The situation for migrants in Greece is dire. And it’s not just the economic crisis, though that is undoubtedly making it worse.
So says, Ioanna Kotsioni, a migration specialist at Médecins Sans Frontières (MSF) in Athens, Greece. Kotsioni visited the IRCT recently to give a presentation on the situation of migrants and specifically migrant health in country.
And the conclusion was grim, to say the least. An estimated 80% of all migrants to Europe come through Greece, according to Frontex data for 2011 [PDF], meaning a majority must face squalid detention conditions and dismal health services upon their initial entry into Europe. But with the deep economic issues plaguing the country, scant attention is being paid to the condition of migrant health and human rights.
“I don’t want to overdramatize the situation,” Kotsioni says, “but it’s going as bad as it could go.”
So what is the migration process into Europe? And along this process, what are the effects for those migrants’ health and mental well-being considering the state of Greece at the moment.
According to MSF, migrants accumulate vulnerability throughout different stages of the migration process, from leaving their home to resettling elsewhere. For example, during the 2010-2011 winter, MSF saw many migrants with severe frostbite, presumably caused during their trek through the mountains in Iran, but acerbated by the frigid conditions in Greece and long periods without medical care. At that time, MSF referred 16 patients with frostbites to the hospital; some had amputations as a result of the frostbite.
After an arduous travel to Greece, whether risking the boat trip to the countries numerous islands or across the border with Turkey, which only recently (2010) was fully de-mined, many migrants and asylum seekers are detained for long periods (according to recent legislation the maximum administrative detention period, both for migrants and asylum seekers, was extended to one year). The practice of detaining migrants has increased in recent years in Europe, Kotsioni reports; this means a majority of migrants coming into Greece are held in deplorable conditions, greatly increasing their vulnerability. The European Court of Human Rights, M.S.S. case v. Belgium and Greece 2011,ruled that the conditions of detention for migrants are often desperately overcrowded and are considered demeaning treatment.
Calling it ‘overcrowded’ is perhaps a far too sanitised term. The Pagani Detention Center, located on the island of Lesvos for migrants who arrived by boat from Turkey, was closed in 2009 following criticisms by MSF and others. In 2008, when MSF visited the centre, they found 200 people staying in a 150-square-meter room; 68 were children younger than 5.
The impact of detention on migrant health is great. MSF estimates that 63% of the diagnoses of the migrants its teams treated in Evros detention facilities between 2010 and 2011 were directly or indirectly linked to the substandard conditions of detention [PDF]. MSF patients between 2009 and 2010 reported many psychological complaints related to detention as well. Nearly 40% of migrants reported anxiety as a result of their detention; other common diagnoses included depression (31%) and post-traumatic stress syndrome (9.5%). Among those diagnosed by MSF, 3.2% reported an attempted suicide or self-harms while in detention [PDF].
These severe mental health concerns arise from the conditions of detention, compounded of course by the previous traumas of refugees from their homeland and the migration process to Europe. But detention alone was the single greatest cause of anxiety and stress; it arises from the desperately squalid conditions, the sense of defeat, hopelessness and perpetual uncertainty, the feeling of injustice, for being treated like a criminal, and shame, Kotsioni reports. And the Ministry of Health provides very little; for example, in the Evros region where there are several detention facilities and several hundred migrants are detained, there was only one psychologist available.
“The police operate the immigration system,” she says. “And they have very limited capacity to do this work. With few exceptions, they have no translators even.”
Occasionally, people are even completely forgotten or lost within the system. Unaccompanied minors — among the vulnerable groups that should be treated with special care, according to the European Council — are at times detained for months. In recent months in police stations in the Aegean Islands which have been receiving migrants and refugees – predominantly from Afghanistan and Syria – men, women, children, elderly were detained in the same tight rooms.
Capacity seems to be the greatest problem, again, fuelled by the financial crisis. The police run the asylum and immigration system because there isn’t a separate government institution to operate it (a recent legislation of 2011 foresees and independent Asylum Service and a First Reception Service however these are not yet operational). As there is no reception system, no one trained to screen for vulnerable people such as torture victims, all migrants captured at the border or detained in random police sweeps are detained.
“It is up to the police’s discretion if they are considered vulnerable,” Kotsioni says, “but they can only see the obvious signs, a fully disabled person or a pregnant woman. But they have no training and no interpreters.”
I think that’s nearly what shocked me the most – no interpreters. No way for the authorities to speak to people during months of detention; no way for authorities to communicate that migrants will, in fact, get out of detention at some point; no way for the migrants to tell authorities or government medical staff if they have an injury or a previous trauma, to tell their story. And there are migrants from dozens of countries – in the last two years, the majority have come from Afghanistan, but also Pakistan, Bangladesh, various countries of Northern Africa, and, in more recent months, from Syria.
Migrant health issues, which are already numerous at the start of one’s journey, get compounded by a thoroughly dysfunctional system. Once they are released from detention, many either make there way to other European countries or apply for asylum within Greece. The wait for an asylum application can take months. In 2008, only .05% of applicants were given asylum. Now that number is 2.5%.
In the waiting time, 300,000-400,000 migrants in Greece have “irregular status”, meaning still no avenues for proper medical care. Kotsioni says that previously, doctors could “find a way” to provide some basic health care to migrants with irregular status; however, now with the dire fiscal challenges, those options have been largely closed off.
To make matters worse, migrants in Greece are often the targets of racist violence, which has greatly increased in the last year of the financial crisis. The Racist Violence Recording Network documented 87 cases of racist violence against refugees and migrants, 83 of which were in public spaces, such as train stations or public squares. A majority of the instances – 48 of the 87 – were believed to involve extremists groups. The fascist, far-right party Golden Dawn garnered 6.7% of the vote in the last election and is believed to have support from “pockets of fascists” within the police.
“There seems to be complete impunity [for these crimes]. That is the word to underline,” Kotsioni says.
While the crisis continues, no EU countries seem to watch to further push Greece and bring up the issue of human rights in the country. But in the meantime, hundreds of thousands of migrants continue across the border and into inhuman conditions in Europe.