Serbia: Mobile Medical Clinic
Providing Holistic Medical Care: Q1 2018
May 30, 2018
Marjan al Mahamid, N’Deane Helajzen, Žarko Stanić, Dr. Andrijana Ljubojević, Dr. Dragana Marković, Dr. Daniel Pejković, Dr. Jovana Milić, Dr. Nataša Benović, Dr. Milica Radonjić, and Dr. Mina Novaković
Summary of Activities
Since May 2015, Serbia has been facing an unprecedented refugee crisis. In 2015 and in the first quarter of 2016, more than 920,000 refugees and migrants, primarily from Syria, Afghanistan, and Iraq, passed through Serbia on their way to Central Europe. As a result of the closure of the Western Balkans migration route, the number of refugees, asylum seekers, and migrants stranded in Serbia now stands at 3,900.
A combination of factors has made the provision of support to refugees and asylum seekers more challenging during this reporting period:
- There is a shortage of basic supplies in government-administered facilities.
- Refugees and migrants are exposed to exploitation, violence, and human trafficking, often as a result of smuggling and violent pushbacks at the borders.
- The unprecedented scale of refugees, migrants, and asylum seekers in Serbia is placing increased stress on an already overburdened health system.
- There is an urgent need for professional psychosocial and mental health support within the centers; the number of refugees and migrants showing symptoms of depression, severe anxiety disorders, suicidal thoughts, etc. is increasing.
- Referral mechanisms for psychiatric illnesses and gender-based violence responses require strengthening to improve protection services for patients and survivors.
- Language barriers remain a challenge.
- Integration mechanisms within the host community are largely absent.
During this quarter, RMF Serbia’s team continued to provide holistic medical care and support to persons of concern during the reporting period through services at Adaševci Transit Center and Obrenovac Transit Centre as well as escorting and referral services.
Adaševci Transit Center
Treating Men, Women, and Children
Primary healthcare services are provided through the Medical Clinic in Adadševci Transit Centre. Medications to treat scabies and body lice continue to be procured, donated to, and used for ongoing camp screening and treatment procedures.
During this reporting period, RMF Serbia provided 2,892 medical consultations to men, women, and children refugees and migrants in Adaševci Transit Centre in Western Serbia between January 1 and February 18, 2018.
Obrenovac Transit Centre
Immediate Access to Specialists
RMF provides primary healthcare services from the Obrenovac Transit Center mobile medical clinic from 3:00 PM to 11:00 PM, 7 days a week. Emergency patients who arrive at the clinic are able to immediately access referrals to secondary and tertiary care facilities.
During this reporting period, RMF Serbia provided 2,407 health consultations to men, women, and children refugees and migrants in Belgrade and Obrenovac. This average of 200 patients per week is consistent with the weekly patient numbers at the clinic in Adaševci.
Provision of Support to the State
Monthly Meetings Facilitated
RMF Serbia continued to support the Institute of Public Health (IPH) of Serbia, the Ministry of Health, relevant health institutions, and partner NGOs in the coordination of healthcare provision.
Monthly meetings were also facilitated with the Ministry of Health to discuss the progress of the mobile dental clinic and ongoing security issues at Obrenovac Transit Centre.
RMF provides primary healthcare and emergency triage services at our Obrenovac Transit Centre mobile medical clinic from 3:00 PM to 10:00 PM, 5 days a week. The work is implemented by a medical team consisting of 1 to 2 doctors, 1 cultural mediator/translator, and 2 drivers. This ensures that emergency cases arriving at the clinic can immediately access referrals to secondary and tertiary care facilities. By providing primary healthcare services, referrals, and cultural mediation, RMF improves the wellbeing of refugees, migrants, and asylum seekers in Belgrade and Obrenovac.
- Improve the health status and overall wellbeing of refugees in Obrenovac Reception and Transit Centre and greater Belgrade.
- Provide medical and translation services to refugees and act as cultural mediators for them at public institutions in Serbia.
- Refer, transport, and escort refugees and asylum seekers to secondary and tertiary medical care facilities in Belgrade.
Rizwan Ranjha, 33
Daily Treatments Heal Wound
This patient arrived with an open wound on his right foot that was infected and bleeding. Five toes on the right foot were amputated with an ax by the Taliban in Pakistan. The foot is deformed and contracted since the patient healed himself after the initial injury without medical care.
Rizwan Ranjha is treated daily in our clinic, in consultation with an orthopedic surgeon from the Clinic for Orthopedics at the Clinical Centre of Serbia. The wound has healed and the patient was rehabilitated and is now able to walk without assistance.
Nick M. Khan
28-year-old man from Afghanistan
Mr. Khan fell on the ground while he was playing cricket, breaking his right radial bone and suffering a contusion in the elbow area. He was taken to the emergency department where his right arm was immobilized and a gypsum plaster cast was applied. In the following days, Nick felt a strong pain in the area of the fracture. His right arm was swollen, and the plaster was removed.
Our teams took him to hospitals on multiple occasions for consultations with an orthopedic surgeon. An infection had developed and was progressing fast. Oral antibiotic therapy was started, and daily dressing of the arm was performed. Nevertheless, Nick was feeling dizzy due to low blood pressure, he was breathing heavily, and his fever was spiking. Thus, our medical team diagnosed him with septic shock. He was immediately taken to the hospital and admitted to the Clinic for Orthopedics at the Clinical Center of Serbia, Department of Sepsis.
His final diagnosis was necrotizing fasciitis, commonly known as flesh-eating disease. He stayed in the hospital for 6 weeks, where he underwent two surgeries in order to remove dead tissue. He barely avoided amputation of the right arm, but he is now recovering well.
Nick’s hospital care was provided by the Republic of Serbia, while RMF provided inpatient support. Since being discharged from the hospital, Nick regularly comes to our mobile medical clinic in Obrenovac for further treatment and rehabilitation of his arm.
36-year-old man from Pakistan
The patient was burned by an open fire in the forests of Serbia. He arrived at Obrenovac Transit Center after the injury with burns on his face and hands. The second-degree burns were badly infected.
He was examined in our clinic and taken to the Clinic for Reconstructive and Plastic Surgery at the Clinical Center of Serbia for further examination by a plastic surgeon. The burns were redressed daily at our clinic in the camp for over a month. Thanks to this regular treatment, he managed to recover, but he has yet to regain motor function of his hands.