tag:blogger.com,1999:blog-86266039645408176382024-02-18T20:00:11.496-08:00Healthcare in a Mobile Clinic for RefugeesThoughts and experiences of a doctor working in a mobile clinic for refugees in SloveniaAaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-8626603964540817638.post-81305924625029102802016-04-01T06:00:00.001-07:002016-04-01T06:00:03.959-07:00The end for now
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<span style="mso-spacerun: yes;"> I </span><span lang="EN-GB">started
writing this post from the departure lounge of Athens airport. It was a
stunningly beautiful day, 20 degrees, not a cloud in the sky, gentle breeze and
I was seeing my husband in a few hours, but my heart was heavy. Heavy because I’m
leaving my most excellent colleagues and will miss them dearly, heavy because I loved
every minute of working here and want to keep doing it, heavy because I don’t know
what will happen to the wonderful people I’ve met and heavy because saying goodbye to
someone who’s future is so uncertain is a deeply unsettling thing. What do you
say? All the best…good luck… I hope things work out for you…Inshallah. </span></div>
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<span lang="EN-GB"> <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhePVyQovmLSueGTBiNzsKfa_2aTn5l7_V2pywNYXoMW_d71rBkl5tE6U3tgAVPpiESvVs1BgQ3VNY4FPGspCmakfRAuG-H358Uht6NPJzBZEKT2EFZm3AOVmt8-IwBepem0Q4F4KIszbkK/s1600/IMG_0488.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhePVyQovmLSueGTBiNzsKfa_2aTn5l7_V2pywNYXoMW_d71rBkl5tE6U3tgAVPpiESvVs1BgQ3VNY4FPGspCmakfRAuG-H358Uht6NPJzBZEKT2EFZm3AOVmt8-IwBepem0Q4F4KIszbkK/s320/IMG_0488.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Some of the team on the last night out</td></tr>
</tbody></table>
</span></div>
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<span lang="EN-GB">There are still 24 people in Souda camp split
into 4 main families and I feel over the past couple of weeks I’ve become their
family doctor. Every morning we’ve been spending the first couple of hours in
the day in the clinic and those who want to see us in the camp can come for
consultations. We’ve been averaging around 8 consultations a day meaning we’re
pretty much seeing everyone in the camp every 3 days. Although its been strange
to adjust to such slow days after the manic times a few weeks ago, its been
really special to get to know some of our patients properly. They’ve been in
such good humour, inviting me for coffee in their Ikea houses and showing me
photos from their lives back home and making judgements about how many children
I should have and when. <span style="mso-spacerun: yes;"></span>One woman Rafah,
has 4 children and is pregnant with the 5<sup>th</sup>. She told me that
everyone she has met in Souda has been so kind to them and she loved us all
dearly, then she hugged me tightly and said that I had entered her heart and
would always be there. Saying goodbye to them yesterday was really difficult
and I just wanted to scream with the injustice of it all. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilA9SfWEeYcAWRfun-1esYts40HpNDGaoIvppYHF_9rVYn9yTdwr-YSX5s3Lgas2McVysigbfTlmAxu8DSSoxSd0q-rS4lexL8lI6J13Mqn3wVYOvRZ7HdgF9VcJL8Sk4-3MjbSg7O6aDu/s1600/IMG_0461.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilA9SfWEeYcAWRfun-1esYts40HpNDGaoIvppYHF_9rVYn9yTdwr-YSX5s3Lgas2McVysigbfTlmAxu8DSSoxSd0q-rS4lexL8lI6J13Mqn3wVYOvRZ7HdgF9VcJL8Sk4-3MjbSg7O6aDu/s320/IMG_0461.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Iman, Rafah and her daughter Khadija</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7V5JpwWQ5gLDNrSnqUj54z3q3Ci7b4115L-Ho4k50LO78jCxdnItMgtRZ7UA4s27W_ROa2ZeNKsQaF35TSv7dxswlse_zVDn-iXdf-8jHOgnIZgZ_34oLVJzKqM8IHPAWJDG5SiAskOsA/s1600/IMG_0457.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7V5JpwWQ5gLDNrSnqUj54z3q3Ci7b4115L-Ho4k50LO78jCxdnItMgtRZ7UA4s27W_ROa2ZeNKsQaF35TSv7dxswlse_zVDn-iXdf-8jHOgnIZgZ_34oLVJzKqM8IHPAWJDG5SiAskOsA/s320/IMG_0457.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Samar and her 5 beautiful children (and Hamed)</td></tr>
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<span lang="EN-GB">As the new team were doing most of the
clinical work this week, I spent a couple of days catching up with some of the
patients we had referred to hospital. One man is very unwell following a major
abdominal surgery and Hamed and I visited him in hospital. He was so happy to
see us but I saw a familiar look of fear in his eyes. As a doctor its something
that you see often in your patients who are vulnerable and scared but I can’t
imagine how it must feel to be so sick, so far from home and have no idea what
will happen to your wife and your unborn child if you don’t make it. We stayed
with them for half an hour and he held my hand tightly the entire time. When we
left, they prayed for both Hamed and I to have long and happy lives, thanked us
so deeply for everything we’d done for them and it took all my strength not to
break down in front of them. <span style="mso-spacerun: yes;"> </span></span></div>
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<span lang="EN-GB">The new team also performed some
consultations in a children’s home in the north of Chios, nestled deep in the
mountains where 22 unaccompanied minors have been housed by the Greek state.
The Ark of the World is a state run care home where there are another 30 Greek
children who live their currently. The centre is beautiful and so peaceful but
unfortunately the refugees have been completely separated from the Greek
children. <span style="mso-spacerun: yes;"> </span>Apparently they are waiting
relocation to a permanent centre in Athens where there is a plan for them to be
integrated into the social system including schooling but at the moment these
kids are stuck in limbo. </span></div>
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<span lang="EN-GB">Every day the Greek children attend half a
day of school and then have structured homework time in the afternoon plus
extra activities organised by the centre staff. The refugees there are housed,
clothed, fed and seem well looked after but there are no organised activities
for them. They have literally nothing to do all day except for entertain
themselves. They were all desperately bored when the new team went to do medical
consultations they begged them to bring books and asked for a teacher so they
could occupy their minds. They are all teenagers and mostly very bright and
acutely aware of their education passing them by. The next day the 2
translators prepared an afternoon of language lessons for them and they said
they had never experienced more attentive class. One thing I think about often
is the generation of children wrapped up in this crisis. The Syrians haven’t been
to school for 5 years but for the Afghans some have never been to school. They
crave stimulation, new experiences and desperately need to be in school. They
need for this to be over and for them to have the chance to be children and
learn and flourish. </span></div>
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<span lang="EN-GB">The weather got better this week and the sea
between Chios and Turkey looked like a lake most days. <span style="mso-spacerun: yes;"> </span>As predicted more people came. Only one or 2
boats a day compared to 30 or 40 a day before the deal, but around 200 people
arrived in the past week. Vial was built to have a capacity of 1200. Our latest
estimates suggest there are over 1500 refugees contained inside and the
situation there is getting more tense. As I was leaving yesterday, I had a
strong feeling that things are going to implode soon. </span></div>
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<div class="MsoNormal">
<span lang="EN-GB">I didn’t have to wait long for my feeling
to be justified. I had news this morning that because Vial was too overcrowded
they have placed some people into the Port camp without registering them and it
is chaos. The MdM team are there to provide medical care but who knows what
will happen now. The majority of NGOs that were providing food distribution and
clothing have all left to help in Idomeni or Athens so for any new arrivals the
situation is terribly precarious. Technically all of these people should be
returned to Turkey but under international law all should have their claims for
asylum individually assessed. There’s no infrastructure to do it and Greece is failing
to meet the demand that grows every day with new arrivals. It seems that the
number of new arrivals will continue to increase as the weather continues to
improve and the Turkish coastguards fail in their task to keep their borders
closed. </span></div>
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<div class="MsoNormal">
<span lang="EN-GB">There are reports from amnesty
international that Turkish border guards have shot dead 16 refugees trying to
enter Turkey at the Syrian border. There is video evidence of Turkish coastguards
trying to sink refugee boats as they attempt to cross. How can we be complicit
in sending refugees back to Turkey claiming it’s a safe country when we hear
stories like this? Let alone how badly managed the camps are and the fact that
we’re depriving thousands of people of the prospect of a real future. </span></div>
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<div class="MsoNormal">
<span lang="EN-GB">Its very hard to express just how bad the
situation is right now and how much worse it’s going to get. The MdM team in
Chios may be moved to another part of Greece where the situation is even worse
than Chios. Many of the refugees that had accumulated in Athens and in Idomeni
are being relocated to makeshift camps across the country where there is currently
no infrastructure and definitely no healthcare. Given we have the mobile unit
at our disposal we’re really equipped to respond rapidly in this evolving context.
There’s just so much need and the state is failing to meet it on every level.
As I said before it’s really not that difficult of a problem if there was
political will as the numbers are still under 55,000 in Greece to date, but
this new deal has created a complete shit storm. </span></div>
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<span lang="EN-GB">I’m back in the UK, it’s great to be back
with Bob and I’m looking forward to seeing everyone and spending some time
decompressing. But I’m ready to go back out before I start GP training again in
August and if MdM call for me, I’ll be on the next flight. Chios already feels far
away for me having spent 6 weeks there so I understand that people in the UK
find it hard to empathise or understand what’s happening. But it’s not far away.
This is Europe. This is our problem. This is our responsibility. We have to
pressure our governments to act in a humane way and find a workable solution.
We have to speak out against the xenophobes and stop them dictating the current
political landscape. We have to combat the fear that’s ripping through Europe
and humanise the people that have lost everything and are seeking refuge here.
We have to have difficult conversations down the pub and with our colleagues
and families and fight the culture of fear. I’m trying not to be dramatic but
this really is a pivotal moment in our history and we have to be unified to
fight for those who need us to most. <span style="mso-spacerun: yes;"> </span></span></div>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3_yrTDuqxqJDCUQ1erPYHUGw2Iu2vSxTV4FegAcrOq8wQ7TSIwkkK7uG3AOW1fZ3OW-4MwYBDgDgJS_h8xWIS1wR5jyP2pcEW6PQ9eGykfU6Ug2uQuv-sWAQLs-cBqKZo0AgnO49mNUIJ/s1600/Chios-Mdm+Belgique2016-+guillaumePINON-32.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3_yrTDuqxqJDCUQ1erPYHUGw2Iu2vSxTV4FegAcrOq8wQ7TSIwkkK7uG3AOW1fZ3OW-4MwYBDgDgJS_h8xWIS1wR5jyP2pcEW6PQ9eGykfU6Ug2uQuv-sWAQLs-cBqKZo0AgnO49mNUIJ/s320/Chios-Mdm+Belgique2016-+guillaumePINON-32.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span role="heading">© Guillaume Pinon</span></td></tr>
</tbody></table>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-684097133591761682016-03-26T11:57:00.003-07:002016-03-26T11:57:23.123-07:00New deal, New disaster<span lang="EN-GB">The new deal continues to be enforced. This
week we had strong winds and big waves so as far as we know no boats have
arrived on Chios. Many of the locals are saying that Tuesday will be D-day as very
calm nights are predicted and we know for sure there are many waiting to come. Either
they don’t believe the borders are closed, have been lied to by smugglers or
are convinced its still better to live in detention in Europe than suffer the
conditions in Turkey. </span><br />
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<span lang="EN-GB">We know someone who’s working with an independent
organization in Turkey and she reports around 2000 people hiding in the “jungle”
near the coast of Turkey. There is literally nothing there in terms of
infrastructure. People are sleeping rough on the floor, no toilets, no food and
no shelter. They have to evade the Turkish coastguards and now more than ever so
reliant on smugglers to keep them “safe”. One of the Greek municipality workers
told me that the smuggling network in Turkey had to date earned billions of
euros in profit, much of which is linked to low level corruption of coastguards
etc and high level corruption of government officials. Smuggling people to Europe
is big business but so is the EU money flooding into Turkey. Turkey needs to
simultaneously sustain its smuggling networks whilst showing it is suppressing
them to continue to benefit from 2 revenue streams. I’ve never felt more
disillusioned in our global political process. </span></div>
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<span lang="EN-GB">Yesterday was a national holiday in Greece
so we were asked by the Greek MdM team to cover their shift in Vial. Vial which
used to be the registration centre is now detention centre. Any refugees that
arrive “irregularly” are detained here and we have no idea what their fate will
be. They are allowed to apply for asylum and family reunification but we have
been told that currently Vial can only process 3 asylum claims per day. This poster
was put up overnight in the camp and explains that refugees who are awaiting
asylum claims will not be allowed to leave Vial. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0XtUmNT3HoyW9IYaOOeCdon36yAWRCI_zs2xowJA1mSgEF9hRBvKV6Exj2-APEerGdYp5gqqQEOivp7CbHnb0dNglKV6XYSwecPMCKfUMSunStx3M1zmMNL6gnepzxG1ovVqi3Gipt0DJ/s1600/IMG_0401.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0XtUmNT3HoyW9IYaOOeCdon36yAWRCI_zs2xowJA1mSgEF9hRBvKV6Exj2-APEerGdYp5gqqQEOivp7CbHnb0dNglKV6XYSwecPMCKfUMSunStx3M1zmMNL6gnepzxG1ovVqi3Gipt0DJ/s320/IMG_0401.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sign in Arabic, Farsi and English</td></tr>
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<span lang="EN-GB">Lots of volunteers, and other NGO workers I’d
spoken to had said Vial was really awful and before I went to Vial, I was quite
nervous about how it would feel to be working inside a militarised detention
centre. I think because I’d worked in a heavily militarized context in
Slovenia, the camp here in Greece seemed relatively ok to me. Yes, there are
many issues and also it’s a completely unsustainably situation but compared to
Slovenia I still felt there was some respect for the people detained there. The
police and army officials here are still Greek which means they are relaxed
about everything. I haven’t seen any guns, and there is a very limited security
presence actually inside the camp. In Slovenia, as I explained before you
couldn’t move without bumping into a gigantic heavily armed solider wearing a
balaclava. At the moment things seem calm but who know what will happen as
people become more agitated. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiucqqvYouqXn26hgeSCjiIzWH4c7XRlwfu9V0tFs3MEwY2kZ35yoO3p34qkuGmpWh2eY6XNvRZcqwQQtXWyWN86r2dUz4167LmMRcNiRD_dOmEHI_zs6PNC2vGeFDKc0RFze7FaPrVYrcN/s1600/IMG_0407.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="192" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiucqqvYouqXn26hgeSCjiIzWH4c7XRlwfu9V0tFs3MEwY2kZ35yoO3p34qkuGmpWh2eY6XNvRZcqwQQtXWyWN86r2dUz4167LmMRcNiRD_dOmEHI_zs6PNC2vGeFDKc0RFze7FaPrVYrcN/s320/IMG_0407.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Entrance of Vial</td></tr>
</tbody></table>
<span lang="EN-GB">Now don’t get me wrong. The situation is
horrific. The exact same population we were seeing before, young families, over
40% are children, disabled people, over 65s are locked inside the camp with
little information and no idea when their cases will be processed. The actual
structure is pretty horrendous, it’s split into 2 parts, a huge warehouse with a
leaky roof and separate shipping containers that house around 10 people in
each, most seem to have bunk beds but some just have wooden pallets with foam
sheets to sleep on. There is a large fence separating the 2 areas and at night
its locked. Food is distributed 3 times a day and seems to be hot meals but it’s
done in one location where everyone has to queue. Volunteers have said that refugees
are hungry and many aren’t getting fed properly, the old and infirm are reliant
on others to get their food for them. There are showers and access to wifi is
available and generally the camp is clean from what we saw. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC3_uYWvDlT7cVapu3GnPjnjj1i8XvhKvzGA4VM6ZpS1sYl6UpDRSnTvcPSRELHbKo5OjGA_Q7ksaqK_l7H_x2gWe1bOsayG_HiIRJxCRlsj42JFBJg5YaqoJ0ytOCHp2RUWQREdX6RvPV/s1600/IMG_0405.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC3_uYWvDlT7cVapu3GnPjnjj1i8XvhKvzGA4VM6ZpS1sYl6UpDRSnTvcPSRELHbKo5OjGA_Q7ksaqK_l7H_x2gWe1bOsayG_HiIRJxCRlsj42JFBJg5YaqoJ0ytOCHp2RUWQREdX6RvPV/s320/IMG_0405.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Line
for food distributions (you can only see half of the line and this was
half way through the distribution) I think it takes over an hour to
queue for the food</td></tr>
</tbody></table>
<span lang="EN-GB">The administration and health clinics are
in the warehouse side so I’m not sure how access to medical services is
organised overnight. There is 24/7 cover with medical NGOs providing care and
in fact there’s a strange situation of many different health care providers.
