Leonard Kirn studied medicine in Berlin and is currently doing his residency in anesthesiology and intensive care medicine. Back when he was still a student, he made the decision to work in humanitarian aid one day. He was always concerned with the situation of people on the move, so he decided to get his own view of the situation on the ground. In March, he was already in Athens with MVI. The experiences there inspired and motivated him to assist in an MVI project again in the fall of 2021.

You spent several weeks as a doctor on Lesbos before you left for Bosnia quite spontaneously. How did the change of location come about?
The situation on Lesvos has changed in the last months: Hardly any refugees are arriving now and several are leaving the camp, so that today there are “only” about two thousand people on the move on Lesvos – at the same time, the network of medical assistance offered by non-governmental organizations (NGOs) has remained relatively stable. This means that not as many doctors are needed as before. Conversely, we have seen that the situation is worsening in Bosnia. The offer of medical assistance for people on the move is significantly lower there – but it is urgently needed. Our advantage as a small, dynamic organization is that we can act quickly and adapt our work to the current situation. In my case, I was basically transferred to Bosnia and left Lesbos by ferry and bus, arriving a few days later in Velika Kladusa.

What were your impressions during your first days in Bosnia?
This may sound bizarre: But compared to what I experience here, Lesvos almost felt like a vacation to me as a volunteer doctor. On Lesvos you have bars, beaches and simply many distractions. Working here is something else. The mental strain is high. The city is a desolate place. It’s cold and barren. I’m usually a very active person, but here I have to force myself to go out at all.

Velika Kladusa is close to the Croatian border and thus the external EU border. You can see the traces of war everywhere. Bombed-out houses and ruins. Unlike on Lesbos, where people on the move arrive in an environment where the majority of locals live in relative prosperity, you can see poverty everywhere – and not just among people on the move. But of course it hits them particularly hard: Most of them live in empty houses and shacks without electricity or heating. They warm themselves with blankets and make fires to keep themselves warm. That’s especially difficult in winter, when the temperatures can sometimes drop below -6 degrees. Seeing the children here, it tears my heart, because you start to think about how some children in Germany are being spoiled in the run-up to Christmas holidays – this makes the contrast even more extrem.

How many people are currently part of the team working in Bosnia?
At the moment we only have a team consisting of the project coordinator, a nurse and me as a doctor here. We are actually on call all around the clock. We even go out at midnight in case there is an emergency. That takes a lot out of you. But MVI only got its registration to work in Bosnia very recently. Unlike the work on Lesvos, it is sometimes more dangerous and difficult for NGOs to work here. Our work is not always welcomed by parts of society and the police. That is why we work undercover as much as possible.

We don’t have a clinic here, as we do on Lesvos. Instead we try to act as tourists. We visit the patients with a backpack full of medicines. We also have a car with which we make some trips. The refugees send us their location via Facebook when they need medical help.

How should one imagine the situation on the ground? What does the life of people on the move look like?
Velika Kladusa is the last stop before the EU border for most of them. A town where they stay and wait for the right moment to make another attempt to cross the border. They call this “The Game”. It sounds a bit irritating to my ears. But I guess it means the game of taking the risk – you never know if you’ll make it or not. Many try to make it by bus or with the help of smugglers. If they are caught, the border guards or policemen take their cell phones, powerbanks and other items. These are destroyed and the people are abandoned somewhere on the other side of the border. Many of them come back to Velika Kladusa after a failed attempt, get the basic necessities of life with the help of NGOs – and then try again from the beginning. We cannot change politics. But we can try to offer people on the move the most basic medical care.

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Natalie Faddul, 31, is a doctor from Hamburg. She lived in Berlin for twelve years, where she began her residency in internal medicine – until she came to Greece in May 2020. She planned to stay for a few weeks only, but ended up staying on a humanitarian aid mission until now.

When the pandemic really hit Europe and people went into lockdown in many places, you flew to Thessaloniki to provide medical care to refugees. What was that like for you?

