6. Healthcare services 141. Overall, access to healthcare and quality of care at both Kos and Samos CCACs was extremely poor, and it was insufficient at Lesvos CCAC. At Kos CCAC, the triage process was completed at the same time as the asylum registration process, which resulted in some persons waiting as long as 30 days to see a doctor for the first time. The delegation met many persons whose healthcare needs were not being met. 142. At Samos CCAC, the triage process for new arrivals was completed within 24 hours but it was carried out by a nurse ‘from memory’ – there was no formal checklist or triage template – and negative findings or psychological problems were not recorded. Further, the triage process was carried out so rapidly that it proved to be of little value; the delegation observed that 40 persons who had just arrived in the centre were triaged in less than an hour – approximately one minute for each patient contact. This is wholly inadequate, and not surprisingly the triage did not pick up important health concerns. For example: - A young woman from Afghanistan who was three months pregnant went to healthcare as she was feeling unwell, short of breath and nauseous. She was given some medication told to walk and eat but no follow up appointment or referral to hospital was made. Two weeks later her health deteriorated with abdominal pain and weakness, was taken to the hospital by ambulance and miscarried. - Another young woman who was HIV positive and six months pregnant was informed that there was no provision for HIV medication on Samos, and yet she was not prioritised for transfer to Athens, where she would have been able to access the appropriate medication. 143. The healthcare team at Kos CCAC consisted of one doctor, two nurses and four social workers.56 The doctor, who was on a short-term secondment from the military, was still in training, and lacked the necessary experience to address the needs of the centre’s residents. No plans were in place to replace him once his secondment ended. The healthcare staff at Lesvos CCAC was comparatively better with two doctors, six nurses, three psychologists, two midwives and a social worker, as well as four interpreters, but still insufficient for the needs of the population of the centre. The healthcare team at Samos CCAC consisted of four nurses, a health visitor, two interpreters and a psychologist. However, two of the nurses were involved in purely administrative tasks that were not clinical and a third nurse was used as a patient escort to navigate people around the local hospital when they were transferred out of the CCAC for care. The remaining nurse was responsible for new patient triages and urgent medical issues within the CCAC. 144. Clearly such small healthcare teams are totally inadequate to address the needs of over 3 500 men, women and children or even half that number. While the CPT takes note of the planned launch of the so-called “Hippocrates” project for the provision of medical care and psychosocial support in all CCACs, it is not clear whether this project will have a positive impact on staffing resources. The CPT recommends that the Greek authorities take immediate steps to significantly reinforce the healthcare teams. As a first step, each CCAC should have one full-time doctor and three nurses for every 500 persons to ensure that the healthcare centres can be fully operational. Contingency plans should be put in place to augment the medical staffing levels when arrival numbers surge. In addition, provision should be made to ensure good access to gynaecological and paediatric services given the number of women (including pregnant women) and small children in the centres. 56. A part-time psychologist who visited the CCAC once a month had recently left. 43