THE CONTEXT Médecins Sans Frontières /Doctors Without Borders (MSF) has been providing medical humanitarian assistance to asylum seekers, refugees and migrants in Greece since 1996. In 2014, MSF expanded its activities in Greece to meet the needs of asylum seekers arriving on the Greek islands and mainland. Since 2016, MSF medical teams in Greece have offered a range of services including primary healthcare, treatment for non-communicable diseases, sexual and reproductive healthcare, physiotherapy, individual and group/family clinical psychological care, psychiatric care and a comprehensive social support package. In 2018, MSF provided services in Athens, Evros, and the Aegean islands of Lesvos, Chios and Samos. Throughout 2018, MSF continued to witness the consequences of the European Union’s (EU) deterrence and containment policies on people’s health and wellbeing in Greece. The closure of the Balkan migration route and the implementation of the EU−Turkey Deal in March 2016 left many people trapped on the Aegean islands and the mainland. In 2018, 60 percent of people arriving on the Greek shores were women and children. In 2018, sea arrivals reached almost 32,500, slightly higher than the 29,718 arrivals seen in the previous year. What is remarkable is the increase in the number of arrivals by land, specifically from Evros, which have tripled since 2017. In 2018, 18,014 people crossed from Evros’ land border, while in 2017, it was just 6,592. The total number of arrivals in Greece in 2018 increased by 45 percent compared to the year before. The new arrivals were mostly Syrian, Iraqi and Afghan families, who had fled besieged cities, war and violence in their home countries, and had travelled to Greece through Turkey. In September 2018, the number of asylum seekers living in and around the Moria Reception and Identification Centre (RIC) on Lesbos island reached record high numbers. At its peak, over 9,500 people were stranded on Lesvos, despite the fact that the RIC only has capacity for 3,100. The same occurred on in the island of Samos, where almost 4,000 people were staying in an RIC with the capacity for only 650. Between October and December 2018, following pressure from several NGOs, including MSF, the Greek government temporarily accelerated transfers of vulnerable people to the mainland, somewhat decongesting the reception facilities. However, many vulnerable people are still staying on the islands indefinitely. As long as these containment policies remain in place, overcrowding on the islands, with horrendous living conditions and insufficient access to basic services including healthcare, will remain the norm. As a result, the health and mental wellbeing of vulnerable people stranded on the islands will continue to suffer. The end of the relocation scheme in September 2017 and the drastically slowed down family reunifications offered little hope that asylum seekers would be able join their families in other European countries in the final months of 2018. This led to increased pressure on the already strained Greek public services. The MSF clinics treating migrants and asylum seekers in Athens continued to note administrative and language barriers preventing proper access to national healthcare services for many of our patients. In addition to its medical interventions, described in more detail in this report, in 2018, MSF carried out vaccination campaigns for children living in Lesvos, Chios and Samos, in collaboration with the Ministry of Health and the Greek Centre of Disease Control and Prevention (KEELPNO). 3
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