deficiencies of medical and psychosocial personnel as reflected on each island, vulnerability assessment is significantly delayed… As a result, in many cases, the procedure of examining an asylum application is initiated without the necessary registration of vulnerability, and with serious shortcomings in supporting and referring vulnerable cases.” 57 These problems persist, given that critical shortages in EODY medical personnel in the island CCAC remain unaddressed. The recent Greek Ombudsman report highlights that “In the CCACs and RICs, it was unclear, especially when the number of new arrivals increase, whether an initial medical screening is carried out or whether the first contact with the Unit takes place after the identification and registration process.”58 According to official RIS statistics, only 8,104 of the 55,875 people who underwent reception and identification (“screening”) procedures over the past year were declared to be vulnerable at that stage: Vulnerability assessment in reception and identification procedures: 2023 Location Vulnerable persons Total registrations Share Islands and land border 6,792 41,790 16.3% Mainland 1,312 14,085 9.3% Total 8,104 55,875 14.5% Source: Ministry of Migration and Asylum, Reception and identification statistics, Dec 2023 At the same time, responsibilities of the Health Care and Psychosocial Support Units of the mainland CTRC include “assessment of vulnerability and recommendation to the Director for referral of those persons to the competent public institution for social support or protection”, “assessment and collection of mental health history, as well as social history and update of the relevant file”, “filling, update and keeping of hard-copy and/or electronic medical file of the residents” and “conduct of age assessment procedures”.59 Greek law therefore entrusts the CTRC too with the duty to assess the vulnerability of the people they accommodate. Practice stemming from cases supported by RSA in mainland camps is different. The CTRC may be able to provide medical and psychosocial support services to residents, provided they have the necessary personnel. They are not, however, able to classify an applicant under a specific vulnerability category or to amend such a classification where it has previously been done by the RIC or CCAC that conducted reception and identification procedures. As a result, asylum seekers whose vulnerability was not properly assessed during reception and identification procedures and was only identified after they were transferred to mainland CTRC cannot update their Foreigner’s Health Card and the remainder of the case file kept by the RIS and uploaded on the “Alkyoni II” information system that is also used by the Asylum Service and Independent Appeals Committees. 57 58 59 RSA, ‘What is happening today in the refugee structures on the Aegean islands’, 3 May 2023, available here. Ombudsman, The Challenge of Migratory Flows and Refugee Protection, April 2024, 69. Article 5(2)(a) MD 23/13532/2020. RSA REPORT │ REFUGEE CAMPS IN MAINLAND GREECE | JUN 2024 18