Dutch doctors shocked by the situation in Moria refugee camp: physical and mental health under great pressure

Dutch physicians working for Boat Refugee Foundation sound the alarm about the situation in Greek refugee camp Moria: ‘Well-being in Moria is under great pressure and the situation is still worsening’.

Decent health services are hard to find in refugee camp Moria at the Greek island of Lesbos. Despite the great efforts listed by several organizations access to healthcare is and remains insufficient.

During one of the night shifts, a concerned young father enters the medical unit. His two-year-old son has a fever and is dehydrated by stomach flu. After receiving some paracetamol and ORS he picks up his son and walks away hesitantly. At the door, he turns around. “Doc…”. With eyes filled with hesitation and grief the man finishes his question. “I have three young kids and ever since we’re here they get sick all the time. Stomach flu, colds, fever – what should I do?”

We see the despair and misery these children have to deal with on a daily base. We can prescribe medication, pay attention and acknowledge this father’s sorrow. However, we can’t take out the unsafe situation and bad hygienic conditions, while these factors obstruct the healthy development of these children.

Infectious diseases

Health care in refugee camp Moria is provided by several local and international NGO’s, each with their own focus. Despite great efforts of these NGO’s the delivered care is insufficient and the situation in the camp is poignant. As medics, we were daily forced to send patients away by the lack of capacity. A place with a maximum permittance of 2000 people now houses 5000-6000 people. A few months ago even 9000. All vulnerable people, including pregnant women, newborns and children. That means untenable situations regarding the shortage of tents and blankets, sanitation and drinking water. 70 people share one toilet and 80 people share one shower.

During our shifts we daily saw patients with diseases related to bad hygienic, such as diarrhea and skin infections. After their short visit to the clinic, people are sent back to the same living conditions in the camp, maintaining a vicious circle. Because people live so close to each other there are frequent outbreaks of viral infections as respiratory infections, flu and chicken-pox. Last winter Doctors without Borders (MSF) started a vaccination program. This offers (partial) protection against a number of infectious diseases but does not prevent diseases due to bad hygienic.

Mental health

The vast majority of refugees comes from war-torn countries, 64% comes from Syria, Iraq or Afghanistan. Are third of this population are children, from which 20% has fled without parents or other adults (Source: UNHCR).

In the camp, there is not much to do for these children and teens and their future is uncertain. This and the insufficient mental health care brings many of this vulnerable group to self-harm. Our medical team from Boat Refugee Foundation has treated various children for self-inflicted wounds, several times a week. Doctors Without Borders did already sound the alarm about the high ratio of suicidality among young children, which we endorse. Unfortunately, a lot of children have to deal with serious behavioral problems after experiencing war situations. There is no adequate support for these children.

An example is a 17 year old unconscious Syrian girl, brought into our clinic by her parents. After half an hour she wakes up and starts shivering fiercely. Her mother tells us that she has been traumatized during the battle for Aleppo. Since then she mistakes overflying planes for bombers. Fighting men take her back to the time when young armed men ruled her home town. She does not feel safe in Moria. She can’t go to the toilet or take a shower without an escort. She calms down, until a male heavy-bearded doctor enters the clinic. “Daesh!”, she screams. The sight of the man takes her straight back to Aleppo.

In the medical clinic, these panic attacks happen every day. After sunset tensions between different ethnic groups rise, the visual world diminishes and the nocturnal worrying starts. Many people are brought in unconsciously, without any physical cause. Derealization and dissociation are symptoms we often saw during these attacks. This means that people are physically present but due to anxiety mentally absent. With patience and counseling techniques consciousness returns after an hour or so. Besides panic attacks, a lot of our patients suffer from psychotic symptoms with or without PTSD. People arrive in camp Moria damaged by terrible experiences in their homelands. In the camp, there is no space to process, both literally and figuratively speaking. In addition to that, living in the camp many patients have to deal with (sexual) violence, insufficient hygienics, and uncertainty about their future.

Doctors who worked in Moria before report an enormous increase in psychiatric symptoms, both in number as in severity. One in six patients who visit our clinic has a mental health problem. For this, we blame the hopelessness and the situation in the camp. This destabilises a lot of the vulnerable camp residents and creates new vulnerable groups.

In a no man’s land between their former homeland and a safe shelter these people, young and old, live packed together on European territory. The inhumane living conditions in Moria lead to infectious diseases and serious mental health problems and form a bad base for growth and development. People arrive already traumatized and get more damaged by their stay in Moria. Besides that, the current medical care is insufficient to provide in basic needs. We are deeply worried and call up for a change. More attention to hygiene, systematic healthcare services, and adequate psychological and psychiatric aid is highly needed.

Written by: Hanaâ Benjeddi, Guda Scholten and Marieke van de Water
Photos: Kenny Karpov, Tessa Kraan