The MdM clinic is next to a red cross clinic, which is next to a WAHA clinic
which is next to a Greek Army medic clinic. All of them work at different times
to ensure a 24/7 service but there are often clinics running simultaneously. </span></div>
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<div class="MsoNormal">
<span lang="EN-GB">One of the issues I saw yesterday was overmedication
with patients able to see many different doctors and clinics over and over
again. Seeing the doctor is an activity and gives the refugees something to do to
counter the boredom and frustration of being locked up for no reason. Many just
come to vent and tell their story again. We heard many people repeating their
list of health complaints and asking how it was ok for them to be locked up. We
also heard many complaints against the organisers of the camp, many people feel
they have no route for information. Who do they get clothes, blankets and
nappies from? I couldn’t answer these questions and when I tried to find out I
felt as lost as the refugees. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB">Another big problem is the tension between
the Syrians and the Afghanis. On Thursday there was a big fight between two
groups involving women and children as well. One Syrian came to the clinic to
get a wound on his head redressed. He said that they had “made up” but
throughout the day we heard everyone complaining about everyone else. The
Afghans push in front of the line for food, the Syrians have all the shelters
with beds… These people have only been detained for 1 week at the moment and
tensions will continue to mount as their situation because more desperate. The
WAHA team which works night shifts have had to leave the camp on several
occasions because of security concerns when the refugees tried to protest
against being detained. </span></div>
<div class="MsoNormal">
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigSiVpYJdKSrMrAnuNMzjuiWSQ5ZdawKCWSdtDS-mE9DWGHQt1M8LXonPHRhMYHCRbFWQ0270qdYX_r9B4Lt9RWqxWSkngSDD7nwRSrfQzHQl-HXRDS9Dww7dY9XEr5h4dtuyGGaoX4evK/s1600/IMG_0404.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigSiVpYJdKSrMrAnuNMzjuiWSQ5ZdawKCWSdtDS-mE9DWGHQt1M8LXonPHRhMYHCRbFWQ0270qdYX_r9B4Lt9RWqxWSkngSDD7nwRSrfQzHQl-HXRDS9Dww7dY9XEr5h4dtuyGGaoX4evK/s320/IMG_0404.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">"Locked" entrance Greek style</td></tr>
</tbody></table>
</div>
<div class="MsoNormal">
<span lang="EN-GB">Working in this context as a doctor is so
challenging. I really struggled to discuss people’s cases without being able to
offer any solace of when things would be resolved. I had one family come to see
me because the father was losing sight in his right eye. He had glaucoma and
had already lost sight in the left and over the past 5 months it was
progressing rapidly. He was concerned he would leave his 5 children with a
blind father. As we talked both him and his wife broke down in tears and begged
us to help them leave the centre. It was truly heart-breaking and I have
organised for him to see an ophthalmologist next week but he’ll be taken by
police escort and marched around like a prisoner. It’s hard not to feel
complicit in the system when you’re providing care in this setting. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB">I also really struggled with another
patient. An 8-year-old boy who was brought by his older brother. They had fled
the Taliban and had been travelling to Europe in search of answers about the boy’s
condition. He was very weak and often fell over and couldn’t stand from
sitting. It only took me a few minutes examining him and listening to the story
before I realised the boy most likely had muscular dystrophy and my heart fell
into my stomach. I thought for a long time how to tell them and explain what
could happen and realised there was no solution for them. Anywhere else they’d
be urgently referred to a paediatrician for muscle biopsies and genetic tests
then put in touch with support networks and physiotherapy, but here all I could
do is explain what I thought the diagnosis was. It was the hardest consultation
I’ve done in Greece and when both of them started crying I could hardly hold
back the tears. I’ve informed UNHCR and all the officials I could find of their
situation but no one could give me any concrete steps to take to help them. <span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDv7y14V56Atf-9dK0aSJvJOVZD4GFAedrGmKDMsK9Ynenmmm1ZucDS5mBZYFihCfg9Ea5XKJio7CLEezu3eFH2B-28zqS5mNL8F56UYaUfx3FBcbP0iHIrvAyYjh5FT3kY-WRrRpaJ0jk/s1600/IMG_0400.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDv7y14V56Atf-9dK0aSJvJOVZD4GFAedrGmKDMsK9Ynenmmm1ZucDS5mBZYFihCfg9Ea5XKJio7CLEezu3eFH2B-28zqS5mNL8F56UYaUfx3FBcbP0iHIrvAyYjh5FT3kY-WRrRpaJ0jk/s320/IMG_0400.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Still nice moments in the clinic, continuing to provide a humanitarian space</td></tr>
</tbody></table>
<span lang="EN-GB">I spoke to an EASO official who said once
the relocation program starts again we should be ready with a list of
vulnerable people to be at the top of the queue. I thought about the patients I’d
seen yesterday and couldn’t begin to triage who was most vulnerable. Everyone
is fleeing extreme violence or terrible situations. There are so many pregnant
women, so many small children, so many disabled people and so many needing
urgent follow up in proper hospitals. There’s young men trying to reach their
families and make something of their lives which are only just beginning and
yet so wrought with tragedy. </span></div>
<div class="MsoNormal">
<span lang="EN-GB"><br />
Currently, in Souda there’s one family who arrived before the deal who had made
it to Athens and registered for relocation but the rest of their family arrived
the night after the deal went live. This half have been placed in Vial. The
family travelled back to Chios to try and be reunited with them and are now
waiting indefinitely to hear news or be able to see their family in Vial. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB">Wembley
stadium has a capacity of 90,000
people. Every weekend 90,000 people go and come back to see football
matches
and watch concerts. Its not that many people in the grand scheme of
things and London’s
infrastructure absorbs it easily. Just over half this number of people
are stuck
in Greece, in makeshifts camps, in squalid conditions, in detention
centers and
a handful in hospitals and hotels. This is not some unmanageable
problem. This
is not some scary flood of people banging at the door of England to come
claim
£75/week in benefits. This is just half a stadium of people that has
been forgotten
and completely abandoned in their most vulnerable and needy time. This
could be managed in a humane and sensible way if the political will was
there. Shame on
Europe. <span style="mso-spacerun: yes;"><br /></span></span></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-71505328512342578562016-03-22T09:46:00.000-07:002016-03-22T09:46:03.819-07:00The morning after the night before
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<br />
<div class="MsoNormal">
The events of the past 72 hours have left me lost for words
and I haven’t been able to shake a deep unsettled feeling in my stomach. Since
my last post at the beginning of last week the context here has turned upside
down and we have no idea how it will continue to evolve. We performed 308
consultations from Monday 14<sup>th</sup> until the 19<sup>th</sup>, a busy
week where we were seeing similar things to what I described in my last post. I was starting to get involved in some exciting talks about improving the public health situation and
thinking more broadly about refugee health in the Greek setting as it seemed
that refugees would be staying longer and longer in Chios. Then everything changed. </div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC0_UMYhL8OuSvSdlMDwU_il6gQP524oTo1OEcxt0dmuvDJWLnGZuJnEJNl4XQmpaSj2AeuXWgpUYnscwmZqjhg_NJzwWBN6UsrtIRIHcTqJEo6WoyrMN1AFzjX0HOjSYw5yxtZQ_FRUy9/s1600/IMG_0312.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC0_UMYhL8OuSvSdlMDwU_il6gQP524oTo1OEcxt0dmuvDJWLnGZuJnEJNl4XQmpaSj2AeuXWgpUYnscwmZqjhg_NJzwWBN6UsrtIRIHcTqJEo6WoyrMN1AFzjX0HOjSYw5yxtZQ_FRUy9/s320/IMG_0312.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Full camp on saturday with our waiting room being used as a playground</td></tr>
</tbody></table>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="MsoNormal">
The EU turkey deal was officially signed and went live from
midnight on Saturday 19<sup>th</sup> and when we left the camp we had no idea
what we’d return to on Monday. The agreement means that all new refugees that
arrived on the island after the 20<sup>th</sup> will be apprehended and
returned to Turkey. For every refugee returned from Greece to Turkey, Turkey
will send one SYRIAN (no other refugees are considered for asylum in Europe)
directly to a country in Europe as per a system of quotas. </div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="MsoNormal">
Overnight the camps we work in were emptied completely,
everyone was advised to go to Athens that night and those people who had bought
ferry tickets for 1 week in advance were encouraged to board the ferries on Saturday
evening and Sunday. From over 1500 refugees on the island on Saturday afternoon,
there are now only 28 people in Souda camp. The Port and Tabakika are completely empty and closed and
those that remain at Souda are mostly the relatives of 2 patients that had
surgery and are awaiting discharge from hospital. <span style="mso-fareast-language: FR;">We have no information about where the refugees that left were taken but
informal reports state many sleeping outside in the streets in Athens. Hamed has
been in touch with some refugees who have been taken to makeshift army run camps
with non heated tents, gravel floor and one sleeping bag per person in north
Greece by the Bulgarian border. No one knows what will happen to those 40,000+ left
in Greece who arrived before the 20<sup>th</sup> March. So many of our patients
will be amongst them and I think that’s the root of the butterflies in my
stomach. All the pregnant women, vomiting children, poorly healing wounds,
poorly controlled diabetics, wheezy babies and one nerve gas victim I told to
go to Athens and seek further care there. I can’t stop thinking about where
they are and if they are ok, if things have got worse of if they went into
labour. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">Over the weekend and
the past 2 days there have continued to be new arrivals to the island but in
smaller number than “normal” despite good weather. We have no handle on what the
numbers actually are and rely on the volunteers that remain in Vial to tell us
from their eyeballing how many they think are there, current estimate is around
1000. The volunteers who used to watch the coast and inform the authorities
when a boat was arriving have been told to leave by officials and the whole
process has changed. The Greek coastguard is escorting all boats that make it
to Greek waters safely to shore. There, refugees are loaded onto buses and
taken directly to Vial by police or military escort, there are reports that
refugees are being made to pay for this service. Vial is located around 15km
inland and is far off the tourist trail, which I doubt is a coincidence. The
camp is completely closed and locked with high fences, barbed wire and armed
guards. All registration processes and distribution has been taken over by the
military and police. We have no information about what will happen now Vial is
full. At the moment there is still free movement out of the camp for the 28
refugees in Souda but we do not know for how long, we also don’t know if they
will reuse Souda now Vial is full. MdM Greece are still running the clinic in
Vial and we’re meeting with them tomorrow to try and understand our role and what
we can do going forward. </span></div>
<div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqbqDrBpvamUxK7cDeoEYl2CpGpxX2QPL0ZHKyqLPXHHK-cVkGL3A6luJZKN5SAcJlYR4-kzkNCwvSF7AbK11FwQQyukC-KdUbiHFqACu7NjVYI0mlSQzdf7RCIYmn5MzSpSEbqj8WiHso/s1600/IMG_0376.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqbqDrBpvamUxK7cDeoEYl2CpGpxX2QPL0ZHKyqLPXHHK-cVkGL3A6luJZKN5SAcJlYR4-kzkNCwvSF7AbK11FwQQyukC-KdUbiHFqACu7NjVYI0mlSQzdf7RCIYmn5MzSpSEbqj8WiHso/s320/IMG_0376.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Empty camp from on top of the castle walls</td></tr>
</tbody></table>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">The past 2 days we
have seen the same 6 patients twice. I’m doing some follow up for a patient who
had appendicitis and has been discharged but otherwise we have no work. MdM
Belgium just received authorization for a new team to arrive so that we could
try and meet the need we were seeing across the other camps and they arrived on
Saturday evening with no patients to treat. Today we were asked to help refer a
patient from Vial to the hospital as we used to do but the police refused to
let us take him without a police escort. It took over 3 hours to get everything
organized and we have no idea what would have happened if the patient had been
sicker. We have asked to be redeployed with the medibus to Athens or Idomeni
but we are waiting for negotiations from MdM Greece and Belgium to be settled.