It was difficult to even get to Greece in the first place. The Corona pandemic had started a few months ago and still had an impact on travelling without obstacles. Originally, I wanted to stay for four weeks only. But when a lot of volunteers were unable to start their missions due to the pandemic, I ended up staying much longer. Half a year later, I was offered the position of medical coordinator and stayed in Thessaloniki for another six months.

What does humanitarian aid look like in times of Corona?

The situation in recent years has increased the challenges for people on the move and also for NGOs on the ground. Thessaloniki used to be the first safe place in Europe for people on the move. But now quite a lot of them are stranded there because they are pushed back at inner-European borders. Many live on the streets, which in turn means they cannot “stay at home” during a lockdown. They often came to us when they received a fine, having to pay several 100 euros, for being in the streets at night, which is of course absurd. Additionally, for some time, unvaccinated people were not allowed inside closed rooms – not even for medical help from NGOs. We were threatened with heavy fines. So we had to move part of the treatment for unvaccinated patients outside, which was a big logistical challenge as well. We had to try to prevent crowds in the waiting room and in front of the clinic. This is why we had to start working with appointments. For refugees without smartphones and What’s App, however, this made access to health care even more difficult.

What aid are you able to provide? And where do you feel powerless?

In Germany, a lot of diagnostics are done. You have to think of it like this: If a patient has a skin rash, we would first send samples to the laboratory to determine whether it is a fungus or an eczema. In our projects in Greece, that is often not possible. You have to rely on your gut feeling. We start the first treatment with an ointment against fungal infestation. If this does not help, we have to think of something else. Especially during summer we see many sore feet and inflammations due to bad hygienic conditions. We can treat these things well with our limited resources. More severe cases are referred to other practices or hospitals. What is difficult to provide, is in-depth psychological help. Many people on the move are traumatized, have experienced violence while being on the move or already in their home country. Unfortunately, there is often not enough treatment available. In addition to medical care, we always try to listen to our patients. Of course, this is not psychological treatment, but it is nevertheless very much appreciated.

You have not only worked in Athens and Thessaloniki, but also in Bosnia, Lebanon and on the island of Kios. How did you end up working in humanitarian aid for almost two years? 

Being able to provide humanitarian aid one day was one of the reasons for me to study medicine in the first place. Therefore, it was only a matter of time for me. Despite the terrible conditions and the additional hurdles posed by Corona, I enjoyed the work immensely right from the start. The nice thing about MVI is that it is a relatively small organization. You have a lot of room to create and try things out. All ideas for the further development and implementation of the projects are heard out first and then we see how realistic the implementation is.

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Nicolai Kissling recently finished his medical studies. After graduating, the medic from Hamburg decided to use his free time to volunteer in Thessaloniki for a month. He knows his efforts can’t change everything, but with his medical training, he’s eager to lend a hand where help is needed.

What made you decide to help in Thessaloniki?
I didn’t actively choose the place. I was sitting on the balcony with a neighbour who is supporting MVI and she told me about the organisation. Volunteering has always been important for me: sharing your skills with those who otherwise wouldn’t have access to care. In 2018, I had already volunteered at a hospital in Tanzania, as part of my medical training. As I was off work, I thought I could and would like to contribute again as a volunteer.

You’ve only been volunteering in Thessaloniki for a few weeks. What feeling accompanies you in the evening when you go to bed?
Lack of understanding but also anger about how undignified people are treated and the conditions they have to live in. It is a very vulnerable situation for them. I meet young, talented people here who just want to get going in their lives and are trapped here in the asylum bureaucracy. People who have experienced sometimes traumatic situations on their way to Europe. People who also live here without shelter and depend on NGOs to fulfill their most basic human rights like food and medical care. People who return from the border with injuries because they experienced violence during illegal “pushbacks.” Also elderly people and families with children, people of all different backgrounds.

It is horrible to see how people with illnesses that are actually treatable but do not receive help because they do not have access to it. The thought: ‘In Germany I would have ordered this or that now’ is very frustrating.

