When a mental health crisis meets a global pandemic

Disclaimer: Since this article was written much of camp Moria on the island of Lesbos was destroyed by a fire which broke out on 9th September 2020.

During the COVID-19 pandemic, many have found themselves struggling with their mental health as fears about job security, health concerns and lockdown fatigue have taken their toll. But for those living in Greece’s refugee camps the pandemic is only exacerbating an existing mental health crisis. 

Back in 2015, Europe’s refugee crisis was closely covered by the media but since then coverage has declined significantly despite 50,000 people still living in refugee camps in Greece. 

According to volunteers and aid workers, mental health issues were an epidemic in the camps even before the outbreak of COVID-19.This is due to the traumatic experiences refugees endured both in their home countries and on their journey to Europe. 

When they did eventually reach Europe, they were met with overcrowded camps and dreadful conditions. The situation is particularly desperate in camps on the Aegean Islands. Camp Moria, on the island of Lesbos, is particularly well-known for its poor conditions and overcrowding. 

Queues in Camp Moria, Lesvos. Photography by Tessa Kraan.

In September 2018, the International Rescue Committee said that 30 percent of the people they treated in Moria that year had attempted suicide and a total of 60 percent of them had considered it. In 2018, Medecins Sans Frontiers (MSF) workers running a clinic for Moria’s inhabitants told BBC they had worked with children as young as 10 attempting to take their own lives.

The pandemic isn’t just introducing new problems, but is intensifying this pre-existing and ongoing mental crisis for refugees. Refugee Trauma Initiative (RTI), an organisation providing psychosocial support to refugees in Northern Greece, carried out an investigation into COVID-19’s impact on refugees in Greece earlier this year. Their report stated that “‘living in dire and desperate conditions, carrying pre-existing trauma and stresses, the pandemic has added to the pressures on people’s mental health and wellbeing.”

Dire conditions

Photo taken by an aid worker of residents of a camp on the island of Chios digging a well. Image courtesy of Human Rights Watch

Aid workers say the appalling conditions in some of the camps are to blame for the poor mental wellbeing of those living there. Joanna Hudak, a Programme Coordinator for Action for Education, has seen how this is directly impacting people, through the NGO’s work on the Aegean Islands. Hudak says that “poor mental health is directly related to the lack of services and the conditions, not having enough food and sleeping in mud…the conditions of Vial [a camp on the island of Chios] themselves create depression”.

Along with this, there are serious overcrowding issues in some camps which is contributing to these poor living conditions. In March 2020 Human Rights Watch reported that the camps on the islands of Lesbos, Chios, Samos, Kos and Leros were almost 31,400 over capacity. This puts a significant strain on resources, including running water. 

In some parts of Moria camp, there was one water tap for every 1,300 people with no soap available. One aid worker on the island of Chios told Human Rights Watch that some camp residents had dug their own wells as access to water was so limited in certain areas of the camp. 

The Greek government’s COVID-19 restrictions have forced migrants and other displaced people to remain locked down in these difficult conditions. The refugees living in camps will remain in lockdown until 15 September, despite tourists holidaying in Greece and bars and restaurants reopening. 

Increasing isolation

In addition to the poor conditions, aid workers and volunteers are increasingly concerned about social isolation caused by the lockdown that is further contributing to poor mental wellbeing. Unfortunately, NGOs not delivering essential services in camps were forced to halt their activities in March to prevent the spread of COVID-19. As a result, many have been left without access to their normal educational and recreational activities.

In April, Refugee Trauma Initiative (RTI) spoke to 19-year-old Amin, a young man living in the Diavata camp in Northern Greece. He said that, ‘before COVID-19 my schedule was full, and now it’s not. I love being with others and enjoying myself, so now it’s really hard’.

RTI’s report found that online initiatives have attempted to fill the gap left by the closure of schools and activities provided by NGOs but access to WiFi or phone data is proving to be a ‘huge challenge’ for the people they spoke with.

Speaking to RTI about her friends in the Nea Kavala camp, a young woman called Aisha said that ‘usually in Ramadan we watch movies, but now there’s no internet so it’s affecting them [in camps] a lot. They have nothing to do. Without the internet, it’s very difficult for mental wellbeing’.

The pandemic is not only causing boredom and isolation. In some camps it’s led to frustrations spilling over into violence. According to media and medical officials in camp Moria the increase in violence has led to the deaths of five people and 15 others being wounded since the start of the pandemic. 

Whilst acknowledging that keeping busy with recreational and educational activities is good for mental health, Nikos Gionakis head of Babel, an Athens based mental health unit for migrants, says that it's difficult for people living in camps to stay focused on these activities when their future is so uncertain.

Uncertainty about the future

As well as living in unstable and desperate conditions, a lack of clarity about the future seems to be a fact of life for migrants living in camps in Greece. Many asylum seekers face long waiting times for an appointment with the asylum services, these appointments are a critical point in the process of applying for asylum. Some asylum appointments have been scheduled as far ahead as 2023.

During Greece’s coronavirus lockdown, Asylum Offices were closed meaning asylum seekers have struggled to access information about asylum procedures or receive updates on their case.

A coordinator from an education project on the Aegean Islands explained that ‘with tight movement restrictions still applying to camp residents accessing legal information, this becomes one more worry which can really affect people’s mental health’.

Camp Moria, Lesvos. Photography by Tessa Kraan.

Limited Support

Although there are widespread concerns amongst aid workers and volunteers about the mental health of migrants’, access to support is proving to be very limited. Joanna Hudak of Action for Education  said her team is frequently faced with young people in their high school and youth centre who require support but there are often no healthcare professionals they can refer them to.

Although there are other organisations offering mental health support, Nikos Gionakis explained Babel Day Centre in Athens is currently the only fully equipped mental health unit for refugees and asylum seekers.

In July 2019, the already limited access to mental health care was further reduced as the Greek government announced newly arrived asylum seekers would no longer have access to public healthcare – including mental health services.

Given the dire conditions, the loss of recreational and educational activities provided by NGOs and lack of access to vital information during the pandemic, it’s unsurprising that the COVID-19 has exacerbated this mental health crisis. 

With the rest of the world’s attention focused on their own COVID-19 crises and boats continuing to arrive on the Greek islands, it seems unlikely the situation will change any time soon.

The Greek Ministry of Health and the Greek Asylum Service were contacted for comment but did not respond.

Wondering how you can support the organisations mentioned in this story?
Check out their websites below.

Samos Volunteers | Refugee Trauma Initiative  | Action for Education | Babel | HIAS 

Choose Love has launched an emergency response fund to support the 13,000 people displaced by the camp Moria fire.

You can stay up to date on all the latest news stories affecting refugees in Greece and beyond at InfoMigrants or Are You Syrious. 

Images from Human Rights Watch and Tessa Kraan. Tessa is a photographer currently working in camp Moria on the island of Lesvos, Greece. Check out Tessa’s website and Instagram.

WORDS: KATIE TIFFIN
PHOTOGRAPHY: HUMAN RIGHTS WATCH, TESSA KRAAN