HEALTH
WITHOUT
BORDERS
A Mi-HEALTH EUROPE x ViiV HEALTHCARE INITIATIVE
THE HUMAN COST OF EXCLUSION
Health Without Borders is a storytelling project that amplifies the lived experiences of migrants navigating Europe’s healthcare systems. Launched in partnership with grassroots organisations in Sicily and Athens, the project uses intimate portraits and first-person testimony to expose the intersection of migration, identity, and health. In a climate of rising xenophobia and systemic exclusion, these stories bring visibility to those often left out of policy conversations—offering not only insight but a call to action.
The project runs parallel to and complements the Mi-Health HIV Partnership, a cross-European network of migrant-led organisations working to improve HIV prevention, testing, and care across ten countries. While Mi-Health generates essential data and policy recommendations, Health Without Borders puts faces to the numbers—reminding audiences and decision-makers that behind every data point is a life. Together, they offer a dual lens: one statistical, one human; both essential.
WHY SICILY AND ATHENS?
We began this project in Sicily and Athens because these places are more than symbolic — they are frontline realities.
As primary entry points into the European Union, Italy and Greece represent both the hope of safety and the weight of neglect. Here, migrants arrive with expectations of care, only to face overcrowded facilities, legal limbo, racism, and often — silence.
Sicily and Athens are also home to brave local organisations fighting to meet people where they are — emotionally, medically, and geographically. These cities helped us start the story of health equity in Europe by showing us just how much work still needs to be done.
CATANIA, SICILY
Europe’s Mediterranean doorstep, where migration routes converge.
In Catania, we spent time with LHIVE — a non-profit committed to defending the rights and health of people living with HIV. Active in the city since 1991, LHIVE provides vital services for those too often excluded from formal systems. During our visit, we were introduced to four individuals who rely on LHIVE for support with accessing care, maintaining mental and emotional wellbeing, understanding their sexual and reproductive health rights, and navigating life in the face of social and legal marginalisation.
We are deeply grateful for their openness and willingness to share their lived experiences — offering essential insight into the challenges migrants face in Italy today.
ATHENS, GREECE
Where the Aegean crossing ends and a new chapter in Europe begins.
In Athens, we spent time with Open Paths Athens—a non-profit dedicated to supporting migrants through the asylum process, trauma counselling, legal aid, and community integration. Operating across the city, Open Paths Athens creates safe spaces where people can access information, mental-health support, and practical guidance in their own language.
During our visit, we were introduced to four individuals who rely on Open Paths Athens to navigate complex bureaucracy, find psychological care, understand their legal rights, and rebuild social connections in a new country.
We are deeply grateful for their generosity in sharing such personal insights—illuminating the day-to-day realities migrants face in Greece today.
Mi-HEALTH EUROPE
Mi-Health Europe is a network of community-led organisations across Europe, championing migrants’ right to equitable, culturally sensitive healthcare—regardless of immigration status.
We unite frontline groups to share expertise, influence policy, and deliver services that meet migrants where they are.
From legal hurdles to community-driven care, these ISSUES define migrants’ access to healthcare in Europe.
MENTAL HEALTH & STIGMA
Many migrants arrive in Europe having experienced profound trauma — from conflict, persecution, poverty or dangerous journeys. Yet mental health support remains difficult to access, especially for those without stable legal status. Language barriers, stigma, and a lack of culturally sensitive care push mental health needs to the margins.
Without support, psychological distress becomes physical. Migrants report high rates of depression, anxiety, insomnia, and PTSD. And still, access to mental healthcare is often an afterthought — if it’s available at all.
To meet these needs, Europe must prioritise trauma-informed, culturally appropriate mental health care. Services should be community-based, anonymous when needed, and free from stigma — recognising that mental health is central to overall health and human dignity.
LEGAL & IMMIGRATION BARRIERS
Across Europe, a person’s ability to access healthcare is too often defined by their legal status. Undocumented migrants face administrative, legal, and financial barriers that lock them out of basic services. Even those with temporary residence permits are frequently met with confusion, inconsistency, and long delays.
This legal uncertainty impacts every aspect of life. Without documents, migrants are forced into precarious work, underpaid and unprotected. The constant fear of being reported or deported prevents many from seeking medical care — even in emergencies. The system creates invisibility where there should be support.
Equitable healthcare access must be separated from immigration status. All people — regardless of papers — should be able to access essential care without fear. European policies must align with humanitarian values and ensure that health is treated as a right, not a reward for citizenship.
COMMUNITY-LED SOLUTIONS
Where governments fail or fall short, community organisations step in. Groups like LHIVE in Sicily and Open Paths Athens are not only filling gaps — they’re leading the way forward. They provide direct outreach, education, cultural mediation, and support in environments migrants actually trust.
These organisations meet people where they are — on the street, in temporary housing, or in the clinic waiting room. They offer information about rights, accompany people through complex health systems, and provide culturally sensitive care that official systems rarely offer.
To truly improve migrant health, European systems must invest in and learn from these community-led models. This means long-term funding, policy inclusion, and recognition that the most effective solutions often come from those closest to the problem.
DIGNITY IN CARE
Access alone is not enough. For many migrants in Europe, the experience of seeking healthcare is marked by judgment, mistrust, and dismissal. Language barriers, cultural misunderstanding, and racial bias from providers can strip care of the very thing that makes it meaningful — dignity.
When care lacks dignity, people stop seeking it. Migrants report being ignored, spoken down to, or denied treatment altogether. The absence of interpreters, rushed consultations, and prejudice based on skin colour or legal status turn simple medical needs into exhausting emotional trials.
Dignified care means more than access. It means being listened to, spoken to with respect, and treated as fully human. European health systems must build trust — through cultural competence, anti-racism training, and accountability — to ensure that no one is made to feel less than they are.
FROM ISOLATION TO INCLUSION, THESE FIRST-PERSON ACCOUNTS UNCOVER THE HIDDEN STRUGGLES BEHIND MIGRANT HEALTH IN EUROPE.
names have been changed to protect participant privacy. their HAVE BEEN lightly edited for brevity and clarity where needed.
MS AWA
I’m a 47-year-old mother from Senegal and, back home, I was a teacher. I thought moving to Italy on a work contract would open doors and give my family a better life.
I came to Italy by plane with a contract to work in this country. The work was hard, I worked from morning until evening, and I lived in the house where I worked. The only positive thing I have experienced in Italy is the support offered by organisations like LHIVE.
I didn’t even know family planning centres existed until I was pregnant. During that time, LHIVE showed me how Italy’s healthcare system works: how to obtain a health card, choose a family doctor, and access free services. Scuola della Pace also helped with eye exams and glasses for me and my children. Through LHIVE’s street outreach and cultural mediators, I learned my rights and how to navigate each clinic visit. Their guidance turned confusion into confidence—and ensured I got the care I needed.
Health services here surpass those in Senegal—where you pay or you don’t get care—but migrants remain on the margins. Qualifications go unrecognised, work is limited to low-paid roles, and true integration feels out of reach. Until our skills, language needs, and dignity are respected, many of us will keep fighting to be seen.
MR. MUSA
I am a 30‑year‑old man from Gambia.
I have suffered from heart disease since I was a child and was always in and out of the hospital. I even volunteered at the clinic that treated me, because I have always wanted to help others.
I left Gambia to find a place where I could have surgery. The journey was brutal—I ran out of the medication I’d taken since childhood and traveled in constant fear of dying. It took me one year to reach Italy, crossing Senegal, Mali, Burkina Faso, Niger and Libya. In Libya, I was tortured.
A year after arriving in Sicily, I underwent cardiac surgery in Palermo, where they replaced a heart valve. My heart condition is now under control. To stay fit and healthy I have started boxing. I work as a cultural mediator in Catania, helping people like me be heard and understood so they can find the support they need.
The joy of having undergone surgery outweighs the discomfort of experiencing racism as an African man in Sicily. Yet in Italy there is still a lack of information on migrants’ rights, a shortage of mediators, and inadequate programs for learning Italian. There should be fewer barriers to obtaining a residence permit and better access to housing so we can truly thrive.
I was fortunate to come across a medical centre in Palermo where the staff did everything they could to get me the surgery I needed. In Catania, I found LHIVE through their street outreach project, and they’ve supported my follow‑up care. Community organisations like LHIVE are crucial for migrants to survive, heal, and rebuild their lives. Because of them, I now work with LHIVE as a cultural mediator—helping others find the support I once needed.
MS. GABRIELA
I’m a 60-year-old woman from the Dominican Republic.
I arrived in Italy in 1992 and became an Italian citizen in 2012 through marriage. I’m a mother of two, and I’ve always considered myself intelligent and good.
Before leaving home, I worked as a biology teacher. Leaving the Dominican Republic meant escaping a cycle of racism: darker-skinned workers were the first to lose their jobs whenever cuts came.
In Italy, discrimination didn’t end—language barriers and stigma followed me into every clinic and doctor’s office. I suffer from depression, tachycardia, hypertension, and diabetes. For a long time healthcare was hard to access. My family doctor struggled to understand me, and specialist appointments came with shame and delay. I only began real treatment when LHIVE intervened.
Five years ago, LHIVE’s outreach workers found me on the street. They brought a cultural mediator to my family doctor and explained how to book specialists. Through LHIVE, I learned about the Department of Mental Health and I have now started a psychotherapy journey with LHIVE's psychologist. What I want politicians to understand about migrants is that racism, marginalisation, stigma, and invisibility are like a death sentence.
