to second- and third-line health care impossible, while all the islands hosting a CCAC suffer from seriously understaffed hospitals. Chios: In Chios CCAC (Vial camp), the Medical Unit has no doctor since March 2021. As noted by RSA662: as of 11 November 2024, “the facility employs six nurses, two midwives, three social workers, and two psychologists. Nurses handle medical documentation and forward it to a doctor who signs the medical records. Primary healthcare services are unavailable in the afternoons and on weekends, so even minor emergencies must be referred to the understaffed Chios hospital by police or emergency medical services. Psychosocial evaluations are nearly impossible due to the severe shortage of interpreters, who must focus on urgent needs (e.g. interpretation for the custody of minors)”. According to information provided by UNHCR in December 2024, a part-time pediatrician was also active in the camp.663 Samos: Serious shortcomings in identifying vulnerabilities continued in 2024. As noted by RSA: Our meetings with refugees confirmed severe deficiencies in identifying, supporting and further assessing vulnerable populations, a clear consequence of the medical staff shortages. Asylum seekers attend their asylum interviews without prior vulnerability assessments. Often, this process is postponed until later stages, after first registration, either upon referral by NGO lawyers who happen to represent vulnerable asylum seekers or during the asylum interview by the Asylum Service. Among those we met, only one survivor of a shipwreck, whose pregnant partner drowned, was referred to a psychologist. A heavily pregnant woman who had been hospitalised upon arrival was not identified as vulnerable. Similarly, a single male survivor of torture requested to speak with a psychologist from the CCAC but had not received assistance as of our visit date.664 As further reported by the organisation I Have Rights, “[t]he camp, with a 3,600-place capacity, had 4,600 people in mid-Nov 2024 and is expected to exceed 5,000 by the end of the year. As of 7 Nov 2024 the CCAC had 1,433 unregistered persons. This results in severe delays in registration and in people waiting at least one month to receive an asylum seeker’s card. […]. The camp has no doctor, only a pediatrician from the Red Cross.” 665 Kos: RSA reports insufficient medical care and inadequate vulnerability assessments during 2024. For the past two years, no permanent doctor has been stationed in the CCAC. Medical needs are covered sporadically by visiting doctors from other areas and a military doctor. The Reception and Identification Service’ response to us (as of 11/11/2024) confirmed that the CCAC employs only three nurses and two social workers, but no doctors. At the General Hospital-Health Centre of Kos “Hippocrates,” located 15 km from the CCAC, there are significant long-standing shortages in key medical specialties – for instance, no permanent pathologist or cardiologist is available. Only one hospital ambulance is staffed and operational. The hospital faces additional pressure during the summer months due to increased tourist activity. Since August 2024, Médecins Sans Frontières (MSF) has been active outside the CCAC, as well as once weekly outside the hospital, providing medical services to both refugees and locals. Additionally, the island hosts a mobile volunteer medical team from Medical Volunteers International (MVI), offering basic emergency care. Due to the lack of medical staff, the mandated medical screening processes and vulnerability assessments are not conducted. For instance, an asylum seeker with diabetes remained in the centre for about two months without receiving proper medication to manage his condition. In one case legally represented by RSA, no vulnerability assessment was performed for a survivor of torture, even after a formal request by our lawyers.666 Leros: As reported by RSA, during 2024: 662 663 664 665 666 RSA, Chios, 10 December 2024, available at: https://rsaegean.org/en/chios-2024/. Information obtained during Legal Aid Working Group meeting, 4 December 2024. RSA, Samos, 10 December 2024, available at: https://rsaegean.org/en/samos-2024/. Information obtained during Legal Aid Working Group meeting 4 December 2024. RSA, Kos, 10 December 2024, available at: https://rsaegean.org/en/kos-2024/. 149