Serbia: Refugee and Asylum Seeker Support
Outreach Mobile Medical Team Operating 24 Hours, 7 Days a Week: Q1 2017
June 18, 2017
Reporting Officer Marjan al Mahamid
Summary of Activities
RMF Serbia’s team continued to provide holistic medical care and support to persons of concern:
- RMF’s mobile medical clinic arrived from Germany and was released by Serbian customs in February 2017. After a period of preparation, which involved the development of protocols and fully stocking medical supplies within the clinic, we commenced operations in the mobile medical clinic in March 2017. The mobile clinic helped strengthen our response to the acute emergencies in the area of “the Barracks” behind the main Belgrade bus station, providing a climate-controlled (safer in winter months), versatile space from which our frontline medical workers and cultural mediators and translators can provide primary healthcare services.
- In February 2017, RMF began operating the medical clinic in Adaševci. We provide health care at the clinic from 4:00 PM to midnight, 7 days a week.
- 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 and provision of health care.
- RMF Serbia provided 3,103 health consultations to men, women, and children refugees and migrants in the Belgrade city center.
- RMF Serbia provided 2,836 health consultations to men, women, and children refugees and migrants in Adaševci Transit Centre in Western Serbia.
- RMF Serbia continued to provide medical services, interpretation, translation and cultural mediation, escorting, and transportation to secondary medical and other facilities in 89 cases.
- RMF Serbia identified unaccompanied and separated refugee children (UASCs), who were referred to the Centre for Social Work in 25 cases.
- RMF provided assorted drugs and medical care, as well as hygiene packs, safety kits, and children’s kits to support the response to refugees.
Mobile Medical Team
Around the Clock Care
The first morbidity report for 2017 covers a period of three months, from January 1st to March 31st. During this period, the outreach mobile medical team was operating 24 hours a day, 7 days a week. The medical clinic in Adaševci is operating from 4:00 PM to midnight, 7 days a week, and the period covered is from the 1st of February to the 31st of March. (RMF began providing medical care at Adaševci on February 1st, 2017.)
Over the period of three months, with an average daily OPD of 67 patients, RMF provided a total of 5,939 health consultations to men, women, and children in Belgrade and Adaševci.
86% Sheltered in Facilities
The first quarter of 2017 saw an influx of unaccompanied and separated refugee children (UASC) from Afghanistan and Pakistan, as well as high numbers of pushbacks from the Hungarian border into Serbia. The overall number of refugees, asylum seekers, and migrants counted in Serbia averaged around 7,800, with 6,700 (86%) being sheltered in 17 heated government facilities. The others were sleeping rough (homeless) in the Belgrade city center, northern Serbia (near the Hungarian border), and western Serbia (near the border with Croatia).
Health Coordination Task Force
During the first quarter of 2017, RMF Serbia maintained its support by cooperating with other humanitarian actors (UN agencies, NGOs, and civil societies) involved in emergency and crisis preparedness at the national and sub-national levels. In particular, RMF Serbia revitalized and supported the health coordination task force in “the Barracks” behind Belgrade’s main bus station to respond to acute emergencies.
RMF participated in monthly health cluster meetings conducted in Belgrade by the Ministry of Health and supported by the World Health Organization. The coordination meetings aim to improve the coordination of emergency health responses throughout the country. While it can be said that these coordination meetings require more targeted facilitation, they have been beneficial in acting as a platform for RMF to raise awareness of our current work. The meetings aim to support joint rapid health assessments, identify current health service provision gaps, and support the development of joint strategies to effectively respond to the current health crises among the refugee and migrant population in Serbia.
Needed Care for Refugees
A total of 3,103 men, women, and children were examined and received primary, secondary, or tertiary healthcare services in Belgrade. A total of 2,836 men, women, and children were examined and treated at the medical clinic within Adaševci Transit Centre.
The most common diagnoses during this quarter:
- common cold
- low back pain
- sprains and strains
Refugees Face Violence
Construction of Hungary’s new detention camps and a second electrified fence, which stretches 108 miles along its border with Serbia, are now underway despite virulent opposition from the UN, human rights groups, and* a European Court of Human Rights ruling*, which many hoped might halt the country’s determination to imprison refugees.
Many refugees face violence along the Hungarian border; humanitarian organizations say the treatment has become a feature of Hungary’s policy toward refugees, with warnings from the United Nations falling on deaf ears of the country’s government. Lydia Gall, Balkans and Eastern Europe researcher for the Human Rights Watch, said they have received numerous reports of police taking selfies with abused migrants and filming them, compounding the beatings with humiliation.