I’m supposed to be leaving in 8 days and I have no idea what I’ll be doing in
this time or whether I’ll get sent home early. For the new team its incredibly
frustrating and I empathise completely with them from my experiences in
Slovenia. </span></div>
<div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisev_xANoe5jLtItle0z5Jr9LVw62P9jMp-dHrm4a6kKyQZ1oDGUFDgYwPP12YXpWdmTQ490LrnSAJJF-ou29xkqtPVEFVRVihbb09_S3GSo20ro4-YEE7QkR75viiF0UYsXmJi9D8sQqD/s1600/IMG_0375.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisev_xANoe5jLtItle0z5Jr9LVw62P9jMp-dHrm4a6kKyQZ1oDGUFDgYwPP12YXpWdmTQ490LrnSAJJF-ou29xkqtPVEFVRVihbb09_S3GSo20ro4-YEE7QkR75viiF0UYsXmJi9D8sQqD/s320/IMG_0375.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">At least there's no queue for the chargers anymore</td></tr>
</tbody></table>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">To me the most incredible
thing is the capacity of Greece and Turkish governments to implement this
overnight. It was always possible. It was always within Europe’s power to stop
children drowning at sea. Now we can see it with our own eyes, that because the
political agenda has been set in 12 hours the entire process is changed.
Everyone we’ve spoken to is distraught. Some volunteers left on Sunday morning
and refused to be complicit in a system that was returning vulnerable people to
what they feel is an unsafe country. Some ladies who work for European Asylum
Support Office (EASO), who spent the past months convincing people to sign up
for the program to be directly sent to one of 24 countries, have been receiving
distraught phone calls from refugees trapped in Athens, unable to find EASO
officials or being told the program has ended. They are still waiting to hear
from their bosses what their job is going to be and if they will stay in Chios
or not. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">Last night there were
demonstrations and a protest held by refugees inside Vial as word spread that
they were going to be sent back to Turkey. For the vast majority they’ve
invested everything and risked their lives to get to Greece and there is no way
they will walk calmly onto a ferry back to Turkey. We are waiting to see how
the authorities will manage this and I’m petrified about how things could
escalate. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">Europe absolutely has
the power to find a humane, compassionate and sensible solution to this crisis
and yes something had to change but what’s happening all over Greece couldn’t be
further from a real solution. Smugglers will continue to find more dangerous
routes to avoid coastguards, people will keep coming and Greece will not cope
with returning these refugees fast enough. A humanitarian disaster is going to
become a catastrophe overnight as overcrowded detention centers treating people
fleeing war and persecution as criminals, continue to pop up over Greece. There
are already 2 million refugees in Turkey, how many more will they “cater” for? Will
they keep saying yes to get more and more EU money and continue the terrible
practices we’re hearing refugees flee from? A lady said to me in Turkey she was
free from the bombs but risked starvation. Some volunteers told us they have
friends in Turkey and the internet is being controlled at the moment, no
whatsapp, no facebook, no twitter means no ability to coordinate or organize any
humanitarian response outside of the governments own and independent volunteers
are being pushed out. The big NGOs are slowly going to Turkey and maybe MdM
will follow but for now we know the situation there is terrible. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-fareast-language: FR;">Its rare that you can say
you’re at a turning point in history but I feel this weekend is going to be
marked as a shameful time in Europe’s history. And perhaps Europe won’t exist
anymore and my kids will laugh at the idea of travelling to France without a
passport. Before the solace I could give people in the clinic was to say “when
you’re settled you can…” and feeling that I knew they would eventually find something better. Now what can I say? No one knows. Who knows if I’ll even
see any more patients. </span></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-60394211227440689142016-03-14T13:14:00.000-07:002016-03-14T13:14:31.276-07:00Closed borders, full island
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<br />
<div class="MsoNormal">
Leaders of European member states are set to agree a deal this
week that will allow Greece to forcibly return refugees arriving to Greece
“illegally” back to Turkey. Illegally means anyone who doesn’t have a visa in
their passport. Believe it or not that’s everyone who chooses to put their
child in an overloaded rubber boat paying smugglers hundreds of euros, rather
than just catching a flight straight from the country they’re fleeing. </div>
<div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKUivWFbTeFZHnFVD7TrJ7L33-ojzGRn1YAmIAQ-Q41RVSScuZVT-YupXhReNJ2sghjelZNM71DgAqXEyDWo9o4wAp3q2tVQ1bI1jr85HpFj_yZcJFBAsMXDKJ6TP2mg_jEnsHiGxH3vSZ/s1600/IMG_0265.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKUivWFbTeFZHnFVD7TrJ7L33-ojzGRn1YAmIAQ-Q41RVSScuZVT-YupXhReNJ2sghjelZNM71DgAqXEyDWo9o4wAp3q2tVQ1bI1jr85HpFj_yZcJFBAsMXDKJ6TP2mg_jEnsHiGxH3vSZ/s320/IMG_0265.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The boats that smugglers use, often discarded on beaches or around the port</td></tr>
</tbody></table>
<div class="MsoNormal">
Many of the refugees we’ve spoken to have spent several
months in Turkey, sometimes years, trying to earn enough money to pay smugglers
to come to Greece. One young man told me he was working in a clothing factory,
another told me he was sorting building materials. We’ve seen several people
with wounds or chemical burns from working in what I can only assume are unsafe
conditions where Turkish business are profiting from having a vulnerable and
captive workforce at their fingertips. There are reports of Turkish authorities
forcibly pushing refugees back into Syria, in direct contravention of
international law. Along with mismanaged camps with little or no sanitation,
medical care, unreliable food distribution, as well a punitive policies
regarding refugees right to work in Turkey, many refugees say that there simply
isn’t any kind of life on offer in Turkey. Amnesty International and other organizations
are campaigning to block this decision which will ignore basic human rights and
international law. While politicians talk, more and more people are trying to
leave Turkey before the borders shut completely. <span style="mso-spacerun: yes;"> </span></div>
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This decision will follow the complete closure of the Balkan
route which happened abruptly last week without any warning. There are now around
45,000 refugees stranded in Greece. Over 13,000 are in Idomeni at the border
between Macedonia (FRYOM) and Greece. The situation there is worse than Calais.
A baby was born in a tent last week. Doctors are treating trench foot. There is
limited food distribution, difficulty for independent volunteers and NGOs to
access people, no sanitation and around 40% of those waiting at the border are
children. </div>
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When I came out to Chios, I was completely unsure about what
I would face when I arrived. I didn’t predict that decisions made at the drop
of a hat by small minded politicians would have such direct impact on the
situation here. Overnight, last week, the numbers of people needing care have
skyrocketed. <span style="mso-spacerun: yes;"> </span>We’ve had a really intense
time the past couple of weeks which is why the blog has been a bit quiet.
Luckily we have a new Farsi translator Fatieh who is a complete badass
political refugee from Iran. She worked with the refugee council and women’s
aid in England for many years and decided to spend some of her retirement translating in
the field! Our coordinator Claire, rewarded us with a full weekend off this
weekend and my amazing hubby jetted in with a days notice to be with me for 2
nights! I now I feel totally refreshed and ready to hit the ground running for
the last 2 and a half weeks. It seems from all sides things are going to get
worse for refugees here and we will have to expand our operation to even try to
meet the need. </div>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS1p-guobmF74NMBX609nT84pIIC2ZvDJXYfiRCz2QZfcES2h_R_CKCXUVIYxe7RPjLO1jgvCd7RxTtKSS8LEUCkbadU00r29EQtQohSbezzx0XP6SRdQk-el5ja5W1as2ZJqcUm9nGKwz/s1600/IMG_0262.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS1p-guobmF74NMBX609nT84pIIC2ZvDJXYfiRCz2QZfcES2h_R_CKCXUVIYxe7RPjLO1jgvCd7RxTtKSS8LEUCkbadU00r29EQtQohSbezzx0XP6SRdQk-el5ja5W1as2ZJqcUm9nGKwz/s320/IMG_0262.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Resourceful Fatieh making sure she gets a cuppa! </td></tr>
</tbody></table>
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The ferry companies have been extremely limited in the
number of tickets they can sell to refugees with some days only 50 people
leaving the island. Last weds night 31 boats with around 900 people arrived on
Chios in ONE night. At the moment I think there are around 1600 refugees on
Chios but that doesn’t take into account any arrivals from the weekend as I
haven’t been up to date with the numbers. More and more camps are opening up on
Chios to try and accommodate people as they get stranded here, unable to leave
to Athens or have any other route off the island. Now the ability for this
island to provide adequate housing, sanitation, food distribution and medical care
for these people is limited. We are the only team able to provide care outside
of Souda and Vial camps which have permanent clinics which are always
staffed.<span style="mso-spacerun: yes;"> </span>All of the people in the other
camps have to wait for us to come with the Medibus (which we cannot predictably
time) to see a doctor. The usefulness of the Medibus has really been proven in the past couple of weeks. On weds we saw 95 patients, on thurs 83 and I think the past 7 days we saw over 450 in total. We’ve been
opening a bit later in the evenings to try and fulfil the need but it never
ends. </div>
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We haven’t analysed the data for the past 2 weeks yet but I
wouldn’t be surprised if the majority of our consultations were women or
children. We asked anyone who wasn’t desperately sick to step aside when we
arrived at the other camps and all the young men with coughs and colds
dispersed. Consultations are taking longer, people are sicker, they’re staying
for more time on Chios so need follow up and I’m seeing the same patients every
day and hoping they don’t get sicker. Tensions are rising in the camp and
especially between Syrians and Afghanis. I think a lot of Syrians feel that
they will have the right to cross the border because their war is still happening
and if it weren’t for the numbers of Afghani’s there would be no problem.
There’s a high level of denial about the situation amongst all refugees and
people just can’t comprehend that Europe would leave people waiting in a field
hoping they’ll turn back. Most people still think heading to Athens is their
best bet but we’re trying to caution those who have chronic health needs to
think about what could happen if they don’t have a spot in the limited camps. </div>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOgfqB9VKZXppVllWXK9Jp-HIBS5XI8L4WO4Kv0H2E6V9tbC1Jx4CSTrw7pysxPo1dgC8uNH8TdyqctSZysl_C7RxEo2ExGeNLy5RAYpbzwvHk2yS0zdBzzeA0B2oLqgM79GGUMzpU1tHl/s1600/IMG_0272.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOgfqB9VKZXppVllWXK9Jp-HIBS5XI8L4WO4Kv0H2E6V9tbC1Jx4CSTrw7pysxPo1dgC8uNH8TdyqctSZysl_C7RxEo2ExGeNLy5RAYpbzwvHk2yS0zdBzzeA0B2oLqgM79GGUMzpU1tHl/s320/IMG_0272.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Tabakika camp, an abandonned warehouse essentially open to the elements housing around 400 people</td></tr>
</tbody></table>
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Despite everyone’s best intentions were seeing full dirty
nappies with subsequent horrific nappy rash and a lack of clean nappies for
Mum’s. We’re seeing impossibly hungry babies whose mother’s breast milk has
dried up due to stress or malnutrition. We’re seeing old poorly healed wounds
that I never want to ask how they were sustained because I know hearing the
story will leave me shaken and find it difficult to treat the next patient.
