health Authority of the City of Turin9, implementation of the agreement. attempts to cross the border with was first occupied in March 2013, and programmes and never resulted in a and administrative procedures to allow linguistic facilitators and France, going by train from Turin to to allocate migrants and refugees living stable integration into Italian society. concerning access to the National cultural mediators to operate in the Bardonecchia station and from there, there to public and social housing. Faced with a crisis in the labour market, Health Service; Local Health Authority services with on foot to the Colle della Scala which The goal was to proceed with the and particularly lack of permanent • outreach information activities in the the largest influx of people coming main gathering places of the MOI and from the MOI. It was agreed that door-to-door in private rooms; written information would be provided • accompanying vulnerable people to in several languages to help people administrative offices and healthcare understand how to use local health facilities; services, and MSF would support (via • health and hygiene promotion activities training activities) Health Authority (among the main topics, proper staff employed in local services.

Municipality residence I have been in Italy since 2011. registration office After obtaining a residency NHS administrative offices permit, I went to work in the fields Local tax office in Saluzzo, not far from here. I Hospitals (including Emergency Dpt.) did not have anyone to host me, so I started going from dorm to GPs dorm. That was until 2013, when Secondary healthcare consultations ORIENTATION OF I joined the occupation of these Woman clinics RESIDENT POPULATION TO TERRITORIAL buildings. Now I am here to help Infectious Disease OPD SERVICES BY MSF MSF volunteers explain to MOI Vaccinations Jan. Nov. 2017 people how to have a family STP OPD (“ISI”) doctor, where to go when they do not have their documents in Other order and are sick. Many do not 0 5 10 15 20 25 30 35 40 45 50 speak Italian, and not knowing the language is all too difficult. I experienced this myself. O., Ivory Coast, Ex Moi OUT OF SIGHT ROME 24 25

