Operations and Context Update

BACKGROUND Migrant Arrivals in Greece In 2023, UNHCR corded 48.721 new arrivals in Greece: 41.561 by sea and 7.160 by land. In the first five months of 2024, UNHCR reported 17602 new arrivals in Greece: 15.278 by sea and 2.163 by land. Since mid-2023, there have been increased arrivals on new landing points on Greek islands as well as a shift in the routes.

Where MSF works

MSF works in two Closed Controlled Access Centers (CCAC), on the islands of Samos and Lesvos, where our teams provide medical and mental healthcare and emergency medical assistance. The ongoing securitization and restriction of freedom within the CCACs have a devastating impact on the mental and physical well-being of the residents.

Migrants in CCACs New arrivals on the islands are directly transferred to the Closed Controlled Access Centers which are in remote areas far from local communities, with barbed-wire fences. Currently, there are 1.748 people living in the Lesvos CCAC and 2.167 in the Samos CCAC. Source: current data on occupancy.

MSF MEDICAL DATA January to April 2024

· 5.169 primary health care consultations: Lesvos 2.620 / Samos 2.549

· 3.043 sexual reproductive health consultations: Lesvos 950 /Samos 2.093, including 413 sexual violence consultations: Lesvos 356 / Samos 57

· 1.080 mental health consultations: Lesvos 489 / 591 Samos

· 40 pregnant women consulting with a midwife

· 1.877 emergency medical assistance: Lesvos 1.374 / Samos 503 during 85 separate EMA outreach operations on Samos and Lesvos.


January to December 2023

· 9.100 primary health care consultations: Lesvos 1.101 / Samos 7.999

· 3.675 sexual reproductive health consultations: Lesvos 1.893 / Samos 1.782, including 419 were sexual violence consultations: Lesvos 325 / Samos 94

· 3,250 mental health consultations: Lesvos 1.876 / Samos 1.374

· 9.230 emergency medical assistance: Lesvos 6.816 / Samos 2.414 during 463 separate EMA outreach operations on Samos and Lesvos.


What happens and MSF provision of Emergency Medical Aid (EMA) When MSF receives an emergency official alert from another organization, such as UNHCR, requesting medical assistance for people in distress, we immediately notify the relevant authorities (Public Prosecutor, Police, FRONTEX, Hellenic Coast Guard, UNHCR, DG Home) of our planned intervention Following this, a mobile medical team goes to the island where new people have arrived.

Once on the spot, our teams provide medical and psychological first aid or refer medical emergencies to a hospital by ambulance. We also provide essentials such as: water, food, clothes and blankets (in the winter). The top five diagnoses among patients during the emergency medical assistance were upper respiratory tract infection, trauma, musculoskeletal (non-injury), pregnancy and diabetes.

People are severely distressed and terrified. As soon as they touch land they run as fast as they can up the hills into the bush to hide from authorities, driven by the fear of being forcibly returned. Some people are so severely affected that they barely speak or walk. Many people tell us of their previous attempts to reach Greece during which they were forcibly returned, some experiencing this multiple times.

Living in Closed Control Access Centre (CCAC) Most people living in a CCAC have not received a final answer to their asylum claim. Various levels of confinement within the camp premises and restricted movement possibilities contribute to stress, fear, and anxiety. Additionally, inadequate living and housing conditions include:

· Lack of running water leads to skins infection like scabies.

· Lack of privacy as people are frequently forced to live in large groups inside containers.

· Unbalanced nutrition with the food provided being one-sided.

· A feeling of constant pressure and uncomfortable surveillance caused by the continuous presence of police and security personnel.

Mental health

MSF teams have witnessed and documented the human cost of containment on the Greek islands. People seeking safety are widely exposed to violent events adding to the unprecedented violence and conflict that they have already encountered in their countries of origin and throughout the journey. These inhumane conditions that they have experienced jeopardize their coping skills and mental health resources making it impossible for some to overcome adversities upon arrival on the islands and during their stay at the CCACs. Our patients continue to report how the limbo situation on the islands, the arbitrary and fast-track asylum processes, the fear of deportation and the precarious living conditions contribute to the deterioration of their physical and mental health. As a result, MSF responds to alarming levels of mental health suffering on Lesvos and Samos.