We’re seeing bad pneumonias, bronchiolitic babies and tonnes of diarrhoea and
vomiting and I don’t know if they’ll get better or worse. I’m seeing many
people without their normal insulin or diabetic medication who are struggling
to control their sugars with the erratic eating patterns. I’m seeing SO many
pregnant women, most of them in the third trimester and no one had a plan for
where they would give birth. We’re seeing many women who feel the baby isn’t
moving as much as normal especially after the boat journey, and I can refer
them for a scan at the hospital but then what…</div>
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Despite all this, I love this island, I love the team I’m
working with and I love my patients.<span style="mso-spacerun: yes;"> </span>I
love the tenacity of a 14 year old boy strolling into my clinic and telling me
he has a cough and needs some syrup because he’s keeping everyone awake at
night. I love the way that Syrians say no to something, it's like a click of
your teeth and move your head upwards in an upside down nod. I love that it
costs 2 euros for chicken souvlaki from Nicolas’s. I love the way that when we
managed to explain we could only see emergencies all the young men left the
queue and made way for pregnant women and children. I love that when it rains
20 minutes later there’s bright sunshine. I loved seeing a desperately sick boy
I sent to hospital playing by the beach 2 days later. I love that when I walk
into the camp in the morning people run up to me to show me the rash has gone
or the cough is better. I love that when it rains everyone gets a poncho and if
they’re giving out blue ones its like there’s a camp full of smurfs. I love
that a 7 month old smiles at anyone and has no awareness of how bad things are
around them. I love that every single Greek person I've met here has been warm and welcoming and thankful for what we're doing here. I love being able to be in the presence of such admirable people
who show such bravery and determination to find a better life for themselves and
their family. </div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDdymQia4GF46d4R-MXr5T2jO18Fn_ddD_FY-Hyv4nN8zeOaa2MU142SUfUkij4SWNyNqH-U5x8QziU_EdZhH_bII8v_EWk8y974CG2ZU49ws8DeQxVtNWHhg93WuAUs0_gCih0Xlrzs3l/s1600/IMG_0222.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDdymQia4GF46d4R-MXr5T2jO18Fn_ddD_FY-Hyv4nN8zeOaa2MU142SUfUkij4SWNyNqH-U5x8QziU_EdZhH_bII8v_EWk8y974CG2ZU49ws8DeQxVtNWHhg93WuAUs0_gCih0Xlrzs3l/s320/IMG_0222.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">List of countries refugees can apply to all of them for asylum and will get randomly allocated to one. They then will get direct transfer by flight to this country if asylum is granted. For vulnerable people but many are skeptical and don't want to sign up as they are heading to a country where they are trying to reach family. </td><td class="tr-caption" style="text-align: center;"> </td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
</tbody></table>
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It worries me how seeing a child without shoes has become
normal, that seeing kids use piles of life jackets as a playground is funny and
walking into the camp feels homely. I asked a bright 11-year-old Syrian girl
when was the last time she went to school. She thought for a moment and said “I
can’t remember”. This is not acceptable. We all need to think what it means to
be European in this time and how we want history to remember our generation.
Hold your leaders to account. Express your disgust at this policy made
humanitarian disaster and demand Safe Passage Now. </div>
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</div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtNaMxRpKM1rlEA3etH1BDYFdGNTj_51vGDVBmECQDsKmvUAI9n0J5XMKrE7k1osLrBB2eHomSYgGTzcHc2idIfM5nPBGc5b4N1yQz6wVF4VkdjGZQWek8O7VCXCSUB4EwB8lpt10kRRvk/s1600/IMG_0273.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtNaMxRpKM1rlEA3etH1BDYFdGNTj_51vGDVBmECQDsKmvUAI9n0J5XMKrE7k1osLrBB2eHomSYgGTzcHc2idIfM5nPBGc5b4N1yQz6wVF4VkdjGZQWek8O7VCXCSUB4EwB8lpt10kRRvk/s320/IMG_0273.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">New recruits helping with the workload! </td></tr>
</tbody></table>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-51919041626076679162016-03-01T11:07:00.000-08:002016-03-01T11:07:16.921-08:00All go in Chios<br />
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-</style>This week I feel like I’ve gotten into the flow of working
in the camp despite there being lots of change and lots of patients. Our team
has switched around a bit this week and Claire the nurse from the UK finished
her contract and Lottie from Holland joined us. A few days later we were joined
by another Arabic translator Ahmad. <span style="mso-spacerun: yes;"> </span>We have
also had visits to the clinic from DFID (our donors), MdM Holland, MdM
international and a journalist who took photos of us working all day for MdM
Belgium! Some stay a few minutes some stay all day. I’m dreading seeing a
hundred unflattering photos of me getting coughed on by small children! </div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAr7Or84eXmRbUiG5ArFXnvYapuOFho5ION2K_6RunBzRges6UlViz2qcsWfkmOXSMwgznj71nLn_7sh7DqIlgzNf9kTwTEQk4IRXnwgp_T63A4Il2kOmyEALGVGF3Uhts3GAcmodjFHWy/s1600/IMG_0171.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAr7Or84eXmRbUiG5ArFXnvYapuOFho5ION2K_6RunBzRges6UlViz2qcsWfkmOXSMwgznj71nLn_7sh7DqIlgzNf9kTwTEQk4IRXnwgp_T63A4Il2kOmyEALGVGF3Uhts3GAcmodjFHWy/s320/IMG_0171.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Advocacy in action! </td></tr>
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I had a great week in the clinic and I’m mostly really
enjoying my time with the patients. But, I’ve definitely been burning the
candle at both ends and after a particularly late night on Saturday, being
coughed at by 50 people with an upper respiratory tract infection a day, combined
with sunbathing and swimming in the sea on Sunday I’m now suffering a bit of a
cold. It has made me slow down a bit and I’ve been getting some early nights
and looking after myself (don’t worry Mum). I’m now much more empathetic
towards everyone coming to the clinic with a sore throat and headache as I know
exactly how they feel! </div>
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<tr><td class="tr-caption" style="text-align: center;">Team photo on night out! </td></tr>
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We are unfortunately lacking a Farsi translator this week
which has made consultations with Afghani people challenging. Its amazing how
many Afghanis we are seeing and I think so many people have forgotten how
fragile of a state it still is. Many Afghanis are saying there has been renewed
violence or Taliban has taken control in their area recently or they have been
in camps in Pakistan for years with no end in sight. Anyway, my finely tuned
charade skills with a mixture of Urdu and a few Farsi words I’ve picked up, have
allowed me to communicate most of the minor illnesses with people. Also many
people are coming from refugee camps within Pakistan so they have reasonable
Urdu which is nice to be able to communicate directly without a translator. </div>
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The clinic has been busy almost every day this week with us
seeing around 50-70 people a day during clinic hours. This week has seen a
couple of emergency cases along with the usual raft of minor illnesses. I’ve
seen many pregnant women, lots of very young babies and children and a few
elderly and disabled people. We made one ambulance transfer to hospital for a
young Afghani boy who had a complicated past medical history. He had been
diagnosed with heart failure two years ago and was giving himself IV medication
through a cannula every other day. He had a packet of X-rays and letters written
in Farsi and a bag of all sorts of medications including IV furosemide! On
arrival in the clinic he had dangerously low blood pressure so whilst waiting
for the ambulance we placed an IV line and gave him urgent fluids. He stayed in
the hospital for a number of days and we haven’t seen him again at the clinic, I
think he may still be an inpatient or has been transferred directly to Athens. </div>
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<tr><td class="tr-caption" style="text-align: center;">For the medics reading spot diagnosis! </td></tr>
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Yesterday I referred an elderly man who was septic with a
bad chest infection. Apparently he was unwell for several days but had got much
worse whilst waiting in Turkey to come to Greece. Several people have told me
that they have to hide in the “jungle” on the Turkish side with the smugglers
and wait for the moment to get on a boat at night. Many are reporting they have
nothing to eat or drink during this time so its no wonder some are turning up
to Chios in such a bad state. </div>
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Another day, I went outside the clinic to see how busy our
waiting room was and saw a little boy sat on the floor with his head on his
knees. I went over and tried to see if he was ok but he was completely unresponsive.
I got a bit worried and quickly lay him down to assess him properly but as I
did, I realized he was completely asleep. He woke up with a start as I
manhandled him and he just picked himself up and walked off towards the tents.
I shouted after him to check he was ok and tried to get a translator to see if
he needed anything but I guess he was just completely exhausted and when he sat
down fell straight asleep in the middle of the road. </div>
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On one afternoon that wasn’t so busy, I saw a young girl
about 8 years old called Najmah playing with a ball by herself. So I called out
to her to kick me the ball so we could play a bit and she excitedly did so. I
immediately, completely uncontrolled, booted the ball over the fence into the
restricted area where she wasn’t allowed to go. I ran round with her to the
security guard who obligingly let us retrieve the ball. Once the ball was back
we realized I had managed to kick it onto the only shard of glass in the entire
camp and it was punctured and constantly deflating. I felt so bad and ran back
to the clinic to patch up the ball and try and rescue it. Luckily, Najmah
forgave me and 2 days later had learnt enough English to come and find me and
say hello and introduce me to all of her friends in the camp as Dr Aaminah. </div>
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<tr><td class="tr-caption" style="text-align: center;">My absolute favourite Jessica!</td></tr>
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The kids here are really amazing and whenever you feel like
the reality of this crisis is getting too much you see a small kids running
around with bubbles or forming little packs and going on missions to get water
or nappies for other kids. They are all so beautiful with huge long eyelashes
and the Kurdish and Yazidi children are just stunning! They’re so resilient and
for most of them its just another day and new place to play and discover. There’s
some really great psychosocial activities being provided for kids here both formalized
and organized by independent volunteers. Our Medibus was transformed into an
open air cinema one night with a film projected onto it. I’ve seen clowns, many
many drawings and face painters and the legacy of people handing out whistles
and party blowers (which get tiring after 6 days in a row!). </div>
<div class="MsoNormal">
<br /></div>
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<tr><td class="tr-caption" style="text-align: center;">Kids activities in the Red cross kids centre</td></tr>
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The current political situation is starting to affect things
here in the camp. There are currently over 35,000 refugees stuck in Greece. Last
week Macedonia closed its borders to Afghanis and introduced stricter language
tests to ensure only Syrians and Iraqis were getting through. I said goodbye to
the mother and father of the child who died, I spoke about in my last blog, full
of guilt at knowing they were walking into a terrible situation to maybe be
stuck at the Greek/Macedonian border indefinitely. I couldn’t believe after all
the trauma they had been through they had so much more to bear. I hugged her
tightly and in that moment Inshallah (God willing) was the only thing I could
say as I said goodbye. </div>
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<br /></div>
<div class="MsoNormal">
Yesterday Macedonia completely closed its borders and other
countries have enforced strict quotas. Austria is only accepting 80 people a
day and there is subsequent chaos here in Greece. The islands have had to restrict
ticket sales on the ferries headed to Athens as people are accumulating at an
alarming rate there. They have had to open up new camps in Athens, including a
baseball stadium and there are still so many people sleeping in the streets. There
they have little access to food or water let alone medical aid. The impact on
the Greek economy, already struggling so desperately to provide for its own population
is enormous. Early reservations for the holiday seasons in Kos, Lesbos and
other islands are down 60% on the previous year. </div>
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<br /></div>
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Today in Chios over 900 people are staying in Souda camp and
its overflowed into 2 more temporary camps. I think we are going to have to
start up evening shifts to provide care at the other temporary camps as there
is no medical care at any of these new shelters. And yet still the camp is controlled
with gentle calmness. There are two entrances and exits and just one security
guard at each. No sign of a gun or an army uniform anywhere near and there is
not a hint of disorder. People calmly wait in lines when food is distributed
and even when the clinic is heaving we have everyone waiting their turn to be
seen. </div>
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<br /></div>
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We have seen a lot more Frontex (international border control)
cars and army vehicles driving around but not an increased presence in the camp
yet. The people of Chios continue to welcome and find space for all of these
people and the cafes are still providing free food. There are now Nato boats
patrolling the waters with an aim of “preventing sinking” of any of the
smugglers boats but if the boats are found in Turkish waters they are taken
back to Turkey. I think its going to be an interesting few weeks as the
political situation evolves and refugees pile up on the Greek Islands. I think
the medibus is going to be very useful in providing care around the island to
those stuck out in temporary camps. We will see how it goes and I’ll be sure to
keep you updated! <span style="mso-spacerun: yes;"> </span></div>
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<br /></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC3fTaeniqDfP4MBK_HX4sqrknT8cK9kEcS5zTTZFqSA7ta3vBxeaduGO5kuN2cTLLCDHpPMAHEm34Cp6iCs1CrqumwkqPxVzB_Q_hJSDItZFTfDwGw3DMDQVlh9QM9sVmi2rR4RccdumQ/s1600/IMG_0149.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC3fTaeniqDfP4MBK_HX4sqrknT8cK9kEcS5zTTZFqSA7ta3vBxeaduGO5kuN2cTLLCDHpPMAHEm34Cp6iCs1CrqumwkqPxVzB_Q_hJSDItZFTfDwGw3DMDQVlh9QM9sVmi2rR4RccdumQ/s320/IMG_0149.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Just in case you're jealous, I've not been sunbathing every day</td></tr>
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<br /></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-59994254065029630502016-02-22T12:15:00.003-08:002016-02-22T12:15:56.122-08:00Hello from Greece!
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Reading through my previous posts Dobova feels a million
years and miles from where I am today! I’m back out with DOTW, this time on the
Greek island, Chios. I’m going to be here for the next 6 weeks (if all goes to
plan) providing medical care to refugees who have just arrived by boat here. </div>
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<br /></div>
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The organization of DOTW here is a bit complicated. As we
all work within a network there’s many different branches involved in
responding to the refugee crisis. All of the work in Greece is being
coordinated by the Greek branch of doctors of the world. MdM Greece has been
providing medical care and support to Greek people for many years and has
increased its operations since the financial crisis for those who can no longer
afford health insurance. When there was a significant increase in numbers of
refugees coming to Greece last year, MdM Greece asked for the support of other
members within the network to help manage provision of healthcare for refugees.
