Recently I had the opportunity to watch a special screening of “Frontline Doctors: Winter Migrant Crisis” supported by Doctors of the World UK. Originally shown on the BBC in March, this uncompromising documentary follows Chris and Xand Van Tulleken across Europe, observing migrants fleeing during winter, and offers an insight into the sheer scale of the medical and humanitarian crisis.

The fact that 52,000 refugees and migrants crossed the eastern Mediterranean to reach Europe in January 2016 alone, facing rough seas, strong winds, and freezing conditions, demonstrates the desperation of the situation from which they are escaping.

More than 250 people died in January attempting to make the crossing. We see a crowded, half-sunk, deflated rib crawling in to shore and it is not difficult to understand why. Nearly all are from Syria, Iraq or Afghanistan, and most have never been in a boat or seen the ocean before. Looking out to sea, Chris VT observes “it’s tough out there,” and I can’t help but agree with him. Most people have paid about €1000 for the dangerous crossing, complete with fake life jackets supplied by the people traffickers.

We hear a 10 year old, who has spent four years under siege, describe why she wanted to escape—“children have no future here, school and education are everything.” There is nothing like a civil war to steal away a childhood. Qusai, a Syrian man with brittle bone disease, crossed without his wheelchair because the traffickers demanded he paid a premium for it. He sustained a fractured arm and a double leg fracture on the journey; risks worth taking to escape threats made by the Assad regime for criticizing it in public.

At a Macedonian border crossing, people walk 4 km through snow and ice, at risk of hypothermia and frost bite. 2000 people arrive per day and must queue in the freezing cold for hours to register. This is an example of the “madness of this crisis”—an empty, warm tent on one side of the border, a queue a freezing people on the other. The disorganisation and chaos of the migrants’ journey is evident, herded from ferries to buses, queue to queue, country to country, all the while at risk of exploitation, ill health, and psychological trauma.

The response to the refugee crisis is, in true cliché, well organised in Germany, which has accepted more than 1 million people to date. The UK, in contrast, has pledged to accept just 20,000 refugees from Syria over the next five years. Chris VT visits a former Berlin airport—Tempelhof—which has been converted into an emergency shelter for thousands of people, and now operates like a small town. The irony should not be lost that Tempelhof was designed by Hitler’s chief architect. Critics of Germany’s response argue that welcoming refugees and providing adequate shelter is encouraging them to make the dangerous journey. This facile argument should be rejected, as Hari says, a Kurdish refugee with a broken back, who has “come here for a new life…for hope.”

The final destinations we visit are migrant camps in northern France; Calais and Dunkirk. Here, Xand VT describes some of the worst conditions he’s ever seen—no sanitation, serious overcrowding and no international aid presence—the UN, Red Cross, and Unicef are not here. This is a public health disaster waiting to happen, and one can only imagine what a bout of cholera would do for the residents of the camp. Xand meets the mother of a one year old very ill with measles, but she is too frightened of officials to take him to see a doctor. Eventually she agrees, but then can’t take him to the hospital he needs because she has to look after her other five children. This mother offered for me the most poignant moment of the whole film. Desperately trying to look after her family, she lifts a neatly folded blanket from the floor of her sodden tent, brushing away the water and says “everything is soaking wet, but we’ve tried to make it look nice.”

In the UK we have to seriously consider our human and political reaction to the worst migrant crisis since the Second World War, with millions of people driven from their homes by violence in Syria, Afghanistan, Iraq, and elsewhere. Ignoring it, or using it for political gain, is deeply unacceptable. With the surge of UKIP, an increase in right-wing populism, and xenophobic incidents already on the rise since the disastrous Brexit vote, rivers of blood have been replaced by rivers of migrants. This is an unconventional humanitarian crisis arguably of our own causing, and the people arriving have been through a series of traumatic and draining experiences before setting foot in Europe. What happens to migrants who arrive in Europe—held in camps, separated from society, vilified and abused—is not acceptable, and we must ensure that we do not add to the destruction that they have already faced. We have a moral duty to educate ourselves regards the crisis in order to stand up for the rights of migrants and refugees in Europe and the UK. Watching this film would be an excellent start.

NB—As defined in the 1951 United Nations Convention Relating to the Status of Refugees:
A refugee is someone who has been forced to flee his or her country because of persecution, war, or violence. A refugee has a well-founded fear of persecution for reasons of race, religion, nationality, political opinion or membership in a particular social group.

Migrant crisis: Migration to Europe explained in seven charts.

10 truths about Europe’s migrant crisis.

Peter Thomson completed core surgical training in London in October 2015 and is currently on secondment as a National Medical Director’s Clinical Fellow based at the Health and Social Care Information Centre.

Competing interests: I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.