Thousands of Hospital Patients Are Dying from Terrible Infections. Instead of Addressing the Situation, the Government Is Working to Cover It Up

“If I stay here, I will die,” Bálint told his fiancé Marianna one summer day in 2015, as he had been suffering completely weakened from weeks of unstoppable diarrhea in the internal medicine ward of Budapest’s Péterfy Sándor Hospital.

The man, who was then in his thirties, athletic, and working as a mid-level manager for a company, was recovering from surgery when he contracted clostridium difficile – an infection that commonly spreads in hospitals. The pathogen is resistant to alcohol-based disinfectants and can spread rapidly among patients who are lying in hospital beds, often in diapers and unable to move – all it takes is a missed hand wash, a poorly disinfected door handle, or an uncleaned toilet.

Bálint was eventually cured in another hospital thanks to Marianna’s personal efforts, but he still suffered serious consequences from the infectious disease. He lost 8 months of his life, 40 kilos of his weight and developed three hernias.

Bálint is one of the thousands of people who in recent years have had to endure unnecessary suffering and even fatal complications from infections contracted in the very place where they went to recover: the hospital.

The number of hospital-acquired infections in Hungary has been rising steadily for many years. Hospitals are reporting more and more cases every year: in 2021, a previously unimaginable number of hospital-acquired infections were identified, some 16-21 thousand depending on the calculation, almost half of which resulted in death. In 1400 of these cases, the hospitals themselves admitted that the hospital-acquired infection played a role in the death of patients. Data on 2022 was not available before the publication of this article.

However, these figures do not fully reflect the actual situation. In 2017 a detailed European study found that more than 78,000 hospital-acquired infections occur in Hungary every year, meaning that 3.5 percent of people admitted to hospital (almost one in 25 people) contract an infection. This is several times higher than the number of hospital-acquired infections reported by the National Centre for Public Health and Pharmacy (NCPHP).

While the problem is obvious, the government and state authorities are not making serious efforts to solve it. Moreover, they are doing everything they can to hide from patients – and even health workers – how serious the situation is, and which hospitals should pay more attention to reducing infections.

However, Direkt36 has uncovered many new details about hospital-acquired infections during a year-long investigation. The main findings of our investigation called the Semmelweis Project and our accompanying documentary film, are the following:

For this investigation, we traveled from inside and outside Hungary, conducted more than 30 interviews and background interviews, and reviewed hundreds of pages of technical reports. We obtained tens of thousands of rows from previously undisclosed data on hospital-acquired infections, which we have made interpretable and analyzed over several months.

Our analysis was based on a raw database obtained from the state through a lawsuit by the Hungarian Civil Liberties Union (HCLU). It contains details of all reported hospital-acquired infections from three years before the Covid outbreak. The analysis was supported by a renowned biostatistician who spent many hours using several complex statistical models to produce the ranking of hospitals in the country.

In the meantime, we and the HCLU have filed a lawsuit for the latest data available on hospital-acquired infections, as the NCPHP continued its efforts to prevent its disclosure – ignoring the fact that several courts have already ruled that it cannot withhold these data.

The Ministry of the Interior, which is responsible for the healthcare system, has not responded to our questions, nor has the National Directorate General for Hospitals (NDGH), which oversees the hospital’s day-to-day operations. We have interviewed the Head of the NCPHP’s Hospital Hygiene and Regulatory Division, whom we quote several times in the article, but she stressed that they only make professional recommendations to hospitals and that it is up to the holspitals’ management and the state to provide the necessary resources.

What is spreading in hospitals?

Pathogens spreading in hospitals are typically resistant to concentrated disinfectants and strong antibiotics. They are known as multiresistant bacteria and can cause serious illness by infecting elderly or immunocompromised people in hospital beds who are already ill.

There are a wide range of them, from acinetobacter baumannii, which can cause pneumonia, wound infections and urinary tract infections, to the bacteria MRSA which can cause abscesses and wounds to fester and heal difficultly. The latter is a type of pathogen that can enter the bloodstream and cause fatal blood poisoning (sepsis). Other common pathogens include the already mentioned clostridium difficile, a spore-forming bacteria, which causes foul-smelling, mucousy diarrhea and even severe inflammation of the intestines. Alcohol-based hand sanitizer by itself is not effective against it.

Pathogens can be spread by droplet transmission, faeces, wound drainage, through medical equipments and to a significant extent by the insufficiently disinfected hands of a doctor, nurse or visitor. Without proper hygiene, pathogens can linger on medical equipment, hospital toilets, door handles, shower curtains, bed linen, nurse call buttons – almost anywhere. Any invasive procedure, such as surgery, as well as a tube, catheter or cannula sticking out of a patient, poses a risk of infection. The longer a person spends in the hospital, the more likely they are to become infected. And even die as a result.

This is a problem not only in Hungary, but in hospitals all over the world. More and more superbugs are appearing and spreading. The difference is in how countries’ healthcare systems handle the problem: whether they tackle it and keep it under control or succumb to it and sweep it under the carpet. There are not only billions spent on treatment, but also lives at stake: if done right, 30-50 percent of infections can be prevented, according to globally accepted estimates.

The personal story of Bálint presented at the beginning of this article illustrates, however, that not enough is being done in Hungary concerning prevention.

By 2015, the young man had been struggling with recurrent colitis for several years, leading to his admission to Péterfy Hospital, only to get worse after two weeks. He was visited every day at the hospital by his fiancé Marianna, who eventually managed to persuade the doctor to conduct an imaging scan. It revealed his bowel was perforated and his faeces had been leaking into his abdomen for weeks. He immediately underwent life-saving surgery.

Bálint was recovering in intensive care and was given antibiotics, yet after a few days he came down with another fever and complained of severe diarrhea. “Afterwards, I went to the doctors again to say that we thought he had caught something, but they didn’t listen to me”, recalled his fiancé.

Marianna then gave up on the help of the hospital doctors and took Bálint’s stool sample to a private laboratory herself. There it was confirmed that he had contracted clostridium difficile infection during his days in hospital. Although this allowed them to identify what was wrong with Bálint, Marianna claims the doctors frowned upon her private action.

“How can I do this when they are doing everything”, Marianna explains the doctors’ reaction after she showed them the results of the private lab.

Even though Bálint had been suffering from a severe clostridium difficile infection for weeks and a laboratory examination confirmed it, he was not isolated but placed in a three-bed ward in the internal medicine department. The man also had to use the same toilet down the corridor – every ten minutes – as everyone else. It was at this time he felt his survival depended on being placed in better conditions. Eventually, a private doctor helped him get admitted to Budapest’s Honvéd Hospital, where he ultimately completed his treatment with antibiotics.

