Poland: Legislators must drop harmful ‘age as a verdict’ measures for children and migrants

Warsaw – As legislators in Poland draft a new law aimed at combatting human trafficking, Doctors without Borders (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 lawmakers 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,” says Dr Alice Silvestro, MSF medical coordinator in Poland. “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.”

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,” says Uriel Mazzoli, MSF project coordinator in Poland. “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.”

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.”

Iraqi mother hugging her daughter. A family of 13 Iraqi Kurds including 4 children asked for asylum in Poland. The family was taken by the Polish border guards back to emergency state zone at the Belarusian border. On the next day, they sent their location indicating that they were back on the Belarusian side of the border. Photographer: Maciej Moskwa | Date: 11/10/2021 | Location: PolandDidar (15) is travelling with his mother, four younger siblings and his uncle to join his father in Germany. After spending at least three days without eating and at least 20 days in the woods being pushed back and forth between Poland and Belarus, he was trembling and almost unable to speak, his clothes were completely wet when he was found by a local resident who is trying to help people on the move in the forest near the border. Photographer: Kasia Strek | Date: 13/11/2021 | Location: Poland

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, we currently run a non-communicable diseases (NCDs) project in Butterworth, Eastern Cape province, where we support the Department of Health (DoH) in improving care for patients with diabetes and hypertension. The project focuses on improving screening, diagnosis, management, and prevention of NCDs through advocacy, research, health promotion, training, and mentorship of Community Healthcare Workers.

MSF is also recognised as one of the pioneers in providing antiretroviral treatment (ART) in the public sector. It started the first HIV programme in South Africa in 1999. The organisation's earlier interventions in the country have primarily been on developing new testing and treatment strategies for HIV/AIDS and Tuberculosis (TB) in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape). The Eshowe project was handed over to DoH in 2023 after 12 years of operations. The Khayelitsha project was closed in 2020 after 22 years of activities and campaigning for improved HIV and TB treatment.

Other projects we have been involved in include our Migrant Project in the country's capital, Tshwane, which was handed over to authorities and a local Community-Based Organisation after building the capacity to work with undocumented populations. We also previously offered free, high-quality, and confidential medical care to survivors of sexual and gender-based violence in Rustenburg, North West province.

To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work: