Saturday 28 November 2015

Responding to the European Refugee Crisis

When I announced at VERY short notice to my family and friends that I was coming to Slovenia to help respond to the refugee crisis as a clinical doctor with Doctors of the World (DOTW) I was unsure what reaction I would face.  

I have been completely overwhelmed by the outpouring of support from my friends, family, colleagues, old (as in long ago not age wise(!) teachers and strangers. I feel incredibly privileged to have been given the opportunity to use my skill set in a really tangible way to help some of these most vulnerable people and feel I’m here on behalf of everyone I know who supports this work.

I want to spend this first post explaining a bit about the work I’m here to do and my (very) limited understanding of the current situation as it stands. I feel in the 2 days I’ve been here I’ve received so much information and feel obligated to get it out there and consolidate it in my head too.

DOTW UK is part of the Medecins du Monde (MdM) international network which along with international humanitarian work has had a long term presence in Europe providing healthcare to vulnerable populations. In June this year DOTW UK launched an emergency response as the crisis worsened across Europe and made a call for volunteers to be added to a bank of staff willing to be deployed at short notice to new clinics as the need arose around Europe. I applied around August hoping to get involved before going to South Africa to work in a hospital there.

The new clinics have been set up mostly at border crossing points where there is a delay of getting people across a border. People are held in “transit centres” for a few hours (or sometimes overnight) whilst the flow of migrants is managed by the national army and police of the country the migrants are leaving. In some situations, there is no flow (like Calais) and people end up being stranded for hours/days/weeks/months/indefinitely until the border point (re)opens or a new route is established.

Now, these transit centres are NOT accommodation centres. There is a clear distinction from those countries who have agreed to house refugees (Germany) and those who have not. In Germany there are designated accommodation centres where under the protection of the Geneva Convention refugees have the right to live indefinitely until a period where EITHER the political situation changes in their country of origin and it is deemed safe for them to return OR the country they are in decides to allow people to have the right to reside as full integrated members of society in the new country OR they are sent to another country to gain residence. Whilst in these accommodation centres the refugees have rights to schooling, healthcare, shelter, meals etc, and to apply for work the same as a national resident (more on this is my second post).

Right, back to our work. At these transit centres there is the theoretical opportunity for food, shelter, clothing, showers and healthcare (you know those basic human rights) as people get backed up through bottle necks as border points try to control the flow of people.
The role I have been assigned is as the physician along with one nurse providing primary healthcare within a “mobile clinic” to those transiting through Slovenia to the Austrian border in a village called Gornja Radgona. The MdM Belgium team is coordinating the project and had set up this clinic at the beginning of November following an exploration team assessing where refugees could potentially accumulate and where best to provide care, in agreement with local partner NGOs. We are relieving one doctor and one nurse from the UK, who with their tiny amazing team, drove from Belgium with 2 vans full of medicines, equipment and a tent, set up a fully functioning mobile clinic within the transit centre created by the Slovenia government.

The Gornja Radgona transit centre has been incredibly busy with around 1-2000 people transiting through to Austria daily. The people are moved three times a day to the Austrian border accompanied by army and police around a 1km walk where they are put onto buses to be transported to the next transit centre in Austria. People on average stay a few hours and most have been travelling non stop for at least a few days and some have started their journeys months ago. There is a real need to provide care for minor illnesses, poorly managed chronic health conditions, pregnant women, young children, psychosocial problems, dehydration and infections from poor conditions and travelling along this route.

I have only been here for 2 days and trying to understand the flow of people, why and how they accumulate at various bottle necks is mind boggling. There is very little concrete information about how individual countries are maintaining their border points and how the flow will change. Quite unexpectedly after 2 weeks of over 1000 people arriving a day in Gornja Radgona, the camp has been empty for the past 3 days. Currently Slovenia is transiting migrants by placing them directly on a train from Croatia non-stop across Slovenia to Austria so the country is acting as a corridor and the transit centres are empty. The police are expecting many to arrive tomorrow or Monday, but there is no real information being shared with MdM and we hear our information second hand from UNHCR and other local actors. 

However, for the MdM team, it has been a much needed break for the outgoing group and vital time for Heather (the nurse) and I to understand and fully handover the clinic before they leave on Sunday.

I’m going to stop here because this post is already too long and if you’ve made it this far then well done! I have so much more I want to say and I’ve not seen a single patient yet so I feel this is going to be an incredibly eye opening, challenging and fascinating 6 weeks. But I’m incredibly excited to be here and Heather and I are raring to go. I want to say thanks again to everyone whose kind words have made me value this work more highly and again I feel so privileged to have been given this opportunity and hope we can make a difference here. 
Heather and I raring to go in snowy Slovenia