Mental health problems increasing since lockdown Moria, evacuation nów needed

An outbreak of COVID-19 in Camp Moria is getting closer and closer. The number of infections in Lesvos has risen considerably in recent weeks. The lockdown, which has been restricting people from leaving the camp since March, has tightened even further. The doctors of the Boat Refugee Foundation are seeing a large increase in mental health problems among the camp’s residents. “People have nowhere to go, even though the demand is immense right now.”

In a short period of time, the number of corona cases on Lesvos rose to at least fifty. Therefore, a virus outbreak in Camp Moria is becoming increasingly likely. The consequences of an outbreak in the overcrowded camp are incalculable. The conditions in Moria mean it has been a ticking time bomb for years now. One corona case – a camp with 15,000 inhabitants, with limited access to running water, general hygiene and medical facilities and many vulnerable people – can easily infect the entire camp in a matter of days. In addition, Médecins Sans Frontières was forced, by the Greek authorities, to close its COVID-19 isolation centre at the end of July. As a result, isolating infected people is practically impossible.

Since the start of the lockdown, six months ago, people can only leave the camp with permission from the police or a doctor’s statement. Since the increase of corona infections on the island, the measures have been further tightened: all so-called non-essential activities are now prohibited, including education and psychological support. The restrictions on leaving the campsite are discriminatory: they only apply to people from Moria. Other residents of the island are free to move.

Alarming lack of mental health care
They measures limit access to essential services such as health care, education, legal aid and food. People in urgent need of care from the hospital, a psychologist, pharmacy or dentist can hardly be referred. “This has always been a problem in Moria, but it is now more extreme than ever before. People are walking around with severe dental infections without access to treatment. In addition, we are witnessing a particularly distressing lack in mental health care. This was already very limited, but now traumatised people really have no one to turn to”, says Karin Arendsen, Boat Refugee Foundation’s field coordinator on Lesvos.

“Mental health care for people in Moria was already very limited, but now traumatised people really have no one to turn to.”

No more prevention
Existing psychological complaints have worsened since the lockdown, says Jamilah Sherally, medical coordinator of Boat Refugee Foundation on Lesbos. “Many patients are clearly dealing with psychological disorders such as depression, suicidality and panic attacks. Other symptoms seem to be directly linked to mental health, such as headaches, insomnia, low back pain and stomach complaints. Remarkably, most patients only experience these symptoms after arriving in Moria.”

The emergence of many new symptoms may be due to a lack in prevention. Because of the restrictive measures, Boat Refugee Foundation has been forced to shut down its psychosocial support programme in the camp. “Many of the complaints we see could have been remedied. For example, through the mental health and stress relief classes that we normally offer,” says Sherally. The ban on preventive care, also from other aid organisations, together with the lockdown leads to stress and powerlessness. Arendsen: “People are in a swelteringly hot camp without basic facilities. They have no prospects at all and can do nothing but sit still and wait. Doing nothing under these circumstances is maddening, is what many people say.

“People have no prospects at all and can do nothing but sit still and wait. Doing nothing under these circumstances is maddening, is what many people say.”

 

Children also affected
The thousands of children in Moria are also seriously affected by the consequences of the lockdown. They can no longer go to school, the only place where they can be a child for a while and forget their worries. They have to stay in their tents for days without any distraction and are exposed to severe, long-term stress. This can be hugely detrimental to their development. Doctors in Moria see children who have stopped talking or sleeping and who have started wetting the bed again.

Without adequate care, the situation will worsen each day, Sherally fears. “Lockdowns have consequences for mental health worldwide. Under the wretched conditions of a camp like Moria, these consequences are very perceptible. We do not have exact data, but I am sure that most medical problems in Moria stem directly from mental health issues: whether they are victims of a stabbing, patients with sleep problems or the woman who comes back for the seventh time with a headache. Good care and prevention could have prevented these complaints. Now the problem is only getting worse.”

Doctors in Moria see children who have stopped talking or sleeping and who have started wetting the bed again.

Evacuation needed
Arendsen and Sherally advocate that immediate evacuation is therefore the only solution. “The chances of corona reaching the camp are increasingly likely. The consequences will be very dramatic. People are already very vulnerable and as a result will fall ill quicker. The pressure on the local healthcare will increase even further. Mytilene’s only hospital cannot cope with an outbreak in Moria with insufficient staff, breathing equipment and only six ICU beds. I fear that this will lead to panic and that patients who need care for other reasons will no longer be able to be seen. Ultimately, I fear that people will die unnecessarily as a result,” says Arendsen.

“Moria is a European refugee camp. The fact that the EU, knowing what a corona outbreak could result in here, refuses to take responsibility and does not offer people humane reception and a fair asylum procedure, is unacceptable. It is high time that other EU countries showed solidarity with Greece, complied with the Refugee Convention and jointly provided for the proper reception of these people. Contrary to what the Dutch government says, evacuation is a structural solution.”