Péterfy Sándor Hospital did not respond to Direkt36’s request for comment.

Transparency is a bad idea according to the state

In the United States and England, patients can check the risk of infection with hospitals or the trusts that operate hospitals. This is not possible in Hungary, and the authorities have long argued that it should not be.

“When will it be that when I’m about to have an operation in a hospital, I can find out how said hospital is doing in terms of hospital-acquired infections online?”, György Baló asked his guest, epidemiologist Beatrix Oroszi, on his TV show back in 2017. “In the next few years, that is unlikely to happen, and I would not consider it right,” replied Oroszi, then head of the National Centre for Epidemiology (an organization that has since been dismantled).

This was the last time that experts from the authorities responsible for monitoring hospital-acquired infections have publicly challenged those who have called for more open communication about hospital-acquired infections. At the time, the HCLU launched a campaign and filed a lawsuit for the public disclosure of data on hospital-acquired infections, as the National Public Health and Medical Officer Service (NPHMOS – the predecessor of NCPHP) only published national statistics on the situation once a year, hidden on its website, as they still do today. The text is difficult to understand, the background of the statistics is not explained, and the causes of changes – mostly deteriorating data – are not revealed.

“How individual hospitals are performing is not at all revealed in these annual reports,” Márton Asbóth, legal expert of HCLU told Direkt36.

Asbóth remembers well György Baló’s show, where he was also a guest. “It became clear to me that the people at the NPHMOS have good intentions and understood the issue, but they didn’t understand why we should talk about it publicly. They also felt uncomfortable that we were suing for the data.”

Politicians have followed a strategy of denial. In 2019, MSZP’s MP Ildikó Bangóné Borbély raised the issue of hospital-acquired infections in parliament. However, Secretary of State Bence Rétvári did not even acknowledge the existence of the problem in his answer, instead, he attacked the health policies of the socialist governments and cited a European comparative figure that made it seem like the situation regarding hospital-acquired infections in Hungary was much better than in other EU countries. “So, concerning hospital-acquired infections, a Hungarian patient is safer than an average European patient in an average European hospital,” said Rétvári.

However, the figures quoted by Rétvári are misleading, as the European study to which he – presumably – referred to ranked Hungary among the worst-performing countries in Europe in many other indicators.

For example, the survey conducted by the European Centre for Disease Prevention and Control (ECDC) every few years – most recently in 2017 – measures the number of laboratory tests. Less testing means more infections remain undetected. An indicator measures the number of haemocultures – the microbiological testing of blood – performed in 1,000 patient days (a full day of hospital care for an in-patient is considered a patient day). In Hungary, this figure is only 3, while in England – the country commonly referred to as the “benchmark” for successful infection control – it is over 45. Hungary, however, is among the worst-performing countries in Europe, as well as in laboratory testing for the aforementioned diarrheal hospital-acquired infection, clostridium difficile. The number of stool tests was 1.3 per 1,000 patient days in Hungary, whereas in England it was over 10.

The NCPHP itself admitted to Direkt36 that the low sample size affects the accuracy of the data. During the lawsuit filed for the latest data on hospital-acquired infections, it was argued, that “low infection rates may be the result of insufficient infection identification rates (e.g. very few blood samples are taken by doctors, so that a low number of bloodstream infections are laboratory-confirmed, which is required for reporting) or loose reporting discipline.”

Despite the previous statement, Dr. Ágnes Galgóczi, Head of the NCPHP’s Hospital Hygiene and Regulatory Division, in an interview with Direkt36, did not admit that the situation is much worse than the figures show. “That certainly cannot be stated,” she replied but did not elaborate on the matter.

The European survey has another telling statistic, in which Hungary also ranked very poorly, second to last in the whole EU. Only 7.4 liters of alcohol-based hand sanitizer were used in Hungarian hospitals per 1000 patient days, while the countries at the other end of the scale consumed well over 50 liters. The EU average is 20 liters.

The survey also found that there were clearly many problems concerning hospital conditions in Hungary. The extreme workload of hospital staff in Hungary was shown by the fact that Hungary had 43 nurses per 100 hospital beds, putting us last among all countries (the same figure for England was 270). The same was true for the proportion of single-room beds, one of the most effective tools for preventing infections. In Hungarian hospitals, 1.4% of beds are in single rooms, the lowest proportion in the EU (France, at the other end of the scale, had 50%).

“It would scare the public”

Behind the government’s denial and secrecy was not just the fact that there was little to be proud of in the case of worsening official statistics. One of the reasons, according to information obtained by Direkt36, was that politicians and public authorities genuinely thought that open communication could cause panic.

A source formerly working in the health administration, who has information about several professional consultations from these years, spoke about this to Direkt36. In such discussions – for example, when infection control days were organized – the argument that “it would scare the public” if they communicated openly about infections was usually put forward according to the source. According to the source, no one was interested in “getting to the bottom of the problem”, although there were infection control campaigns, experimental programmes and there were “some very enthusiastic colleagues in the NPHMOS who were trying to push the issue.” But no overall improvement has resulted from these efforts.

The source told us that even the chief medical officer is not interested in “showing the public how serious the situation is”, as this would also raise their responsibility. This is why public authorities still choose secrecy today.

“The reality is that hospitals are reporting fewer cases than are occurring, and fewer microbiological tests are being carried out than should be. Meaning we are not seeing the reality in the statistics, but the tip of the iceberg”, said the source.

A significant gap between statistics and reality is shown by the European comparative study carried out by the ECDC in 2016-2017, which has been cited several times. They calculated – based on data from Hungarian hospitals – that 78,000 hospital-acquired infections occur in Hungary every year. In those years, Hungarian hospitals reported only slightly more than 10,000 hospital-acquired infections to the NCPHP. The difference between the figures is multiple.

There were promises

In 2018, when Miklós Kásler, Professor of Medicine, became Minister of Human Capacities, it seemed that a turning point was about to be reached in the treatment of infections. In his first interview after his appointment, the minister stated he wanted to take action: “The issue of hospital-acquired infections must be resolved very quickly,” he said on TV2, for example.

Several measures have been taken, for example, a ministerial decree on how to strengthen infection control in hospitals was issued in the summer of 2018. Kásler was very optimistic, stating at the time of the decree’s introduction that following the “protocol change” the number of infections could drop by 30-50 percent. He expects positive results within a week or two, the minister said.

However, these measures did not make a substantial difference, at least not in the following year, according to the NCPHP’s 2019 and 2020 statistics, which they simply suppressed for two years and refused to publish until they faced litigation. The coronavirus outbreak of early 2020 led to a number of new restrictions and hygiene measures in Hungarian hospitals, however, infections have not been reduced as a result. In fact, the figures revealed the contrary.

