In Moria Detention Centre Refugees Fear the 'Catastrophe' of a Coronavirus Outbreak
The UN refugee authority has cut financial aid to people in the Moria refugee detention center on the Greek island of Lesbos, after two centers on the mainland went into quarantine with coronavirus cases. Moria detainees and healthcare workers are now anxiously awaiting signs the virus has made its way into the camp.
Reza is an asylum seeker from Afghanistan, who came to Moria with his wife and two children via Turkey. The family live in a tent on the outskirts of the camp. He says at first people didn't take much notice of coronavirus, but over the last few weeks, especially as the extent of the outbreak in Iran (over 3,500 deaths at time of writing) became known, people started to get nervous.
"All of them are worried. And there is nothing they can do."
There are around 22,000 detainees in the Moria center, which was designed with a maximum capacity of 3500. A former army barracks, the center itself is too small to contain everyone, so detainees live in the area around it, in tents or small shipping containers known as "iso-boxes."
"We cannot quarantine ourselves," says Reza. "In many iso-boxes, there are six, seven families living together. And in the tents there are four or five families. It's really bad."
As for hygiene, the situation is even worse. The camp has long been decried for its poor sanitation facilities, but as overcrowding continues to worsen, the situation is extreme. The camp has around twelve taps for handwashing, and around the same amount of bathrooms, according to Reza: "Anytime you go, there are maybe six or eight people in the line. And you have to wait there and you don't have any idea who is sick, who is not sick."
Makeshift tents in the camp surrounding Moria detention center, April 6th 2020.
Eline von Königslöw is a doctor and medical coordinator with Stichting Bootvluchteling (the Boat Refugee Foundation), which is active in one of the two medical clinics operating in the camp. She says on average around two to three hundred people per day visit the clinic, around half which the clinic has capacity to treat. The health complaints range from common ones such as cold and flu to parasites such as scabies as well as infections and chronic conditions such as hypertension and diabetes. They also see stab wounds, as violence occasionally flares up in the camp. A 16-year old Afghan boy was stabbed to death just this week. The clinic also sees people presenting with psychiatric issues.
As the clinic is small, people presenting with symptoms of coronavirus have to be seen outside, or referred to the Greek health authority. There are already several confirmed cases of coronavirus among the Greek population of Lesbos, and hospital facilities are minimal. The hospital in the main town of Mytilini offers only a handful of ICU beds. Coronavirus tests still have to be sent off to Athens, which takes several days.
Von Königslöw says there is nowhere near the testing capacity available to cover everyone they suspect of having the virus: "We can only refer those with fever and severe breathing distress to the hospital, so other patients, that have more mild symptoms and could test positive for corona, we can not refer them for any testing."
She says over the last few weeks they've been able to send only around five people for testing, despite having reason to suspect coronavirus among many others. She says if an outbreak were to occur, the camp would be totally unprepared to deal with it.
"We have proposed several plans and stressed the importance of a central triage system, a central spot in Moria where all patients can go, falling under the responsibility of the Greek public health (authority). And we have also proposed several locations for self-isolation of vulnerable people and people that have confirmed or possibly confirmed COVID-19." She said the Greek health authority had agreed to the triage system, but so far nothing concrete has been put in place, and implementation of the proposals has been "way too slow."
The clinic has recorded around 800 people who are either over the age of 65 or who have conditions that make them particularly vulnerable to coronavirus. If only a small amount of these “high-risk” people were infected, the local hospital with its six intensive care beds would have no capacity to deal with them.
With the help of construction NGOs in the area, von Königslöw says the capacity certainly exists to build the facilities needed to physically isolate at least some patients in the camp, but that is not enough by itself. "It's also about the medical staff capacity and the training that is necessary in treating patients, and protection outfits. And that's something that really has to come from the Greek government."
Von Königslöw says that while she thinks the Greek government has done well in responding to the crisis in Greece overall, "when it comes to really concrete plans, specific plans for inside the camp, for when the outbreak actually starts, that has been very slow."
A coronavirus outbreak would only be the latest in a long line of troubles for the residents of Moria. Better Days is a grassroots NGO that provides protection and logistical support to the inmates of Moria camp, in particular unaccompanied minors, of which there are over a thousand. Dan Teuma is emergency response director for Better Days. He says the ongoing crisis that already existed in the camp is exactly the kind to be exacerbated by a deadly outbreak: "Last year, some people were waiting ten hours to have a shower and hours to access food. That situation just keeps getting worse and worse. There's 1,300 people per tap. You're taking an overpopulated humanitarian disaster situation and you're putting COVID-19 on top of that."
"Moria in terms of its population and area is one of the most densely populated places in the world. You just need to do the math. 20,000 people living in such a small space with unhygienic conditions. It is a recipe for absolute catastrophe and disaster."
In the meantime, Reza, the Afghan asylum seeker living with his family on the outskirts of the camp, says while Greek merchants are still allowed in to sell produce, the United Nations High Commissioner for Refugees (UNHCR) has cut off financial aid to detainees, in an effort to prevent them going into town to withdraw cash.
Unable to get money out, many people don't have the cash to purchase their own food. UNHCR and the Greek army provide food in the camp but Reza says it is often not enough, and many families miss out (not to mention the concern about thousands of people at a time queuing up for it. In March, a group of refugees went to the commander of the Greek army to complain, claiming some 1500 families had gone without food for weeks.
In an emailed statement, UNHCR confirmed the suspension of financial aid: "It is true that cash assistance for asylum-seekers in the islands’ reception centers (including in Moria) is postponed for a few days, until the Greek authorities are able to place a sufficient number of ATMs and encourage “mobile” shops close to the reception centers. This measure has been introduced in order to contain further the movement of the centers' residents, for public health reasons."
The food line at the camp, sometimes thousands of people at a time wait in line.
UNHCR stressed they are working with the Greek government to try to speed up other ways for detainees to access money, and that coronavirus is not the only risk detainees are facing in this crisis: "The public health controls are extremely important but need to be balanced with putting on hold asylum seekers’ access to essential and critical goods (including medicines)."
Von Königslöw says that in the case of an outbreak, the only way to protect people would be to get them out of the camp and into isolation and treatment facilities elsewhere on Lesbos or even on the mainland: "That's the only way this could really be prevented." She is not alone in thinking this, with a number of public health academics signing a call to evacuate the Moria camp.
Under the current political climate, that seems unlikely. The Greek authority's response to coronavirus diagnoses in the Ritsona camp on the mainland has been to quarantine the camps completely, essentially locking people in.
Reza says, if there is an outbreak, he will try to move his family's tent as far from the camp as possible. He's afraid of how quickly coronavirus could spread if it does reach the camp: "I think, if the virus comes inside the camp in the morning, by noon all of the camp will have it. In 14 days, half of these people will be dead."