by Rome’s Police Headquarters of alternative housing solutions are citizens were also found amongst the ROME including: a limit of 20 appointments resulting in the multiplication of residents. per day for the submission of spontaneous unofficial settlements, in The majority of medical problems applications; the request for a domicile disused buildings far from city centres, detected – respiratory, dermatological, In Rome, thousands of asylum seekers through a declaration from a private where invisibility is accompanied by and refugees are excluded from musculoskeletal, gastrointestinal person or by a reception centre; the deplorable living conditions, where institutional reception centres. As – were linked to living conditions a result, they live on pavements, in request for a passport or a declaration men, women and children cannot in deeply unhealthy and insanitary abandoned and unsafe warehouses, in of loss of the same; and, in order to access the most basic needs. sites. The incidence of mental health public and private occupied buildings. request relocation, the presentation of This is the case for many settlements related problems was also marked. a medical certificate of “suitability for in the area of Tor Cervara (Tiburtina), These are the outcomes of traumatic Despite of the mayor calling for more 6 limits to the number of asylum seekers community life” . where hundreds of migrants and experiences and violence suffered in sent by the government1, the city The number of “Dublinated” migrants refugees live in abandoned buildings, countries of origin and during transit, hosts about 2,000 fewer people in its (those asylum seekers being disused factories and warehouses. with secondary traumatisation due to institutional reception centres than the transferred to Italy from another They live without water, electricity and people’s current living conditions and 11,000 allocated to it by the State- EU Member State under the Dublin gas, often in rat-infested buildings marginalisation from society. Regional agreement2. Regulation and for which there is no surrounded by illegal landfill sites. automatic and immediate access to the In November 2017, MSF initiated Organized occupations Migrants in transit institutional reception system) who are an operation with a mobile unit being helped in the camp is increasing. consisting of a doctor, a psychologist In Rome, more than 100 occupations In June 2015, the Municipality of Rome Also rising is the number of refugees and a cultural mediator8. During the have been recorded. At least announced plans for an ad-hoc centre who have left reception centres due to first six weeks of activity, until the 600 asylum seekers and holders in the FerrHotel on Via Masaniello to the expiration of their terms, holders of end of 2017, 194 consultations were of international or humanitarian cope with the increase in arrivals of forms of international or humanitarian made (39 women, 29 minors) in four protection live in settlements linked migrants in transit from Southern Italy protection in the absence of effective settlements. The population is mostly to three different movements for the to other European States. However, the social inclusion7. of sub-Saharan origin (about 64%), right to housing, equal to about 20% former hotel, which extends over 1,000 having arrived in Italy in the last two of the total number of occupants9. In square metres and was made available the last five years, the settlements by the State Railways, has not yet been Unofficial settlements in years. Many are applicants or holders opened3. Tor Cervara of international or humanitarian have mitigated the lack of places in the After Via Cupa was evicted in protection, some having appealed reception system for asylum seekers September 2016, and after around The chronic lack of refuge places against the denial of the protection. and refugees. They also represent twenty more forced evictions, the and forced evictions in the absence In one of the sites visited, Italian the only alternative to the shameful volunteers of the group “Baobab Experience” in April 2017 set up an informal camp in support of the CONSULTATIONS IN TOR CERVARA migrant in transit in a square near INFORMAL SETTLEMENTS Tiburtina train station, nicknamed Nov. Dec. 2017 4 Piazzale Maslax . Tents, food, clothes, Upper respiratory legal and social assistance and tract infections healthcare, are all provided in the Pneumonia In Africa, you think this is a good camp, thanks to the collaboration of place to come, but once you are a network of organisations and the Asthma/COPD here, you would like to go back. solidarity of private citizens. According When you do not eat for four to volunteers' estimates, more than Hypertension Via di Vannina (36 consultations) days, it seems like you are going 70,000 people have been assisted Ex Penicillina (55 consultations) by Baobab Experience since activities Gastroenteric problems Baobab (85 consultations) crazy. I have been here for three began⁵. Currently, an average of years, waiting for my appeal between 80 and 100 migrants are Urogenital problems result. I slept by a train station staying in the square, with peaks in Eye problems when I arrived in Rome. Then the summer months of 150 people some fellow countrymen brought present every day. Amongst the most Dermatological problems prominent nationalities are Eritreans me here. We are all suffering in (>70%), Sudanese, Somalis and Iraqis. Musculoskeletal this place. I respect the Italian In the last two years, Baobab people because they saved me Experience has provided legal guidance Wounds from the sea. But now I would to migrants – mostly Eritreans – with Psychological/neurological like to say, "Hey, I'm here, do the right to relocation to another problems something". Sometimes, I think it EU Member State, compensating for Dental problems would be better to have drowned the lack of information received by rather than suffer in this way. people in the first reception centres Other immediately after arrival in Italy. I. I., Nigeria, Via di Vannina Access to the relocation programme 0% 10% 20% 30% – and to the asylum process more generally – was hampered by a series of administrative barriers established OUT OF SIGHT ROME 26 27 1. Cf. http://roma.repubblica.it/ cronaca/2017/06/13/news/ conditions of the unofficial settlements asylum seekers and protection under complete self-management Obstacles to accessing TuPassi, an online booking platform. raggi_al_prefetto_di_roma_limitare_ described above. holders. Together with Palazzo and without any form of intervention This procedure creates an obstacle presenza_migranti_-167976971/. About 400 people, including around Selam and Palazzo Naznet – the two by public institutions. In the last few medical care: the problem to access, because it requires a tax 2. 3,166 in the SPRAR network. 100 asylum seekers or protection settlements where refugees from months, the gas supply has been cut of residence code that many migrants do not 3. In January 2017, Rome municipality have. Certain tax offices illegitimately decided to allocate 500,000 euros for the holders (20 from the Horn of Africa, Eritrea and the rest of the Horn off and the electricity supply reduced. Asylum seekers and protection holders restructuring of FerrHotel, promising to 70 from sub-Saharan Africa), live in of Africa have historically settled, The Regional Decision no. 110 excluded from the government centres request that residence must be proved open it in June of the same year; opening the Santa Croce in Gerusalemme and whose populations have risen (15/03/2016) allows people “living in have difficulty getting the residence in order to issue a tax code, creating has been postponed to the first half of 2018. a spiral from which it is difficult to building, occupied in 2012. Amongst further after the evacuation of Piazza occupied building by December 2013” registration, a necessary condition 4. Maslax Moxamed, 19 years old, arrived in escape. Italy from Somalia in August 2016. He spent the residents there are Italians. Indipendenza in August 2017 – the to apply for public housing. However, for enrolment in the National Health District five has not yet implemented two months in Rome at the Baobab camp Activities within the building include, building is included in the list of sites the prevision was revoked by the Service. In the event that they live the TuPassi system, so access is easier. before reaching Belgium. On 31 January, he in addition to a legal assistance desk to be cleared as a priority under aforementioned Decision no. 50/2016. in occupied buildings, the Law no. landed at Fiumicino airport. The Belgian However, the registry office requires and Italian courses for migrants: Resolution no. 50/2016 of the former In 2017, the network of associations 80/2014 impedes electing residence in authorities had sent him back to Italy 11 a passport as a necessary document because of the Dublin Regulation. On 1 carpentry and screen printing Extraordinary Commissioner Tronca. known as “Romaccoglie” formulated such places. Living in Palazzo Sudan, in Via for the issuance of residence, a February, Maslax Moxamed was transferred workshops and theatre courses in a number of proposals to deal with As of last March, the municipal collaboration with schools in the Scorticabove, are a hundred Sudanese the critical issues related to the request that hinders asylum seekers to one of the Extraordinary Reception administration decided to issue Centres (CAS), in Pomezia, thirty kilometres neighbourhood. Currently ongoing refugees – all men – who came from reception system in the capital. Two and holders of international and south of Rome. On 15 March, he was by itself fictitious residence, with 13 is a temporary refuge project– from another informal settlement, the of the measures were the recovery humanitarian protection . found dead in a park near the residence Via Modesta Valente to be used for three to 12 months – exclusively Hotel Africa near Tiburtina station and enhancement of public housing In both Districts, before an where he was staying. Maslax Moxamed homeless people including migrants for asylum seekers and refugees about 10 years ago. Over the years, for social use, and the development appointment with the registry offices, had taken his life by hanging himself. present in unofficial settlements12. (currently 12 in all) to access specific the building has been included in of projects aimed at the effective a fact-finding interview is scheduled 5. Cf. https://baobabexperience.org/chisiamo/. From the information gathered by social integration pathways, such as various programmes financed by autonomy of refugees, through the with social workers to verify that the 6. Activity report of April-October 2017, "Rete the responsible offices of Districts legale per i migranti in transito" (A Buon vocational training courses. public entities and managed by private search for accessible rents and shared place of actual residence of those four and five (those with the highest Diritto, Baobab Experience, CIR - Italian Of the 500 occupants of the Via cooperatives10. Once the programmes housing, via a strengthened role of requesting the fictitious residence is in concentration of unofficial settlements Council for Refugees, Radicali Roma). delle Provincie building (occupied and funding were exhausted, the guidance and coordination by local the territory of the districts. Available at https://www.abuondiritto. since 2012), just under 100 are refugees remained in the building authorities. for asylum seekers and refugees), Finally, for the residence registration, it it/images/Rapporti/Report_attivit_ it is clear that the application of is necessary to show a valid residency Rete_legale_migrant_transito.pdf this resolution remains broadly permit. Recently, Rome’s Police 7. Cf. previous footnote. discretionary and not homogeneous. required proof of residence for the 8. In agreement with the Local Health The main differences concern not renewal of a residency permit, which Authority of Rome2 and the INMP – When we arrived, we saw one of the residents walking around the building only the timing for the issuance of (National Institute Promoting Migrants’ generates a situation in which the Health and Countering Poverty Disease). with his arms flailing about uncontrollably, tearing his clothes off. He said the residence, but also the methods migrants bounce between the Town 9. Drafted based on data provided he was frightened by the presence of a snake inside his chest and was of access and the list of documents Hall and the Police Headquarters by Action – Diritti in Movimento, looking for an object to kill it. He even tried to strangle himself. We sat him requested. without being able to obtain either of Blocchi Precari Metropolitani, down and called an ambulance. In District four access occurs via the two documents. Coordinamento di Lotta per la Casa. 10. Latterly, the Casa della Solidarietà MSF field coordinator Consortium connected to the Arciconfraternita del Santissimo Sacramento e di San Trifone, involved in the investigation of the Mafia Capitale. FICTITIOUS RESIDENCE REGISTRATION 11. Promoted by the CGIL (Italian General Confederation of Labour) of Rome Rome and Lazio and other associations. 12. Deliberation of the Capitoline Council RESIDENCE REGISTRATION OFFICE: no. 6691/17 of 03/03/2017. In the past, tax code requested fictitious residence was issued by some private humanitarian organizations: Caritas Roma, Comunità di Sant’Egidio, Esercito della Salvezza, Focus-Casa dei diritti sociali, Centro Astalli. Cf. circular in possession not in possession no. 19120 of 1994 and no. 54478 of 1995. SOCIAL ASSISTANTS: TAX OFFICE: 13. Travel documents are accepted, but the domicile requested residence requested holders of subsidiary or humanitarian protection do not always possess them, having to request them from their consular offices in Italy. domicile in different domicile in same urban area urban area RESIDENCE REGISTRATION OFFICE: procedure starts again residency permit requested

