Doctors without Patients

The past week has been an interesting time for me, unfortunately we have not been able to see any refugees as the camps continue to be empty. We are almost certain Gornja Radgona is closed for the foreseeable future has now been empty for 12 days and shows no sign of being reopened. The reason for this has been a decrease in the flow of people coming through in general because of worsening winter conditions, Turkey’s crackdown on people crossing to Greece and the prevention of any refugees not from Syria, Iraq or Afghanistan from crossing into Macedonia.

This policy to only allow entry to Syrians, Iraqis and Afghanis has led to the accumulation of around 3000 people in a camp in Idomeni on the Greek/Macedonian border. A large fence is being constructed along the entire border to prevent people from travelling through other than at specific border points where they can control people based on nationality. Things have escalated at this camp and protests became more violent last week. Some migrants tried to rush an unguarded border point but were fought back with riot police using rubber bullets and tear gas. A young Moroccan man was electrocuted to death trying to cross the train lines. Refugees who are not from Syria, Iraq or Afghanistan have been blockading the route to prevent other refugees from entering Macedonia stating “either the border is open for everyone or it’s closed”. MdM’s clinic had to run a shortened service on the worst affected days as tensions mounted and safety of staff was questioned. Because of these protests many “accepted” nationalities are still stuck in Idomeni and the flow of “allowed” refugees into Macedonia remains reduced.

Since this policy was installed the Greek officials have put on buses to transport people from Idomeni to Athens stating they will be provided with accommodation and basic needs, but as refugees are not sure of their fate if they move to Athens many are choosing to stay in Idomeni. Over the weekend things have escalated with Greece now talking about forceful evacuations of Idomeni and request for more border police to manage the situation. There have been reports of those who left voluntarily to Athens already returning to Idomeni claiming conditions in Athens are worse.

Currently, there are only 2 camps in Slovenia that are being used, the entry point Dobova and exit point of Sentjil. The entry point is just a registration facility where people are transferred from Croatian authorities to Slovenian and then sent on buses or trains to the exit point on the Austrian border. At the exit point there is more of a delay to cross and people seem to stay overnight sometimes but usually only stay for a few hours as was the case in Gornja Radgona. 

At both of these camps there are local actors (one French NGO and the Slovakian army) providing the opportunity for medical care but our team is unsure if the medical needs are being adequately met. People from our team witnesses refugees scared to break line, as they queue to be registered, to see a doctor for fear of being separated from their family or being denied access to the next train leaving. However, given these actors have already got this space and by the Slovenian authorities measures are “meeting the medical needs” of people we are unable to work in either of these camps currently.

The other main concern with the current situation, is that unlike Gornja Radgnoa the exit point being used in Sentjil uses tents for accommodation rather than a building and with winter approaching we are worried about the inevitable freezing temperatures that will affect all those staying overnight there. We have however, been told by the civil protection authorities that if the weather does become very bad then Gornja Radgona will be reopened and used instead of Sentjil.

So in response the other MdM staff here are now trying to negotiate with the Slovenian government to be given humanitarian spaces within which we are able to set up a clinic, whilst also being on standby to react to the reopening of Gornja Radgona should a large number of refugees overwhelm the system again. The possibilities to create new spaces are to slow down registration like the Gornja Radgona set up, stop the trains at designated points to provide healthcare along the journey or consider providing healthcare on the trains transporting people.  Me and Heather made a briefing of how we think a clinic on train could be run and what issues we would need to consider. It was quite fun to think about and who knows it might go somewhere!

The negotiation of MdM with ministry of health is very complex and the government is sceptical of a sudden influx of NGOs with no benefit to the Slovenian population. One thing MdM is discussing is the possibility of providing long term care to Slovenians without health insurance as part of deal to operate in this crisis. So this work is incredibly political and not the job of a doctor and nurse looking for patients to treat! As a team we decided last Friday that until something more concrete was agreed we are being sent home on Wednesday, possibly to be redeployed to Greece or return to Slovenia if/when there are refugees back in Gornja Radgona or another space is found for us to work.

Today we had a meeting with our local partner and did a presentation outlining our work and what we have been doing. They ended up not finding any people without health insurance for the clinic they requested so again we didn’t actually see or treat anyone! We also had a positive meeting with the public health official linked to another entry point in Lendava which may be used if numbers increase again. She said that if her camp reopened they would consider MdM to provide support to the local staff to manage the health needs of refugees.

So I’m sure from all my rambling you can see that this in such an incredibly complex situation that depends on so many factors. The flow of people, the ability of the states to provide for them, the political will for states to provide care, the acceptance of local countries of foreign NGOs, the (lack of) sharing of information, the interplay between NGOs fighting for contracts, the requests of donors pushing for interventions where maybe it’s not relevant, the rapidly changing context which means long term planning is essentially impossible…..the list goes on and on.

I’ve only spent 2 weeks in Slovenia trying to identify and understand the interplay of these factors and I feel I’ve only scratched the surface. But what I know for sure is, this crisis isn’t going away, refugee’s health needs aren’t being met and EU policies on asylum and migration are directly causing human suffering and humanitarian needs. I’m heading home on weds with a head full of ideas and a desire to come back out with MdM as soon as they ask for me!