While measures introduced in Germany and Austria have reduced the spread of several hospital-acquired infections, including clostridium difficile, in Hungarian hospitals not only has the coronavirus spread despite all the hand disinfection, isolation, protective suits, medical masks and rubber gloves, but the spread of already well-known pathogens have also resulted in never-before-seen infection and death rates.

Hospital-acquired infections have been spreading in hospitals ever since, but the topic has died out in the public discourse. But the strategy of secrecy is still in place. Last autumn, Direkt36 tried to obtain detailed statistics on hospital-acquired infections between 2017 and 2021 broken down by hospital from the NCPHP as data of public interest. Since HCLU had already fought in court for the same data – for previous years – and finally won with the decision of the Curia, we expected that this would be a formality and that we would soon have the valuable database in our hands. This was not the case, the NCPHP refused to give us the data, so we had to file a lawsuit with the help of HCLU, which we won in the second instance on 14 September. According to the judgment, it is clear that the data is in the public interest. The NCPHP itself did not dispute this in the lawsuit, but only put forward technical arguments that “the disclosure of detailed data on the institution could be dangerous and mislead the public and patients.”

Until now, it was a secret how Hungarian hospitals were dealing with infections. Direkt36 has created and now publishes its ranking.

As we needed to wait for the end of the trials in order to get the most recent data, we decided to analyze the data available at the time. The original raw database received from the HCLU consisted of four .pdf files containing all the data (excluding personal data) on all hospital-acquired infections reported to the NCPHP between 2014 and 2016: when, where, what type of infection occurred, what underlying diseases the infected person had, how they were treated and what their fate was – whether they died or recovered, and if they died, whether their death was related to the hospital-acquired infection. The files contained a total of 6189 pages, tens of thousands of rows of data on the infections, only they were a complete mess. However, with the help of a team of data analysts and researchers from the international journalism organization OCCRP (Organized Crime and Corruption Reporting Project), we managed to turn them into a manageable database.

There were a number of obstacles to correctly analysing the data, so we asked Tamás Ferenci, one of the country’s most renowned biostatisticians for help. He has used a total of 21 statistical computing models, and filtered out differences between patients and between hospitals, to produce an analysis that allows an objective assessment and comparison of the performance of individual hospitals. No statistical analysis of hospital-acquired infections in Hungary – at least not one that is publicly available – has ever been carried out to this level of detail.

You can read a longer account of how we worked at the end of this article. You can find Ferenci’s own in-depth methodological description here.

The main findings of the analysis are the following:

The comparison is based on data from previous years, which the Hungarian Civil Liberties Union has obtained from the state through a lawsuit and made available to us. The data is from 2015-16, however, there are several indications that the situation has not changed significantly.

Firstly, hospital-acquired infections have continued to rise year after year, and a record amount of infections were reached during the coronavirus pandemic: by 2021, the total amount of hospital-acquired infections had increased by around two and a half times compared to 2015. The overall trends revealed by the 2015-16 data have not changed either. No data is available for individual hospitals since then, but there is region-specific information in the public statistics of the National Centre for Public Health and Pharmacy (NCPHP). These show that the same regions – mainly Central Hungary and the northern part of the Alföld region – continue to perform poorly every year.

Here are the results

Below you can see the rankings of Hungarian hospitals by different hospital-acquired infections. At the top of the charts are the hospitals with the highest incidence rates, and at the bottom are the hospitals with the lowest. The number in the “Incidence” column shows the number of infections per 100,000 patient days, according to our calculations. You can also filter by location in the search box. (We have created three different charts as the NCPHP also collects data on different infections separately, and the numbers cannot be simply added together due to possible overlaps.)

The first chart shows infections caused by multidrug-resistant pathogens, by hospital. These are bacteria that are resistant to several types of strong antibiotics, which is why they are so dangerous: they are difficult to kill and can cause serious complications for already sick patients.

The second chart shows the incidence of Clostridium difficile infections. This is a common hospital-acquired infection causing severe diarrhea and, in weakened hospital inpatients, can lead to life-threatening bowel inflammation if not treated properly. Once again, the most problematic hospitals in terms of reported infections are at the top of the list.

The third graph shows the incidence of bloodstream infections. These are cases in which pathogens enter the bloodstream and cause a profoundly serious condition – sepsis or septicaemia – which is fatal in a significant proportion of cases.

If you are also interested in the ranking of each hospital department, you can also browse through that: here you can download the multidrug-resistant pathogen infections per 10 000 patients and 100 000 patient days, here the clostridium infections per 10 000 patients and 100 000 patient days and here the bloodstream infections per 10 000 patients and 100 000 patient days

And from here you can download in .xlsx format the full, original database on which our analysis is based: all the data for all reported infections, by hospital and hospital department.

Large hospital, small hospital

The charts clearly show the significant differences in the incidence of infections between hospitals, even after adjusting for biases. There is also a huge deviation in the number of cases: there is a Hungarian hospital that, for example, has not reported a single clostridium infection (and thus does not appear in the ranking), and another that has reported well over 400 in a single year. The same is true for multidrug-resistant pathogens and bloodstream infections.

For infections caused by multidrug-resistant pathogens, the four hospitals with the most problems are smaller institutions. In first place is Toldy Ferenc Hospital in Cegléd, where these pathogens are the most common in the whole country, according to our calculations. Markhot Ferenc Hospital in Eger and Gróf Esterházy Károly Hospital in Pápa do not compare well either. Károlyi Sándor Hospital in Budapest is among the worst in all three types of infection – in the top five.

We contacted the mentioned hospitals, but none of them answered our questions.

We did not rank how many people died from infections in each hospital. Although a significant percentage of patients who get an infection never return home, hospitals only see a link between death and infection in a small portion of cases. The assessment of what led to the death of a patient is highly subjective, with often no time to investigate the causes thoroughly, and also depends on self-reporting by hospitals.

A corpse in the bathroom

We did not have the opportunity to explore the reasons behind the performance of all hospitals individually, however, we wanted to take a closer look at some of the seemingly more problematic hospitals to see what is behind the high number of reported infections. Therefore, we selected four of the hospitals that are among the worst performers in our rankings for all three types of infection. These are Toldy Ferenc Hospital in Cegléd and Jahn Ferenc Hospital, Károlyi Sándor Hospital and Bajcsy-Zsilinszky Hospital in Budapest.

