Serious violations of human rights and access to healthcare for new arrivals of asylum seekers on Lesvos island in 2021
During 2021, Greek and foreign human rights organisations witnessed severe violations of asylum seekers’ rights in the field of healthcare, even though civil society has repeatedly urged EU and Greek authorities to ensure a dignified and appropriate response for the prevention and control of the COVID-19 outbreak, including the cooperation with the foreigner communities on the Greek islands. There have also been recordings of a systemic detention of new arrivals under the pretext of preventative quarantine at the ‘Megala Therma’ site on the North Coast of Lesvos.
Since 2020 “Doctors without Borders (Medecins sans Frontiers -MSF), who provide medical and humanitarian assistance on Lesvos since 2015 and nowadays a patient-centred medical and psychosocial care for survivors of torture, violence and ill treatment, integrated mental health services for children and adults and sexual and reproductive health activities for women, conducted a rapid assessment of the Megala Therma site and identified multiple inadequacies in terms of shelter, water, hygiene and sanitation. This includes the complete lack of infection control and prevention measures that render the site inappropriate for quarantine and protection of the health of the population. Since January 2021, more than 400 men, women and children have been exposed to risk and forced to stay in degrading conditions. The area is divided in 12 separate cohorts with 3-6 family tents per cohort. Depending on the number of arrivals, the site cohorts can reach severe overcrowding that does not allow for preventative measures and physical distancing and fails to meet basic infection control and prevention (IPC).
All new arrivals confined at the ‘quarantine’ site of ‘Megala Therma’ are subject to rapid antigen testing one, two or maybe more days after arrival by the National Public Health Organization (EODY). Once rapid antigen testing indicates a positive case, the person is confined with the people from the same boat, even if they have been tested negative for COVID-19. Although ECDC has clearly indicated that probable or confirmed COVID-19 cases, not requiring hospitalization, should be isolated or separated from others, in the premises this recommendation has been systematically violated at ‘Megala Therma’ site.
The application of mass quarantine increases the risk of further transmission within the quarantined community, while there is no evidence that mass quarantine protects the general population more aside from conventional preventative measures. Nobody among newly arrived has access to healthcare upon arrival. Subsequently, persons with COVID-19-like symptoms are not promptly identified, isolated and monitored, while persons with underlying conditions are not protected. Positive and negative cases are confined in the same cohort in tents that often exceed the recommended 4 people per tent, sharing the same water and sanitation facilities. Although rapid antigen tests can indicate possible transmission within the community and allows for swift mass surveillance for COVID-19, it is not as accurate as the RT-PCR.
The European Center for Disease Control (ECDC) has recommended that either repeated antigen tests are conducted, provided that viral loads fall into the sensitivity range of the tests, or testing by RT-PCR7 should be conducted. Current practice at the quarantine site of Megala Therma suggests that rapid antigen testing is merely conducted for surveillance purposes rather than ensuring an adequate outbreak control on site. There is no permanent presence of the public health authority, EODY or other health actors in the camp. The site is located in a remote location, approx. 50 km away from the secondary health care facility in Mytilene. In case of emergency, it is left to the police to call the ambulance, thus increasing the risk of either underestimating the risk or overestimating the need for emergency care. There is no provision of psychosocial support on site despite the high prevalence of mental health conditions related to trauma in migration settings. New arrivals often see a doctor only when MSF visits the site which can be a week later depending on the date of arrival.
Two UNHCR field officers and one member of staff from the Reception and Identification Service are permanently present during morning hours. Three meals and potable water are provided and distributed once per day by the UNHCR field officer. Severe deprivations exist with regards to access to other essential services such as provision of non-food items and especially clothes.
MSF have witnessed hundreds of men, women and children including pregnant women, unaccompanied minors, torture survivors, victims of severe violence including pushbacks and persons with serious medical or mental health conditions, being detained without access to the registration of their asylum claims. According to MSF, despite a brief information session upon arrival conducted with the use of translators from within the community, none of the people confined on site, have any access to information related to their rights as asylum seekers. Finally, none of the residents of the site has access to legal assistance or information of their right to legal aid.