In Borgo Mezzanone people live in tin shacks, without drinking water, electricity and essential services. In this limbo are thousands of seasonal workers who bend their backs every day in the fields without any protection, invisible to a system that exploits their labor but ignores their rights. Here, where poor access to care turns even a trivial infection into a chronic risk, INTERSOS mobile clinics enter every day bringing not just medicine, but dignity, a listening ear and protection for men and women whom the state has chosen not to see.
WHAT IS BORGO MEZZANONE
In the North of Apulia, in the countryside between Foggia and Manfredonia, there is a town that no one sees. It is called Borgo Mezzanone: it is one of the largest informal settlements in Europe.
This village is located exactly in the area of a former military airport where a reception center for asylum seekers (CARA) was established in 2005. Outside the perimeter of the center, a huge informal settlement consisting of shacks made of wood, plastic, sheet metal and small brick buildings has formed over time.
During the summer season, the settlement has about 3,500 inhabitants, mostly foreign farm laborers who come to Apulia to harvest tomatoes. But even in winter there are many who stay there, more than a thousand, despite the fact that living conditions are extremely precarious: there is a lack of drinking water, electricity, sewage, and essential services.
Borgo Mezzanone is people, animals, houses and stores, water containers, undisposed waste, cars, bicycles and mopeds, roads and shacks. It is not a static place, but rather a place in constant transformation. People come and go, mostly following the seasonality of work. Some stay, and for them Borgo Mezzanone becomes home.
INTERSOS worker in Foggia
The settlement of Borgo Mezzanone represents a complex microcosm, in which strong community solidarity dynamics coexist on the one hand and, on the other, phenomena of crime, drugs use and serious mental health issues, often related to the condition of isolation and extreme marginality.
Although this “city” has been here for more than two decades, not many people are familiar with it. And those who heard about it, did so when it made the news mostly for the accidents and shack fires that also cost the lives of those who lived there.
“When you first get there, you see a place where you don’t think dignity can exist. Then you see the people: men and women returning tired and dirty from work, exchanging small talk and laughter with each other. You walk around the shacks and find the dignity of these people who have built their homes here despite poor sanitation and the only waste materials available.”
INTERSOS social worker – Foggia
THE CONTEXT
The province of Foggia, known as Capitanata, is one of Europe’s most important agricultural districts, but it also represents the epicenter of a deeply entrenched system of labor exploitation. In this area, the agricultural economy is largely dependent on an “invisible” foreign labor force, which is often exposed to the phenomenon of “caporalato. Local organised crime exercises pervasive control over the territory, influencing access to basic necessities and transportation.
Migrant people who work as farm laborers and factory workers in factories that package agricultural products are very often people who experience severe social exclusion, experience racial discrimination, and face barriers to accessing basic territorial services on a daily basis. In this context, even finding housing in urban centers becomes extremely complex. Therefore, over time, unformal and unregulated housing developments have developed in the vicinity of agricultural areas.
THE NEEDS
In Borgo Mezzanone, housing conditions are extremely precarious: there is a lack of sewage, water and electrical systems and an adequate waste management system. These are all factors that determine a high-risk health environment.
This settlement, as well as the other smaller ones in this area, is characterised by marked geographic isolation: population centers are distant for those without their own means and there is no public transportation. Thus, a great distance, not only physical but also symbolic, is determined between those living in the “ghetto,” local communities and territorial services.
In a study conducted in 2025 in collaboration with Maastricht University, INTERSOS found that 81 percent of respondents did not have access to safe water; 75 percent reported indicators of extreme poverty; 66 percent said they had experienced at least one incident of discrimination and/or stigma; and 96 percent said they did not have sufficient economic resources to cover basic needs. In this context, there are widespread indicators of mental distress and suffering, often associated with increasing drug addiction issues.
Within the settlement there is also a significant female component-about 10 percent of the population-predominantly of Nigerian origin, exposed to sexual exploitation, trafficking and abuse.
Available data show that the main critical issues related to the female population are related to difficulties in accessing and using territorial health services (general practitioners, counseling centers, hospitals), cultural, linguistic and communication factors, and organizational obstacles.
The multidimensional nature of violence, discrimination and exploitation experienced by women, both inside and outside of settlements, makes them particularly distrustful and difficult to intercept by services.
THE LACK OF ACCESS TO HEALTH CARE
Social isolation, the conditions of legal uncertainty, together with linguistic-cultural barriers and complex and slow bureaucratic paths create, for the inhabitants of the settlement, huge obstacles in accessing health services.
This, added to the precarious housing and working conditions, seriously compromises people’s health. Indeed, among them are numerous cases of chronic diseases (hypertension, cardiovascular disease, diabetes), trauma (stab and impact wounds), and infectious diseases (hepatitis B, HIV, tuberculosis), as well as mental health-related illnesses.
The people we intercept present conditions of multi-vulnerability that manifest themselves in interconnected ways and exacerbate the complexity of interventions: economic, housing, legal and health precariousness are intertwined, producing clinical-social frameworks that are difficult to manage.
INTERSOS health worker
WHAT DOES INTERSOS DO?
Since 2018, INTERSOS has been working in Borgo Mezzanone and other smaller settlements in the province of Foggia through social-health activities, mainly employing mobile clinics and a multidisciplinary team. The activities, which are carried out in collaboration with local facilities of the Regional Health Service, include: medical examinations, orientations and referrals to territorial social-health services, health awareness and promotion campaigns, screening for sexually transmitted infections, personalized and multidisciplinary intake paths, and linguistic-cultural mediation.
To bring our care to informal settlement residents on a daily basis, we use a vehicle equipped as a mobile clinic so that people have free, continuous, low-threshold access to basic health services. The staff of the mobile clinics consists of a person in charge of the team, a mediator and a cultural-linguistic mediator, a doctor, a nurse and a social-health worker. Inside the vehicle, visits are conducted in a specially arranged space to ensure privacy, confidentiality and adequate sanitary conditions.
1.130
people reached by our services in 2025
90.2%
of these were men
9.8%
of these were women
804
people received medical assistance
The mobile clinic represents the core of the intervention in the territory: it allows early interception of health-related needs, preventing the aggravation of diseases and directing people to public health services when necessary, facilitating pathways of care taking and continuity of care.
“We do not see them while they are working, but we meet them at the end of the day, on their way back after their long days of work in the fields, as they walk in a line along the dirt path from the highway to the settlement,” tells the mobile clinic staff. “Some arrive by car, others are dropped off quickly by white vans that then run away. They often stop at the mobile clinic, still wearing their raincoats and rubber boots, their work uniforms. They have open wounds caused by work tools, swollen and watery eyes from some seasonal allergy or widespread pain in their bodies, backs, legs. If we were not there, very close to their homes, few of them would go to the doctor or go to the hospital to have their wounds medicated, rather they would try to tamp down the damage with some homemade method. The mobile clinic in these cases is the quickest way to get relief.”