in possession not in possession RESIDENCE POLICE HEADQUARTERS: REGISTRATION OFFICE: residence requested residence released FUORI CAMPO 29

One brother of mine died in prison in 1996. I run away and arrived in Italy in 2007 together with another brother. I am a refugee. I have been given accommodation in several reception centers, in Rome, in Lecce province, and now I am living here. It is not easy for us. My brother is not young anymore, and has some eye problems, but he is a good musician: he is self-taught. C., Turchia, Via S. Croce in Gerusalemme, Rome OUT OF SIGHT PUGLIA 30 31 5. The facility can provide accommodation to 25 people. The Municipality decided to reinforce MSF operated within the Ex Socrate 6. At least one case of a person PUGLIA its programme of intervention to fight building, with the involvement of returning to the Ferrhotel has 8 against serious adult marginalisation , volunteers from the local Bari group. already been documented. With the closing of the tent city, The Gran Ghetto of Rignano Garganico showers, kitchens, infirmary, offices) focusing above all on low-threshold The general objective of the programme 7. This guarantees urgent interventions for I found myself on the street for was emptied in March 2017, but by and tensile structures for the soup reception services destined – in all areas of social emergency (family, 4 was to promote access to local months, until the day of the August of the same year the number kitchen . The provision of places is addition to Italians – for foreigners minors, the elderly, homeless, migrants, of people had risen to 6001, and in completely inadequate, especially in public healthcare services for the female victims of violence, etc.). The accident, when I was on my holding a residency permit, and service is available 24 hours a day. September the numbers doubled again. Foggia. Moreover, the logic of the ‘open residents, through information and bicycle and was hit by a car, in characterised by: 8. Cf. Municipality resolution no. 747 Hundreds of caravans have replaced and close’ big scale container camps a limited duration of stay; guidance activities and direct support an underpass in the city. I was • of 17.11.2017. In addition to the Casa the camp made of scrap material, and does not seem to be functional to the • the presence of a managing body, to access the administrative offices delle Culture, the municipal reception the sanitary conditions have worsened objective of the social inclusion that system currently includes Andromeda hospitalised, with damage to the with provision for possible and and healthcare facilities, particularly spine. When they discharged me, in comparison to the old ghetto, where could instead be achieved through limited forms of self-management; night reception centre (low threshold at least there was water each day, forms of widespread reception, i.e. for vulnerable people. Some of the intervention, 40 places); Sole e Luna I was back on the street. Now I • limited resources, to be used above social housing for adults in difficulty transported by tanker trucks. residents received specific training on am in a centre run by the City. ordinary houses; morover, it does not all for primary needs and not for (second reception, 10 places); five Most of the roughly 2,000 inhabitants take into account the presence of an 9 laws and administrative procedures to Community houses, residential and But still just for a limited time. On social inclusion . of the ghetto spilled out onto the ever-increasing number of migrants in Amongst the homeless people, there access NHS territorial services. semi-residential; (with municipal funds) Red Cross night reception centre (82 the positive side, my request for informal settlement in Borgo the territory, including many refugees, is a significant number of applicants Eleven people were specifically Mezzanone (along the old airport places). The number of places has asylum has been re-examined and for the entire duration of the year. and holders of international protection, supported, including five women and doubled in the last year, also providing runway) close to the government The Region has not yet adopted the shelters for families. Cf. http://www. I now have a regular residency 2 vulnerable groups with specific one minor, coming mainly from Eritrea permit. first reception centre , with a general immigration plan for the three-year needs that are incompatible with lavoro.gov.it/temi-e-priorita/poverta- deterioration of humanitarian 2016-2018 period. (seven) and Ethiopia (two). Support ed-esclusione-sociale/focus-on/ L., Gambia, Bari low-threshold structures such as was provided in particular for chronic Reddito-di-Inclusione-ReI/Documents/ conditions. Access to medical care In Bari the Ferrhotel has been occupied those described above. In particular, diseases (hypertension, asthma) Bottalico-Comune-Bari-4-12-2017.pdf. is practically non-existent. In Borgo for years by dozens of Somali refugees for refugees that had already been Mezzanone there is no emergency 9. The Municipality’s funds ranges – men and women – without water or in Italy for a number of years – such and in case of particularly complex from €12.50 per person per day for medical service. All migrants – even electricity, in the heart of the city. Some as those at the Ferrhotel, the Ex Set administrative procedures also due the semi-residential low-threshold those not holding a valid residency accepted a transfer to the new multi- and the Ex Socrate – the provision of to the chronic lack of linguistic and night-time reception service, to permit – should, under regional law, be €15.00 for residential services. When I saw the rail police officers, functional centre called Casa delle limited forms of self-management (and cultural mediators in local services. entitled to a family doctor. However, Culture5. In view of the maximum period thus of autonomy), limited services They needed help accessing primary I asked them to help my 5-year- they are unable to access medical of stay in this centre (three months, aimed at integration and limited time care to a lesser extent, as 90% old daughter and my wife who care due to the lack of information usually extended to six), there is a high of permanence do not facilitate a were enrolled in the National Health was seven months pregnant. The about laws regulating access to care, risk that the refugees will return to the process of structural social inclusion 6 agents gave us hot chocolate and language barriers and difficulties in Ferrhotel again, if not to the streets . and risks to result in a ceaseless and Service and given their own general called social services. They took us travelling (a lack of means of transport, On 20 April 2016 refugees staying in the useless passage between one reception practitioner, entirely justified given the no money). The only way to access first to a centre for the homeless, tents of the Ex Set were transferred to structure to another one. extensive stay in Italy of most of the healthcare is through the emergency a low-threshold reception centre called From September 2016 to June 2017, residents. then to another with more than department at the nearest hospital, Villa ATA. The transfer involved 55 a thousand people [the first which is more than ten kilometres away. people, compared to almost 200 in the reception centre in Bari-Palese]. In 2017, the Puglia Region allocated six tent city at the time of its closure. All I thought that, as refugees, and million euros to set up three camps for the others were dispersed throughout given my wife's condition and seasonal workers, one in the province the territory. of Lecce (Nardo, 300 places)3 and In the first half of 2017, the Municipality with such a small child, we would two in the Capitanata (Apricena, 400 of Bari recorded 500 homeless people, have had the right to a different places, Cerignola 400 places). The 52% of whom were migrants. Of the arrangement. camps, to be opened during periods 1,610 requests for help received by the H., Pakistan, Bari of seasonal agricultural work only, Emergency Social Intervention7 office are made up of containers of various in the first half of 2017, 66% concerned types (sleeping quarters, bathrooms, migrants.