What was your expectations before you came here?
I didn’t have a concrete idea. But I definitely had more confidence in the EU than what I am experiencing here now. I don’t understand at all how European law can be broken under the pretext of “protecting” the EU. But we betray exactly what we stand for: Respect for the rights of every human being. Nevertheless, illegal pushbacks are the order of the day.

How is your experience of the situation for refugees in Thessaloniki at the moment?
Originally, Thessaloniki was a safe place for people in transit, or so I was told by refugees, volunteers, and coordinators who have been here for a while. After crossing the Turkish border, it was the first stop for many before moving on and trying to get further west. Those who can, now walk past Thessaloniki to the next border. Only those who have to stop because they need medical help come here. This is because attacks by right-wing extremist groups and police violence are on the rise. Life on the street is no longer safe.

What are the medical problems that people come to you with?
In the past, it was mostly wounds on the feet from long walks. This is now less, but people still come to us with open feet from walking for ten or 15 days. At home, you would tell the patient: take warm baths and rest. Here we offer wound care and try to treat infections as long as the patients are there because most of them move on as quickly as they can. In addition to the acute complaints, there are now many people who have been stranded in Thessaloniki for some time and have chronic complaints. For these patients, some with complex chronic conditions, we are often the only medical care and act as a General Practitioner. Whenever possible, we try to treat the patient ourselves. But we also write referrals for hospitals and accompany the patients, as their “advocates” so to speak, because they are often turned away in the already overburdened Greek health system. It is most difficult for undocumented refugees. They are officially not entitled to medical care.

What contribution do you want to make with your work?
Of course, I am here to provide medical help. But beyond that, I want to meet people at eye level, to listen to them, to take my time. What I often think of here is the word “dignity. I think it is important that patients know that they are seen as individuals, not as refugees, not as numbers, not as members of an ethnic group. As a human being. What we do here is not charity towards the needy. Health care is a human right. We are simply helping people here to get what they have always been entitled to.

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1 year after the burning of Moria, there is hardly anymore attention for the people there. Asylum procedures have been accelerated – many refugees received a rejected asylum decision and are now on the Greek mainland or have disappeared. Due to the strict border controls of the coast guards and “illegal pushbacks” hardly any people arrive on Lesbos any longer. However, about 4000 people are still living in the new camp “Kara Tepe”, receiving general medical care from Medical Volunteers International. Amar Mardini, 31 years old, doctor, since the beginning of May with MVI on Lesvos reports about the current situation.

Please introduce yourself briefly. 

My name is Amar Mardini, I am 31 years old and a doctor by profession. I completed my medical studies in Marburg and have since worked at the University Hospital there in the Department of Cardiology, Angiology and Internal Intensive Care Medicine.

How long have you been on Lesvos?

I have been here on Lesvos since May this year.

What is your job on the ground?

I am a doctor responsible for primary health care of the refugees in the camp, Kara Tepe, and I have also recently become the second medical coordinator of the Medical Volunteers international (MVI) on site.

You have probably prepared yourself for your assignment and also read up on it.
What surprised you when you arrived?

Since this is my first mission as a medical volunteer, I made a conscious decision to go to a place in Europe. During my training, I was primarily instructed in emergency and intensive care medicine at a German hospital. I was aware that this “high-end medicine” probably differs significantly from what is available locally. MVI sends an information guideline to each new volunteer before arrival, which gives you a rough idea of what to expect on the island. Once on the ground, however, you quickly discover that the challenges can be very demanding. The simplest diagnostic examinations and therapies are difficult here. So, to my astonishment, I had to realize at the beginning that the guidelines of “Doctors without Borders”, which were designed for crisis areas in developing countries, are being used in a European country.  

What was your motivation to plan such a mission?