Toldy Ferenc Hospital in Cegléd is the place where – at least according to the 2015-16 data – superbugs resistant to antibiotics are infecting patients at the highest rate in the whole country. At the hospital in Cegléd, they know there is a problem. In a document uploaded to their website, which reads like a cry for help – and which sets out the hospital’s strategy for 2018-2023 – they openly admit that “the number of infections caused by special multidrug-resistant pathogens is increasing year by year, while no new antibiotic is expected to be developed to solve this problem. In the treatment of (…) infectious patients, the difficulties of isolation and the insufficient number of isolation wards are a cause for concern. The prevalence of (…) infections is also currently making medical work difficult.”

They also describe the dramatic conditions under which the staff of the institution have to provide treatment. They say that the Pesti Road facility is in conditions “reminiscent of the 1950s”, with a steadily increasing volume of patients in the four-bed surgery unit, which has long been over capacity.

“The wards are overcrowded, with 6-8 beds and we have no wards with separate water blocks (…). In summer months, the heat in the wards is unbearable. The kitchen, the laundry and the energy centre also need renovation”, says the report.

None of this helps to reduce infections. Our database shows that the surgical, intensive care, urology, cardiology and neurology departments have serious difficulties in preventing infections. For multidrug-resistant infections alone, the hospital has reported 130 cases in two years. There have been 145 cases of clostridium infections acquired in the hospital and 74 patients have received blood poisoning as a result of infections in the two years.

According to our calculations, Jahn Ferenc Dél-pesti Hospital had the highest prevalence of clostridium difficile infections in the whole country, with the most severe situation in the internal medicine department in 2015-16. The institution ranked fifth worst for multidrug-resistant pathogens. An exceptionally high amount of infections occurred in the hospital’s psychiatric ward, where out of the reported 7 cases in two years, 3 patients died from infections of MRSA and Acinetobacter baumannii pathogens.

Jahn Ferenc Hospital is struggling with the well-known problems of Budapest’s major hospitals, from outdated infrastructure to severe staff shortages and overcrowding to a lack of funding. In 2022, more than 1,500 people worked at the hospital, but 332 positions were unfilled.

Overcrowding and inadequate cleaning may have led to the 2016 national scandal following the discovery of a dead body in a visitors’ restroom at the hospital. As it turned out, the corpse had been lying there for days. The hospital launched an investigation, apologised and concluded that no one was at fault, nevertheless a number of changes were announced regarding the use of toilets, the operation of the reception service and cleaning. The cleaning service, for example, was ” partially taken back into institutional responsibility to ensure higher standards”.

This, however, did not last long, as in 2018 they contracted the external company responsible for cleaning the hospital at the time of the incident. The company won against several applicants because it significantly underbid the hospital’s estimated price: it undertook the work for 60 percent less. Price was a deciding factor of 98 percent at the time of the evaluation, while quality accounted for 2 percent.

Károlyi Sándor Hospital in Újpest has a much lower volume of patients than Jahn Ferenc, yet according to our calculations it still has one of the highest infection rates in the country: uniquely, it is among the worst five institutions in all three infection types. Within two years, the hospital has reported over a hundred cases of both clostridial and multidrug-resistant bacterial infections.

There is little public information about the work being done within the walls of Károlyi Hospital, although the documents uploaded to the hospital’s website reveal a lot. Staff turnover is very high, with more than half of the hospital’s staff leaving in 2011, hundreds of people leaving over the last decade, and by 2021 the number of staff have halved compared to ten years earlier.

Károlyi Hospital has published a pessimistic report for the year 2021, which is the last available written report on their official website. In a document signed by the hospital’s Chief Financial Officer and Director, they stress that the institution has been struggling with underfunding for a decade, its IT system is outdated, and staff headcount is constantly decreasing. They added that the introduction of the 2020 law on employment in the health service has led to a further decline in staff numbers, as more staff have not signed new contracts. “Further reductions in staffing levels, which are barely adequate for current patient care activities, would put patient care at risk,” they write.

The toughest surgical and internal medicine department in the country

Bajcsy-Zsilinszky Hospital is a large institution: it serves patients from Kőbánya, Rákosmente, Monor, Gyömrő and their surrounding areas, treating 40,000 inpatients a year. Our calculations of infection incidence ranked Bajcsy as the sixth worst performing hospital in the country for the most common types of infections: for both clostridium difficile and infections caused by multidrug-resistant pathogens.

Outbreaks have also occurred, for example in the department of internal medicine, where an outbreak of clostridium affected 14 people in the summer of 2015 alone (May to September). This is hardly surprising, as our calculations based on 2015-16 data show that the hospital’s internal medicine department is the second worst in the country when it comes to diarrheal infections.

Beáta Dunavölgyi, a former nurse at the hospital, recalls there were many shortcomings in the institution.

She worked full-time in the oncology department for most of the 2000s and 2010s and was deputising in the surgical department. „The surgical department was a disaster. It was hot, the air-conditioning didn’t work and they put a fan in the septic area. You can imagine what was spreading in the air”, she recalled. The cleaning, she said, was done by the hospital’s employed cleaners, who were all very elderly. “Poor Mária was pushing the cart at the age of 84 and helping to serve food, it was a disaster. There were other cleaners like that, well, they clowned around like that,” she said, referring to the fact that hospital cleaning was entrusted to people who were too old for this physically hard job.

“There were not enough rubber gloves, disinfectant, nappies, sheets, the list goes on. The rules can’t be followed like this,” said the nurse, adding that if a hospital-acquired infection had occurred, they did not investigate why it happened, they only isolated the patient using a privacy screen. “Not by placing the patient in another room, but with a screen,” she said. She also noted that no feedback or statistics were shared on how many cases of infection or even malpractice had occurred, there for they did not talk much about these things.

None of the detailed four hospitals answered Direkt36’s questions.

During Covid, things got even worse

When Covid came everything became even worse with hospital infections. Interventions for less serious cases were postponed, intensive care and covid wards became filled with infected people gasping for air, suffering from serious underlying conditions, while nurses untrained in caring for the seriously ill had to be put to work next to ventilators. In the shadow of Coronavirus the already well-known hospital-acquired infections were still spreading and taking their victims among the weakened patients in Hungary, despite all the protective suits, rubber gloves and hand disinfection.

The NCPHP’s national statistics clearly show the serious crisis that has emerged in the health sector. The incidence of all three types of infections has increased by around two and a half times compared to 2015. At least according to the number of infections reported to the NCPHP by hospitals – and this does not include the number of covid infections contracted in hospitals, which was quite common.

According to Dr. Ágnes Galgóczi, the NCPHP’s professional responsible for the issue, the number of hospital-acquired infections increased so dramatically during the coronavirus epidemic because hospitals were not prepared to isolate patients properly and the “patient material”, i.e. the condition of the people admitted to hospital changed. “Covid infection, even with healthy people, could result in long ICU stays, a major risk factor for nosocomial infections [hospital-acquired infections]”, Galgóczi said.