ORIENTATION OF RESIDENT POPULATION TO TERRITORIAL SERVICES BY MSF 1. Source: Progetto Presidio, Sept. 2016 - Jun. 2017 by Caritas Italiana. 2. 4,000 in summer, according to Secondary healthcare consultations estimates by the CGIL of Foggia. GPs 3. The camp was opened – late – in August 2017 and closed the following month. Hospital (Emergency Dpt. excluded) 4. Cf. the deliberation of the Regional Council no. 906 of 7 June 2017 and no. Emergency Dpt. 1951 of 29 November 2017. In the absence NHS administrative offices of aqueducts and sewage collectors, the camps will be serviced by tanker Woman clinic trucks and/or accumulation tanks. Other 0 2 4 6 8 10 12 14 16 18 20 OUT OF SIGHT CIVIL SOCIETY AND CRIMINALISATION OF SOLIDARITY 32 33 1. EU Council Directive 2002/90/CE, implemented with the Legislative Decree no. 286 of 25 July 1998. CIVIL SOCIETY AND CRIMINALISATION OF SOLIDARITY 2. Legislative Decree no. 286/1998, Article 12. 3. European Parliament, Fit for Purpose? In recent years, civil society of interpretation in the hands of EU rejecting the request for a conviction of The Facilitation Directive and the organisations, volunteers and Member States in the implementation eight months in prison, sentenced the criminalisation of humanitarian activists have mobilised in solidarity of the clauses hinders humanitarian activist to a fine of 1,000 euros. assistance to irregular migrants (12/2015), cfr. http://www.europarl.europa.eu/ with migrants, offering assistance actors’ activities, as underlined in the In June 2016, seven volunteers from RegData/etudes/STUD/2016/536490/ and promoting an alternative European Parliament’s LIBE Commission the Ospiti in Arrivo association in Udine IPOL_STU(2016)536490_EN.pdf 3 management model entirely different report . The European Commission were investigated for assisting migrants 4. European Commission, Refit Evaluation to the emergency and security based itself underlined the collateral risk of sheltering in abandoned buildings. They of the EU legal framework against government’s approach. Ensuring “criminalising humanitarian assistance” were accused of unlawful occupation facilitation of unauthorized entry, transit access to essential needs, regardless in the application of the directive4. and aiding irregular migration for and residence: the Facilitator’s Package (22/03/2017), https://ec.europa.eu/home- of the legal status of the migrants in a Between France and Italy, activists profit. Using a broad interpretation of affairs/sites/homeaffairs/files/e-library/ vulnerable position, is the top priority were persecuted for helping migrants the financial clause, the prosecution appealed, the ban must be respected doing so for personal gain or with the documents/policies/irregular-migration- in this model. These organisations to cross the border or to assist those accused the association of making a until the end of the trial, as the appeal aim of subverting the established order. return/20170322_-_refit_evaluation_ have often faced political pressure stranded there5. One such person is profit through using the ‘cinque per of_the_eu_legal_framework_against_ process does not suspend the order. All this helps dissuade many from facilitation_of_unauthorised_entry_ and in some case, activists have been Felix Croft, a French activist arrested mille’ pre-tax donations chosen each The main victims were activists in the supporting migrant people, the ultimate transit_and_residence_en.pdf persecuted by the law. near Ventimiglia in July 2016 whilst year through the Italian tax return No-Border network, accused of having result being a progressive decrease in 5. Report on International In 2002, Brussels approved the driving with a Sudanese family in system for the contested activities. Two participated in demonstrations in the space for action by civil society, and Protection in Italy 2017. so-called Facilitation Directive – his car. Prosecutors requested that years of investigations concluded in support of migrants, or of organizing the weakening of its ability to respond 6. Law no. 46 of 13 April 2017. implemented in Italy with Article 12 he be sentenced to three years and February 2017 with a dismissal for all protests against forced transfers to to humanitarian needs. 1 7. Médicins Sans Frontiéres, Foreign of the Law on Immigration – which four months imprisonment. However, volunteers. hotspots in the regions of Southern Italy, citizens and threat to public health: punishes those who assist the transit or the Court of Imperia acquitted him In addition to judicial appeals, the in particular that of Taranto. In July an unjustified alarm with no scientific stay of undocumented migrants in the in April 2017, concluding that his use of administrative measures is 2017, the Regional Administrative Court basis. MSF also lodged a complaint to territory of a Member State. In Italy, the action amounts to a humanitarian act growing in many cities to discourage the UNAR (Anti racial discrimination of Liguria ruled such charges to be office), http://www.medicisenzafrontiere. facilitation of irregular immigration is and “does not constitute a crime”. In and, in some cases, move the most illegitimate and cancelled the measures, I have always wanted to work in it/notizie/blog/cittadini-stranieri-e- punished with five years’ imprisonment France, many activists in Val Roja have active volunteers away. Even before in particular the compulsory expulsion rischi-la-salute-pubblica-un-allarme- 6 international cooperation. So, and a fine of 15,000 euros for each been subjected to similar processes. the Minniti-Orlando Law legitimised order for a duration of three years from ingiustificato-senza-alcuna migrant transported2. The European Amongst them is the Italian Francesca the extensive use of this instrument, in Ventimiglia and other neighbouring when I heard about 130 people 8. Article 650 of the Penal Code: “Anyone Directive contains a humanitarian Peirotti, tried by the Court of Nice in Como and Ventimiglia some activists municipalities. The Como activists are on the streets in my city in 2014, who fails to comply with a provision and financial clause, to protect those November 2016 for “favouring the illegal were forcefully expelled from the legally given by the Authority for reasons still awaiting for the final decision on I thought it was absurd not to of justice or public security, or of public who help undocumented migrants for entry of eight migrants onto French cities. This provision has a strong their cases. respond, to pretend that nothing security or hygiene, is punished if the humanitarian reasons rather than for territory”. Her story came to an end impact on the personal life of those to The Minniti-Orlando Law strengthens was happening. Many of us fact does not constitute a more serious profit. The existence of a wide margin in May 2017: the judges in Nice, whilst whom it is applied: although it can be the power of mayors to ensure urban offense, with arrest for up to three helped out of good nature – we months or with the fine up to €206”. safety and decorum, ultimately were very naïve. That is why they legitimising a practice already in 9. The report intentionally does not mention wanted to hit us. Simply helping, the events of summer 2017 related to place. In the summer 2015, the mayor SAR activities in the Mediterranean Sea of Alassio prohibited entry into his as individuals, was bothersome. and the controversy over some NGOs’ municipality for non-EU citizens without They wanted to intimidate us, activities – among them MSF. While fitting a medical certificate7. so that we would give up. At into the category of “criminalisation of solidarity”, those events do not relate to In September 2015 the mayor of Padua the beginning, there was no the population of the informal settlements, denied migrants access to public parks, great impact on the association. and thus are not covered in this report. while in November 2016 the mayor of Indeed, there was strong Trieste prohibited sleeping or camping public support, with signatures out on the streets. In March 2017, three French activists were reported for collected in support of what we violating the orders of the mayor of were doing. But there have been Ventimiglia, which had prohibited the consequences in the long run. distribution of food to migrants in the Our names were published in the city8. The order was withdrawn in April, newspapers, and we were talked following numerous protests. about as being people who make Whatever form it takes – be it money from migrants. It was as an accusation of aiding irregular immigration, or damage to urban if all our efforts were gradually decorum and security, we are failing, little by little. An erosion. witnessing the birth of the ’crime of I was convinced that I was living solidarity’9. Besides the individual in a system that still protected consequences for the volunteers and you. Instead, it was an icy activists involved, the criminalisation shower. In short, we have been of civil society places humanitarian treated like criminals. I do not action in a bad light and delegitimises it. Those who act to ensure the rights, want to stay in a country like this and satisfy the primary humanitarian anymore. It is not worth it. needs of migrants, are suspected of Volunteer, Ospiti in Arrivo, Udine OUT OF SIGHT CONCLUSIONS AND RECOMMENDATIONS 34 35 1. The same approach is at the basis of the Ministry of Labour and Social Policies document Guidelines for the fight against CONCLUSIONS AND RECOMMENDATIONS serious adult marginalisation in Italy. 