Serbia: Refugee and Asylum Seeker Support
1,026 Patients Treated Despite Continued Challenges: December 2016
January 15, 2017
N’Deane Helajzen
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).

Results &
ACCOMPLISHMENTS

Enhancing Shelters
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
Developing Partnership
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
Belgrade Epidemic
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
Demographics
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
Mass Eviction
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:
- Transportation
- Escorting
- 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.

Background
& Objectives
Background
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.
Objectives
- 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

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