Kitrinos Healthcare – Caring for lives of refugees – Part One



my name is dr. Jana Mardle Shafi I would love to tell you about the story of how we developed Katrina's health care as a small project that is providing health care services in Greek refugee camps currently in the camp of Maria in lesbos I am Sri Lankan born been working in Britain as a medical practitioner GP for nearly about 25 years I consider myself now a humanitarian medical doctor four years ago I was privileged to be able to go as a humanitarian doctor leading a medical mission to the small island of Lesbos in Greece where there was a small crisis emerging when I had the ability to run one of my women's health clinics so I'm considering myself a women's health practitioner as a woman doctor one of the privileges was the conversations that I was able to have with the women in privacy and I remember one woman in particular saying to me she came in with something really basic it was just the rash but actually when we were in that closed space together she opened up to me that they left – they left Syria because the two children's journey to school in the morning on a school run which I do with my children was that they would have to navigate a street sometimes with heads rolling around so there were beheadings happening a lot in Syria and she didn't want this for her children she didn't want her children to have to see that on their way to school and on their way back you know it's like a scene from an apocalypse of a horror film we don't even let our children's watch that on a film why would you allow your child to go through and see that so she said that's why they left otherwise they had a good life you know they had a good life it was a civilized society and the war destroyed it in our clinic our patients are quite privileged to have a facilitated consultation so we do primary health care is our main role that's the reason we're there but as humans ultimately that's never enough so we have to do a little bit more sometimes we provide if we notice that someone perhaps isn't eating very well we can supplement their food and their nutrition we can provide for breastfeeding mothers and babies in particular we also have been known to go that extra mile and get extra blankets if we notice that someone is exposed and doesn't have proper clothing you will see feet with no socks on them we'll get some socks on them so we have to keep the little extras around us one of the key and pioneering services that Weaver for offered in our clinics that isn't offered in any other clinic in any of the other clinics in the entire Greece that I know of is that we offer physical treatment as well as psychological support in the same place so as people enter if they're noticed to be quite distressed we actually are able to perform a technique which is called TTT trauma tapping technique that can that is a proven technique to bring about relief for stressed individuals we can do it on-site there's no waiting list we even use lavender oil to bring calmness so if anybody goes on our website and downloads that the reports they'll be able to read more about the TTT technique which doesn't actually be have to be used just in refugee camps it works for anybody who's traumatized dressed one of my greatest pleasures is to have the privilege of such a wonderful team working with me from the moment a person comes to the clinic I think everyone knows that their to treat this person with kindness and respect and certainly from the interpreters from the clinicians who come to us one of the things I do with my team and my doctors and nurses when we're selecting them is we actually put them through a very rigorous vetting process we get from them copies of their degree which are certified we get the DBS certificate certificate to prove that they don't have a criminal record and I've been accused of having asking for more paperwork than even MSF a big organization so but I'm very proud of that that actually you know I'm doing my due diligence and I think one of the best things about our team is that they're we don't cut corners you know what you see is what you get and everybody gets the same there is no privileges given to one person or another everybody regardless of their sex the country they come from everybody gets the same and the best possible treatment so the care that I like to give in our clinics is the same that I would give in my UK clinics to my UK patients and again I've been accused of perhaps going a bit over the top here but I will not cut corners not just because I'm in a refugee camp I have about just over a thousand now registered clinicians who come regularly I think it's been really heartening for me to see some come over and over again one or two have actually been there now for over a year and one of them is dr. Thomas semanek from Slovakia he gave up a very well-paid job in the Czech Republic he was on the career ladder to become an A&E consultant which is what he wants to be and he came to me in January 2017 2018 January 2018 he started working with me and I actually wanted to employ him at that time when we got to about March my funding situation was pretty critical and we had to write emergency letters to all our staff and Thomas was one of them and I had to write a letter to say I'm really sorry but I actually don't think I'll be able to pay you coming forward to going forward and of course he was then at the Liberty to go wherever he wanted to go back to Slovakia he turned around and he said to me see Anna I came here on a mission to help you and to help the people and I will manage and he stayed and he continues to stay so my name is Tomas semanek I'm from Slovakia and I'm working with the kitchen since February 2018 as a monetary and doctor and I mean here in Maria's since middle of a summer like the end of the show I came here sexually we provide like a kind of primary health care in the in the refugees refugee camp with them like a circumstance is what you can see around and in the facility or equipment what is it a Lada so it's not a typical premier primary health care facility what you can see in in in hospital and in a hospital in other conditions so it's kind of improvising and basically we are focusing on the people who are based in the camp which are more and like 8,000 people but coming with the acute disease or in also we also provide like management of a chronic disease because the kitchen of healthcare is like a quite long term good experience with this kind of healthcare and also doctors are are more trained for this situation because we know that this is this is something what you would not learn in the schools or in other hospitals is something what doctors needs to have a experience so prisoners have taken providers doctors who can aim or the focus they are not naive and other more practical doctors so it means they're able to solve the problems at the point where we are you know you don't have to be depend on the hospital because we know that hospital system is overwhelmed overloads so and instead of waiting patients a long time for appointment specific vitamin we can already start to do something here from this point and then also because of our long-term stuff for example a couple coordinates our translators so people already know us and they have like that like it just us we know that it mostly these angels are based off volunteers who are changing after sometimes who just come in for shorts and a net available from the hospitals I used to do it like that but now let's say I'm a bit longer here so I know if anybody would like to do their best still the most the biggest benefit is because that we have these six long term stuff and people already know us and it's also better easier to keep a continuity and Trust and like that for myself I can see that like Elizabeth the profession I would do something like this in the future and the same position like for example act doctor see Anna she's the director of NGO who provide these kind of health care so as a caregiver as a doctor something like that in profession life unless I until I will obtain a sufficient experience education all these things because