In coordination with MdM Belgium, UK and Holland a plan has been made to
provide human and financial resources to respond to the ongoing needs of
refugees as they arrive on Greek Islands, which is how I’ve ended up here! </div>
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<br /></div>
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I’m going to be working as the only doctor this time with
one nurse, two translators, our project coordinator, Claire (who I worked with
in Slovenia) and Remi our logistician. The plan is very changeable, but at the
moment our remit is to provide care as a mobile unit using a Medibus which was
specially made for MdM. The aim is to move around the island and travel to
other islands to provide care where its needed most outside of the refugee camp
setting. Currently, we are providing cover for the Greek MdM clinic, as they
set up a new centre, within one of the refugee camps where people await the
ferry to Athens. </div>
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<tr><td class="tr-caption" style="text-align: center;">The Medibus</td></tr>
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There are several camps across the island but at the moment
there is a plan to open a new “hot spot” where there can be complete
registration of refugees on the island rather than only doing registration in
Athens. The clinic we are covering runs the same as the Dobova clinic, where
its open access and anyone who wants to can see a doctor. There are quite a few
organisations providing medical care in the camps and given the unpredictable
arrival of refugees, we are working in rotation with a couple of NGOs to
provide cover for the clinic 24 hours a day. Luckily we’ve got the day shifts
and have Sundays off, if there’s no major disasters. </div>
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<br /></div>
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The medical work is very similar to the clinic in Dobova but
the surroundings couldn’t be more different. We don’t have the same set up at
the Slovakian team and are operating more at a primary health care level with a
small pharmacy and the ability to do dressings and refer to the hospital if
needed. Again we are seeing lots of coughs and colds, chronic diseases and this
time more injuries as people have been crammed into boats and injured getting to Turkey. </div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0w-EY3c8ISmVIJ2SuBlEsPu0_nn5VYI1eKEUMDNaWMfJrJlcYw_A1_2wB80t5caZr0kgUeLO6XB2zvii7WfFOxt_vl8mzpCNLOUdeFEvJj0ti8V9KD7GlrkDEIO10oc9tIpK-LetJ3ps2/s1600/IMG_0112.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0w-EY3c8ISmVIJ2SuBlEsPu0_nn5VYI1eKEUMDNaWMfJrJlcYw_A1_2wB80t5caZr0kgUeLO6XB2zvii7WfFOxt_vl8mzpCNLOUdeFEvJj0ti8V9KD7GlrkDEIO10oc9tIpK-LetJ3ps2/s320/IMG_0112.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Clinic in Souda Refugee Camp</td></tr>
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The camp here is organized by Norwegian Refugee Council and
has been completely founded with humanitarian principles at its core. There is
no military presence at all. Since I arrived I have not seen a single gun and I
cannot describe how differently the refugees are treated. The camp is
completely open and refugees are free to come and go as they please. On arrival
refugees are issue<span style="mso-spacerun: yes;"> </span></div>
d a coloured wrist band to show they have been registered,
after that they are free to leave the camp and walk around the island. They can
stay as long our as little as they want although the majority leave on the earliest
ferry to Athens. Information is sign posted everywhere to allow people to plan
their onward trip.<br />
<br />
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<tr><td class="tr-caption" style="text-align: center;">Information on the route through Europe</td></tr>
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Refugees are encouraged to be self sufficient and many of
the islanders have opened up their businesses to cater for the refugee
population. Free food is being offered by one of the local cafes. The camp
itself has free wifi for everyone, charging points for phones, solar powered
hot showers and many individual family sized “tents” that can house one
extended family.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihvSLUeJqLBR3Gxkuco3wVxr64iOTPyfQagD26dafTeL7qVhtgFeftpiIqh2JB0HaUiCPLUDPXiIX76wyULZB6lkLADT_KYCll0LXgH93M02zgICKWkfqnTJUi36NdwocQEi1_OVkSazvG/s1600/IMG_0070.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihvSLUeJqLBR3Gxkuco3wVxr64iOTPyfQagD26dafTeL7qVhtgFeftpiIqh2JB0HaUiCPLUDPXiIX76wyULZB6lkLADT_KYCll0LXgH93M02zgICKWkfqnTJUi36NdwocQEi1_OVkSazvG/s320/IMG_0070.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Temporary "houses" built by UNHCR in collaboration with Ikea</td></tr>
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<br />
These temporary structures are allocated based on need and
families with lots of children are given priority. The larger tents are where
the rest of the refugees can sleep and are full of proper camp beds raised off
the floor. There is a children’s play area equipped with staff providing activities
like arts and crafts, music and an outdoor area to run around in. It is staffed
like a nursery so parents can drop their kids off and not worry about them
giving them much needed respite. I really couldn’t believe this was the same
crisis I was involved in Slovenia and had to keep asking what the rules are
about people coming to the clinic and being referred to the hospital despite
their being no restrictions on the movement of people for medical needs. The multiple
agencies here are working in complete cooperation with a whatsapp group
coordinating all the volunteers working on the island and sharing information
as much as possible. It’s very surreal driving and walking past big piles of
life jackets discarded on the beaches all over the islands in the morning.
Punctured rubber boats are washed up on the beaches and collected by diligent
volunteers and piled up for weekly collection by the bin men. <br />
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<tr><td class="tr-caption" style="text-align: center;">Abandonned life jackets</td></tr>
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Chios is only 4km from the coast of Turkey and has been hosting
the second largest number of refugees arriving from sea after Lesbos. In the
first 4 days of this February, Greece saw 7483 arrivals by sea which was more than
the entire month of February in 2015. Everyone is predicting as the weather
improves the numbers will spike again up to thousands arriving every day as
there is no sign of hope that the situation in Syria will improve. Once people
make it to Turkey and want to reach the EU they cannot go by normal routes on
ferries to Greece as they require visas/passports to buy the tickets. Therefore,
they are in the hands of smugglers who charge depending on how dangerous the
route is. The most expensive option is to go to the islands closest to Greece
thereby minimizing the danger, for those who have less money then there are
cheaper options to travel to islands further away such as Kos. <span style="mso-spacerun: yes;"> </span>The translators here tell me that people have
told them they can pay anywhere from £400- £2000 each to get on these boats. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Today a young Afghani woman visited the clinic and I have to
share her story here. Her husband along with her extended family and her 3
small children had paid smugglers to get on a boat made for 45 people. When
they arrived at night to take the boat she said 60 people were being pushed
onto the boat. They refused to board the boat because they didn’t want to risk
their lives and could see it was dangerously overloaded, but they were forced
at gunpoint onto the boat. She got separated from her husband in the panic as
some people were thrown onto the boat and others were left on the shore. She
thought her husband had her youngest child were together and would get the next
boat behind her. When they arrived in Greece someone looked in the bottom of
the boat to check if there were any bags left and they found a child face down.
When they pulled him out she realized it was her youngest child and they were
rushed to hospital by the paramedics. She told us when they arrived at the
hospital their resuscitation attempts were futile and he was pronounced dead.
He was one and half years old and died from suffocation and being crushed at
the bottom of an over loaded boat. She came to the clinic complaining of
stomach ache but her entire body was reacting to this horrific tragedy. She
stayed with me and the Farsi translator Simin and we sat and drank tea and shared
in her grief as she told us her story. When we left her with the UNHCR staff
and local charities arranging the management of the child’s corpse and
reunification of her with her husband she told us she still hadn’t managed to
contact her husband who didn’t yet know what tragedy befell them. <span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The whole feel of the island and the refugees is in stark
contrast to where I was in Slovenia. Despite being surrounded by story after
story of immense human suffering, there is a feeling of calm here in Chios.
Young men swim in the sea and bask in the sun after being registered. Families
wander around and see the sights of the town, enjoy interactions with locals
and plan their next steps in contact with their families behind and in front of
them. The stress and anxieties that we saw in Slovenia seem to be far less prevalent
and when people come to the clinic it’s with specific medical problems rather than
for respite. The intense natural beauty of this wonderful island and the outpouring
of compassion and love from the local population and volunteer community
restores my faith in the goodness of the world and humanity. We will see how
soothing they remain after 6 weeks here. </div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg90UVkmwUhpZbFuSwKOpAMV3Wlftksqd4BIzdtKUgd81SeX56fqVSlEDX0bm6-dEJCTk0ONoIqQ1hqhilKctPELtsFyH8Lli8tnVntrKzO0gdhM32ZMJ1cHnmBd2iAWufKlOAJ1SXkOCBp/s1600/IMG_0056.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg90UVkmwUhpZbFuSwKOpAMV3Wlftksqd4BIzdtKUgd81SeX56fqVSlEDX0bm6-dEJCTk0ONoIqQ1hqhilKctPELtsFyH8Lli8tnVntrKzO0gdhM32ZMJ1cHnmBd2iAWufKlOAJ1SXkOCBp/s320/IMG_0056.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The view from Souda Camp</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkllEu-j8KtX_YicW786i4wTk1o0Vz50bp9ABY2uhyphenhyphenjW5qfmYhbYKkOYDJ4MBHeQDeA4jkJAm6AdHT8cgpQsR-F0x_gfuVvOGo__rc18ptBA2pNJIAD-HOxHY1-68rUTfx0va9iYIn_Mtu/s1600/IMG_0065.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkllEu-j8KtX_YicW786i4wTk1o0Vz50bp9ABY2uhyphenhyphenjW5qfmYhbYKkOYDJ4MBHeQDeA4jkJAm6AdHT8cgpQsR-F0x_gfuVvOGo__rc18ptBA2pNJIAD-HOxHY1-68rUTfx0va9iYIn_Mtu/s320/IMG_0065.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Claire and I enjoying some lunch in the sun</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVWvHV3vm7pe0-fhBx0Wb3Bk12TeBQwZBhLeTvrcA3G5Ui_vlM1XVBg4Tsf-f0S5qy3WSzG3ybdcjfLI3gRot-E6dmcetTDLgWzrZDq-69JqAq3FngoSyCXNAn5PLpnr7zYMmh7OPmacGn/s1600/IMG_0111.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVWvHV3vm7pe0-fhBx0Wb3Bk12TeBQwZBhLeTvrcA3G5Ui_vlM1XVBg4Tsf-f0S5qy3WSzG3ybdcjfLI3gRot-E6dmcetTDLgWzrZDq-69JqAq3FngoSyCXNAn5PLpnr7zYMmh7OPmacGn/s320/IMG_0111.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Beautiful sunset looking out over Chios town</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoLKAkyL0jMm47maK3QiisTAaENOYOEyreVJkLtqRys8AOrt3abmqclYHygcTZa8-wAqKZBcr5A1Fj9MXlrnDHcbSh-U5R6fPSadntQG_YRHV6jPpGyGR07LUQLZohMEr0798fDLZH0D3F/s1600/IMG_0116.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoLKAkyL0jMm47maK3QiisTAaENOYOEyreVJkLtqRys8AOrt3abmqclYHygcTZa8-wAqKZBcr5A1Fj9MXlrnDHcbSh-U5R6fPSadntQG_YRHV6jPpGyGR07LUQLZohMEr0798fDLZH0D3F/s320/IMG_0116.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">This sign outside a restaurant says: "Salaam, refugees welcome, all food is halal, price is cheap, you can use internet and toilet for free, we speak arabic!" (according to Hamed our translator!)</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggA5VU1C6g5tU-l4UBnEeQ_ikTd-GYznvw0qOdCiUL7LkDfrTUXbcFdg9ZbM7dZjsQY2Jb9dIbbx7k0Yx4ceFZoIc6OaOr6sDRhyZRgQ9WxGqTZ_LUrrS8aTANVcXj0rRPe78ueZDDWedt/s1600/IMG_0101.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggA5VU1C6g5tU-l4UBnEeQ_ikTd-GYznvw0qOdCiUL7LkDfrTUXbcFdg9ZbM7dZjsQY2Jb9dIbbx7k0Yx4ceFZoIc6OaOr6sDRhyZRgQ9WxGqTZ_LUrrS8aTANVcXj0rRPe78ueZDDWedt/s320/IMG_0101.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Happy team on sunday drive around the island</td></tr>
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Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-87494699932912642542015-12-28T10:45:00.000-08:002015-12-28T10:45:54.741-08:00Isme Aaminah Ana Tabeebah
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">I tried to write this post a couple of times whilst I was still out in
Slovenia but I just couldn’t find the time or energy to do it justice. Now I’m
home I’m trying to consolidate all the little notes I made to myself and I’m
afraid this is going to be a mammoth post about everything I was thinking,
feeling and witnessing whilst working the past week in Dobova. Its not the most
flowing piece of writing and I hope you can manage to get to the end! </span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">In total we worked the initial shift I already blogged about and then two
24hr shifts with 24 hour rest in between then another 9 hour shift on Christmas
day. We saw 319 patients over those shifts with around 100 a day on the 24
hours shifts and a few less on the 9 hour shifts. <span style="mso-spacerun: yes;"> </span>Generally, the shifts were much busier in the
evenings and our first 24 shift started in a very chaotic way. A train had just
arrived at 9pm when our shift began and over 1000 people were coming into the
camp. We saw 40 patients in first 2 hours with another 55 in the next 6 hours
including 4 very sick patients. On our second 24-hour shift finishing at 9pm on
the 24<sup>th</sup> we ended up staying another hour as the team we were
handing over to consisted of just one doctor and when she arrived we had 2 very
sick patients plus reports of a third needing to be picked up at the train
station. </span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">We noticed quickly that “batches” were much sicker than others and it
was linked to which route they had taken and how long they’d be travelling
without stopping. Those who had walked across Bulgaria rather than risk the sea
were much more exhausted and seemed to have been more neglected health wise.
