Serbia: Refugee and Asylum Seeker Support

Extreme Violence

22-year-old man from Afghanistan

A 22-year-old young man presented with a compound fracture of the left forearm. He had been beaten by a smuggler on the Hungarian border. The injury happened 12 hours before RMF’s team examined him. First, he was checked by the orthopedic surgeon in Subotica, who recommended hospitalization. The patient refused that option, because he wanted to be treated in Belgrade, where he felt safe. RMF’s team brought him to the ER, where an orthopedic surgeon ordered another x-ray of patient’s left arm to confirm the diagnosis already made in Subotica.

The young man was also referred to the neurosurgeon and general surgeon in order to exclude trauma of any other organs. Tests did not show any other signs of trauma, and the orthopedic surgeon admitted the patient to the hospital and performed surgery on his left forearm. The patient made a full recovery.

Marginalized Local Population

46-year-old man from Serbia

In the area of “the Barracks,” where RMF’s team often worked before the buildings were demolished in May 2017, we provided care for refugees and migrants that were not in the camps and had no access to medical care, hygiene facilities, or any type of protection and care. Long before the migrant crisis occurred, however, marginalized local populations were living in “the Barracks,” and with the arrival of RMF’s medical team, they finally had someone to turn to for help.

We were approached by a homeless Serbian man who had been living on the streets of Belgrade for the last 8 years. He did not have any documents or a medical card, and he desperately needed help. One month before, he had an accident and had a severe (stage III) burn on his lower left leg, and it had been neglected. His wound was infected and in bad condition. The patient also had hepatitis C and diabetes mellitus. We took him to the plastic surgery hospital, where his wound was cleaned and our team was instructed how to treat it until next check-up. After antibiotic therapy and regular dressing, his wound had improved.

Flesh-Eating Disease

26-year-old man from Afghanistan

On May 2, 2017, a 26-year-old young man was examined by MSF and RMF doctors. He had broken his right arm on April 28th and been taken by volunteers to the ER, where a cast was put on his arm. His diagnosis: fracture of the upper part of the radial bone. In the following days, his right arm was swelling and became very painful. After examining the patient, we concluded that he needed to be taken back to the ER because of the extreme swelling and pain.

The young man received numerous blood tests, x-rays, and consultations with surgeons for 3 consecutive days, but they all concluded that his condition was not severe and didn’t require hospitalization. In between examinations, the patient started to show signs of skin discoloration and blisters that where opening and producing a discharge of fluid. Despite our efforts to clean the area and treat the young man with antibiotics (as well as trying unsuccessfully to admit him to the hospital), on May 5th, his condition deteriorated further; he had a fever of 38.5°C and heart rate of 121. The young man was in very poor physical condition, and his wound was in extremely poor condition. Our team took him to military hospital, where he was diagnosed with necrosis of the wound and sepsis. He was finally admitted to the orthopedics department of KC of Serbia, where he was later diagnosed and treated for necrotizing fasciitis, commonly known as flesh-eating disease.

The young man is now safe and well. He on his way to full recovery, and RMF’s team is monitoring his rehabilitation.

Bronchitis and Possible Bronchial Asthma

Unaccompanied 14-year-old boy from Afghanistan

A 14-year-old boy was referred to RMF’s team by MSF doctors because of a serious asthma attack that he had in their clinic, which did not subside with regular therapy. The patient reported that he has had breathing difficulties since childhood and that he used to take some therapy. He could not tell us which medications he had been taking. The boy was traveling alone, living in “the Barracks,” and there was no way to contact his relatives. Our team decided to take him to the children’s hospital, where he was diagnosed with bronchitis and possible bronchial asthma. The pediatrician prescribed him with antibiotics and inhalation therapy, but these were difficult to administer, since he was not in a state camp and did not understand the seriousness of his disease.

Eventually, the boy was moved to Obrenovac Reception Centre and placed under child protection services. At this point, we were able to provide him with proper therapy. In collaboration with DRC doctors from the camp, he was monitored at the University Children’s Hospital in Tiršova, and his asthma therapy was adjusted. He is being carefully monitored by our team in the Obrenovac camp.

Surgical Emergency

30-year-old woman from Iran

A young woman was referred to RMF’s team by Miksalište Centre for Refugees (a platform that provides protection for refugees in Belgrade). They called us because the young woman had a fever of 39.7°C, nausea, and abdominal pain in the upper and right lower quadrant of her abdomen since that morning. She denied diarrhea, vomiting, and symptoms of urinary disease or pregnancy. She was completely examined by RMF’s mobile team and after negative urine and pregnancy tests, she was prescribed with antiemetic and anti-inflammatory drugs. After two hours, she was feeling much better, and we advised her to come tomorrow for another check-up.

The next day, the patient was experiencing the same symptoms, with slight deterioration. Her abdominal pain was getting worse, and she had one liquid stool that was without blood. She was taken to the general surgeon in the ER in order to exclude appendicitis. The general surgeon ordered an abdominal ultrasound, as well as CBC and urine sediment analysis. Although the tests came back negative, according to the Alvarado scoring system (6/10) and clinical presentation, appendicitis was a possible diagnosis. After an infectious diseases specialist was consulted, the general surgeon in the ER admitted the young woman to the surgery department. Later that evening, she underwent an appendectomy. The surgery went well, and the patient recovered fully.

Note: Due to privacy and safety concerns, many patients do not wish to have their photo taken.