A Day in the Life of a Refugee in Moria Camp, Lesbos

March 9, 2016

by Kirsten Senturia

Thousands of refugees from as far away as South Sudan and as near to Greece as Syria continue to arrive on the island of Lesbos daily.  Their boat landing is just the beginning of their odyssey which is both physical travel and negotiating a complex system of rules, laws and bureaucracy. Once their feet have touched dry ground on Lesbos, they transfer to Moria Camp for food, shelter and documentation. Here?s what it is like for refugees to navigate a day at Moria:

1. You arrive at the camp by bus, taxi or foot.  When Moria first opened in the fall of 2015, refugees were walking there from the beaches. This could be as far as 60 kilometers.  Those who were fortunate enough to retain their belongings when making the sea passage had to carry those belongings and any small children all the way to Moria. Non-governmental agencies (NGO?s) are not permitted to transport refugees in their vehicles at all.  Fortunately, the United Nations High Commission for Refugees (UNHCR) is now coordinating bus transportation for refugees who arrive by boat.  When you enter at the base of the camp, you are probably wet, exhausted and emotionally drained.  You could arrive at any time of the day or night.
2. When you disembark the bus, you are separated into two groups (Arabic speakers and others), line up and receive a numbered wristband. Throughout the day you listen for your number to line up and be registered.  Everyone wants to register because without registration papers, you cannot move through Greece or the rest of Europe legally. The registration is in no way a residency permit, but you MUST have the registration to move on.  We have heard  stories about Tunisian and Algerian men unable to get registered; they risked arrest and deportation if they left Moria at any time, so they were trapped.
3. Either before or after registering, you wander around the camp.  If you have energy, you can line up outside any number of temporary ?huts? for free tea, dry clothing, etc.  Food is only served three times per day.  Everywhere you turn, you see families or large groups of people sitting or laying on blankets awaiting something.
4. All those in Moria must exit their sleeping barracks at 8:00 am everyday.  Those who are registered are free to move both in and outside the camp if they choose.  International volunteers and paid Greek cleaning staff thoroughly clean and reorganize the barracks in anticipation of the 3:00 pm re-housing.
5. At 2:30,  you and your family join a line that snakes down the hill and waxes and wanes over the next two hours as re-housing takes place.  If you are a single man traveling without a wife and/or children, you cannot be housed in the family barracks, even if you are traveling with an extended family.  You will be housed in separate barracks  or tents.
6. At 3 pm you are welcomed into the camp, one family at a time, by the volunteer crew, who must figure out the complicated system of trying to house language and ethnicity groups together, while separating registered from non-registered refugees. You will end up in a room of  bunks and floor mats where 25 to 50 refugees will sleep under UNHCR-issued thick gray blankets.
7. Dinner is served at 7:30 pm in the barracks.  Breakfast, lunch and dinner are free and are generally something resembling rice and vegetables or curry.
8. You can then fall asleep exhausted if you haven?t slept through the afternoon and evening.
9. At any point, registered Syrians may be removed and sent to a satellite camp, Kara Tepe, where they remain until they can come up with Athens ferry fare  ($50/adult, under 5 years free).  For these refugees, the move to Kara Tepe  is generally a positive step.
10. Repeat steps three through nine every day until you depart Moria Camp.  This can take one day to over a week. Limiting factors include registration status, money for tickets to the Greek Mainland and ferry passenger capacity.

If registered refugees are not satisfied with the conditions inside Moria camp, there is  an option of staying in a Mytilini hotel or the outer camp located immediately adjacent to Moria and completely run by volunteers—not Greek government. It is known as “Better Days for Moria”.  There, families are offered tents that become their personal space but with less infrastructure.  A long journey is made longer with endless lines, waiting and exhaustion.

Kirsten Senturia is a medical anthropologist who does community assessment and program planning with immigrant and refugee communities in Washington State.   She is currently volunteering in Lesbos, Greece with Salaam Cultural Museum, a Seattle Based NGO.

From Dr. Bill Dienst:

March 7, 2016

David Eng, the Starfish Harbor Master in charge of refugee operations on Molyvos Harbor on the North coast of Lesbos, called me at 5:45 am. “There is a boat with about 100 refugees at sea being rescued by the Greek Coast guard. We need you to assemble your team and meet us in Molyvos Harbor in 20 minutes.”

In the darkness of early morning, I assembled my team: Salaam Cultural Museum medics, currently 2 doctors and one nurse. We also activated humanitarian volunteers, several with critical skills of speaking Arabic and Urdu. We arrived just in time to met the Greek Coast Guard ship in the harbor at early dawn. We heard later that another refugee boat had been turned back to Turkey by the Turkish Coast Guard. Turkey is now under tremendous pressure by the European Union to prevent refugee crossings to Greece.

