Emergency Refugee Camp Dentistry
It’s hard to imagine anything worse than being forced to uproot your family, abandon your home and set off across the planet in search of sanctuary. For many refugees the struggle is made far worse by sickness and physical pain. Hastings dental surgeon Kyriacos Hajikakou has been travelling to Greece since 2016 to offer emergency treatment in refugee camps. Recently returned from his seventh trip, he recounts some of his experiences.
Kyriacos Hajikakou with wife Diana and a volunteer dentist
PICTURE: K. Hajikakou
Dental treatment is often overlooked among the provision of services in emergency situations but there is nothing more miserable than being in pain from a toothache with no prospect of treatment. On the first five visits we were based in Thessaloniki in northern Greece. From there we travelled daily to various camps to set up temporary clinics. Diana, my wife, accompanied me on all but one of my trips.
We take essential equipment and set up surgeries in venues as varied as tents, a semi-derelict former psychiatric hospital, a disused toilet-paper factory and a hotel bedroom. At the end of each day everything has to be packed up and instruments taken away to be sterilized.
Camps can be up to two hours from our base. Once on a public holiday, the route was deserted and we lost our way. As we turned down a narrow lane, our car was attacked by a pack of about 20 feral dogs. On another occasion we were escorted out of a camp to ensure our safety following news of an imminent riot. Violence was not unusual in the camps: tension between Syrians and Algerians often resulted in fights. I sometimes had to treat patients who had been injured in these disputes.
Moria Camp on the island of Lesbos
PICTURE: K. Hajikakou
Our last two trips were to the island of Lesbos just off the Turkish coast. Many refugees arrive here having paid smugglers to provide space in overloaded dinghies. Each day we headed to a former army camp near the village of Moria. Our clinic was in a compound, surrounded with barbed wire fencing, with guards on the gate. With so many arrivals the camp had spilled over into a tented settlement in the local olive groves.
But at least the Moria clinic is a permanent one, partially funded by donations from local residents who’d attended talks we had given. It was a relief not to have to set up a surgery each day. The clinic is managed by a small NGO called Health Point Foundation (HPF), entirely run by self-funded volunteers. They do sterling work but there is a far greater need than HPF can currently satisfy. In 2018 there were as many as 10,000 refugees in this camp designed for just 2,000. It was then a truly terrible place with a palpable air of menace and despair. On this last trip we found improvements, with the number of residents about four to five thousand – it can be hard to get accurate figures.
Thousands of Moria camp residents had been moved from Lesbos to other parts of Greece where there is no dental service for them. Thousands more refugees are on the island of Samos, with very few services and no emergency dental provision.
The translation needs of Moria camp had changed from our last visit. 80% of the camp is made up of Dari or Farsi speakers from Afghanistan or Iran. This was a marked difference to previous trips when the majority of patients had been Arabic speakers. We’ve previously treated numerous Kurdish speakers but this time none at all. Sometimes we’ve had two translators – Kurdish to Arabic, Arabic to English then vice versa and one couldn’t help but wonder how much was being lost in translation.
We travelled to and from the camp by bus, along with refugees and other volunteers. One morning we met a GP from the Midlands who was volunteering with a small charity called MedGlobal. Perhaps surprisingly the physical health problems encountered in the camp did not differ much from those in a deprived area of Derbyshire though the psychological trauma was, of course, on a different scale.
We treated a number of unaccompanied minors aged 15 to 17. Every one had major dental problems, which would require many visits to the clinic. There was however limited time and a long queue of patients. One 15 year old came in with his father, he simply needed a filling but I remember him because of the multiple scarring on his arms and the side of his face. The translator said that such self-harm is common among teenagers, some adults too. One man had been in the camp for 3 years and was resorting to extreme self-harm with a risk of permanent injury.
Waiting for the bus at the end of the day was memorable on one occasion due to torrential rain and lack of shelter. We waited for 40 minutes. When the bus arrived a large crowd of very wet people boarded. I was very aware that we were returning to a comfortable, dry room, rather than a crowded tent or Portacabin. At the end of another day there was great excitement and confusion with a mass of soldiers and policemen stopping traffic, clearing the road and moving people around in an officious manner.
Surgery at Moria Camp
PICTURE: K. Hajikakou
There were large groups of refugees, many with quantities of luggage, waiting for coaches to take them on the first leg of their journey to Athens. I witnessed one group of people being herded and moved on in an unnecessarily aggressive way for no obvious reason. The majority just accepted it but one man drew himself up and said, “We are human beings, we are not animals” and the policeman slunk away. It’s an image that will stay with me for a long time. It turned out that all the fuss was because of the impending visit of the leader of the main opposition party, elections were due and the issue of the camps and refugees is a sensitive one. Eventually a cavalcade of many limousines swept past us. We had another forty minute wait for our bus home.
Each day ended with a mixture of satisfaction and frustration. We had great support from a team of translators and a coordinator who was a dentist from Aberdeen nearing the end of a three-month volunteering stint. They were all lovely people. The team found things to laugh about despite the circumstances; there was great team spirit and camaraderie. It is part of what makes the experience so worthwhile and keeps drawing me back.
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