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The lack of access to healthcare is one of the main issues that characterizes Ventimiglia as a border-city and the borderzone alike; this has taken a toll on the physical and mental health of people on the move residing in Ventimiglia. In a report, Doctors Without Borders noted that the recalling of traumatic events was widespread, leading to “the repetition of mental health issues including depression, a sense of abandonment, post-traumatic symptoms, apathy, symptoms of adjustment anxiety and, in certain cases, psychosomatic problems.”

Mental Health

According to the World Health Organization (WHO), mental health conditions are more prevalent in migrants than host populations because of the varied difficulties they face at different stages of the migration process. During their migration process, they are exposed to life-threatening conditions in the transit stage and can face difficulties assimilating during settlement. While these stressors increase the likelihood of developing mental health conditions, they also exacerbate pre-existing conditions.

Out of the 2,452 psychological consultations that they have done for migrants in Ventimiglia, Médecins Sans Frontières observed that one in five of their patients showed mental health disorders. An Ethiopian man who told us his story is one of the many people who experienced this trauma:

“I crossed to Europe by boat, a passage that was very, very hard. After arriving, I stayed in Italy for a few months during the COVID-19 pandemic in 2020 and have since moved to Ventimiglia. While my wife stayed in Libya, I was in a constant state of fear for her safety. After some time, my wife was also able to cross by boat. She, like me, was traumatized from this journey, which she has yet to recover from”.


While Camp Roya was still in operation, the workers noticed a spike in mental health issues of migrants as they entered the camp. While they may have experienced trauma during their travels, a large causing factor includes the processes they have to go through as they arrive in Italy. Constantly facing uncertainty perpetuates mental health symptoms such as depression, apathy, anxiety, and even psychosomatic problems. Many migrants re-experience the traumatic events that they hoped to escape from by suffering through humiliation, imprisonment, and physical violence.


This is heightened by the contrasts that are made between the dynamics within the camp and their lives before migrating. Having to rely on Camp Roya workers for all their needs has stripped these migrants of their sense of autonomy. The dependence migrants have on the camp workers has created a hierarchical relationship, an infantilization process (Altin and Minca). This is even displayed in some of the workers' words toward them. A study by Beneduce reveals that Camp Roya’s role as a “space of containment and control” contributes to the worsening of these migrants’ mental health.


Even within these camps, some migrants cannot assimilate and often feel disconnected from each other. These camps house migrants from various backgrounds, so language and cultural barriers can hinder communication. This barrier also prevents some migrants from properly expressing their needs and concerns to camp personnel. These barriers pertain to the larger issue experienced by migrants living in Ventimiglia. A large majority of these migrants come from Francophone countries and cannot speak Italian, making the integration process all the more difficult. These feelings are expressed in the following testimony from a Cameroonian man one of our volunteers encountered:
“The hardest part about living in Italy has been the language. I want to live in France, where I can speak the language and work. Some Italians say that we have not been integrating well, but how can I do that without speaking Italian?”


The aforementioned solidarity actor Maria Picarelli stressed that the language barrier adds a further level of difficulty to the already cumbersome process of dealing with Italian bureaucracy. She explains that people on the move are rarely provided with a comprehensive explanation around the steps to undertake in order to request asylum and that, if it was not for NGOs and their legal departments, they would have been left with no guidance at all. According to the numerous stories she has listened to, the most difficult part of a migrant’s journey starts when people settle: this is when they need to deal with complex and slow bureaucratic processes, with the lack of the state’s efforts to facilitate their integration and with the nightmares from their journey.


As the provision of mental health services continues to be limited and sometimes even non-existent, there is insufficient data to assess the current mental health of migrants living in Ventimiglia. Even if these care centers were available to them, there are still certain barriers that prevent them from being able to receive the proper care that they deserve. According to a study done by Medecins Sans Frontieres, migrants who lived in Camp Roya did not seek care for fear of being denounced and because of a lack of information. Those who lived in the Roya River Settlement faced a larger array of problems accessing health services such as long waiting lists, lack of cultural mediators, and long distances. Camp Roya is often not the first camp that migrants stay at.

On the 26th of March, one of our volunteers encountered a 16 year old who had lived in a camp in Lampedusa for a while:

Like most people on the move, he suffered a very violent experience while crossing to the other side of the Mediterranean Sea in an unstable and unsafe boat. As he tearfully told us, there were 44 of them who left Tunisia at night on that boat, hoping to go to Europe. However, the boat turned over at five o'clock in the morning and they were not rescued until the beginning of the next day by Tunisian fishermen. There were only 9 survivors,who were left floating, trying to keep their heads out of the water. 35 lives now lie at the bottom of the sea. 9 and 44, numbers that he kept repeating. Having experienced various traumas, the deprivation of basic rights in the Lampedusa camp had worsened his condition. The food was scarce, they had to sleep on the floor, and had no access to medical care or basic sanitary conditions. That's why he escaped, he said. And he was not the only one. With him there were four other young people who confirmed what he had said.


