The trauma of stranded refugees

Liv­ing un­der cloud of un­cer­tainty in poor con­di­tions, many ex­hibit­ing psy­chi­atric prob­lems

Kathimerini English - - Focus - BY YIAN­NIS PA­PADOPOU­LOS

“I can­not an­swer how I feel when af­ter four months of wait­ing, the only so­lu­tion they can of­fer is to give you a big­ger tent, when they for­get your name and call you by the num­ber of your tent.” Doc­tors Without Bor­ders (Medecins Sans Fron­tieres, MSF) pro­gram di­rec­tor Apos­to­los Veizis re­ceived this mes­sage from a refugee liv­ing at the camp in Vasi­lika, Thes­sa­loniki last July.The mes­sage was signed 2B5.

Since then, lit­tle has changed. In some main­land camps tents have been re­placed with con­tainer-type struc­tures – such as at Malakasa two weeks ago – while small groups of vul­ner­a­ble pop­u­la­tions have been trans­ferred to ho­tels un­til the cold win­ter weather sub­sides. The ma­jor­ity of refugees on the main­land, how­ever, re­main gripped by the in­er­tia of ev­ery­day life and un­cer­tainty about their fu­ture. The con­di­tions ei­ther cause or ex­ac­er­bate cer­tain anx­i­ety dis­or­ders, de­pres­sion and psy­cho­log­i­cal trauma.

“We pro­duce pathol­ogy, we in­duce pathol­ogy,” says psy­chol­o­gist Nikos Gion­akis re­fer­ring to the liv­ing con­di­tions of these peo­ple. As sci­en­tific di­rec­tor of the Ba­bel Day Cen­ter for the men­tal health of im­mi­grants which in re­cent years has been in­volved in the train­ing of po­lice, port au­thor­i­ties and NGO staff who work with refugees and mi­grants.

As he points out, even to­day there is no or­ga­nized state mon­i­tor­ing plan and many in­ter­ven­tions are frag­men­tary. The pic­ture is not uni­form across all refugee cen­ters, the ben­e­fits and needs vary, and the pop­u­la­tion com­po­si­tion dif­fers from one place to the next. How­ever, the is­sue of the im­pact of their predica­ment on their men­tal health goes largely un­no­ticed.

The data

Indica­tively, from in­for­ma­tion gar­nered by Kathimerini, at three camps in Epirus, out of a pop­u­la­tion of 900 peo­ple, 68 are cur­rently un­der­go­ing psy­cho­log­i­cal coun­sel­ing by staff from Doc­tors Without Bor­ders. Of these, 18 have been put on med­i­ca­tion. In ex­cep­tional cases, par­tic- ularly in ac­com­mo­da­tion close to or within At­tica, refugees are re­ferred to the Athens Psy­chi­atric Hos­pi­tal (APH).

Since June, 20 pa­tients have been seen by the APH’s emer­gency de­part­ment, of whom four were hos­pi­tal­ized. Most re­fer­rals were made from the Elliniko hot spot (4) and Skara­man­gas (4).

Mean­while, MSF psy­chol­o­gist Christina Sideris of­fers sup­port to refugees and mi­grants at the Malakasa camp. Some ex­hibit de­pres­sive symp­toms, ei­ther wak­ing up too early or hav­ing dif­fi­culty stay­ing awake, of­ten cry­ing and suf­fer­ing from in­tense anx­i­ety. Child refugees have more acute re­ac­tions to stress, oc­ca­sion­ally show­ing ag­gres­sive ten­den­cies to­ward their peers, sep­a­ra­tion anx­i­ety dis­or­der, or bed wet­ting. Among the 474 refugees and mi­grants who re­ceived psy­cho­log­i­cal sup­port from MSF this year at camps in north­ern Greece and on Lesvos, 22.31 per­cent had de­pres­sive symp­toms.

“Most peo­ple I see are par­ents. They feel they have a huge re­spon­si­bil­ity to- ward their chil­dren. One mother told me, ‘I’ve im­pris­oned them here and they are los­ing days of their lives,’” says Sideris. “What we are ex­pe­ri­enc­ing is a com­pletely ex­pected re­ac­tion to their liv­ing con­di­tions. If they had some prospects, they could be or­ga­nized. What they fear most of all, how­ever, is that this pause in their lives will be for­ever.”

Feel­ing trapped

In Malakasa, the pop­u­la­tion is al­most ex­clu­sively from Afghanistan. The fact that peo­ple of that na­tion­al­ity are not in­cluded in the Euro­pean Union re­lo­ca­tion pro­gram which sees refugees set­tled in other mem­ber-states in­creases the feel­ing of be­ing trapped. “When you have no power over your own life and you have noth­ing to do, you have a lot of time to think about neg­a­tive things and lose hope. The Afghans es­pe­cially feel com­pletely aban­doned,” says Cle­ment Per­rin, head of the MSF mis­sion in Greece.

His col­league Loic Jaeger has pre­vi­ously worked in Syria and Ukraine on mis­sions that pro­vided psy­cho­log­i­cal sup­port. “It is un­ac­cept­able that in Greece we are hav­ing to help these peo­ple over­come the trauma caused by their liv­ing con­di­tions and not the trauma from the war,” he says. A woman from Malakasa who at­tends the clinic has ex­pressed sui­ci­dal thoughts. Other refugees have had thoughts of tak­ing their own lives too.

MSF psy­chol­o­gist Danae Vaya met one woman with se­vere post-trau­matic stress dis­or­der. Her hus­band had stayed in Syria and she was in ac­com­mo­da­tion in At­tica with six of her seven chil­dren. The sev­enth, a mi­nor, had man­aged to get to Ger­many. The woman was suf­fer­ing from se­vere pho­bias and emo­tional de­tach­ment. She spent most of the day in bed, feel­ing afraid and cry­ing.

“They came here think­ing Greece would be a short stop and now the pro­longed ac­cu­mu­la­tion of acute fa­tigue is be­com­ing ap­par­ent,” says Vaya. “The trauma of these peo­ple is chronic, and re­quires a very safe en­vi­ron­ment for them to be­gin heal­ing.”

‘ The trauma of these peo­ple is chronic, and re­quires a very safe en­vi­ron­ment for them to be­gin heal­ing,’ says Danae Vaya.

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