Friday, January 15, 2016

Last day

Samos - January 11, 2016

My last day in Samos was bittersweet. I was feeling the pull to return home to my family but also the urge to stay and do whatever I could to relieve the suffering I saw.

The clinic does not open until 2pm and no new arrivals had journeyed over and therefor no extra help was needed at the camp.  Linea and I took a tour around the island to explore and find our bearings.  It was educational to see where we are, where Turkey is (just across a small expanse of water on one end, and quite far on the other), and understand how and why it is so difficult to assist people who land on Samos.  The north end of the island is vast and comprises of rocky beaches next to steep cliffs and paths.  Unless a boat arrives in the daytime and is clearly visible it would be difficult to know anyone is there on many of the beaches.  The far northeast corner did not have accessible roads to explore and consists of a peninsula - another barrier to easy visibility and rescue.

When the clinic opened people started trickling in and was in full swing by 5pm.  It was not as busy as the day before, but it seems the conditions being treated were more serious and time consuming. Once again the need for my services was clear:  the woman who miscarried 3 days before in a tent in Turkey,  infections, prenatal exams, lots of kisses given in thanks...I gave one woman who was due a safe birth kit in case she was en route to her next destination when she goes into labor.  I shudder to think of what she will experience and hope she will at least be in a place where a medical facility is available.  It is more frustrating because I will never know what happens.

At least everyone was dry.  It was also a night a ferry was leaving for Athens so there was excitement in the air as everyone was wishing those on their way safe travels and patiently awaited their turn.

The stark difference between the day before - cold, wet, hungry, traumatized, exhausted.  And today - dry, fed, restful, and determined was amazing. It was an entirely different camp.  The sun was shining, the air was crisp, children were playing with whatever they could find - it seemed more of a community than an encampment.  As night fell a group of men circled up and started dancing and singing and after a game of football and lots of laughing and cheering.

What did I learn on this trip?  That we are all one people.  The culture differences were not nearly as stark as I had been expecting and we are more similar than different.  That people are strong.  That people are soft and love is universal.  That those fleeing and those helping both have much to offer.

I leave this blog with my favorite memory of that day, and possibly of my whole trip.  I think because it was a memory of hope and happiness.  One couple arrived to the clinic with complaints from the wife that probably was a urinary tract infection.  In speaking with them they told me they were just married and left Syria the next day after their wedding.  After more history was taken I ran some tests and we discovered she is carrying their first child.  It was a moment of rejoicing and then of course the disbelief as they tried to imagine a new life and all the changes it would bring - something I remember well from my own experiences.  It is a wondrous circle and I wish this child a life of peace and joy knowing his/her parents are doing their best to ensure just that.  To Life!  Insha'Allah!

Sunday, January 10, 2016

Samos Day 2

Samos Day 2 - January 10, 2016

We arrived at the port at 11am to head to the screening center camp to do assessments when we were met with an influx of arrivals.  It was pouring rain and the Swedish Coast Guard was ferrying passengers in via their rescue boat.  We had reports of dozens who spent time in the water but most were soaked through due to the rain.  By days end almost 900 refugees had come to the camp and several hundred more were brought to the screening center camp.  It was a long and exhausting day for everyone.

As soon as we arrived we went straight to work passing out ponchos and electrolyte drinks.  Children and babies who were not breastfed were provided with formula or milk.  Hot tea was made and passed out and assistance given to whoever we could.  It was a difficult task for all of us but what was most intriguing for me was the lack of titles or care for which NGO would do what, there was none of the  political posturing I have seen so much of lately but which seems to disappear when a crisis really hits.

After everyone was as settled as they could be, and before more boats arrived, we did manage to get to the screening center.  Like Moria camp it was a detention center prior to this use.  It is supposed to house 300 but often over 1000 are crammed into the accommodations.  It used to have running water and toilet facilities but that was broken during the height of summer and it is more to provide shelter than anything else.  Many people opt to sleep in tents on the tree lined hillside instead of inside. Children were running up and down the hill but surrounded by high walls and barbed wire it was not inviting.  Trash was piled everywhere and it was clearly a place only for those who had no where else to go.  The average stay there was approximately 1 week but sometimes longer.

