Greek Report

Greek National Report

EUROPEAN PROJECT EVASP

Enhancing Vulnerable Asylum Seekers Protection

Greek National Report 2009-2010

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This report, produced under the auspices of the transnational EVASP (Enhancing Vulnerable Asylum

Seekers Protection) project and co-financed with ERF funds, was created by a team within the Medical

Rehabilitation Centre for Torture Victims, Athens-Greece1.

Research – Ioanna Babassika and Maria Piniou-Kalli

Report drafted by – Ioanna Babassika

Project Coordinator – Dimocritos Sarantidis

Technical Assistance – Georgia Stribakou

In particular, we’d like to thank the organizations running asylum seekers’ reception centres and

especially the Open Reception Centre for asylum seekers in Lavrion run by the Hellenic Red Cross, the

shelter-polyclinic for vulnerable asylum seekers in Athens run by Medecins Du Monde and the reception

centre for vulnerable cases run by NGO PRAXIS, for their accessibility and valuable collaboration, as

well as the centre personnel and asylum seekers who, with their first person accounts, made our work

possible.

The pictures in this report represent some of the works donated to the Medical Rehabilitation Center for

Torture Victims by volunteer artists from Epiros in occasion of an Art Exhibition organized by MRCT in

collaboration with the Municipality of Athens and dedicated to the 26th of June (United Nations

International Day in Support of Victims of Torture)

1 The views expressed herein are those of the authors and do not necessarily represent the views of, and should not

be attributed to, those of the EU and of the other organizations participating to the EVASP Project.

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Executive Summary

This report contains the result of contains the results of the research and working group conducted

within the framework of the European project EVASP, Enhancing Vulnerable Asylum Seekers Protection,

co-financed by the European Commission under the auspices of the ERF programme. It was realized

with the contribution and participation of the organizations mentioned in the previous page and

implemented by the Medical Rehabilitation Centre for Torture Victims of Athens.

The project lasted 18 months (15 December 2008 -15 June 2010), and was conducted simultaneously in

Italy, England, Greece and the Netherlands. Its aim was to produce a clearer definition of

“vulnerability” and in particular of “vulnerable asylum seeker,” to allow for more accurate needs

identification and provide the most appropriate assistance responses.

The study involved a sample of beneficiaries and caseworkers at Greek asylum seeker and refugees’

reception centres and employed qualitative research tools such as individual semi-structured interviews,

focus groups, active observation and roundtable discussion.

The concept of vulnerability is examined here in its structural factors - specifically at the legislative,

temporal/spatial level and functional levels - and from the dual perspective of the beneficiaries

(specifically vulnerable asylum seekers) and reception centre personnel.

In identifying the needs of the two sample groups, the study offers a dynamic reflection on vulnerability

that sheds light on specific critical issues common to asylum seekers and caseworkers that have

implications on several levels (psychological-autobiographical, socio-cultural, and structural).

In addition to presenting the factors that compose the definition of vulnerability, this paper also explores

existent and potential measures to address the problem, considering the solutions as an integral part of

any systemic and multifactor definition.

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CONTENTS

Introduction to the project ..................................................................................................... 7

Vulnerability of asylum seekers – torture survivors .............................................................. 9

Legal regime.......................................................................................................................... 10

INTERNATIONAL CONVENTIONS ....................................................................................................................... 10

MAJOR ISSUES CONCERNING THE ASYLUM PROCEDURE IN GREECE AND HUMAN RIGHTS SAFEGUARDS

............................................................................................................................................................................. 10

ASYLUM SEEKERS’ RECEPTION AND DETENTION CONDITIONS ...................................................................... 13

Research activities ................................................................................................................ 15

RESEARCH IN THE RECEPTION CENTER OF LAVRION (LARGER AREA OF ATHENS) ...................................... 16

Location of the facility .................................................................................................................................. 16

Description of the facility- material conditions........................................................................................... 16

Staff.................................................................................................................................................................. 17

Historical facts ................................................................................................................................................ 17

Funding and management.......................................................................................................................... 18

Capacity......................................................................................................................................................... 18

Needs of the facility ...................................................................................................................................... 18

Interviews ........................................................................................................................................................ 18

RESEARCH IN THE SHELTER - POLYCLINIC OF THE NGO MEDECINS DU MONDE IN ATHENS ....................... 25

Location of the facility .................................................................................................................................. 25

Description of the facility- material conditions........................................................................................... 25

Staff.................................................................................................................................................................. 26


Capacity......................................................................................................................................................... 26


Interviews ........................................................................................................................................................ 26

RESEARCH WITH THE NGO PRAKSIS IN ATHENS ............................................................................................... 38

Introduction .................................................................................................................................................... 38

Staff.................................................................................................................................................................. 40


Capacity......................................................................................................................................................... 40

Interviews ........................................................................................................................................................ 40

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RESEARCH IN THE RECEPTION CENTER OF SAMOS (NORTH AEGEAN ISLAND CLOSE TO TURKISH

SEASHORE).......................................................................................................................................................... 46

Description of the facility .............................................................................................................................. 46

Staff.................................................................................................................................................................. 47


Capacity......................................................................................................................................................... 47


Interviews ........................................................................................................................................................ 47

RESEARCH IN THE RECEPTION CENTER OF CHIOS (NORTH AEGEAN ISLAND CLOSE TO TURKISH

SEASHORE).......................................................................................................................................................... 49

Description of the facility – Material Conditions ........................................................................................ 49

Staff.................................................................................................................................................................. 49

Capacity......................................................................................................................................................... 49



Interviews ........................................................................................................................................................ 49

LESBOS ................................................................................................................................................................ 50

Interview with service users........................................................................................................................... 50

Focus group discussion ................................................................................................................................. 51

Comments and conclusions ................................................................................................ 58

BIBLIOGRAPHY ....................................................................................................................... 60

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Introduction to the project Introduction to the project

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Over the last few years Greece has become a main entrance into Europe for thousands and thousands

of undocumented migrants and asylum seekers and people needing international protection for

obvious reasons (geographical position and easy to cross borders). As it is clearly stated by the Council

of Europe, Human Rights Commissioner in a recent report “Greece received the sixth largest number of

refugee applicants in the EU during the first half of 2009 (9800 applications). In 2009, a total of 15.928

asylum applications were lodged in Greece; there were 11 recognitions of Convention refugee status

and 18 grants of humanitarian status or subsidiary protection. In 2009 the recognition rate at first

instance was 0, 04% for Convention refugee status and 0, 06% for the other two statuses. The pending

applications at first instance in 2009 reached 3.122. As regards asylum appeals in 2009, there were

12.095 appeals, 25 recognitions of Convention refugee status and 11 grants of humanitarian or

subsidiary protection. The respective recognition rates on appeal were 2, 87% and 1, 26%.”. On 10

February 2010, the Commissioner was informed by the Minister of Citizen Protection of the fact that the

total of pending asylum claims in early February 2010 was as high as 44.560, and found this to be

worrying.

Given that the Police authorities had declared in the Press that more than 90.000 people have been

deported in 2009, it becomes obvious that only a small percentage of people entering the country,

undocumented, are allowed to access the asylum procedure. There is no monitoring of these

deportations procedures including NGO’s or international organizations. So, there is no way to verify if

people were given the opportunity to express their need for protection and to explain their special

problems.

The above data need to be completed by additional data concerning Dublin returns: “According to a

report presented on 22/3 by AI’s Greek section, a total of 995 asylum seekers were sent back to Greece

by countries such as Netherlands, Norway, Switzerland and Belgium in the first 10 months of 2009, as

dictated by the EU’s Dublin II Regulation which stipulates that refugees should apply for asylum in the

first EU country they enter, increasingly Greece. But Greece has serious inefficiencies in its asylum

system, according to the Head of AI’s Greek section, Georgia Trismpioti: “we are asking the European

Countries to stop returning asylum seekers to Greece, until improvements have been made to the

Greek system and until the Dublin Regulation has been revised, so that the responsibility of providing

asylum to migrants is more fairly distributed”. The Head of UNHCR Office for Greece, Giorgos

Tsarbopoulos, agreed that transfers to Greece should stop, until concrete reforms are put in place, while

also noting that Dublin II serves northern and western Europe”.

On the other hand, exit from Greece towards other European countries due to the Dublin I and II

became extremely difficult. As a result, without intending to remain in Greece, people were in reality

trapped. This has been described in a relevant report as a Revolving Door.

The Greek Authorities were overwhelmed by numbers and, due also to policies or rather lack of policies,

responded in a primitive way (refoulement, detention in very harsh material conditions, total lack of

social care for the non-deportable, etc.).

Following the legislative elections of October 2009, the new Government declared its intentions to

change radically the whole system. Changes are now under way in legal and organizational issues but

not yet operational. Therefore, the chapters to follow include descriptions that were accurate at the

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time of the collection of the material and carrying out the research activities but, hopefully, will soon

present a different picture.

Vulnerability of asylum seekers – torture survivors

People who migrate are not a homogeneous group. Persons leave their home countries for various

reasons. One can consider that anyone leaving his/her country is forced to do so. However some are

more forced than others. People who migrate looking for a better life elsewhere they are doing it on

their own will. In this case they have prepared their migration and have the freedom to return. Some

others are forced to migrate to save their lives. In this case they practically flee, knowing that they may

never return.

Among the persons who have to leave are persons who have been persecuted and most of them have

been subjected to torture. Torture victims are a special group of people who have suffered under the

hands of other people (in most cases co-patriots).

According to the United Nations Convention Against Torture (CAT) torture is defined as “any act by

which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such

purposes as obtaining from that person or from a third person information or a confession, punishing that

person for an act that either that person or a third person has committed or is suspected of having

committed, or intimidating or coercing that person or a third person, or for any reason based on

discrimination of any kind, when such pain or suffering is inflicted either by or at the instigation of, or with

the consent or acquiescence of, a public official or other person acting in an official capacity.”

Torture victims are refugees who have experienced the stress of both the forced migration and the

experience of torture. Consequently, most of them develop psychiatric disorders. As in any other

stressful situation that a person can go through, a number of psychiatric disorders can be developed

such as depression, generalized anxiety disorder and even psychosis. The official classification of

psychiatric disorders includes a disorder that develops when a person experiences a situation in which

he/she felt that his life or his physical integrity are under threat. This applies to natural as well as to man-

made disasters. The symptomatology of Post Traumatic Stress Disorder (PTSD) includes symptoms such as

suddenly appearing memories of the event (flashbacks), avoidance behavior of any situation that

reminds to the person of the event and symptoms of hyper vigilance with startling response

accompanied with irritability and outbursts of anger. The syndrome is accompanied by numbness

(inability or decreased ability to feel certain feelings) and an expectation that his/her future will be

somehow constrained in ways not normal to other people. The syndrome generally causes significant

impairment in all the levels of functioning.

Perhaps the critical parts that make the torture victims vulnerable are the symptoms referring to the

victims’ feelings that their future is constrained as well as the numbness, which gives the impression of

apathy. Also, due to the hyper vigilance and irritability, they may easily exhibit outbursts of anger when

they perceive that their needs are not met. In addition the avoidance behavior can be a problem with

personnel with uniforms, particularly when they were tortured by persons on uniform.

Since the purpose for the identification of vulnerable groups is to provide specialized care according to

the condition that make them vulnerable, in the case of the torture victims all that mentioned before

should be taken into account in the care of this group.

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Apart for the care of torture victims, an equally important issue and the first step is how to identify torture

victims among the asylum seekers. A lot have been said that many asylum seekers claim that they have

been tortured. Indeed the identification of torture is not always easy and sometimes impossible to verify

because after some time the physical traces of torture have been healed. However the application of

the guidelines of the Istanbul Protocol, by trained physicians, provides a professional way to verify

torture. The Istanbul Protocol is a United Nation Manual on Effective Investigation and Documentation

of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, as the full title states. In

many cases where the physical traces have disappeared, the diagnosis of PTSD can be a valuable

finding. By its definition, PTSD can be applicable only to torture victims and does not normally inflict

persons who are refugees but they have not been tortured.

Legal regime

INTERNATIONAL CONVENTIONS

Greece is party of all UN Human Rights Conventions, including the 1951 Refugee Convention and its

1967 Protocol, the four Geneva Conventions and their Protocols (International Humanitarian Law) and it

should be noted that it was one of the most active countries when the Convention against Torture was

being negotiated and adopted.

In the frame of the Council of Europe, Greece has also ratified all Conventions concerning human rights

protection, except the one on minorities.

In the frame of the European Union legislation, Greece has adopted all the relevant European norms,

even with some delay, especially the 2 Directives on Reception of Asylum seekers (the Reception

Directive) and on the procedural aspect in the asylum procedure (the Procedures Directive).

However, adopting rules does not necessarily mean full and correct implementation of these rules.

Indeed, over the last decade the situation in practice has been deteriorating and this fact is illuminated

again very recently by the Commissioner of Human Rights of the Council of Europe, Mr. Thomas

Hammarberg, who intervened before the European Court for Human Rights in Strasbourg as a third

party in a group of cases concerning the transfer of asylum seekers from the Netherlands to Greece on

the basis of the Dublin Regulation. His intervention has been published in mid-March and is descriptive

in a very precise and accurate way of the legal and real situation.

Therefore, it is an excellent recent source for describing the issue in an accurate and balanced way.

MAJOR ISSUES CONCERNING THE ASYLUM PROCEDURE IN GREECE AND HUMAN RIGHTS

SAFEGUARDS

Legal framework

In 2007 and 2008 there were certain positive developments in Greek refugee law: In November 2007

Presidential Decree 220 transposed Directive 2003/9/EC concerning the reception of asylum seekers. In

July 2008 Presidential Decrees 90 and 96 amended Presidential Decree 61/1999 (the major piece of

legislation regulating asylum procedures until then) and transposed respectively Directive 2005/85/EC

concerning the asylum procedures and Directive 2004/83 concerning the qualification of refugee or

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subsidiary protection.

On 30 June 2009 Presidential Decree 81/2009 concerning asylum was promulgated and had as an

effect the lowering of international protection standards in Greece. It is of particular concern the

abolition of the examination of the merits of asylum claims at second instance by the Appeals

Committee and the transfer of the asylum decision-making responsibility at first instance to the Police

Directors around Greece. This Decree created an Advisory Refugee Committee composed of two

police officers (the most senior acting as President of the Committee), one staff member of the

Department for Aliens and Immigration of the respective region and a UNHCR representative in each

Police Directorate. A major issue of concern is the reported lack of sufficient initial and continuous

training that should have been made available by the state to the members of these Committees. The

first instance decisions can be appealed only on points of law, through an application for annulment,

before the Supreme Administrative Court (Council of State) (see subsection below on remedies).

Following the parliamentary elections in Greece in October 2009, the new government established a

Committee of Experts to provide advice on the reform of the Greek asylum system. This Committee,

comprising experts from the Citizen Protection, Interior and Health Ministries, the UNHCR, the Greek

Council for Refugees and the Ombudsman as well as academics, was mandated to propose

amendments to the existing law and practice and suggestions with regard to the composition and

operation of a new civil authority that would deal with asylum claims, staffed by civil servants, with no

police force members as is the case today.