I still consider myself as a junior doctor even if even if I have some years of experience what I wish for myself or what I was able to do I wish also for them whatever it is and mostly we are talking about like education having them having a good job as a I had that luck that I could choose my job and just just these basics and I don't think these people they don't expect anything more just being like a cone that's safety sometimes you can dry place because when it's raining and and then slowly slowly because we know it's not very easy but very very basic things what they I can say will say what I wish for them but I fish for them an example that but I can see that all of us we have the same dream and we don't expect like so much from our life just too basic a lot of young doctors who come to work for us Paul burrows L they helped me immensely in the clinic especially with the gentleman who was unconscious I think it's very refreshing for them because working in the NHS like I used to it has its own challenges we are becoming very bureaucratic and very defensive in our practice so we do things which our managers asked us to do and the government asked us to do but doesn't necessarily improve patient care and what's really nice about being in such a basic facilities again is the doctor-patient relationship blossoms we can actually suddenly become the people that we were trained to be the caring individuals the ones who you know want to give and want to make people happy and better I'm Raisa I'm a junior doctor from London and I've been here for two and a half weeks we just see any patients you come on the day most of them are the type of problems that someone will go and see their GP about at home or maybe go to Amy about we have some basic medications we can do some basic procedures like suturing if people have wounds and the nurse is very good at wound care here and sometimes we can refer things to the hospital but we have to be quite careful about what we can and can't refer but sometimes we do that as well and obviously if it's an emergency then we would send them to the Amy Department in Italy I think it's very important because they really don't have access to healthcare and they have a lot of problems because most them have been on very long journeys and in their home countries often been or on that journey being exposed to very dangerous things so they have a lot of health problems so not it's a population that have increased needs and then don't have any access so it's quite a satisfying job to be here I enjoy being in the clinic and it's really good because there's interpreters and often you feel like you do can help people but usually was quite basic things but equally it can be frustrating because there's lots that you can't do for them that you feel and there are a lot of people suffering a lot and we can't always give them the help that they need but sometimes we can't that's good it would be completely impossible I haven't seen I've seen maybe less than one patient a day that can't be good enough English to be able to tell me what's wrong with them so we wouldn't be any use here we hadn't really so there was a lady who came in and she had been raped about a week before and she had been given medication for preventing HIV and she taken an overdose of the HIV medication and was unconscious by the time she got here so that was really sad we did the very basics here but she needed to go straight to the A&E department who we just called an ambulance straight away a lot of the day is spent dealing with mental health problems which is very sad and we have very limited resources to deal with that which is really hard because people are really suffering especially with PTSD and depression and we're not really a man we are not allowed to prescribe any psychiatric medications which is understandable because some of them are quite dangerous and they have a black market value and also if there's a risk someone would commit suicide they can also be drugs that people could overdose on and so it needs to be an environment where you can monitor people and which isn't necessarily what you can do here so there are good reasons for that but it's very difficult to see lots of people suffering and there's very little you can do there's some psychological available as well and there are some we can refer some patients to psychiatrists but there's not nearly enough available so I think that's one of the nicest things about waiting here I feel like I've made friends with people from all over the world and I think it helps you to realize when your colleagues are also refugees everybody's exactly the same we'll say a bit more of an understanding about what it would actually like be like to live in Moria and just all the other issues about being a refugee and that your entire life is never going to be the same again I guess it would be ideal if everybody in the camp could have medical treatment just like anybody else in Europe does and I don't think people get that in our clinic one of the advantages is that we do have access to some few tests like blood tests and x-rays and even an ultrasound we have an ultrasound machine in the clinic and these young doctors are sometimes quite pleased that they can actually put practical skills into use at the point of care this is not something that always happens as we know in our part of the world we have to be referred we have to wait for a few weeks or months sometimes for an appointment and then someone does it then that person has to write a report and that report comes back No here we have it that source so actually whoever said that in my clinic I provide sometimes better care than the NHS perhaps they could be right in the refugee camps what is becoming apparent is the high rise high rates of psychological illnesses and of course people despite having hope in when they first arrive if they have been there for months and in some cases are years up to two years before the decision is made about what happens to them it can wear them down and when a grown man during Ramadan of 2018 when a grown man was found hanging from a tree next to the Masjid in the in the camp makes the mosque in the camp and he was brought rushed in and the rope was still on his neck and he had the marks on his neck and he was really struggling to breathe and he was about to take his life in them a holy month and it really is saying something and we often see this now where some of the biggest emergencies in our clinics are these situations where people get brought in collapsed young man in particular they get very deprioritized shall we say because obviously we should prioritize women and children and the elderly and therefore naturally the young men become like the bottom of the ladder in terms of needs and what what's good for them and so when this young man comes in collapsed he was found collapsed outside a tent he'd been sick and he was really really cold we we wondered if you know perhaps he'd taken an overdose of something and then a few months later we actually found out that a young man was found dead in the camp and it does make me wonder you know what what conditions they're living in with the refugees I always put myself in their situation because I can see that you know quite easily my own father left our small island of Sri Lanka because he wanted a better life for us his children and that's what I want for them I think everybody deserves a chance in life you know the world isn't we were not we were not all born in one place we have all ended up where we have ended up but coming from so many different backgrounds and who are we to judge or say that these people must now stay where they are it's very haughty and it makes me angry that we can't put ourselves in their shoes or see how we used to be I mean even in Britain you know just at the turn of the century there was a big war and our queen who presides over us now we remember the hard times when children were left on platforms of trains stations to be picked up by complete strangers in order to survive were humans we deserve to survive that's all right

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