I did find out that those assigned there were still ferried to Athens and then they would be either allowed to travel forward or sent back to their home country.  It is unlikely that any make it further than Athens since the rules have gotten stricter.

We did reach out immediately when we arrived and triaged and treated the best we could,  but we did not open the clinic at 2pm and the queue started immediately (Praxis was open all day so we did not need to have another clinic at the time).  Like the day before we saw just about everything but today we had several cases of mild hypothermia to add to the mix.  Lots of sick babies and even an injury to a  girl who fell when getting out of the boat and landed her hand directly on a sea urchin.  I turned the storage room into another clinic room and just started in with the women and saw children when I had the time.   By the time we were able to leave we were all exhausted, more so because the language barrier adds to the work load.  Thank goodness Linnea, the Danish nurse, speaks some Arabic.  I took her under my wing for a bit to teach her some skills  she will no doubt use while here. Another issue that came up for me personally is that the medication has European names and many were in Greek.  It took me a while to figure out the most common I ended up needing and slowed me down when I had to ask for something because I could not find it.  By days end I had lost count of how many people I personally saw and treated.

The man with two broken legs which were filled with shrapnel due to bombs in Syria.  How he made the journey this far astounds me still.

The young pregnant woman who came in to have her baby checked and when I told her the baby sounded perfect she asked if I could tell her if it was a boy or a girl.  We all laughed when I said “One or the other.” It was lovely for me to have such sweetness during this heart wrenching day.

The woman who had spent 8 hours in her boat making the crossing and was so cold she could barely walk.  She fell into the water just as the Coast Guard was arriving due to the winds tipping the boat.  She was with her 5 month old grandson (who was fine).  When she left the clinic hours later she was warm and dry and kissed me hard on the cheek in thanks.

Making hard decisions on who we could see and who could wait until the morning clinic opened.  We did see all children and elderly and most men and women, but some of the mild concerns we needed to ask them to come back or go to Praxis in the morning.  It was not easy to do but we just could not see everyone and were assured all acute issues were dealt with.

The volunteer who came running in because he was concerned about a 10 year old child in the big tent.  I ran in to assess and the child was exhausted and traumatized.  He had been asleep but awoken vomiting and could barely stand.  When he stiffened and his eyes rolled back I had someone carry him quickly to the clinic.  He was physically fine but soaking wet and we could never determine his medical history (due to translators being elsewhere at the time).  I am hopeful the dry clothes we put on him and the hot food we gave him then sent him back to sleep were all he really needed.  But what he has been through at his age breaks my heart and when I think of my own children it is almost too much to bare.


Samos Day 1 - January 9, 2016

I took the first part of the morning to get the lay of the land and getting organized – renting a car, arranging lodging for the rest of my stay, and finding the camp.  When I arrived the clinic was not yet open and people were starting to arrive after arriving on the boats last night and form queues.

I am still a bit confused about the process but it sounds like once a boat has landed and help can get to them, MSF runs a big bus that will then take them to one of two camps depending on their nationality. The clinic I will work at is at the port and houses Syrian, Iraq, and Afghan refugees.  Due to the weather lately few families were there.  There were some boats that crossed in the night and early morning and by the day’s end about 300 people were present.

It gets more confusing because some families do not sleep in the camps but find more comfortable lodgings in a hotel.

There is also another camp, the screening center, that houses everyone else (non Syrians, Iraqis and Afghanis).  There is an estimated 1000 people there and I am getting conflicting responses as to how long they have been there and how long they will stay.  The process for those not considered refugees but are designated are migrants has varied from each island I am will be interested to know what will happen.  No doubt they will be sent back to their home country but how and when is a mystery.