The proposals of the above Committee were submitted to the Greek government on 22 December

2009. The Minister of Citizen Protection informed the Commissioner during their meeting in Athens on 10

February 2010 that a Bill was under preparation and trusted that the new asylum legislation would be in

place by May 2010.

Legal aid for asylum seekers

The first comprehensive legal aid statute (Law 3226) in Greece was introduced in 2004. Legal aid under

the above-mentioned Law has been provided for low income persons only with regard to civil and

criminal cases. Administrative law proceedings were not covered even though the Council of State has

recognised the right to legal assistance for persons without means in proceedings before it.

Article 11, paragraph 1, of Presidential Decree 90/2008 that transposed Directive 2005/85/EC provides

that asylum seekers have the right to consult legal or other counsel ‘at their own expense’. Paragraph 2

of the same Article provides for legal aid only for the judicial review cases brought before the Council of

State, on condition that the application for annulment before the Council of State is not ‘manifestly

inadmissible or manifestly unfounded’. The system of legal aid provided for by law does not function in practice. Several factors hinder access

to lawyers providing free legal aid: lack of sufficient information to asylum seekers about possible legal

counseling; only a few lawyers are registered in the legal aid list of the Bar Association, as there is an

important delay in fee reimbursement, coupled with low fees; the procedure for benefiting from the

legal aid scheme is complicated.

Interpretation for asylum seekers

Whilst Presidential Decree 81/2009 provides for an interview to be carried out by the first instance

Advisory Refugee Committee and for the selection of an interpreter able to ensure appropriate

communication in a language understood by the refugee applicant, it is of grave concern the chronic

problem of lack of sufficient interpretation in the Greek asylum system. Already in 2001 the Greek

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National Commission for Human Rights (NCHR) had stressed that the lack of official interpreters in

asylum procedures violated the elementary procedural principles of the rule of law and fundamental

principles of international human rights law. Seven years later grave concerns were again expressed on

the same issue by the NCHR, a sign of a lack of any real progress in this area. Of particular concern is

the reported lack of qualified interpreters in the regional Police Directorates, now wholly in charge of

the first instance asylum procedures, where co-detainees or other migrants are used by the Police for

interpretation when asylum applications are lodged.

On 10 August 2009, the Greek Ombudsman issued an Opinion concerning issues of lawful notification of

first instance asylum decisions and appeals, highlighting the practice of unlawful notification of

negative asylum decisions due to insufficient interpretation or inappropriate methods of informing the

refugee applicants about the appeal procedure upon notification. The Greek Ombudsman

recommended that the Greek authorities, inter alia, include in the first instance decisions a text in the

most common languages of the asylum seekers informing the latter of the asylum procedure, including

appeal deadlines and NGOs that may provide aid.

Asylum seekers’ access to domestic and international remedies

The need for the right of judicial remedy within the meaning of Article 13 of the Convention has not only

to be guaranteed in law but also to be granted in practice when a person alleges that the competent

authorities have contravened or are likely to contravene a right guaranteed by the Convention.

Until the promulgation of Presidential Decree 81/2009, first instance decisions taken by the Greek Police

could be appealed before an Appeals Committee. The Appeals Committee is now abolished and the

only remedy available to asylum seekers against a negative decision is the application for annulment

before the Council of State, which is competent for judicial review of administrative decisions.

The Council of State offers safeguards of independence and impartiality as an ultimum remedium in the

asylum process. However, given the well-known, chronic problem of excessively lengthy proceedings in

Greek administrative courts, especially before the Council of State, it is not possible to consider this

remedy as effective in the context of refugee protection, which by definition requires prompt decision-

making by all competent authorities. The average length of proceedings before the Council of State is

currently reported to be five and a half years, while interim measure decisions are reported to be

rendered in a period ranging from 10 days to 4 months. Moreover, the Council of State is only allowed

to examine appeals on points of law and cannot review the merits of the case, in particular the

existence of a risk of persecution in the country of origin.

The lodging of an application for annulment does not automatically suspend the deportation order

delivered following a negative asylum decision. The appellant needs to request the suspension of that

order separately until the Council of State delivers a judgment on the application for annulment.

The asylum seekers in Greece face a serious, real risk of being deprived of their right to an effective

remedy in respect of the violations of the Convention of which they allege to be victims, which is

guaranteed under Article 13 of the Convention and Article 39 of the Directive 2005/85/EC. The notion of

an effective remedy under Article 13 requires a scope of review conducted by a domestic court able

to address the key elements of whether there has been a violation of the Convention.

As regards access to the European Court of Human Rights, although this is guaranteed in principle for

every individual within Greece’s jurisdiction, lodging an application before the Court appears to be

very difficult in practice. The same applies for requests made under Rule 39 of the Rules of the Court

(interim measures): the number of such requests introduced from and against Greece seems to be

quite low compared to other state parties, and can be linked to difficulties, described in other parts of

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the present written submission, in accessing interpretation services and lawyers, in particular for people

in detention, and to the lack of proper legal information available in general.

Protection of asylum seekers from refoulement

Based on reliable information it seems that there are instances of non registration by the Police of

asylum claims and of instances of refoulement, especially from Greece to Turkey. Such forced returns

have occasionally taken place before the migrants were able to apply for asylum, but also concern

‘pink card’ holders registered as asylum seekers in Greece. Characteristically, one of migrant detainees

at the Feres border guard station reported that of the group of 65 persons who were arrested in 2008,

having crossed the Evros river, 50 of them were ‘immediately deported’. Another particularly disturbing case has been the reported expulsion in March 2007 from Greece to

Turkey through the Evros River of an Iranian irregular entrant who attempted to reach her refugee

husband in Greece with her 6-year old child who suffered from heart problems. Reportedly she was

later recognised as a refugee by UNHCR in Turkey and family reunification subsequently occurred in

Greece.

In this context, it is noted that Greece has not as yet acceded to the 1963 Protocol No. 4 to the

European Convention on Human Rights which, inter alia, proscribes the collective expulsion of aliens,

while Turkey still adheres to the geographical limitation of the 1951 UN Refugee Convention, thus

excluding from refugee status persons coming from outside of Europe.

Another reported case of refoulement concerns a group of 43 Kurds who had arrived at the town of

Chania, Crete on 18 July 2009; 17 of them applied for refugee status. According to NGO reports, on 27

July 2009 they were all transferred to the aliens’ detention centre of Venna (North East Greece) from

where they were subsequently expelled to Turkey. A series of other collective expulsions of migrant

groups, ranging from 30 to 120 persons, to Turkey (through the land border of the Evros department)

from various eastern Aegean islands were reported by Greek refugee lawyers to have occurred in July

and August 2009.

Such practices are not compatible with member states’ obligations recalled by the Committee of

Ministers Twenty Guidelines on Forced Returns (especially Guideline 3 - prohibition of collective

expulsion) and with the states’ fundamental obligation under the Convention not to return a person to

a country where they would face a real risk of being subjected to treatment contrary to Article 3, or

even Article 2. The asylum seekers returning to Greece by virtue of the Dublin Regulation may face such

risks, jeopardising the enjoyment by them of their human rights enshrined in the Convention.

ASYLUM SEEKERS’ RECEPTION AND DETENTION CONDITIONS

Asylum seekers’ accommodation

In February 2010, there were eleven reception centres for asylum seekers, including asylum seeking

minors, in Greece with a total capacity of 741 persons. All of them are managed by non-governmental

organisations and financially supported (partly or wholly) by the state.

Given the fact that asylum applications between 2005 and 2009 ranged from 9 050 to 25 113 per year,

the above reception capacity is far from satisfactory. Such a serious deficiency in the asylum seekers’ reception capacity harshens even further the lives of thousands of asylum seekers and their families,

children in particular. It also raises serious issues with regard to the protection of, inter alia, their right to

social and medical assistance and their right to benefit from social welfare services, as provided for

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notably by the European Social Charter (ratified by Greece), and the ‘Refugee Reception Directive’ (2003/9/EC, transposed by Presidential Decree 220/2007). In fact, many asylum seekers are detained in

aliens’ detention centres often in substandard conditions, or simply live out in the open (see subsection

below on asylum seekers’ detention).

Asylum seekers’ detention

Refugee applicants are being routinely detained in detention centres for three months (the maximum

period provided for by Greek law at that time for irregular entrants subject to deportation). By Law

3772/2009 the maximum period for the detention of migrants in view of deportation became six months.

A further extension of detention for 12 months is also possible under the same Law if the migrants do not

cooperate with the authorities or there is a delay in the provision of the necessary documents by the

authorities of the migrants’ country of origin. There is an observation of an increase in the actual

average duration of detention in the period following the introduction of the above Law.

From 2006 to 2009, the annual numbers of irregular migrants (including traffickers) ranged from 95 239 to

146 337. In this regard, a number of recent judgments delivered by the Court concerns the detention of

migrants in Greece, notably in police stations, and violations of Article 3 or Article 5 of the Convention.

The description of the various detention centres made by the Commissioner of Human Rights of the

Council of Europe confirms other reports about the material conditions made by NGO’s previously or

around the same time. The details are conducive to the inappropriateness of the installations, as well

as the insufficiency of the staff in the specialties that would give an acceptable level of health and

social care.

On 3 February, there had been an uprising of migrant detainees at the above detention centre. The

detainees reportedly protested about the material conditions of their detention and lack of proper

medical care.

It was reported that on 5 February 2010 the Misdemeanours Court of Rodopi tried and convicted 42 of

the migrant detainees, originating mainly from Iraq, Afghanistan, Pakistan and Bangladesh, on charges

of contempt of Authority and damage to property, and ordered their deportation. Greek lawyers

following the case reported that legal counselors could not contact the migrant detainees before,

during or after the above trial.

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Research activities Research Activties

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The activities carried out will be described in detail in the following report. They consisted mainly to

visiting one-open refugee camp, two detention centers, two shelters for vulnerable asylum seekers in

Athens plus interviews with a number of individuals, interviews with service providers in all the visited

places, meeting with focus groups and a round table in Athens.

The process was hindered by the refusal of the Police to allow us free access to the detention centers in

the islands and, especially, possibility to interview the detained persons (the details in the full report).

The above problem had consequences in the timing of the planned activities (please see the details in

the Annex).

Note: the training events planned to take place had to be postponed due to the fact that the total re-

structuring of the asylum system at this moment does not allow to know yet who the trainees will be. The

Government is planning to establish a new asylum service or agency composed of civil personnel with

studies of Law or Political Science or International Relations, etc. who will serve in the central unit in

Athens but also in peripheral units. For the time being, asylum procedures are stopped and there is

going to be governmental decision of a transitional nature concerning the “old” applications

(estimated to be 40.000) as well as applications filed now and until the date of the implementation of

the new Asylum Law, being drafted now. 2

RESEARCH IN THE RECEPTION CENTER OF LAVRION (LARGER AREA OF ATHENS)

Location of the facility The reception center for asylum seekers is situated in the center and very close to the port of the city of

Lavrion, at a distance of 80klm from Athens, very close to cape Sounion, which is the end of the

peninsula of Attiki.

The center is composed of three buildings with two yards among them, next to the central square of

Lavrion. The visit was carried out during 2 days, 6 & 7 July 2009.

Description of the facility- material conditions The buildings are made of concrete (technology of the ‘50s) and are two-story buildings.

On the ground floor there are rooms for common use, kitchen, offices, rooms for classes, etc. In the

area of the ground floor are offices for the nurse, social workers, director, etc., maintenance and all

related services.

On the 1st floor, rooms for sleeping and common toilets and showers. The rooms are arranged internally

to provide sleeping space with double deck beds, separately for mail and female occupancy with

some of them reserved for families.

2 Ioanna Babassika is a member of the Independent Expert’s Committee that prepared the report with detailed proposals for the new Asylum Law to be and, also, member of a second Independent Expert’s Committee working now on a screening system to be established.

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The buildings now are old and in bad state of repair (for instance, one of the three buildings is not used

for the last three years or so because there are even problems of stability (dangerous stair case) and

humidity has taken over even the first floor). The swage and plumbing problems are a constant every

day fact in the facility. There is no plan yet to invest important amounts of money for a complete

refurbishment. The ownership of the buildings belongs to the State.

Three years ago, the kitchen had been completely refurbished and modernized. The staff of the

kitchen is sufficient and the menu on a weekly basis on a rather good quality.

An observation made on the spot was that asylum seekers do not sit all together in a dining room to

eat, but they take their meals to their rooms.

Another observation about the occupancy is that in the one of the two remaining in use buildings the

occupancy are mainly of Turkish and Kurdish origin and in the other mainly of Afghan origin.

These two blocks of occupancy have repeatedly in the past quarreled among them on the one hand

and systematically “chased” asylum seekers of different origins from the facility.

Staff The total number of staff is 32 persons under various categories and specialties (management, kitchen

staff, cleaning staff, maintenance, three guards, two secretaries, one interpreter, social service, lawyer

(external), medical staff.

Historical facts The facility of Lavrion is the first and, until very recently, the only facility for asylum seekers in Greece. It

was founded in 1947, at the beginning of the Cold War when Greece started receiving refugees from

Eastern Europe following the separation between Eastern and Western Europe.

The concept at that time was that people escaping Communist Regimes and asking fro protection in

Greece would be resettled rather quickly to the three main receiving countries (and a few European

ones) namely USA, Canada and Australia.

Specialized services, such as the World Council of Churches and CARITAS, in arranging all the needed

documentation, etc. for the resettlement were dealing with the applications in order to process them

with the relevant Embassies.

During their stay in Lavrion, asylum seekers were receiving language courses (English) and general

information courses about the countries of final destination.

Following the above, it becomes clear that there was a constant rotation of people coming into

Greece, staying for a short while in Lavrion and then leaving the country and that the facility was a

location for transiting people. This character of transit created a mentality and culture among the

greek authorities who up until the ‘90s perceived refugees as just transiting from Greece. It has been

extremely difficult to change this perception and to make understood that asylum seekers will, if

granted protection, most probably stay permanently in the country.

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Important note: this perception of transiting refugees was also reflected in the legal system in the sense

that there was no national law or national procedure in Greece on asylum. UNHCR was conducting a

process of eligibility, in order to give a temporary protection to asylum seekers until their resettlement.

Only as late as 1991, Law 1975/1991 has been adopted and a national asylum procedure has been

established (Entrance-Exit, Residence, Work, Deportation of Foreigners, Recognition procedure for

foreign refugees and other provisions).

Funding and management Funding for this facility has always been provided by the Greek State through the Ministry of Public

Order (Police) and the management is always done by the Police. The police director of Lavrion is at

the same time the director of the Center. The police station is just next door to the facility, on the same

street.

The day to day care as far as food, health services, social services etc. are concerned, is trusted to the

Hellenic Red Cross by contract with the Ministry, which pays for the relevant expenses, salaries and so

on.

Capacity The three buildings can shelter up to 320 persons. However, with one of the buildings out of use until

refurbishing is finished, capacity now is about 262 persons, according to the last counting on July 1st ,

2009)

Needs of the facility The buildings condition, as described above, is at a critical stage. The consequences today are

reflected on the capacity, as well as the hygienic and safety of the installations.

