Médecins Sans Frontières / Doctors Without Borders (MSF) is an international, independent medical humanitarian organisation. We provide medical and humanitarian assistance to people affected by conflict, epidemics, disasters, or excluded from healthcare. At times, MSF may speak out publicly to bring a forgotten crisis into view, or to denounce abuses, or challenge the diversion of assistance, or to call out policies that cause harm, restrict access to medical care or essential medicines.  Our teams are made up of tens of thousands of health professionals, logistic and administrative staff - bound together by our Charter.  Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality. We are a non-profit, self-governed, member-based organisation.

Médecins du Monde / Doctors of the World (DOTW) is an international and independent humanitarian organisation that aims to empower access to medical care to vulnerable and excluded populations. The organisation was established in 1979 and today operates or supports over 400 projects in over 70 counties. Since 1998 DOTW has been a registered charity in the UK. DOTW runs volunteer-led clinics with GPs, nurses, midwives and caseworkers that assists the most vulnerable members of the community –usually those with insecure immigration status - access to the healthcare they need. DOTW also run national advocacy programmes aimed at overcoming barriers to GP registration and access to secondary NHS care in hospitals.



MSF’s teams have been responding to humanitarian needs and severe physical and mental damage inflicted on people seeking safety caused by harsh migration policies focused on deterrence, externalisation and containment.  We have extensive experience of providing medical care to asylum seekers, refugees and other migrants in Greece, Italy, France, Belgium, the Balkans, Nauru Island, Libya and on our Search and Rescue (SAR) missions in the Central Mediterranean.

DOTW UK have vast experience of providing medical care to asylum seekers and refugees in the UK. We have run medical outreach programmes and consultations in asylum accommodation centres, hotels and hostels used as contingency accommodation and large containment sites, such as Napier. This has provided us with a good understanding of the complex medical needs of asylum seekers and the conditions and medical care they need to heal and rebuild their lives.

MSF and DOTW have recently started a project providing medical care to men seeking asylum held at RAF Wethersfield, Essex, UK.  The vast majority of these men arrived in UK after the Illegal Migration Bill gained royal assent.  It is likely their asylum applications will be deemed inadmissible and they are at high risk of being sent to Rwanda. 

MSF and DOTW oppose the Safety in Rwanda (Asylum and Immigration) Bill (‘the Bill’) in its entirety. The evidence in this submission focuses on the medical and humanitarian consequences of the Bill.

Based on MSF and DOTW’s experience, the organisations are inclined to address one of the questions raised by the Joint Committee on Human Rights:

     Does the Bill give rise to any other significant human rights concerns?


  1. Medical consequences: evidence of harms caused by outsourcing the asylum process and forced expulsions to third countries

MSF and DOTW are profoundly concerned about the UK government’s plans to fully externalise its asylum system and forcibly and permanently expel people seeking safety in the UK to Rwanda.

  1. Access to medical care in Rwanda



  1. Risks of being forced to return to dangerous migration routes between Rwanda and the UK




  1. Harm in the UK





(12 January 2024)






[1] M Gleeson, N Yacoub, ‘Cruel, costly and ineffective: The failure of offshore processing in Australia’, Kaldor Centre for International Refugee Law, August 2021

[2] MSF, ‘Indefinite Despair’, 2018

[3] MSF, ‘Indefinite Despair’, 2018

[4] MSF, ‘Indefinite Despair’, 2018

[5] MSF, ‘Indefinite Despair’, 2018

[6] MSF, ‘Indefinite Despair’, 2018

[7] MSF, ‘Indefinite Despair’, 2018

[8] MSF, ‘Indefinite Despair’, 2018

[9] MSF, ‘Indefinite Despair’, 2018

[10] UN Human Rights Council, ‘Report of the Special Rapporteur on the human rights of migrants on his mission to Australia and the regional processing centres in Nauru’, June 2017.

[11] WHO ‘WHO renews alert on safeguards for health worker recruitment‘, March 2023

[12] UNHCR, ‘UNHCR analysis of the Legality and Appropriateness of the Transfer of Asylum Seekers under the UK-Rwanda arrangement’, June 2022; International Refugee Rights Initiative, ‘I was left with nothing”: “Voluntary” departures of asylum seekers from Israel to Rwanda and Uganda’ 2015, pg. 7; S. Shoham, L. Bolzman and L. Birger, Moving under Threats: The Treacherous Journeys of Refugees who ‘Voluntary’ Departed from Israel to Rwanda and Uganda and Reached Europe, October 2018

[13] See MSF Medical and Humanitarian Aid, Libya https://www.msf.org/libya

[14] MSF, ‘No one came to our rescue’, 2023 ://www.msf.org/no-one-came-our-rescue-human-costs-eu-central-mediterranea-nmigration-policies   

[15]  MSF in France https://www.msf.org/france ; MSF in Belgium https://www.msf.org/belgium

[16] Medical Justice, ‘Who is Paying the Price? The human cost of the Rwanda scheme’, September 2022

[17]  Guardian ‘‘Despair’ over Rwanda deportation leading to suicide attempts, say UK charities’, 2022.  

[18] Letter to Prime Minister from medical organisations, 23rd September 2022; Public letter from the UK medical community on the dangerous health consequences of Rwanda expulsions, 21 June 2022.