Category Archives: extreme medicine

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.