The issue of refugees, reasons for fleeing and migration has preoccupied me for several years. Then last year I read the book “The Shame of Europe: Of Refugees and Human Rights” by Jean Ziegler, Vice President of the Advisory Committee of the UN Human Rights Council. I was horrified by the circumstances described there on the Aegean island. People who fled hardship and misery and endured inhumane hardships during their journey found themselves, long before the fire in Moria, in an inhumane situation in the European Union. 

The increasing acceptance of this situation in Europe stunned me. It contradicted my image of the European Union as a humanitarian community committed to universal and inalienable human rights and admired by so many people around the world. I wanted to help change something so that this narrative of Europe would not be found in later history books only as a hypocritical narrative. But there were also personal reasons. My father is originally from Syria. He emigrated to Germany decades before the civil war broke out. Although I myself, having been born and raised in Germany, have little connection with my father’s country of origin except for some wonderful childhood and youth memories during school vacations, I have probably experienced through my father a deeper and more personal insight into the suffering that this despicable civil war has been inflicting on my father’s relatives and acquaintances and the people on the ground and on the run for a decade now. 

What does your “everyday life” look like here and how does it essentially differ from your work in Germany?

Whereas in my training at a German hospital all diagnostic and therapeutic options as well as interdisciplinary expertise were available at all times, here you have to go back to the basics of a medical examination and treatment. Anamnesis, physical examination and the simplest diagnostic tools are all that are available here.  It is quite a challenge at first to get back to these basic examination and treatment methods. Despite the younger patient population compared to Germany, we see many patients every day due to the adverse conditions in which people live here. Abdominal pain, back pain, headaches, and communicable diseases such as scabies are common. The camp makes people sick, and not just physically. Many of the refugees need psychological support due to their experiences in their home countries, their journey or in the camp. Stories of torture, violence or sexual abuse are not uncommon. Symptoms of post-traumatic stress disorder, panic attacks and even psychogenic seizures are commonplace.

Despite this, as a volunteer it is also great to experience the international and interdisciplinary cooperation here. The stressful everyday life in a German emergency room is partly characterized by a dispute between the different departments. The tone between surgeons and internists can get very rough on some days. As MVI, we are responsible on site for primary health care and sometimes psychological care of the patients in the camp. We therefore have to work closely with all the medical players. Doctors and nurses from various countries of Europe, such as the United Kingdom, the Netherlands, Switzerland, Portugal and Greece, bring their diverse expertise to the international team. They work together hand in hand and always with an open ear for advice. It is enriching to see and discuss the partly different approaches of treatment. For me, it is a hopeful sign that the European community works and that we will find a solution together.   

Are there any situations in dealing with patients that you especially remember?

Yes, it´s been a situation quite at the beginning of the mission. A young man from Sierra Leone came to see a doctor with a headache. A typical case in the camp, it is hot, water is rationed and people are under permanent stress. Medically not a challenging case and therefore actually quite quick to treat. However, since we were well staffed at the time, I was able to take my time with the patient. I asked him how old he was and when he arrived on Lesvos. He was 19 years old, all by himself and had only been on the island for a few days. There were very few people from Sierra Leone in the camp. He spoke English, which made me happy because we therefore did not need a translator to communicate with each other. However, in the camp, he found it difficult to connect in some cases due to the poor or lack of English skills of the refugees from other countries. At that moment, I thought about how it must be for a man who had just grown up to have to live in a camp with almost 8,000 unknown people. I started my medical studies in Marburg at the age of 19, and at that time of day I was probably sitting in a lecture at university, hungover, or still in bed after a long night with fellow students and new friends. When I asked him if he was already in contact with an NGO for legal aid, he answered “no”. I then showed him a paper with contact details of the various legal aid organizations and advised him to seek legal help as soon as possible, preferably on the same day. The young man, who at first listened very quietly and skeptically to my questions, gradually began to become more talkative. The headache seemed to have disappeared almost without a tablet by the end of our conversation. He thanked me at the end of our conversation. Since the beginning of him fleeing from his home country, he had received little help from strangers, he told me as he left the room. He followed my advice and even before his first interview with the authorities, he found an organization that advises him on legal assistance. He continues to drop by the clinic from time to time to tell me the latest about his case. The chances for a positive decision are not bad. He has only needed painkillers for headaches once. 

