Day 10 and 11 SAMS Global Response: last days

Day 10 started with the penultimate Project Awesome session. We did push ups, sit ups, burpees and ran lengths of the grass before heading back to the hotel for breakfast and the morning briefing.

After the briefing we had a team leaders meeting, to try and work out issues we were having at the camp. Previously we had been feeding back problems to Alison the Medical Coordinator, but she was a bit overwhelmed and we realised it was quicker and simpler, and reduced her workload if the team leaders met each day to brainstorm common problems occurring in clinics. We identified lack of translations for patients at hospitals, and lack of guidelines for treatment or management of common conditions as pressing issues. It was also thought that team leader meetings would help new team leaders with handover and ensure better continuity given the regularly changing stream of volunteers.

Day 9 SAMS Global Response

Another frustrating morning in clinic. Patients we had referred to hospital came back to us saying they had been treated by a humiliating fashion, laughed at and their needs not paid attention to. A woman sent for a neurology review due to constant migraines was instead given a chest X-Ray and sent away with antibiotics. After breaking down crying in the hospital at being treated like this, an Arabic speaker had noticed her and directed her to the right department, but the damage had been done. Dr Mohammed had to console the woman on her return to camp, and placate her furious husband who was declaring he would rather go back to Turkey or Syria than endure this. Mohammed reckoned it was prejudiced beliefs - that all the refugees had TB - that led to the woman being treated this way.

A big problem is lack of translators in the hospitals. Dropping people off for blood tests is fine. When people need a complex examination or consultation, language is a huge barrier. MSF has cultural liaison officers (translators by another name) in three of the four main hospitals, but they aren't always available, or are needed by too many patients.

Day 7 & 8 SAMS Global Response

Day 7 and 8 SAMS Global Response

Sunday was a quiet day. We had several new doctors, translator and volunteers arrive, and we had to say good bye to several whose time with SAMS had finished. The new volunteers were welcomed in the morning meeting then sent to different camps to get a feel for the work. The new community triage officers were also being trialled at some of the camps. Thankfully it was quiet day at the clinic so they weren't overwhelmed, although one or two apparently found it quite challenging and didn't wish to continue. Things were a little eventful as we had to send a pregnant patient to hospital for an obstetrics review as she was at term. The practice in Greece is to induce labour if it has not already begun at this point. Given the conditions in the camps, this was judged the safer option than waiting for labour to begin naturally. An ambulance was called and the woman was sent to hospital accompanied by a friend. Her husband had to wait till the next day to go and see her, as the hospital wouldn't accommodate anyone overnight. 

Sunday afternoon we went for lunch in the nearby town of Sindos, it was nice to have the whole team together and not have to rush back off to clinic, and the new volunteers got to meet everyone.

Day 5 SAMS Global Response: Return to Karamanli

Today me and Omar were assigned to recruit for the trauma support initiative. We started at Karamanli. This was the first camp SAMS opened a clinic in, and where I did a few shifts back in May.

The camp has developed since then, with the clinic moving into proper office space, a school being built and organised, and a lot more infrastructure being put in place. The refugees were still living in tents in the warehouse, but there is now a small shop run by refugees, alongside a government shop that distributes consumables on a points system, giving people the chance to choose their own food, wash products or clothes. There is also a tailor who comes to the camp and works for free several hours a week, repairing  and making clothes. A dentist visits every fortnight, and residents from nearby camps can be brought over for treatment. There is a play area for kids, and a cafe with board games. There is even an area set aside for a gym, but no equipment just yet. The residents work out using makeshift equipment at the moment.

Day 4 SAMS Global Response: coffee and counselling

Today was a calm day in the camp. We saw a steady flow of people. A few of the sick children we saw earlier in the week had recovered from their coughs and fevers and were repaying us by hanging around the clinic and subjecting us to sweet but annoying pestering that only young children are capable of. Clambering on the waiting benches, grabbing pens and pencils off the triage desk, and trying to take gloves from the wound dressing box served as their main source of amusement for much of the day.

Day 3 SAMS Global Response

The day started with an early morning exercise session run by the field coordinator. It's done Monday, Wednesday and Friday, to help maintain the physical and mental well being of volunteers. Alongside this there is a weekly welfare meeting where volunteers can raise issues about the work, and any problems and pressures they may be experiencing.

We did half an hour of intense cardio exercise then went off to breakfast and the morning briefing.

After the briefing we headed back to Iliadis, now with a Syrian doctor with us as part of the team. Mohammed (not his real name) is a recently arrived refugee from Syria. He had been living in Eastern Syria, but ISIS tyrannical rule had forced him to leave with his family.