 

Winter in Moria: ‘The situation is getting worse by the day’

As winter is coming, the situation in the overcrowded refugee camp Moria is threatening to derail even more. Over 19.000 people live there now, while there’s officially space for  3.000. Extra places aren’t available: families sleep in festival tents in the rain and cold and are completely left to their own devices. Karin Arendsen (32) is field coordinator at Boat Refugee Foundation and sees the situation get progressively worse daily. “This is happening now, that should not be overlooked.”

“It’s really getting cold in Moria”, tells Karin Arendsen over the phone from the Greek island of Lesbos. She has been working there as a field coordinator for Boat Refugee Foundation for over three months now. She comes to refugee camp Moria almost daily. “We’re on an island: the wind and the rain can really cause it to be very cold and harsh.” Karin shudders when she thinks of the coming weeks. “I have seen a lot of rain and storm already, even though the real winter has yet to start. This situation – so many people packed together with so many flaws – is a disaster in the making. There is just no change in sight. My hope is that our team will succeed in continuing our work here and in responding to this situation.”

‘Imagine being in one of those small festival tents with your family for months on end’

Over 19.000 people are now living in the camp, which officially houses 3.000 people. “Imagine being in one of those small festival tents with your family for months on end. It becomes one big slippery pool of mud. And this will only exacerbate in winter. With the cold comes the risk of fire: people try to stay warm in every way imaginable. That’s a huge risk in itself.”

The 32-year-old anthropologist from Amsterdam has been on Lesbos for six months now, working for Boat Refugee Foundation which runs a clinic, school and community center in the Greek camp. Before that, she has worked a lot with people who have fled their homes, but she had never been in Camp Moria until three months ago.

 

Cooped up for months
She tries to describe the situation. “It’s extremely hectic here and mainly very, very crowded. These people aren’t here just for a little while, but they live cooped up for months, in a place where there is a shortage of literally everything. Only a small number of people live in the actual camp. Most people live outside the gates, in small tents. There’s a former olive grove outside the official camp terrain which is packed with more and more tents and continues to expand. But the number of facilities does not. You cannot all of a sudden have three clinics or ten times as many bathrooms. People are being crammed into a small piece of land together and have to figure it out for themselves.

The medical clinic is also feeling the crowdedness. “We are helping over 200 people every night and are forced to send away a number of people. Our waiting area in the clinic is small, so many of them have to wait for their turn outside in the cold. With the temperatures as they are, this sometimes causes lines to shrink. In the meantime, the cold and the decreasing level of hygiene results in a higher number of sick people.”

‘Unaccompanied teenagers vulnerable to violence and psychological issues’

Another effect of the crowdedness is the increased tension in the camp. “No surprise there, with this number of people put together, all with very diverse backgrounds. Furthermore, there is a large group of unaccompanied teenagers, an extremely vulnerable group. They are very susceptible to violence and psychological issues. Only a small number of them live in a separate section, but they don’t receive any personal guidance. They lack everything. For starters, they lack information: how should you, as a young teenager, know what to do or where to go? They are completely left to their own devices.”

Political problem
The circumstances are tough on Karin. “It touches so many layers of emotions. Naturally, it angers me, mostly because it’s so unnecessary. This is not happening due to a natural disaster, but only due to a lack of political will. I think it’s very important to acknowledge that with each other. It may sound like a lot, 18 000 people, but relatively speaking this is not a very large group. Practically speaking this should be quite easy to fix, it’s purely a political choice. That you treat people who have fled their homes for war and violence like this is completely incomprehensible to me.”

This same anger is Karins drive. “I just cannot wrap my head around the fact that this exists, that Europe lets this happen. Even though there are positive points. While we see human rights being violated daily, wonderful things happen too. The resilience, innovation, and entrepreneurship of people are so amazing to see in this context. You see that in our projects as well. When kids can relax and play in our schoolyard, when people retrieve part of their sense of self worth through working for us or through pride in the certificates they obtained at our English lessons, this warms your heart.”

Power and hope
Karin also sees this daily in her contacts with the team of translators. “We work together with the people from Camp Moria who help us in the translation of medical consults. People do want to help and remain busy so badly; if only to fill their head with something other than the reality of Moria. Recently, someone stood outside our clinic in his best dress shirt, holding all of his diplomas just because he wanted to get to work again so badly… I think this bears witness to an enormous strength. I have the utmost respect for people who are able to hold their own in this place. We cannot imagine what it means to live here, in a place where you are so marginalized and denied the possibility of just being yourself. Seeing the strength in all these people gives me hope.”

Sometimes the work in Moria grates on you, says Karin. “We come here out of solidarity, to show people that they are not alone. But at the end of the day we return to a warm home. That feels really harsh. We do what we can, but of course it’s the system that has to change. That means it should remain help under protest.”

Everyone can do something, Karin knows. “Obviously we are in need of many practical things where donations can help. Money for a wheelchair or medication for our clinic, or a rain roof above our community center; those are things that could make a huge difference. And apart from that people should not stop talking about this. Talk about it with the people around you. This is happening right now, that shouldn’t be forgotten. This is a European problem, the Netherlands are partly responsible. That sound should also continue to be heard.”

Would you like to contribute to a more humane situation on Lesbos? Go to www.bootvluchteling.nl/en/boatsarestillcoming/ and see what you can do to help.

