Serbia: Refugee and Asylum Seeker Support

Background
Serbia continues to face an increasing number of persons seeking international protection: since the beginning of the crisis 393,069 people were registered in Serbia. Persons seeking international protection mainly originate from “refugee producing countries” such as Syria, Afghanistan, Eritrea, Somalia, etc. Due to newly imposed border regulations based on nationality profiling only those refugees from Syria, Afghanistan and Iraq are currently permitted to cross the border at Miratovac and transit through Serbia, those refugees of other nationalities are stuck at the border regions unable to more forward in their journey, and unable to move backwards. The majority of asylum-seekers do not perceive Serbia as their final destination and continue their journey to developed EU countries before having formally submitted their asylum claim or their claim been adjudicated in final instance. However, if borders begin to close, as has been predicted this will inhibit refugees from continuing their journey. There may also be returns of refugees to Serbia under the principles of readmission. The impending winter may also force refugees and asylum seekers to seek shelter in Serbia. The number of refugees currently entering Serbia is around 4,000 per day, less than previous months due to nationality profiling, however such numbers are putting great strain on service provision and Government resources.
 
RMF is partnering with ADRA Serbia who has been responding to Europe’s refugee crisis since August 2015 by providing a comprehensive protection and assistance response.  This is done by promptly identifying and addressing acute humanitarian and protection needs. As a response to the gradually increasing influx of refugees and migrants, in parallel with continuing the work of the Asylum Info Center in November 2015 ADRA increased its presence at the border areas with the mobilization of protection response teams. The current work is focusing on the identification and referral of extremely vulnerable individuals for appropriate assistance and follow up by relevant institutions, including ensuring communication with service providers and state institutions through the engagement of interpreters. This work enhances the access of refugees and migrants to their basic rights by provision of material assistance (distribution of food, winterization items and NFIs), protection information including child protection, pragmatic information dissemination related to their onward journeys and basic, rapid psycho social support.  Further assistance is urgently required in the health sector such as the provision of basic medical care and health assistance.  The establishment and support to a free-of-charge protection telephone (hotline) for information dissemination purposes is another urgent need.
 
RMF and ADRA Serbia work in collaboration with Government of Serbia authorities to ensure that the appropriate Government bodies and agencies are supported in managing the efficient response to the refugee crisis.  We do not set up unsustainable parallel systems. Humanitarian needs are required at the main entry and exit points, as well as along the journey through the country (e.g. Preševo, Vranje, Bujanovac, Dimitrovgrad, Bosilegrad, Zaječar, Niš, Belgrade, Subotica, Šid) through comprehensive aid delivery mechanisms (storage and secondary distribution of F/NFIs to EVIs).
 
A comprehensive needs assessment of the asylum seeker population in transit through Serbia is currently facilitated in the protection and health sectors.  This assessment indicates that whilst the humanitarian space is relatively crowded particularly in Preševo, asylum seekers are still in need of the most basic assistance water, food, hygiene items and other NFIs such as clothes and winterization items, psycho-social support and healthcare. Many refugees have come from conflict zones where families and individuals have been exposed to extreme violence and loss. Loss of their family members, neighbors, homes and livelihoods.  Our current work primarily engages in the protection sector addressing the trauma they have experienced through triage, and support through escorting and referrals to relevant service providers who can provide adequate assistance in a timely manner.  Medical care is provided at border entry and exit points, one-stop centers and asylum reception centers by Government services and NGOs such as MSF and DRC. The coming winter has not affected the numbers or the flow of refugees as was originally anticipated.  In some border crossing areas such as Dimitrovgrad the temperatures can drop to minus 25 degrees.  This is predicted to result in increasing numbers of refugees entering and staying in Serbia placing pressure on health system resources.
 
RMF and ADRA Serbia aim to support the existing medical institutions with capacity to increase the scale and scope of the current response as well as accessing areas currently underserved due to the geographic difficulty of the terrain and length of the border particularly in the East of Serbia along the border with Bulgaria.
 
