Europe gears up to attend to refugees' health.

Abstract

Dr Santino Severoni and his team conducted their first mission to Lampedusa in March 2011. For months large numbers of refugees and migrants from the Eastern Mediterranean, Africa and Asia had been arriving on the shores of the tiny Italian island. realized back then that few if any countries had considered the scenario of a large influx of refugees and migrants to Europe, says Severoni, public health and migration coordinator at the World Health Organization (WHO) Regional Office for Europe. Countries were prepared for disasters such as earthquakes or floods, but the sudden arrival of a massive group of refugees was hardly considered, he says, let alone the health consequences of such an influx. Four years later that scenario has become a stark reality for many European countries. The large numbers of refugees and migrants arriving since then have put a major strain on European countries that are still feeling the effects of the 2008 financial crisis. An estimated 700 000 refugees and migrants arrived in the Europe Union this year and, according to the European Commission, more than three million more may arrive by the end of 2016. Severoni and his team have been working on a project to help such countries. A key element of this project known as PHAME or Public Health Aspects of Migration in Europe--is the technical support provided by WHO to these countries. This involves a mission to each country concerned to assess the health system's ability to cope with the arrival of large numbers of people and make recommendations in a report. Severoni's team have designed a or guide for this purpose. Greece has become the main entry point for those travelling to Europe in recent months. More than half a million refugees and migrants have arrived in Greece since the beginning of this year, according to the United Nations High Commissioner for Refugees (UNHCR). The vast majority of them are often traumatized families fleeing the conflict in the Syrian Arab Republic followed by other refugees from Afghanistan, Iraq and Pakistan. The rest are people seeking better living conditions in another country. Medecins Sans Frontieres (MSF) is one of several nongovernmental organizations providing medical and mental health care services to the new arrivals on many Greek islands and on the border with the former Yugoslav Republic of Macedonia. Everywhere we work, the local health centres and hospitals are struggling because they are already serving the local population and the holidaymakers --and now refugees, says Constance Theisen, humanitarian affairs officer with MSF in Greece, where MSF physicians make referrals to local health services. do medical consultations every where we work. We also offer mental health support and have a psychologist in all our teams, says Theisen. In the vast majority of cases whether people are receiving first aid or mental health support--it is short-term because most of them want to continue to their destination countries. Even when we have serious incidents, when a medical evacuation to a hospital is necessary, the migrants themselves do not want to go to hospital, they just want to move on, says Dr Hasan Abuhamdan, working with MSF in Greece at the Eidomeni temporary relief camp on the border with the former Yugoslav Republic of Macedonia. [ILLUSTRATION OMITTED] The WHO toolkit has been piloted successfully in many countries on Europe's southern rim, including in Albania, Bulgaria, Cyprus, Greece, Hungary, Italy, Malta, Portugal, Serbia and Spain. Our team arrives in the country and we assess the national health system by interviewing all key stakeholders involved in the management of the migration process in the country, in collaboration with the ministry of health visiting the most important spots and institutions receiving the migrants, Severoni says. …