In the western media the refugees are perceived as a seething homogeneous threatening mass. The longer I spend here, talking to the folk who have made this long journey from home, the more their individual, varied but universal tragic stories precipitate out. That being said, like departments and clinics around the world, we have a few typical cases.
There is a lot of viral illness spreading around the camp with some many people living in such close proximity. Most of our patients consider a fever to be an emergency regardless of other symptoms. These largely be given a once over and some paracetamol or , once in a while some, antibiotics. Hopefully this offers some reassurances.
Longstanding muscular-skeletal problems.
Scars from bullet wounds and bomb blasts have hardened over time, leading to many of our patients to have longstanding pain. This is very difficult for us to treat. We do have a physical therapy we can refer to, but the surgical cure most of these people are seeking is a long way away.
It is 35 degrees here at the moment; apart from leading to some very sweaty consultations in also leads to some pretty bad kidney stones. In additional at least half the camp seems to have some degree of reflux or gastritis. Some omeprazole comes in handy for short term relief.
Our younger patients are of course more vulnerable to this. With many have diarrhoea. Unfortunately the cure that the parents are seeking does not exist, but the WHO homemade ORS recipe is a cheap life-saver.
The physical scars are usually less of a problem that the mental ones. I was surprised (naively) about how much insight this population had into this. They turn up already fully aware that their panic attacks, nightmares and depression are secondary to the horrendous things they have seen. They are keen for medication and to see a psychiatrist. This is only available for the most severe of cases, hopefully the group therapy sessions that are available are helping these patients.
Tension run high with this amount of people in such a small , overcrowded space. This often spills out into violence. Depending on where the patient’s wound is it can be simple stitches or an urgent transfer to hospital.
Luckily, we don’t see too many true emergencies here. Hopefully for the other conditions we see the little we have access to provides some solace as they wait for their complex needs of sanctuary, psychological support and community to be properly addressed.