Serbia: Mobile Medical Clinic
Stationary Clinic Steps in to Continue Caring for Refugees: Q1 2019
June 01, 2019
Mirko Rudić, Dr. Dragana Marković, and the RMF Balkans Team
Summary of Activities
Since January 2016, RMF Balkans has been responding to the refugee crisis in Serbia by providing comprehensive protection and medical services to persons of concern. Our teams began by working 24/7 throughout the Belgrade city center, and when most refugees and migrants in the area were relocated to refugee camps, RMF Balkans and its medical services moved to the camps along with our patients.
Currently, our team of doctors, dentists, medical support workers, and cultural mediators/translators is working primarily at Obrenovac Reception and Transit Centre, the second largest refugee camp in Serbia, which is home to over 700 refugee boys and men.
RMF Balkans also provides interpretation and translation services to refugees at Obrenovac Reception and Transit Centre and in the Belgrade city center. In addition, we provide medical transportation and escort services to primary, secondary, and tertiary medical care facilities in both Belgrade and Obrenovac from 7:00 AM to 10:00 PM, seven days a week. During this reporting period, 139 people were referred to medical care facilities in Belgrade and Obrenovac.
RMF Balkans continued to build and maintain partnerships through the following activities:
- Continued to participate in monthly health cluster meetings in Belgrade, conducted by the Ministry of Health and supported by the World Health Organization and the heads of Serbian health centers. At the meetings, we assessed and discussed medical needs, priorities, and service gaps for this period as well as next year in an effort to build the capacity of health systems to respond to the refugee and migrant situation.
- Participated in weekly coordination meetings conducted in Obrenovac by the Commissariat for Refugees and Migration and supported by all organizations working at the Obrenovac Reception and Transit Centre: Save the Children, Center for Youth Integration, Caritas, Oxfam, Danish Refugee Council, SOS Children’s Villages, Ana and Vlade Divac Foundation, and International Organization for Migration.
- Participated in meetings with the Director of Obrenovac Health Centre as needed.
- Communicated with the Institute for Public Health through weekly reports.
During the first quarter of 2019, RMF Balkans faced technical challenges that affected the operations of our programs in the Balkans. Since February 4, 2019, RMF Balkans has been unable to use its Mobile Medical Clinic and Mobile Dental Clinic. The Asylum Resource Center (ARC) Project is also on standby until the challenges are resolved. Thanks to the Commissariat for Refugees and Migration, however, RMF Balkans was able to reinstate services at the stationary clinic in Obrenovac Reception and Transit Centre, where we continue to provide medical and cultural mediation services. We hope to resume our mobile clinics and other programs in the near future.
To The Rescue!
The Mobile Medical Clinic teams were forced to put services on hold in early February 2019 but were able to resume services at the stationary clinic in Obrenovac Reception and Transit Centre in March 2019.
By providing a medical team consisting of one to two doctors, one cultural mediator/translator, and two drivers, 20 to 40 health consultations can be facilitated per shift, as well as referrals to secondary and tertiary care facilities.
Because of technical challenges, the Mobile Medical Clinic teams ceased operations from February 4, 2019 to March 11, 2019. However, in January and March, RMF Balkans performed 1,878 health consultations in the Obrenovac camp and Belgrade city center. All of the beneficiaries were boys and men, most of whom were from Pakistan (48) and Afghanistan (43). Patients’ ages ranged from 18 to over 58 years old.
Variety of Conditions
During this reporting period, RMF doctors treated a total of 591 patients with acute upper respiratory tract infections, such as the common cold, pharyngitis, rhinitis, sinusitis, and tonsillitis. Our team also treated 111 beneficiaries with different types of wounds and insect bites. Due to poor hygiene and living conditions in the camps, 144 patients were treated for scabies and 176 for local skin infections.
RMF provides primary healthcare and emergency triage services at our Obrenovac Transit Centre mobile medical clinic from 3:00 PM to 10:00 PM, 5 days a week. The work is implemented by a medical team consisting of 1 to 2 doctors, 1 cultural mediator/translator, and 2 drivers. This ensures that emergency cases arriving at the clinic can immediately access referrals to secondary and tertiary care facilities. By providing primary healthcare services, referrals, and cultural mediation, RMF improves the wellbeing of refugees, migrants, and asylum seekers in Belgrade and Obrenovac.
- Improve the health status and overall wellbeing of refugees in Obrenovac Reception and Transit Centre and greater Belgrade.
- Provide medical and translation services to refugees and act as cultural mediators for them at public institutions in Serbia.
- Refer, transport, and escort refugees and asylum seekers to secondary and tertiary medical care facilities in Belgrade.
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Farid Khaksar is a 24-year-old from Afghanistan. The RMF Balkans team was taking a break in the office, drinking tea, while migrants were enjoying making a big snowman in front of the dormitory. Suddenly, the atmosphere completely changed. We heard a terrifying scream, and a minute later, three panicked men carried their friend into the RMF clinic with blood trailing behind them. It was clear that this was an emergency situation.