Pushbacks Forced returns on the Aegean Sea are widely reported both in the media and by several human rights organisations and other institutions. An MSF report, published in November 2023, found that patients seen between August 2021 and July 2023 described interceptions, both on sea and on land, by security and border authorities or unidentified masked men on their previous attempts to reach Greece.

People assisted by MSF on arrival points and in the CCAC report having been subjected to or witnessing physical violence or inhumane and degrading treatment, such as beatings, strip-searches, forced genital examinations, theft of possessions and being left adrift in motor-less dinghies at sea. The consequences of direct and indirect border violence on the physical and psychological health of the people we assist is very concerning.

Asylum claims and processes

Greece has introduced the safe-third-country-concept for almost all applicants arriving from Turkey already in 2016. This implies (instead of a regular asylum procedure) a rapid screening of "admissibility" to the asylum procedures, where authorities only determine whether Turkey is safe for the applicant. Many people tell us they are not given a chance to speak about their experiences, including sexual violence and trafficking, and their cases are examined fast through interviews.

If ultimately denied asylum, people quickly become undocumented, lose their legal status and are left without any type of medical coverage and social care or assistance and easily end up at risk of detention and homelessness.


We urge the Greek government and European leaders to take all necessary measures to ensure that individuals seeking protection in Greece and the European Union are treated with humanity and dignity. This includes immediately and permanently ending all pushbacks and violent practices at borders; ensuring continued search and rescue activities at sea; and granting individuals access to fair asylum procedures and humanitarian and medical assistance on arrival, in line with their obligations under European and International law.



Samos CCAC

Sonia Balleron, Head of MSF projects in Samos:

“The CCAC in Samos is called Zervou, reachable by a 20min drive from the main town, Vathy, and there is a public bus a few times a day going between the town and the camp. The camp is in a remote area, surrounded by dry hills covered in small bushes. By car, it is a 20min drive from Vathy to the camp. There is a public bus a few times a day going between the town and the camp.

When you stand in front of Zervou, you feel like you are looking at a prison-like structure. At the main gate, you face a security checkpoint, and you look through several layers of mesh wire fences. Looking to your right and left, you cannot see the end of this fence. Behind you is a massive parking lot mostly used by staff working in the camp. One thing you witness very often when arriving at the camp is a long line of people waiting – they are being checked for proper paperwork to be allowed to leave.

Once you have entered the camp, you are facing container after container. They are grey and white, symmetrically arranged with no more than 1meter of distance between them and there are no trees, no plants in sight. The containers have no additional roof that could provide protection which means that once you leave your container you have no chance to escape either the direct hot sun in summer or the rain and wind in winter.”

MSF activities in Samos Island & CCAC MSF goes to the camp three times a week with a mobile clinic, providing primary healthcare, sexual reproductive health services and mental health support. Additionally, we run a day care center in Vathy where patients can either book medical appointments or simply walk in. In cases of medical needs beyond the above, we refer people to the local hospital. Our team also offers socio-legal services to provide a comprehensive package of care which migrants need.

Lesvos CCAC

Duccio Staderini, Head of MSF Projects in Lesvos:

“The CCAC in Lesvos is called Kara Tepe or Mavrovouni, is reachable by a 20-minute drive from the island’s capital, Mytilini, either by public bus or car. The area where the CCAC is built used to be an army shooting range, and the whole structure is built on rocks leading to the sea. One end of the camp faces the shore, the other side faces hills.

At the main gate you also must pass a security checkpoint and wire mesh fences to get in or out. However, Kara Tepe is smaller, and you can see the outlines of the camp once in front of it.

The camp was built hastily after the fire in Moria in September 2020, and not all existing structures are walled. Some areas of the camp also consist of big storage tents (rub halls). People in the camp live in containers like the ones in Samos, and when occupancy reaches high levels, new arrivals might be given tents to set up in between the existing structures.”

MSF activities in Lesvos MSF team in Lesvos provides primary health care services with an integrated mental health and sexual and reproductive health approach in a clinic across Mavrovouni camp. Furthermore, to ensure that individuals receive the necessary support, our multidisciplinary approach also comprises health promotion, intercultural mediation and social and legal services. Since June 2022, we provide emergency medical care to people who arrive on Lesvos by boat. Our support consists of medical and psychological first aid, including referrals to hospital by ambulance.

About MSF UK

This is the press room for MSF UK - the UK office of Médecins Sans Frontières/Doctors Without Borders (MSF), an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF offers assistance to people based on need, irrespective of race, religion, gender or political affiliation.

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