Gaps in the provision of health care to migrants in detention Ineffective screening at arrival According to the UN Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment, “[A] proper medical examination shall be offered to a detained or imprisoned person as promptly as possible after his admission to the place of detention or imprisonment, and thereafter medical care and treatment shall be provided whenever necessary.”40 Moreover, Greek legislation provides that “Every detainee is examined by the prison doctor at the time of his arrival.”41 However no standard protocol regarding medical screening of asylum seekers and migrants upon arrival is in effect in Greece.42 As a result, practices vary according to different geographic areas. In the island of Lesvos new arrivals were sent to the hospital for a chest X-ray after they were arrested. With the exception of infants and pregnant women, they did not receive a general medical examination. Emergency cases, such as migrants suffering from hypothermia or serious injuries, were immediately transferred to the hospital. When migrants were arrested in the northern border area, they were not taken to the hospital for screening but instead transferred straight to the detention centers. In the detention centers medical screening for new arrivals was not always routinely performed as the availability of medical personnel was limited, the mobility of the population was often high and no interpretation services were available. Limited access to health care while in detention Migrants and asylum seekers systematically complained to MSF teams about inadequate medical care and difficulties in communicating with the doctors. In Pagani and Venna detention centers migrants complained that the medical staff was uncaring and did not take their medical complaints seriously. In total, 23% of our patients complained about the lack of medical care during individual psychological counseling sessions. The inadequate number of medical personnel, the lack of psychologists, the absence of interpreter services, and the lack of a specific procedure for medical emergencies and referrals are factors that limit the delivery of health care in the detention centers. © MSF 16