Serbia: Refugee and Asylum Seeker Support
1,026 Patients Treated Despite Continued Challenges: December 2016
January 15, 2017
Summary of Activities
During the December reporting period, RMF Serbia treated 1,026 patients—an average of 33 patients per day. Approximately 600 referrals were made to MSF/Miksalište for the treatment of body lice and scabies. A high number of refugees in the Belgrade city center are considered extremely vulnerable individuals, many with pressing medical needs that go beyond performing basic triage in the field.
RMF Serbia also worked to maintain and build partnerships through the following activities:
- Participated in the Health Working Group, co-chaired by WHO and the Ministry of Health (MOH), on December 15th, 2016.
- Participated in the Refugee Protection Working Group (RPWG), co-chaired by UNHCR and the Ministry of Labor (MOL), on December 9th, 2016 in Belgrade. This is the key coordination mechanism for agencies/NGOs operating in the country, as well as a source of information for donors and diplomatic missions that attend the meetings as observers. RPWG has over 90 members and meets on a monthly basis.
- Participated in the 13th monthly Partner’s Briefing on the Refugee and Migration Situation in Serbia, where the UNHCR/UNRC, Ministry of Foreign Affairs, and Ministry of Labor/Chair of Government WG on Mixed Migration update the diplomatic corps, donors, and NGOs on the refugee and migrant situation and the response of UN agencies and their partners in the previous period. This meeting took place on November 30th, 2016 in Belgrade.
- Provided monitoring and follow-up services for our patients and received referrals from UNHCR/DRC doctors, Palilula Health Center doctors working within Camp Krnjača, Doctors of the World (MSM), Médecins Sans Frontières (MSF), Save the Children, Praxis organization, Info Park, Miksalište, and the Asylum Information Centre (AIC).
Preparing for Winter
The authorities and the humanitarian community enhanced winterized shelter capacities and intensified winter NFI distribution. Though additional health risks were posed by the winter weather, authorities and health partners, including RMF, managed to reduce or eliminate body lice and scabies infections in all asylum and reception centers. Challenges remained in some transit centers and for the refugees and migrants who were not accommodated in government facilities but staying in the Belgrade city center.
Doctors of the World
During December, RMF negotiated a partnership with Doctors of the World (MDM) to share their medical clinic located within Miksalište Centre for Refugees. RMF will work in this clinic daily from 4:00 PM to 8:00 AM, commencing in January 2017. This will ensure that both program beneficiaries and RMF Serbia staff have a safe environment for patient care, as the temperatures plummet to minus 16°C in the coming weeks.
Lice and Scabies
RMF continued to support the treatment of body lice and scabies in the city center, primarily through referrals and collaboration with MSF, which has exclusive access to the shower facilities in Miksalište Centre for Refugees. The showers are, however, not enough to successfully treat the affected population. Furthermore, due to the complete absence of sanitary facilities available for refugees “sleeping rough” (homeless) in Belgrade, they are infecting each other with body lice to gain access to the showers. Without expansion of sanitation facilities, the epidemic remains impossible to contain.
Refugee Population Rises
With continued irregular arrivals and limited regular departures (10 per day, excluding weekends, to Hungary), the estimated number of refugees, migrants, and asylum seekers in Serbia further rose to 7,000 during the month of December 2016.
According to all available data, most were not adult men, but:
- Children – 46%
- Men – 39%
- Women – 15%
Around 85% of them had fled “refugee-producing countries,” including:
- Afghanistan -49%
- Iraq – 19%
- Syria – 10%
1,120 intentions to seek asylum in Serbia were registered, raising the total for the year to 12,961.
Belgrade City Center
There are ongoing discussions between civil society and the government of Serbia concerning the mass eviction of refugees and migrants from the Belgrade city center, and the government has requested support from humanitarian actors. In November, RMF offered support to the government of Serbia through the provision of information sharing and counseling of people regarding relocation once the steps to be taken by the government are clear.
RMF participated in a UNHCR-led service provision mapping exercise to ensure that humanitarian actors can contribute quickly to the government of Serbia’s response. The response for the Ministry of Labor was that they only require assistance with transportation and escorting to government facilities. RMF withdrew our offer, as we do not support the forcible removal of people, particularly in the absence of communication and required support structures.
Holistic Medical Care
Caring for the Entire Person
RMF is the only medical service provider whose core work is to provide holistic medical care, which involves:
- Cultural Mediation Services
Once RMF’s outreach team identifies a patient:
- An examination and assessment is made of the individual’s health condition and referral options.