Farid had been attacked by three robbers, and while trying to defend himself, he was stabbed in the right arm. The attacker’s knife caused a very long and deep wound, and, based on the profuse bleeding, RMF clinicians assumed that one of his main arteries was injured. Slowly, Farid started to lose consciousness. The ambulance was called immediately, and doctors managed to stop the bleeding using first aid techniques. Less than an hour later, Farid was on the operation table in the ER. His brachial artery, brachial vein, and median nerve were totally severed. The doctors put forth all of their efforts in order to help him, but it was a very serious injury. Surgeons could not initially reconnect the median nerve, so Farid had to undergo a second operation a month later.
Farid knows that the damage was severe, and there is a major possibility he will never regain full use of his right hand. However, he has an enormous will to recover. For the last two months, he has been visiting a physiotherapist at the Obrenovac Health Centre every day, and it is evident that his condition is improving. Farid’s dream of becoming a tailor no longer seems unattainable, and the RMF team wishes him the best for his future.
Khan Dawod, a 27-year-old from Afghanistan, contacted RMF Balkans’ doctors due to a high temperature and muscle aches. During the first examination, in addition to the previously listed problems, he also had a sore throat. He started antibiotic therapy, but by his next visit, there was no improvement. He also mentioned that he felt chest pain when attempting to take a deep breath.
Despite the efforts of the RMF team, Khan’s condition continued to deteriorate. He underwent laboratory analyses and lung radiographs, which showed that he had severe pneumonia. He was examined by a lung disease specialist and began significantly more intensive therapy. Khan returns to our clinic every day to receive the treatment, and with the attention and care of the RMF team, his recovery is in progress.
Kakar Abdul Hannan
Kakar Abdul Hannan, a 25-year-old from Afghanistan, fell and broke his leg. His friends brought him to the RMF outpatient clinic due to the agonizing pain. With the rapid intervention of our team, Kakar was transported to the ER, and in the shortest possible time, all necessary diagnostics were performed. A left-foot radiography revealed a fracture in the left bone. The same day, he underwent surgery. During his time in hospital, Kakar received anticoagulants, analgesics, and antibiotics. In accordance with recommendations, an early rehabilitation program has been started. After five days, he returned to the camp, where his recovery was carefully observed on a daily basis.
For the next two months, our team visited Kakar every day, administering his treatment and taking care of him. Every medical control required by his orthopedic surgeon was performed without delay. Less than seven days ago, Kakar began daily rehabilitation under our supervision.
Masam Jan Swati
Masam Jan Swati is a 28-year-old from Pakistan. His friends brought him to the RMF clinic because of pain in the upper stomach. After taking anamnestic data and examining the patient, doctors first thought that he might have food poisoning and started treatment according to that diagnosis. He received an intravenous infusion with a couple of medications which should have improved his condition quickly. However, time was passing, and despite all efforts made by our staff, the patient’s condition was getting worse. The pain in his stomach was intensifying, his arterial pressure and body temperature were increasing, and he had vomited several times. After observing these symptoms, RMF doctors began to think that he could be suffering from atypical inflammation of the appendix.
Since the RMF clinic is not equipped for this type of condition, our doctors decided that the best choice would be to send Masam to the ER as soon as possible. This turned out to be the best solution, since diagnostic procedures conducted in the ER confirmed the diagnosis of our doctors: acute appendicitis. Because Masam was in such a serious condition, the surgeons had no other option but to operate immediately. The surgery was successful, and Masam is currently feeling much better. He returned to the Obrenovac camp, where he is slowly recovering and making plans to continue his journey to Western Europe.
Alusta Yousef is a 25-year-old young man from Palestine who arrived in Serbia at the end of 2018. He initially contacted the RMF outpatient clinic for insomnia and nightmares. RMF clinicians discovered that, less than a decade ago, Alusta was held in custody for seven years. During that time, he was tortured both physically and mentally. He was not given regular meals and was given food just three times a week, mainly bread. “The judicial system did not respect basic human rights. You may find yourself waiting for a judge for few hours or couple of years,” he said to the RMF Balkans team. The conditions in the prison and the separation from his family had profound consequences on Alusta’s physical and mental health, to the point where he declared that his life was not meaningful. He added that not having his wife by his side only magnified his despair.
A psychiatrist evaluated Alusta and taught him therapy techniques to help him calm down in moments of deep sorrow. Nevertheless, despite the teamwork of the doctors, translators, and psychologists, our fears for Alusta came true. He tried to hang himself. The quick reaction of his roommates saved his life. A detailed assessment was conducted both by the psychiatrist and the team of ER doctors. Fortunately, there were no injuries to his body or internal organs, and a competent physiatrist administered therapy for Alusta, who now visits the RMF clinic daily. The therapy seems to be benefiting him, as he has been seen sitting and chatting with his friends since beginning the treatment.