2. Considering rescue operations on land borders (for example, in high mountain crossings) as being similar in nature to The migrants and refugees living in unofficial settlements – on the borders, in open spaces, in occupied buildings in the search and rescue operations at sea. cities and in ghettos in rural areas – are men, women and children in vulnerable circumstances. Regardless of their legal 3. On the other hand, MSF discourages status, they should all be guaranteed access to basic needs and medical care throughout the period of their stay in Italy. private humanitarian organizations from The relevant institutions have a duty to ensure this1. implementing health programs addressed to migrants and refugees parallel or alternative to those offered by NHS to Italian citizens. Rather, they should MSF calls on the responsible authorities to: focus their resources and strategies In relation to access to medical care, MSF calls on the in terms of advocacy, in urging health 1. Strengthen humanitarian months after obtaining protection. institutions to fulfil their mandate. assistance to the so-called competent authorities to: 5. Provide economic, work and “transient migrants” at the border 8. Set up monitoring of unofficial 1. Ensure the full and uniform 5. Strengthen services that are areas and ensure full compliance housing support programmes for settlements – in particular by accessible under the STP, with the with legal options already existing refugees leaving the government municipal social services – application across Italy of the option of immediately assigning for those crossing borders centres. These programmes should with the minimum objective of Agreement between Government, (such as family reunification, support the refugees until their identifying and taking care of the Regions and Autonomous Provinces the code at any potential direct relocation, implementation of the stable autonomy. most vulnerable residents. Social of Trento and Bolzano containing access point for migrants without services intervention must not be “Indications for the correct a legal residency permit (such as humanitarian clause included in 6. Avoid dismantling unofficial limited to crisis phases (such as application of the legislation dedicated OPD, women clinics, the Dublin Regulation etc.). People settlements – such as those in forced evictions). for health assistance to foreign mental health centres and crossing borders irregularly must occupied buildings – by means of populations” (20 December 2012). addictions centres), in order to not be subjected to violence, forced evictions when alternative 9. Ensure the full application of the such as those documented by facilitate immediate access to care. housing solutions are absent. humanitarian clause that explicitly 2. Eliminate bureaucratic and MSF in Ventimiglia, under any Alternative solutions should be excludes relief activities and 6. Guarantee a paediatrician to all circumstances. administrative barriers that hinder for all people involved: as for humanitarian assistance from the the registration to National Health underage migrants, regardless of 2. Reform the governmental protecting vulnerable people, crime of aiding and abetting the Service, forcing the improper their legal status. reception system for asylum families should always be kept entry, transit and permanence of use of the Temporarily Present 7. Provide exemption from the co- seekers and refugees – including together. Wherever possible and undocumented immigrants. The Foreigner (STP) code. Specifically, pay system for medicines and unaccompanied minors, getting in the absence of other solutions, interpretation of this clause must provide registration procedures 2 healthcare services for applicants through the extraordinary use the same sites as the current also include the rescue of people , for asylum seekers and refugees reception centres (CAS), making unofficial settlements, removing as well as helping them to access and holders of international that are not subject to any formal protection without employment. the local authorities responsible any administrative irregularities essential needs (shelter, food, residence requirements and for managing the ordinary and proceeding with the necessary water) and medical care. exclusively related to the place of 8. Promote access to the National reception facilities within the renovation works even involving 10. Reform the L.48/2017 provisions, actual residence, declared through Health Service for migrants in framework of the general welfare residents to restore buildings in order to prevent the increase self-certification. Registration transit to other EU countries (such system provided to the resident themselves, favouring an 10. Recruit on a permanent bases in municipal power for the sake must be guaranteed regardless as in the border areas), under the population on the base of quotas approach that aims to support the linguistic and cultural mediators of urban safety and decorum, of the nature of such a place (for STP regime if they do not have a of asylum seekers and refugees protection holder until they can at the health services with greater can compromise the access to example, occupied buildings), even residency permit, with priority decided at national and regional be independent, through relevant access by migrants and refugees, primary needs and medical care when residence is temporary, as in for primary healthcare, women's with particular reference to primary level. forms of self-management. The for vulnerable people and the the case of settlements linked to and children's health and mental health care services and those removal of unofficial settlements 3. Under the regulation in force, fulfilment of the mandatory duty seasonal agricultural work. health. Introduce treatment and with direct access without pre- cannot justify the use of violence ensure that migrants are entered of social solidarity as expressed in follow-up protocols for second- booking or referrals (woman clinics, under any circumstances. into the reception system as soon Article 2 of the Italian Constitution. 3. Eliminate the provision of fixed level services that take into mental health centres, addictions as they declare that they wish 7. In planning and implementing medical personnel in the account the limited time spent centres and hospital emergency to seek asylum, not delaying it housing solutions for seasonal extraordinary reception centres in the territory by the transient departments). until the request is formalised by agricultural workers – without – firstly the smaller ones – migrants. completing the C3 Form. prejudicing law provisions requiring guaranteeing access to the 11. In cases where specific services National Health Service, according 9. Set up outreach programmes run addressed to migrants and 4. Extend to all asylum seekers employers to provide housing for to law provisions. by local health authorities in or refugees are delegated to private living in institutional reception contracted workers – envisage nearby unofficial settlements, in humanitarian organisations, local centres for more than two months options that favour models of 4. Eliminate the improper use of the order to direct residents towards health authorities must continue – regardless of the type of centre widespread reception, facilitating STP regime for asylum seekers, local services, identify and take in to have a programming and co- – the same measures set out in the access to available ordinary particularly after the formalisation charge of most vulnerable cases, ordination role: humanitarian SPRAR network relating to social housing, rather than providing of the request for international notably minors, pregnant women, organizations should have a role inclusion, including the possibility accommodation in large camps protection (completion of the C3 people affected by physical or in stimulating, innovating and of staying in centres six more with high concentrations of people. Form). Promote enrolment into mental disturbs, victims of torture supporting the National Health the National Health Service, as or other physical or psychological Service; they should not substitute required by the law. maltreatments. it3. OUT OF SIGHT LIST OF INFORMAL SETTLEMENTS 36 37 Bolzano