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
Male Patient: Beaten
Violence among Refugees
After the closure of the Western Balkan route, refugee camps in Serbia are counting, every month, a higher number of refugees spending a longer time in Serbia or looking at an indefinite stay. Due to the lack of integration programs and psychosocial support in the camps, refugees are left alone to struggle with life in isolation and uncertainty. We are faced every day with a high number of violence reports, which are a reflection of the poor living conditions that refugees are forced to endure.
A male patient came to us during the night, between the 30th and 31th of March. He told us that he was beaten by three unknown men inside the camp. Local findings included deformity of the bones of the face, especially the nasal bone. He also had blood contusions around his nose and eyes. We took him to the ER, where he was examined, and head scans and an x-ray of the facial bones were performed. He was diagnosed with multiple fractures of the nose, which required an operation. We requested support to relocate the patient to another camp due to protection concerns.
Note: Due to privacy and safety concerns, many patients do not wish to have their photo taken.
9-month-old Boy: Bacterial Pneumonia
Holistic Care for Baby and Family
A 9-month-old boy was referred to RMF doctors by the medical team working in a state-run refugee camp. The boy had presented with a fever, cough, and trouble breathing for more than a month. On various occasions, the infant was treated in the camp with oral antibiotics, but they had no effect. Over a period of three days, the boy’s symptoms became worse, and doctors from the camp requested support from our team. After examination and assessment, our team escorted the boy and his mother directly to the University Children’s Hospital in Belgrade. There, he was diagnosed with bacterial pneumonia and was immediately admitted to the hospital. Doctors also noted that the infant was neurologically underdeveloped for his age.
According to hospital regulations in Serbia, the mother should stay in the hospital with her child. As she was a single mother traveling with two children, it was a challenge to provide facilities and accommodation for the second, healthy child.
The mother reported that her older son was being molested by the other family that they share space with in the camp. RMF’s team reported the incident to Serbian Social Services. We also provided provide diapers for the infant. After two weeks, he was discharged, full recovered. The family was transferred back to the camp. RMF provided a comprehensive report regarding the case to the camp officials, who were advised to call RMF in case the boy’s medical condition deteriorated.
18-year-old Boy: Hand Wound
In Belgrade city center, there are a number of young refugee boys who play their favorite sport: cricket. Our mobile medical team has treated a number of sports injuries. In this case, an 18-year-old boy from Afghanistan was playing cricket and fell on his right hand.
On examination, the wound was clean. However, it was three centimeters long, two centimeters wide, and one centimeter deep. Because of the wound’s depth, he was taken to the ER, where he received an anti-tetanus shot, antibiotics, and stitches.
16-year-old Boy: Severe Frostbite
Extreme Cold and Exposure
In January and February of 2017, the weather and living conditions for refugees and migrants in Serbia were extremely hard. This was due to the low temperatures, sometimes as low as -16°C, and our beneficiaries’ ongoing exposure to the cold weather. During January, refugees and migrants in the Belgrade city center suffered severe forms of frostbite. Below is just one example of our cases:
A 16-year-old boy from Algeria was diagnosed by RMF’s team with frostbite on his right index finger. Due to the clinical appearance of second to third-degree frostbite, he was taken directly to the Clinic for Plastic Surgery at the Clinical Center of Serbia. In the clinic, the wound was cleaned, and ongoing dressings and follow-up indicated. We followed up with the patient for a month. Due to his age, situation of traveling alone, and fear of possible surgery to his finger, he did not comply with the prescribed wound dressing and other therapy, which resulted in deterioration of his condition.
The case was further compounded by the boy’s unresolved legal status in the country, which meant that hospitals refused to treat him. These factors led to further necrosis of the finger.
In February, it was assessed again, and decided that his finger required amputation. We feared that he could lose his whole hand. Surgery was scheduled and the amputation performed mid February.
16-year-old Boy: Abscess
At the end of March, we were engaged in treating many cases of skin infection, due to poor hygiene conditions in the informal, self-organized refugee camp “the Barracks.” One such case is of a 16-year-old boy who was bitten by a mosquito on the lower left leg. Despite antibiotic therapy, the bite developed into an abscess.
RMF provided referral services to a clinic, where incision and drainage of the abscess were performed. We provided daily wound dressing and therapy, and he made a full recovery.