Mediterranean boat migrants doctor in Greece: A typical day at work

A typical day in November 2015 on Lesvos, Greece:

09:00 It is olive harvesting season and I  liberate my car from under a huge net meant to catch the olives from the trees on the parking space. I share a house just outside Molyvos on the north coast of Lesvos with two other volunteers, respiratory therapists from the United States, who mainly work on the North Coast.

Treating patient at Moria Camp
C leaning a wound  at Moria Camp

09:10 On my way to Moria Camp I pass an interimistic  camp. 50 people, who had arrived by boats during the night waited for busses to transport them to the transit camps.

10:00 I arrive at Moria Camp.  Colleagues are already at work examining patients, who queue outside the tent. Many patients do not speak English. That seems to be the main issue right now. I then began the day by walking around the hill looking for translators: Farsi-English was the no. 1 need as the Arab-speaking Syrians were registered, and thus left for mainland Greece sooner than the other nationalities.

Treating patients at Moria Camp
Treating patients at Moria Camp assisted by a translator

10:30 I had succeeded finding three volunteer translators, all waiting to be registered them selves: A 21-yr old woman from Afghanistan, a 20-year old man, also from Afghanistan and another 20-yr man from Iran. Female translators were in particularly high demand, for cultural reasons.

11:00 I start to see patients. Most have minor illnesses, mainly  common cold and many ask for antibiotics. Tooth problems are another major issue, for which we as doctors can do little but dispense painkillers. Our pharmacy was remarkably well supplied as several volunteers had brought medicines with them. Furthermore, complete strangers would come by and donate medicines while others would buy medicines according to a list made by some of my colleagues at the local pharmacy.

Dentist at work at Moria Camp
Dentists at work at Moria Camp

12:00 A 20-year old Afghan male arrived with severely burned fingers, which he explained happened when lighting a campfire in Turkey. Luckily our extraordinarily well-stocked pharmacy had the items needed to treat him.

12:30 Out of the blue, two dentists arrived with their equipment. They installed themselves on a plastic table right outside our tent and started working.  This first day they performed five tooth extractions.

14:00 A young man, paralyzed from the lower neck and down arrived in a wheelchair pushed by his brother. The young man had been paralyzed for 11 years after he broke his neck falling down from a rock. The told me they had made the long journey from Afghanistan hoping his brother could be cured in Germany.

Treating boat migrants during night on Lesvos
Examining new arrivals in the evening

16:00 I left Moria and drove up to the North Coast. It was a quiet afternoon and I chatted with volunteers from some of the other groups.

19:00 A big boat with more than 200 migrants arrived at the harbor of a small fishing village as I drove by on my way home. I went out to have a look, but all seemed fine.

Mediterranean boat migrants doctor: 13 lessons learned

During the Mediterranean migrant crisis I worked on the Greek Island Lesvos with the organizations PAIH and Health Point Project in November 2015. I worked both on the north coast receiving the boats and in the inland Moria transit camp.

  1. Rubber boats overfilled with migrants/refugees arrived on the northern coast of Lesvos only 7 km across the narrow strait to Turkey. Migrants are neither allowed to take the 10-Euro public ferry, nor to cross safely to Greece in northern Turkey. Thus the bizarre situation had arisen where people risked their lives crossing the sea from Turkey to Greece in shaky rubber dinghies, often without a captain.

    Rubber boat with migrants arriving on Lesvos
    Rubber boat with migrants arriving on Lesvos
  2. In fine weather this short crossing was generally uneventful. However, in bad weather as well as at nighttime problems may arise. Such as at the remote  Lighthouse beach area, covered with life-vests, which lightened up at night subsequently attracting boats to what is a dangerous coastline. Upon arrival in Lesvos rubber boats were immediately punctured and left on the beach and locals as well as volunteers scavenge whatever they may use.
  3. UNHCR buses deposited all the incoming refugees at a transit  camp, where they then waited up to 7 days for registration. Once registered they could leave the camp,  and most opted for the ferry to Athens. A boat ticketing office was even located right outside the main camp entrance.  Some migrants were allowed to wait inside the camp, however the majority have to wait outside.