A very serious need is the shortage of interpreters.

There is lack of psychologist.

The medical emergencies can be covered by the local public health center and, if needed, by

referrals to public hospitals in Athens. However, the local health center does not have a psychologist

either.

About children’s schooling (most of the children are at the age of primary education) in principle is

provided by the local public school. However, the need for a specialized teacher to work with non-

Greek children in order to better prepare them to adapt, is felt.

Interviews To be noted that the working hours of the social service, the interpreter and the other professionals is

until 2:30 to 3:00 in the afternoon. This has put time limits to our “useful” time in Lavrion.

Interviews with service – users

Interview 1: H.K. (male)

Full identity data in the files

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(with interpreter)

1. Turkish national of Kurdish ethnic origin, born in 1965, single.

He left his country due to his political activity, because his life was threatened and he was tortured and

convicted to imprisonment. He spent several years in prison.

He is in Greece since 2002 and he is still having the status of asylum seeker.

He says that he was pressed to leave the country, he went to Germany and he was sent back to

Greece.

It took 8 months from his arrival to Greece to receive the status of asylum seeker (pink ID card).

2.1.

Level of education: Secondary.

In Turkey he was working occasionally in building construction but, mainly, he was working for his party.

He continues to deal with political problems of the Kurds and he sees himself as politicized.

His main problem is medical (with the spine) and he complaints about medical services in public

hospitals in Greece, saying that it takes a long time to have appointments, tests, etc. As a

consequence of his health problem he cannot work. He does not receive any welfare assistance and

his friends help him, outside the possibility of food and shelter in Lavrion.

Since his asylum application has been rejected twice (first instance and appeal) and now his case is

pending before the Supreme Administrative Court, his residence is still uncertain. He complaints about

psychological anxiety caused by the fact that he does not feel safe, he says that he is always in the

company of his friends for safety reasons and discussing expectations he seems quiet pessimistic for the

future, he talks about possibilities to move to some other country just for facing the issue of his health

and he is totally negative to the prospect of ever returning to Turkey.

He speaks about torture continuing to take place in Turkey on a large scale (information coming from

the Press and from political organizations) and he knows about the convictions of Turkey in Strasbourg

for violation of article 3 of the European Convection of Human Rights.

He is also discussing the prospects of ever ameliorating conditions for refugees in Greece.

On the issue of self-image, first he says that it’s better to stay in prison in Turkey than to come to Greece.

The problem is not the society and the individual people, but the authorities who put psychological

pressure in many ways. He feels that he has changed as character since his arrival and he has become

much more short-tempered, something his family and friends have noticed.

Asked if he could have chosen, at the time, another country to seek protection, he says he would have

not chosen Greece.

2.2. Asked about his past experience in Turkey, namely his political involvement, arrest, torture, prison,

etc., and about changes caused to his personality, he says that there were positive and negative sides.

The positive side is that he found, through this ordeal, his Kurdish identity. The negative side is that he is

now away from his people, unable to help them.

It was his ideology that kept him alive. Family, friends, etc. Had a positive influence but the main factor

is the faith of his people to freedom. His friends in Bairampasa prison were burned in front of his eyes

and their faith made him stronger. Stronger to face difficulties while very sensitive about he always felt a

refugee, a foreigner in his own country.

2.3.1. Asked about whether his health problem was identified and cared for, he said that after his arrival

20


in Greece he described to a medical doctor his experience of torture and, especially, that he had

been subjected to “Palestinian hanging” due to which he had shoulders and spine problems. The

doctor in the border area seemed to know about such problems and to understand. When he arrived

in Lavrion, he spoke about his problem and he was referred to a public hospital waiting for many hours

in line. He also visited 2 or 3 times the Rehabilitation Center and he complaints that no proper attention

was given to his case

(He refers to a general problem, namely lack of coordination and communication between the various

health services that have dealt with the same patient which will be analysed in the conclusions).

The only issue he accepts as causing vulnerability is his somatic health problems.

(This is an issue to be further analysed having to do with ideological – political, as well as cultural

factors).

2.3.2., 2.3.3. More generally, he considers that there is no system to identify needs and to provide proper

help.

Interview 2: M. K. (male)


(with interpreter)

1. Turkish national, born in 1961, single. No relatives outside Turkey.

Arrived in Greece first time in 1984. He received asylum. After a while he went back to Turkey to

continue his political work. He was arrested in 1990 and convicted to imprisonment.

He participated in both big hunger strikes in the Turkish prisons in 1996 and 2000-2001. He was given

temporary leave from the prison for health reasons. Threatened that his leave would be terminated

and that he should return to prison to serve the rest of his sentence, left the country illegally and came

to Greece for a second time in 2006 through the river border. He does not have a very clear legal status

now since, his refugee status had been revoked after his return to Turkey, and a procedure is pending

for the last 3–4 years without outcome so far. Lack of status means no rights to residence, work, health

care, etc. (he is still considered an illegal alien).

2.1. In Turkey he was working in building construction as painter. Education: finished primary school.

Parents, brothers and sisters live in big city in Turkey. In Turkey he was living with his family. In Greece, he

does not have proper housing since even his stay in Lavrion, although known to the management of

the Center, is not legal, since he has no status.

He speaks a lot about his political activities and his effort to create an association of families of

imprisoned and tortured persons, which caused very frequent visits of the Turkish Police to his home

(while he was given leave from the prison) and he insist that his political conviction and ideology are

the reasons he has survived. The difficulties were serious and numerous. He describes torture suffered

and gives many details about the circumstances, the methods and the duration.

He says that he does not suffer today from serious sequelae of torture.

Not having legal papers, he has difficulties to access public hospitals. So, he had visited the

rehabilitation center also for health problems not related to torture.

He does not feel safe since his residence is not assured. He believes that the authorities drag their cases

for a very long time to make the asylum seekers leave the country and abandon the effort.

He describes all the problems encountered by asylum seekers with non-sufficient information and

21


advice.

His wish is to be given residence again in order to obtain work permit.

Due to his past as a political activist, he feels sustained by his ideology and strengthened by the

difficulties and problems encountered (relevant comment in the conclusions). He did not feel a chased

person following his ordeal, although all parameters in his life have changed.

2.2. This ordeal turned his life up-side down and changed everything for his present and future.

However, he does not face this as a necessarily negative factor because he says that he does not

regret whatever he has done in his life so far and that his primary concern is to be consequent to his

ideology.

2.3.1. He does not feel vulnerable. Again his political convictions, ideology and activity are the factors

for this stand in life.

2.3.2, 2.3.3. There was no particular procedure to identify his needs by the authorities. His torture

experience, related to social service of Lavrion, was referred to the Rehabilitation Center for further

examinations (relevant comment in the conclusion).

Interview 3: B. H. (male)


(with interpreter)

1. Turkish national, born in 1974, single. Finished technical school specialized in design.

When visited on July 7, he was already on hunger strike for 20 days. He was politically active in his

country, arrested and, as a consequence, he was convicted to imprisonment. He was in the prison of

Bayrampasha in Istanbul during the long hunger strikes of 2001. He was severely burned when the

Police invaded the prison and he still suffers from these burnings (60%). He escaped and came to

Greece. His application was rejected, went to Germany, was sent back (Dublin case) and after more

procedural steps his lawyer (from the Greek Refugee Council) has re-opened the case. Still waiting to

be invited before the Asylum Board for interview.

Although during the interview he is all the time invoking his health problems, he maintains that the

“others” (meaning the State Authorities, etc.) are to blame for his present situation, as far as his status is

concerned. He does not admit his vulnerability and reacts in a way reversing responsibility for his

present situation to those who should recognize without his active participation into supporting with

evidence his case.

It is evidently a very serious case with a big need for psychological support and the social workers in

Lavrion, despite their efforts, cannot fulfill that role.

The fact that he refuses to take an active role into supporting his case, even by presenting himself to the

Asylum Board, etc., shows the psychological state he is in.

Interviews with service providers and target group discussion

1. Mrs Katerina Vryoni, social worker responsible for the Social Service of the Hellenic Red Cross in

Lavrion Camp

Born: 1981

Works in Lavrion since January 2005

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2. Virginia Bethani, social worker

Born: 1982

Works in Lavrion since April 2007.

The two interviews were carried separately but coincided in the answers.

This was to be expected because the social workers collaborate very closely, they work both on the

same files, they substitute each other and they discuss every case extensively in order to be able to

have all the necessary information at any moment. Later on, when we had the target group discussion

the above became very obvious, since they were speaking as one. Therefore, for reasons of

coherence, we give the important points discussed both during the interviews, as well as during the

target group discussion, following the order of the questionnaire.

Challenges: The difficulties are originating from the fact that they do not have at their disposal well

organized structures and means. By this they mean the whole state mechanisms concerning refugees’

protection.

Another difficulty is that asylum seekers during the initial period following their arrival into the country are

very difficult to handle because they do not understand the limits of the system. It takes a rather long

time until they begin to grasp the reality and to know what to demand and where is the limit. Therefore,

in every case there is this difficult initial period.

On the other hand, since people in Lavrion usually stay for a long time, they will be given the time to

adapt and the social service will be given the opportunity to help them through this process.

What is positive for the social workers is to have every day contact with the asylum seekers, especially

those who belong to vulnerable groups, this way acquiring a lot of experience.

Another positive point is that they work as a team and they collaborate closely with the other

professionals and members of the staff, dealing in a holistic way with problems arising.

Education: The education given at the School of Social Work is clearly not sufficient to give enough

tools to do this work. It was certainly helpful to do a Post Graduate Course and to have real

experience, doing their practice within a relevant frame. There is not sufficient information in the Social

Work Faculty to help the students choose for their practice in a very informed way. So, that choice is

done more or less at random. (comment to follow about defaults of the education system in the

conclusions).

Safety: There is no feeling of threat or danger. Besides, asylum seekers make an effort to be at their best

behavior, even if their problems and psychological state is in a poor situation. In general, they don’t fell

that a safety issue is part of their every day reality.

Expectations: The discussion turned around hopes to ameliorate their working conditions and whether

and how they could achieve short term or long term changes in the Center. The answer is that

whatever can be done is only done based on their efforts and limited to the Center itself. They cannot

influence other Services, state and private, into better coordinating their work, which ,of course, creates

difficulties and delays whenever they need to refer their cases to other services (comment about

coordination of services to be included in the conclusions).

One of the main problems is that other structures, organizations, services know very little, if at all, about

23


special problems and needs of asylum seekers, let alone those with specific problems causing

vulnerability.

(comment about lack of information and training to be included in the conclusions).

Self-image: The discussion turns around the way service providers perceive the idea asylum seekers

have for them. Initially, the mention the question of sex (they are both female, as the vast majority of

social workers in Greece). The asylum seekers usually staying at Lavrion come from societies where the

traditional roles of the sexes are still very present and where authority exercised by women is at least

something new or surprising for the majority of the asylum seekers. Therefore, initially there is an amount

of reluctance or reserve but, usually, after a while it is no longer an issue. In any case, from the very

beginning there is absolute respect in the relations and contacts.

Another important point is that during the initial stage asylum seekers are still full of anger and they want

to express this anger, but, very soon, they calm down and collaborate (notice: the time factor is very

important. To be analyzed in the conclusions).

2. External help - Debriefing

A long discussion followed about pressures suffered in the course of duty and ways to alleviate the

burden fight the stress and avoid burn out. The answers are centered around:

- taking conscious about their personal role within these many times stressful situations and learning to

make the distinction between things involving them in a personal way or not. Also, thinks expected

from them by the service users and by their superiors in the Social Service. Therefore, an important

factor is to situate themselves within this exchange and relations net.

- As for external help, there is no budget for professional debriefing (for instance, with a mental health

professional. To note that this is a general default for all services and organization in Greece dealing

with relevant issues. Comment to be included in the conclusions). Something they have organized and

trying to keep as a permanent feature of their weekly program is the weekly meeting where they

discuss all sorts of problems that have arisen during the week, share information and opinions, consult

each other always to handle newly appeared situations, etc. They have also set up specific hours for

consultation with the clients in order to put a skeleton of program necessary for their work. Added to

that, the Supervisor for the central offices of the Hellenic Red Cross in Athens has a meeting with them

once a month. They insist that the meeting should take place always in the premises of Lavrion, in order

to familiarize the supervisors with their specific situations and problems on the spot (comment to be

analyzed in the conclusions).

3.1 The discussion turned more specifically to the subject of the research. Asked about the negative

behaviors or reactions of asylum seekers given their long experience, they say that it is to be expected

that, on the basis of the ordeal suffered by the asylum seekers both in their country of origin and during

the journey, it is normal to present reactions of mistrust, reserve, difficulty to adapt. Also, at the

beginning they have false information and impressions as to the material help given by the Greek

authorities, because most of them have heard about reception conditions in other European countries

and they are bitterly surprised.

The question of what gave them strength to go through all the ordeal and reach finally Greece, taking

into consideration the ethnic origins of the residents of Lavrion, the Afghans see themselves as

responsible to protect their families back home (home includes also refugee camps for Afghans in

24


Pakistan and Iran) and they have to be strong at all costs in order to sustain their families. Therefore, for

them, family ties are the most important motive. For the Turks (either of Kurdish ethnicity or not) political

motivation and ideology is the strongest motive.

To the question whether following all these persecutions and problems makes them stronger or whether

they have managed to draw psychological and mental strength through all these, there is a two-fold

answer: on the one hand, the law of nature is that the strongest survive; therefore, we don’t know how

many did not manage to survive and to escape and, on the other hand, we don’t know how strong

they were as characters, personalities, etc., before the events changing their lives took place. So, it

may be risky to come to easy conclusions.

3.2. Vulnerability: regarding the definition of vulnerability, there is no definition for the contents within

the organization. They use for their work the international terminology and definitions. However, the

limits of vulnerability are not very precise. According to their experience, persons who cannot adapt to

certain social standards may be vulnerable.

The question regarding limits of vulnerability that may be different for various individuals, in a way that

certain people may be vulnerable in certain sides or parts of their existence and not to other sides or

expressions of their personality, a discussion follows clarify the proper understanding of this notion,

followed by the answer that judging the cases one by one for their own particular merits and

characteristics is the answer. There is no way to face different and particular problems and abilities in a

blanket fashion. Therefore, the factor of time again is very important in order to explore problems and

strengths. Being an asylum seeker, in any case, is a vulnerability.

3.3. Individual approach is the key to facing properly the needs of asylum seekers. Their two basic

demands are legal safety (status) and work (financial stability). Torture victims and other vulnerable

person, however, have additional problems, such as somatic and mental health problems, infirmities,

there is a lot more time needed to help them follow therapies, etc. in order to help their empowerment

and autonomy (notice: the factor of time, along with specialised professionals is extremely important).

3.4. There is a long discussion as to what would really help into better organising the professional’s

working in reception or refugee center, in order to identify as soon as possible the particular needs of

vulnerable persons. Would it be more specialised staff? Would it be special additional training?

