“Because I am a prisoner for a long time, I feel that my mind is not working well anymore.” 22-year-old man, 5 months in detention 1.1 Impact of detention conditions on observed the unacceptable practice of distributing a migrants’ physical health single razor to be shared by more than one person, putting those in detention at risk of the transmitting “When I first started working in the detention centres, I was shocked by the conditions. Apart from the really limited space in which people are packed, another major problem is sanitary conditions, especially in the latrines, which are in a dreadful state.” MSF doctor police stations and in the pre-removal centre in Komotini – physical conditions are extremely poor. substandard hygiene “Most of the diseases I treat are connected to the detention circumstances. For example, it is too humid – I have seen patients who sleep on completely wet mattresses. People also face problems related to their psychological condition, In many detention facilities – particularly in regular Overcrowding, infections such as HIV, hepatitis B and hepatitis C. conditions, inadequate heating, not enough hot water and a lack of ventilation are all factors that contribute to the outbreak and spread of respiratory, gastrointestinal and dermatological diseases. In 2013-14, MSF’s medical data10 shows that the most common complaints were upper respiratory tract infections (24.7%); gastrointestinal disorders (14.7%); musculoskeletal problems (13.7%); skin diseases (8.5%); and dental problems (7.9%). Τhe recurrent scabies outbreaks observed in many detention facilities are indicative of the substandard conditions, as the spread of the disease is directly linked to poor sanitary conditions. During 2013 alone, MSF teams had to carry out two separate scabies control interventions in most of the detention facilities where they worked. In some detention facilities, MSF also and they have sleep disorders and psychosomatic issues.” MSF doctor The risk which detention conditions pose to the health of detained migrants and asylum seekers has also been reported by the European Centre for Disease Prevention and Control (ECDC) after a delegation conducted a field visit to Greece in 201111. 9 MSF report: Migrants in detention – Lives on hold, 2009-10 (http://www. doctorswithoutborders.org/ article/greece-lives-hold) / MSF report: Emergency intervention in Evros, 2011 (http://www.msf.org/article/more60-percent-medical-problems-faced-detained-migrants-evros-greececaused-inhumane-living) /MSF report: Medical assistance to migrants and refugees in Greece, 2013 http://www.msf.org.uk/sites/uk/files/ greece_refugees_2013.pdf 10 Statistics derived from 3,203 medical consultations which took place between October 2013 and March 2014. 11 “The main problem is the increased risk for communicable diseases in the detention centres, mainly linked to severe overcrowding, lack of hygiene, lack of basic supplies (eg blankets, shoes, soap etc), lack of the possibility for outdoor activities and the long duration of detention. The conditions in the centres are below the internationally accepted minimum standards in all visited detention centres. It is well documented that overcrowding increases the risk for communicable diseases spread, such as tuberculosis, diarrhoea, upper respiratory infections etc.” European Centre for Disease Prevention and Control, Evros field visit report, April 2011. 9|