In contrast, in Austria the incidence of clostridium difficile has decreased during the years of Covid, which the Austrian Ministry of Health’s press spokesperson attributed to the success of the stricter measures. We have not received an answer from NCPHP as to why such a large gap developed between Hungary and Austria during the epidemic.

DISCLAIMER:

This article is a summary of articles published in October, November and December as part of Direkt36’s Semmelweis Project. The articles published so far in the series can be read in full here:

In February, we published the rankings of hospitals using the latest data from 2017 to 2022

Cover art (the pictures uploaded to supporting materials):
Péter Somogyi (szarvas) / Telex

Data Visualizations:
Ferenc Bakró-Nagy / Telex

Contributors:
András Pethő – editor
Tamás Ferenci – biostatistician
OCCRP data team
Telex.hu

Documentary film:
Máté Kőrösi – director
Máté Fuchs – director

How Europe Outsourced Border Enforcement to Africa

When Cornelia Ernst and her delegation arrived at the Rosso border station on a scorching February day, it wasn’t the bustling artisanal marketplace, the thick smog from trucks waiting to cross, or the vibrantly painted pirogues bobbing in the Senegal River that caught their eye. It was the slender black briefcase on the table before the station chief. When the official unlatched the hard plastic carrier, proudly unveiling dozens of cables meticulously arranged beside a touchscreen tablet, soft gasps filled the room.

Called the Universal Forensic Extraction Device (UFED), the machine is a data-extraction tool capable of retrieving call logs, photos, GPS locations and WhatsApp messages from any phone. Manufactured by the Israeli company Cellebrite, renowned for its phone-cracking software, the UFED has primarily been marketed to global law enforcement agencies, including the FBI, to combat terrorism and drug trafficking. In recent years it’s also gained infamy after countries like Nigeria and Bahrain used it to pry data from the phones of political dissidents, human rights activists and journalists.

Now, however, a UFED had found its way to the border guards stationed at the crossing between Rosso, Senegal, and Rosso, Mauritania, two towns with the same name along the winding river that divides the countries, and a crucial waypoint on the land migration route to North Africa. In Rosso, the technology is being used not to catch drug smugglers or militants, but to track West Africans suspected of trying to migrate to Europe. And the UFED is just one troubling tool in a larger arsenal of cutting-edge technologies used to regulate movement in the region — all of it there, Ernst knew, thanks to the European Union technocrats she works with.

As a German member of the European Parliament (MEP), Ernst had left Brussels to embark on a fact-finding mission in West Africa, accompanied by her Dutch counterpart, Tineke Strik, and a team of assistants. As members of the Parliament’s Left and Green parties, Ernst and Strik were among a tiny minority of MEPs concerned about how EU migration policies threaten to erode the EU’s very foundation— namely, its professed respect for fundamental human rights, both within and outside of Europe.

Author: Matt Rota

The Rosso station was part of those policies, housing a recently opened branch of the National Division for the Fight Against Migrant Trafficking and Related Practices (DNLT), a joint operational partnership between Senegal and the EU to train and equip Senegalese border police in hopes of stopping migration to Europe before migrants ever get close. Thanks to funding by EU taxpayers, Senegal has built at least nine border posts and four regional DNLT branches since 2018, supplied with invasive surveillance technologies that, besides the black briefcase, include biometric fingerprinting and facial recognition software, drones, digital servers, night-vision goggles and more. (A spokesperson for the European Commission, the EU’s executive body, noted in a statement that the DNLT branches were created by Senegal and the EU only funds their equipment and training.)

Ernst worried that such tools could violate the fundamental rights of people on the move. The Senegalese officials, she recalled, had seemed ​“very enthusiastic about the equipment they received and how it helps them track people,” which left her concerned about how that technology might be used.

Ernst and Strik also worried about a controversial new policy the Commission had begun pursuing in mid-2022: negotiating with Senegal and Mauritania to allow the deployment of personnel from Frontex, the EU border and coast guard agency, to patrol land and sea borders in both countries, in an effort to curb African migration.

With a budget nearing $1 billion, Frontex is the EU’s best-funded government agency. For the past five years, it’s been mired in controversy following repeated investigations — by the EU, the United Nations, journalists and nonprofits — that found the agency violated the safety and rights of migrants crossing the Mediterranean, including by helping Libya’s EU-funded coast guard send hundreds of thousands of migrants back to be detained in Libya under conditions that amounted to torture and sexual slavery. In 2022, the agency’s director, Fabrice Leggeri, was forced out over a mountain of scandals, including covering up similar ​“pushback” deportations, which force migrants back across the border before they can apply for asylum.

While Frontex has long had an informal presence in Senegal, Mauritania and six other West African countries — by helping transfer migration data from host countries to the EU — Frontex guards have never been permanently stationed outside of Europe before. But now the EU hopes to extend Frontex’s reach far beyond its territory, into sovereign African nations Europe once colonized, with no oversight mechanisms to safeguard against abuse. Initially, the EU even proposed granting immunity from prosecution to Frontex staff in West Africa.

The potential for problems seemed obvious. The day before Ernst and Strik traveled to Rosso, they’d listened to stark warnings from civil society groups in Senegal’s capital city of Dakar. ​“Frontex is a risk for human dignity and African identity,” one advocate, Fatou Faye from the Rosa Luxemburg Foundation, a progressive policy nonprofit, told them. ​“Frontex is militarizing the Mediterranean,” agreed Saliou Diouf, founder of Boza Fii, a migrant advocacy group. If Frontex is stationed at African borders, he said, ​“It’s over.”

The programs are part of a broader EU migration strategy of ​“border externalization,” as the practice is called in eurospeak. The idea is to increasingly outsource European border control by partnering with African governments, extending EU jurisdiction deep into the countries from which many migrants come. The strategy is multifaceted, including the distribution of high-tech surveillance equipment, police trainings and development programs — or at least the illusion of them — that claim to address the root causes of migration.

Author: Matt Rota

In 2016, the EU designated Senegal, both a migration origin and transit country, as one of its five priority partner nations in addressing African migration. But in total 26 African countries have received taxpayer euros aimed at curbing migration through more than 400 discrete projects. Between 2015 and 2021, the EU invested $5.5 billion in such projects, with more than 80% of the funds coming from developmental and humanitarian aid coffers. In Senegal alone, according to a report from the German Heinrich Böll Foundation, the bloc invested at least $320 million since 2005.

These investments carry significant risks, since it appears the European Commission does not always conduct human rights impact assessments before unleashing them on countries that, as Strik notes, often lack democratic safeguards to ensure the technology or policing strategies aren’t misused. To the contrary, the EU’s suite of African anti-migration efforts amount to techno-political experiments: equipping authoritarian governments with repressive tools that can be used on migrants, and many others as well.