Apparently, the social workers participate to in-service seminars, in order to be informed about new

best practices and to exchange good practices and better coordinate with other stakeholders.

What would be really helpful would be a resident psychologist.

The referral possibilities, although existing, are not sufficient. Some years ago, the Red Cross had a

project (non-existing now due to funding) covering the visits of a Psychiatrist and a Sociologist, twice a

month.

The question what else would help to better face and fulfil the needs of the asylum seekers raises the

issue that the better and the sooner asylum seekers can understands their own situation and be clear

about their goals, the sooner they will leave the Center and receive help leaving independently. The

aim of the Social Service is to help them leave the Center sooner than later.

Of course, steady funding would be the most important tool to cover the many-many existing needs

despite all the help and volunteer offer the Center receives. As far as funding is concerned the main

issue to be understood is that it should be steady and continues and not based on projects having a

25


beginning and an end (.

Target group discussion

It has been very difficult to try to organise a target group discussion in Lavrion for the following reasons:

1. The third interviewee, who is in hunger strike, refuses to talk about anything else, or of a more general nature, than his own specific case. Apart for the two other interviewees, two more residents participated in the target group discussion.

2. The others were obviously not eager to sit together and discuss personal issues involving health, vulnerability, personal needs, etc. They bring the discussion all the time only around politics, the future of the political struggle in their country, the tolerance or even collaboration of European countries towards Turkish authorities as far as human rights protection is concerned and other matters of political nature, social issues and such.

3. Every time there is an effort to turn the discussion to the matters dealt with by the questionnaire they are clearly avoiding to give answers. Probably, they do not even trust each other or the interpreter and they are always suspicious that such a discussion may reach the information services of their country.

Notice: this is not without reason since there are grounds to believe that several times in the past their

political groups and organizations had been infiltrated by informers.

RESEARCH IN THE SHELTER - POLYCLINIC OF THE NGO MEDECINS DU MONDE IN ATHENS

Location of the facility The facility is located in a building in a very central place in Athens (Samphous str., no 12). The Polyclinic

has been established by the NGO several years ago providing health services to all undocumented

foreigners, who have no access to the National Health System (State hospitals), but also to Greek

nationals who have no social security.

It is staffed with volunteer doctors of various specialties and provides very good services considering the

limited means. From the beginning of their operation there was always very close relationship and

collaboration with the Rehabilitation Center and they were referring to MRCT cases of probable torture

victims for further examination and identification. The visit was carried out during the first two weeks of

October 2009.

Description of the facility- material conditions The building is a construction of the 70’s and the effort to maintain it in a good state of repair is visible.

When the visit was carried out they had moved the beds, etc. to half of the usual space in order to re-

paint the floor.

The organization uses the building of seven floors for its offices (5th and 6th), for the offices used by the

social service (4th floor), the shelter (2nd and 3rd floor), for kitchen and storage (1st floor) and the

Polyclinic (ground floor).

The shelter is situated in two floors of mixed use; part of it as sleeping area and part of it as common

space for meals, gatherings, language lessons, space for the children to play. Since there are not

enough rooms to use as sleeping areas, they had to separate men from women and children. This

26


means unfortunately that families are separated. The effort of the staff is to find outside the shelter small

apartments etc. to settle the families in priority, as it was the case with the first interviewee.

The place is clean and orderly. One of the rooms, usually used for lessons of language and culture, has

also a TV and this is where the interviews took place in privacy. Next to it, there is a room where

volunteers come to give lessons to the children and to organize creative activities for them.

Staff The staff, although, under a lot of pressure shows good disposition and the atmosphere seem quite

relax, although not without lack of order and discipline. The overall impression is positive. Paid staff is

only a minority. The social workers belong to the paid personnel. Also, the general manager, the two

secretariat assistants, the cultural mediator, cleaners, cooks, etc. are paid staff. As to the health

professionals who are volunteers, since they rotate, the numbers are not stable (some of them are

participating also to the missions of the organization outside Greece).

Funding and management Funding has two sources: one is voluntary contributions of individuals, companies, etc. to the NGO. The

other is projects submitted and funded by the Health and Welfare Ministry. Especially for the shelter, this

second source sustains its existence.

The management is done by the general coordinator of the organization’s projects, Mrs Thanou, who

responds to the President and the Board of Directors of the NGO.

Capacity The capacity fluctuates around the number of 40 persons.

Needs of the facility What would be needed is more space, especially in the form of separate rooms, so that families can

live together during the months they will spend in the shelter before another solution can be found.

Interpretation needs are partly covered by the cultural mediator (Dhari and Farsi), but for other

languages they have to out source, which is not always easy.

Medical and psychological assistance and care does not seem to be a concern, since they have it

practically in house.

About children’s schooling (most of the children are at the age of primary education) in principle is

provided by the local public school. However, the need for a specialized teacher to work with non-

Greek children in order to better prepare them to adapt, is felt.

Interviews VII a. Interviews with service users

Interview 1: E. Z. (female)

(with interpreter)

1. Citizen of Afghanistan, ethnic origin Tadjik, age: around 60. Three children, all boys, aged 17, 14 and

12 years old. Husband killed by the Taliban. In Afghanistan their village was near Majar-i-Sharif and they

were farmers. Before the Taliban, they had no problems.

27


2.1. She is in Greece already for one year and three months. She traveled through Turkey and passed

by boat illegally to the island of Lesvos. She stayed with her children for 12 days in the detention camp

of Pagani.

During that period the only thing they were given was food, they were spending 24 hours per day in

doors, without permission to go to the yard and she had contact only with people in uniform (police).

When they came to Athens due to their situation they were taken in charge by the NGO Medecins du

Monde and spent a long time in the shelter of the organization in the center of Athens.

The NGO found an apartment for them nearby and will be paying the rent for one and a half year. The

family has to pay the bills, like electricity, water, etc., which is difficult because the financial help they

receive, is very low and they have to cover expenses for food, etc. (to note that financial help given by

the State Welfare Services to recognized refugees with special protection needs is no more than 300,00

per month).

Due to the care needed by the children, but also her educational level, language problems, etc., it is

very difficult to adapt in a society and culture so different fro her own, she cannot find work and she is

constantly worried about her children and their future.

The children go to school, again arranged by the NGO with additional hours for adapting into the

language, the schooling system, etc.

She is very glad that herself and her children do not have health problems.

They feel safe and secure. Exceptionally, and due to the help of the NGO, they were very quickly

recognized as refugees. Others, in similar situation, have to wait for years (comment to be analyzed in

the conclusions).

They have no relatives anywhere else and her expectation is to stay here and to have her children

study.

She is feeling socially and economically vulnerable (lack of husband, very young age of the children).

She is feeling very dependent to the supporting NGO as there is nobody else to turn to for help. She is

feeling grateful and, at the same time, insecure for the future.

2.2. The whole ordeal made her more tough and strong since she had to take full responsibility for the

children and herself. It was merely a question of survival.

For the time being, she does not feel at all that she has regained confidence to herself and her abilities

since she is totally dependent from public welfare and help from the NGO. She does not speak the

language. She cannot even understand what her children are learning at school. She needs the

intervention of the social service of the NGO in all her everyday transactions, apart from going to the

local market to buy food. This sense of helplessness is bound to continue for a long time given her

inability to work.

2.3.1. She does not understand the term “vulnerable” and she can only grasp part of it expressed as

“needs” (woman, not educated, widow, three children under age, no language skills, no work skills).

2.3.2. It was the NGO that identified the needs and put pressure on the authorities to give refugee

status, which entails this little amount of Welfare aid.

2.3.3. The authorities did not really address any problems by themselves, without the intervention and

pressure of the NGO.

Interview 2: A. R. (male)

(with interpreter)

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Afghan, age 45, married with four children. In Afghanistan, he was a farmer living in a village close to

Kabul.

Fourteen years ago, his left leg had to be amputated, due to a bombing by the Taliban. Their life in the

village was destroyed and they had to move to Kabul first and later to Iran. They spent six very difficult

years without documents and they decided to leave the camp in Iran and managed to enter Greece

illegally via Turkey and by boat to the island of Lesvos, one year ago. The family has the status of

asylum seekers (pink card) and the legal and social support comes by the Greek Refugee Council and

Medecins du Monde. There is no financial or other support by public authorities.

2.1. In the camp in Lesvos the family spent 12 days and the Greek Refugee Council intervened notified

the Medecins du Monde and they came to Athens to the shelter of the NGO, in the center of Athens.

In the camp in Lesvos (the detention center of Pagani), they were kept indoors all the time, only met

police officers and they were not given any information about their situation, their rights, etc.

Housing: The family lives in the shelter of the Medecins du Monde for the time being (see description of

the premises above), but they are wishing that they could move into a small apartment where they

could have their privacy as a family.

Work: Due to his health situation, it is not possible to work (any manual jobs) and language problems

and lack of skills make it impossible to have any desk job. The children are very young - the first one, a

girl, is only 13 years old and the other three 12, 10 and 4 – to work.

Education: The children go to school. The educational level of him is very low (primary school) and his

wife is almost illiterate.

Health: He has many problems with his amputated leg. There is need for replacing it, but, for the time

being, there is no possibility to cover the expenses by the public health system. Later on, if he receives

refugee status, it may be possible. In any case, he suffers a lot of pain, especially at night, which

prevents him from sleeping, with the additional problem that he shares a dormitory room with other

men.

Safety and security: Since they don’t have a definite status, he cannot yet feel secure about staying in

the country. He can only hope….

Rights and citizenship: The information and assistance they receive comes only from the NGO

protecting and helping them. They don’t have the education to fully understand the various legal and

procedural intricacies of the system. They are totally dependent on the help and advice by the NGO.

Rights to citizenship in Greece is a very difficult and far away prospect for refugees

Expectations and hopes: First, to move from the shelter to a small apartment in order to have again a

family life. Secondly, to receive status, therefore residence and stability in Greece. For the future, he

wants education for his children. He cannot make any more specific projection for the future given the

precariousness of the present situation.

Self image: Living in the shelter and having additionally mobility problems due to his infirmity, he is not

29


yet in real contact with the social environment (the Greek Society).

For the time being, he is facing many difficulties and problems, despite the fact that he recognizes and

feels grateful for the help of the NGO.

2.2. The balance turns towards the negative points, meaning that he does not feel having developed

any particular strengths. Only his sensitivity is increased when he relates his ordeal, with tears in his eyes.

2.3. Without really understanding the term, he speaks about his infirmity, the needs of his family, etc.

There was not any measure from the authorities to face his vulnerability. Without the intervention of the

NGO, he would not be in the present situation. He is not able to elaborate further, since his

understanding of the procedure is extremely limited.

2.3.2. He is not in a position to judge whether the identification of his needs was done well or not. He

only knows one thing; how the NGO gave him shelter and protection. He has no measure to compare.

2.3.3. Again he has no measure to compare. The NGO staff do the best they can and this is all he can

see.

Interview 3: A. K. (male)

(with interpreter)

Age 25, Afghan citizen, from the area of Majar-i-Sharif (Tadjik ethnic origin). He is single. His paternal

family was killed 15 years ago during the war with the Russians. Together other refugees he went to Iran

where he stayed for 14 years without legal documents, without school and without steady work. In

essence, since the age of 10 years old, he is without any schooling. It is obvious that learning Greek is

extremely difficult since he is practically illiterate in his own language.

He came to Greece one year ago, crossing the river in the border between Greece and Turkey and,

without being apprehended by army or police, came to Athens, went to the Greek Refugee Council,

which helped him with the asylum application.

2.1. The GCR identified him as vulnerable and referred him to the Medecins du Monde where he is

living in the shelter.

He has psychological problems and he is in therapy.

He resides in the shelter of the Medecins du Monde. He does not have a job and his asylum application

is pending. He now has the status of asylum seeker (pink card).

His health problem (psychological) makes very difficult to discuss with him in a structured manner

because he erratically jumps from one thing to another and is not easy to make him concentrate.

He has fears about his safety and stability and he does not express any expectations.

Due to the difficulty described because of his health, it has not been possible to respond in a coherent

way to the questionnaire.

It is obviously a vulnerable case which is under shelter in protection only because the GCR and the

NGO were able to identify and give assistance. The State authorities had not played any role in this.

It is useless to analyze what can be the future, etc., since the number one problem is how his health will

develop.

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Interview 4: Y. D. (male)

(without interpreter, interview in French)

Single, age 32, Mauritanian. He has brothers in France and in Belgium and one sister in Norway. From

Mauritania went to Senegal and from there to Syria (no visa required) and through Turkey he came to

Greece without documents in May 2008. He tried to join his family in Western Europe but he was sent

back to Greece following the Dublin Regulation.

When he entered Greece, he stayed for six days in a camp in Samos island. There was no social

service in the camp and the medical care consisted of the following: initially, he was taken to the

public hospital for X-rays and then nothing else because there was no systematic clinical examination.

The medical doctor visiting the camp invited to appear for consultation only those who had a health

problem.

2.1. He is residing in the shelter of the Medecins du Monde, in the center of Athens. He has no job and

he is to begin therapy due to psychological problems.

His education is low. He never had the chance to go beyond a few classes of primary school and he

was doing manual jobs until his arrival to Europe.

He is in the process of his asylum application; therefore he has no permanent status. This makes him

insecure.

His information about his rights is coming from the NGO. Citizenship is not something for any number of

years to come, if ever.

His dream is to join his brothers or sisters. How will that be possible, since he tried and failed already, due

to the Dublin Regulation, is something that he has difficulty to understand.

He expresses his need for help, but his contact with the society around him is for the time being

extremely limited since he lives in the shelter and does not confront everyday problems.

2.2. His ordeal has negatively influenced him and his state of mind coming round and round again to

the same points with limited ability to concentrate shows that he needs psychological help. He

responses to any question having to do with his state of mind or perception of his situation and problems

in an incoherent way.

2.3.1. He does not really give an answer about his vulnerability. 2.3.2. As to the identification of his needs, the state authorities never identified anything. If it were not

for the NGO’s intervention, he would not be in the present situation enjoying shelter and protection.

2.3.3. He is grateful for the help received by the NGO’s but he say that his real need is to join his brothers and sister and that is not addressed (comment to be further analyzed in the conclusions).

Interview 5: M. S. (male)

(with interpreter)

Age 24, Afghan citizen of Hazara ethnic origin. Family was living in Kabul.

The whole family including his sister, 36 years old with husband and four children, left Afghanistan and

went to Iran. There is another younger sister (age 22), married who has a baby. Her husband works as a

carpenter.

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In August 2007, came to the island of Lesvos, by boat. The numbers of undocumented entrants were

lower then and the situation more tolerable in the camp. They stayed two days and were given an

order to live Greece within one month.

2.1. They came to Athens and it took them two weeks to find the Greek Refugee Council offices.

Helped to submit asylum applications, they were sent by the state authorities to a shelter – ex-military

camp – far away around 200 klms from Athens. The place is completely isolated and after two months

winter came and they could not stand any longer to stay away from everything and left, came to

Athens and try to survive.