To further complicate the situation on Samos is the lack of a clear place where the boats land.  Turkey is very close but the nearest point is a peninsula of land with no roads and is impossible to post a lookout at all points.  They often will also land on the north side of the island – anywhere the current and the small motors can carry them – but this is too large of an area to monitor and the beaches are often down steep trails and cliffs.  The Swedish Coast Guard is monitoring the waters but they can’t be everywhere at once.  This means people may land and no one will know they are there for hours and then it takes time for help to arrive.

I met one family who has been traveling for over 3 weeks from Syria.  The husband was a nurse and he, his parents, his wife and their two young children have journeyed and were very tired, walking for days at a time.  The boat ride in last night was cold, wet, and terrifying and they spent the night on a rocky hillside in the wind  until help arrived this morning.  To make matters worse, the terrain they had to traverse was steep and rocky, difficult for the young and spry but almost impossible for the frail and elderly.  His mother fell twice and hurt her back and knee.  By the time they made it into the clinic her knee was twice as big as her healthy one and she could not walk at all.  Pain medication was given and x-rays were recommended at the nearest hospital but they were too tired to consider that just now. Not once did she complain  about her pain or the little we could do for her and instead she was grateful for our care and bestowed us with blessings.
They had not showered or washed at all in that 3 week time and though it was more than they could comfortably afford they spent the $90 for a hotel for their family to shower and rest.  When speaking with the young father his  daughter came up to me and hugged me tight – at first glance.  She must have been 5 years old and her trust and heart filled with such love filled me with joy.  They allowed me a photograph of them but I will not post it here to protect their privacy.  His brother is in Sweden and that is where they hope to arrive soon – but Sweden is currently making it more difficult for refugees seeking asylum  and having family already there is not a guarantee.  I wish them all the best and will always wonder how they fared.

Since the camp is so small compared to most the volunteers are trying to offer respite in any way they can.  Just this past week they borrowed a screen and started screening nightly movies  in the clinic waiting area - tonight was Pink Panther cartoons and Mr. Bean – movies that entertain and need no language to understand.  What a treat to see such happy faces on the children and adults alike and to give the parents a chance to rest.

At the peak last summer Samos averaged over 1000 refugees/day, its biggest day 2500.  Today approximately 200 people arrived, but that total isn’t clear.  The port police keep different statistics from the other police and we do not know how many arrived in totality for both camps.  For now, though, it is considered quiet and manageable.  I can’t imagine what it is like in the summer when the seas are calmer and more people are entering.

The clinic is staffed by an RN from France with  Women and Health Alliance International (WAHA) and an MD from the Hellenic CDC who are kept busy from 2pm-9pm, often later.  They open then because that is when people arrive from the screening center. Today a volunteer nurse from Denmark joined them for 2 weeks and I pitched in as well.  It was fortunate she was there because even though she is not an interpreter she does speak some Arabic and was able to help with communication.
We saw everything from respiratory illnesses to infected feet.  Lots of sick children and babies and I  managed to do some women’s health and prenatal care as well which excited the MD who tirelessly staffs the clinic as I brought my equipment, personal pharmacy, and expertise.  It was very rewarding and humbling – but the team was fun as well and we had a good time doing it.  In addition the clinic has some supplies to offer families in need: wheelchairs (which they give to the person who needs it to take with them), socks, gloves, children’s coats to name a few.

Linea, Laureli, Manos

I was also called in to help with fitting baby carriers.  Unfortunately the only carriers available were the tie kind which I was able to help put on the mothers and fathers and demonstrate on another volunteer.  The families looked at me with pleading eyes and will no doubt do their best when it is their turn to put them on and somehow make them work, but they are too complicated to learn quickly and not practical.  We even provided a card with illustrations to assist but it was more than they could manage.  I will make a plea to Carry the Future to get some user friendly carriers to Samos as soon as possible.

