Serbia: Refugee and Asylum Seeker Support
8,502 Patient Consultations: Q3 2017
November 15, 2017
Reporting Officer Marjan al Mahamid, with input from the RMF Project Manager, Žarko Stanić, Coordinator of Global Programs, N’Deane Helajzen and RMF Serbia’s Medical Officers: 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
During the third quarter of 2017, the number of refugees, asylum seekers, and migrants declined slightly in Serbia, with 4,250 counted on September 30, 2017. Of these, 3,900 were accommodated in one of five asylum centers or thirteen reception centers. 300 persons of concern remain housed in temporary emergency shelters.
The beginning of the new school year brought a hopeful surprise for refugee and migrant children. A pilot program by the Serbian government allowed around 450 of some 800 refugee and migrant children ages 7–14 to start attending public primary schools across the country alongside their Serbian peers. The refugee and migrant children are integrated into Serbian children’s classrooms, where they have learned the Serbian language and can comfortably follow lessons.
In September, 589 persons registered intention to seek asylum in Serbia (as compared to 282 in August). 51% were filed by adult men, 15% by adult women and 34% were registered for children. The Asylum Office granted one person subsidiary protection, increasing the number of positive first-instance decisions during this year to three.
Gap in Dental Care
Plans for the Future
Serbia’s Ministry of Health is currently discussing the gap in dental services for refugees and asylum seekers and how RMF can participate in treating patients who are in dire need of these services. RMF Serbia is also discussing with the MOH how we can assist in the development of refugee and asylum seekers’ health care in general, so the care can be both practical and visionary. With these goals in mind, RMF Serbia is preparing to set up a new mobile dental clinic in the fourth quarter of 2017.
Treatment of Mental Disorders
Identifying Best Practices
RMF Serbia is also talking with the MOH about how to beat the cultural challenges involved in treating patients with mental disorders, the tendency towards simplistic solutions that are insufficient to address highly complex and evolving disorders, and situations when patients escape from the hospital. RMF Serbia is working with the MOH to identify best practices and human resources for health requirements.
Monthly Health Cluster Meetings
Raising Awareness and Developing Partnerships
RMF Serbia continued to participate in monthly health cluster meetings conducted in Belgrade by the Ministry of Health and supported by the World Health Organization. These coordination meetings summarized the current situation, issues, problems, and challenges, while identifying response strategies and actions to carry out during the final quarter of 2017. Through our participation in these meetings, RMF Serbia also continues to raise awareness of our work and develop ties with government health programs.
Holistic Medical Care
8,502 Health Consultations
- RMF Serbia provided 3,844 health consultations to men, women, and children refugees and migrants in Belgrade and Obrenovac.
- RMF Serbia provided 4,658 health consultations to men, women, and children refugees and migrants in Adaševci Transit Centre in Western Serbia.
Support Services Provided
- RMF Serbia continued to provide medical services, interpretation, translation and cultural mediation, escorting, and transportation to secondary medical and other facilities in 87 cases.
- RMF Serbia identified unaccompanied and separated refugee children (UASCs), who were referred to the Centre for Social Work in 18 cases.
Medications and Care Packs
Providing for Physical Needs
RMF provided assorted drugs and medical care, as well as hygiene packs, safety kits, and children’s kits to support the response to refugees.
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
Persistent Follow-Up for Tuberculosis
In August 2017, RMF’s clinic and mobile team was asked to help a 17-year-old boy who was traveling alone through Serbia. For the last few months, he had been placed in Obrenovac Reception Centre, where he was under the protection of the state. The boy was experiencing a consistent fever, night sweats, and coughing up blood. Considering the seriousness of his condition and possible diagnosis of tuberculosis (TB), RMF’s team, together with social welfare, took over the case. The boy was taken to get an x-ray, which showed consolidations of the lung area and hilar enlargement, consistent with a possible TB infection. As soon as diagnosis was made, the boy was admitted to the Hospital for Lung Diseases for further diagnostics.
Four days following his admission to the hospital, the boy escaped and decided to return to the Obrenovac Reception Centre. After numerous efforts to make a connection with him and build trust, RMF’s team finally managed to convince the boy to return to the hospital, where he was treated for TB. By providing persistent follow-up, RMF’s team was able to protect the boy and those around him.
Ensuring Proper Diabetes Therapy
A 29-year-old man had been suffering from diabetes for two years. During an illegal crossing of the Serbian-Hungarian border, Hungarian police deliberately took his insulin and left him stranded on the Serbian side of the border. He was not able to purchase more injectable insulin, since it can be only acquired in pharmacies with a valid medical report signed by a state doctor. The young man was doing his best to maintain a proper diet, hoping to reach somebody who could help him. When he came to RMF, his glucose level was 15.2 mmol/L. He was taken to the health center in order to perform further laboratory tests and urine analyses. An appointment was made with the endocrinologist, and he received proper insulin therapy, preventing infinite complications that can be caused by untreated diabetes.
Diagnosis and Referral Lead to Recovery
18-year-old man from Afghanistan
An 18-year-old man from Afghanistan came to the RMF clinic with abdominal pain, maculopapular rash/purpura, and generalized joint pain. The patient also reported loss of appetite and vomiting blood. Based on the clinical presentation, RMF doctors diagnosed Henoch-Schönlein purpura (HSP) and referred the patient to the ER. After we spent the night in the ER with the patient, he was finally admitted to the intensive care unit with the diagnosis of HSP, and treatment with corticosteroids was started. We are very glad to report that the patient recovered well.
Patient Treated for Self-Inflicted Wounds
Adolescents are observed to have a higher incidence of self-harm injuries than other populations, and a significant association has been made between deliberate self-harm, low self-esteem, mental issues, and drug and alcohol abuse. These issues are exacerbated by the displacement of refugee and migrant youths.
An 18-year-old patient came to RMF’s clinic with fifteen self-inflicted wounds on his lower left arm. He admitted that he was under the influence of drugs and alcohol when he burned himself with a cigarette three days before. Since the event occurred, he had not seen a doctor. The wounds were red, painful, and swollen, and the patient had a fever. We treated his wounds and infection, but the young man refused any psychosocial help.