INSIDE MORIA’S MENTAL HEALTH CRISIS

≈ Written by Ceci Sturman ≈ Photography by Sayed Ahmadzia Ebrahimi

“If somehow you don’t enter Moria with a mental health problem there is no doubt you will leave with one.”

This quote, first spoken by a Syrian woman who has lived as a refugee in Lesvos, Greece for the past two years, was echoed in some variation by each refugee, aid worker, and psychologist we interviewed.

As of October 2018, Moria refugee camp is home to roughly 8,000 refugees. Moria is a former detention center on the Greek isle of Lesvos that was built to house roughly one quarter the amount of its current inhabitants. In the summer months, 300-350 refugees arrived weekly to Lesvos from 38 different countries; mainly from Afghanistan, DRC, and Syria. Over 2250 refugees arrived in September 2018. 

The majority of refugees are detained on Lesvos until they receive their asylum notice and are allowed to legally leave the island. Asylum notice, depending on the case, could take from two months to two years. Many wait months for their first asylum interview. 

Organizations serving Moria such as Medecins Sans Frontieres have continuously called out the inhumane conditions in the camp that lead to added abuse and re-traumatization of refugees. Refugee living conditions vary from UNHCR container boxes and permanent structures to tents of various shapes and sizes to “rub-halls” (makeshift dormitory structures with blankets for walls). With four adults living to one small tent, three families to one large tent, or 20 single men per small room, privacy is nearly impossible. The camp has informally overflowed to the “Olive Grove”, or the field immediately outside Moria’s back gate, with 70 people to each functioning toilet and 80 people per functioning shower. Regardless of the living situation, it is overwhelmingly cramped and unsanitary.

The constant influx and overflow of the camp, as well as the shortage of personnel (social workers, medical staff, and asylum claim officers), cause extreme delays and gaps in service. To receive food, to go to the washroom, to speak to someone about their needs, to get a doctor’s appointment, to actually go to the doctor, to talk to UNHCR (United Nations High Commissioner for Refugees) about their asylum case, to talk to EASO (European Asylum Support Office) about their asylum case, to meet with lawyers, one must wait in a line, sometimes for hours, and sometimes just to be referred to another line. Refugees feel they have no control over their own fates and instead, feel imprisoned to a system they believe hates them.

In Moria, there are daily rumors of riots over the camp’s food service and or fights between clashing ethnic groups. These riots can often turn into knife-fights. Often there are altercations with the Greek police. And an asylum decision? It feels tedious, humiliating, like ‘purgatory’, the threat of deportation always looming. “Sometimes I think they like to play games with us so we do not know how they do it," commented a Sudanese man who has lived two years in Moria camp. “You can wait years and not know one thing.”

Increasingly there are reports of incidents of Sexual and Gender Based Violence (SGBV) against women. For women, safety is a significant concern. Presented (verbally) at an Interagency Coordination Meeting, a recent UNHCR Gap Analysis Participatory Assessment study in Moria surveyed major concerns of refugees in focus groups broken down by women, men, and unaccompanied minors; women’s safety was cited as a major concern in each focus group. Other major concerns included a lack of knowledge of available services in Moria and a lack of translation or interpretation services available.

Self-harm is extremely common among the youth and the number of attempted suicides increase monthly, with recent reports of children as young as ten years old attempting to take their lives in Moria. In the UNHCR survey, the unaccompanied minor focus group cited this as a huge problem and asked for more resources that would teach them how to talk about their friends that are self-harming.

Many refugees suffer daily with severe loss, PTSD, depression, panic attacks, and in Moria they are being re-traumatized when they are supposed to be safe. On the other hand, spending time outside of Moria is not an option for many refugees who feel discriminated against by local Greeks. In the survey, refugees said there was a need to educate local people about refugees: to eliminate racism and to explain that refugees are not “dirty” like they assume.

In identifying some of the major problems that refugees encounter in Moria, many of which contribute to their extreme suffering, it is important to understand how the mental health system works in Moria: when refugees first arrive to Moria (or any refugee camp), they are given an all-inclusive intake assessment, covering general concerns as well as physical and mental health concerns in order to make a “vulnerable” or ”non-vulnerable” decision. If the doctor or assessor labels a refugee as “vulnerable”, the refugee is able to receive special care and accommodations in Moria.

As “vulnerable” status is given to the most severe mental health cases, such as suicide and people with a history of past hospitalization, “non-vulnerable” people who still experience mental health problems such as general anxiety and depression and post traumatic stress disorder are not given prioritization, and therefore face extreme difficulties when seeking help in Moria.

We were given numerous first hand accounts of “non-vulnerable” refugees who have asked to been referred to psychologist and were given an appointment with the Greek psychologist 6 months later, in the town of Mytilini (6.9 km away). In response, one Syrian woman said, “Forget it, I’ll figure it out my own way.” One man, after literally begging for support, was told there was nothing that could be done and referred to different organizations outside of the camp. Refugees believe that the only way their mental health will be taken seriously is if it looks like they are crazy enough to jump in front of a car, and some that are desperate enough have resorted to that.

Without the capacity to sustain basic human dignity, and to properly address mental health issues, Moria itself has become a mental health crisis.

≈ Published 10 October 2018.

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