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Population: 11.1 m. Child mortality rate: 4/1000 Life expectancy at birth: 78.9 Medical humanitarian assistance to undocumented migrants Greece is located at the external border of the European Union, at the crossroads between Asia, Africa and Europe. While the numbers of irregular arrivals by sea in Italy and Spain are decreasing, the number of migrants and asylum seekers arriving in Greece increased dramatically during 2007. Many of these people do not want to stay in Greece but to continue on to one of the other EU Member States. Therefore most of them do not seek asylum in Greece and, since most EU countries have closed their borders, these people remain withinn the countries borders for unknown period of time. Many come via Turkey. There are two main routes into Greece from Turkey: one is across the Turkish-Greek land border in the northeast of the country, in the Evros region. The other route lies via the Mediterranean: refugees and undocumented migrants attempt to reach the islands in the North Aegean situated only a few kilometers away from the Turkish mainland. Particularly those of Chios, Samos and Lesbos are important points of entry to the EU for arriving by sea. Patras is a town of 240.000 inhabitants and the main port of exit to Italy. In the last 10 years there has been a constant influx of migrants transiting in their way to Italy, hidden inside trucks. At the beginning they were few and mostly Kurds, nowadays the majority are Afghan and are living in a refugee settlement near the harbour. Projects From the 11th to the 28th of February 2008, an MSF team conducted an exploratory mission for the situation of undocumented migrants in Patras, Igoumeniza, the islands of Samos, Lesvos and Chios and the Evros region. In the detention centres in Samos, Chios and Lesvos the main problems that were encountered were the irregularity and inefficiency of medical healthcare, the lack of personnel, the lack of special measures for vulnerable groups and generally the unacceptable living conditions. In the migrant’s settlement in Patras, the situation for migrants is mach more difficult. The MSF team saw that migrants live under precarious conditions with limited access to health care. On the 13th of May 2008, based on the findings of the exploratory mission, MSF decided to start an emergency intervention program in the temporary migrants’ settlement in Patra and later on the 2nd of June 2008, in the detention centre of Pagani in Lesvos. The third place where MSF had planned to intervene was Evros, but finally the intervention did not start, since the detention centre of Peplos was closed. Temporary migrants’ settlement in Patra From the 13th of May 2008, MSF provides primary health care services and psychosocial support to the undocumented migrants inside the camp of Patra. The running of the clinic on a daily basis and the presence of a psychologist helps in the direction of dealing with all the cases that need evaluation and referral, as well as in supporting and dealing with cases on a personal and on a group level. There are 20-25 consultations every day. Up to the end of July, 1.020 consultations were conducted. The main medical problems of the population are skin diseases, mainly scabies and infections, respiratory infections (of the upper and the lower respiratory system) and gastrointestinal disorders (diarrhea). Myoskeletal pains and injuries are also a common medical finding, as a result of the migrants’ frequent involvement in attempts to get on moving tracks (as a means of leaving the country). Without hot water, without adequate ventilation, the reality that the migrants face and MSF has recorded is very difficult. MSF provides free treatment. We take full medical records from all cases, and when there is need for a referral and further examination, we ask for the assistance of the local health authorities. Up to the end of July, 175 patients have been referred to hospitals. At the same time, group sessions are carried out frequently, in order to inform the population about issues of personal sanitation, prevention of diseases etc. The mental health workers record cases of depression and post-traumatic stress among migrants – situations linked to their families and the problems they have left behind in their countries, the hard living conditions and the uncertainty about the future. It’s also worth noting that access of the population to toilets and showers is limited to some constructions built from scratch by the migrants themselves, that the waste management is problematic inside the camp, access to clean water is limited and as a consequence personal sanitation is deficient. Under this light, migrants do not have the means to efficiently see to their personal sanitation in a way that would reduce the risk of diseases. The logistician of the team provides systematic support towards the improvement of the living conditions. There is frequent distribution of materials necessary for the improvement of the living conditions (plastic containers, showers, toilet seats, litter bins, cleaning material etc.) and the personal sanitation (soaps etc.) of the migrants who live in the camp, while at the same time the improvement of the infrastructure (the showers and the toilets are not sufficient) is ongoing, in order to ensure better care of the population’s hygiene. Detention center in Mytilini Similar services are provided in the detention center of Pagani, with the daily presence of a doctor, a psychologist and a logistician of the organization since the 2nd of June 2008. More than 591 consultations have been conducted so far. The main medical problems of the population are skin diseases, mainly scabies and infections, respiratory infections (of the upper and the lower respiratory system) and gastrointestinal disorders (diarrhea) – diseases that are directly linked to the existing living conditions. At the psychosocial support level, the presence of a psychologist aims at supporting vulnerable members of the population (children, pregnant women, victims of violence, families) by organizing activities inside the detention center. Moreover, MSF has constructed showers, toilets and other infrastructure. In addition, since the 17th of July the team provides humanitarian and primary health care at the migrants’ arrival point in the Harbor of Mytilini. At the same time, the MSF teams are conducting frequent visits to the reception place of unaccompanied minors in Ayasso, while they are following up the progress on the setting up of this new structure. Detention Center of Peplo (Evros) The intervention in the detention centre in Peplo, while it was considered a priority according to the results of the exploratory mission –February 2008- (and one of the 3 locations that MSF was going to intervene), was never realized because this particular center stopped functioning. MSF continues its work in the pre-mentioned locations of intervention, and at the same time we are in regular contact with the relevant authorities regarding vaccinations, following up issues of public health and exploring the possibility of collaborating with the health departments at a local and at a central level. Further evaluation of the medical needs of the undocumented migrants is ongoing. |