The 13 year old with feet so swollen and raw it hurt to look at them,  I actually almost cried when he took off his socks. He did not complain when walking, though he did hobble.  His family had been traveling for almost 4 weeks and his feet started hurting 10 days ago.  This was common due to the continuous wet conditions and sometimes with ill fitting shoes as well.  He was provided with dry shoes and socks as well as medication and instructions to keep his feet open to the air – but that will not be possible other than his time here. And given how cold it is right now doubtful he can manage for long when not traveling.

The young pregnant woman with a sick 2 year old, so hungry and tired.  She had not eaten in 2 days when she arrived at the camp and then only had a few biscuits.  Soup was to be served later that night and that would be her meal for the day. Her husband was not with her and there was no interpreter to ask where he was or if he was even alive.

Countless children without shoes and many without coats.  The volunteer distribution center was doing their best but they ran out early and would not get more until late at night for the next day. And it was cold out – too cold for young children to be barefoot which did not help them stay healthy.  Tired, cold, often in cramped quarters with no way to wash or protect themselves from illness.

Friday, January 8, 2016

Leaving Lesvos

Leaving Lesvos January 8, 2016

Night nor storm deterred one boat of 22 souls from making the crossing.  They arrived late during the train and thunder and other than mild hypothermia and fear, all were fine.  I was not there for that landing but in the morning when the seas had calmed  boats started coming.  Just as one arrived another was coming into our vision. It was heartbreaking and exhilarating at the same time.  The joy on their faces when making landfall yet the realization their journey was not near the end.

Word had gotten out to the medical groups and other volunteers that Lighthouse had midwives, “women doctors,” and pregnant women with any concerns were brought to the clinic before Shea and I were even aware. Fortunately everyone was fine, even those with complaints. I had to leave early to get back to Mytilini to catch my ferry to Samos, but at last repot Shea was busy all day as 10 boats arrived and when not in the clinic she was staffing the women’s tent and helping them to find dry clothes.

Without a doubt our presence will make a difference and Midwife Pilgrim will do our best to keep Lighthouse staffed with our midwives.  For now Shea will be on call for any needs in addition to her scheduled shifts.  I am grateful for her service and her 3 remaining weeks there.

After the refugees arrive they are quickly triaged and those with medical needs are brought to the clinic.  Everyone else is brought to the tents to warm by the fire, have hot tea, and change into dry clothes.  As son as they are ready (and if the UNHCR is there with their smaller buses) hey are bused several miles up a steep hill to another landing where a larger bus will take them to Moria for registration and to stay until they can leave.  If they land in the night they are given blankets and a place to sleep until morning.

Now off to Samos.  I have no idea what to expect when I arrive and will spend the next three days getting the lay of the land and discussing with the main medical team there ways we can support them. I have heard they are very busy and need more help. I hope I can lessen their burden a bit while I am on the island.

Approaching the shore of Skala as his boat arrived a man jumped up and out of the boat into the water shouting with joy.  Everyone in the overcrowded boat cheered and so did all of us on the rocky beach.

After they land the boats are taken apart and popped.  The noise is very loud bang and echoes throughout.  One woman in the queu for dry clothes started shaking and crying.  She was from Syria and showed me her scars fron a bomb that destroyed her home and killed her brother.

The cold and shaking children too tired to even cry.

The family with two young children that was finally together after getting off the boat and just held each other for a long, quiet time.

Thursday, January 7, 2016

Lesvos: Skala Sykimineas

Lesvos January 6-7, 2016

Skala Sykmineas

Skala Sykmineas is at the north end of the island one hour from Moria.  Like the rest of Lesvos the landscape is dotted with olive trees and rocky hills looking over the ocean. Turkey is on the horizon.  It is a quaint town with lots of cafes in the port but is known lately for the number of refugees that arrive on its shores.

Just yesterday, while I was at Moria four boats landed in quick succession at Skala, but  the seas are clear.  There are many rumors as to why.  The waters are choppy making passage more dangerous, but that often does not stop the smugglers from putting people in their flimsy boats, in fact, they charge less during bad weather to further tempt those who have so little already and just want a better life.  Yesterday 21 people drowned trying to cross and were found on the Turkish beaches.  Some say the decreased boats today (only one this morning on the southern side of the coast) are due to the fallout and political pressure and increased Turkish Coast Guard surveillance.  Whatever the reason, today is a slow day and tomorrow promises rain and possibly thunderstorms.