    Moria Transit Camp, Lesvos
    Moria Transit Camp, Lesvos
  4. The Moria camp itself is an old military installation just outside the small village of Moria surrounded by privately owned olive groves. On one side of the camp UNCHR had built some shelters where people could stay on a first-come first-serve basis.  On the other side, also known as The Olive Grove or The Afghan Hill, people were left to themselves. More than 400 people mainly from Afghanistan but also from Bangladesh and Pakistan stayed there. No one was managing the hill:  No infrastructure, no toilets, no showers. People were left to buy low-quality tents for 35 Euros from vendors. The whole place looked and smelled like day four of an outdoor rock festival.
  5. On the north coast, there is an excellent  look-out point where people gathered and follow the journey of the rubber boats over the narrow strait. Both Greek and Turkish coast-guards were spotted in the water as well as Frontex helicopters in the air, all seemingly passive.
  6. The entire coast was cacophony of unorganized organizations and volunteers milling up and down to receive the arriving rubber boats. The large organizations such a UNHCR were not visible. Neither was the official Greece. Thus, astonishingly, hundreds of unpaid,  inexperienced individuals as well as interimistic organizations were managing the border or Europe.

    Treating patients at Moria Camp
    Treating patients at Moria Camp
  7. Volunteers consisted of local people stepping up to the task, individuals traveling  on their own, or interimistic aid groups. Some groups consisted of doctors, others of lifeguards, paramedics or general volunteers offering blankets and hot drinks.
  8. Though highly motivated, most volunteers were unexperienced and supervision was not available. Furthermore, there was no central coordination of efforts which led to volunteers congregating at certain areas of the beach while others were completely empty.
  9. Thus, I would not recommend people to show up now unless they are affiliated with an organization. This applies to all of Greece.
  10. It was quite a moving experience seeing a boat coming ashore, with people crying from relief at what they think is the end of the dangerous part of their journey.

    Arranging the pharmacy, Moria Camp
    Arranging the pharmacy, Health Point Project, Moria Camp
  11. At Moria Camp, I worked with Health Point Project, an organization established a couple of weeks prior to my arrival and run by approximately 10 volounteers. Prominently located at the bottom of the Afghan Hill, hundreds of people would queue outside the white plastic tent. Furthermore, the volunteers, all of whom had dropped in from the street, were both very qualified as well as motivated. On the medical side I worked with a Canadian rural general practitioner,  US and British emergency physicians and nurses as well as highly qualified people managing supplies as well as logistics.
  12. We saw approximately 100 patients every day, most with minor complaints, but also a couple of more serious cases, such as old burns. A major concern was dental problems.
  13. During the time I spent in Lesvos, the weather was fine and clear and no genuine emergencies happened at the coast where an average of 3500 migrants/refugees arrived every day.

    Volunteer helping to strengthen the hospital tent
    Volunteer helping to strengthen the hospital tent

Following the agreement between EU and Turkey in March 2016boat arrivals on Lesvos have vastly declined, however as I understand it, boats still arrive. 

Among the many people and volunteer organizations I collaborated with on Lesvos were:

The owners of the Aphrodite Hotel:  They had, at their own expense, assisted hundreds of boat migrants, who arrived at their nearby beach since early summer. They most kindly offered me a free place to stay.

The Kempsons: Philippa and Eric Kempson, long-term residents,  have been active since the beginning and became informal coordinators of the entire response on the north coast. They kindly introduced me to the work. They are still active through The Hope Project assisting those (few), who now arrive.
Positive Action in Housing: With whom I was affiliated and loosely worked together with The Kempsons.
Health Point Project: With whom I worked in Moria Camp. The organization has now split into Health Point Foundation and Off Track Health.
AdventistHelp: A fully equipped medical bus including highly qualified staff stationed on the coast. Now this project has moved to Athens.
IsraAid: A team of doctors working on the coast.
Disaster Medics: Primarily a mobile team of paramedics. I clearly saw that paramedics has the exact skill set needed to manage a situation like the one on Lesvos.
Lighthouse Relief: Was running a transit camp as well as a health post on the beach and as of  November 2016 they are still active.
Furthermore I had the pleasure to work with Nurses Ravi and Sarah as well as John Caron in Moria.

