Eyewitness: Migrants suffer in Morocco
Xavier Caser, a doctor working with Medecins Sans Frontieres Spain, tells the BBC News website about his experience treating African migrants in Morocco trying to get into Europe through Spain's enclaves of Ceuta and Melilla.
"I worked in Morocco for a month and a half at a our clinic in Tangier, but most of my work was in a 4x4 vehicle, treating immigrants who live in the forest close to the border with Melilla.
They live in the middle of nature, in the wild, with no houses, no nothing. We carry all the medicines and medical supplies in the car with us.
They are very pleased when we arrive, because nobody else is looking after them. The only other people who visit are the police and the army. The immigrants aren't suspicious because MSF Spain has been working there for three years, so they know us.
The typical patient is a person who has tried to jump the fence into Melilla, and is wounded and maybe traumatised.
Open wound
For example, the last man I treated was 24 years old, from Mali (the majority of them come from Mali, Senegal and Cameroon, or Nigeria). This man had a very bad head wound, after a Moroccan soldier had hit him in the head.
It was an open wound, and when I arrived in the forest it was eight hours after he'd been injured, and he was bleeding badly. He lost consciousness, and was very traumatised.
I saw cases like this every day - every time I went to the forest, I would find four, five, six cases like this.
Another problem is the lack of hygienic conditions in the forest. There's no potable water, nowhere to go to the toilet - they go to the toilet in the middle of the forest, close to where they live.
They live with wild animals, they have no shelter - they make little shacks with plastic sheeting - it's filthy.
If you visited, you might think it was impossible to live like this, but they do it. It's also overcrowded - there are 400 to 500 people in a patch of about 400m sq in the forest.
Forest births
I've seen a lot of women give birth in the forest. About 10% of the immigrants are women, and around a quarter of these women are pregnant. (Another quarter have small babies.)
In a month and a half, I saw six deliveries in the middle of the forest with no medical help, apart from us, but often we arrived too late to help with the birth.
One delivery I saw, the woman had a disease called eclampsia, with hypertension and convulsions. I remember the woman was convulsing - it was very dangerous.
We took her to hospital, and this story has a happy ending. She recovered, and the baby was fine.
But it was lucky we arrived. The immigrants won't go to hospital because the police are around - they prefer to stay in the forest, hidden from the security services.
Occasionally we do take patients to hospital, and the staff there always take them in, because we only take the most serious cases. We've never been refused, but they do it reluctantly.
We have to supervise their treatment, because sometimes the hospital refuses to treat the patients in the same way as the Moroccan patients. I know this is a serious allegation.
Often they tell us that MSF has to pay for the medicines for the patients. It's a form of discrimination.
It's true that Moroccans have to pay, but I know that there are some cases when they will tell us we need to pay for medicines they give freely to Moroccan patients.
'Many die on the way'
It is difficult work, mainly because of the working hours. We often work for 24 hours - we have to be available at night, on Sunday mornings, whenever there is an emergency.
But for me personally, this work is very fulfilling. This last experience in Morocco has changed my mind about the immigrant problem.
Sometimes you need to see the problem from inside - from close up, to change your mind. I had a different opinion than I do now.
European governments have to do something.
The situation of these people is terrible - they have nothing. I don't know what the solution is, but the problem needs solving quickly because people are suffering.
And those who arrive at the border are only 10% of those who set out. Many die on the way."
"I worked in Morocco for a month and a half at a our clinic in Tangier, but most of my work was in a 4x4 vehicle, treating immigrants who live in the forest close to the border with Melilla.
They live in the middle of nature, in the wild, with no houses, no nothing. We carry all the medicines and medical supplies in the car with us.
They are very pleased when we arrive, because nobody else is looking after them. The only other people who visit are the police and the army. The immigrants aren't suspicious because MSF Spain has been working there for three years, so they know us.
The typical patient is a person who has tried to jump the fence into Melilla, and is wounded and maybe traumatised.
Open wound
For example, the last man I treated was 24 years old, from Mali (the majority of them come from Mali, Senegal and Cameroon, or Nigeria). This man had a very bad head wound, after a Moroccan soldier had hit him in the head.
It was an open wound, and when I arrived in the forest it was eight hours after he'd been injured, and he was bleeding badly. He lost consciousness, and was very traumatised.
I saw cases like this every day - every time I went to the forest, I would find four, five, six cases like this.
Another problem is the lack of hygienic conditions in the forest. There's no potable water, nowhere to go to the toilet - they go to the toilet in the middle of the forest, close to where they live.
They live with wild animals, they have no shelter - they make little shacks with plastic sheeting - it's filthy.
If you visited, you might think it was impossible to live like this, but they do it. It's also overcrowded - there are 400 to 500 people in a patch of about 400m sq in the forest.
Forest births
I've seen a lot of women give birth in the forest. About 10% of the immigrants are women, and around a quarter of these women are pregnant. (Another quarter have small babies.)
In a month and a half, I saw six deliveries in the middle of the forest with no medical help, apart from us, but often we arrived too late to help with the birth.
One delivery I saw, the woman had a disease called eclampsia, with hypertension and convulsions. I remember the woman was convulsing - it was very dangerous.
We took her to hospital, and this story has a happy ending. She recovered, and the baby was fine.
But it was lucky we arrived. The immigrants won't go to hospital because the police are around - they prefer to stay in the forest, hidden from the security services.
Occasionally we do take patients to hospital, and the staff there always take them in, because we only take the most serious cases. We've never been refused, but they do it reluctantly.
We have to supervise their treatment, because sometimes the hospital refuses to treat the patients in the same way as the Moroccan patients. I know this is a serious allegation.
Often they tell us that MSF has to pay for the medicines for the patients. It's a form of discrimination.
It's true that Moroccans have to pay, but I know that there are some cases when they will tell us we need to pay for medicines they give freely to Moroccan patients.
'Many die on the way'
It is difficult work, mainly because of the working hours. We often work for 24 hours - we have to be available at night, on Sunday mornings, whenever there is an emergency.
But for me personally, this work is very fulfilling. This last experience in Morocco has changed my mind about the immigrant problem.
Sometimes you need to see the problem from inside - from close up, to change your mind. I had a different opinion than I do now.
European governments have to do something.
The situation of these people is terrible - they have nothing. I don't know what the solution is, but the problem needs solving quickly because people are suffering.
And those who arrive at the border are only 10% of those who set out. Many die on the way."
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