Mohammed had been working as a volunteer in various projects in Athens supporting refugees there with medical care, until he was recruited by SAMS to work in the camps in Northern Greece.

Day 2 SAMS Global Response: Iliadis Camp

Day 2 SAMS Global Response

Every morning there is a briefing for all the volunteers. Any issues at the camps are discussed, updates are given about relations with the health service and local government and plans made for the days ahead.

Last week there were threats made to medical staff in two of the camps, and a man even drew a knife (albeit a very blunt one) on them in one incident. The field coordinator has now drawn up some security protocols for us to follow in the event of threats of violence, and made signs saying knives aren't allowed near the clinic.

I've been assigned to Iliadis camp. It's in a warehouse on the outskirts of Thessaloniki. It's much like the other camps, rows of tents in and outside the building for people to live in. There are signs of more infrastructure; lots of covers providing shade, and rows of sinks with running water. Toilets are still just portaloos, and I didn't see showering or bathing facilities.

Day 1 SAMS Global Response: Arrival

Arrived in Thessaloniki. SAMS Global Response is staying in a hotel just outside the city, near the government camps.

I arrived too late to join any of the clinics, so instead helped out with the day to day admin. The medical and field coordinators are trying to keep accurate records of all the patients who are treated. Finding a system which isn't time consuming and can be quickly taught to new volunteers isn't easy.

Most of the afternoon was spent trying to get excel and Google spreadsheets to communicate, and working out the best way to teach people how to use them. Not very exciting, but necessary.

BMA: No more concessions, escalate the action

Following the successful all-out strike on 26th and 27th April, the BMA and DOH have entered negotiations for 5 days, under pressure from the Royal Colleges who asked that they both "paused" their stances and talked without preconditions.

While the talks may be a welcome sign that the pressure of regular and escalating strike action is finally forcing movement from the DOH, without serious concessions there are no grounds currently for demobilising the strike.

While the DOH narrative has been of doctors unwilling to negotiate, the fact is the Junior Doctors have gone out of their way accommodate the DOH. They have made a number of significant concessions, with the main redline being extra payments for Saturday shifts, and the discrimination against women that will result from the contract.

The Junior Doctors even sat outside the DOH for days leading up to the strike practically begging Jeremy Hunt for talks. This became a propaganda coup as Hunt's refusal to talk with the doctors - despite them sitting outside his office for 12 hours a day - made him appear even more unreasonable and singleminded to the public.

Idomeni Diary: Day 5

Idomeni diary day 5

On the final day we met in the morning to discuss how we were going to organise the days activities. The medical volunteers had been joined by some new teams, more paramedics from Norway, medical students from Germany and the rest of the Jordanian-American medical relief team. There was a long discussion of how to divide up the work, and what was feasible given the logistical resources available. The group was split into three teams, one team would cover the Idomeni camp in the morning, while the other would cover Eko camp in the morning, and a third do Eko again in the evening.

We headed into Polykastro to drop off medications and other supplies the new volunteers had brought with them, and pick up supplies for the morning clinic. I joined the team heading up to Idomeni camp.

We set up clinic in the same spot, and were joined by a few of the translators from the previous day, and some new faces. Adel from the Eastern Ghouta came to help, as well as a young guy called Deyar, a teenage Kurd from Qamishli. Both were extremely helpful. Deyar was extremely proficient, switching easily between english, arabic and kurdish to make sure the patients fully understood what we asked, and the treatments that we were giving them.

Idomeni Diary: Day 4

Day 4 at Idomeni

I joined a group of volunteer medics organised by Offtrack Health, a grassroots clinic set up by medics who wanted to quickly deploy to crisis areas. It's run from Britain, but has become an organising pole for all the volunteer medics and healthcare professionals coming to the camp.

New people come and go all the time, at present its a couple of British docs, German paramedics from Leipzeig who had been working in a refugee camp there, Swedish paramedics from Skane, an American medical relief group, a Norwegian medical relief group, and various administrative volunteers and translators.

They've rented a house in Polikastro which they are housing volunteers in, and the basement serves as a warehouse for medicines and equipment. We collected supplies from there then, and picked up one of the volunteer translators, Sherin, and drove up to Idomeni. Sherin is a Palestinian, from a town near Haifa, who came to Greece several months back to help translate for the volunteer relief efforts.

When we arrived the police would only allow one vehicle into the camp so we had to put all the equipment in one van and take that inside.

Idomeni Diary: Day 3

Day 3 at Idomeni - March 18th

Tried to do the food distribution in the morning, but we were delayed outside the camp; a government minister was visiting and no one else was allowed in until they left, also cleaning firms were going around with trucks emptying the portaloos and bins and we were held up for an hour and a half. We scouted around for other distribution points outside the camp, including around the old train station where lots of people camped, but none were suitable.