Two months ago there was room in the shelter of Medecins du Monde and they were settled

temporarily in the shelter, in the center of Athens.

He goes to classes of Greek language and he has already made some progress.

He hopes to be able to find a job, but he seems rather of delicate health, giving the impression of under

nourishment. Without complaint of any particular health problem.

He was following Lyceum when they left Afghanistan.

For the time being, they feel safe but it will no be really so until receiving status.

His information is coming from the NGO assisting them and explaining to him step by step what they are

doing.

He would like first to receive refugee status and to study, but, most of all, to find work to sustain himself

and help the family.

He sees himself as somebody with serious problems who needs a lot of help in the near future. He

cannot disassociate himself from his sisters and their families. His perception is not individualistic, but he

sees himself as part of the collectivity of the family.

2.2. Given his present precarious situation, he tends to see things rather negatively. On the other hand,

he tries to acquire patience and not to expect too much of fear of disappointment.

2.3.1. Again his perception is not about only himself, but as a part of a vulnerable family (very small

children, etc.).

2.3.2. Identification of vulnerability was made initially by the Greek Refugee Council.

2.3.3. The state authorities addressed the need by sending the family to the camp of Sperchiada (see

relevant comment in the conclusions). Two months later, they “escaped” and preferred to look for

solutions in Athens than to stay there. Now, their needs are much better addressed by the NGO.

Interview 6: Z. S. (female, sister of interviewee no 5)

(with interpreter)

Age 22, married, with a baby. Husband doing odd jobs. He used to be a carpenter. Hazara ethnic

origin. They were living in Kabul. Left with the elder sister, her husband and four children, as well as their

brother (interviewee no5) and the whole story presents the same facts as in the interview no 5.

2.1. The differences are that:

- She, as a girl, never had any proper schooling.

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- Her condition because of social and educational situation is much more dependent on the men in the family and now with a little baby in her hands she does not have many chances for an education or a job.

She seems to be in good health and she is grateful for the help provided by the NGO.

She does not have any expectations other than to live with her family and raise her child without major

problems.

She expresses herself in a very low key way feeling that she is part of the family bound to face life as

such.

2.2. Until now, she only met difficulties in her life and she does not feel strong enough to face problems

on her own.

2.3.1. She feels dependent on others, being a woman and being an asylum seeker feeling that things will be decided by others without have ability to influence such decisions.

2.3.2. The identification and the addressing of the needs follows the same pattern as the one concerning the rest of the family (see interview no 5).

VIII. Target group discussion

Participants were all the interviewees with some members of their families.

It has been very difficult to organize a target group discussion because, although most of the

participants are residing in the shelter of the Medecins du Monde, therefore it is easier to gather them,

they belong to different nationalities or ethnicities and they are not eager to share a number of things

with others. Reserve, even mistrust are a problem, since, especially, their status is still and precarious.

Given the above, the discussion centered around the following main problems:

1. Material conditions; although grateful to be sheltered and fed, they complain about lack of privacy.

2. Medical care is provided and the quality and attention given by the NGO (volunteer doctors) is good.

3. They do not feel very optimistic in regard to the future and their stability, since they know that Greece is the most restrictive country of the European Union in granting asylum.

4. Finding jobs is very difficult for them due to their health problems, level of education and lack of qualifications.

When we moved from more general topics to the most specific questions as per the guidelines of the

research protocol, their answer was that they had already discussed that during their individual

interviews and it was evident in the atmosphere that they were not eager to discuss it in a larger group.

They begun being restless and showing that they want the discussion to end.

VIIb. Interviews with service providers

Interview 1: Qadir

Cultural Mediator with Medecins du Monde

He is Afghan citizen of Hazara ethnicity, male, age 32.

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Already in Greece for more than 10 years. He translates from Dhari and Farsi.

1. This interview is of particular interest, because Qadir has been a service user before becoming a

service provider. H understands very well the needs of vulnerable person under the protection of the

NGO. He has been through all the usual stages of asylum seekers coning to Greece (illegal entry, arrest,

staying in detention camp, difficulties with the asylum procedure, final rejection, chance to legalize his

residence, etc.) and he was run of the those few who showed particular strength and took his life in his

own hands managing finally to overcome the difficulties and impediments.

In short, his story is that his struggle begun when he was a student in the last class of the Lyceum and the

Taliban attacked the town and took the whole class as hostages. He was imprisoned along with the

other boys for about two months and after his release went back to find his family but they were gone

and the house was destroyed. Still under the danger of the Taliban, he had to join a group of people

escaping and left the country.

After his arrival in Greece, started with the help of the Red Cross to look for his family without result. Two

years ago, managed to travel to Afghanistan together with a cinema director and camera and he

searched and finally reunion with his family is filmed into a very interesting documentary. He also got

married during his stay with his family, he returned to Greece and now he is making arrangements for his

wife to come and join him in Athens.

2.1 Having being through the ordeal himself is in a better position to understand what the others are

feeling and experiencing. Of course, the language he shares with the asylum seekers is a great asset.

Education: While in Greece, he followed a specialized course for interpreters. His knowledge is coming

also from years of experience and discussions with the staff of the NGO, in particular social workers and

psychologist.

Safety and security: in this field he never felt any problem.

Expectations: He has no particular comments to make other than he will continue his efforts to do his

work in the best of his ability, although it is difficult to see the pain of other people and be reminded of

his own problems in the past. As for improvements, this is connected to bigger budget of the NGO in

order to hire another person to share his work load. After some thought, he adds that it would be good

to be able to follow more specialized training seminars in order to ameliorate his level of knowledge

and skills and, also, that a more systematic de briefing would it be helpful to face the tensions.

Self-image: He thinks asylum seekers are looking at him with expectations for help, after going through

at some point a stage of reserve and this makes him try harder to fulfill their expectations. However,

again the possibilities, especially in material questions of the NGO are limited and this puts also a limit to

what he can do to help the asylum seekers.

Assessment of experience: He considers his experience so far to be positive as a whole. He feels that he

is really helpful and this gives me satisfaction.

2.1., 2.2., 2.3., 2.4. Of course, there is a lot of pressure on his work and sometimes he feels it more than

other times, especially when he is unable to do something practical and concrete for reasons outside

his control. All the assistance he can have dealing with such pressure is to discuss things over with the

staff of the NGO (social workers and psychologist).

3.1. Emotional involvement is the most difficult part when you need to keep safe distances in order to

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do this work with the necessary objectivity. Especially this is important when you have to interpret for

not just the every day material needs, etc., but for therapy sessions with the psychologist, where people

open up and express their inner feelings and needs (Qadir mentions this because he also works with the

NGO BABEL providing psychological support and therapy to refugees – asylum seekers). In this context,

sometimes during therapy the asylum seeker was coming in a very intense state of nerves, etc. This may

create sometimes safety concerns.

3.1.b,c.. Personality and strength of character is the main equipment needed to survive situations such

as the ones encountered by refugees. What can be helpful additionally is to have some external

conditions giving them the chance to recollect themselves, such as a space to live which can provide

privacy and calm. It has been his own experience when he was in the position of asylum seeker.

However, these conditions under the present circumstances in the country with inadequate housing

conditions cannot be met.

3.2. He has not really questioned the definition of vulnerability given by his organization because, on the

one hand, he thinks they know more about such things and, on the other hand, people who are helped

by his organization are never turned away as non-vulnerable, therefore the question was not raised for

him of making a selection.

3.3. His attention is turned more to the issue of identifying well the needs and doing their best to fulfill

them. Again, he mentions funding as being the number one issue into providing better material

conditions in order, then, to improve all the services provided.

3.4. So, he thinks that within the existing limits (funding, staff, etc.) the organization is doing quite well,

given that most of the staff is volunteers.

Interview 2: Nansi Retinioti (female)

Social Worker

Born: 1984

3 years of work in the NGO

Languages: Greek, English, French and some knowledge of Farsi

Before the interview she has discussed the questionnaire with her colleagues, social workers, and she is

giving answers for the three of them, since the other two were not available. Therefore, we could

consider that we interviewed three persons and not only one.

To note that the Medecins du Monde have apart from the Polyclinic and the shelter to take care of a

mobile unit going with a van at late hours in places where drug addicts are gathering and, also, they

have recently opened a second medical unit in a poor, industrial neighborhood of Piraeus. This means

that the same staff members have to alternate around these various units and services.

2.1 Challenges: In certain cases, the presence of an interpreter can be creating difficulties of

communication, especially when the interpreter is male and the service user is female, victim of

violence (rape, torture, etc.). This is why they try to acquire some little knowledge of one or the other

language in order to have a possibility of some basic communication for certain issues.

Another difficulty is of course the difference in culture between the service provider and the service

user. When it comes to European culture professionals to help service users from oriental culture, they

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need to be properly informed and understanding of differences in rhythms of life, mobility to face

problems, in general. When it comes to vulnerable cases more in particular, the above are becoming

even more acute due to health problems, infirmities, etc. This makes integration even more difficult.

Another challenge is the educational level. When it comes to Afghans, for instance, it should be kept in

mind that the vast majority has rural origin and in Afghanistan they were living in villages working in

agriculture. It is exceptional to meet Afghans with educational level higher that secondary education.

Now, these challenges open minds and widening horizons for the professionals in the way of thinking

and mentality. On the other hand, it is difficult to feel that people are totally dependent on you.

About more positive and negative points, it should be added that although you have to perform your

duties in a holistic way from A to Z, very often you don’t have structured guidelines, protocols and

instructions.

It is positive that the service users have the patience to hear and learn from you, but it is negative, at

the same time, that they do not take initiatives to help themselves.

As for the education of social workers, it is certainly not sufficient to face vulnerable groups and to

acquire knowledge on transcultural issues. There has to be a bigger effort within the educational frame

and more opportunities during the practice period in this field.

Safety and security: As for physical safety, sometimes they may feel threatened by an agitated person.

But the most important to them is the professional safety and security in the sense that they feel that

they cannot offer adequate and sufficient services to the service users and that the asylum seekers do

not have the feeling of being secure enough and assisted enough.

Expectations: There is a huge amount of work needed concerning the whole system in the country

comprising of course more programs of education, of transcultural understanding and, of course,

funding.

The focus should be empowerment and not just welfare. The system should provide hope and openings

instead of institutionalizing. There should be inclusion and creativity.

Self image: Dependency is the key word here. Although, the social workers develop close relations with

the asylum seekers and feel very concerned and also satisfied when they manage to achieve results,

on the other hand this dependency is also a burden. So, if they want to assess, they would say that a

positive assessment has its origin in professionalism, but a negative assessment burdens you when

although you have tried your best there are limits because of inadequate or even non existent

structures. Therefore, the environment surrounding their work may time is causing dissatisfaction and

feelings of powerlessness.

3.1.a The people we work with come from a different cultural origin. It takes them a long time to

understand a number of differences and, until then, they feel insecure in their behavior since they were

raised in a different culture and way of life. Here they are facing unknown situations creating feelings of

insecurity. In other words, they suffer a cultural shock. The passivity and inertia characterizing to a large

extent their societies of origin, not only are an impediment in their new environment, but also make

them more inept to absorb the cultural shock suffered and to start reacting positively towards

integration.

3.1.b. Observations and experience shows that they have been able to a large extent to handle

situations of mourning, disaster, catastrophe, war. Perhaps, two factors are important in this respect:

- one is that, as all human beings, they have the natural ability, up to a certain degree, to absorb such

severe shocks in human beings lives

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- the other factor is the element of time; between the terrible events causing them to flee their country

and arrival to Greece there is usually a rather long interval, amounting to months if not years. This

element combine with the element of the struggle to escape and to arrive somewhere safely may be

another factor helping their acceptance of the terrible events.

Therefore, what we might say is that they have to develop survival dynamics.

3.1.c. In the third stage, takes place the process of helping them to develop strategies and dynamics

of integration. Professionalism on behalf of service providers is very important in order to prevent

institutionalization and to develop a whole series of new feelings and reactions towards survival,

adaptation, integration.

At this stage it is very important to fight insecurity and lack of information (for instance, concerning their

rights, etc.)

3.2. There is no special definition used by the NGO, but as it derives from the statutes of the Medecins

du Monde in their goals it is to fight in order to help (a) victims of natural catastrophe, of war, of

maltreatment, of torture, of violence, of racism, (b) refugees, (c) migrants, (d), monoparental families,

(e) families with numerous children, (f) disabled persons, (g) citizens without income and social security,

(h) undocumented persons, (i) unaccompanied minors, without distinction of nationality.

3.2.c. So far, there is not much analysis when dealing with this or that category. It could probably be

useful to develop in the future. The way it is done may hide traps, in the sense that people could be left

outside the protection net.

3.2.d. At this point, we think that the element of time is very important in order to show that vulnerability

may be in part or as a whole a temporary situation which, given time and the right interventions, may

pass. It is very important to avoid the stigma of vulnerability for life.

3.3. They are of the opinion that training is never enough and that there is always room for more

training, more information, better development of skills and knowledge. This can be done by outside

training, which is extremely useful because they exchange views, information, experiences with other

organizations and training inside the organization, which is an on going process. Very important factor

is to have frequent meetings of the interdisciplinary team. This gives the opportunity to have view-points

and perspectives from other scientific specialties and in the case of Medecins du Monde the team has

regular weekly meetings.

Another important tool developed in an on going way is internal guidelines, covering the main aspects

of the NGO’s work with refugees. These guidelines are informal, just as a sort of orientation tool for the

staff, including issues like psychosocial support, medical care, employment counseling and needs

resolving teams according to the particular case.

3.4. Again, training and more training along with the practical every day experience is the only way

that enable the professional to give more and something even better and not to feel having filled all

the gaps. The particular group of service users is a very “difficult” one. But the other side of the coin is

that once you succeed in doing something, satisfaction is even higher.

Interview 3: Ianthi Stavropoulou (female)

PhD in Psychology

Volunteer, Head of Mental Health Service of the Medecins du Monde

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Languages: Greek, English

Tasks include: organizational issues of the mental health service, supervision of the

Professionals, therapeutic sessions, group therapy with the children living in the shelter

2.1. Her work with the NGO has started recently and her working experience is mostly coming for the

U.K., where she was accustomed to work within a certain organizational framework in a structured

program, with a number of principles and terms of reference. In that context, she was able to

appreciate all the aspects of working with different cultures and the value of open mindedness and

flexibility. She was working with the existentialist method and she believes that there is need for

constant supervision in this field of work.

Discussing the general conditions in the shelter, she says that material conditions are not helping at all

since the shelter has limited space and possibilities and people cannot have neither privacy nor normal

family life (see description of the premises and material conditions).

In questions of safety and security, she does not feel threatened or in any way endangered in general.

Expectations: She hopes to be able to have the help of a psychiatrist in the near future, to whom she

would be able to refer cases when needed. As her work in the NGO is rather recent, she is hopeful to

organize mental health services in a more flexible way, in order to serve more users, without of course

lowering the level of services and the quality.

Self image: She understands her role as a person representing hope, together with the other

professionals of the NGO, that they are a sort of life-buoy thrown into the sea as a possibility for the

refugees to unload their burden.