New Zealand top hikes

Emerald Lakes, Tongariro Crossing
Emerald Lakes, Tongariro Crossing

Top multi day hikes:

  1. The Routeburn Track. A glorious walk through meadows, ancient forests, waterfalls and lakes including a high mountain pass.
  2. The Tongariro Northern Circuit. Walk through active volcanic scenery passing craters and steamy lakes with the possibility of climbing Mt Doom.
  3. Lake Waikaremoana Track. A very atmospheric walk around a remote lake.The Milford Track. Unique animal and vegetation as well as wonderful waterfalls on the way to Milford Sound.
  4. The Milford Track. Unique animal and vegetation as well as wonderful waterfalls on the way to Milford Sound. It is located close to the Routeburn Track, which I would walk instead of the Milford if not possible to secure a space.

    The Pacific coastline between Heaphy Hut and Kohaihai
    The Pacific coastline between Heaphy Hut and Kohaihai

Top day hikes:

  1. The Tongariro Alpine Crossing. I walked this as part of the Tongariro Northern Circuit. This is a spectacular walk through volcanic craters and lakes next to Mount Ngauruhoe (Mount Doom) with steam coming up from underneath.
  2. Pacific Coast walk between Heaphy Hut and Kohaihai. Spectacular walk along the Pacific Coastline. Is also the last day of the Heaphy Track but can be walked as a day walk up to Heaphy Hut.
  3. Mount Taranaki Summit Track. The toughest hike I did in New Zealand, much tougher than any of the Great Walks, crossing a snow-filled crater and with fabulous views from the summit
  4. The Mueller Hut Track. Great hike with views of hanging glaciers and Mt Cook.
  5. Avalanche Peak. Once above the treeline the views of the neighboring snowcapped peaks in the Arthur´s Pass National Park is glorious.

    Lake Harris on the Routeburn Track
    Lake Harris on the Routeburn Track

List of New Zealand walks I have walked:

Multiday walks:

Great Walks:
Abel Tasman Coast Track, New Zealand (2015)
Heaphy Track, New Zealand (2016)
Kepler Track, New Zealand (2015)
Lake Waikaremoana Track, New Zealand (2016)
Milford Track, New Zealand (2015)
Routeburn Track, New Zealand (2015)
Tongariro Northern Circuit, New Zealand (2016)

Other multi day walks:
Angelus Hut Track, New Zealand (2016)
Queen Charlotte Track, New Zealand (2016)
Tarawera Trail, New Zealand (2016)

Day walks:
Avalanche Peak Track, New Zealand (2016)
Mount Taranaki Summit Track, New Zealand (2016)
Mueller Hut Track, New Zealand (2016)
St Arnaud Ranges Track, New Zealand (2016)

Panekire Bluff
Panekire Bluff, Lake Waikaremoana

New Zealand Great Walks

In 2015 and 2015 I walked all seven of the mainland New Zealand Great Walks that are actual walks. Thus, the only two I did not walk were the Rakiura Track on Stewart Island and the Whanganui Journey (on the mainland, but a canoe trip, not a walk).

Sutherland Falls, Milford Track
Sutherland Falls, Milford Track

The Great Walks are all relatively easy walks, with no scrambling required, thus appealing to people of average fitness and average hiking experience. They have also been chosen to represent the variations in scenery and ecosystems offered. The drawback to these walks are that all camping and hut spaces must be booked in advance via the DOC (online or in person), meaning that some of the most popular tracks sell out months in advance, most notably the Milford Track. I succeeded in getting tickets to all of the below walks a couple of days before departure, except the Milford Track (I finally booked with a commercial agency) and the Routeburn Track (I walked it in one long day).
There are plenty other hikes just as beautiful as the well-marketed Great Walks, some of them significantly more difficult. Unfortunately, I have, as of now, only walked a few of them.

Lake MacKenzie on the Routeburn Track
Lake MacKenzie on the Routeburn Track

Below a brief characteristic of each walk linking to an in-depth post:

Abel Tasman Coastal Track, New Zealand (2015)
Golden beaches and tropical vegetation. A very easy walk.
Heaphy Track, New Zealand (2016)
Pleasant walk through meadow and forest ending in a glorious walk along the Pacific coastline.
Kepler Track, New Zealand (2015)
Ascending to a ridge with fine views, the a pleasant walk through forest.
Lake Waikaremoana Track, New Zealand (2016)
A very atmospheric walk around a remote lake.
Milford Track, New Zealand (2015)
Unique animal and vegetation as well as wonderful waterfalls on the way to Milford Sound.
Routeburn Track, New Zealand (2015)
A glorious walk through meadows, ancient forests, waterfalls and lakes including a high mountain pass.
Tongariro Northern Circuit, New Zealand (2016)
Walk through active volacanic scenery passing craters and steamy lakes with the possibility of climbing Mt Doom.

