Aris Messinis / AFP / Getty Images

Greek island struggles to provide medical care to refugees

With 6,000 new arrivals a day – many in need of emergency attention – Lesbos’ health care system is unable to cope

LESBOS, Greece — Tragedy has struck the island of Lesbos, in the eastern Aegean Sea, repeatedly in the past year, and October was the worst month yet. Lesbos received 125,000 refugees, double the number in August. It saw dozens of shipwrecks, with at least 35 people killed on Oct. 28 alone. Despite the worsening weather, people keep on coming — about 6,000 per day. Overwhelmed, Lesbos now faces serious gaps in emergency medical care. 

The local paramedics all work out of Bostaneio, the island’s main hospital in the capital, Mytilene, in the southeast, some 40 miles from the northern coastal beaches where most refugees land. Ambulances must race through winding mountain roads to reach it. On Nov. 2 the paramedics’ union held a protest in Mytilene over the extreme strain the refugee crisis has placed on them. The island’s team of 32 EMTs responded to 700 emergency calls last month, compared with 250 in October 2014.

Paramedics, from left, Leandros Giakoumis, Dimitrios Begiannis and Kostas Soropos participated in a protest on Nov. 2, 2015, about the increasing strains on their staff of 32.
Tania Karas

They have four ambulances, one of which is badly in need of repair. Their stock of basic medical supplies such as oxygen masks and rubber gloves is not enough to handle sea-related emergencies that are growing in seriousness, frequency and scale. 

According to the union’s vice president, Kostas Soropos, the paramedics have repeatedly asked the National Center for Emergency Help, the umbrella organization for Greece’s emergency and ambulance workers’ unions, for additional supplies and staffers. But the country’s prolonged financial crisis, hiring freezes and budget cuts to the national health system mean the EMTs haven’t received the necessary help. 

“We have two crises — the refugee crisis and economic too,” he says. “The European Union has called Lesbos a hot spot for migration. But what we have is a flaming spot. We are on fire.” 

Refugees sleep on the ground at Lesbos’ main port city. The seamen’s union is on strike to protest pension cuts. Since Nov. 2, the islands have been without ferries to the mainland.
Tania Karas

Meanwhile, a four-day strike of the nation’s ferry workers has stranded thousands of refugees on the island. Hundreds of people are sleeping in tents or atop pieces of cardboard around the main port, fueling worry about hypothermia. This is also a concern in the two refugee camps, Moria and Kara Tepe, where refugees must wait in line outdoors for hours to enter and be registered. 

More than 608,000 refugees have landed on the Greek islands since the start of the year, according to the Office of the United Nations High Commissioner for Refugees. Lesbos is a prime landing spot for those fleeing wars in Syria and Afghanistan and seeking a safer life in Europe; the island’s eastern shore is just 3 1/2 miles from Turkey. 

Refugees pay smugglers in Turkey $1,200 or more for a place on flimsy rubber dinghies. Often more than 35 people are packed into boats that are meant for 12 or fewer. Cheap, broken-down engines can stretch out the crossing to Lesbos to hours. 

All along the island’s northern coast, hundreds of volunteers, including dozens of doctors and nurses, wait every day to receive refugees with warm blankets, food and donated clothing. They come from all over the world and represent international nonprofits such as Médecins du Monde and Save the Children as well as local organizations such as Village of All Together and Aggalia (Greek for “embrace”). All of them bolster the ranks of overextended medical professionals on Lesbos. 

Asylum seekers wait in heavy rain outside the Moria registration camp on Oct. 23, 2015.
Aris Messinis / AFP / Getty Images

But many say coordination of logistics — among volunteer and international aid groups and between them and local authorities — is lacking, particularly in medical emergencies that begin at sea. 

“We have a lot of well-meaning but obstructive volunteers,” says Helen Zahos, a nurse and paramedic from Australia who has been volunteering with Médecins du Monde in Lesbos for just over a month. “Sometimes it’s a clash of egos. You might have two volunteer doctors for one patient, and they all have different expertise that’s not emergency medicine.”

Several boats have capsized in recent weeks amid rain, cold and big waves. As winter sets in, search and rescue missions, led by the Greek coast guard and Frontex, the European border control agency, are becoming far more dangerous.

In the most dramatic single incident, a wooden boat carrying at least 300 refugees sank the night of Oct. 28 when the upper deck collapsed under the weight of too many people. (That was one of five boats to sink that day.) The coast guard and Frontex rescued 242 with the help of local fishermen. They were also aided by a Spanish group of six volunteer lifeguards on personal watercraft. The lifeguards performed CPR on dozens of people and helped officials hoist refugees onto rescue ships so they could be taken to land. 