How would you describe the current situation of refugees on the island? 

As a doctor, I cannot give a complete overview of the current situation of the refugees.  From a medical point of view, it is still a very precarious situation. Although they have arrived in Europe, it is not possible to treat them according to medical guidelines. They are second-class patients. In particular, due to the Covid 19 pandemic, we have few diagnostic tools at our disposal. The local hospital only allows emergency cases, patients wait several months for appointments with specialists. In some cases, even though the treating physician suspects a preventable cause of the disease and fears that by the time the specialists have clarified the situation, it will have deteriorated further or even become irreversible. However, to blame solely the Greek authorities is wrong. The health care system in Greece was already significantly strained before 2015 in the wake of the financial crisis. Caring for the thousands of refugees is not possible for a health system like this. International help is needed quickly on the ground with experts and specialists from the European community to change the situation of the refugees. 

How has this changed since you arrived?

When I started my mission on Lesvos, there were just under 8,000 people in the camp. In the meantime, there are significantly fewer. For the remaining refugees, the situation has become more and more hopeless. Most of them have already received one or two rejections of their asylum applications, some even four. People’s desperation has increased. After a large wave of rejections and threats of deportation from official government authorities, we saw a significant increase in suicide attempts, some cases of extended suicide by desperate parents with children. Only a few refugees still manage to cross the dangerous waterway from Turkey to Greece. Due to the illegal and inhumane push-back methods, which can be easily tracked on social media like Facebook thanks to organizations like “Aegean Boat Report”, even arriving on the island is no longer a guarantee for a fair asylum procedure. Men, women and children, although they arrived in the European Union, are put back on rubber boats off the Turkish coast.

What can people in Germany do to support?

After the fire in the old camp “Moria” on Lesvos, there was a great willingness to donate. The situation on the Aegean island may have changed somewhat since the fire, but people have not simply disappeared. Tens of thousands of people remain stranded in Greece, without legal means for food or medical care. For many, NGOs working in Greece are the only way to get the basic necessities of life. It shouldn’t take another major tragedy to remind people back home of the dramatic situation on the ground. 

What would you wish for? What should change here in Greece or in Europe?

First of all, the illegal and human rights violating push-back methods must end immediately. The problem of refugees and migration cannot be solved on a national level. The European Union must finally face up to its responsibilities. Throwing human rights, literally, overboard must not be the answer. The necessity to have so many non-governmental organizations within the European Union to maintain a minimum of human dignity is a disgrace for an international community like the European Union. Due to political pressure, it was possible to create a new border control organization in a very short time. It must therefore also be possible to create a European organization to maintain medical care at the borders of the Union. Financial support alone will not help countries like Spain, Italy or Greece to cope with the increasing human dramas taking place at our borders. It needs people with expertise on the ground. I am sure that numerous nurses and doctors would be willing to do this. They are already doing it voluntarily on their well-deserved vacations and with their saved money. 

What do you think requires more attention?

It´s the individual stories of people who had to leave their countries. Through framing words like refugee crisis, the fate of the individual often disappears in a threatening-looking force of nature. Through the work in the clinic in the camp, especially through the numerous conversations with the translators with whom we spend several hours in a room every day, the differences of the supposedly foreign quickly disappear and the many similarities become apparent. Young men and women who studied before they had to leave their homes or earned their living as nurses or craftsmen and were in the process of building a life for themselves have now not only been deprived of their homeland. They have become prisoners within Europe, often without hope. In front of their eyes, the Europe they long for is so close, but it remains out of reach for most of the refugees. And looking back, the image of the burning homeland unfolds, which, due to current events, has not escaped even the international press.  

Thanks very much, Amar, for the interview.