Information: Department of Conservation information on the Great Walks.

Everest Base Camp – how to do it independently

Contrary to what many websites suggest, the Everest Base Camp trek is a very straight-forward trek and, as such, even for a moderately experienced solo hiker, neither guide nor porter is necessary.

What documents/permits need to be arranged in advance: TIMS (get it on the spot in Kathmandu), National Park Fee (in Kathmandu or on the trail).

Everest Base Camp Trek
Everest Base Camp Trek – starting the ascent to Namche Bazaar

Getting there: The trek starts in Lukla (plane from Kathmandu). It is also possible to walk in from Jiri (12 hours bus-ride from Kathmandu and an additional 5-6 days hike).

The trail: Is like a highway. Up and down valleys bordered by 6000+ meters high mountains. On the standard route to Everest Base Camp I would say it is impossible to get lost. If crossing the three high passes more care may be needed.

Everest Base Camp Trek
Namche Bazaar

The backpack: Pack light, though remember temperatures may drop to minus 10 degrees or more and snow may be encountered at any times: Down jacket, shell jacket and pants, sturdy hiking boots. Consider a four-season down sleeping bag. Consider hiking poles. A backpack with all this equipment need not weigh more than 7 kg.

The teahouses: Are widely distributed. They all serve food and beverages and sell snacks. The accommodation is basic, blankets will be provided, however heating is only available in the dining room. The last teahouses before Everest Base Camp, mainly in Gorak Shep may be full, in which case accommodation will be in the dining room.

Everest Base Camp Trek
Chhukung Valley

Electricity: Sporadically available after Namche Bazaar. I brought solar panels. Note that when temperatures are below zero, the iPhone looses battery power rapidly.

The altitude: Altitude sickness is the major danger. The recommendations from the Himalayan Rescue Association is a maximal daily ascent of 3-400 meters after 3000 meters. As it takes only 1,5 hours to ascend 300 meter and many people are impatient, I saw many guided tours ascend too rapidly with their parties. I saw helicopter evacuations every day. Some recommend intake of Diamox for prevention, however this is, in my opinion, not an alternative to ascending slowly.

The weather: May shift at any time. Above 4500 meter it gets very cold, especially when the sun is not out. Pack accordingly.

Everest Base Camp
I met this porter on the way up to Tengboche. The weight of these two cylinders is 80 kg. I tried but could not even lift them up.

The Most Memorable Moment:
Hiking up the Kongma La Pass at 5535 meter I was surprised by a heavy snowstorm, a genuine whiteout, at about 5400 meter, just below the summit. As I could see nothing I had to turn back down the valley, the track being obliterated I had to find my way down scrambling off-track for 6 hours until I reached Dingboche:

Everest Base Camp Trek
On the way to Kongma La Pass
Everest Base Camp
Same as above, one hour later

The highlights:

  • Generally, the really spectacular scenery opens up above the tree-limit around Pheriche and the most spectacular scenery was around Chhukung and Kongma La pass.
  • Watching the porters carry impossible loads on their backs and still walking past me.
  • Everest Base Camp itself. Walking around the camp thinking about the history. When I was there the camp was empty as expeditions had been abandoned after an ice avalanche  caused the death of 16  nepalese a couple of weeks earlier.

Itinerary (as walked in April 2014):

I planned to hike over The Three Passes, however after I was forced  to descend the Kongma La Pass by a snowstorm, I walked the ordinary route up via Pheriche and back.

Lukla-Benkar-Namche Bazaar-Tengboche-Pangboche-Dingboche-Chhukung-Kongma La (return)-Dingboche-Dughla-Gorak Shep-Everest Base Camp-Pheriche-Namche Bazaar-Lukla.

Everest Base Camp
Everest Base Camp

Click for photogallery of the hike to Everest Base Camp in April 2014