As the ship arrived, we identified 78 refugees, mostly Afghans who speak Pashtu and Dari; but can also understand some Urdu. There were also some Iraqis who speak Arabic. Overall, the refugees were in pretty good condition as they disembarked: Welcome to Europe!

A little cold but not too wet; some were suffering from panic episodes, some had been separated from other family members who were put on the other rescue ship during the confusion when the rescue ships first arrived. The other rescue ship was sent to another harbor (Skala Sikaminias), located an hour away on a bumpy dirt road.

Through our Urdu and Arabic translators, we had to insist multiple times to those missing their loved ones that they get into the vans that will take them to the receiving camp at Apanemo, which is run by the International Rescue Committee (IRC). One Afghan woman insisted she was not moving until we found her husband. We reassured her that she will find him at the IRC camp. That is where the other arrivals from the other rescue boat that went to Skala Sikaminias will also go.

Debra, our nurse-midwife evaluated 2 pregnant women initially thought to be in early labor. They were OK; they boarded the evacuation vans with the others without incident. One woman suffering from a severe panic attack slowly improved with verbal reassurance that everything will be OK; for the moment. The next chapter in the long ordeal for these refugees is just beginning.

Apanemo Camp is the temporary receiving camp where refugees arriving from shore are taken by the IRC vans. There they receive food, clothing and water. A makeshift clinic is there to do secondary medical evaluations. Later in the day, refugees will be transported down to the Transitional Refugee Center in Moria Camp, near Mytilene, the capital city of Lesbos.

When refugees arrive in Moria, they are sorted into Arabic speakers, mainly Syrian and Iraqi, and the others, mainly Afghan, but also Yazidi, Pakistani and several other ethnicities. In the next article, my colleague Kirsten Senturia will describe a day in the life for a refugee arriving in Moria Camp.

Dr. Bill Dienst is a rural family and emergency room physician from North Central Washington. He has extensive experience in medical exchange programs in Veracruz, Mexico and in the West Bank and Gaza Strip. He is currently on assignment with Salaam Cultural Museum, a Seattle based nonprofit organization doing humanitarian and medical relief work in Lesbos, Greece.

From Dr. Bill Dienst:

March 6, 2016

The straits between Turkey and the North Shore of Lesbos have been a major route for human migration for hundreds of years. The present migration is nothing new; its uniqueness is only due to its magnitude, because of the current humanitarian crises caused by poverty and war. In late October, over 7000 refugees crossed in boats during one 24 hour period, mostly across the Northern route. On March 1, about 1450 people crossed, mainly in the South of the Island, due in large part to Naval pressures in the North, which are trying to prevent these crossings. Today, 15 refugees drowned and 18 were saved when their boat capsized off the Turkish Coast, while tying to reach Lesbos.

As a direct result of tremendous humanitarian needs, many Nongovernmental organizations have come to Lesvos and systems for providing first response/medical relief have evolved.

There are 2 watchtowers along the North coast, where volunteers use infrared binoculars at night to spot incoming boats full of refugees. They are reinforced by a radio tower run by Doctors Without Borders which provides communication between refugee boats and the Coast Guard in the event of a maritime emergency. When boats are spotted, a system of text messaging is activated, giving international teams on shore the estimated time and location of arrival. These on call teams of humanitarians and medical relief personnel are activated and then respond to these locations. Frequently, refugee boats are intercepted by the Greek Coast Guard or other agencies and brought into the harbors, since direct landings on the Northern beaches are treacherous.

As refugees disembark, they are greeted by a medical triage team and translators. Various degrees of hypothermia are by far the most common medical concern, so warming blankets, hand warmers and removal of wet clothing are paramount. People are given water and transferred to an overnight camp by bus, with special concern for keeping families together. Acute medical conditions are treated on site and ambulance evacuation is available if necessary. This is what happens during a routine arrival.

In cases of a Mass Casualty Incident (boat capsizing, drownings and near-drownings being the most common) a triage system based on international norms has been developed. In this case, a primary triage officer meets arrivals being taken off the boat or ship, and sorts them into categories: Red (in need of Emergency Care for immediate life or limb threatening conditions), Yellow (in need of Urgent care, but can wait a bit), Green (those with no medical issues or those with minor medical issues that can wait longer), and Blue/Black, (those who are dead, or who suffer such devastating injuries that care is deemed futile.) Emergent life and limb threatening conditions are treated as they are identified and suspected fractures are splinted.

A system of secondary triage is also implemented as patients can change from one category to another. Emergency care is given on site, and patients needing inpatient care are transferred to a hospital an hour and a half away by either ambulance or private vehicle, depending of the seriousness and urgency of their condition.

