The trauma of stranded refugees

“I cannot answer how I feel when after four months of waiting, the only solution they can offer is to give you a bigger tent, when they forget your name and call you by the number of your tent.” Doctors Without Borders (Medecins Sans Frontieres, MSF) program director Apostolos Veizis received this message from a refugee living at the camp in Vasilika, Thessaloniki last July.The message was signed 2B5.

Since then, little has changed. In some mainland camps tents have been replaced with container-type structures – such as at Malakasa two weeks ago – while small groups of vulnerable populations have been transferred to hotels until the cold winter weather subsides. The majority of refugees on the mainland, however, remain gripped by the inertia of everyday life and uncertainty about their future. The conditions either cause or exacerbate certain anxiety disorders, depression and psychological trauma.

“We produce pathology, we induce pathology,” says psychologist Nikos Gionakis referring to the living conditions of these people. As scientific director of the Babel Day Center for the mental health of immigrants which in recent years has been involved in the training of police, port authorities and NGO staff who work with refugees and migrants.

As he points out, even today there is no organized state monitoring plan and many interventions are fragmentary. The picture is not uniform across all refugee centers, the benefits and needs vary, and the population composition differs from one place to the next. However, the issue of the impact of their predicament on their mental health goes largely unnoticed.

The data

Indicatively, from information garnered by Kathimerini, at three camps in Epirus, out of a population of 900 people, 68 are currently undergoing psychological counseling by staff from Doctors Without Borders. Of these, 18 have been put on medication. In exceptional cases, particularly in accommodation close to or within Attica, refugees are referred to the Athens Psychiatric Hospital (APH).

Since June, 20 patients have been seen by the APH’s emergency department, of whom four were hospitalized. Most referrals were made from the Elliniko hot spot (4) and Skaramangas (4).

Meanwhile, MSF psychologist Christina Sideris offers support to refugees and migrants at the Malakasa camp. Some exhibit depressive symptoms, either waking up too early or having difficulty staying awake, often crying and suffering from intense anxiety. Child refugees have more acute reactions to stress, occasionally showing aggressive tendencies toward their peers, separation anxiety disorder, or bed wetting. Among the 474 refugees and migrants who received psychological support from MSF this year at camps in northern Greece and on Lesvos, 22.31 percent had depressive symptoms.

“Most people I see are parents. They feel they have a huge responsibility toward their children. One mother told me, ‘I’ve imprisoned them here and they are losing days of their lives,’” says Sideris. “What we are experiencing is a completely expected reaction to their living conditions. If they had some prospects, they could be organized. What they fear most of all, however, is that this pause in their lives will be forever.”

Feeling trapped

In Malakasa, the population is almost exclusively from Afghanistan. The fact that people of that nationality are not included in the European Union relocation program which sees refugees settled in other member-states increases the feeling of being trapped. “When you have no power over your own life and you have nothing to do, you have a lot of time to think about negative things and lose hope. The Afghans especially feel completely abandoned,” says Clement Perrin, head of the MSF mission in Greece.

His colleague Loic Jaeger has previously worked in Syria and Ukraine on missions that provided psychological support. “It is unacceptable that in Greece we are having to help these people overcome the trauma caused by their living conditions and not the trauma from the war,” he says. A woman from Malakasa who attends the clinic has expressed suicidal thoughts. Other refugees have had thoughts of taking their own lives too.
MSF psychologist Danae Vaya met one woman with severe post-traumatic stress disorder. Her husband had stayed in Syria and she was in accommodation in Attica with six of her seven children. The seventh, a minor, had managed to get to Germany. The woman was suffering from severe phobias and emotional detachment. She spent most of the day in bed, feeling afraid and crying.

“They came here thinking Greece would be a short stop and now the prolonged accumulation of acute fatigue is becoming apparent,” says Vaya. “The trauma of these people is chronic, and requires a very safe environment for them to begin healing.”