145. The situation at Samos CCAC was alleviated to some degree by Médecins Sans Frontières (MSF) operating a mobile clinic three times a week with a team consisting of two doctors, a midwife, two nurses, three psychologists and a social worker.57 The delegation observed that residents in the centre formed long queues to access this service. However, there was a need for the CCAC to be more reactive to the requests from the MSF team for transfers out of the centre to hospital. 146. The pharmacies in all three CCACs were very small and relied on donations from a social pharmacy on the islands for medications. However, in nearly all cases, residents had to buy their own medication if they could afford it. Moreover, there was no proper recording of healthcare interventions, including as regards transfers to hospitals, which meant that up-to-date medical records did not exist. The only recording of information in a centralised medical record seemed to concern Covid testing. The CPT recommends that the pharmacies in all three CCACs be stocked with a range of the most in-demand basic medication, which can be provided to residents free of charge. Further, a medical record should be established for every resident upon their arrival and systematically updated each time there is a healthcare intervention. 147. At Samos CCAC, the basic healthcare equipment was adequate with an Electrocardiogram (ECG) machine, oxygen and a defibrillator and lifesaving equipment all in working order. However, at Kos CCAC, there was no defibrillator, and the ECG machine was not working. Such lifesaving equipment is essential in any large residential facility and the CPT recommends that the Greek authorities ensure that all CCACs have operational up-to-date lifesaving equipment, including an ECG machine, oxygen and at least one defibrillator. 148. At both Kos and Samos CCACs, there was an obvious lack of space and equipment in the areas being used to provide healthcare services. Yet both CCACs had large, specifically designed medical centres within their own compounds, located near the entrance to the centre, that were not being used due to a lack of staff. These medical facilities were clean, well equipped and included a spacious waiting room. The delegation proposed during the visit that these medical centres be brought into immediate service and used as a first day triage screening for all new arrivals prior to their allocation to an accommodation area to enable prompt identification of illness, special needs and vulnerabilities. The CPT considers that at both CCACs a two-step screening process should be introduced, with triage screening on the day of arrival to identify specific needs and vulnerabilities which would be followed by a second stage screening to help identify those with psychological distress, mental health needs and other vulnerabilities, such as survivors of torture or other forms of ill-treatment, trafficking in human beings or sexual and gender-based violence. The CPT recommends that the Greek authorities bring into operation the specifically designed medical centres in each CCAC and ensure that they are appropriately staffed. Further, it recommends that a two-step screening process be introduced in all CCACs as set out above (see also paragraph 138). 7. Staffing issues 149. The CPT has consistently emphasised that working in an immigration detention centre is highly challenging for staff. Consequently, the CPT places a premium upon the supervisory staff in such centres being carefully selected and receiving appropriate training. Staff should possess well-developed qualities in both the fields of interpersonal communication and cultural sensitivity, including on trauma-informed care, given the diverse backgrounds of the detained population. Further, at least some staff should have relevant language skills and they should be taught to recognise possible symptoms of stress reactions displayed by detained persons and to take appropriate action. 57. MSF also operated a mobile clinic outside Lesvos CCAC. 44