Our team, Salaam Cultural Museum is allied with a Norwegian Team called Medics Bergen. We have a medical van that is equipped with warming supplies, wound care and splinting devices. We also have acute care medications such as treatments for asthma, antibiotics, gastrointestinal complaints, allergies, etc. We also have basic life support equipment such as airway supplies, IV fluids and Automated External Defibrillators (AEDs).

In my next article, I will describe the situation in the transitional camps for refugees in the South of the Island of Lesbos, near the capital of Mytilini.

This is a link to a good information source about the refugee crisis in Greece and the humanitarian response.

Refugee Flows to Lesvos: Evolution of a Humanitarian Response

29 February 2016 | Dr. Bill Dienst

I landed here on the Northern shore of the Greek Island of Lesvos on 26 February. Lesvos is the third largest of the Greek Islands, and is the closest to the Turkish coast, separated on its Northern Coast by only 6 miles (10 km). For this reason, it has been the main crossing point for refugees.

It has been very quiet since I came here 3 days ago in terms of refugee boat arrivals on the Northern Coast. The current political situation of the Turkish Government, the Greek Government, the European Union and NATO is an elaborate dance of Cat-and-Mouse with the human smugglers and refugees from Syria, Iraq, Afghanistan and other locations.

The refugees are intermittently stranded on the Turkish Side. Their goal is to land in Greece, thereby entering the European Union, then making their way to the Greek mainland. From there, they try to travel overland through Macedonia, Serbia, Slovenia and Austria to Germany and other locations in Northern Europe.

There are bottlenecks and various hardships along the way, (e.g. Macedonia just started building a fence). There is a lot of uncertainty: hurry up, then wait, then hurry up again. For us rescuers, there is a need for flexibility and improvisation. During the past few months, there have been periods of working too hard, and then periods of hardly working. We are currently experiencing the latter, which gives me opportunity to write about this overall situation.

The goals of the Powers That Be are convoluted and confused: on the one hand they are trying their best to come to grips compassionately with the humanitarian catastrophe that endless wars have created in the host countries from whence the current refugees are fleeing. On the other hand, they must deal with the chaos and personal consequences experienced by their own citizens from their host countries, whose lives and economic well being are also being affected.

Here on Lesvos, the economy is based largely on agriculture, fishing and tourism. The tourist season usually starts in the late spring, and lasts through September. The effects of the current refugee crisis have been tumultuous on the local economy. There have been both winners and losers, but the current overall perception among the local Greeks is that the overall effect on the economy will be a loss. Bookings for this summer?s upcoming tourist season are down 80%. Tourists do not seem to want their restful summer escape from their hectic lives in the North of Europe to be interrupted by dead refugees washing ashore on the beach.

On the plus side, hotels and restaurants, usually moribund during the winter months, are currently fairly active, as they are being utilized by humanitarians and health care workers currently here to help the refugees. But these humanitarians do not spend their money as freely as the tourists. Some of the younger ones have been known to misbehave at times as well.

The refugees began arriving in large numbers this past October. Since then, various Non-Government-Organizations have arrived and infrastructures have evolved to provide services to refugees arriving from Turkey. They are based on the Northern and Eastern coasts of Lesvos. These have included the UN High Commission for Refugees (UNHCR), the International Rescue Committee (IRC), Medecins San Frontieres (MSF) or Doctors Without Borders, and many others.

Here in the Northern shore of Lesvos, we are divided into 4 zones of responsibility. I will be working in Zone 1 with a Seattle based NGO called Salaam Cultural Museum (SCM). We are comprised of both health care workers and humanitarians. Our members arrive for a week or longer assignments. I have decided to stay here for 2 and a half months.

Our health care workers are aligned with a Norwegian group of Emergency Medical Technicians (EMT?s and Paramedics) known as Medics Bergen. Our mission is largely pre-hospital care, triage and acute/urgent care. We receive refugees at local docks, where they have usually been rescued at sea by the Greek Coast Guard or Frontex, the Border Control service of the European Union.

There is an Italian group called Group Mission, who are currently in negotiations with the Greek government, so that they can deploy a mobile Intensive Care Unit. This would be helpful, as there are currently no hospital services on this end of the Island. There is only a clinic staffed part time by one Greek general practitioner a few days a week about 10 kilometers away in the town called Petra. The nearest hospital is a one and a half hour drive away in Mytilene, the capital city of Lesvos. Medecin Sans Frontieres has 2 ambulance services in our area if we have unstable patients who need transport to the hospital.

In my next article, I will try to explain how the local system of receiving refugees on shore works.

Dr. Bill Dienst is a rural family and emergency room physician from North Central Washington. He has extensive experience in medical exchange programs in Veracruz, Mexico and in the West Bank and Gaza Strip. He is currently on assignment in Lesvos, Greece

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