When a boat arrives there are throngs of people to help them disembark and find their way to warmth and a change of clothes.  Sometimes there are more helpers than refugees and there have been complaints of how chaotic and inefficient it is when everyone gets in everyone else’s way.  Sometimes no one is around except a passerby, which happened to one of our midwives this week on a late night walk on her first full day on the island.  Finding help quickly everyone was brought ashore safely.

There are two organizations with “camps”  to meet the refugees at Skala – Lighthouse and Islamic Aid.  Depending on the number of boats arriving someone directs the boats to the shore closest to the camp that is ready for more arrivals.  They are within 100 yards of each other on a narrow strip of land with a steep rocky hillside behind.  It is one of the most beautiful places  I have ever visited.  The road in front is muddy and narrow as well yet somehow traffic seems to flow.  Both are set up to offer respite, food, tea, clothing, and healthcare if needed.  Depending on the time of day people remain at the camps until a bus comes to take them to their next stopping point – one of the camps set up for registration.

I was able to meet with Shea Citron, a midwife from Florida who joined Pilgrim and is here for a month helping women and children and stepping in with whatever thask needjs to be done.  She will be scheduled every other day due to the sheer amount of work involved on busy days and the need to rest.  Of course, if the boats aren’t arriving the work will be more in organizing and preparation but she also plans to visit the camps at Moria and Pipka and to help if needed there.  With one busy shift behind her she felt her skills and compassion were already put to good use.  I will be accompanying her on the night shift tomorrow, my last night in Lesvos before heading to Samos.  Of course I want to help, but given the likely conditions of the sea, I am hoping it is quiet and no one risks this short but dangerous journey.

Lesvos day 3
On my third day in Lesvos I started off in Mytilini and made my way back to Skala Sykmineas.
It was a stormy morning filled with meetings and making connections. The seas continue to be rough and as expected no boats landed yesterday.  The refugee population was 750 for the whole island and if anyone is able to travel to Athens will dwindle further.

No one seems to know if the lack of arrivals is due to continued monitoring on the Turkish side or the weather or both.  In the past weather has not been a major factor in the decision to cross or not, as smugglers charge much less ($500/person vs $1500/person on good days) and for those with little means it is their only chance to risk the journey.  But these seas were treacherous and I hope no one ventures out tonight.

My plan tonight is to work the night shift with Lighthouse. I expect it to be slow and may even get a full nights sleep. The most common time for arrivals is 5:30-8:30am but there are no set rules. Tomorrow is predicted to be calm and sunny and that may change the numbers.  I leave tomorrow afternoon for Samos via the ferry and will be able to assess the situation there over the weekend.

As I prepare to leave I am again overwhelmed with the beauty of Lesvos. Hillsides with walls that are now part of the earth itself and boulders that seemed to have been placed there as works of art.  I walk around listening to the crashing waves and feel the ancient energy – a history I try to imagine. I now know why  Lesvos is an  island of poetry as plain words themselves cannot describe the emotions you feel when you are here.

Wednesday, January 6, 2016

Lesvos: Moria

Lesvos Day 1 - January 5, 2016 Moria Camp

I arrived on Levos with no issues.  Kelly Milligan from Sisters In Health was waiting for me at the airport to guide me to her home, which she has graciously shared with me for the few days I am here.

Kelly came to Lesvos with her husband Scott to work with Health Point Project – the first healthcare provision for refugees outside Moria camp – and by far the busiest.  I had contacted Hadia the founder of HPP when she first began about setting up a women’s focus and she agreed it was necessary.  I then contacted Kelly and the rest is history – but with a few side stories along the way. HPP has changed its focus and another entity has taken over – but fortunately healthcare is still available. Sisters in Health are independent and do continue to work with other groups when needed.