“If the police have this technology at their disposal to track migrants,” explains Ousmane Diallo, a researcher with Amnesty International’s West Africa bureau, ​“there is nothing to ensure it won’t be used to target others, such as civil society or political actors.”

Over the past year, I have trekked through Senegal’s border towns, spoken with dozens of people and sifted through hundreds of public and leaked documents to piece together the impact of EU migration investments in this key country. What has emerged is a complex web of initiatives that do little to address the reasons people migrate — but a lot to erode fundamental rights, national sovereignty and local economies in African countries that have become EU policy labs.

The EU’s frenzy to half migration can be traced to the 2015 migration surge, when more than one million asylum-seekers from the Middle East and Africa — fleeing conflict, violence and poverty — arrived on Europe’s shores. The so-called migrant crisis triggered a rightward shift in Europe, with populist leaders exploiting fears to frame it as both a security and existential threat, bolstering xenophobic, nationalist parties.

But the peak of migration from West African countries like Senegal came well before 2015: In 2006, more than 31,700 migrants arrived on boats in the Canary Islands, a Spanish territory 60 miles from Morocco. The influx caught Spain’s government off guard, prompting a joint operation with Frontex, dubbed ​“Operation Hera,” to patrol the African coast and intercept boats heading toward Europe.

Operation Hera, which civil liberties nonprofit Statewatch described as ​“opaque and unaccountable,” marked the first (though temporary) Frontex deployment outside EU territory — the first sign of externalizing European borders to Africa since the end of colonialism in the mid-20th century. While Frontex left Senegal in 2018, the Spanish Guardia Civil remains to this day, continuing to patrol the coast and even carrying out airport passport checks to stop irregular migration.

It wasn’t until 2015’s ​“migrant crisis,” however, that EU bureaucrats in Brussels adopted a blunter strategy by dedicating funds to stem migration at the source. They created the ​“European Union Emergency Trust Fund for stability and addressing root causes of irregular migration and displaced persons in Africa,” or EUTF for short.

While the name sounds benevolent, it’s the EUTF that’s responsible for the Rosso border station’s black briefcase, drone and night-vision goggles. The fund has also been used to send European bureaucrats and consultants across Africa to lobby governments to draft new migration policies — policies that, as one anonymous EUTF consultant told me, are frequently ​“copy-pasted from country to country” without regard for the unique circumstances faced by each.

“The EU is forcing Senegal to adopt policies that have nothing to do with us,” Senegalese migration researcher Fatou Faye told Ernst and Strik.

But European aid serves as a powerful incentive, says Leonie Jegen, a University of Amsterdam researcher who studies EU influence on Senegal’s migration governance. Such funds, she says, have led Senegal to reform its institutions and legal frameworks along European lines, reproducing ​“Eurocentric policy categories” that stigmatize and even criminalize regional mobility. All of it, Jegen notes, comes wrapped in the underlying suggestion that ​“improvement and modernity” are things ​“being brought from the outside” — a suggestion reminiscent of Senegal’s colonial past.

Centuries ago, the very borders now being fortified by EU demand were drawn by European empires negotiating among themselves in the rush to plunder African resources. Germany seized swaths of West and Eastern Africa; the Netherlands staked its claim in South Africa; the British captured a belt of land spanning from north to south in the eastern part of the continent; and French colonies stretched from Morocco to the Republic of the Congo, including present-day Senegal, which gained independence just 63 years ago.

I arrived at the dusty checkpoint in the village of Moussala, on Senegal’s border with Mali, at noon on a sweltering early March day. As a main transit point, dozens of trucks and motorcycles were lined up, waiting to cross. After months of ultimately fruitless efforts to get government permission to access the border posts directly, I was hoping the station’s chief would tell me how EU funding is shaping their operation. The chief refused to go into detail, but confirmed they’d recently received EU training and equipment, which they regularly use. A small diploma and trophy from the training, both emblazoned with the EU flag, sat on his desk as proof.

The creation and equipping of border posts like Moussala has also been an important element in the EU’s partnership with the UN’s International Organization for Migration (IOM). Besides the surveillance tech the DNLT branches receive, migration data analysis systems have also been installed at each post, along with biometric fingerprinting and facial recognition systems. The stated aim is to create what eurocrats call an African IBM system: Integrated Border Management. In a 2017 statement, IOM’s project coordinator in Senegal loftily declared that ​“IBM is more than a simple concept; it is a culture,” by which he apparently meant a continent-wide ideological shift toward embracing the EU’s perspective on migration.

In more practical terms, the IBM system means merging Senegalese databases (containing sensitive biometric data) with data from international police agencies (such as Interpol and Europol), allowing governments to know who’s crossed which borders and when. That’s something, experts warn, that can easily facilitate deportations and other abuses.

The prospect isn’t abstract. In 2022, a former Spanish intelligence agent told Spanish newspaper El Confidencial that local authorities in different African countries ​“use the technology provided by Spain to persecute and repress opposition groups, activists and citizens critical of power,” and that the Spanish government was well aware.

A European Commission spokesperson claimed that ​“All security projects funded by the EU have a training and capacity building component on human rights” and that the bloc conducts human rights impact assessments prior to and during the implementation of all such projects. But when Dutch MEP Tineke Strik asked for those assessment reports earlier this year, she received official responses from three separate Commission departments saying they did not have them. One response read: ​“There is no regulatory requirement to do so.”

In Senegal, where civil liberties are increasingly at risk, the threat of surveillance technology being misused is amplified. In 2021, Senegal’s security forces killed 14 anti-government protesters; in the past two years, several Senegalese opposition politicians and journalists have been jailed for criticizing the government, reporting on politically sensitive issues or ​“spreading fake news.” Many feared that in 2024 current President Macky Sall intended to seek reelection for an unconstitutional third term. In June, Sall’s main opponent was sentenced to two years in jail on charges of ​“corrupting the youth.” The sentence set off nationwide protests that left 23 people dead in its first few days and saw the government restrict internet access. Sall finally announced in July that he won’t be seeking reelection, restoring stability throughout the country, but not dispelling fears among its citizens that their government is becoming increasingly authoritarian. And in that context, many worry the tools the country is receiving from the EU will only make things worse at home, while doing nothing to stop migration.

Just as I was about to give up trying to talk with local police, an undercover immigration officer in Tambacounda, another transit hub that sits between the Malian and Guinean borders, agreed to speak under condition of anonymity. Tambacounda is one of Senegal’s poorest regions and the source of most of its outbound migration. Everyone there, including the officer, knows someone who’s tried to leave for Europe.

