Torture is a structural element of the Mediterranean migration route, according to a June 25 report issued by the medical charity Doctors Without Borders (MSF) in Italian ahead of the UN International Day in Support of Victims of Torture.

The report is the outcome of a study on migrant and refugee survivors of torture centered in Palermo, in collaboration with the Policlinico Paolo Giaccone medical center, the Clinica Legale per i Diritti Umani, and Palermo University.

Between January 2023 and February 2025, 160 people were treated by MSF as part of the project, hailing from 20 countries. The largest number came from Bangladesh, Gambia, and Ivory Coast, with an average age of 25. A total of 75 percent were men.

Among the patients MSF treated were people who had survived torture and violence on their migration journey in transit and destination countries, but also people who fled violence and abuse in their home country; many suffered violence in multiple places.

Over half of the people who were treated by MSF reported that they had been tortured in Libya (108 of the 160 people). 36.5 percent of the patients said they had suffered abuse in nine countries that Italy deems safe, namely Algeria, Bangladesh, Ivory Coast, Egypt, Gambia, Ghana, Morocco, Tunisia, and Senegal.

A total of 80 percent of women patients had suffered one or more incidents of sexual assault, and 67 percent of all patients showed signs of post-traumatic stress. Only 22 percent were granted refugee status despite the torture suffered, according to the report.

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'Chronic pain frequent among survivors'

Torture and abuse, including beatings, whippings, burning, the pulling out of fingernails, electrocution, and suffocation, can have multiple, profound effects at the psychological, cultural, and social levels, noted MSF in the report.

Chronic pain is a common consequence among survivors, it noted, considering the brutality of many torture practices that in some cases are used repeatedly on victims.

In addition to the physical consequences -- including musculoskeletal (15 percent), digestive tract (12 percent), neurological (9 percent), ophthalmic (6 percent), and gynaecological (6 percent) symptoms -- torture leaves profound, persistent, and debilitating scars on the victims' mental health, which in turn affects all other aspects of their lives.

Some 67 percent of those assisted suffered from post-traumatic stress, depression, and anxiety issues, with 3 percent experiencing suicidal thoughts, MSF said.

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Slim admission chances

The medical charity added that, despite the fact that all those assisted by the project had survived torture and inhuman, degrading treatment, only 22 percent of them had at the time of admission and release received refugee status, and only 5 percent international protection.

"The rest of the patients must face not only the physical and psychological consequences of torture but also conditions of uncertainty and social and economic precariousness," it added.

The organization described this as a concerning aspect of the emergency-driven management of Italy’s migrant and refugee reception system, noting that it has been further affected by increasingly restrictive laws on migration and international protection.

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