Kelly and Scott have taken an area inside the compound in a place designated for the most vulnerable, creating an oasis in the midst of chaos and turmoil.  Their clinic at Moria Family Compound, is  open far more than any of the others within the camp (MSF and Praxis) and at times when the population tend to need the most care. In addition, due to the success of the work they are doing they are able to fill their roster with providers who can also do outreach within the camp and in times of need outside the camp as well.

My first glimpse of Moria was just a few short months ago when my husband went over to volunteer and was a major player in the setup of HPP.  At the time he described the compound (which resembles a prison with high walls and barbed wire, and in fact may have once been a prison)  as a place where only those who have registered were allowed in – and sometimes registration takes days, longer for ethnicities not deemed urgent.  Those who were vulnerable were supposed to be allowed entry at all times, but it often was difficult and sometimes impossible.

The hill outside the compound is an olive grove and tended to be filled with non-Syrians (who get priority for registration) and was deemed Afghan Hill.  At the time other than the clinic tent set up only people and the flimsy tents they had to protect them from the elements were there.

It has certainly changed. The hill is now crowded with food vendors, a large “barn” (which is more like a long rounded structure) which houses the clinic, a children’s tent, chai tent, food  distribution, clothing distribution, bathroom facilities, even vending machines, as well as many different tents for various NGOs crowd the hill and new hopefully sturdier tents for shelter dot the landscape.  It was so chaotic I found it difficult to find anything and wonder where the refugees will be able to find places to rest when the population increases as spring and summer descend. People come and go a bit easier, and the area for vulnerable population is more accessible.  Volunteers have stepped up and ensured food is provided for all meals and while far from ideal, there are ore resources and assistance.

The family from Afghanistan whose mother was struggling to walk but still had to make it up and down the steep hill to the compound to sleep.  She also suffered from incontinence and it became very clear that donations are focused on the very young but not the needs of adults or elderly.

The look of joy on the faces of children as they watched bubbles float through the air at the food tent.

The myriad of volunteers from all over the world dedicated to helping those in need.  It was heartwarming.

Sunday, January 3, 2016


Leros  January 2-3 2016

The descent to the island seemed fairly straight forward to me. A bit of turbulence,, some shaking, but nothing that had me worried.  I was curious as to why most of the passengers were praying and crossing themselves and a huge cheer roared out when we touched ground and came to a halt – including from the flight crew.  It was only later I heard that for the last several days all landing attempts had been unsuccessful and that one flight actually was turned sideways and came close to hitting the mountains surrounding the airport.  I felt very lucky indeed and a glad I had picked the day I had to go to Leros.

I met with Luke Arnwyck, one of the founders of Refugee Aid, who is working with Midwife Pilgrim to establish a women’s health focus on Leros.  Their organization of UK physicians and nurses  is trying to fill the gaps not being met by MSF, Praxis, or the UNHCR and we seem to be a perfect match.  I appreciate his attention to detail and establishing working relationships with those already on the ground instead of just independently jumping in and getting in the way. He can manage this way because Leros is a small island with only a small number of refugees arriving daily.  In addition, the organization here is quite impressive and from what I have heard much more effective than some of the larger islands.

Leros is also unique in how the refugees arrive here.  Those who leave Turkey destined for Leros are left at a military island Farmokanisi, where there is very little shelter or resources.  It is a military island and I still have yet to understand the politics surrounding this procedure.  Refugees are often left there for day at a time and if the weather is bad for much longer. There have been reports of 100s of people stranded there for days with no food and little water.  When they are picked up and brought to Leros it is either via a  UK civilian transport ship with military personnel, the VOS Grace, that could carry 150-170 refugees and  is equipped with a medical team – however, they left yesterday back to Athens and now a private ship, the Ilyius is available and can only handle 45 refugees at a time and does not have medical personnel.  Refugee Aid is working on establishing a triage unit on the Coast Guard ship to fast track those who are in more need of medical aid when they arrive on the island.