Lately the Greek coast guard has been carrying out 10 to 15 rescue missions per day, according to Lt. Cmdr. Antonios Sofiadelis, the head of the coast guard on Lesbos and the local liaison with Frontex. But usually there is no doctor on board, he says. Crew members are trained in CPR and give people blankets to keep themselves warm. Anything more serious must wait until the ship can get to a harbor, where volunteer doctors and aid workers are waiting. 

Refugees in a Lesbos chapel, Oct. 28, 2015. They were rescued from a boat that was carrying 300 people and sank while crossing the Aegean Sea from Turkey.
Giorgos Moutafis / Reuters

On land the logistical hurdles are no less. Though volunteer medical teams pack plenty of supplies such as defibrillators, oxygen masks, bandages and medicine, they don’t have a warm, dry place to work on patients being pulled from the freezing water. During the Oct. 28 shipwrecks, a tiny Greek Orthodox church at the port became a makeshift emergency room. 

Part of the problem is that refugees may land anywhere along an 8-mile stretch of coast. At night the boats are hard to detect until they are very close to shore. Medical volunteers are spread out across the beaches, with no command center.

Because of the distance between the northern coast and the hospital, ambulances take up to an hour to arrive, according to Ania Van de Ridder, a 23-year-old volunteer nurse from Holland. This results in an unnecessary delay for patients with precious time to spare. Volunteers say they have taken in critical patients themselves to cut down on transit time. 

Peter Klemontschitsch, right, a retired surgeon from the Netherlands and a volunteer with the Boat Refugee Foundation, stitches a refugee’s hand in a medical tent on Efthalou Beach in Lesbos.
Tania Karas

“Sometimes we take our van and travel like an ambulance — a doctor and two nurses in the car with one patient,” says Van de Ridder, who is affiliated with the Boat Refugee Foundation, a Dutch nongovernmental organization. “We don’t have all the supplies we need, but we have no other option.” 

After the massive Oct. 28 shipwreck, Van de Ridder rode to Bostaneio pumping oxygen for a blue-lipped boy the entire way. The hospital employs 85 doctors, plus 26 residents, for an island with a local population of 86,000. The pediatric unit numbers just six. Staffers were overwhelmed with other patients when she and the boy reached the hospital.

“The child was very cold when we arrived — 25 degrees [Celsius], when normal is 36,” she says. “There wasn’t enough people in the hospital, so me and another nurse from the organization stayed.”

Pediatric nurses Kerry Andriotou, left, and Olga Iordanou have worked to keep several hypothermic children alive in recent weeks. A child rescued from a massive shipwreck on Oct. 28, 2015, died in this crib.
Tania Karas

The deluge of patients is having an emotional impact on Lesbos’ medical workers as well. When ambulances reached Bostaneio after the Oct. 28 shipwrecks, pediatric nurse Olga Iordanou was there to receive them, with many in critical condition.

“This one had pigtails and earrings,” she says softly, looking fixedly at an empty crib where a baby girl died. “We did our jobs that night, but we are people too, and we were crying,” Iordanou says. “Psychologically, I couldn’t take it.”

Earlier this week she attended a funeral for five refugees who died at sea. One was 9 months old; another was an 8-year-old boy. 

“It’s like a war,” she says. “And we all fear — we know it will happen again.” 


Organizations that work with refugees in Lesbos and help local health care staffers are accepting donations and volunteers. Some of the smaller ones:

Boat Refugee Foundation — This Dutch NGO assists refugees as they arrive on land with food, dry clothes and medical care.

Proactiva Open Arms — Using personal watercraft, this group of volunteer lifeguards from Spain helps the Greek coast guard and Frontex with sea rescue operations.

JustGiving Campaign for an Emergency Van — U.K.-based volunteer Bethany Usher is independently trying to crowdfund the purchase of an emergency vehicle to act as an ambulance. 

A Drop in the Ocean — This Norwegian group helps refugees as they arrive, including administering first aid and medical treatment. One of its volunteer nurses delivered a baby on the beach in mid-October.

Starfish Foundation — Founded by Melinda McRostie, the owner of Captain’s Table restaurant in Molyvos, Starfish hands out food and clothing to refugees and helps refugees with logistics at transit camps.

How to volunteer — Various local nonprofits and charities are coordinating volunteers through Lesvos Volunteers. 

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