Our programmatic activities will address current gaps in the response in the areas of medical first aid, basic primary health services and an upscaling of the current psychosocial support program. Small teams of doctors will be mobilized at the border entry and exit points, and within reception and registration facilities throughout the country, to provide basic medical services, distribute medicines and provide referrals. These doctors will be mobilized from the Belgrade based Military Medical Academy (MMA). The MMA is a medical, educational and scientific-research institution with a commitment to responding to crisis through the deployment of its medical personnel to peacekeeping missions.  Through collaborating with the MMA this program would mobilize doctors with extensive experience in crisis situations (war surgery, treatment of injured and diseases in mass catastrophes and post-traumatic stress disorder) and provide them with the opportunity to support and respond to the crisis while building professional and personal capacity within the State institution. The MMA currently has medical teams mobilized to MONUSCO the United Nations Organization Stabilization Mission in the DR Congo and the European Union Training Mission Somalia, conducted in Uganda. Although further discussions will be facilitated between RMF, ADRA Serbia, the Commissariat for Refugees of Serbia, the Ministry of Health and the MMA directors it is envisaged that the medical teams will comprise of one medical doctor, one nurse, one pediatrician, one psychologist, interpreter/translators (for example Arabic, Urdu and Farsi) and an epidemiologist to cover the immediate medical needs of refugees and migrants. A team from the emergency department will be on call at night (possibly mobilized from the closest Hospital to the area the mobile teams are working within such as Vranje, Negotin and Zaječar). Depending upon the health needs of the refugees more doctors or other specializations may be mobilized. Medical assistance would include history, physical exams, diagnosis and provision of essential medications.  Minor injuries can be treated such as wounds resulting from climbing over fences which require dressings. Referrals and escorting will also be facilitated. The majority of health issues currently being treated are fatigue, wounds, injuries, hypothermia and respiratory infections. Medical supplies for treating these injuries, as well as syringes and needles should be procured[1].  The specificities for the procurement of necessary medical items required for the medical response teams needs further consultation.
 
There is the possibility that the MMA can mobilize an ambulance from which patients can be treated. Furthermore, having easily accessible transport will reduce wait times for more critical cases and can be easily mobilized to different areas along the refugee/migrant route depending on needs. That is key to an effective response in this crisis. The situation on the ground changes so quickly that any programs developed must be flexible and readily able to change and adapt to the new conditions. 
 
RMF and ADRA Serbia together with its Asylum Info Center program in Belgrade will provide gender and cross-cultural training for medical teams to ensure that medical staff engaged on the project have an understanding of the historical and current socio-political context in which the project beneficiaries are fleeing their countries and to ensure that medical interventions are facilitated in a culturally and gender sensitive way. These training materials are developed inline with Gender in Emergencies guidelines and published so that they are accessible to a range of other stakeholders involved in daily work with the refugee and migrant populations. In this way longer-term capacity building aiming to improve the knowledge and skills in responding to the populations needs can be developed.
 
Locations will be identified on a daily basis in coordination with other project partners, the Commissariat for Refugees in Serbia and the Ministry of Health, it is expected that these mobile clinics will operate at informal refugee gathering places along the borders of Serbia, in Belgrade and within the one-stop centers (ADRA is one of the very few organisations to have Government approval to operate within the centers) and the five Asylum Centers. For example, at the entry point on the border with the Former Yugoslav Republic of Macedonia, in the village of Miratovac a Refugee Aid Point was established while a One Stop Center is located a couple of kilometers further in Presevo. For the exit points in the North, support to refugees is provided at the Refugee Aid Point in Kanjiza (Staro Vasariste) and in Sid/Bapska.  A mobile medical clinic is needed for the Reception Centre in Principovac.
 
The mobile clinic together with its team members will collaborate with another ADRA program focusing on Women’s Protection and Empowerment.  A program of similar scope that addresses the specific gendered needs in the crisis. 
 
The program will be monitored on an ongoing basis by the project manager to ensure that the response best meets the needs of the project beneficiaries.