Independent organisations established to provide assistance to those in need face increasing obstacles to provide care and are confronted by a growing trend to criminalise the very act of assistance.

Médecins Sans Frontières/Doctors Without Borders (MSF) is one of the few organisations working with displaced people around the world before, during and after their forced migration journey.

What we have witnessed in 2019 is that governments are making that journey increasingly dangerous and cruel. As an international medical organisation, our humanitarian efforts to save lives and reduce suffering have been criticised and blocked.

One year ago, thanks to a sinister campaign of European legal action and administrative blocks MSF was forced to stop the Aquarius, the only remaining independent search and rescue vessel on the central Mediterranean.

This despite the fact every operation was strictly monitored and managed in compliance with international law.

People are so desperate that facing death at sea is still perceived as a better option than returning to the countries they fled or the horrors of detention in Libya, currently in the throes of an armed rebellion.

European states continue to fund Libyan authorities to intercept people at sea and return them to Libya to keep them off European shores. Europe also funds offshore processing in Libya (i.e. detention), despite it now being well known that refugees and migrants face alarming levels of violence and exploitation.

Meanwhile, thousands of women, men and children remain trapped on the Greek island of Lesvos, most of whom have fled conflicts in Syria, Afghanistan and Iraq.

One quarter of children attending our group therapy sessions in Lesvos have self-harmed, had suicidal thoughts or have attempted suicide.

In Central and South America, people enter a similar cycle of exploitation and abuse. Hundreds of thousands of people fleeing the crisis in Venezuela are obliged to seek safety in neighbouring countries, where they are vulnerable to traffickers and armed groups.

In Mexico, 68 percent of the migrant population cared for by MSF report experiencing violence during their transit towards the United States.

Closer to home, in October 2018 MSF was forced to leave Nauru where our team had been providing mental healthcare to Nauruan nationals, refugees and asylum seekers. We tried in February 2019 to resume care for our patients through 'telehealth' consultations but were blocked again.

When mental health professionals say there's a mental health crisis, authorities need to listen. Yet, despite having reported that 60 percent of the people we'd treated on Nauru had suicidal thoughts, that grim statistic is now visible in action.

Since the election last month, more than 50 suicide attempts have been reported among those still detained on Manus Island. It's the loudest cry for help we'll ever hear.

It has been six years for most of the refugees held there under the Australian government's policy of offshore detention.

The patients we left behind are critically ill and exist in a cycle of despair. They have limited freedom or control over their lives, no information and no plan.

They are mostly registered refugees with a legal right to protection, and yet they have less clarity over their future, and less access to legal processes, than many convicted criminals.

Using a group of highly vulnerable people to set an example for another, while causing them permanent physical and mental harm, is morally abhorrent.

Australian governments old and new say they want to save lives at sea, and that as a measure to stop people getting on boats, offshore processing is a "humanitarian act".

Let us be clear - offshore processing resulting in indefinite detention causes severe mental illness and is leading to self-harm. Eventually it will lead to more offshore deaths.

There is nothing humanitarian about this policy. The suffering it causes is predictable, severe and widespread.

States have the right to manage migration across their borders, but they also have a responsibility to minimise human suffering.

We must not tolerate Government policies and practices that knowingly cause harm, however much this is spun in a dialogue of border protection and deterrence. And we must not let anyone fool us into thinking that seeking protection is a criminal act, or that helping those in need is wrong.

It's time to look towards a world that provides a more humane response to people on the move, who are seeking nothing more than a better, safer life - like all of us.