MR. IMRAN
I’m a 54-year-old craftsman from Pakistan who came to Italy to support my large family.
Cooking and exploring new places bring me joy, but sending money home is my proudest achievement. Every day, I feel the weight of that responsibility—and the strength it gives me.
In Sicily, I couldn’t register with a doctor or secure a health card, every clinic visit turned into a battle with paperwork. When I lost access to my Permesso di Soggiorno (Residence Permit), accessing medical care & basic necessities became incredibly difficult and frustrating. I encountered LHIVE on the street and was promptly informed of my rights.
They assisted me in obtaining documents, especially the STP health card (Foreigner Temporarily Present on Italian territory), and their cultural mediators provided significant support.
Migrants in Italy need to have facilitated access to documents. And we need cultural mediators to be present in all public health centres. Community organisations are crucial; their presence is invaluable.
MR THÉO
My name is Mr. Théo, and I was a lawyer in the Democratic Republic of Congo.
I defended human rights and spoke out against injustice—campaigning against arbitrary arrests, disappearances of dissenters, and the torture of political prisoners. My activism made me a target.
One evening, men stormed into my home and dragged me to a detention center. For months, I endured unimaginable torture simply for daring to speak up.
The slow asylum process, language barriers, and bureaucracy make accessing mental healthcare a complex, frustrating challenge.
Open Paths Athens became my refuge. They guided me through the asylum process, protected my legal rights, and connected me with counsellors who understood trauma.
Even now, simple tasks can trigger panic attacks—transporting me back to that dark cell. The support from Open Paths Athens has been essential to regaining my sense of identity.
MARIAMA
Let me introduce myself. My name is Ms. Mariama and I am from Sierra Leone.
I am an activist and the founder of a women's empowerment organisation in Greece. I left my country because of the dictatorship. Life was very difficult; even finding food to eat every day was very hard.
There were many human rights abuses, and the healthcare system was very bad. There were no doctors. People died every day because of hunger and disease.
Most undocumented immigrants or refugees are afraid to go to hospitals. Living without a residence permit disturbs and affects your mental health. It also impacts your physical health because you are forced to work in the black market, working more hours for less pay and without any workers' rights.
The proudest moment of my life was when I obtained my Greek citizenship and gained the freedom of speech as an activist, a privilege I didn’t have in my home country. I expected to have access to a better healthcare system, specifically mental health support.
My experience fell far short of my expectations.
My biggest health challenge was suffering from depression, and accessing the necessary healthcare was very difficult.
Organizations like Open Paths Athens are crucial because they are established by our sons and daughters who continue to fight for and educate people about their rights.
They provide information and ensure people are treated with dignity and respect.
MS. ALINA
I am one of many immigrant women who came to Greece from Albania seeking a better future.
I have had a serious health problem since infancy, and my main reason for coming to Greece was to find solutions that my country could not offer. Initially, I struggled to access the health system, but with the help os Open Paths Athens, I obtained legalisation and registration to stay in the country.
Initially, I struggled to access the system, but over the years, as I obtained legalization and registration to stay in the country, things became somewhat more manageable. While the system supports me in terms of pharmaceuticals, it does not recognize the difficulties I face in daily life or facilitate my efforts to be an active member of society within my capabilities. I am encouraged to push beyond my limits every day, which exhausts my body and worsens my overall health.
Migrants are an immense force. If our integration is facilitated, we can contribute significantly to this society and bring fresh perspectives to the electoral process of the country that hosts us.
MR. IDRIS
My name is Mr. Idris, and I am 42 years old.
When I was living in the Ivory Coast, I worked as a receptionist at an import/export company and served as president of a non-profit association that helped orphans.
I was forced to leave my country due to human rights abuses: I was imprisoned and tortured because of my beliefs, my father was arrested and killed in prison, our family home was destroyed, and I was hunted.
I left in September 2017 and arrived in Turkey where I was imprisoned for 1 month. When I finally made it to Greece, I had experienced so much that it felt like I had discovered new wisdom I could use to help others.
My experience is my wisdom.
I now live in Greece and work as an immigration expert and anti-racist activist. What makes me happy these days is that when I help migrants in Greece, someone in need of help, they feel happy. I do not need anything in return, just the knowledge that someone has that feeling.
Accessing healthcare in Greece is a challenge. When you do finally get an appointment to see a doctor it is for a time far in the future. Even when I have had medical emergencies I have chosen not to have the issue treated.
Migrants deserve equal access to health care regardless of what the skin colour, religion or sexual orientation is.
Health Without Borders Partners & Sponsor
ViiV Healthcare (sponsor), LHIVE Diritti e Prevenzione (partner), Open Paths Athens (partner), Africa Advocacy Foundation (partner)