1 Pordenone LIST OF INFORMAL SETTLEMENTS Como Udine

Milano Gorizia

Trieste Torino REGION MUNICIPALITY NAME TYPOLOGY MINIMUM NUM. PRESENCE MAXIMUM NUM. PRESENCE WOMEN MINORS (<5 YRS. AGE) WATER ELECTRICITY Bolzano Various sites Outdoor 150 200 Yes No No No Calabria Cosenza - Via Savoia Buildings 50 60 Yes Yes Yes Yes Calabria Cosenza - Various sites Outdoor 30 50 No No No No Rimini Calabria Crotone - Strada 106, cavalcavia Outdoor 100 150 No No No No Calabria Rosarno (RC) Container 150 200 Yes Yes Yes Yes Ventimiglia Calabria S. Ferdinando (RC) - Old tent settlement Tents 200 400 Yes Yes Yes No Campania Castel Volturno (CE) Buildings 50 70 No No No No Campania Varcaturo (NA) Buildings 60 80 No No Yes Yes Firenze Emilia Romagna Rimini - Casa Andrea Gallo Buildings 30 40 Yes No Yes Yes San Marco in Lamis Friuli Venezia Giulia Gorizia - Tunnel Outdoor 100 150 No No No No Foggia Friuli Venezia Giulia Pordenone - Various sites Outdoor 50 100 No No No No umero massimo presenti: San Severo Friuli Venezia Giulia Trieste - Silos Outdoor 20 50 No No No No 100 Cerignola Friuli Venezia Giulia Udine - Various sites Outdoor 20 70 No No No No Roma Lazio Roma - Baobab experience Tents 50 150 Yes Yes No No 100 - 00 Bari 00 - 1.000 Lazio Roma - Ex La Stampa Buildings 50 80 Yes Yes Yes Yes Borgo Lazio Roma - Hotel 4 Stelle Buildings 150 200 Yes Yes Yes Yes 1.000 Castel Volturno Mezzanone Lazio Roma - Via S. Croce in Gerusalemme Buildings 80 100 Yes Yes Yes Yes Lazio Roma - Viale delle Province Buildings 80 100 Yes Yes Yes Yes Outdoor Lazio Roma - Via di Vannina Buildings 100 150 Yes No No No Varcaturo Lazio Roma - Various sites Tor Cervara Buildings 350 500 Yes Si No No Shacs Cosenza Crotone Lazio Roma - Stazione Termini Outdoor 50 100 No No No No Tents Lazio Roma - Via Cavaglieri (Palazzo Selam) Buildings 1000 1200 Yes Yes Yes Yes Container S. Ferdinando (RC) Lazio Roma - Via Collatina (Palazzo Natznet) Buildings 600 800 Yes Yes Yes Yes Rosarno (RC) Lazio Roma - Via Scorticabove Buildings 60 100 No No Yes Yes armhouses Palermo Liguria Ventimiglia Outdoor 100 200 Yes Yes No No uildings Lombardia Como - Autosilo Val Mulini Outdoor 50 100 No No No No Lombardia Como - Ex Dogana Buildings 20 50 No No No No lectricity Trapani Messina Lombardia Milano - Various sites Outdoor 100 200 No No No No ater Catania Piemonte Torino - Corso Chieri Buildings 40 80 No No Yes Yes Piemonte Torino - Corso Ciriè Buildings 20 40 Yes Yes Yes Yes Caltanissetta Piemonte Torino - Ex Moi Buildings 1100 1300 Yes Yes Yes Yes Piemonte Torino - Via Bologna Buildings 50 80 No No Yes Yes Piemonte Torino - Via Madonna delle Salette Buildings 80 100 No No Yes Yes Tents Puglia Bari - Ex Socrate Buildings 60 80 Yes No Yes Yes 9% Lazio Puglia Bari - Ferrhotel Buildings 50 70 Yes No No No Puglia Outdoor Puglia Borgo Mezzanone (FG) - Runway Shacks 500 1000 Yes No Yes Si 28% Piemonte Buildings Sicilia Puglia Cerignola (FG) Farmhouses 100 200 Yes Yes No No 53% Calabria Puglia Foggia - Ex Daunialat Buildings 50 100 No No No No Site FVG Puglia San Marco in Lamis (FG) Farmhouses 100 150 No No No No typology Lombardia Puglia San Severo (FG) - Gran Ghetto Shacks 200 500 Yes No No No Bolzano Sicilia Caltanissetta - Pian Del Lago Tents 20 50 No No No No Shacks Liguria 4% Campania Sicilia Catania - Various sites Outdoor 50 100 Yes Yes No No Toscana Sicilia Messina - Various sites Outdoor 20 50 No No No No Containers Farmhouses Emilia Romagna Sicilia Palermo - Missione di Speranza e Carità (Women/Minors) Buildings 150 200 Yes Yes Yes Yes 2% 4% 0,0% 5,0% 10,0% 15,0% 20,0% 25,0% 30,0% 35,0% Sicilia Palermo - Missione di Speranza e Carità (Men) Buildings 600 1000 No No Yes Yes Sicilia Trapani - Campobello di Mazara Tents 50 200 Yes No Yes Yes Toscana Firenze - Via Baracca Buildings 40 60 No No Yes Yes 53% Sites with adult men only