Eventually we were allowed in and set up on the far side of the camp. Few groups distribute on this side, so the need is greater. Due to the fact we were delayed by the time we started distributing most people had gone to get food elsewhere, or brought it from some of the private businesses which set up just outside the camp. We distributed 1000 meal packs then decided to go elsewhere as the queue was petering out.

Idomeni DIary: Day 2

Day two at Idomeni - March 17th

Today was slightly better than yesterday. There hasn't been any rain for two days so the camp has started to dry out. I assisted one of the coordinators with a tent check last night; they do this every night and it involves walking around the whole camp looking for individuals or families in obvious distress who needed a tent for shelter. The coordinator said the last few days had been horrendous with the constant rain and the border closure, thankfully with the end of the rainfall, and the fact hundreds had abandoned the camp, we didn't find anyone whose situation was too bad. A man needed a tent as he was sleeping outside due to lack of space in his tent (his wife and four kids were all in there) and another family were squatting in an old railway building and needed a tent for added protection against the cold, but that was it. We also dropped off a tent for a newly wed couple who were travelling with their extended family. They had married one week before they left Turkey, thinking it would be a short journey to Germany with their family. Six weeks later and still stuck in Greece they were desperate for their own tent for some privacy. We also put up a UNHCR tent to provide some better quality housing for the most vulnerable families. There are dozens of pregnant women in the camp, several of them 8 months pregnant and staying in appalling conditions. The volunteer coordinators try and identify vulnerable families and individuals to the NGOs like MSF who can then transfer them to the better quality tents. To give some idea of how bad things had been previously, the depth of need, and lack of resources; just to qualify for an extra tent a family or group had to have at least three or four children under two years old. Volunteers had to establish this fact before they would be given a tent to give to the family. Thankfully as things improve resources are less stringently managed, but it's still a horrible job having to ration resources only for the worst affected, when everyone is so obviously suffering. One coordinator put it that "we came here because of our hearts, but when here we have to think with our heads, and stop using our hearts".

Idomeni Diary: Day 1

From the 16th to the 21st March I visited Idomeni refugee camp in Greece to assist with the volunteer relief efforts. The following posts contain pictures of the camp and an account of my time there.

Hotel Polikastro, the unofficial volunteer center 

Warehouse for storing items for distribution at the camps

UNHCR tents, fresh shelters for vulnerable refugees

Will the Junior Doctors strike be sold short?

The strike action by junior doctors has been historic and brave, but there is a real risk that the potential of the strike is wasted. The fight against the contract, and the wider fight to save what remains of the NHS could be set back if the strikes don’t realise their full potential, and instead settle for a compromise.

From the start the Junior Doctors Committee (JDC) have emphasised their main aim is to secure a fair contract for doctors. While the mass of junior doctors on protests, in the media and on strike have emphasised they see their fight as being to protect the NHS.

This focus on the nature of the contract omits the context of the attacks (which the wider community of doctors are well aware of), that the contract changes are part of much broader attacks on pay and conditions across the NHS. When seen in isolation, a demand for a fair contract may seem realistic, but against the backdrop of pay freezes, widespread down banding, cuts and privatisation, the new contract is an integral part of the plan to dismantle the NHS, and not something the government will concede on easily.

If the aim really is a fair contract, the JDC needs to demand an improvement in conditions, and escalate its actions until the government begins to grant them concessions, not the other way round.  However, rather than setting the status quo as a non-negotiable minimum, and advancing a set of demands to improve the contract, the JDC have gone into negotiations and repeatedly made concessions to the government.

Details are hard to come by as the JDC has kept the details of what is being negotiated secret from its members, a problem in itself, but its understood the five “redlines” that the JDC had initially have now been reduced to one; that Saturday remain an unsocial hours day. This has been born out in the leaked details of an offer made to the government by BMA negotiators.

Granting concessions only gives doctors less to fight for, while the on again, off again nature of the strikes demoralises members and disorganises local activists. The constant entering into negotiations and demobilising of strike action disrupts the service more than regular, planned strike action, and gives the government more time to campaign in the media against the strike with resources we could never dream of.

Last year other health unions suspended strikes with only a paltry pay offer on the table, this killed the momentum of the dispute and when it was put to the members to vote only 17% of UNISON members bothered to participate, not wanting the deal but not trusting their union to lead an effective fight either.

Junior Doctor leaders need to be bold and brave and advance a vision of a better, safer contract for the NHS, and put forward a plan of strike actions and protests and stick to it until the government gives them what they want. The privatising, austerity-driven government won’t give NHS staff anything unless we pressure them. Junior Doctors are in a unique and powerful position to strike a blow against the governments plans. Don’t waste it!