Serbia: Refugee and Asylum Seeker Support
Target Population Increases: Q4 2017
March 01, 2018
Reporting Officer Marjan al Mahamid, with input from Coordinator of Global Programs N’Deane Helajzen and Program Manager Žarko Stanić, together with 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 fourth quarter of 2017, the number of refugees, asylum seekers, and migrants increased slightly in Serbia, with 4,273 counted on December 24, 2017. Of these, around 3,999 (94) were accommodated in one of five asylum centers or thirteen reception centers. Most are from Afghanistan (46), followed by nationals of Pakistan (21), Iran (12), Iraq (10), Syria (2), and other countries (9%).
At the end of September 2017, Serbia lifted its visa requirements for Iranian and Indian citizens. Due to the current situation in Iran, and because its citizens no longer require a visa to enter Serbia, the fourth quarter saw an increase of new arrivals from Iran, primarily entering by air.
According to UNHCR data in December 2017, 497 persons registered intention to seek asylum in Serbia. 55% were filed by adult men, 12% by adult women, and 33% were registered for children. Most asylum applications were filed by citizens of Iran (30), Pakistan (30), Afghanistan (18), or Iraq (12). In December, one person was awarded subsidiary protection, bringing the total number of positive first-instance decisions by the Asylum Office in 2017 to 14, of which 3 received refugee status and 11 subsidiary protection, in comparison to 2016, when 19 persons were granted refugee status and 23 subsidiary protection.
Serbia-Hungary Border According to UNHCR data in December 2017, 54 asylum seekers, mainly families from Afghanistan, Iraq, and Syria, were admitted into the “transit zones” of Hungary. 10 asylum seekers were camped at Horgoš and Kelebija border points awaiting admission to Hungary. Subotica Transit Centre sheltered 105 asylum seekers (including 36 unaccompanied or separated boys), while Sombor Transit Centre sheltered 132, mostly families from Afghanistan, Iraq, and Syria, as well as 17 unaccompanied or separated boys.
Health Cluster Meetings Attended
Conducted by the Ministry of Health and WHO
At the meetings, we assessed and discussed medical needs, priorities, and gaps for this winter and next year, as RMF Serbia continues to build the capacity of health systems to respond to the refugee and migrant situation. RMF has played a key role in developing, collecting, and disseminating knowledge, analysis, and evidence on progress and challenges, lessons learned, and recommendations, identifying best practices and innovative approaches to improve the health response.
Medical Transportation and Escort Services
Filling a Need
Transportation and escort services to secondary and tertiary care institutions continue to be a key challenge for the Ministry of Health; hence, RMF has been providing medical transportation and escort services in both Belgrade and Obrenovac from 7:00 AM to 11:00 PM, 7 days a week.
Provided transporation in 127 cases.
Primary Health Services
Adaševci and Obrenovac
Primary health care services are provided through the medical clinic in Adaševci Transit Centre in Šid, near the border with Croatia. The clinic is open from 8:00 AM to midnight, 7 days a week. RMF’s partnership with Médecins du Monde (MDM) allows for extended clinic operating hours. Medications to treat scabies and body lice continue to be procured, donated to, and used by the Commissariat for Refugees and Migration and the Ministry of Health for ongoing camp screening, treatment procedures, and health promotion sessions.
In Obrenovac Reception Centre, RMF provides primary healthcare services from 3:00 PM to 11:00 PM, 7 days a week. By providing a medical team consisting of two doctors, one cultural mediator/translator, and one driver, up to 60 consultations can be facilitated per shift, as well as referrals to secondary and tertiary care facilities.
Holistic Medical Care
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 of healthcare provision.
- RMF Serbia provided 3,735 health consultations to men, women, and children refugees and migrants in Belgrade and Obrenovac.
- RMF Serbia provided 3,324 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 127 cases.
RMF Serbia identified unaccompanied and separated refugee children (UASCs), who were referred to the Centre for Social Work.
During the reporting period, 1,100 hygiene kits for men, 550 dignity kits for women, and 250 packages for babies were procured, and a distribution system was devised to ensure fair and equal distribution.
RMF also provided assorted drugs and medical care, in addition to hygiene packs, dignity and safety kits, and children’s kits to support the response to refugees.
Good News in February
The design and procurement of RMF’s mobile dental clinic was further delayed by a 3-month wait for importation of the vehicle. During this reporting period, the tendering process was completed, with a local ambulance builder offering the most competitive quote and being awarded the contract. All medical equipment was also purchased, including the dental chair and associated components. The technical design drawings were completed by an architect and the vehicle importation finalized. The mobile dental clinic will commence work on the 16th of February 2018.
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
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Urgent Dental Care
An 18-year-old young man came to RMF’s clinic and asked us to treat his upper respiratory infection. During routine examination of the patient, RMF’s doctors discovered that in addition to viral rhinitis, the patient had a dental fistula that he was not aware of. Dental care is a user-pays system in Serbia, but RMF’s team was able send the patient to a state health center, where the patient received a fistulectomy and, unfortunately, a tooth extraction. Because of the poverty of the Serbian health system and its citizens, these kinds of dental infections usually go untreated, leading to chronic osteomyelitis, cellulitis, and facial abscesses. Additionally, tooth loss can cause irreversible physical and psychological damage, especially in young patients, whether they are coming from a refugee or domestic population. To prevent and quickly treat similar infections, RMF Serbia is preparing a mobile dental clinic, which will begin services in February 2018.
Ongoing Violence in Asylum Centers
Amending the Physical and Emotional Consequences
Crimes, including incidents of theft, brawls, and physical assaults among refugees, as well as attacks on police officers, are common in asylum shelters in Serbia, especially in all-male shelters such as Obrenovac Reception Centre, where RMF’s team is the leading healthcare provider for more than 600 refugees. Cramped spaces, constant noise, sleep deprivation, abuse of alcohol and drugs, as well as an uncertain future generate fear and aggression in which religious and ethnic differences are used as an excuse for violence. RMF is working to amend the physical and emotional consequences of the violence that is present in Obrenovac Reception Centre daily; however, without the support and understanding of the authorities and the entire community, problems will remain, and we will keep on treating symptoms instead of the cause. Psychosocial support and integration mechanisms would go far towards creating hope and diffusing tension among refugees and asylum seekers.
Respiratory Inflammation Triggers
Improving Quality of Life
The area of Obrenovac is considered to be polluted, with air, water, and earth pollutants coming from a nearby thermal power plant, causing an increase in the number of local residents suffering from respiratory tract infections and obstructive lung diseases like bronchitis and asthma. Since the reception center in Obrenovac was opened in April 2017, RMF’s team started noticing an increase in the number of refugees suffering from acute bronchitis, newly diagnosed asthma, and worsening of preexisting asthma. Patients have been treated mainly with inhaled bronchodilators and corticosteroids. With the constant supervision of RMF doctors and implementation of chronic preventive therapy for obstructive lung diseases, most the patients’ quality of life has improved.