- We then treat the patient in situ to stabilize their condition, before seeking referral papers and transferring the patient to secondary or tertiary care if needed.
- RMF’s outreach team then stays with the patient for the duration of his or her consultation and therapy to provide support with cross-cultural interpretation and translation, comfort, and reassurance.
- We then transport the patient back to his or her chosen location. Such consultations can take up to 8 hours due to patient wait times within the state facilities.
RMF has been responding to the refugee crisis in Serbia since January 2016, by providing comprehensive protection and medical services, including emergency triage, to persons of concern. Our teams work in and around the Belgrade city center and at Obrenovac Transit and Reception Centre, the second largest refugee camp in Serbia. We operate 3:00 PM to 10:00 PM five days a week at our mobile medical clinic located in Obrenovac, with a second medical team providing referrals for secondary and tertiary care institutions. From 2017 to 2018, we also provided services near the border with Croatia, operating the medical clinic at Adaševci Transit Centre from 4:00 PM to 12:00 AM, seven days a week.
Additional programs include a mobile dental clinic at Obrenovac Transit and Reception Centre—the first of its kind in Serbia—providing dental care for migrants, who previously only had access to emergency interventions. RMF Balkans also distributes hygiene kits at six camps throughout Serbia to help improve personal hygiene and prevent the spread of infectious diseases. To improve the residents’ quality of life, RMF renovated Obrenovac Transit and Reception Centre in 2018 and continues to maintain and use the renovated facilities to conduct cultural and empowerment activities.
- Provide comprehensive protection and assistance response
- Provide material assistance and information
- Provide psychosocial support
- Provide translation and cultural mediation services
- Support existing medical institutions with capacity and mobility
- Establish an information dissemination hotline
Click to enlarge
Girl from Afghanistan
Age: 3 months old
The baby and mother had fallen during the walk through the woods. The baby’s head hit the ground. When they came to Miksalište, an RMF doctor examined the baby. Previous shifts took the baby and mother to the hospital, and they were admitted to the neurosurgery in ER because the children’s hospital neurosurgeon was not on duty.
When we arrived for our shift, we called the hospital to inquire about the health condition of the baby. The doctor told us that it is now stable, and the baby and mother are to be transferred to the Children’s Hospital Tiršova. The baby has a fractured skull. We and a Farsi language translator from the Asylum Info Centre (AIC) went to the hospital and stayed with the mother and baby during their transfer from one hospital to another. The baby remained in the hospital for further monitoring and diagnostics.
In cooperation with another organization, we provided the baby with diapers and the mother with a personal hygiene package.
Boy from Afghanistan
We recived a call about the boy from the camp for underage refugees, Vasa Stajić.
High temperature and sore throat.
We went there and examined him. He had a body temperature of 39.2°C and his pharynx examination indicated tonsillitis. Since refugees living in government shelters have the right to be examined in state hospitals, we transported/escorted him to the primary care center for children, where he was examined by a pediatrician, blood tests were performed, and viral tonsillitis was diagnosed. The pediatrician prescribed antipyretic paracetamol and oriblete. We provided him the needed medicines and transported him back to the shelter.
Boy from Afghanistan
He tried to cross the border, and a Hungarian policeman hit him in the eye.
Painful, red eye.
We transported him to the ophthalmology clinic, where he was examined by a specialist with biomicroscope and was diagnosed with corneal erosion. The ophthalmologist presrcribed chloramphenicol ointment for 4 days and eye drops. We provided him with the needed medicines and transported him back to Miksalište.
Boy from Syria
Pain, unable to walk, swollen right ankle joint.
We took the boy to the Institute for Mothers and Children (children’s hospital), where the surgeon examined him. After examination, the surgeon requested an x-ray, which showed that he has no fracture, just dislocation. He received corrective splints. Since our shift was over, we left the second shift to take him to the primary health center for anti-tetanus.
We provided crutches for him to walk.
Male from Pakistan
Nail plate of the big toe darkly stained (left leg). Periungual, whitish pus, and granulation.
He was driven by a surgeon accompanied by our organization. The surgeon said he had to go to the dermatologist. We took him to a dermatologist and the doctor examined him. We explained to the doctor that he cannot maintain good hygiene, which is very important. The doctor solved that by hospitalizing him to provide all-day care. The hospital admission was scheduled for tomorrow morning.
We went to the UNHCR doctor in Camp Krnjača to give us a referral for hospitalization, without which he could not be admitted to the hospital.