“If I wasn’t a policeman, I would migrate as well,” the officer said through a translator after hustling away from his station. The EU’s border investments ​“haven’t done anything,” he continued, noting that, just the next day, a group was crossing into Mali en route to Europe.

Since gaining independence in 1960, Senegal has been hailed as a beacon of democracy and stability, while many of its neighbors have struggled with political strife and coups. But over a third of the population lives below the poverty line, and the lack of opportunities drives many to migrate, particularly to France and Spain. Today, remittances from that diaspora constitute nearly 10% of Senegal’s GDP. As Africa’s westernmost mainland nation, many West Africans also cross through Senegal as they flee economic hardship as well as violence from regional offshoots of al Qaeda and ISIS, which has forced nearly 4 million people to leave their homes.

“The EU can’t just solve things by raising walls and throwing money,” the officer told me. ​“It can finance all they want but they won’t stop migration like this.” Much of the EU money spent on policing and borders, he said, has accomplished little more than buying border town officials new air-conditioned cars.

Meanwhile, services for deported people — such as protection and reception facilities — are left severely underfunded. Back at the Rosso border crossing, hundreds are deported weekly from Mauritania. Mbaye Diop works with a handful of volunteers at the Red Cross center on the Senegalese side of the river to receive those deportees: men, women and children, sometimes bearing wounds on their wrists from handcuffs or after being beaten by Mauritanian police.

But Diop lacks the resources to actually help them.

The entire approach was wrong, Diop says. ​“We have humanitarian needs, not security needs.”

The EU has also tried a ​“carrot” approach to dissuade migration, offering business grants or professional training to those who return or don’t try to leave. Outside Tambacounda, scores of billboards advertising EU projects pepper the road into town.

But the offers aren’t all they promise, as 40-year-old Binta Ly knows well. Ly runs a pristine corner shop in Tambacounda, selling local juices and toiletries. Although she finished high school and studied a year of law in college, the high cost of living in Dakar ultimately forced her to drop out and move to Morocco to find work. She lived in Casablanca and Marrakech for seven years; after falling ill, she returned to Senegal and opened her shop.

In 2022, Ly applied for a small business grant, meant to entice local Senegalese to not migrate, from an EU-funded migration reintegration and prevention initiative office called BAOS, which opened within the Tambacounda branch of Senegal’s Regional Development Agency that year. Ly’s proposal was to start a printing, copying and laminating service in her shop, conveniently located next to a primary school with a need for such services.

Author: Matt Rota

Ly was approved for a grant of about $850 — a quarter of the budget she requested, but exciting nonetheless. A year after approval, however, Ly hadn’t seen a single franc of that funding.

In Senegal overall, BAOS has received a total $10 million from the EU to fund such grants. But the Tambacounda branch got only $100,000, according to Abdoul Aziz Tandia, director of the local office of the Regional Development Agency — enough to fund just 84 businesses in a region of more than half a million people, and nowhere near enough to address the scale of its needs.

A European Commission spokesperson said that grant distribution finally began this April, and Ly received a printer and laminating machine, but no computer to use them with. ​“It’s good to have this funding,” Ly says, ​“but waiting so long changes all my business plans.”

Tandia admits that BAOS isn’t meeting the demand. Partly that’s because of bureaucracy, he says: Dakar must approve all projects and the intermediaries are foreign NGOs and agencies, meaning local authorities and beneficiaries alike have no control over the funds they best know how to use. But also, Tandia acknowledges, with many regions outside the capital lacking access to clean water, electricity and medical facilities, micro-grants alone aren’t sufficient to keep people from migrating.

“For the medium- and long-term, these investments don’t make sense,” Tandia says.

Few of the EU’s migration projects seem responsive to local realities. But saying so out loud carries substantial risk, as migration researcher Boubacar Sèye knows better than most.

Born in Senegal but now living in Spain, Sèye himself is a migrant. He left Ivory Coast, where he was working as a math teacher, when violence erupted after its 2000 presidential election. After brief stints in France and Italy, he arrived in Spain, where he ultimately obtained citizenship and started a family with his Spanish wife. But the heavy death toll that came with the 2006 migrant surge to the Canary Islands prompted Sèye to start an organization, Horizons Sans Frontières, to help integrate African migrants in Spain. Today, Sèye conducts research and advocates for the rights of people on the move more broadly, with a focus on Africa and Senegal.

In 2019, Sèye obtained a document detailing EU migration spending in Senegal and was shocked to see how much money was being invested to stop migration, while thousands of asylum-seekers drown every year along some of the deadliest migration routes in the world. In press interviews and at public events, Sèye began demanding more transparency from Senegal about where the hundreds of millions of dollars in EU funding had gone, calling the programs a ​“failure.”

Author: Matt Rota

In early 2021, Sèye was detained at the airport in Dakar on charges of ​“disseminating fake news.” He spent two weeks in prison, and his health deteriorated quickly under the stress, culminating in a non-fatal heart attack.

“It was inhumane, it was humiliating and it gave me health issues I have to this day,” Sèye says. ​“I just asked: ​‘Where is the money?’”

Sèye’s instincts weren’t wrong. EU migration funding is notoriously opaque and difficult to track. Freedom of Information requests are delayed for months or years, while interview requests to the EU delegation in Senegal, the European Commission and Senegalese authorities are often declined or ignored, as I’ve seen myself. The DNLT and border police, the Ministry of Interior and the Ministry for Foreign Affairs and Senegalese Living Abroad — all of which have received EU migration funds — did not respond to repeated interview requests for this story made in writing, by phone and in person.

EU evaluation reports also fail to give a full view of the programs’ impact, perhaps by design. Several consultants who have worked on unpublished impact assessment reports for EUTF projects, speaking anonymously because of nondisclosure agreements, warned that little attention is given to the unforeseen effects some EUTF projects have.

In Niger, for instance, the EU helped draft a law that criminalized virtually all movement in the north of the country, effectively making regional mobility illegal. While the number of irregular crossings on specific migration routes decreased, the policy also made all routes more dangerous, increased prices for smugglers and criminalized local bus drivers and transport companies, with the result that many lost their jobs overnight.

The inability to assess this sort of impact mainly stems from methodological and resource constraints, but also because the EU hasn’t bothered to look.

One consultant who works with an EU-funded monitoring and evaluation company explained it this way: ​“What is the impact? What are the unintended consequences? We don’t have time and space to report on that. [We are] just monitoring projects through reports from the implementing organizations, but our consultancy doesn’t do truly independent evaluations.”

An internal report I obtained noted that ​“very few projects collected the data needed to track progress towards the EUTF overall objectives (to promote stability and limit forced displacement and irregular migration).”

There is also a sense, one consultant said, that only rosy reports are welcome: ​“It’s implied in our monitoring that we need to be positive about the projects so we get future funding.”

