Written by Dr Bethany Sampson, ST6 Emergency Medicine, South Yorkshire

The clinic is full to bursting soon after it starts with equipment and medication boxes squeezed into the small room. There’s just enough space for a table, an examination couch and our patient, with me perching on a stool by the corner of the table. A queue forms rapidly outside with mothers holding children tightly by the hand and noise levels starting to rise in at least five different languages. This is a normal start to the week for the Med’Equali clinic Greece.

I travelled out to Thessaloniki in September to volunteer at the mobile clinic for refugees run by a small French organisation called Med’EqualiTeam. My time with them is part of an out of programme experience (OOPE) year I’ve taken to allow me the flexibility to do some longer international global emergency care trips. In my day job I’m an ST6 trainee in South Yorkshire. 

Much of the clinic work day-to-day isn’t too different from work in a busy UK emergency department. I can be involved in triage of patients and trying to split and manage our stretched resources. Many of the clinical cases are similar to what I’d see in the UK: viral illnesses, gastrointestinal infections, respiratory infections and skin infections. Of course, there are also some differences; infectious can be more common and for this I can draw on my learning from the Diploma in Hygiene and Tropical Medicine (DTM&H) some years previously, and the experience I’ve gained working internationally in other contexts since then. We also see a lot more untreated chronic conditions. Refugees in Greece can face a lot of barriers to accessing the Greek healthcare system such as lack of translation provision, difficulty navigating the system and lack of money to buy medications. The skin diseases I see in the clinic are mostly related to the poor conditions that people are having to live in. Infected insect bites, fungal skin infections, bed bug bites, and scabies being common. 

Of the people queuing to see a doctor currently the majority have travelled from Syria, Afghanistan or Palestine which is a change from when I was on the island of Samos in Greece before with the same organisation in 2019 when we saw more people fleeing violence in Yemen, the Democratic Republic of the Congo and Iraq. Migration has been quite present in the media this year which can make it feel like a more recent pressing issue. Contrary to some media portrayals if you look at the statistics the numbers arriving in Greece are slightly higher this year than last, but much lower than prior to 2020. Over 40% of the arrivals are women and children. 

Refugees arriving to Greece mostly arrive by sea from Turkey. Sometimes recently arrived groups or families arrive at the clinic looking exhausted, pale and shell-shocked. The sea crossing often involves paying large amounts to human traffickers (boarding a boat at night and is a dangerous journey which not everyone survives). The people I have seen arriving are fleeing violence and insecurity having been forced to leave their homes and cover often large distances seeking safety. They rarely find the welcome they were hoping for on their arrival. 

I travelled back to the UK and work in the emergency department again in November but the work of the clinic in Greece carries on. Back in the UK though my work doesn’t stop. We also regularly provide care for migrants and my experiences abroad can help me providing them better care. Inclusion health of minority groups is an issue most departments are actively working on. We’re also all distinctly aware of the relevance of the management of infectious diseases that can cross borders, in the wake of the covid pandemic among others. And on my return I’m interested to learn bed bugs and scabies cases are reported to be on the rise in the UK as well so I can perhaps look forward to recognising those familiar beasts presenting to my emergency department soon.  

My experience in Greece with the mobile Med’equali clinic was a valuable and enjoyable experience of migrant healthcare outside of the UK. I hope to return to support their work again in the future. The things I learnt and saw are experiences I will carry with me, as are the friends and memories.