1. Last updated: 30 September 2017. The criteria for the inclusion of settlements in this research were: i) prevalent or relevant population, consisting of refugees in broad sense Sites with water/electricity (holders of forms of international and/or humanitarian protection, migrants at all stages of the asylum procedure, from those prior to the formalization of the request, to 45% 13% Adult men and women those following the notification of the outcome of the interview with the Territorial Commissions, to the various stages of the judicial appeal against the denial of protection); ii) exclusion from the government reception system for asylum seekers and refugees, in all the different types of centers; iii) not exclusively seasonal nature of the settlement; Sites without water/electricity iv) more or less marked forms of self-management by the resident population. Regarding the settlements in areas characterized by agricultural seasonal work, the number 55% 34% Adults with minors of inhabitants is relative to the population present permanently throughout the year, and not to the peaks recorded in conjunction with the same agricultural work. More then 80% of the sites were personally visited by MSF staff. 0 20% 40% 60% 80% 100% 0 20% 40% 60% 80% 100% OUT OF SIGHT 38 39 MSF IN INFORMAL SETTLEMENTS MÉDECINS SANS FRONTIÈRES IN ITALY

Since 2002, MSF has been present facility where patients can find the torture survivors and victims of cruel Turin Como Bolzano across Italy in particularly sensitive support they need before they are able and degrading treatment. Patients are Occupied Ex MOI, refugees Migrants in transit Migrants in transit and excluded places, including the landing points in to return to their place of residence. assisted through a multidisciplinary ¡¡From Sep. 2016 ¡¡End 2016 – Sep. 2017 from reception Lampedusa, amongst seasonal workers In Trapani, MSF provides psychosocial approach involving medical and ¡¡Orientation to territorial health ¡¡Psychological First Aid (PFA) ¡¡From 2017 in southern Italy, on the northern support to asylum seekers hosted in the psychological care, physiotherapy, services ¡¡Distribution of hygiene kits, ¡¡Distribution of hygiene kits, border and in reception centres for province's CAS. A group of psychologists and social and legal assistance. ¡¡Agreement with NHS local branch blankets, sleeping bags, even blankets, sleeping bags, even migrants in various regions. Since 2016, and cultural mediators visit more The activities are carried out in Città di Torino through local volunteers through local volunteers MSF has also run activities in some than 15 centres each week to provide collaboration with the Medici Contro la informal settlements, giving residents psychological support through group Tortura (Doctors Against Torture) and information about local health services, and individual sessions. A transcultural ASGI. distributing basic commodities and psychotherapeutic clinic was opened Also in Rome, a mobile MSF team Udine, Gorizia, Pordenone providing psychological first aid. in July 2016 in collaboration with the provides medical and psychological Asylum seekers Currently, MSF manages a post-acute local NHS mental health department, to assistance to migrants, refugees ¡¡From 2017 care centre in Catania specialising tackle the most serious mental health and asylum seekers in unofficial ¡¡Distribution of hygiene kits, in refugees and asylum seekers cases. In addition, an MSF psychosocial settlements where access to medical blankets, sleeping bags, even discharged from hospital facilities team visits the Sicilian ports to provide care is not guaranteed. Since 2015, MSF through local volunteers in Sicily, who are failing to access psychological first aid to survivors of has undertaken SAR activities in the ¡¡Heated tent installation adequate medical care during their shipwrecks or tragic experiences during Mediterranean Sea. Nowadays, MSF post-acute or convalescence phase. sea voyages. provides medical care on board the The MSF centre aims to fill a gap by In April 2016, MSF opened a ship Aquarius, in cooperation with SOS VENETO providing an intermediate medical rehabilitation centre in Rome for Mediterranèe. LOMBARDIA Rome Migrants excluded from reception PIEMONTE ¡¡From Nov. 2017 ¡¡Primary healthcare (mobile clinic) ¡¡Psychological First Aid