2.1. Due to practical problems, one cannot help at the level one might expect and wish. This creates

disappointment. On the other hand, whatever you can do makes the difference and can give

satisfaction. It is also, of course, the question of setting realistic goals. So, the goals that realistically can

be set for the time being and for the existing financial and organizational possibilities, have to do with

resolving practical problems of an external nature and, also, continuing to provide education and

training, as well as supervision for the staff. This way, the staff will be better empowered to carry out

their duties.

3.1.a. The usual findings are PTSD, trauma, depression.

3.1.b. The will to survive makes asylum seekers to continue the efforts in the various aspects of their

livelihood. They suffer frustration and they turn back and they need assistance and support to begin

trying again.

3.1.c. There has to be a holistic way to assist them. Social assistance together with psychological

support, with help to find employment and educational chances, all of them together are needed to

reach to a satisfactory outcome.

3.2. The problem is a very broad one, with many faces and sides. Therefore, the definition until now has

rather being given in the negative way than in the positive. For example, who is not vulnerable?

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3.3. The level of services in identification and addressing of the needs given by the NGO so far was

acceptable, given the limits financial, organizational, etc., of the NGO. However, there is a lot of room

for improvement.

VIII. Target group discussion with service providers

Participated the three professionals who were separately interviewed, namely the social worker Nansi

Retinioti, the psychologist Ianthi Stavropoulou and the cultural mediator Qadir.

To note that I had separate discussions with the President of the organization, Dr. Nikitas Kanakis, as well

as the Director of the whole unit, Polyclinic and Shelter, Mrs. Evgenia Thanou, but the general policies

and strategies of the organization, as well as funding issues, organizational issues, relations with the

government, etc., although relevant in a more general way are not specifically linked to the questions

contained in the research questionnaire. They were very useful, though, in order to have a clear idea of

their positions and views about problems encountered in every day practice by a health service

providing NGO in the specific political, social and economic environment. This is reflected in the

general part of this report.

There is no need to give more details about their profession, position in the organization, origin,

languages,, etc. Therefore, it is useful to go directly to the discussion.

General issues: The work puts a lot of pressure on the shoulders of the professionals and there is a

difficulty to carry out this big load without assistance because of the financial constraints. There are

many things that could be valuable, but, since there are no real possibilities, they prefer to keep their

expectations low. For instance, they cannot have a woman interpreter.

Specific research topics: Instead of replying to the specific questions, they thought it was more

appropriate and useful to insist on problems of a more acute nature, which are not yet resolved so as to

reach the stage of analyzing in depth (strengths, weaknesses, etc.). Such problems are in an indicative

way their great limitations in material means and organizational possibilities in all aspects of the holistic

care necessary; in the housing (see description of the shelter), in the employment possibilities, in the

needed number of staff, etc.

There was nothing to change in the discussion regarding vulnerability definitions in what they responded

in the interviews and they ended with the comment that in order to offer more they need re-loading

which can come from satisfaction from the level of services they are in a position to offer.

They used the term “refueling” and the discussion was ended by coming around again to the means

they need to have to strengthen their potential.

RESEARCH WITH THE NGO PRAKSIS IN ATHENS

Introduction PRAKSIS is a non-governmental, non profit organization, established more than 10 years ago in Athens.

The basic team had worked for many years with refugee and migrant assisting NGO’s, especially in the

health sector.

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The manager of PRAKSIS from its establishment until today is a social worker, Mr. Tzanetos Antypas, with

very long experience with Medecins sans Frontieres.

There is a long standing collaboration and friendship between MRCT and PRAKSIS and a lot of trust

established.

On the basis of this, they immediately responded positively to our request for help with the EVASP

research, providing us with a number of possible interviewees with a relevant profile, in order to choose

representative cases.

The interviews took place in the social workers’ offices in the premises of the polyclinic of PRAKSIS

situated in Athens, 5, Peoniou str. (very central in Athens, easily accessible by transport)

The organization does not have a shelter as Medecins du Monde. They have followed a different

working method in having a number of “protected apartments”, as they call it, where they settle

directly asylum seekers considered vulnerable cases.

From the suggested by PRAKSIS list of candidates for interviews, we selected those who had been

subjected to torture using, also, two other selection criteria:

their presence in Greece already for a considerable time (the time factor is very important as it will be shown in the conclusions).

the interviewees had visited the Rehabilitation Center and were followed by our services for a number of health problems (physical and mental). We want to stress the importance of the holistic approach for vulnerable cases, especially torture victims (see in the conclusions).

The interviews took place in the first week of November 2009.

All the interviews carried out with the help of interpreter because the linguistic level in Greek of the

interviewees is not sufficient to carry out a discussion including complex, notions or fine distinctions, etc.

(the time factor is very important as it will be shown in the conclusions).

We want to stress the importance of the holistic approach for vulnerable cases, especially torture

victims (see in the conclusions).

In the Polyclinic the services offered consists of primary health care, gynaecological treatment, dental

care, pharmaceutical treatment, psychosocial support, as well as promotion to the labour market.

Medical Service

Every year during the last years, they help more than 10.000 beneficiaries from 75 countries visited the

Polyclinics of PRAKSIS in Athens and Thessaloniki, while medicines of a total value of over 164.000 € were

supplied to 4,150 patients by the organisation’s two Pharmacies. The main sources of this medication

are donations by citizens from all over Greece, as well as by pharmacies and pharmaceutical

companies.

Social Service: Getting rid of obstacles

The Social Service undertakes the treatment of the multiple needs and problems of the people visiting

PRAKSIS Polyclinics. Social Service covers a vast range of services. It is the reception at Polyclinics. Their

aim is the prompt diagnosis of the pressing problems of people “at risk”, and the immediate and

efficient satisfaction of their requests. At the same time, the socially excluded groups that approach

PRAKSIS are given information and advice about their rights.

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The NGO offer its services to any socially excluded group which hasn’t got access to health services

and/or social and legal support.

Staff The staff is composed of medical doctors, nursing staff, social scientists (social workers, sociologists,

social anthropologists), psychologists, career advisors, various specialties (managers, teachers etc), but

also people who offer their time to support the administration of the organisation. Most of them are

volunteers and there is a core staff to manage the NGO.

Funding and management Funding has two sources: one is voluntary contributions of individuals, companies, etc. to the NGO. The

other is projects submitted and funded by the Health and Welfare Ministry. Especially for the shelter, this

second source sustains its existence.

The management is done by the general coordinator of the organization’s projects, Mr. Tzanetos

Antypas, who responds to the President and the Board of Directors of the NGO.

Capacity The capacity varies according to the funds available. The NGO has no shelter and has to rent a

number of cheap apartments for the protected persons. From year to year, it changes.

Apartments were not visited because we understood that the organization was not eager to organize

that.

Interviews Interviews with service users

Interview 1: E.M.A.R. (male)

(with interpreter)

Country of origin Sudan, born in 1977, ethnicity Arab, single.

He was arrested four times in his country of origin and spent in prison totally 14 months.

He had been tortured during his detention with systematic beatings, he was left for 3 days in a hole in

the ground, he was burned with hot iron, he suffered rape with broken bottles and other forms of

torture.

Following all these, when he managed to escape fearing for his life with the help of smuggling networks

through Turkey he managed to come to Greece illegally by boat. He was detained in a camp in the

islands during 3 months and then released as non-deportable and came to Athens.

He attempted twice to go to the U.K., where he has relatives and was twice returned to Greece as a

Dublin case. He is in Greece since 2007 and he was referred to MRCT in 2008.

His status is still unstable, remaining an asylum seeker.

2.1. His intension has never been to settle in Greece. He tried twice to join relatives in the U.K.,

unsuccessfully and his state of mind continues to be unwilling to settle in Greece. Furthermore, since the

41


protection and assistance in Greece is very minimal compared to what he knows from his relatives, he

sees every difficulty of every day life under a negative light.

Housing: The only positive thing that happened to him was to be given shelter by the NGO.

Work: Since his status is still uncertain and he still has health problems, he has not been able to find a

steady job. He survives with odd jobs here and there (like washing cars, etc.)

Education: Only compulsory education (he was a farmer in Sudan).

Health: He still suffers from torture sequelae and he was in need of surgical interventions and

gastroenderological care. He still suffers from pain and other symptoms due to his torture.

Safety and security: He feels anxious since his status is not yet stable.

Rights and citizenship: Only when he came in contact with NGO’s, he was explained about his rights

and helped with the procedural aspects of his case.

Expectations: His greatest and most important expectation is to be able to leave Greece and join his

relatives in the U.K.

Self image: Due to his past experiences and present status, he feels that he cannot cope without help.

He does not feel part of the society in Greece. He has the feeling that his temporarily here and remains

foreigner, although he is making an effort with the language.

Assessment of experience: For him there was not a question of choosing to migrate or not. He left his

country forced by persecution. His experience so far was very hard encountering many problems and

impediments.

2.2. His understanding of strengths and weaknesses and sensitivities is difficult. He turns over and over to

his problems, medical and social, and actually is not giving a sensible answer.

2.3.1. After a long explanation of the term, he recognizes himself as vulnerable from the health points of

view and socially.

The authorities by not granting him status yet have not recognized his vulnerability. He is only based on

the help of the NGO putting pressure on the authorities.

2.3.2. and 3.3.3. His needs were never identified by the authorities. It is only due to the help and

intervention of NGO’s that he has the status of asylum seeker so far.

Interview 2: A. K.D.J. (male)

(with interpreter)

Born in 1963, citizen of Afghanistan of Hazara ethnic origin, married without children.

Still and asylum seeker since his arrival to Greece four years ago via Turkey and then by boat to the

islands.

This is a typical case of an asylum seeker with serious health problems originating in his past experiences

in the country of origin, somatic and mental, which was never identified.

He left his country of origin due to persecution. He was arrested three times and spent two years in total

in prisons, subjected to torture (among other things non systematic beatings, electroshock to his fingers).

He has health problems; both somatic (orthopedic and neurological for back pain) and psychological

(PTSD) and he is following psychotherapy.

.

42


2.1. After his arrival, he had many problems until he came into contact with NGO’s, who by their

interventions tried to face them. Due to this assistance, he has received housing, language lessons,

integration to programs in order to find work and assistance for his health.

Education: Compulsory. His job was merchant of automobiles

Safety and security; He still feels insecure about his status (being still an asylum seeker).

Rights and citizenship: All the information about his rights is given by the assisting NGO’s.

Expectations: He hopes to be able to settle and live normally, having a job and being independent.

Self image: As he is still dependent on the help of the assisting NGO’s, he sees himself as a person in

need and himself esteem suffers.

Assessment of his experience: The difficulties he encountered on arrival (legal, social, etc.) make him

see his experience as a negative one, although he is grateful to the NGO’s that helped him.

He would like to have had a different choice, for instance seek asylum to a country with a structured

reception system, but he had no choice in reality. Therefore, he considers it useless to discuss.

2.2. Through his ordeal, he thinks that the way he faces life has changed and that he is more receptive

to understand the problems of others. His sensitivity to a number of issues is increased, including the

behavior of others towards him, how they see him in the social context of the country of asylum. Help

and support came only form the NGO’s dealing with his case.

2.3.1. The authorities have not in any way played a role in identifying his vulnerability. It was due to the

intervention of the NGO’s that his health and social problems were identified. He puts emphasis on his

somatic health problems, which make it difficult for him to find manual jobs and he avoids discussing his

psychological problems.

2.3.2. and 2.3.3. The authorities have never identified his needs. The proof is that he is still in the status of

asylum seeker. As for addressing needs, it was again not the authorities but the NGO’s that took care of

him.

Interview 3: H. M. A. N. (male)

(without interpreter, he speaks English)

Country of origin Afghanistan of Hazara ethnicity, born in 1987, single.

He has the status of asylum seeker. Legal proceedings are in course for family reunion since the rest of

the family (the mother and the brother) have been settled in Sweden. His family in Sweden is granted

asylum, already in 2008.

He left the country persecuted by the Taliban because his father’s involvement with the previous

regime. In 2002 his father and two of his brothers were arrested and disappeared. Eventually his mother

sold the property in 2006 and the family moved to Pakistan. Then the family split and he went to Iran

and through Turkey tried to enter Greece. The boat was spotted by the Greek Coast Guard. The

smuggler was arrested and the people left helpless on the boat. When the boat was drifted to the

Turkish coast, the police arrested the passengers. Our client was released following a mobilization of

Amnesty International and the second time the attempt to enter Greece was successful at 2008. He

was detained for 2 weeks in the camp in the island of Lesvos.

His mother, brothers and sisters are in Sweden and there is an effort to help him join his family and

43


because of this, his goal is not to stay and integrate in Greece. This influences his attitude towards a

number of things that would normally help him to settle.

In Afghanistan, he had suffered torture and threats and in Turkey beatings, deprivation of food and

sleep.

2.1. When he came to Greece, after his release from the detention camp he found himself alone in

Athens, without any help. Fortunately for him, NGO’s started dealing with his case.

Housing: He was given shelter and food provided with legal and medical assistance.

Work: He does not have a steady job because, mainly, his state of mind is that his stay in Greece is

temporary.

Education: He had received compulsory education.

Health: He has mental health problems and he is seen by psychologist and psychiatrist.

Safety and security: Since his status is not a stable one, he still has feelings of insecurity, aggravated by

his mental health condition and the separation of his family.

Rights and citizenship: All the information about his rights and the relevant assistance is coming for the

NGO’s.

Expectations: His expectations centered around his departure to join his family in Sweden. Only that.

Self image: He has a low self esteem for not being able to help his family and cope with problems.

Assessment of experience: Very negative assessment of experience. For him there was not a question

of choosing to migrate or not. He left his country forced by persecution. His experience so far was very

hard encountering many problems and impediments.




view and socially.





Interview 4: F.Z.A.M. (male)

(with interpreter)

Country of origin Palestine of Arab ethnicity, born in 1978, widowed with 2 children and his mother under

his protection.

He belongs to a Palestinian family, living in Iraq for many years. They has to leave the country and go to

Syria due to the war Iraq-Iran, when he was still 10 years old.

He had no status in Syria

He was arrested 5 times by the Syrian authorities where he resided, spent 42 months in prison. He was

subjected in various torture methods including falanga, electroshock, and evulsions of nails. He

managed to leave Syria and came to Greece. His wife as well as the baby died during the delivery. He

44


came to Greece with his mother and his two children.

He came to Greece in 2008 and he the whole family was detained in the detention center of Chios

before letting them come to Athens. His status is still the one of asylum seeker.

2.1. Being the protector of the family (two small children and his mother), it was particularly difficult for

him to face the problems of housing, food, etc., since there is no automatic provision by the state

authorities.

He started making the round of NGO’s to find solutions to the various aspects of his problematic

situation. There was nothing positive of all this experience of the first several months in Athens.

Thanks to the NGO’s the situation ameliorated in order to find housing, school for his children, some odd

jobs here and there (since his health problems demand not only a lot of his time, but also energy) (see

conclusions and comments).

He has being only up to level of compulsory education.

