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.



A number of patients came to us chasing up referrals which had been made in the last several weeks. Referrals are made on carbon paper, with the patients getting a master copy, a copy going to the medical coordinator, and a copy staying in the record book at the clinic. Two Greek nurses when translate the copy into Greek and send it to the relevant hospital, and we have to await a reply. With the constant turnover of volunteers, and the system still being in its infancy, patients don't always hear back about what is happening, until the SAMS driver arrives to take them to their appointment.

A number of the referrals were for complex conditions and needed to be acted on fairly promptly, others were for routine scans or blood tests. Sadly all will have to wait, either weeks or months. Despite the effort the Greek healthcare workers are making to accommodate the needs of the refugees, the health system here is already massively overstretched, under huge pressure from the government's austerity measures, and struggling to cope with the influx of patients with extremely complex healthcare needs.

The recruitment team working to find community healthcare triage officers came to the camp. They went tent to tent looking for volunteers but sadly couldn't find anyone suitable. The requirement is that the person have at least high school education, and be able to speak and write English, so they can record notes and communicate with the medical teams and the camp administration. There was 15 year old who spoke decent English and was eager to help, but their young age ruled them out, and no one else in the camp had the necessary proficiency. The camps population is mostly from rural areas of Northern and Eastern Syria, so access to basic education for many was limited, let alone education in a foreign language. Luckily the other camps have several volunteers with the required proficiency, so the back up plan is that a volunteer is recruited from another camp to work at Iliadis. This may have benefits as it means they don't have to live among the camp residents while knowing lots of personal healthcare information about them, a potentially compromising situation, but presents logistical problems of having to organise transport between the camps, and lessens their ability to serve the community all the time and be a consistent advocate for them.

We did find a few more volunteers for the children's psychological support role which was welcoming, and for this there is no English language requirement as they will mainly be working directly with the camp residents, or with the medical teams with translators.

A couple of the camp residents made us coffee later in the day as a way of showing thanks for the work we were doing. Despite the heat it was a pleasure to have this, and a lovely gesture from people who had very little to give.

In the evening we had a session with psychologists from the Refugee Trauma Initiative, another volunteer medical organisation specialising in psychological support for refugees. They have expanded their remit to include support for those carrying out volunteer work with the refugees, recognising the psychological trauma that can result from working in the refugee crisis. The session was an hour and was slow to start, but everyone contributed eventually, talking about the different aspects of the work they found rewarding or troubling. The session became extremely heavy as everyone recounted from different perspectives the complexity of the problems the refugees faced, and how little we felt able to effect and improve their situation. Mohammed's contribution was particularly affecting, as a refugee himself and facing the same challenges, and yet trying to do what he could to help his people. The session was worthwhile, but I felt we could have almost done with another session afterwards to process everything that came out in this one.

Tomorrow morning is another exercise session, so I'm going to get some rest now, and try and ensure I have some energy for that.