Warsaw – As legislators in Poland draft a new law aimed at combatting human trafficking, Médecins Sans Frontières (MSF) urges that any measures inscribed in the legislation must not harm children. Children who are migrants are currently exposed to unreliable and inappropriate medical screening methods to determine their age. MSF calls on law makers to reject these methods as part of the law, and to ensure that ethical, comprehensive, and holistic means of assessing a child’s age are included.

A new MSF report, Age as a verdict, written with partners Save the Children and We Are Monitoring, looks at how age‑assessment procedures currently used in Poland are at risk of being formalised in the new law as part of the victim‑identification process. However, these procedures – including dental and radiological methods – are not scientifically reliable and are unethical for use in this context, in addition to carrying significant risks for children. Using these procedures to determine a minor’s legal age leads to harmful consequences; they can be unlawfully denied entry into Poland, and therefore protection and safety.

In the past, we were notified about young people who, shortly after undergoing an age‑assessment test, had been pushed back to Belarus directly from hospitals, still wearing casts and bandages. No-one should be denied care or pushed back from a hospital because of a medical test that was never designed to determine a person’s legal status.
Dr Alice Silvestro
MSF medical coordinator in Poland

The proposed law, “National Action Plan Against Trafficking in Human Beings”, is planned to enter into force no later than 2027. It comes as the government suspended the right for people to seek asylum in Poland in March 2025, and was supposed to be temporary – exceptionally introduced in response to an influx of people along the Polish-Belarusian border – yet it remains in force today. The suspension for seeking asylum does not apply, however, to some groups of vulnerable people, including unaccompanied minors. But there is no effective mechanism for identifying people belonging to those vulnerable groups, including children.

Over the past years, MSF teams providing medical support to asylum seekers in Poland have repeatedly observed the ineffectiveness of age assessment procedures, particularly on unaccompanied minors at the border with Belarus.

“We’ve seen children having to undergo harmful methods of age assessment to prove that they are not adults, to avoid being sent back to Belarus,” says Dr Silvestro. “These procedures have included using ionising radiation, which is not only scientifically unreliable, but it also goes against the fundamental principle of acting in the child’s best medical interest.”

In the case of minors, the initial need to recognise them as individuals under the age of 18 poses a significant challenge when someone does not hold a travel document, such as a passport. This lies within the discretion of officers when they apprehend someone at the border; and is particularly challenging in situations where this occurs in forests, without witnesses, under stress, and with language barriers.

Since March 2025, border guards in Poland have exercised even greater authority over determining a person’s path. They are the ones who decide whether someone is allowed to undergo the full age assessment procedure and apply for asylum. But we know these procedures are flawed; children must be protected rather than exposed to additional harm.
Uriel Mazzoli
MSF project coordinator in Poland

The Act on Combatting Trafficking may offer an opportunity to address these flaws and ensure that any future procedures prioritise child protection, scientific validity, and medical ethics.

“We call on paediatric radiology and endocrinology societies in Poland to take a position on age‑assessment practices and their scientific limitations,” says Dr Silvestro. “Standardised reporting guidelines and a clear affirmation of doctors’ right to refuse participation, without legal or professional repercussions, are essential to ensure ethical and effective methods, and safeguard children’s rights.”

COVID-19 in India: “The situation is terrible, but the commitment of the staff is extraordinary

Premananda Hessenkamp/MSF

By Mabel Morales, MSF Medical Coordinator

The situation in India and in Mumbai is very bad and critical. We’re providing medical support to one of the COVID-19 treatment centres here in Mumbai with 1,000 beds. There are many, many cases and the last week of April has seen a real increase. The health workers are overwhelmed and exhausted. There is so much work to do.

The authorities here are well-organised and are adapting to the situation as it evolves as best they can. But as the cases increase, it’s getting harder to find beds. They’re calling from hospital to hospital trying to refer patients, but they’re struggling.

Despite the difficulties we’re facing, the morale in the team is very high. Everybody is extremely committed. Some of them worked with us in our first COVID-19 intervention here in India during the first wave. As soon as we called them, they immediately came and joined us. That was a real boost for us. There are so many more cases now, that the staff we have aren’t enough. We still need to recruit more.

"No one was ready for the second wave. In a very short time, it’s turned into a major crisis."
- Mabel Morales
MSF Medical Coordinator

The team is working six days a week in eight-hour shifts. The conditions are not easy in the treatment centre. They’re tents, and inside it’s very hot. Add to that the fact that the team are kitted out in PPE with face masks and gloves and everything else, and it’s a tough environment.

The situation is terrible, but the commitment and the dedication of the staff is extraordinary. There is a very strong feeling of solidarity in the team. People are so committed to helping the patients.

No one was ready for the second wave. It caught everybody by surprise. In a very short time, it’s turned into a major crisis. MSF had concluded its support to the COVID-19 centre in Mumbai in mid-February 2021 as we had hardly any cases. But we kept the community activities going and kept in contact with the people who had worked for us the first time.

"We’re doing a lot of work at the community level and are focused on vulnerable people and people with chronic health conditions."
- Mabel Morales
MSF Medical Coordinator

We’re doing a lot of work at the community level and are focused on vulnerable people and people with chronic health conditions and with HIV. People’s living conditions are very challenging. How do you talk about isolation or social distancing when you have a whole family of eight people living in one room with no ventilation? How do you talk about the need to wash hands regularly when so many people have no easy access to water? How do you institute preventative measures in a situation like that? A lot of the key messages about avoiding transmission just don’t work in these situations.

The needs here are so great and what MSF is doing is just a small part. But it’s important for us to be here. Staff from other hospitals are coming to us to take part in the trainings and we’re able to support them and share what we know. We all feel a strong sense of solidarity with our patients and with the staff. I feel that we’re in the right place and we’re all working together. It’s hard work, but I’m happy to be part of it.





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