SCM Medical Missions

There are Lots of Rumours; Some of them are True

Dr. Bill Dienst

Sunday April 10th, Idomeni, Greece

It’s 8 am. I arrive at breakfast in our Hotel Maison, located 40 minutes South of the Greek-Macedonian border. There at the border, thousands of Syrian and other refugees remain stranded.

David Stanton, the EMT working for Medics Bergen tells me about rumours he has heard the night before: Large numbers of refugees are planning to breach the border today. I hear similar rumours from time to time, but nothing much has happened so far on my watch.

Two weeks ago, also on Sunday, there was a big standoff between the refugees, encouraged by Spanish and Italian solidarity activists. They faced off with the Greek Police in full riot gear on the railroad tracks, 100 meters from the fence. We had our trauma bags deployed, fully ready, but the situation eased off several hours later. As far as I know, no one was hurt. The activists went back to Italy and Spain the next day, and the refugees went back to their squalor and their tents. We went back to treating colds and sore throats. Several hundred refugees boarded buses and left Idomeni for “relocation centers,” while thousands others still remain here. People are becoming more stir crazy and reckless: Children walk aimlessly right in front of my car, and I must drive defensively in order not to hit them by mistake.

I head North to Eko Gas Station refugee camp and attend the weekly medical logistics meeting for our coalition of small NGO’s. My medical and humanitarian team goes directly to the medical warehouse in Polykastro to restock our mobile health van. We stock every morning to prepare first for our mid day clinic at Idomeni, and then our evening clinic back at Eko. While at the morning Eko meeting, I hear more substantial rumours: several hundred refugees left Eko at 6 am this morning and are presently walking 20 km to the border at Idomeni: They are going to try and cross. Many left with their belongings in tow, just in case they get a chance.

We finish our meeting at about 11 am; then I head North to join my colleagues to start our clinic in our usual spot in Area C at Idomeni. When I arrive, I see thousands of people, not at the usual spot of protest at the railroad tracks, but to the West: right smack dab up against the fence topped with Concertina Wire, and some are trying to cut their way through.

DSCN2080On the immediate opposite side of the fence are riot police and soldiers from the Former Yugoslav Republic of Macedonia (FYROM). Tanks with mounted machine guns and Armoured Personnel Vehicles (APV’s) are there too. Things escalate; rocks are thrown across the fence at the soldiers, and FYROM forces respond with tear gas and sound grenades.

As I approach our Mobile Health Van located 250 meters South of the fence, I see David the EMT stumbling back, extremely sweaty, clammy and coughing uncontrollably. He has been gassed. We douse him with water, and he starts to recover. Moments later, we start receiving dozens more who have received more intense gas exposures. We start shifting into Mass Casualty Incident mode.

As we get over our initial astonishment and emotional shock, we start to get a handle on the situation. We start triaging people based on intensity of symptoms and associated trauma, related directly to the melee. Chaos and Pandemonium dominate, and now we need exert crowd control measures. We instruct our translators to start shouting loudly in Arabic: “Family members only! All others who are not hurt need to back away!”

Some people have been struck with billy clubs or rubber bullets, but 90% are simply suffering from different levels of tear gas inhalation. A few are splinted for possible fractures and we call the Greek Ambulance for one suspected low back/pelvic fracture. We send some of our volunteers forward wearing masks and equipped with 1 liter water bottles with a hole punched into the middle of the cap, so they can quickly douse those gassed and mitigate the severity of their symptoms, thus reducing their need to be carried by others to our van. Most of these cases are self limiting. One man gets IM epinephrine as we are concerned about his impending respiratory collapse, and several with asthmatic reactions receive bronchodilator therapy.

DSCN2138The wind suddenly shifts to the South, and all of us medical volunteers are now being gassed too. We become wounded healers. Our van pulls back 100 meters further South through trampled wheat fields to try and escape the gas.

This immediately feels familiar to me: instant recall. A feeling one never forgets if you have been tear gassed before. The burning on your face, the intense watering and stinging of your eyes; the uncontrollable sneezing and coughing. The feeling that you are going to suffocate, and then it passes, just as long as you don’t die right away: 2 minutes, 5 minutes, 10 minutes, depending on the concentration of gas you received and any premorbid conditions you might have.

It has been 10 years since my previous and only other gassing. This one occurred in 2006 at the hands of Israeli Occupation Forces in the West Bank village of Bil’in. Those weekly gas attacks there continue to this day. They involve concertina wire fences too: built to steal valuable olive groves from Palestinian villages and incorporate them into Jewish-only settlements. The tools used there and here are the same: concussion grenades, tear gas, rubber coated steel bullets and sometimes live ammunition. For me, that gas attack back then was much worse than this one; compounded by a concussion grenade that exploded right next to me, and left my ears ringing for hours.

The FYOM forces are now using rubber bullets and I am hoping it goes no further. We have previously seen a Greek helicopters, but now a FYROM military helicopter approaches, weaves in and out, then hovers menacingly over the border. I again start having quivering flashbacks, having seen American supplied Apache attack helicopters in Gaza before firing heavy shells over our heads from the sky and killing young men behind us. I am praying internally that it will not come to this.

I am sure leaders from both Greece and Macedonia do not want any further escalation either. The last thing either country needs right now is a war, given that the economies of both countries have been in the tank, even before this current refugee crisis.

We think the gas victims are waning; but they continue coming in waves. Gradually, the numbers keep getting smaller. It’s three o’clock: we pack up our van and head to Polykastro for lunch.

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 with refugee populations in Lesbos and Idomeni, Greece.

April 22, 2016

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