It is hence unsurprising that there remains a strong desire for migrants to escape these living conditions. However, while doing so, they lose their right to accessing reception services (after 3 days of leaving their camp, they may not re-enter it; of course, their right to claim asylum is preserved) and they might incur in situations with equally dire administrative and human conditions. When migrants are released from the Italian border police station in Menton, they are often in a distressed state. During our border permanence shifts, our volunteers have encountered migrants that were crying, stressed, or displaying signs of serious mental health conditions. Some practices of the border police directly contribute to worsening their mental state; practices such as splitting up of families, extended confinement in small spaces, screaming. This was observed by one of our volunteers on the 7th of March:

Outside of the Italian border police station, there was a woman in tears. When asked about what was wrong, she told us that her brother was still inside the police station and not being released. The police told her that they were checking his documents but she doesn’t understand whether something is wrong. They had arrived at 2pm the day before and spent the night at the PAF, then were brought to IPS at 7am that day, questioned and then she was released .


Last year on the 13th of November, another one of our volunteers encountered a man from Ghana who experienced a panic attack. He was sleep deprived, exhausted and delusional. He had had a bad experience with an NGO in Toscana, hence why he was determined to cross into France. The practices of the border police have clearly exacerbated pre-existing mental conditions that the migrants have. At every stage of the migration journey there seem to be factors that contribute to worsening one’s mental health.


On February 18, 2023, during the morning shift at the Italian border, individuals who had stayed overnight were released by the Italian police. Among them was an Algerian woman who displayed visible signs of distress, leading her approximately 8-year-old daughter to cry as well while embracing her. In contrast, the older daughter, around 13 years old, remained tearless but appeared distant and aware of the situation. The woman expressed her hunger, revealing that they had not eaten for two days. Although the Italian police usually provide food to overnight detainees, this particular family had arrived too late and no provisions were available.


It’s important to recognize how, throughout these stages, family remains an important source of support; the practice of separating family members can cause additional stress or trauma.

Sexual Health

On March 5, 2023, a volunteer reported:

A woman at the border approached me to ask me if the box of medicine I had in my hand was for morning-after pills. As the medicine was for headaches and nausea, I had to tell her this was not the case. She asked me to please write how to say it in Italian on a piece of paper. I was guessing it was for her to buy one in Ventimiglia. Another woman approached me to ask the same thing when I did this. From what I understood, men had sexually assaulted them the night before in Ventimiglia. Since the pills must be taken as soon as possible to be effective and the Red Cross van was not arriving (it never did), I asked an independent volunteer — who is a long-term volunteer at the border — to take them in his car to Ventimiglia and help them find the pills that they needed. He immediately agreed to take them. While the first woman agreed to go in the car, the second woman hesitantly decided not to.

Under the EU Charter of Fundamental Rights: IV Solidarity Article 35 - Health care “Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices. A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.” However, in practice, application to people on the move is harder. Sexual violence committed by migrants appears a lot in media and public discourse, but only little is little that committed on them. Italy has a public healthcare system (Sistema Sanitario Nazionale) that is quite inclusive of undocumented migrants. Based on Immigration Law 1998, undocumented migrants shall have access to urgent and essential care, including pregnancy and maternity care, childcare, etc. Even though healthcare workers can not report undocumented migrants to the police, barriers to access to healthcare exist.

A study conducted by the Monitoring System of Health Status and Healthcare of the Immigrant Population (MSHIP) published in 2022 shows that immigrant women seek less gynecological care than Italian women, as 12% of them had their first prenatal check later than in the 12th week, and about 3.8% of them had one or no ultrasound during their pregnancy. This indicates strong barriers to accessing reproductive health services. However, as this study concerned foreign residents in Italy, the statistics concerning undocumented migrants and asylum seekers might paint an even harsher picture, as additional data show that undocumented migrants accounted only for 0.4% of hospitalizations in 2010 and between 1998-2017, just about 0.2% of annual National Health Fund was allocated to providing care to UMs.


Compared to Italy, undocumented migrants seeking health treatment in France are in a more precarious situation, as undocumented migrants cannot benefit from health insurance there. Historically AME (Aide Médicale de l’Etat) provided undocumented migrants with health protection, but recently introduced conditions of residence and financial contributions make access more difficult.

The data from Mèdecins du Monde also show that this option is critically underused as only 10.2% of undocumented migrant patients in their health facilities have access to AME. This can make obtaining reproductive health — and other medical services — practically impossible for many undocumented migrants. Emergency contraception is widely available in France, as of January 1, 2023, as it is available in pharmacies, without medical prescription and without advance payment, for any minor or adult. Yet, undocumented migrants encounter a dead end here as a carte vitale, or AME card must be presented by an adult to obtain it. For minors, a simple declaration of honor is sufficient to justify age.

Similarly, with very limited access to health insurance and AME, getting an abortion becomes incredibly hard. Still, undocumented migrants may be able to obtain a morning-after pill without social coverage in sexual health centers like centers de planification or d’éducation familiale. The medical support accessible to undocumented migrants following sexual assault is insufficient, as is legal support, given in most situations, irregular migrants face a real risk of disclosing their irregular status and being removed as a consequence of reporting crime. European law tried to address the lack of safe reporting practices through temporary residence permits for victims of human trafficking (Directive 2004/81), in exceptional situations labor exploitation victims (Directive 2004/115/EC), and granting residence permits to domestic violence victims on dependent visas (Istanbul Convention), but comprehensive safe reporting mechanics are missing. In France in July 2010, the Law on Violence Against Women established a protection order (ordinance de protection) obliging the Prefecture to provide temporary resident cards to undocumented women migrants facing violence. Nevertheless, irregularities, delays, and discretionary demands for evidence were reported by CNDF. Under the circumstances, it is no wonder that undocumented women are reluctant to report a crime as it enhances their vulnerability to victimization, while perpetrators do not fear facing legal consequences because police are not on the side of their victims.