Health: Apart from his somatic problems due to torture, he has also psychological problems and

received counseling for a while.

Safety and security: Since his status is not a stable one, he still has feelings of insecurity, aggravated by

his mental health condition.

Rights and citizenship: All the information about his rights and the relevant assistance is coming for the

NGO’s.

Expectations: he is expecting status and help for himself and his family. His old mother needs medical

care and he is very concerned about the future of his children.

Self image: He has a low self esteem for not being able to help his family and cope with problems,

without the help of others. This goes contrary to his culture and up bringing as a man who protects and

sustains the family.

Assessment of experience: Very negative assessment of experience. For him there was not a question

of choosing to migrate or not. He left his country forced by persecution. His experience so far was very

hard encountering many problems and impediments.




view and socially.





Interview 5: K.M.A. (male)

(with interpreter)

Country of origin Palestine. Born in Gaza of Palestinian ethnic origin, in 1962, married (with 4 children).

Wife and children are now in Egypt.

He had an amazing (although many other Palestinians did) life for our standards. In short, as a child

with his family went to Egypt as refugees (after 1967). As he grown up, he became a teacher but he

45


was finding work, being discriminated by the Egyptians. He decided to move to the Emirates where he

opened a shop selling electronical appliances.

He was involved in a court case concerning his business and his license was not renewed. Instead, he

was arrested and put to prison where he finally spent 6 years. He was heavily tortured and finally

deported to Syria, beginning a series of deportations to Iraq, Jordan, Syria, Lebanon, etc.

While under custody by the various persecutors he was subjected to threats for his life, falanga, non-

systematic beatings, electroshock to genitals, hanging upside-down.

He is in need of medical aid, ophthalmologist for glasses, orthopedics, urologist for torture sequelae and

surgeon.

Today he suffers from sequelae, somatic and psychological.

He came to Greece illegally through the land (river) border between Greece and Turkey, in 2007.

His status is still the one of asylum seeker.

2.1. It was very difficult for him after all his adventures and whereabouts to settle into yet another

country and found his way around. He receives help from NGO’s and from time to time when his health

allows works in building construction. He receives counseling and material aid. The social worker of the

NGO has arranged for him a number of visits in the hospital and volunteer private doctors for his health

problems, whilst he is under psychological help.

He has finished University (teacher).

Safety and security: He feels safe in Greece compared with all the ordeal he has been through in the

past and he believes that as a Palestinian he would not be sent back to any of the countries where he

has faced so many problems. However, until receiving status, he cannot fell completely secure in

Greece.

Rights and citizenship: All the information received about his rights originates from the NGO’s.

Expectations: He hopes to have a permanent status in the future and be able one day to re-unite with

his family.

Self image: He is still very shocked and discouraged by his situation and his self image is low.

Assessment of his experience: The overall assessment is negative. He is still in a temporary situation;

away from his family, without health, job, and money.

2.2. He is insisting on his health and social problems and says that Palestinians are outcast and will never

be recognized as citizens of a country, like the others. The only strength developed is that he managed

to survive so far, but he feels extremely tired and pessimistic.

2.3.1. He feels himself as vulnerable, on account of his health and social problems and he cannot see in

his future a specific plan of life.

2.3.2. His needs were not identified by the authorities and, if it were not for the NGO’s, he would

probably have died in the streets.

2.3.3. The NGO’s again addressed his needs to the measure of their possibilities, but not the authorities.

Target group discussion with service users

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It has not been possible to gather service users for such a discussion due to the fact that they do not

leave all together in a shelter, facilitating this kind of activity, but scattered in the city, working at odd

hours, etc.

Interviews with service-providers

In fact, due to the lack of available time of the service providers and since in reality the managerial

staff also has an in depth experience and understanding of their tasks, the interviews were in fact

incorporated in the target group discussion, following in any case the same content as we had with the

service providers of the Medecins du Monde. Therefore, there is no reason to repeat the same.

Target group discussion with service providers

The target group discussion with the service providers was made with the management of the

organization, since the professionals (social workers, psychologist) were too busy to have any time

available. However, Tzanetos Antypas is a social worker himself with a very long experience of work in

the field and he is in a position to follow closely the work done, supervise and control the quality, as well

as take care of financial, organizational and other managerial duties.

The discussion was extended, but it is useless to give it in detail since in all the main and important issues

it was in complete agreement with the contents of the relevant discussion with the Medecins du

Monde. This is not unexpected, since both organizations work in the same environment, with the same

principles, with the same methods, facing the same problems and impediments. Therefore, reference

should be made to the contents of the target group discussion with service providers in the NGO

Medecins du Monde.

RESEARCH IN THE RECEPTION CENTER OF SAMOS (NORTH AEGEAN ISLAND CLOSE TO

TURKISH SEASHORE)

Description of the facility The center consists of 9 buildings.

The administration occupies the first floor and consists of the office of Police, the office of the Social

Worker, the medical office, the psychologist’s office, infirmary and the office of registration

In the 2nd building, there is a yard, used for counting the immigrants, a basketball field, a children’s

playground and a Mini Market

In the 3rd building, there is the restaurant with a capacity of 119 persons (17 tables with 7 seats each),

the toilette, a storage room, the laundry and drying rooms.

47


The buildings 4th to 9th are used for the boarding of immigrants. There is a total of 9 rooms with a

capacity 20 to 30 persons in each

The allocation of the people is as follows: the 1st room: is for the unaccompanied minors, the 2nd and 3rd

rooms: are occupied by families and single mothers with their children. All the rooms mentioned are

separated from the rest to protect the vulnerable groups.

In the rest of the rooms (4th to 9th) are occupied by immigrants allocated according to their nationality

and age

Staff The total number of personnel is 15 persons. There are two physicians, one psychologist, one lawyer, one

administrator, one nurse, one social worker, one nurse assistant, six Cleaners and one interpreter

Funding and management Funding for this facility is provided by the Greek State and managed by the Prefecture.

Capacity The capacity is 285 persons.

Needs of the facility There are several serious problems that need to be addressed. During the summer there is a large influx

of immigrants during the summer resulting in inadequate number of beds. The unaccompanied minors

are held for long period of time because of a delay in issuing the court decision for the assignment of a

guardian. Even if a guardian is assigned, in most of the times, he/she refuses to accompany the minors.

As a result the minors’ mental state is at stake. There were also incidents of hunger strikes by the minors

and attempts to escape.

There were certain good practices such as the presence of permanent medical, psychological, social

and legal care provided by the Prefecture of Samos. Medical examinations for all the immigrants at the

Samos General Hospital have been implemented. The meals are provided on the advice of a

nutritionist. Recreation facilities (children’s playground, basketball field) exist. The tenants have free

telephone access as well as access to Mini Market. Finally the personnel meet once a month to solve

problems and they have briefing of personnel by the physicians regarding the prevention and

management of diseases

Interviews Interviews with service – users

Note: The interviews were carried out in Athens since the Greek Police did not give us access to the

detention centre.

Interview 1 S.F.K (male)

He was arrested in Sudan in 2003. During his arrest he was subjected to non-systematic torture, during

which he lost the vision of his right eye. His first phalanx of his left hand was cut off.

48


He escaped Sudan and went to Turkey. From there he reached Samos with 35 people on a boat. He

described the reception by the center as “real good”. He was given clothing. He mentioned to the

authorities that he was victim of torture but no care was offered. He suffers from nightmares and wakes

up at night in terror.

Interview 2 F.H.P. (female)

She was persecuted and subjected to torture (non-systematic beating, phalanga and submarino). She

suffers from nightmares and night perspirations.

She came to Samos brought by smugglers. She had a good reception on the island and stated that she

is satisfied with the conditions at the center.

She mentioned heart problems as a result of rheumatic fever. She was hospitalized for a week at the

hospital in Samos.

Interviews with service providers

Name: Mary Siganou

Date of birth: 25/9/1974

Address: 2, Dioskouridou str., Pagrati, Athens-Greece

Position: Coordinator of the European Project “AEGEAS – Enhancing

Reception capacity for migration flows at border areas of Greece”

Mrs Siganou has a good picture of the centers in Samos and Chios and has an experience of 10 years

working with asylum seekers.

In the list of the commonly mentioned vulnerable groups, such as unaccompanied minors, single parent

families, torture victims etc, she adds the group of asylum seekers that go through the ordeal of the

Greek asylum procedure (the ongoing vulnerable groups as she called it).

As for the conditions of the detention centers, she stated that she is “far for being satisfied”, although

she admitted that some minimum standards are implemented. However it is impossible to keep these

standards when the capacity of the centers becomes fivefold most of the time.

The medical needs of the people are covered by one physician and one nurse at the facilities in Samos

and Chios, financed by the Prefecture. All the arrivals have a medical screening. All the necessary

examinations are carried out at the local hospitals.

Torture victims are not generally identified because a specific procedure does not exist and the facility

does not have specialized personnel.

Her suggestions to improve the situation are: (a) the cooperation between civil services and NGO’s and

(b) the adequacy of facilities (c) the permanent medical, psychological, social and legal care by the

Prefecture of Samos, as well as of Chios.

Name: Antonis Sahantas

Position Interpreter

49


He stated that situations were very difficult regarding the working conditions, the communication

between the employees, as well as the living conditions of the illegal immigrants. In the summer of 2008,

there were accommodated about 800 persons while the facilities were for 300. Each employee had to

do more things than his duties and the detainees couldn’t receive the appropriate attention and care.

Being the only interpreter had to cover for all the service providers as well as for the courts and the

coastguard. He added that the psychological situation of the detainees was very bad.

He mentioned several cases, where people were desperate and confused.

The last couple of years things have been improved somehow. The police officers’ behavior has been

better as well as the cooperation between the employees. Also one physician, one nurse and one

psychologist were hired.

RESEARCH IN THE RECEPTION CENTER OF CHIOS (NORTH AEGEAN ISLAND CLOSE TO

TURKISH SEASHORE)

Description of the facility – Material Conditions The physical structure of the centre includes a 3 stories building and 10 small houses.

Staff The staff consists of one physician (dermatologist) on a voluntary basis, one nurse, one social worker,

two administrators, one lawyer, one person with general duties, two interpreters in Arabic and an

advisory and self-knowledge team

Capacity The capacity: is for 120 persons

Funding and management Funding for this facility is provided by the Greek State and managed by the Prefecture with the help of

the local branch of Red Cross.

Needs of the facility The main problems are the large influx of immigrants during the summer resulting in inadequate number

of beds and the long detention of detainees

However as good practices one can points out the permanent medical, psychological, social and

legal care by the Prefecture of Chios, the medical examinations for all the immigrants at the Chios

General Hospital and place of recreation

Interviews Interviews with service providers and target group discussion

Name: Eftihia Syrri

Year of Birth: 26/2/1984

Address: 24 July 1974, St. George of Vrontades, Chios

Position: Social Worker, Detention Center of Chios

50


Years of work: One year

At the detention centre there are several groups of vulnerable persons, in which she included persons

with increased danger of deportation. She also stated that the identification of who is and who is not

vulnerable is not within her expertise (this applies primarily to torture victims) and if she attempts to do

this she will probably run the risk of dropping out cases.

She described the conditions at the centre as not very good, mainly because the centre is

overcrowded. Also she points out the fact that there is only interpreter for Arabic.

The medical needs are covered by a physician and a nurse. For more specialized care and

examinations persons are referred to the hospital

Name: Vaggelis Farmakis

Date of birth: September, 1965

Address: 31, Politechniou str., Chios

Position: Dermatologist (reception center of Chios)

Experience in the field: 3 years

Approximately the same with the previous service provider were expressed by Mr Farmakis. He stated

that the people belonging to vulnerable groups should receive special care.

As for the conditions at the detention centre, he pointed out the fact that most of the time the center is

overcrowded. He believes that the level of medical care is satisfactory. All the new arrivals are

screened for contagious diseases.

As for the definition of what constitute a vulnerable group, he declared himself unable, due to lack of

training, to identify the persons that are vulnerable. Particularly he cannot certify if someone is torture

victim because he has not been trained to Istanbul Protocol. He has some idea that makes him to

reach the point of suspecting someone he/she might be torture victim.

Finally his proposal for improvement of the conditions at the centre includes the training to Istanbul

Protocol, the Police should not have any longer the responsibility for asylum requests and the Prefecture

should have full control of the centre.

LESBOS We were not able to have a description of the center or any other details because we the entry

permission was denied by the police.

Interview with service users

Note: The interviews were carried out in Athens since the Greek Police did not give us access to the

detention centre.

Interview No 1

A. J. Male

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He was persecuted by Sunnites who entered his house and with gun threat took his brother who had

the same religious beliefs. After a month his brother was found dead, dismembered and maltreated.

Then, the same group entered his house again and he was kidnapped. He was maltreated and

tortured.

He left his country and through Turkey reached Lesvos, where the smugglers left him in the sea. He was

later spotted by the coastguard.

He had harsh treatment by the coastguard. He also describes the situation in the camp as traumatic.

There was no space and the food not enough. He stated that he answered “yes” when he was asked

about tuberculosis hoping that he would moved to a better place.

When was kidnapped in his country he was subjected to beatings. He was stabbed with a knife. The

kidnappers threw boiled water in his right hand and tried to rape him.

He now suffers from nightmares, aches all over his body.

Interview No 2

D. Z. male from Bangladesh

He stated that he was forced to leave the country because of his religious beliefs. He was subjected to

several persecutions and torture. When he left is country he went first to Turkey and from there,

smugglers dropped him in the sea near Lesvos and e was forced to swim to the island.

He describes the reception in the island as good. People came and provided him with clothing and

blankets. He said that at the center he had enough space and he went through a medical

examination and sent to the hospital for additional examination.

He was subjected to torture, mainly beating and burning his leg. In his asylum request he mentioned

that he is a torture victim.

He has some sequel such as trouble sleeping, nightmares and anxiety.

Interview No 3

H. A., Male from Afghanistan

During an attack of Taliban in his village they started torturing people they were Hazaras as he is.

He left his village and after 38 hours walking reached the Turkish border and after another 22 hours he

reached Istanbul. The smugglers, there, locked him in an underground room with some others, for many

days and one night they put them in a truck and arrived to Izmir. All were embarked in a motor boat,

which they sink near the island and rescued by the Greek coastguard.

He stayed in the camp for 11 days and then he was sent to Athens.

He suffered beatings in the face with a gunstock, his left eye was injured and lost the vision. He was also

left with a wild dog which attacked him.

Focus group discussion

The following are the minutes of the discussion that took place in Chios with the participation of several

stakeholders and service providers from 4 detention centers.

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1st Working Group – Minutes

“Presentation of good practices in health sector at Detention Centers”

Chaired by: Dr. Maria Piniou-Kalli, Medical Director of the Medical Rehabilitation Center for Torture

Victims, Athens, Dr. Anestis Papanastasiou, Deputy Director of Bacteriological laboratory of the

Prefectural West Athens Hospital “Agia Varvara”.