Sometimes the make up of a train was mainly young healthy men and our only
consultations for hours would be coughs, colds and headache. Then the next
train would arrive and there would be large extended families with many
pregnant women, new born babies, young children and old sick grandparents. I
was so amazed at the resolve of families to bring along and continue to care
for <i style="mso-bidi-font-style: normal;">every</i> member of their families including
the wheelchair bound grandma with type 2 diabetes, the severely disabled
premature baby requiring urgent heart surgery to save his life and the granddad
requiring dialysis every 3 days! When we had a group like this, the clinic was
crazy and we were running around like mad trying to keep the flow of minor
cases moving whilst providing emergency care alongside. Luckily our team gelled
really well and we were able to adapt to the situation when the clinic was
heaving with sick people. I felt that as the 2 doctors (and I hope Elly agrees)
we had a very good mix of complimentary skills and I never felt like we lost
control and patients were always safe. <span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">We saw several cases where people just could no longer keep it together
and something snapped. A young girl around 9 years old was rushed into the
clinic hysterically screaming in pain and unable to stand. I rapidly assessed
her and found she was very tender in her abdomen and was concerned she had
acute appendicitis. We checked her vital signs and actually everything was
normal. I gave her some simple analgesia (paracetamol and ibuprofen) and after
15 minutes she was up walking around smiling. She couldn’t really explain what
had happened and we observed her for another couple of hours and the pain had
completely resolved. One thing Elly and I talked about at the end of that shift
was the importance of sitting on people like this and waiting to see what
happened if it wasn’t immediately apparent there was a life threatening
condition. We saw this type of presentation a few times and we could only
really explain it as a psychological response to the extreme conditions they
were going through and that being seen by a doctor, being reassured and maybe
given any pill was enough to build the resilience back up and carry on with the
journey. </span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Elly and I shared out the task of going to the train station and
transferring cases by ambulance to the hospital. Our first referral was a 7-year-old
boy who presented with severe exacerbation of asthma. His mum stated he was on
inhalers in Syria before they left but all their belongings including his
medicine had been thrown into the sea by the smugglers to make the boat lighter
as they crossed from Turkey to Greece. He was really unwell but it was a
presentation I’m very used to dealing with in A&E in Lewisham and Woolwich.
As we had nebulisers and oxygen I was able to give a significant amount of
treatment to him in the clinic to see if he responded. Having experience with
these kids I knew pretty early on he wasn’t going to respond and would almost
definitely need referral to hospital but actually his clinical state was
completely irrelevant when negotiating the referral with the family. His
extended family were all travelling together and I think in total there were
around 20 people linked to the child. Our Arabic Translator Hakim was amazing
at mediating between the family and us and explaining the seriousness of the child’s
condition. Despite the mother and father realising how unwell he was there was
still severe resistance to the family being prevented from continuing with the
journey. Many of the extended family wanted to know exactly how many hours
they’d be kept in the camp, predictions we just couldn’t make. It was really
hard as a doctor to delay referral for a child who was clearly unwell to
appease the family until the point that we had everyone on board in order to
make sure the family wouldn’t be separated. Even once they had agreed to go we
had a hard time from the family every hour or so having to give updates and
trying to stop them boarding the next bus in the morning and wait for the kid
to come back from hospital. But about 9 hours later the child returned looking
almost unrecognisable to when we sent him to hospital and it was one of the
really great moments when he came back to the clinic to say goodbye. </span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"><br /></span></span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzO2odIQT9Q7DrVXeqNJdRNDGUYCztxXLQacSKnG-LrUHA4EQYhV0DCCToOKimFb0WBfBJnoBMKQxPbA5XqVqKWWaP6W9t5OALEaAnPNGsrS4UA1nfeopcCjf_HbjC1bXuETUP_nf058Vr/s1600/IMG_0225.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzO2odIQT9Q7DrVXeqNJdRNDGUYCztxXLQacSKnG-LrUHA4EQYhV0DCCToOKimFb0WBfBJnoBMKQxPbA5XqVqKWWaP6W9t5OALEaAnPNGsrS4UA1nfeopcCjf_HbjC1bXuETUP_nf058Vr/s320/IMG_0225.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Happy Mustafa back from hospital</td></tr>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Another patient I transferred was a desperately sick little baby who was
only 2 months old and had been born just before the family left Syria. The
child had a respiratory infection and was unable to feed and was in bad
respiratory distress. The mum and dad and baby were travelling together with no
extended members and we managed to negotiate with the hospital to keep all of
them at the hospital together. They had already been admitted in Turkey for a
few days during their travel and I think they knew that the child was still
unwell. The mum was only 20 years old but she was so strong and really sorted
the Dad out when he started talking about missing the next train. The
paediatrician I referred to was an amazing old school doctor who had excellent
English and was clearly very skilled. Her first action when we brought the baby
in after a thorough history and examination was to give the baby a bath! I
found it very weird especially as the child needed urgent IV antibiotics in my
head! Anyway, she was amazing at reassuring the parents and was very empathetic
offering them showers and to wash all their clothes whilst they were in
patients. I thought the child would have to be admitted for at least 48 hours
and the paediatrician agreed but it was nice to see the family in a safe space
and all together. </span></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">The other interesting part of the job was going to the train station to
collect patients who were extremely unwell. When I went to the train it was an
evening train with around 1000 people arriving. The station was crazy and
chaotic and there was one doctor on the station with a handful of meds making
direct referrals to us in the camp if she was concerned. When I arrived the
patient in question was a young man who had a very high temperature and had
collapsed on the train. She had to physically take him off the train and was
trying to assess what was wrong with him. Whilst I started assessing him
someone started pulling my coat and asking me to see someone else. A 9-month
pregnant lady was so exhausted she also couldn’t get off the train and was
unable to walk. I decided neither was so sick they desperately needed to go
straight to hospital and brought them to the camp. Both turned out to be fine
after a period rest, observation, IV fluids and some basic meds and didn’t need
referring to hospital but the whole visit to the train station gave me a
different perspective. </span></div>
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<br /></div>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Although it sounds dramatic I couldn’t help but compare it to pictures
I’d seen of the holocaust where people were transported on trains and then
taken without knowing where they were going to these heavily militarised camps.
They were going to be transported to be stored in empty warehouses for an
unknown period of time all clutching a handful of personal items with the hope
of finally reaching somewhere safe. When I looked in the train on my way out of
the station it had clearly been horrendously overcrowded, vomit on the floors
and just so dehumanising. When it was suggested to think about providing a
clinic on a train I was quite excited about the logistical challenge. However,
seeing that situation now I feel it’s so totally inappropriate to provide care in
that setting as this would further legitimise the way the crisis was being
managed. People have the right to stop, rest, eat, drink, feed their babies, change
their clothes, have showers and seek medical care in a calm and controlled
environment whilst making this horrendous journey. The priority should not be
shuttling people across your country as fast as you can so its someone else’s
problem. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ6BPpezCg4QZvfYBKlw6bOl2j5XdAKXHll1RfogLvBJ41EXdFhTdzN6dXaebp3iGt4l_pX8mlq6XO3CDmaOArAdOg5PTTQHcWZTvH4EwDj_4jHKr5cP6DnGvx69w-BgcF49euQlUPIU0h/s1600/IMG_0231.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ6BPpezCg4QZvfYBKlw6bOl2j5XdAKXHll1RfogLvBJ41EXdFhTdzN6dXaebp3iGt4l_pX8mlq6XO3CDmaOArAdOg5PTTQHcWZTvH4EwDj_4jHKr5cP6DnGvx69w-BgcF49euQlUPIU0h/s320/IMG_0231.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sleeping overnight at the camp</td></tr>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">A case that I got really emotionally involved in was a young teenager
who had a congenital heart problem that required surgery. I wasn’t really sure
why he hadn’t had the surgery as a baby but the family were very keen that he
gets to Germany where he could have proper care and follow up. He was brought
into the clinic having collapsed whilst waiting in the registration line in the
cold. When he came in he was completely blue and short of breath. His oxygen
level was 55% (normally >95% in healthy adults) and we put him on oxygen
immediately. Within 5 minutes he was much better and once he’d warmed up we
decided that his background oxygen level was normally around 75% which he
stabilised to. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5jC_E2taXXqloCsEDpikHA5pGCmM3TzOQIiuAESP6Rm9k-t5o5O64QDrARL9XunoYGE0WR6BfQzNaOCtluOY6C8Iq4U9UWZ8CySCjoZdQh_k-dE4FCsv4dV8dK4YoXtQJ03hObyC_FayD/s1600/IMG_0204.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5jC_E2taXXqloCsEDpikHA5pGCmM3TzOQIiuAESP6Rm9k-t5o5O64QDrARL9XunoYGE0WR6BfQzNaOCtluOY6C8Iq4U9UWZ8CySCjoZdQh_k-dE4FCsv4dV8dK4YoXtQJ03hObyC_FayD/s320/IMG_0204.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: #0000ee;"><span style="font-family: "Times New Roman";"><u>Severely clubbed <span style="color: #0000ee;"><u>fingers (for the medics)</u></span></u></span></span></td></tr>
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<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">We worked out that the reason he had decompensated so badly was
being made to stand in the cold so we wrote a medical note and went to speak to
the police to ask if he could be fast tracked through the queue and not made to
wait in line. After an hour or so he wanted to go back with his family and
sleep in the main tent until the bus arrived in the morning so we let him go
with the note to the police to ensure he wasn’t made to stand outside again.
Only 30 mins later he was rushed back in, in the same condition as before. This
time we decided the only way to ensure he was warm and ok was to keep him in
the clinic. So we identified the whole family and managed to get access to the
mother and baby container (run by another charity WAHA) to allow his 23 family members
to sleep there where we would collect them from when the morning bus arrived.
Early in the morning the police chief came to say him and his family needed to
get on the bus now so we started waking everyone up and getting them on the
bus. The chaos of trying to wake up and dress 13 children ready with all your
belongings for another journey was indescribable. I was so stressed the family
would miss the bus I was running around picking children up, putting their
shoes and coats on and collecting them together. Even though it was only 15 or
20 minutes I was involved in helping them get on the bus I had totally adopted
the stress of the family and felt fully responsible for keeping everyone
together. The relief and emotion I felt when I finally got the last kid on the
bus and double checked to make sure everyone was there together was a small
taster of what the adults in these families must be going through at every
stage. </span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3PYqnYdFKEup-hmFC6zhvySeqZjb7OgYXBK8T_V2klfxisgTNILKy7GFDrw75a3hg75rEEPk3FfdlHJ6na3lMCM5q0Vg4nCpzQ28uApr6T7KJgGxYVxKwPb94PS_wuN8eIJQVi5y3PYRv/s1600/IMG_0207.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3PYqnYdFKEup-hmFC6zhvySeqZjb7OgYXBK8T_V2klfxisgTNILKy7GFDrw75a3hg75rEEPk3FfdlHJ6na3lMCM5q0Vg4nCpzQ28uApr6T7KJgGxYVxKwPb94PS_wuN8eIJQVi5y3PYRv/s320/IMG_0207.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The family in the WAHA container before they went to bed</td></tr>
</tbody></table>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">When we did get a break in the flow of patients we sometimes took a
moment to lie down for a couple of hours. It was very disorientating sleeping
inside the medical tent where you can hear the movements of everyone else in
the camp around. Towards the end of the first shift and definitely in all of
the rest of the shifts my brain had shifted to a hyperarousal state. The
smallest noise or movement inside or outside the tent and I would wake up
immediately expecting a huge flow of people into the clinic. Those who know me
well, know I’m prone to sleep talking and predictably I woke up Heather and
Elly! One night I shouted out in the middle of the night “When does the next
train arrive?!” and would only lie back down once Elly reassured me we were in
the hotel I could go to sleep. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Consciously I hadn’t realised that being in a militarised environment
was affecting me but I had several dreams about being shot by the soldiers or
about the clinic being bombed. I found it really weird that this was my
subconscious reaction as my personal interaction with the police and military
was mostly very pleasant and respectful. However, we witnessed every day
unnecessary shouting and some pushing/shoving the refugees as they were were
boarding buses or being registered. I can’t imagine how it must feel to have
fled a war zone where your life was actually threatened by militia and then
have to spend every day being pushed from pillar to post by more military
actors. The entire team spoke about how unnecessary it was for the police and
soldiers to be so heavily armed and how just that simple presence of guns
changed the entire feeling of the camp. Individual police and soldiers were
very pleasant and often when the treatment of refugees was at it worse it
turned out that they were being forced to work unpaid overtime or had been
drafted to work without notice that morning. The camp did run “efficiently” and
the flow of people was managed well but overall it was just so unnecessary to
have so many physical barriers and escorting people often children, with huge
weapons to just go to the toilet. </span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmybd5XAwHxvZ-ZWNd4etfRw5owA0J6t2MVryAW0sLTdGrjjYL5ci_pOHjzW2yMu5dFtyzwBqbxZe-HWXasAMe3U5pFDTlFoy2dZTWfy61Di8jhDnUPe_tnMuxZR7z1JiWuvHg-PnWGhUt/s1600/IMG_0294.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmybd5XAwHxvZ-ZWNd4etfRw5owA0J6t2MVryAW0sLTdGrjjYL5ci_pOHjzW2yMu5dFtyzwBqbxZe-HWXasAMe3U5pFDTlFoy2dZTWfy61Di8jhDnUPe_tnMuxZR7z1JiWuvHg-PnWGhUt/s320/IMG_0294.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Open access to healthcare....</td></tr>
</tbody></table>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">I have so many more stories of individuals and families that we were
privileged enough to share a small part of their journey and feel this post is
becoming way too long again! One of our observations I touched on earlier was
actually defining the mandate of the clinic. Our team had a very shared ethos
where we wanted the clinic to be a humanitarian space and we really wanted the
clinic to run as an open access self referral system. This means that if anyone
wants to see a doctor they are able to and there should never be any triaging
by police or military to decide if your sick “enough” to see the doctor. Trying
to define the role of clinic is difficult as defining medical care is not as
clear cut in this setting. Providing rest is the treatment to exhaustion,
providing nappies and a space to feed the treatment for an irritable baby,
rewarming the treatment for hypothermia and play the treatment for kids who
have been travelling non stop for days. However, when we had acutely sick
people like a lady who was maybe having a heart attack or the boy with severe
asthma our clinic suddenly morphed into an A&E majors department and we
went from blowing bubbles to cannulas in a heartbeat. Many health actors are
stepping in to provide the humanity in this setting and actually there
shouldn’t really need to be a “humanitarian space”. The whole camp should be
made with humanitarian principles as a priority not the logistical issues. After
all these are people fleeing war and persecution not criminals or cattle or
cargo. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Another thing we talked about as a group was seeing ordinary Slovenians
differentiating themselves from the state and providing that humanity to
people. All the food distribution, escorting to and from the clinic and
providing of new clothes, nappies etc was being managed by unpaid volunteers
working with Slovenian Philanthropy. They were incredibly responsive to our
presence and really amazing at trying to improve the position of the people
they were helping in whatever ways they could find despite the barriers created
by the system. This crisis so far will be remembered for the terrible way our
state organised activities have failed these refugees and how ordinary people
and voluntary organisations have stepped in to pick up the slack. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">One final point I want to make is that I have noticed the softening of
the media to the plight of Syrians and there seems to be accepted that Syrians
have the right to flee. This is of course welcome news and vital to help apply
pressure onto the government to accept more refugees. However, everyone has the
right to escape persecution and claim asylum in any state. Because Macedonia’s
policy is still in place, where only Syrians, Iraqis and Afghanis (SIA) are
allowed to cross the border we only saw people from those countries or pretending
to be from SIA countries. This means that anyone who is black is unable to pass
for SIA and is returned immediately on arrival. We saw 2 Somali girls who were
detained at the camp and sent to a detention centre in Slovenia despite having
every right to claim asylum. The Syrians we met sure have every reason to be
fleeing, but so do the Afghanis, the Somalis, the Pakistanis pretending to be
Afghanis and the Iranians pretending to be Afghanis and everyone else the world
over who’s countries are so fragile or poor they have no prospect of a future.
