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March 6 Update on Lesbos

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.

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