Refugee medicine; A startling introduction.

The day before I started work for the boat refugee foundation we went on a trip around the beautiful Greek island of Lesvos (Lesbos). In the middle, in a forgotten corner there is a pile of life-jacket’s the size of a small hill. A testimony to the vast quantity of humanity that have come to this tiny Greek Island undertaking unimaginable journey’s. Each one represents a individual tragic story, most of these stories have stalled in the Moria refugee camp run by the Greek/EU authorities.

This is where I had come to volunteer my time and whatever skills I had that could be useful to this unique population of patients. Driven my a desire to break away from the norm of daily U.K medical practice I had swapped the English emergency department for a clinic operating out of a shipping container in a hot, dry and sweaty distant corner of Europe.

The presenting complaints were diverse, and there was frustratingly little we could do for a significant proportion of these patients. The viral respiratory illness which we treated with paracetamol, the long-standing muscular-skeletal problems usually the result of injuries from torture and violence sustained in war tour home countries or on route to Europe, exacerbated by sleeping on the hard floor, which we treated with paracetamol and unexplainable all-over body pain, which we treat with paracetamol.

What I was not prepared for is the sheer quantity and severity of mental health issues affecting the patients. From palpitations and panic attacks to semi-catatonic depression and PTSD; the mental scars that emerge after our patients arrive at a place of relative safety following a long and dangerous road are serious. Once you have heard their stories of why they have left their home countries and what then endured on route the toll it takes on the mind is not surprising.

Contrary to my ignorance and that of the media this crisis is not over, six more boats arrived on my first day here, leading the people sleeping on the hard ground in the open air. The solution to this overwhelming problem is complex and I certainty don’t have the answer. For now; the mantra is doing what we can with what we have.