Boat Refugee Foundation ends its medical mission on Lesvos

On January 1st, 2018 Boat Refugee Foundation (BRF) has completed the medical mission on Lesvos. Changed policies in the camp make it more difficult for us to fulfill our mission in a responsible and safe way. Through overpopulation in the camp we can no longer guarantee the safety and security of our team and our patients. This mission is an expensive one and we want to spend the donated money as efficient as possible. The current circumstances make it impossible for us to continue the medical mission as it is supposed to continue.

We do realize that in camp Moria the need for adequate medical care is as urgent as before. Our medical coordinator therefore will stay on location to find out if and how BRF will be able to provide medical help in another responsible way in 2018, in cooperation with the Greek organizations Keelpno and ERCI. We gratefully look back on two-and-a-half-year medical mission Lesbos in which we could make a difference in the lives of so many people in need.

In the next months we will expand our psychosocial activities in camp Moria. Last December we opened our new community centre with a school and library. On a daily base there are lessons for adults and children. We also want to expand our training sessions regarding mental health, with exercises and tips for better coping with stress and suicidal thoughts.

 

More information is available from Evita Bloemheuvel, Press Officer BRF evita@bootvluchteling.nl

The new school in Moria gets a name

‘Today was the first day since I’ve arrived at the camp that I felt really happy’, says the Afghan refugee teaching the children of camp Moria. We look at each other and quickly blink away our tears of emotion. Months of hard work in setting up the school in Moria comes together at this very moment. Today we are having a teambuilding session with ten school teachers in the beautiful nature of Lesbos.

The camp Moria school has been in existence for a few weeks now. When I say ‘school’ you should think of one cabin with two rooms. Each room contains about ten tables and chairs, made by refugees. These past weeks we have scoured the camp for teachers. Currently, we have a team of teachers and still new teachers are applying.

Me, I have only arrived two days ago and count myself lucky for having the immediate chance to participate in this teambuilding session and get to know all the teachers. This way, I can continue building and streamlining the school and transfer it to the new volunteers.

Above all, it’s a fun day. We have prepared several workshops on things like administration and teaching skills. We start the day by introducing ourselves using cards with images on them. Everyone picks a card and then explain why this card is so typical for them. The stories are heartening because everyone tells about their situation filled with positivity and hope. When a teacher tells that today is his 24th birthday we break out into a spontaneous ‘Happy birthday’ for him. Tears come to his eyes. It’s incredible how such a small gesture can generate such emotion.

The workshops progress well. We are impressed with the teaching skills the teachers have. Just about every teacher was a teacher in his or her homeland. I can learn a lot from them. During lunch, we have conversations about all kinds of subjects. At such a moment you really forget being at a table with multiple nationalities, and that these people are refugees who have come from horrible circumstances. It’s my wish that the entire world could see through my eyes what kind of unity we have here today and that we are all people with hopes and dreams.

Together with the teachers we brainstorm and vote on a name for the school. ‘Moria School of Hope’. There are some doubts whether we should put ‘Moria’ in the name, as many refugees have a less pleasant association with the name of this camp. But, as one of the teachers says: ‘Let’s put hope back in Moria.’

 

Is my mom dead yet?

Before I left to work with the Boat Refugee Foundation, I had many ideas about what I would see and experience while working on Lesvos. I expected to meet people who had suffered horrendous ordeals; to see through dreadful living conditions. What I never expected, and what took me by surprise was the warmth exhibited by the people I met, the friendship they offered to each other, and to me, and the resilience that they demonstrated on a daily basis.  These people had left behind everything and everyone they knew. They fled for their lives, made treacherous journeys and experienced highly traumatic situations. Now some people have spent over a year waiting to be processed. Their lives have been put on hold. Yet they still have the innate ability to be kind to each other, and to help whoever and whenever they can. There are hundreds of examples I could use to illustrate my point, but there is one that has stuck with me.

It was during a medical shift in Moria. It was about 11:30 PM, when all of a sudden a crowd of people carried a Syrian woman to the medical cabin who had collapsed and was unconscious. They had with them a small child, a girl of about 3 years old, who was the woman’s daughter. They had arrived to Moria 4 days ago by boat, and were sharing a tent with 10 other people; 10 strangers.  These strangers carried the woman and child up the steep hill to the medical cabin and then stayed en masse to monitor the woman’s condition for hours. While she was being treated by the medical team, her little girl was sitting on the ground. She asked me if her mother was dead. The way how she asked the question, as if it was something she just expected, broke my heart.

After I reassured her that her mother was just sleeping, a young Afghani man sat next to her – a child whom he had never met, and kept her company for hours. He played with her, helped her draw pictures and comforted her. They were strangers; different countries, different languages, but it didn’t matter. She was a child that needed help, and he stepped up.

The mother recovered, and when she was able to, her and her daughter were escorted back to her tent by the same people who had carried her up. 4 days ago they were strangers, now they have become much more.

This act of kindness, and many others I witnessed during my time in the camps, are what I will take home with me. That even though people can be subject to horrendous and inhumane experiences and conditions, their humanity still shines through.

Text: Helen O’Dowd
Photo: Henk van Lambalgen