Unaccompanied minors in Marseille: from emergency humanitarian action to multidisciplinary care
Intervening for the first time in Marseille during the automatic suspension of evictions that applies in France during the winter months in January 2020, then during the COVID-19 pandemic, Médecins Sans Frontières now offers medical assistance and multidisciplinary support to age-disputed foreign minors.
Today, 20 young people on the move are accommodated by the association in Marseille. Julien Delozanne, MSF Project Coordinator, explains how this program was born and assesses the results of a one-year intervention.
What does the MSF project in Marseille consist of?
MSF currently hosts 20 age-disputed foreign minors, who were refused by the Departmental Council of Bouches-du-Rhône (to which Marseille belongs to) and who have seized the judge for juveniles to challenge this decision.
In collaboration with the Lawyers from the Marseille Bar Association and civil society, while the decision on their age is delivered, we accompany them throughout this lengthy legal procedure.
We focus on medical care in a reassuring environment and prioritize access to education. Indeed, enrolment in school or in a training course leading to a qualification offers these young people an opportunity to build a future for themselves, to integrate quickly into society and contributes to accelerating the healing process of invisible wounds caused by the difficulties faced in the country of origin with their families, isolation, exile and precarity they face once left alone on the streets.
The particularity of our approach is the multidisciplinary support. Each young person is monitored by a team of different professionals (nurses, psychologists, social workers) who examine his difficulties and work to support them on this difficult journey, while offering the opportunity to rebuild their identity in a safe and caring environment.
However, only a small number of young people benefit from this accommodation. Most of them are housed in squats supervised by solidarity groups. MSF intervenes there to provide them with consultations aimed at guiding them through the health system.
Even though everything seems to be done to make it extremely difficult for most of them to access protection, our efforts bear their fruits: at the end of the age-dispute procedure, nearly 80% of young people accompanied by MSF are finally granted temporary or permanent protection.
Why is MSF running such a project in Marseille?
At the beginning of 2020, almost all young people on the move in Marseille had to wait several months before they could be admitted temporarily to the emergency shelter provided by the Childcare Protection service (Aide Sociale à l’Enfance).
By law, this provisional shelter must be "systematic and immediate" for all persons declaring themselves as minors and isolated. It is at the end of this five-day provisional reception period that the minority assessment takes place. However, in the middle of winter, they were sleeping in the street, without being provided with any means of subsistence.
When I arrived in France, telling the assessors about my journey made me live through the trauma again: I wanted to start a new life, but I was asked to tell them everything I had experienced. I didn't do it, I was tired, I wanted to forget, and I didn't trust them.
Faced with the inaction of the public authorities, Médecins Sans Frontières intervened in support of and in collaboration with local associations and solidarity groups, by financing 100 beds in a guest house as emergency accommodation.
This lasted for six months, during which we repeatedly alerted the Departmental Council regarding the fact that the majority of the young people accommodated by MSF fell under the Department’s responsibility, notably newcomers recently arrived in the country and who had not been age assessed yet, unaccompanied minors and other children who had the right to benefit from an accommodation, under the special protection provided for children who are undergoing age assessment.
The end of this emergency sheltering activity provided by MSF was initially scheduled for 31 March 2020. However, due to the pandemic, it has been extended to the end of May 2020. This was an emergency humanitarian action, during which we were able to better understand the difficulties of unaccompanied minors and the local associations supporting them.
As any solution was proposed by the department, together with Doctors of the World, we went before the Marseille administrative court twice in a row. The courts have systematically ruled in favor of the associations, reminding the Bouches-du-Rhône Departmental Council of its obligations in terms of child protection and obliging them to provide shelter for these young people.
In July 2020, the opening of a regular project in Marseille resulted as evidence: we switched from an emergency humanitarian action to providing long-term multidisciplinary care.
In both cases, the observation is the same: the benefit of the doubt is not applied in age assessment procedures and the vulnerability of these young people is not properly assessed and taken into consideration at the time of assessment.
What are the issues of concern to MSF?
First, assessments are often based on ethnic profiling and an initial sorting is made between young people considered "obviously underage", those "obviously of age" and those for whom "a doubt" persists. This practice of "pre-sorting" is illegal and discriminatory.
Secondly, following an unfavorable assessment, young people considered to be of age are returned to the streets. Without accommodation and being unable to provide for their basic needs, it is unrealistic to expect these young people to be able to claim their right to appeal.
When you try to explain to the assessors everything you have been through, they think you are lying. They turned me down, saying I was lying about my age, and I was told I could appeal the judge's decision. An appeal? I had never heard of that, I didn't know what that word meant.
Thirdly, an unfavorable minority assessment should not mean the end of medical care. In practice, we have observed that not all young people who have been screened during the period of initial reception and diagnosed with a pathology have received medical follow-up. Without medical care, their health condition deteriorated, even though a diagnosis had already been made.
We have also noted that many of the young people cared for by MSF have never had access to a health check-up. This is unacceptable and irresponsible on the part of the Childcare Protection Service when we know that these young people, because of their life history and exile, constitute a vulnerable group, overexposed to health risks and psychological disorders.
What is the outcome of this intervention?
Since the beginning of the project in 2020, we have admitted 154 young people to our program: this may seem a very small number compared to the existing needs in the area. However, the cases we have taken on were often very complex and required a lot of work in terms of individual care, but also a lot of work on collective dynamics. We must not forget that it is the responsibility of the State, the Prefecture and the Departmental Council to protect these young unaccompanied foreigners, particularly during winter.
In the Ile-de-France region, Médecins Sans Frontières opened a day reception center in 2017 offering multidisciplinary care in four areas: somatic health, mental health, legal support, and social support. The center has welcomed more than 3,000 young people since it opened.
In Marseille, a 20-bed hostel has been receiving age-disputed UFMs since January 2020. Two 20-bed hostels in Sevran (Department of Seine Saint-Denis) have been age-disputed unaccompanied foreign minors since October 2020. A 10-bed hostel in Bobigny has been receiving young girls since April 2021. In total, since 2019, more than 350 unaccompanied minors have been accommodated and cared for by Médecins Sans Frontières adopting a multidisciplinary approach and more than 900 emergency beds in guest houses have been financed by the association.