"The camp was built to hold 1,500 people, but we often have more than 4,000. This overcrowding creates unhygienic conditions that increases the risk of the spread of infection. There have been days where we have seen over 200 people in one shift because the overwhelming need for medical assistance."
New border restrictions at the crossings between Greece and the Balkan states of southern Europe have left thousands of men, women and children travelling the so-called Western Balkans migration route stranded in a no-man’s land without access to the care they should receive under international agreement.
Dr. Tim Jagatic is a Canadian physician with Doctors Without Borders/Médecins Sans Frontières (MSF) who is helping deliver medical assistance to people fleeing war-torn homelands such as Syria, Iraq and Afghanistan in search of security and hope in Europe. He recently moved from an MSF medical project for migrants on the Greek island of Lesbos to Idomeni, along Greece’s border with the Former Yugoslav Republic of Macedonia.
Where are you currently working, and what are MSF’s activities there?
I started on Lesbos in the refugee and mobile clinic that was set up for the migrants who cross the Aegean Sea by boat. We provide primary medical care services that cover for basic diseases and situations that include upper respiratory tract infections, hypothermia, dehydration and gastrointestinal infections. We also refer patients to local hospitals for more complex care when needed.
I have since moved to Idomeni camp, which is in the north of Greece right on the border with Macedonia. We provide the same primary healthcare services and refer patients needing more comprehensive care to local hospitals.
Describe the patients you are seeing. Who are they, where are they from, and what kind of medical cases are you responding to?
On Lesbos, we were seeing patients from all over the Middle East and North Africa, including Syria, Iraq, Iran, Afghanistan and Morocco. In Idomeni, we only see patients from Syria, Iraq, and Afghanistan because those are the only nationalities that are allowed to cross the Greek border with refugee status. The registration process that is done on Lesbos and at other points of entry organizes migrants according to whether or not they have been approved to move on through Europe.
What are the medical needs you are seeing?
The needs we see are mostly very basic. Flu-like symptoms, bacterial infections of the upper respiratory tracts and joint pain from travelling are frequently seen. The difficulty of travelling long distances has prevented people with more complex illnesses from participating in the movement across continents. The majority of people we see are fairly healthy individuals with conditions that can be treated in primary healthcare settings.
What are the biggest challenges you are facing when it comes to delivering care and assistance?
The migrants are being sent by bus from within Greece to the border of Macedonia. The border opens and closes without warning, so buses are often bringing migrants to the camp even when there is no movement across the border. This quickly leads to overcrowding in the camp. The camp was built to hold 1,500 people, but we often have more than 4,000. This overcrowding creates unhygienic conditions that increases the risk of the spread of infection. There have been days where we have seen over 200 people in one shift because the overwhelming need for medical assistance.
Is there a mental health component to the work MSF is doing?
MSF is providing psychological support to many people, mostly because of the contexts people are fleeing. Many of our patients suffer from post-traumatic stress disorder resulting from their experiences in war-torn countries. The patients in need of counselling are sent to an MSF psychologist on-site.
Is MSF doing anything else for refugees and migrants beyond medical care?
MSF is supporting NFI distribution in the various points we are present along the route through Europe. Many people come ill-prepared for winter weather and require warmer clothing. Some migrants have been found travelling in pyjamas (which shows how quickly decisions to leave are sometimes made). We also try to provide food distribution when possible.
Are there any patients or people you have met that have made a particular impression on you?
The patients who we refer for psychological support often have stories that you can't quickly forget. One patient was a journalist who was forced to watch his son be executed in front of him, then was sent to prison for two years and put in an isolation room where he didn't see sunlight the whole time.
Stories like this remind me that so much more is happening every day than we hear about in the media. It also reminds me that this is a situation that the average person hears about for a few minutes now and then in the news, but it is actually happening every moment of every day. People are being tortured, forced to flee their homes, and to leave family and friends who are too old or sick to join them — only to be made to feel unwelcome in arrival countries, or judged by people who don’t know what they've been through. The resentment being directed toward the refugees is disturbing, especially once you hear their stories.
You started in Lesbos, and then moved on to Idomeni, on the Greek border with Macedonia. What are the differences and/or similarities you have seen between the two contexts?
The major differences between the two is the general mood of the refugees. On Lesbos, there was a greater sense of optimism and relief because the refugees had made it to the final part of their journey. In Idomeni, there is greater reservation, because by the time they reach the Greek border they have experienced unwelcoming sentiments from some people. We had a situation where anarchists made their way into the camp in order to protest the presence of migrants in Greece, along with incidents such as bus drivers leaving people at gas stations because they didn't feel it was necessary to make sure all the people were back on the bus. This type of behaviour has separated families and forced people to wait in the camp for days until they were reunited.
Why is it important for MSF to be present along migration routes?
It is important for MSF to be here first and foremost so someone will provide the services and care that people are not receiving. This includes primary healthcare, referrals to hospitals for more severe cases, food and appropriate clothing for the climate.
MSF is also trying to ensure the rights of all migrants are being respected and recognized as they travel through Europe until they reach their final destinations.