In 2018, the European Court of Auditors, an independent EU institution, criticized the EUTF, charging that its process for selecting projects was inconsistent and unclear. A study commissioned by the European Parliament similarly called the process ​“quite opaque.”

“Parliamentary oversight is unfortunately very limited, which is a huge issue when it comes to accountability,” German MEP Cornelia Ernst says. ​“Even as someone very familiar with EU policies, it is almost impossible to understand where exactly the money is going and for what.”

In one case, an EUTF project to create elite border police units in six West African countries, meant to fight jihadist groups and trafficking, is now being investigated for fraud after allegedly misappropriating more than $13 million.

In 2020, two other EUTF projects, meant to modernize the civil registries of Senegal and Ivory Coast, sparked significant public concern after revelations that they aimed to create national biometric databases; privacy advocates feared the projects would collect and store fingerprints and facial scans of both countries’ citizens. When Ilia Siatitsa, of Privacy International, requested documentation from the European Commission, she discovered the Commission had conducted no human rights impact assessment of these projects — a shocking omission, considering their scale and the fact that no European countries maintain databases with this level of biometric information.

A Commission spokesperson claimed the EUTF had never funded a biometric civil registry and that the projects in Senegal and Ivory Coast were always limited to just digitizing documents and preventing fraud. But the EUTF documents Siatitsa obtained clearly outline the biometric dimension in the diagnostic phase, specifying the aim to create ​“a biometric identification database for the population, connected to a reliable civil status system.”

Siatitsa later deduced that both projects’ true purpose seemed to be facilitating the deportation of African migrants from Europe; documents about the Ivory Coast initiative explicitly stated the database would be used to identify and return Ivorians illegally residing in Europe, with one explaining the objective of the project was to make it ​“easier to identify people who are truly Ivorian nationals and to organize their return more easily.”

When Senegalese privacy activist Cheikh Fall learned about the database proposed for his country in 2021, he reached out to the country’s data privacy authority, which, by law, should have been the one to approve such a project. Fall learned that the office had only been informed about the project after the government had already approved it.

In November 2021, Siatitsa filed a complaint with the EU’s ombudsman, which, after an independent investigation, ruled last December that the Commission had failed to consider the potential negative impact on privacy rights that this and other EU-funded migration projects could have in Africa.

Based on conversations with several sources and an internal presentation from the project’s steering committee that I obtained, it appears the project has since scrapped its biometric component. But Siatitsa says the case nonetheless illustrates how technologies forbidden in Europe can be used as experiments in Africa.

In late February, the day after their visit to the Rosso border crossing, MEPs Cornelia Ernst and Tineke Strik drove two hours southwest to meet a contingent of community leaders in the coastal town of Saint-Louis. Most likely named for the canonized 13th-century French King Louis IX, the city was once the capital of France’s West African empire. Today, it’s the epicenter of Senegal’s migration debate.

In a conference room at a local hotel, Ernst and Strik’s EU delegation gathered before leaders of the local fishing community to talk about the proposed deployment of Frontex and migration dynamics in the area. On one side sat the MEPs and their aides; on the other, the locals. On the wall behind the Senegalese contingent hung a painting of a white colonizer in a pith helmet sitting in a boat on a Senegalese river, lecturing the two African men who rowed it. The irony was thick, the atmosphere tense.

Author: Matt Rota

For dozens of generations, Saint-Louis’ local economy has relied on the ocean. The catch from artisanal fishing represents 95% of the national market and the core of the local diet. The fishermen, the women processing the catch for sale, the boat builders, the painters and the local distributors all rely on fishing as it’s been practiced in Senegal for hundreds of years. But a 2014 agreement between the EU and Senegal’s government, allowing European vessels to fish off the West African coast, has decimated the area’s once plentiful bounty and threatens to collapse its economy.

Since European industrial boats threw their first nets, Saint-Louis’ local fishermen have been forced farther and farther offshore. Now, as Chinese trawlers also compete in their waters, they regularly travel 60 miles out to sea.

There’s also a new BP gas platform offshore, which has enticed European leaders as a means of reducing dependence on Russian energy, but which also represents another area Senegalese fishermen can’t go. Locals charge that the coast guard, which primarily used to conduct search and rescue missions for fishermen in distress, now focuses on guarding the foreign rig.

“The people earning money from the exploitation of gas will be at the expense of the blood of the fishermen,” said Moustapha Dieng, the secretary general of the national fishing union.

As the situation has deteriorated, many locals lost their only source of income and were forced to consider migration instead.

After several hours of heated complaints, Strik acknowledged this irony, which was becoming painfully apparent. ​“It is very clear,” she said, ​“that the EU trade policy and its fishing agreement is creating migration towards Europe.”

The month after Ernst and Strik returned from Senegal, the European Parliament’s human rights committee held a hearing about the impact EU migration policy is having on human rights in West Africa. Cire Sall, from Boza Fii, together with a Human Rights Watch researcher working in Mauritania and an NGO staffer from Mali, all voiced their concerns that the EU’s policies in the region don’t address local needs but undermine sovereignty and human rights.

The Commission’s representatives brushed away these complaints, as well as Strik’s call for a monitoring system to suspend EU participation if human rights are violated. There was no need for a human rights assessment, one representative said, seeming to downplay a major announcement, because Senegal’s government had signaled it wasn’t open to Frontex moving in.

In the hearing room and in Senegal, the news brought a sense of relief. Strik saw it as a sign that the ​“EU is losing influence in Senegal because of frustration about the unequal relationship.”

But that relief shouldn’t last. While Frontex’s deployment has been (at least temporarily) blocked in Senegal, it appears on track for Mauritania, and likely other countries soon. The European Commission has committed to funding international partnerships in Africa until at least 2027, including through another, recently launched fund, the Neighbourhood, Development and International Cooperation Instrument, which is dedicating nearly $9 billion for what are essentially anti-migration projects worldwide.

All of it means that one of the wealthiest regions on earth will continue redirecting sorely needed development aid toward stopping the flow of migrants instead, under the pretext of addressing migration’s root causes. But as the experience in Senegal makes clear, the real root causes  —  the ones that serve European interests  —  are here to stay.

Credits:

Kathryn Joyce – Investigative Editor, In These Times
Jessica Stites – Editorial Director, In These Times
Rachel Dooley – Creative Director, In These Times
Matt Rota – Illustrator
Anna Sylvester-Trainer – Editor in Chief, Le Monde Afrique
Mady Camara – Local journalist and translator
Hannah Bowlus – Fact checker, In These Times
Ivonne Ortiz – Fact checker, In These Times
Valentine Morizot – English-French Translator, Le Monde