Corona has turned many things upside down, including the start of our volunteers on site. Currently, you (still) have to go into quarantine in one of our accommodations before things can really get started. In our MVI – QUARANTEAM Edition, we introduce you to new arrivals who are or have been in quarantine due to Corona measures and want to know what and how they are keeping themselves busy. This will give you a personal impression of the great people we can count among our team.

In this interview you will learn more about the psychologist Brigitte, who will support our Children Support Project on Lesbos – or is already doing so from her “home office” during the quarantine period. 

What gives you hope at the moment?

The experience that there are so many people here who are so committed and happy to help and give back their confidence and dignity to the people who have to live here under such terrible conditions. And that I am so lovingly accompanied and encouraged by so many great people. In one word: to encourage.

What has been your best experience with the MVI team so far?

I have not been with the team for long, but I have already had an amazing number of wonderful experiences. Among other things, the sympathetic help from Verena in Hamburg and from Carlotta, my psychologist colleague, who has been accompanying and instructing me so warmly for 3 weeks now via Zoom, Whats-App and now in person. The helpful preliminary consultations with Carlotta and another colleague via Zoom, as well as the support of colleagues who are also in quarantine.

How has COVID-19 changed your view of our work?  

The work here on the ground has probably gotten much more difficult by the pandemic. Especially for the people in the camp, the situation has definitely worsened due to the restrictions on leaving the camp and the difficult conditions. I find it all the more gratifying and hopeful that MVI and other NGOs are not letting themselves be defeated despite COVID-19 and are still trying with all their effort to help here on the ground; with all necessary caution. 

And personally, I realize that this week of “Easter retreat, as I call it (instead of quarantine or compulsory break ?), also helps me to arrive here, getting well connected with myself in order to prepare for the new challenges in a peaceful way.

In relation to our work here on site, we can even “be grateful” for the quarantine regulations: If we manage to “slow down our speed” a bit during the quarantine and we come to rest, recharge our batteries during this time, then it can only be helpful for our subsequent work here: Helpers with calmed nervous systems can presumably approach people who are under high stress and high tension at a more thoughtful pace and in a more healing or empathetic way. And we ourselves have more strength to cope with the situations we will encounter here.

Together, make three true “we” statements each. For example, “We are both in this room feeling…” or “We both feel that…”: 

So WE, my lemon tree and myself talk to each other a lot; (German, Upper Austrian, English, Greek I learn from him/her). We make the experience that he/she teaches me many things: he/she “nudges” me when I am not mindful enough and he/she teaches me deep gratitude. “We both agree that the Greek sun is good for us”. And to be honest, I think Lemon Tree is a SHE ?.

What surprising thing did you/do you stock up on in quarantine (no toilet paper)?  

With lemons. And that Austrian good fairies put something restorative in addition in front of my garden fence was a special surprise. And that the Easter bunny also stopped by and hid an Easter nest for me – filled with chocolate and Easter cookies from Austria and lots of little surprises. The Austrian Easter bunny seems to have an agreement with the Greek Easter bunny ?.

What hobbies or passions are you/can you pursue right now?

Dancing, singing, reading, meditating, knitting, sleeping, yoga, writing, learning English, being in touch with my family and friends, listening to music. And to prepare myself intensively with psychological topics (traumatized people, children, resilience).

What similarities or hobbies have you discovered?

My lemon tree and I are great fans of the sun. 

What problem would you like to solve next?

Turning my prepared Powerpoint presentations (for parent groups) into useful English work material. 

What item accompanies you through quarantine?

My notebook and a snare drum, a good luck charm on my keychain.

What song are you or are you currently listening to up and down?

“Absolute beginners” by David Bowie; we’re allowed to start over anytime, anywhere. “Gabriela’s Song,” which is about how everyone is strong and free. I want all the people who are being held here to get their dignity and your freedom back and there’s a hopeful future, in freedom. 

Or “Morning has broken” by good old Cat Stevens.

What are you most looking forward to after this time?

Getting to know all the colleagues in person and start working together.