Overcrowding, poor sanitation and a lack of security at Greek migrant camps are taking a heavy toll on refugees' mental health. InfoMigrants spoke to a clinical psychologist on Lesbos who everyday witnesses the human cost of misguided migration policy.
It is late afternoon on a Friday and Greg Kavarnos, a clinical psychologist on the Greek island of Lesbos, has just finished seeing his last patient of the week. He sinks into his chair, opens his diary and flips through its heavily inked pages.
"I see five patients a day," he tells me. "You might say that doesn’t sound like much - but it is the type of stories you hear: rape, war, torture, sexual violence, sexual violence and torture. It is five sessions everyday of really serious psychiatric and psychological problems."
Greg works at Médecins Sans Frontières’ (MSF) clinic in Mytilene, the island’s main town, just a few kilometers south from the refugee camps Kara Tepe and Moria, where the majority of his patients live. He’s seen around 250 patients in 18 months in the role. "At the beginning in 2015 and 2016, the demand for psychological support was so high we were forced to focus on the most severe cases," Greg explains. "Our work here at the clinic now focuses on victims of trauma."
'Mental health emergency'
MSF has argued the situation on the Greek islands of Samos and Lesbos constitutes a "mental health emergency". Human Rights Watch has called it a "silent mental health crisis". Research from both organizations highlights the scale and severity of patients needs on the islands.
Everyday Greg gets a glimpse into the depth of this suffering at the edge of Europe. In the four walls of his office, he attempts to untangle complex experiences that sometimes span years, borders, land and sea. "Someone might turn up to the clinic and say they were tortured in their home country," says Greg as an example. "And then the boat they were aboard sank when they were trying to cross from Turkey. And then yesterday there was a riot in the camp in Lesbos and the police came in using tear gas and busting people’s heads open. My job is to make sense of all these parts so a person can move forward.”
The unfolding impact of border policies
Lesbos, among the other Greek Islands, has since 2015 been at the frontline of Europe’s refugee response. Since then, the media gaze has trailed off but the cumulative impact of EU border policies has unfolded.
Pivotal for the islands was the 2016 EU-Turkey deal, which commits Turkey to accept the return of most asylum seekers that traveled through its territory before arriving in Greece, in return for billions of euros in aid, among other promised benefits. In practice, thousands of asylum seekers have found themselves stuck in camps on the islands.
The human cost of EU policy can be found both inside and beyond the walls of Greg’s office, ringing out across the island: from the chants of Moria camps residents protesting in Mytilene’s town square against their treatment, to the radio calls to rescue teams in the north, still plucking flimsy dinghies out the ocean in 2018.
The semantics of the conversation around mental health, of course, matter. Greg points out that speaking of a "refugee mental health crisis" in some senses avoids confronting what Europe's role is in exacerbating the problem.
"At one meeting I was asked: How many psychologists do we need to deal with the mental health crisis in Moria?" recalls Greg. "I said you could have one psychologist for every person in Moria, but if you don’t change the conditions in the camp, we will never be able to deal with the mental health crisis. Why? Because we, European society, are traumatizing people. It’s not enough that they are already traumatized by their experiences in their home country, it’s not enough that they are traumatized by their experiences in transit, we are traumatising them here as well."
Dire conditions in camps
Overcrowding, poor sanitation and a lack of security in Moria camp, where it is estimated over 5000 currently live in temporary facilities built for 2000, play a role in impacting people’s mental health, argues Greg. “One element of the mental health issue is that people left war zones and many have lost half their families and expected to find organization and democracy on European soil,” says Greg. “Instead inside they find themselves in a prison camp, where nothing works and it is dog eat dog…These camps say to people: ‘You aren’t even a second class citizen. You are a fourth class citizen.’”
Organisations such as MSF and Human Rights Watch are two among many organizations who have criticised the “containment policy” enacted on the islands. Last week, 21 organizations signed a joint statement condemning Greece’s decision to overturn a court ruling lifting the restrictions of movement for newly arrived asylum seekers on the islands.
Lack of transparency
It is not only the material conditions that Greg sees having an impact on his patients. "If I was a refugee here in Lesbos on top of everything, I have to deal with the bureaucracy,” says Greg. "But I can’t find anyone to speak to, and there are only a few legal organizations on the whole island. But there is also a lack of clarity on the asylum procedures. In some cases, newly arrived asylum seekers get moved after one month while others have been waiting in camps for two years with no clear reason why. All of these problems, even if you didn't have preexisting traumatic experiences, just having to live in this situation is enough to drive anyone crazy."
Greg, a local resident of Lesbos, remembers thousands of people sleeping in the ports, the parks and on the sidewalks in late summer of 2015 when the town of Mytilene (with a population of 30,000) was seeing arrivals of a few thousand people every day. He’s seen how locals, many themselves the children and grandchildren of refugees from Turkey, dealt admirably with the pressures.
Yet tension among certain sections of society are also bubbling to the surface. On the Sunday evening and early Monday morning after Greg and I meet, the protest in Mytilene’s town square by residents of Moria camp ends in violence, after far right demonstrators attacked the protesters, with some reportedly yelling “burn them alive”.
While the road ahead for Lesbos is unclear, the boats keep arriving and the volunteers and locals keep on working. And Greg keeps seeing patients five times a day.
Traumatic memories are stored and processed differently to normal memories, Greg explains. "When we try to recall them, we actually relive them in a certain way." In light of extreme trauma, where does he begin in trying to make a positive impact? "What I can do is to try and get people to break the cycle in their recall,” he explains.
"Yes, you remember the torture and you won’t ever forget it. And maybe it’s not even helpful to forget it. But do you remember when you were released? How you felt at that moment? And do you remember when you survived the boat that sank, when you were rescued? Do you remember that feeling? And do you remember when you first kissed your wife or saw your child first smile at you? Focus on that."