THE EVERYDAY REALITY FOR ASYLUM SEEKERS ON LESVOS AND SAMOS Inadequate living conditions: In recent weeks, living conditions in Samos’ Vathy camp and in Lesvos’ Moria camp have once again sunk to critical levels. New arrivals are sleeping in small tents, or on a piece of cardboard in the woods. With winter rapidly approaching, we are extremely concerned for the health and the well-being of asylum seekers on the islands. “ I have been under a sheet in the woods for 10 days now. I have three small children. They get bitten by the insects at night and can’t sleep. I had protected them until now from the war, but I can no longer protect them here. It makes me want to scream, but I can’t, not in front of the children. “ 32-year-old woman from Syria, Samos, September 2017 “ I was raped. It happened in Turkey. It was a group of men, one of those gangs. I spoke to a psychologist here, but the interpreter was there and I didn’t trust him. “ 20-year-old man from the Democratic Republic of Congo, Samos, September 2017 Protracted asylum procedures putting people at risk of violence, detention and deportation: For over a year, our psychologists on Samos and Lesvos have witnessed how a lack of clarity, repeated delays and perceived unfairness in the asylum procedure on the islands are a major source of distress for our patients. More recently, they have also seen an increase in suicidal thoughts among our patients, many of whom have received second rejections on their asylum claims. They explain that the risk they face of detention and deportation causes them huge anxiety. “ “ 29-year-old woman from Syria, Lesvos, July 2017 The conditions asylum seekers are living in on the Greek islands constitute continuous traumatic stress. It is therefore inevitable that people with mild or moderate mental health symptoms will develop much more severe ones. It is harrowing and incredibly disempowering to see the mental health status of the asylum seekers in Lesvos progressively getting worse. We do our best to help those that we can, but the situation they are in is so horrendous. We hear of 15 suicide attempts every month in Moria – it’s an unbearable situation. “ |10 General view of the Samos Reception & Identification Center. ADMINISTRATIVE DETENTION12 AS A FIRST RATHER THAN LAST RESORT, WITH DRAMATIC HEALTH AND PROTECTION IMPLICATIONS In recent months, our medical teams have treated a number of severely ill patients on Samos and Lesvos who had been or were subsequently put into administrative detention – most often following a refusal of their asylum claim on second instance and whilst they await a third appeal. The fear of not knowing what will happen to me, to my family, is crushing us. It is killing us inside. I tell my children that everything will be okay. But I hear that they want to send us back to Turkey, to Syria, that they say we are safe there. We would not have put our lives at risk to come here if it was safe there. “ © Mohammad Ghannam/MSF Failure to identify and care for vulnerable people: Over the last 18 months, MSF has continuously documented the failure of the authorities to adequately identify vulnerable people and move them to the mainland. In recent months, this has worsened, as the capacity for such screenings has reduced and the number of people arriving on the islands has increased. Significantly, only a third of our patients on Lesvos that are victims of sexual violence have been identified as vulnerable. MSF psychologist, Lesvos, September 2017 Administrative detention should remain an absolute last resort, but it is widely resorted to on Lesvos and Samos – with few to no safeguards to prevent the detention of someone with a serious medical condition. As a result, many people continue to be detained despite this detention putting their health and lives at risk. Since August 2017, we have been treating on Lesvos a 25-year-old man who was evacuated from the besieged town of Madaya, Syria, who suffers from post-traumatic stress disorder and hallucinations. When he arrived in Greece in 2016, his vulnerability was not recognized, despite a clear diagnosis from Lesvos hospital. He was detained for at least four months on the island following a second negative decision on his asylum claim. He did not have access to his psychiatric drugs, and his condition deteriorated. Only after many interventions from MSF and other actors was he finally released. On 9 September 2017, another Syrian patient of ours on Lesvos was detained following a police operation in Moria. Despite this patient still awaiting a final decision on his asylum claim, our having issued a certificate regarding his very serious health condition which is incompatible with detention, having engaged with the authorities at Lesvos and Athens level, and our having warned key other actors, this patient remained in detention as of 26 September. 11|