vulnerabilities. Furthermore, due to the lack of personnel, accessing medical assistance for residents is extremely challenging. The staffing shortages render diagnosis, monitoring, and assistance for individuals with serious or chronic health conditions unfeasible. For example, in two cases of individuals with medical issues, RSA lawyers formally requested medical assessments and vulnerability evaluations. Although the CCAC administration referred these individuals to the Medical Control and Psychosocial Support Unit, no such assessments have taken place to date. One of these cases involved an individual blind in one eye and experiencing vision problems in the other, who had not been examined by a doctor since arriving in Greece in late July, with their health issues remaining unaddressed. When the individual sought help independently at the hospital, they were informed that medical examinations require a referral from the CCAC. Refugees reported to us that hospital referrals, even for unaccompanied minors, are made only in very severe cases. Meanwhile, the Leros hospital itself faces significant staff shortages.681 In December 2024 METAdrasi and Equal Rights Beyond Borders noted that there were 750 unregistered persons beyond the 25-day time limit in CCAC of Leros. Numbers were higher and had reached 1,000 previously. People are allowed to exit after the 25-day period but without any rights, health care etc. The CCAC has no doctor to perform medical checks and is serviced by a doctor performing three-day missions, mainly to sign health cards and occasionally to offer care to urgent cases.682 Lesvos: Shortages in Medical and Psychological Support have continued during 2024. As reported by RSA: [s]erious shortages in medical and healthcare staff are evident in the Lesvos CCAC. According to the Reception and Identification Service’ s response to us (as of 11 November 2024), there is only one general practitioner, one gynaecologist, two midwives, six nurses, one laboratory technician, two psychologists, and one social worker in the CCAC. Newly arrived individuals undergo a basic medical check-up, while no psychosocial evaluation is conducted. Even individuals with obvious vulnerabilities are not identified. Furthermore, medical staff only work during business hours, leaving the facility without a doctor at night or on weekends. NGOs attempt to fill this gap, but this complicates prescriptions and referrals, as only certified Greek doctors can issue them. The Vostanio Hospital in Lesvos is also severely understaffed. There is currently no active child psychiatrist on the island, making it impossible to identify minors with mental health vulnerabilities.683 Based on GCR’s and partners’ observations, asylum claims are frequently examined before vulnerability assessments are carried out, and, in any case, the outcome of the latter are often not communicated to the Asylum Service before it issues its decision on the application. The lifting of the geographical restriction (see also Reception Conditions – Freedom of Movement). Under the Asylum Code (and previously the IPA), the recognition of vulnerability of asylum applicants has no bearing on the asylum procedure under which their application is examined. Therefore, vulnerable groups, even when identified as such, are no longer referred to the Regular procedure, unless it is proven that no appropriate health care regarding their individual medical problem is available on the island where they reside (see below). In such cases, the geographical restriction imposed upon arrival is lifted and the applicant is transferred or allowed to travel to the mainland. Therefore, the exemption of vulnerable individuals from the Fast-Track Border procedure has become much more difficult. In particular, the movement of asylum-applicants who entered Greece through the islands of Lesvos, Chios, Samos, Kos, Leros, and Rhodes during 2023 is limited to within their respective island (‘geographical restriction’), as per Ministerial Decision 1140/2.12.2019 (GG B’ 4736/20.12.2019) in force since 1 January 2020.684 Greek law transposes Article 7 RCD, allowing Member States to impose a restriction of movement to asylum-applicants within a specific area, provided that it does not affect their unalienable sphere of private life and that it allows sufficient scope for guaranteeing access to all the benefits granted under the Directive. Until 31 December 2019, the geographical restriction could be lifted, inter alia, in respect of vulnerable persons. Following amendments to the law, since 1 January 2020, the 681 682 683 684 RSA, Leros, 10 December 2024, available at: https://rsaegean.org/en/leros-2024/. Information obtained during Legal Aid Working Group meeting of 4 December 2024. RSA, Lesvos, 10 December 2024, available at: https://rsaegean.org/en/lesvos-2024/. This act is based on Article 45 L. 4636/2019. It is worth noting that the act mentions that the geographical restriction is necessary for the implementation of the EU-Türkiye statement. 137