People are people and we need to stop making a distinction between those who
have the right to flee and those who don’t. No one would put their children and
disabled mother in a boat and travel thousands of miles to Europe if there was
not the hope that life would be better than where they left.</span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkoiZUanL00fw_WaYWcqAGAjuuwytpgipb4jYXm5X2WB9_gHTCgdW6XDEmcI6QWj_rUnq9_krdW77SYVGy52EIYeTsFtBPY3u1cySvyKNHFZsrXhcyyAiqVO9TSXEDlFd2bDza_oBfYaYX/s1600/IMG_0265.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkoiZUanL00fw_WaYWcqAGAjuuwytpgipb4jYXm5X2WB9_gHTCgdW6XDEmcI6QWj_rUnq9_krdW77SYVGy52EIYeTsFtBPY3u1cySvyKNHFZsrXhcyyAiqVO9TSXEDlFd2bDza_oBfYaYX/s320/IMG_0265.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Best selfie ever.</td></tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com1tag:blogger.com,1999:blog-8626603964540817638.post-61271600512661454952015-12-21T09:07:00.001-08:002015-12-21T09:07:05.728-08:00Back in Action!
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<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">So just
when I had adjusted to the fact that my time away had been cut short and I was
going to have a Christmas back home, I got a call last Thursday from DOTW
asking if I could come back to Slovenia on Saturday to stay one week. I don’t
think I fully appreciated the reality of “being on standby” for this kind of
emergency, and it took me one evening to make a positive decision to come back.
I owe everything to Bob as always for constantly supporting me to make these decisions and to his family for being so understanding
about me missing Christmas with them. <span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Since we
left 10 days ago, our team on the ground have been working tirelessly to try
negotiate with the Ministry of Health to agree to a long term presence for a
DOTW camp in the currently used entry and exit points but to little avail. In
Dobova (the main entry point), a team from a Slovakian University has been
providing medical care for refugees when they enter Slovenia from Croatia. We
have been asked by the Slovakian coordinator to step in to provide some much
needed respite for their team of docs and nurses so they could have time off
over Christmas. When we arrived we were really unsure as to how many staff
members would be remaining, what kind of clinic we’d be stepping into and how
many refugees, if any, there would be to treat. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Our little
team from Gornja Radgona has grown a bit. In addition to Heather, myself and
Claire our stand in coordinator/data collector (whilst Titi is on holiday), we
have been joined by Elly an experienced Gp from Belgium who has volunteered in
the Belgian MdM clinic for a few years, Hakim our Arabic interpreter from
Morocco and Ramin our Farsi interpreter from Iran. We’re staying in a time
capsule from post soviet 1960’s complete with wood panelling and VERY patterned
carpets and cosy shared rooms. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">We got
stuck straight in on Sunday and went to meet the Slovakian team quite early in
the morning. The Slovakian coordinator is a fiercely efficient lady who has
clearly cultivated a very functional and efficient clinic and is quite rightly
protective of her operation. They have an amazing clinic that is heated with a
well stocked pharmacy and good space for consultations. They have an ultrasound
machine, capacity to give medicines intravenously, provide nebulisers, do ECGs
and defibrillators if someone’s heart stops! </span></div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ8g3GNPWEgee1elbw8546yFk8AHTx-VnhDnypq4Ra_rZFWydDDf9pgoGZJK6d24_4HS_zhEmHd236cZhoZ-WLii3Ic3krgFw8os3UGOfR_ayZZY27VF4ToWIfd9u22CMXUEhOxR7NN6hd/s1600/IMG_0183.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ8g3GNPWEgee1elbw8546yFk8AHTx-VnhDnypq4Ra_rZFWydDDf9pgoGZJK6d24_4HS_zhEmHd236cZhoZ-WLii3Ic3krgFw8os3UGOfR_ayZZY27VF4ToWIfd9u22CMXUEhOxR7NN6hd/s320/IMG_0183.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Consultation space to have some privacy</td></tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfmeS0BUviVEzsvPQM-ZXNbrlBxeIBerj6kXALLr1whGws1jQUOuu1twdWi18YOd9jsMcGgMvBXlgPa8vqBvDKE0f-CKe0ilxnTXohignWPLNSco5wivZYw3YVU0OZAXl3PzkkZxawPvPG/s1600/IMG_0187.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfmeS0BUviVEzsvPQM-ZXNbrlBxeIBerj6kXALLr1whGws1jQUOuu1twdWi18YOd9jsMcGgMvBXlgPa8vqBvDKE0f-CKe0ilxnTXohignWPLNSco5wivZYw3YVU0OZAXl3PzkkZxawPvPG/s320/IMG_0187.JPG" width="320" /></a></div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFS2i4nybeUy423T7uliy-t9x9Na3aEnLFceVnhtcwcqK6i694R8qnyWZpSYUXFHrhnYrJkBCuRI9TGmA55D9e2Ii35gvXvVWnIud4TKq_usp0z_gf6XuKNQ5rQjC_aBuP1QONgE18zOYe/s1600/IMG_0188.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFS2i4nybeUy423T7uliy-t9x9Na3aEnLFceVnhtcwcqK6i694R8qnyWZpSYUXFHrhnYrJkBCuRI9TGmA55D9e2Ii35gvXvVWnIud4TKq_usp0z_gf6XuKNQ5rQjC_aBuP1QONgE18zOYe/s320/IMG_0188.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Pharmacy (bit better than our mobile one!)</td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuXDEHrbbYnSyXzqlMZflme2BFIhJ-YQiIU_JK0ZtfmsDE7ArCL8Ty20IP3JaDp3ZE2sOZpzBNHc9v0hGAI3xuG3a5wz3PNt-TZvmHhHNmZ92cEgL3garO9LG8ckeQdkBf9RK_-LEVymSD/s1600/IMG_0185.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuXDEHrbbYnSyXzqlMZflme2BFIhJ-YQiIU_JK0ZtfmsDE7ArCL8Ty20IP3JaDp3ZE2sOZpzBNHc9v0hGAI3xuG3a5wz3PNt-TZvmHhHNmZ92cEgL3garO9LG8ckeQdkBf9RK_-LEVymSD/s320/IMG_0185.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Ultrasound, defibs and emergency bags</td></tr>
</tbody></table>
<br />
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Unlike
Gornja Radgona there seems to be no plan as to when refugees arrive and the
medical team have to be on standby to run the clinic 24/7. The Slovaks have decided
to run the clinic in 24 hour shifts so they work from 9pm one night until 9pm
the next night and start 24 hours later. The clinic runs with 2 doctors and 1
nurse and sometimes final year nursing students. The reason for 2 doctors is
first, to manage the numbers of refugees they are seeing in short time periods
and second, to provide cover for the train station. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Refugees
transit through Dobova in 2 ways. They are either brought from trains or buses
to be registered at Dobova camp where they will wait an undefined period for
the next bus or train. Whilst they are waiting in Dobova this clinic provides
an opportunity for healthcare, food, clean clothes and toilets. There are
heated tents but no formal sleeping areas as people do not tend to stay “overnight”
despite arriving through the night, normally the next bus or train arrives in a
few hours to take them across Slovenia. The other possibility is that they are
brought by train to Dobova and are taken off one train and made to wait an
undefined period on the platform of the train station before boarding the next
train. </span></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">At the
train station there has been a need for medical care as people wait at the
platform. The Slovakian team has been providing a doctor and a paramedic with
an ambulance to wait on the platform and identify anyone who needs urgent
medical care and bring them to the Dobova camp or if necessary take them to the
local hospital. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">I’m not
really sure why some people are brought to the camp for registration and why
some people stay at the train stations. Its also unclear if those who are kept
at the station are registered or not in Slovenia. Obviously without the
possibility of visiting a camp those basic human rights are not being met and
people are made to wait in the cold for the next train. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">The set up
of the camp is similar to Gornja Radgona but is extremely militarised and very
controlled. The presence of lots of heavily armed uniformed officers creates a
pretty bleak and oppressive environment not helped by the unending dense fog
that only let up today. From the moment the refugees enter the camp all we hear
is “quick, quick… fast, fast…” and people run from one barrier to the next
scared they will be separated from their family or miss the next bus. There is
SO little information sharing with the refugees and the whole system appears
very dehumanising. Almost all officers wear masks and gloves and the people are
just pushed through as fast as possible. The clinic is only signposted at the
very first tent when the refugees enter where there is a small sign saying “if
you need a doctor just ask” translated in Farsi and Arabic only. There are
Slovenian volunteers and the red cross providing clothes and distributing food
but its done very much on a production line and although the majority of
volunteers are kind they are forced to wear gloves and masks too. </span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_UNBWp7E0fArtbbU4knXqr4OThzLKL0xUtpmCA9dSUvH6TFWAXH48Q0bFI30WT8KVSEt8bF9RgSFK9i_SbSpuVyQxyEPzjnur4qb2MEcjofDGgV3ufl2Bo2z5o0hA1Ma8JukkQM9EkeHB/s1600/IMG_0182.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_UNBWp7E0fArtbbU4knXqr4OThzLKL0xUtpmCA9dSUvH6TFWAXH48Q0bFI30WT8KVSEt8bF9RgSFK9i_SbSpuVyQxyEPzjnur4qb2MEcjofDGgV3ufl2Bo2z5o0hA1Ma8JukkQM9EkeHB/s320/IMG_0182.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Fences to control the movements of refugees</td></tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">The clinic
should be open access whereby anyone who wants to see a doctor can, but I can
already see there are so many barriers to care seeking. Refugees first have to
feel comfortable enough to spend time visiting the clinic and not worry they
will miss the next bus/train, they also need to know that there IS a clinic
with doctors and nurses in it and then they have to inform one of the staff
members they want to see a doctor. In order to come to the clinic they are not
allowed to walk over freely and join a queue. They have to be escorted by
either a volunteer or the police/military which is not the most welcoming of
starts to a consultation. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Right so
hopefully that has explained the context of Dobova camp, although I’m not sure
I will ever fully understand what dictates the flow of people. The only people
who seem to have a permanent handle on this are the police and military. Back
to Sunday, we were asked to do our first shift immediately at 12pm until 9pm
and the coordinator has asked us to work as an independent team in the rota she
has created. When we are working the Slovak docs have time off and we hand over
to them each evening. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">So in our
“short” shift we got stuck straight in and saw a total of 41 patients. It took
a while for us to manage the flow and I would describe the way the clinic works
as feast and famine. A bus arrives and there are suddenly 100 more people in
the camp within a few minutes several people will be escorted to the clinic and
we could get up to 10 patients arriving in 10 minutes which is explained by
families or groups coming together. Then after a bus leaves it could be up to 2
hours when the camp is empty and we have no patients in the clinic at all. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Most of the
patients we saw were minor illnesses such as coughs and cold but we saw several
exaccerbations of asthma, diabetes and other chronic conditions. We also saw injuries
people sustained during their journey, one diabetic gentleman had a poorly
healing wound on his toe which happened when he was trying to get out of the
boat in Greece and another young man who had been pushed to the ground by
police and injured his hand in Belgrade. We saw lots of families and children
mainly with coughs and colds but also one child who was rushed off a bus as it
was leaving having a convulsion associated with high fever. </span></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;"> <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTq2Q_ctJ0pW00I6tdc9R10mY1B3qDFyJ307ZE3CIxHdS6Hp4Z-l6nvXTmIC7GMplyB_da0n6Oc0TEKJN0CEgmwsQVGBcc84oxlNyLBWvGprq5a1bpZ89jWRIU3HcBYoc60soIAlZlItCJ/s1600/IMG_0198.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTq2Q_ctJ0pW00I6tdc9R10mY1B3qDFyJ307ZE3CIxHdS6Hp4Z-l6nvXTmIC7GMplyB_da0n6Oc0TEKJN0CEgmwsQVGBcc84oxlNyLBWvGprq5a1bpZ89jWRIU3HcBYoc60soIAlZlItCJ/s320/IMG_0198.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Mid consultation</td></tr>
</tbody></table>
</span></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">We also had
one lady who was 8 weeks pregnant and had abdominal pain. She was mostly well
but dehydrated from vomiting which had been going on since the start of her
pregnancy. The worry was she was tender in her lower abdomen. In England I
would have rushed her to hospital with a possible ectopic pregnancy (where the
baby grows out of the womb usually in the fallopian tube) as even though she
was well at this stage it’s a life threatening condition. I was really glad to
have Elly there to talk through the case with and despite neither of us having
training in performing ultrasounds we had a go and Elly managed to visualise
the baby bobbing away in the womb. I doubt if we had told the patient to go to
hospital she would have, but regardless it shows the difficult decisions we
have to make providing care in this setting. In a way not having the ultrasound
would have simplified things and we would have to suggest she goes to hospital
and put her through the trauma of having to decide to stop her journey or
continue knowing the risk she was taking. Having the ultrasound allowed us to
rule out one of the most dangerous diagnoses but we still had to be very
careful explaining the warning signs of other possible diagnoses and hope that
she sought care further down the line. It’s really hard to face the reality
that health is not a priority for people and although they want to see a doctor
moving forward and continuing their journey is the most important thing. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">I’ve
already written so much and as always have so much more to talk about, but to
finish I want to try and describe why the clinic is so valuable. The medical
care we’re giving is really secondary in most cases. Most people have minor
illnesses that could go with or without the paracetamol or strepsils we give
out, for a few we’re staving off serious illness for another couple of days and
for even fewer we’re genuinely treating a serious condition. The key provision
the clinic provides is a humanitarian space, free from “fast, fast” and guns
and running to the next barrier. It’s warm and welcoming and gives people the space
to breathe and think about themselves and their health and take stock of what’s
happening and what they’ve been through. It’s the chance to be greeted by
someone who touches you without gloves and smiles at you not from behind a mask
and takes the time to listen to whatever you want to say and wishes you well. It’s
simply a place to be a normal human which has been lost as the logistic problem
of solving the “European refugee crisis” has been “solved”. </span></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-82592526276037457142015-12-07T15:12:00.002-08:002015-12-07T15:12:48.091-08:00Doctors without Patients<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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.<span style="mso-spacerun: yes;"> </span>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! <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">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!</span></div>
Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-21444575385649709932015-12-01T08:10:00.001-08:002015-12-01T08:10:24.804-08:00Doctor...check, nurse... check, pharmacy...check, patients.........