TOSCANA Bari Ventimiglia Occupied Ex Socrate, Migrants in transit refugees ¡¡End 2016 – Sep. 2017 ¡¡Sep. 2016 – Jun. 2017 ¡¡Psychological First Aid (PFA) ¡¡Orientation to territorial health services ¡¡Women's health ABBRUZZO ¡¡Distribution of hygiene kits, blankets, sleeping bags, even through local volunteers LAZIO

CAMPANIA

CALABRIA

Campobello di Mazara Seasonal agricultural workers ¡¡From Oct. 2017 SICILIA ¡¡Health promotion ¡¡Distribution of hygiene kits OUT OF SIGHT FUORI CAMPO 40 41

GLOSSARY

Asylum seekers – People who are outside the borders of Refugees (holders of refugee status) – According to Thanks for the support in the phases of realization of the their home country and who present a request for refugee Article 1 of the Geneva Convention, those who, fearing research to: status in another State. The applicant remains such until the persecution on the grounds of race, religion, nationality, > Action Diritti in Movimento, Roma decision on the submitted application is made. belonging to a particular social group or for their political > ADIF – Associazione Diritti e Frontiere opinions, are outside the country of which they are citizens > Alter Ego, Roma C3 Form – A form filled out at Police station through which and cannot, or do not want to because of this fear, avail > Antenne Migranti the request for international protection is formalised, and themselves of the protection of that country. In this report, > Architetti Senza Frontiere Italia which is valid as a first temporary residency permit. the term is used in a broader sense, to include the holders of > ASGI – Associazione per gli Studi Giuridici sull'Immigrazione CAS (Centri di Accoglienza Straordinaria, or Extraordinary all forms of international and humanitarian protection. > Baobab Experience, Roma Reception Centres) – Established by Legislative Decree no. > Blocchi precari metropolitani, Roma STP (Straniero Temporaneamente Presente, or 142/2015. These are set up by the Prefectures in agreement > Borderline Sicilia Temporarily Present Foreigner) code – Introduced in 1998. with various management bodies. The level of guaranteed > Cambio Passo, Milano This allows foreigners present within the territory who are services is a bare minimum, without the provision of specific > Campagna “LasciateCIEntrare” not in compliance with the rules on staying (which is the programmes aimed at social inclusion. > Campagna Welcome Taranto case, for example, of migrants in transit to another EU state) > Caritas Borgo Mezzanone (FG) Dublin Regulation (EU Regulation no. 604/2013, the so- to receive urgent, essential and continuous healthcare, from > Caritas Gorizia called ‘Dublin III’) – Establishes the criteria and mechanisms the National Health Service. > Collettivo Mamadou, Bolzano for determining the State responsible for assessing an SPRAR (Sistema di Protezione per Richiedenti Asilo e > Coordinamento Cittadino Lotta per la Casa, Roma asylum application presented in one of the Member States Rifugiati, or Protection System for Asylum Seekers and > Comitato di solidarietà rifugiati e migranti, Torino by a third-country national or a stateless person. The basic Refugees) – A public system of second reception for holders > Comitato per la casa ed i diritti umani di Via Fanelli, Bari principle is that the competent State is that in which the and applicants of international and humanitarian protection. > Como Senza Frontiere migrant first arrives/enters. This consists of projects set up throughout the country, led > Co.S.Mi. (Comitato Solidarietà Migranti), Reggio Calabria ENA – (“North Africa Emergency” programme) – by local authorities that voluntarily access the National Fund > CSA Ex Canapificio, Caserta Extraordinary reception centres, managed by the Civil for policies and services of asylum managed by the Ministry > CSC Nuvola Rossa, Reggio Calabria Protection and activated by the DPCM 12/2/2011 in order to of the Interior. > Emergency – Progetti di Castel Volturno e Polistena process the arrival of people coming from Northern Africa. > Ex OPG Occupato - Je so' pazzo, Napoli Vulnerable Persons – In the context of international The programme was closed in January 2013. > Fondazione Alexander Langer Stiftung, Bolzano protection, such people are to be understood as minors, > Fondazione ARCA, Milano unaccompanied minors, the elderly, pregnant women, First reception centres – Defined in Legislative Decree no. > Gruppo Lavoro Rifugiati, Bari single parents with underage children, victims of trafficking, 142/2015. The process of identification should be completed, > ICS – Consorzio Italiano di Solidarietà Ufficio Rifugiati, Trieste people suffering from serious physical illnesses or mental and the asylum procedure started, within these centres. > Insieme con voi, Gorizia disorders, people who have suffered torture, rape or other In reality, due to the lack of places in secondary reception > Intersos, Roma severe forms of psychological, physical or sexual violence, facilities, asylum seekers may end up staying for the entire > La Kasbah, Cosenza and victims of genital mutilation. asylum procedure. > Làbas Occupato, Bologna Hotspots – Reception facilities located in the entry > Medici per i diritti umani (MEDU) ‘hotspots’ for migrants to ensure their identification and > Melting Pot Europa, Padova photographic registration. These overlap with the pre- > Movimento di Lotta per la Casa, Firenze existing CPSA (Centri di Primo Soccorso e Assistenza, or > Naga, Milano First Aid and Assistance Centres), established by Legislative > No Border, Rimini Decree no. 142/2015. Law enforcement officers proceed with > Ospiti in arrivo, Udine the identification and registration of asylum seekers within > Oxfam the first 72 hours of arrival. Currently, the active hotspots > Prendocasa, Cosenza are in Lampedusa, Pozzallo, Taranto and Trapani. > Progetto 20K > Razzismo Stop, Padova > Rumori sinistri, Rimini > SIMM – Società Italiana di Medicina delle Migrazioni > SOS Bozen, Bolzano > Tenda per la Pace e i Diritti, Gorizia > Ufficio Pastorale Migranti, Torino

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Médecins Sans Frontières (MSF) is the largest independent medical humanitarian organization in the world. Founded by doctors and journalists in 1971, MSF delivers emergency aid to people affected by armed conflict, epidemics, malnutrition, exclusion from healthcare, and natural disasters in almost 70 countries. MSF offers independent and impartial assistance to those who need it most. MSF also acts to denounce forgotten crises, combat the inadequacy and abuses in the aid system and publicly support a better quality of treatment and medical protocols. In 1999, MSF was awarded the Nobel Peace Prize. www.msf.it

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