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The Ebb and Flow of Confrontation and Suppression

Monday-Wednesday April 11-13
Idomeni and Polykastro, Greece
By Dr. Bill Dienst

On Monday, we experienced the aftermath of processing our own emotions, those which we had no time to digest while it was all happening on Sunday: the tear gas, the sound bombs, the rubber bullets, the stampeding people full of panic, and the adrenaline rush of it all. The morning after brings with it a hangover of somber moods, as we reflect on what it all means: the growing loss of any hope among the lingering refugees.

I have been through all these emotions before in Gaza.* First, an oddly euphoric feeling of being alive during all the excitement of being under attack, then melancholy; and then feeling depressed with Post Traumatic Stress symptoms later.

But we have no time for all that now. We must get out of bed, have breakfast and head back to the front at Idomeni. With some trepidation, we proceed with our mobile health van, and set up in our usual spot.

Monday turns out to be fairly routine. We are back to our usual old practice pattern of “Urgent Care, Light.” A lot of self limiting conditions, for which we can only provide symptomatic relief. A lot of chronic complex medical and social problems which we can do little about. There are also the few cases where antibiotics are indicated. We provide a few wound dressings for second degree burns from hot water and campfires.

It’s the usual stuff: seemingly boring, but showing the people that we still care for them, while they are feeling that most of the world has forgotten them and their current predicament. We practice the art of primary care medicine: First do no harm! Try your best not over-medicate those with emotional distress presenting with physical complaints, but try not to miss those few serious conditions that require our medical intervention either.

Tuesday is much like Monday. Our mobile clinic at Idomeni runs smoothly, and I end my day there with the usual collaboration meeting with Medecins Sans Frontieres, Medecins Du Monde and the heads from all the other smaller NGO’s like us, who are providing health care in the camps. We review our response to Mass Casualty Incidents, like the one that occurred on Sunday, and how we can collaborate better. We are trying to start a vaccination program, but are still awaiting a green light from the Greek government. There is a clinical report of a case of measles without lab confirmation. We fear preventable epidemics might break out.

Then when we least expect it, Wednesday turns out to be a much different day. When we arrive, refugees are again amassing at the fence, and a standoff with Macedonian troops on the other side is already underway. There are fewer protesters this time than there were on Sunday. A few tear gas canisters and sound grenades fly. But then from the West, we see a column of Greek riot police moving forward to the east, fully equipped with riot shields and billy clubs, creating a wedge between the refugee protesters and the fence, with the FYROM soldiers watching from the other side.

Greece and Macedonia (or FYROM, as the Greeks prefer to call it) have had their share of hostilities in the recent and distant past. But neither side is looking for an armed conflict. The economies of both countries are suffering, even before this refugee crisis began; the last thing either country needs right now is a war, provoked by this refugee crisis. This escalation could easily have happened last Sunday, especially when the FYROM helicopter weaved menacingly along the border. I am sure it was equipped with attack weapons, which could have been unleashed into the crowd below.

On Monday, the media was full of reports from the Greek government which were critical of how the FYROM government handled the situation. But nobody in either government wants any further escalation: the Greek riot forces are now advancing their wedge, to cleave the refugee forces away from the fence. People are stricken with billy clubs, and we start taking casualties at our mobile health van.

We get fewer tear gas injuries than on Sunday, but more lacerations courtesy of the Greek riot police: about 5 cases within just a few minutes. Fortunately we are equipped with staple guns, which are much quicker than using conventional sutures. We have no time to dilly-dally. We must work fast, because we don’t know when the deluge of patients will stop. First iodine to disinfect, then wash the wound with saline, then lidocaine injection, then staples: pop, pop, pop! Antibiotic ointment, sterile dressing, then out the door. Next patient please. We can’t worry about tetanus, for we have no tetanus vaccine available.

Over the following days, it appears that the spirit of the refugee people is being gradually and persistently worn down. More people are getting on buses and going to the relocation centers, which some call internment camps. I doubt we will see riots of the magnitude we saw Sunday and Wednesday again, but who knows for sure?

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