Weeks after the mass crossing at its border, Ceuta is still grappling with a deepening humanitarian crisis. More than 72,000 people reportedly entered the Spanish enclave irregularly from Morocco on 30 and 31 July, sharply exceeding its normal reception capacity. Hospital admissions have eased since the initial surge, but migrants remain in precarious conditions on the city’s outskirts, including in improvised camps, on beaches and in the streets. The European Union Agency for Fundamental Rights (FRA) described the wider pressure on safeguards as “Fundamental Rights under pressure at EU borders.”
The FRA said media reports indicated that at least 88 people died attempting to swim to Ceuta. Humanitarian organizations cited in the account of the crossing put the death toll at at least 141. The agency also identified risks to the right to life, allegations of disproportionate use of force, inadequate reception conditions and failures in child protection. The Geneva International Centre of Justice characterized the crisis as involving political instrumentalization, border-control failures and an erosion of migrants’ rights, reporting that some were “living in makeshift camps, on the streets or on the beaches.”
Ceuta’s hospital and health services continue to treat migrant patients, even though the emergency’s immediate peak has passed. Spain’s National Institute of Health Management (Ingesa) recorded 2,423 medical contacts involving migrants between 14 and 22 October: 1,460 through basic care and the 061 emergency service, and 963 in the emergency department of Ceuta’s University Hospital. The Otero medical point accounted for 1,072 contacts and the Tarajal centre for 87; ambulance services recorded 216 deployments. Ingesa also reported 802 vaccinations and 34 panoramic dental examinations during the nine-day period.
The hospital operated with 210 to 211 beds during the reporting period. On 22 October, 104 beds were occupied and 107 were free; the daily number of hospitalized migrants ranged from 15 to 21. Overall occupancy stood between 99 and 111 patients. The figures show that expanded capacity was not fully occupied at the latest reporting point, while the volume of medical contacts indicates that demand for care continued. Ingesa said it was monitoring activity and coordinating health professionals as demand changed.
On the ground, conditions in areas such as the El Tarajal industrial zone remain starkly different from those inside the hospital. Families, mainly from Morocco, have set up makeshift camps using construction barriers and sheets. These locations, once bustling with cross-border trade, now lack a permanent police or military presence. With no public toilets or showers, many migrants must treat wounds and illnesses themselves, raising concerns about public health and access to basic care.
International aid groups have stepped in to fill the gap. Médicos del Mundo recently provided medical assistance for the first time since the border crossing, treating infected wounds and common illnesses such as gastroenteritis and skin infections. Volunteers, supported by NGO interpreters, are often the only source of care for these communities. Children and women form long lines for basic check-ups, then return to their precarious shelters.
Save the Children estimates that more than 4,000 minors remain outside Ceuta’s official protection system, awaiting identification and referral to social services. Separately, figures presented by Spain’s Minister for Inclusion, Social Security and Migration, Elma Saiz, on 21 October showed that Ceuta’s child-protection system had taken in 3,331 migrant minors who arrived during the mass entry at the end of July. Of the children transferred to mainland Spain, 107 moved through family reunification and 181 were relocated to other autonomous communities under Article 35 of Spain’s Immigration Law. The official figures count children reached by the protection system; they do not include all minors who may have arrived or remained outside formal care.
The Article 35 transfers are part of a statutory mechanism for distributing responsibility for unaccompanied children among Spain’s autonomous communities. The arrangement involves the central government, Ceuta’s autonomous administration and regional authorities. Save the Children’s teams are met by crowds of teenagers eager to register, a sign of the scale of the identification challenge. In less than an hour, volunteers can collect the names of more than a hundred children, with more arriving constantly.
Health Minister Mónica García has denied that Ceuta’s health system is collapsing, while acknowledging that the most urgent needs lie outside hospitals. She has described the epidemiological risk as “moderate” for migrants and “low” for local residents, citing two confirmed cases of tuberculosis: one in a minor who arrived with a diagnosis from Morocco, and another in a Ceuta resident. Additional positive Mantoux tests and several cases of gastroenteritis have also been reported.
García says the priority is to provide migrants with safe shelter, clean water, hygiene and food. The central government has urged Ceuta’s authorities to open more spaces for migrants to prevent outbreaks and support epidemiological control. Local resistance remains strong. Residents in peripheral neighborhoods oppose new facilities near their homes, and proposals to use the former flour factory as a migrant centre have sparked public protests.
Spain’s government declared a “Situation of National Security Interest” in Ceuta, establishing a reinforced coordination structure for the General State Administration. The government said the mechanism was intended to coordinate resources, organize reception and manage returns and accommodation. Between 10 August and 20 October, authorities reported that more than 12,700 people had returned to Morocco; most adult migrants still in the city were housed in facilities supplied by the state administration. The government said the coordination arrangement was “already clear evidence that there has been no inaction” by state services.
As the city marks 20 days since the deadly crossing, Ceuta’s government is holding an extraordinary meeting to decide on further measures. The city’s leadership warns that Ceuta “remains at risk,” despite the restoration of order at the border following Morocco’s military intervention. The FRA’s assessment and conditions reported by the Geneva International Centre of Justice show that the humanitarian consequences extend beyond the initial crossing, including shelter, healthcare and child protection.
The Spanish government continues to send high-level officials to the city. Elma Saiz, Minister of Inclusion, Social Security and Migration, is scheduled to review humanitarian operations and meet with local authorities. She is the sixth minister to travel to Ceuta since the crisis began at the end of July. For additional background on the strain facing Ceuta’s health system and the political tensions surrounding migrant care, see this recent report on the ongoing challenges.
Ceuta’s position as a Spanish enclave on the African continent has long made it a focal point for migration from North Africa and sub-Saharan countries. The city’s limited infrastructure and resources are frequently tested by sudden influxes of people. Spanish law requires authorities to provide humanitarian assistance and protection to minors, but the scale of recent arrivals has exposed gaps in the system. The standoff between local and national authorities over where and how to house migrants reflects broader tensions in Spain’s approach to border management and integration. The balance between public health, humanitarian obligations and community concerns remains fragile.