Rapporteur: Mrs Eftihia Syrri, doctor at the Detention Center of Samos

• Presentation of the procedure for examination and treatment of cases with contagious disease by the doctors in the entry points/good practices

• “Role playing”: - A case with TBC at the Detention Center in Lesvos-Samos - Scabies – Detention Center inChios

- Hepatitis – Detention Center in Evros borders

• Presentation: “ Contagious Diseases – Prevention – Confrontation”

Dr. Anestis Papanastasiou, Deputy Director of Bacteriological laboratory of the Prefectural West Athens

Hospital “Agia Varvara”.

Continuation of the 1st Working Group: Cooperation between doctors and employees at the Detention

Centers - recording of common procedures and good practices-Conclusions.

The group started at 9:30 and lasted 4 hours because a series of important medical issues should

become clear so as to be well understandable from the staff at the detention centers that are not

specialized in medical issues.

Participants in the group Chios 15 persons

Lesvos 8 persons

Evros 5 persons

UNHCR 2 persons

Samos 5 persons

Ministry of Mercantile Marine 1 person

Ministry of Public Order 1 person

Experts Dr. Maria Piniou-Kalli, Medical Director of the Medical Rehabilitation Center for Torture Victims, Athens

Dr. Anestis Papanastasiou, Deputy Director of Bacteriological laboratory of the Prefectural West

Athens Hospital “Agia Varvara”

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1. Contents

Dr. Anestis Papanastasiou, Deputy Director of Bacteriological laboratory of the Prefectural West Athens

Hospital “Agia Varvara”:

The new types of tuberculosis, especially for those coming from African countries, are vary dangerous

and that’s why a thorough examination should be followed.

Tuberculosis is a contagious disease that mainly attacks the lungs.

Contagious diseases should be identified at the very early stage because there is a high risk of turning

to pandemia.

One factor that makes the situation more difficult is the transmutation of the bug from the one country

to another. Especially, cases of hepatitis are more often in the Islamic countries.

Kleri Georgeli, doctor at the Detention Center in Lesvos:

Upon arrival of illegally entering foreigners check-up takes place with an X-Ray without prescription of a

specialized radiographer. They go to the Center with the X-Rays and in case the doctor of the Center

sees some findings, she make referral to the hospital. However, the huge amount of the persons

encumber hospital services.

Sometimes, at the center there is also a second doctor who works on primary health care. In case a

person that has been referred to hospital is diseased, he is not sent back to the Detention Center, but

he remains in the specialized room of the hospital, the capacity of which is too small.

Nobody can stay at the Detention Center before he has gone under examination and it has been

certified whether he is healthy or not and keep him at the hospital or back to the Center.

At the Detention Center, there are different rooms for those who are infected, as well as for the kind of

the disease that are at better condition.

Blood test is not taking place, except someone mentions that he suffers from a disease. Most of the

time, the doctors based on their experience are asking for further examination.

Scabies is not usual at the Detention Center of Lesvos.

During the last period there is one case of milliary tuberculosis (generalized acute form in which as a

result of blood stream dissemination, mini multiply tuberculose foci are scattered throughout many

organs of the body) and he has been kept at the hospital for 15 days in order to avoid the transmission

of the disease, until he is transferred to the specialized General Hospital in Athens “Sotiria”. An

important problem at this phase is that the doctors do not “stamp” the case as an URGENT one, so as

priority to be given.

Another important problem is that the patients feel reluctant to follow the necessary treatment and it

takes much time for the doctors to explain the dangers of their situation and how important is the

prescribed treatment.

Dr. Anestis Papanastasiou: Explanation of the difference between cavernous tuberculosis and milliary

tuberculosis. The difference is detected on the X-Rays. In the case of cavernous tuberculosis we see

caves on the X-rays, while the milliary tuberculosis causes measureless TBC injuries in the size of millium.

Mouflouzelis: Doctor at the Detention Center in Lesvos

54


The health condition of illegally entering foreigners is depended exclusively of each doctor. At Lesvos

hospital, the doctors work overtime since they have to face a huge number of cases. There is a big

number of irregular arrivals that goes under X-rays so as the internees to have a first picture of the health

condition, although they do not proceed to a diagnosis.

Most of the time, we can see a wave of overreaction from the other patients and their companions

towards immigrants due to the fact that the bad health condition of immigrants creates fear that the

hospital is a focus of infection and the patients take use of this situation for their better service.

G. Stavrakelis: Health Visitor, Plomari Health Center

He serves at the Reception Center of Juvenilles, the capacity of which is for 90 persons, but most of the

time more than 110 persons are accommodated.

The problem in this Center is that the juveniles live without supervision and most of the time they leave

either for work or for a better life, but if someone of them is diseased, this causes many troubles.

At the Reception Center Mantoux is done again and in case someone has a positive Mantoux, he goes

for X-ray and he is under supervision in the Center.

At the reception center in Agiasos, some cases of scabies were diagnosed, especially to some children

from Patra. The communication is difficult and most of the time they are reluctant to any kind of

treatment.

Dr. Maria Piniou-Kalli, Medical Director of Medical Rehabilitation Center for Torture Victims

In case of scabies, their clothes should be washed and aired for 8 days. Scabies are not spread by

handgrip or a hug, but when someone puts on the patient’s clothes or lays in patient’s bed.

Scabies symptoms, like prurigo, are more strong during night hours when the patient is laid in his bed

because the scabies are supported from high temperature.

If the clothes and the objects of the patients will be kept away for 8-10 days and they will not find

another human body to pierce, then the scabies die.

One precautionary measure for the new arrivals is to spray their body with spegal, after their first bath.

F. Tserdanis: Police Officer, Aliens Bureau

The big problem in the guardian sector is that there is not a stable team of Police Officers, trained in

medical issues, but they change from time to time and that’s why they react with fear in many

circumstances. The Police Officers in Lesvos ask for a medical certificate from asylum seekers.

Chr. Vakali: Police Officer, Aliens Bureau

What happens with the Police and Coast Guard Officers who are the first that come in close contact

with the irregular arrivals without having gone through a thorough diagnostic examination at the

Hospital? There might be serious danger of contagious diseases and this may not be realized from the

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beginning upon their entrance.

Training seminars for contagious diseases should be organized for the Police and Coast Guard Officers

Officers. By this way, the Police and Coast Guard Officers will not use this situation as a mean of

determent for not coming to their duties.

The training of security services in medical issues it is at most importance because lack of knowledge

causes fear.

Ir. Karagiaouri, Doctor at the Detention Center of Samos

10.700 persons reached Samos at 2008.

At the Detention Center there is a trained nurse who handles with the Mantoux.

The doctor conducts the medical interview of those staying in the Center.

A good practice that already exists in Samos, based on the fact that the staff should be informed for all

medical issues of the Center they work, is that there is a board inside the Police Headquarters (a place

where the irregular arrivals do not have access) where it is written the names of the persons with

contagious diseases.

What is the tuberculosis?

Tuberculosis is a contagious disease deriving from a bug called mycobacterium of tuberculosis and

rarely from other types of mycobacterium. The mycobacterium of tuberculosis can affect any of the

human organs, but mostly the lungs.

How the tuberculosis is spread?

The tuberculosis is spread from one person to another through aspiration of dribs that contain

mycobacterium. Persons with lung tuberculosis take out such minor dribs when coughing, sneezing and

speaking loudly. The disease is spreading out when someone comes in close contact with the infected

persons every day for many hours. Those persons could be their family, their friends or their colleagues.

What exactly means that someone is diseased?

The mycobacterium of tuberculosis is activated when the defensive system cannot stop their expansion.

The active mycobacteriums are multiplied inside the body and cause the disease. Some people are

falling sick immediately after the infection, some others are falling sick later when their defensive system

runs down. Children and the elderly are more sensitive, as well as persons suffering from diabetes,

chronic nephritic insufficiency, leukemia or lymphomas, alcoholics, drug addicted. Furthermore, the

persons who take corticosteroid or immuno-depressive drugs and those who are not fed well, are

conveyers of HIV (which causes AIDS).

The symptoms of tuberculosis depend on the organ that has been infected. The disease affects mainly

the lungs, which are also the entrance of the mycobacterium. Through the lungs the mycobacteriumss

can be spread to the body and move in other organs, like the lemphedenes, the kidney, the bones, the

spondyls and the ménages.

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When we have lung tuberculosis, the symptoms are often cough with spits or not, spitting-blood, pain at

the chest, dyspnoia. Some other common symptoms are weakness, exhaustion, loss of weight,

anorexia, quiver, fever, night perspiration.

There people that although they have been infected from the mycobacterium, they never get sick

from tuberculosis. But there are some other people that can more easily to get diseased for

tuberculosis, lie:

- HIV conveyers - People that are in close contact with patient that has contagious disease (lung tuberculosis) - Infected persons during the last 2 years - Infants and small children - People with chronic diseases and their defensive system is run down - Elderly people

Evg. Iliadou, Sociologist, Detention Center in Lesvos

There is a big argument in Lesvos because the employees at the Detention Center are forced to wear

uniforms, gloves and masks because the Police Officers consider them as a focus of germs due to the

fact that they come in contact with the detainees.

Ang. Koukoumialou, Hellenic Red Cross (Chios branch)

During all these years of the work of Hellenic Red Cross with refugees, most of the time under

unacceptable conditions, never appeared a health problem that it was directly associated with the

illegally entering foreigners.

P. Gika, Doctor, Evros guard-house

The capacity of the center is for 374 persons. The newly arrivals go firstly at the Hospital in Didimotiho for

X-rays and further examination and after their return to the detention center, they are given clothes, a

card with their personal info, some instructions and at the end the doctor takes a medical history.

A big problem is that many times after police operations for clearing the area of the illegally entering

foreigners, many of them go back to the Center without having gone under X-rays.

There is a huge delay on the transportations to the Hospital.

There is also an engrossment on the issue of how often the doctor of the Center actualizes briefings to

the guardians.

M. Podia: Nurse, Detention Center in Chios

The illegally entering foreigners go through diagnostic check-up, skin-reaction mantoux, X-ray and

thermometry. In case the mantoux is positive, the person is transferred to Hospital and goes under

treatment with chemistry-protection, as well as he is given a medical report with mandatory instructions.

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Comments and Conclusions

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Comments and conclusions

It has to be stressed from the very beginning that in the camps of detention on the islands, as well as

near the land (river) border there is no structure so far organized by the state authorities destined to

identify special needs of vulnerable people in order to address these needs.

It is hoped that in the future the screening system to be created by the state authorities will be able to,

at least partly, perform such tasks (provided of course the proper staff available and trained, and a

number of other conditions which have been detailed in the pages of this report).

Therefore, during the research all the service users interviewed replied that in most cases they never met

anybody else but uniformed people (in particular police officers) who were interested on other issues

and certainly not in helping to identify and face vulnerability.

The information collected during the research, always took place at a time distanced by weeks or

months, or even years, of the experience of entering the country. The time required to carry out the

interviews and group discussions was creating difficulties to the every day functioning of the

cooperating NGO’s, given their small number of paid professionals who, among all their tasks, had also

to dedicate time for us. This, of course, included their interpreters who are also playing other roles, such

as working inside and outside the offices for many things not having to do with interpretation.

In the following we have decided to highlight some concluding considerations that we believe useful to

understand the problems and gaps of the system and the possible way forward to strengthen

protection of vulnerable asylum seekers in Greece. Most of these considerations are based on the

comments we collected during interviews with Asylum Seekers and Service providers and that are

noted in various places in the pages presented above.

1) Added Vulnerability created by the System : There are many Asylum Seekers, confirmed by the

statistical data about asylum recognition, as well as about the several years a case may take until

positive conclusion, that have to wait for years and count among the 40.000 pending applications,

creating another category that we could say is an on-going vulnerable group. It is the case of persons

that go under time-consuming and extremely difficult asylum procedures where their anxiety for

ensuring their legal status in Greece and their stress for gaining legal papers leads them to denial in

following some procedures of integration (language lessons, find a job, etc.), whereas many of them

suffer from depression and they need special treatment with sedatives. So, we could say that we could

have an added vulnerability, created by the system of asylum in Greece

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2) Isolated and remote places: The element of distance from a big city with available services (health,

education, psychological support, etc.) is another factor aggravating vulnerability. In many cases, the

authorities have sent families with various health and other problems to live in ex-army camps, no longer

in use, in remote places around 200 klms north of Athens, at a distance for the nearest village that

cannot be covered easily by foot. People have nothing to do there the whole day and the only thing

provided is a roof over their heads and food. After a while, all of them “escape” and come to Athens

which means that they have to struggle on their own since they have “refused” the social care

provided by the authorities.

3) Funding and professionalism: NGO work is based mainly on volunteers who give some of their extra

time after finishing from their job (for instance, in a hospital). The enthusiasm and the overall offer is

admirable, but it is obvious that they cannot substitute paid professionals who would be available for

much longer hours having as main task to work with refugees. Of course, funding once again is the

reason for not being able to hire more professionals. With the means available, NGO’s can only provide

welfare to some of the target population. This welfare by no means can reach the level of

empowerment needed for Asylum Seekers.

4) Interpretation: It has to be noted that both state authorities, as well as NGO’s have to use the services

of non-professional interpreters and translators who are themselves refugees (recognized refugees or

migrants with legal residence), but in most cases have no background in education or training for this

responsible work. The situation gets even more difficult when it comes to vulnerable asylum seekers, to

people under psychotherapy or with complicated medical problems. There is now an effort by a newly

established NGO to train some of these interpreters in order to acquire necessary skills and to go

through a certification process. The program will begin in the next months.

5) Lack of Coordination: There is a problem of lack of efficiency of services rendered due to the fact

that so far the state authorities with the other stakeholders involved (NGO’s) do not have a system well

structured to coordinate activities. This may result in services lacking or the same service repeated (for

instance, medical tests and other similar services). By this fact a negative effect is produced for the

service user, adding to the sense of vulnerability. This was a very important issue discussed also during

the roundtable among the various stakeholders, namely that because of the different structures and

practices there is not a common way of working, for instance like a Protocol providing for the exact

actions to be undertaken in a structured way, which leads to gaps and repetitions. Every organization

also feels that common training along the same lines would lead to better coordination, therefore to

better results for the users.

6) Need for supervision and de-briefing: Another point stressed by the service providers was the lack of

a de-briefing support. So far, there is no budget to cover this very important need of service providers in

a professional way which as a result may have burn outs and inefficiency. Therefore, supervision and

de-briefing are two very important factors that need to be included in the care of vulnerable persons.

7) Time factor: is an overall problem stressed particularly by all participants to the research. More

explicitly, service providers stressed the importance of having enough time available in the shelters or in

any way protected structures for the users, in order to be able to identify the various aspects of

vulnerability and take action accordingly. This is not something that can be done in such a few days.

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Service users should be given time to feel secure and sheltered in order to start unfolding the whole

range of their problems. It is obvious that under the stress of detention conditions and insecurity, it is not

easy to detect various aspects of their situation. Therefore, detention is a negative aspect of the whole

process from the users’ point of view. From the providers’ point of view, time is also very important in

order to think through all the aspects of every case, to consult with colleagues and other specialists in

order to properly appreciate the course of treatment to be provided.

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Documents

Greek Report