The camp at Leros is set up with an enclosed compound for those just arriving.  They are not allowed to leave until they have been registered, which is usually within a day. Upon arrival they are given a sleeping pad and bag, and a snack and water.   After registration is complete they are assigned to either a bed in the new shelter – Pipka – a renovated Ministry building that can house up to 400 of the most vulnerable (families, elderly, ill) when it is completed and has heat, warm showers, and laundry facilities.  In fact, the first night Pipka opened was when I arrived.  The Villa is a separate house for single women and those with young children and infants. It too had a warm and welcoming feel with a play area for the children.  The camp itself which houses men  is made up of prefab Ikea houses – definitely better than tents but not luxurious in any way.

Women and children are often separated from the men at night, ,especially if they have young infants or sick children.  The Villa is a safe place and more comfortable than the other options.  I helped one mother carry her baby through the pouring rain to a waiting car to take them to the  Villa.  She had a 3 year old and a 2 year old in tow as well, in the dark her children looked very sleepy and were barely able to walk themselves.   Her baby had a bad cough and had just seen the doctor on call at the camp, provided by a group called Praxis – a nice man who tried to make the children laugh and admitted to me he was doing his best but often felt it was not enough.  When I introduced myself and the work we do he was very grateful and we had a long discussion about ways we can make more of an impact.

There is a core group of volunteers on the island who have managed to create as warm and welcoming a reception as could be imagined in this situation.  That isn’t to say there are not hardships for those arriving, but that there are many who are doing their best to give them comfort and respite.The Boutique is an area set up by the Volunteers where donated clothes are sorted and refugees can queue and gather what they need.  It is quite impressive as they have it all sorted by type of clothing, size, and gender.

How will Midwife Pilgrim be involved?  After hearing of the success of Swedish midwives Nathalie Kron and Kim Wallgren, we feel it is best to have a presence at the villa where women will be more likely to open up and share their stories.  In that way we can better assess their needs and offer assistance and resources as necessary.  We will, however, be limited as the NGOs still do not feel there is a need for this kind of service. Sadly when asked about their training or management it was clear this kind of specialty is not a priority and I have no doubt women are not receiving sensitive care. This is an issue I plan to bring up with my meeting with the UNHCR tomorrow in Athens, but they have assured me time and time again that all NGOs on the ground working in Greece with their assistance have clear guidelines and specially trained providers.  If only it were true. In the meantime we will partner with  Refugee Aid, and begin to make it inroads and do more of the care we know is necessary.

More and more I am hoping we can find volunteers to work in the Villa, to be a presence for women to confide in, to have someone to talk to who can address their needs.  Women are not going to the male physicians and when their partners are around do not talk at all.   To have a separate place where they can feel safe and not have to worry about cultural issues will undoubtedly lead to better care.  Given that women are often there several days and sometimes up to a week it will give our midwives time to develop relationships and also educate.  The person in charge of the Villa is very excited by the idea as it has already proven itself a valuable service in the past.

As my second day on Leros progressed, so did the skies darken and the wind became fierce.  By nightfall the driving rain was pouring down just as 100s of refugees who had been waiting for days were finally lining up for the ferry to Athens.  The mood was a mixture of excitement and anxiety.  The cold rain drenching everyone and everything but no shelter was to be had as people stood there, shivering, waiting to be told where to go next.  Finally a taxi came and was quickly overwhelmed with people vying there way to get there first.  At last more taxis came and after a while the crowd was dwindling down.

In the midst of the rain, before the taxis, a young girl of about 12 came up to me beaming.  She spoke a few words in English and she signaled to me how happy she was to be going.  “Go, Go!" she said.  We laughed at how wet we were and her sister and brother joined our small group huddling together for warmth.  They had been there for 4 days with little sleep and were very cold.  Her name is Nasza and she was beautiful, innocent, and yet filled with hope.  She came from Syria and all she could say with a shudder was “Syria bad.”  I can’t imagine what she had endured.  It was bittersweet to say “Good-bye” when her father finally was first to reach a taxi.