In Samos CCAC, there were significant shortages in doctors, medication, and medical supplies. As confirmed by the RIS in November 2024, the facility had 4 nurses, 2 social workers, 1 psychologist, and a laboratory technologist/radiologist, but no doctor.558 In Kos CCAC, there was no psychologist throughout the entirety of 2024. Periodically, a psychologist from Leros CCAC was visiting the facility only to sign medical cards with references to apparent vulnerabilities, without carrying out herself a substantive assessment of the phycological condition of the applicants.559 In Leros CCAC, there was no doctor operating in the facility. There were only 6 nurses, a midwife, 1 psychologist, and 1 social worker. The medical screening was conducted by the medical unit of the Ministry of Health, with nurses and occasional visiting doctors to the island. Essentially, a medical assessment could not be conducted in the case of newly arrived individuals, resulting in an impossibility to identify potential vulnerabilities. Additionally, due to staff shortages, access to medical assistance remained challenging for residents.560 As a result of the above-mentioned shortages and the inability to identify vulnerabilities, decisions of inadmissibility are issued against applicants with serious vulnerabilities, whose cases are then brought before the Appeals Authority. On February 23, 2024, the 9th Committee of the Appeals Authority annulled the initial inadmissibility decision for a Somali applicant. The decision was based on the fact that, as a single woman and a survivor of sexual violence, Türkiye could not be considered a safe country for her. This was due to the lack of adequate infrastructure in Türkiye to support and rehabilitate vulnerable individuals. 561 On 12 February 2024, the 19th Independent Appeals Committee annulled a first instance negative decision that considered inadmissible the asylum application of a Somali single woman on the basis of the safe third country concept, taking into account inter alia that “i) the applicant is a single woman without a family or other support network in Türkiye, which makes it particularly difficult, if not practically impossible, to establish social and employment links in this country, where the problems of women's access to services and legal protection, gender discrimination and of women's living and working conditions are real and the Turkish authorities are not taking sufficient measures to address them”, the Appeals Committee concluded that “Türkiye cannot be considered a safe third country for her […]”. 562 In Lesvos CCAC, there are serious shortages of medical and health personnel. There is a general practitioner and a gynaecologist in the structure, as well as 2 midwives, 6 nurses, 1 laboratory technologist, 2 psychologists and 1 social worker. New arrivals are subjected to a standard medical checkup and no psychosocial check-up. Even people with obvious vulnerabilities are not identified. In addition, medical staff only work during working hours and days, resulting in no doctor in the evening or on weekends. This gap is attempted to be filled by organisations, which creates difficulties in prescriptions and referrals, as only Greek certified doctors can issue prescriptions. There is also serious understaffing at the Vostaneio Hospital of Lesvos. There is no child psychiatrist in practice in Lesvos at the moment. As a result, minors with mental health vulnerabilities cannot be identified. 563 According to internal SOPs, circulated within the Asylum Service in the autumn of 2021, asylum applicants from the 5 nationalities affected by the JMD (Syria, Afghanistan, Somalia, Pakistan and Bangladesh), who have entered Greece from Türkiye and have stayed in Greece for a year or more must be considered as not having a special link/connection with the third country (i.e., Türkiye) or that in any case the special link/connection has ceased to exist (See Safe third country). In some cases, the above-mentioned internal directive is strictly applied without taking into account any substantive criteria. As a result, asylum applications from people who are only a few days away from the end of their one-year stay in Greece can be rejected as inadmissible. In September 2024, the Appeals 558 559 560 561 562 563 Refugee Support Aegean, What is happening today at the in the refugee structures on the Aegean Islands Serious Problems in the EU - funded structures- SAMOS, 10 December 2024, available in Greek here. Refugee Support Aegean, What is happening today in the refugee Structures on the Aegean Islands - Serious Problems in the EU - funded structures - KOS, 10 December 2024, available in Greek here. Refugee Support Aegean What is happening today in the refugee Structures on the Aegean Islands - Serious Problems in the EU - funded structures- LEROS, 10 December 2024, available in Greek here. Decision IP/129654/2024 9th Appeals Committe, summary [in Greek] in: GCR et al, Greek Asylum Case Law Report, Issue 2/2024, 6, available here. Decision 96007/2024 19th Appeals Committee. Summary of the decision available [in Greek] in GCR et al, Greek Asylum Case Law Report Issue 1/2024, available here, 3. Refugee Support Aegean What is happening today in the refugee Structures on the Aegean Islands - Serious Problems in the EU - funded structures- LESVOS, 10 December 2024, available in Greek here. 108