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<br />
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">To even try
and begin explaining what’s going on here is incredibly difficult, our
information changes by the minute and by the time I finish writing this
everything will probably have changed again!</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">I’ll start
with what I know for sure. We have been here for 5 days now and we have not
seen any patients yet! Our camp where we are based in Gornja Radgona has had no
refugees transiting through since the 25<sup>th</sup> November. Information
from local partners and governmental officials suggest that Slovenia is now
acting primarily as a corridor for refugees to be transited directly through
the country from the Croatian border straight into Austria. They are only
stopping to be registered at the Croatian/Slovenian border in a town called Dobova.
There are some actors (not Hollywood ones) providing healthcare at this point
but informal reports from refugee networks suggest that there are still vast
health needs and this is before people are being shuttled onto overcrowded
trains. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Last Sunday
the Turkish Prime Minister struck a deal with EU leaders dangling the carrot of
<i style="mso-bidi-font-style: normal;">possibility</i> of entry into the EU, no
restrictions on visas for Turkish nationals and 3bn euros in exchange for
preventing refugees from travelling into Europe. Turkish authorities have since
made raids at the coast of turkey and rounded up and apprehended 1300 people
aiming to make the journey by boat across to Greece. These actions along
with a worsening in the weather have led to a decline in the numbers of people
arriving in Greece daily (from 5000/day to hundreds). Turkey is
already home to 2 million refugees and has increasingly limited capacity to
manage them let along new refugees arriving daily. <span style="mso-spacerun: yes;"></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Last week a
statement was issued by Serbia, Croatia, Slovenia & Macedonia stating that
they will now only permit entry to refugees from Iraq, Syria and Afghanistan (I'll explain in my next post why this is horrendously illegal under international law).
All other refugees will not be allowed entry and in order to control this, all
countries mentioned are considering or in a process of building fences to “control”
the entry of migrants. This policy has directly led to around 2500 people getting
stuck at the camp in Idomeni on the Greek/Macedonian border as people of other
nationalities are denied entry to Macedonia. The situation is becoming
increasingly tense as refugees are protesting against the unfair ruling and protests
and becoming more extreme, suicide attempts, hunger strikes and some young men
sewed their mouths shut as part of the protest. The health needs are great and
the camp is very exposed to the elements, as winter hits the needs of these
people stuck here will escalate. There are also those putting their lives in
the hands of smugglers as they attempt to gain entry into Macdeonia by walking
on foot through dangerous mountain roads in freezing conditions. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">The
situation in Calais is also getting worse. Police seem to be mounting a much
more brutal response to those still trying to cross each evening and tensions
between lorry drivers and refugees are escalating. The MdM clinic there is seeing
regular tear gas injuries, broken bones, dog bites and lacerations from people
trying to cross the razor wire. Accidental fires are becoming commonplace in
the jungle as desperate people try to stay warm. However, some good news for
people in Calais, an emergency court ruling has been passed obliging the Calais
officials to provide urgent access to plumbed drinking water, toilets, organising
the rounding up of unaccompanied minors putting them under state protection and
more organisation of the camp to allow access for emergency services. We’ll
have to see how this is implemented and if it brings any relief to the people
stuck there. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">So what
have we been up to whilst all this is going on?? Well firstly we’ve been
feeling very frustrated that we are a completely functioning mobile medical
clinic with no patients to treat despite there being such urgent needs across Europe.
Second, we have been reorganising our stock and rationalised our mobile pharmacy
which sounds like a small job but took a long time to make sure everything was
where we could find it. </span></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;"> <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjS-Xw9PTl9DoNzhQSo_1DurNEStR5IDli13FkV1G-q9eRvv2xPg3_9NDyC318vdgnTvqJMdpDuLyB6EQLtWCsAMwxplxVu4zs65ESSPWd4uJSl1cRe8G8CTUeiNlq0VTgfjH17zrMf6ZFV/s1600/IMG_0026.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjS-Xw9PTl9DoNzhQSo_1DurNEStR5IDli13FkV1G-q9eRvv2xPg3_9NDyC318vdgnTvqJMdpDuLyB6EQLtWCsAMwxplxVu4zs65ESSPWd4uJSl1cRe8G8CTUeiNlq0VTgfjH17zrMf6ZFV/s320/IMG_0026.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Organised!</td></tr>
</tbody></table>
</span></div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimIywVEJOiLVpq_XbsjO6jRhLMIEhMOBUslDk1uFpyNq7ExHpunb9mYl1CmvI6ePGWsT2ihT0AC6l3FWDKzNJHOT0ggXXAXI4AKOkeMdaEtZqAav5O4z4DNV4er-z_R_EpRZXdhGsu0_BY/s1600/IMG_0029.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimIywVEJOiLVpq_XbsjO6jRhLMIEhMOBUslDk1uFpyNq7ExHpunb9mYl1CmvI6ePGWsT2ihT0AC6l3FWDKzNJHOT0ggXXAXI4AKOkeMdaEtZqAav5O4z4DNV4er-z_R_EpRZXdhGsu0_BY/s320/IMG_0029.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Titi proud of our new pharmacy</td></tr>
</tbody></table>
<br />
<div class="MsoNormal">
<span style="mso-no-proof: yes;"></span><span lang="EN-GB" style="mso-ansi-language: EN-GB;"></span></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">Third, we
have been meeting with local actors to try and gain more information about the
situation and predict if there is going to be a need for our clinic in
Slovenia. We have heard that another exit point (Sentijl) may start to be used
again to allow processing for people on the Austrian border. The Czech army is
currently providing healthcare in this camp but they are leaving on the 10<sup>th
</sup>Dec so we could potentially take over the healthcare of this camp. This camp
is not as well set up as Gorna Radgona and is just tents so it’ll be a
completely different set up and we could spend the next week planning logistics, finding a new place to stay
and moving the clinic and tent there. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">We’ve been
invited along with a lot of other actors and NGOs to a meeting next Monday to
explain the work that we do and see how best the Slovenian NGO network thinks
we can deployed. At this meeting we’ve been asked to run a small clinic for
some “migrants” that are there. We don’t have details who these people are but
we think they maybe vulnerable populations in Slovenia (maybe Romani people
along with very few refugees from this current crisis who have claimed asylum
here). We are also going on Thursday to meet with the minister of public health
in the capital along with our regional coordinator to try and see if he can agree
gainfully employ us! </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">There is
vague talk about making a clinic or running some kind of medical service on the
trains that are passing through but its very early days with that one and I
have my reservations about how feasible it is but could be very cool! We’ve
also been eating pizza and watching films so please don’t think I’m in any way
hard done by. Titi our coordinator keeps telling us to enjoy the relaxation as
we will need the energy once we start but I feel like a fraud sitting around in
our lovely hotel waiting for news of refugees arriving but impotent to help
anyone else. <span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">On the one
hand, I’m really glad to be here and be involved in the coordination and
planning of our clinic and its really pushed me to think in depth about how
complicated these situations are. I feel like I’m learning a lot and exploring
all sides of how a humanitarian response is created but the overwhelming
feeling is just frustration about not being able to help in a tangible way. It’s
incredibly difficult for MdM to plan its human resources and when we were
deployed here there were 2-3000 people transiting daily through the camp and
the need was overwhelming. Its amazing how quickly things change here and how
volatile the situation is. Trying to predict anything is impossible as its an
entire network of countries and how one behaves affects all the others in a
chain. There’s also the worry that we know there is a need here because the
team before us were seeing up to 200 people a day for medical consultations and
if we leave to go somewhere more urgent that need will never have any chance of
being met. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;">There seems
to be a general feeling that the Balkan governments wants the refugees in and out their
country as fast as possible and in organising those logistics, officials have
forgotten these are people being transported not goods. We have no concrete
idea about how things are on these trains but there is a real worry about the
dehumanising processes being used as European governments try to move people as
“efficiently” as possible. These people urgently need some humanity and watching this beautiful sunset in Slovenia tonight I have hope we will get a chance to provide that soon. <span style="mso-spacerun: yes;"> </span></span></div>
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Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0tag:blogger.com,1999:blog-8626603964540817638.post-55006423544590348582015-11-28T08:51:00.000-08:002015-11-28T08:51:31.586-08:00Responding to the European Refugee Crisis<div class="MsoNormal">
<span lang="EN-GB" style="mso-ansi-language: EN-GB;"></span><span lang="EN-GB" style="mso-ansi-language: EN-GB;">W<span style="font-size: small;">hen 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. <span> </span></span></span><span style="font-size: small;">
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<span style="font-size: small;"><span lang="EN-GB">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.<span><br /></span></span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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). </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">The role I
have been assigned is as the physician along with one nurse providing <i>primary</i> 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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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.<span> </span></span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
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<span style="font-size: small;"><span lang="EN-GB">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. </span></span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxRj2mjbemU3tdZR1txCDRtuwW2Y3tcgXX4il0vNBpArRgHjODF9-PCSuchyiQZwcA5iu2qgZ_sDAp3KKGk2XnR-1ZZX6gWRXg9oImYlTGJe7afIQHKrqYqfdY3U-W4MNVSXfPwysblDho/s1600/IMG_0011.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxRj2mjbemU3tdZR1txCDRtuwW2Y3tcgXX4il0vNBpArRgHjODF9-PCSuchyiQZwcA5iu2qgZ_sDAp3KKGk2XnR-1ZZX6gWRXg9oImYlTGJe7afIQHKrqYqfdY3U-W4MNVSXfPwysblDho/s320/IMG_0011.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Heather and I raring to go in snowy Slovenia</td></tr>
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Aaminah Verityhttp://www.blogger.com/profile/09367524397221136014noreply@blogger.com0