Driving home for Christmas

I´m sitting in an airport hall in Athens as Chris Rea’s Driving Home for Christmas blares out of the speakers. I put in my earplugs. The only thing I can think about is 18-year-old Congolese Jack, who saw his parents and sister being murdered in front of his eyes. I still see him sitting in front of me in the clinic, ticking two stones together, suffering from mutism, abruptly turning his head from one side to the other as he catches sight of his visual hallucinations. I prescribed antipsychotics for a few days and referred him to MSF (Médecins sans Frontières), who have a trauma-psychiatrist employed in their team. Only the most severe cases can be seen by this psychiatrist and it can take a few weeks. In the meantime, the only thing I could offer is to see Jack every 3 days to monitor his situation. The call for my flight brings me back to the airport hall: I’m going home for Christmas, but Jack has to call his tent in Moria his home for probably the next year. In reality, Moria is a home to no-one.

This last month, I´ve been working as a junior medical doctor for the Boat Refugee Foundation, a Dutch NGO providing both medical and psychosocial care for the inhabitants of camp Moria, one of Europe’s biggest refugee camps situated on the island of Lesvos in Greece. Originally set up as a transit camp for a maximum of 3100 refugees with a maximum length of stay of 48 hours, it currently houses around 7000 inhabitants who can expect to live in the camp for many months or even a few years. All the words I could use to describe the place – inhumane, appalling, depressing, tragic –  don’t do it justice. The muddy paths; the tents leaking and often housing more than 10 people; the cold wind blowing through the blankets that serve as a door; the open sewage;  the people waiting for hours in the food-line in something that looks like a cage: it’s a demoralizing place.

Together with a group of doctors, nurses, support crew and translators, I´ve worked in a medical clinic, covering the evening hours to make sure medical help is always available to the inhabitants of the camp. Around a hundred patients visit the clinic every night, mainly presenting with primary care or psychiatric problems. It gives courage to know that a group of, often young, doctors and nurses, see the importance of working for the most vulnerable people living in this world, and although we all work in the camp for relatively short time periods, we work like a well-oiled machine. As soon as we are driving out of the camp at midnight, we share our frustrations about how little we can offer most of these patients but, despite all the limitations, we are flexible, inventive and we often find ways to improve our care. Despite our efforts, sometimes the circumstances of Moria can’t be beaten: the best ‘management’ would be ‘discharge’ out of Moria, which is impossible.  

Another day in the clinic: at the fall of night, the first patients with panic attacks get brought in. Often they are the patients from the unaccompanied minor section; a boy from Afghanistan this time – crying and hyperventilating.  I´m not experienced in psychiatry; I haven´t learned much about the techniques of handling an anxiety attack, but I trust the communication skills I’ve acquired over the last years: I ask him to focus on his breathing, I emphasize that he is in a safe place in the clinic. Slowly tatters of his story fill the room. I hear terms like ‘encircled’, ‘Taliban’, ‘beaten’. I notice the scars on his head and his back. It grabs me by the throat. After an extensive talk, I refer him to the stress relief and mental health classes, also run by the Boat Refugee Foundation. I’m relieved that the next patient comes in with just a rash – another case of scabies.

In March 2016, the European Union struck a deal with Turkey. A deal set up to battle migration by sea from Turkey to the Greek Islands, by sending all ‘irregular’ refugees back to Turkey. Whether a refugee falls into the category ‘irregular’, would have to be decided by an individual asylum procedure in Greece. In exchange for accommodating the refugees, Turkey received EU money and the negotiations regarding the accession of Turkey to the EU were resumed. For every migrant Turkey would take back, the EU agreed to settle a Syrian refugee in one of their countries. But Greece is suffering under an enormous amount of refugees. The asylum process is long and treacly and there’s a shear lack of human resources and adequate facilities. The amount of refugees transferred back to Turkey is only a fraction of what was projected. The deal has caused the borders of Greece to close and turned Moria into an end-station for all migrants crossing the Aegean Sea. In the meantime, although at a lower number than at the height of the crisis, the boats keep coming: so far in 2018, almost 31000 migrants have arrived the Greek Islands.

I find it hard to describe how I felt while I worked in the camp and now that I’m home. Frustration and anger dominate at one time: frustration about the pretention of some political parties that the EU-Turkey deal is successful. Then I feel the guilt for having had to send back a young couple with their 5-month-old twins, who lost most of their belongings in the sea, back into the cold. At other times I feel ashamed that this is the EU I live in, ashamed about the fact that I get irritated when there’s no hot water coming out of my shower while in 0 degrees Moria hot showers are non-existent. I feel discouraged for the 10-year-old girl who always accompanied her depressed mother to the clinic, she hasn’t been going to school during the last year. If no action is taken there’s a lost generation growing up in this camp.

Against the pure despair you can often read in the refugees eyes, there are also glimmers of hope: the resilience of some refugees trying to improve the conditions of the camp; the Cameroonian lady who feels empowered after having followed our mental health classes; the amount of inspirational people working for the various NGOs on Lesvos; the help we receive from our translators, refugees themselves, who not only translate but also offer psychological support to their fellow citizens; the refugees taking the bus out of Moria, one step closer to a human life somewhere in Europe. These stories work as silver linings in a sea of despair.

The stories above are just a few stories. There are 7000 more stories to tell from the people that currently live in Moria. They are all searching for a brighter future; I can only hope their next ‘home’ is a better one.

Text: Manon Heldens
Photos: Bertina Kramer