Refugee Survey Quarterly  47 conditions are often appalling and unhygienic, and facilities were in a poor state of repair.28 As a result, Greece was convicted repeatedly by the European Court of Human Rights in connection to the detention of migrants and asylum-seekers for violations of the European Convention on Human Rights; in particular for violations of Article 3 which prohibits inhuman and degrading treatment and Article 5(1), which ensures the rights to liberty and security.29 Ironically, however, this immigration detention policy has been made possible in part due to the co-financing by European Commission Funds, such as the European Return Fund, which finances – with a rate of up to 95 per cent – costs relating to the operation of immigration detention centres in Greece.30 4. I MP AC T OF D E TE NT IO N O N M I GR A NT S’ HE A LT H A N D M SF ’ S R E S P O NS E MSF has a long history of working with people on the move since its foundation in 1971, motivated by recognition of their increased vulnerability during different stages of the displacement process. This is considered by MSF as an area where life, health, and human dignity are put at risk, and detention is one of the harmful experiences faced by people during the migration process. As increasing numbers of migrants have been detained over the past few years, MSF and other humanitarian organisations have responded to their medical and humanitarian needs, which remain unmet in detention. More specifically, MSF has provided medical and relief support to migrants and asylum-seekers held in detention facilities in different countries and contexts since 2004, including Greece, Malta, Belgium, Italy, Yemen, South Africa, and Malaysia. The situation of migrants and asylum-seekers in detention has been worryingly similar across the countries where MSF worked: serious barriers to accessing healthcare, including mental healthcare; interruption of medical treatment; absence of a system for the identification and management of vulnerable persons, including minors, pregnant women, torture victims, and seriously ill patients; very limited access to support services such as legal aid and interpretation; and lack of communication with the outside world.31 28 The Greek legislation in accordance with EU legislation sets an upper limit of 18 months for the detention of migrants and asylum-seekers. However, even this upper limit has recently been violated following an Advisory Opinion (44/2014) of the Greek Legal Council which interpreted the clause of the EU Returns Directive which foresees the possibility to impose restrictive measures to persons pending their return as allowing for the prolongation of their detention indefinitely, until they cooperate for their return. See United Nations Human Rights Council, Report of the Working Group on Arbitrary Detention – Addendum: Mission to Greece, UN Doc. A/HRC/27/48/Add.2, 30 Jun. 2014. 29 European Court of Human Rights, Factsheet – Migrants in Detention, Strasbourg, European Court of Human Rights, Jul. 2014, available at: http://www.echr.coe.int/Documents/FS_Migrants_detention_ ENG.pdf (last visited 22 Feb. 2016). See European Convention on Human Rights, CETS No. 005, 4 Nov. 1950 (entry into force: 3 Sep. 1953). 30 A. Fotiadis, “European Commission Bankrolls Anti-Immigrant Policies”, Inter Press Service, 17 Mar. 2013, available at: http://www.ipsnews.net/2013/03/european-commission-bankrolls-anti-immigrant-policies (last visited 22 Feb. 2016). 31 MSF, Invisible Suffering; MSF, Torture, Exploitation and Abuse of Migrants in North Africa; MSF, Over the Wall; MSF, Migrants in Detention; MSF, “Not Criminals”.