By Elisavet Athanasia Alexiadou, Leiden University,  ea.alexiadou gmail.com

Given the global context (i.e., the Syrian crisis and other humanitarian crises) Greece in virtue of being one of the frontier States of the EU (i.e., one of the main entry points to the EU) experiences a sustained pressure over the course of the last years as regards to the number of refugees mainly arriving from Middle East under difficult and most of the times degrading circumstances.

This development is reflected in numbers as follows. In 2015 approximately 850,000 refugees arrived in Greece, 49% of whom were Syrian nationals, 21% were Afghan nationals and 9% were Iraqi nationals, whereas in 2014 and in 2016 43,500 and 173,450 refugees arrived, respectively. Currently, it is estimated by the Greek authorities that over 60,000 registered refugees are being hosted in 52 refugee camps located throughout Greece. In particular, there are 6 camps located in a number of Aegean islands (i.e., Lesvos, Chios, Samos, Leros, Kos and Rhodes) and 46 camps in the mainland (e.g., Attiki, Thessaloniki, Pieria and Volos etc.). Note by way of legal background that Greece has incorporated within national legal order both the 1951 Refugee Convention and its 1967 protocol by Legislative Decree 3989/1959 and Compulsory Law 389/1968, respectively. Additionally, Presidential Decree 141/2013, regulating criteria on refugee status, grants those who are recognised as refugees a number of entitlements under the same conditions as Greek citizens (e.g., Article 31 provides for the same entitlements to health care).

Here, it must be conceded that the recognition of legal entitlements to refugees in Greece is not automatically reflected within the national policy context. Importantly, as will be analyzed more fully below, refugees in Greece experience extremely poor living conditions with negative impacts upon their prospects for enjoyment of their right to health (care) in Greece. In fact, notwithstanding the multi-million EU funding (ERF- period 2008-2013 & AMIF- period 2014-2020) allocated from the European Commission to assist Greece with the implementation of national measures towards refugees, the social and health infrastructure required for improving refugees’ settlement in Greece remains highly questionable. This is most obvious if one looks at the several repeated calls of concern and recommendations of the European Commission towards Greece during the year 2016 (i.e., in February, Juneand September).

At the same time, within January 2017 in Greece there were 5 reported cases of refugees’ deaths, among them the death of an infant, as well as 3 reported suicide attempts of refugees, largely attributed to the appalling conditions at refugee camps. In fact, some of the main problems in refugee camps identified by international organizations (e.g., United Nations High Commissioner for Refugees (UNHCR) operated in Greece) and NGOs (e.g., Human Rights Watch) involve the lack of and/or the limited access to critical determinants of the right to health (i.e., the overall context that shapes health outcomes, within which the right to health for refugees is to be implemented), which raise significant human rights concerns, such as:

–        Limited access to adequate health care services and to areas such as immunization; prevention of transmission and appropriate treatment of chronic and infectious diseases; treatment of mental conditions through the provision of adequate psychological support. It is indicative that post-traumatic stress disorder(see, e.g., UN Doc. A/HRC/4/28/Add.2) is a significant cause for concern for this population group, exacerbated by the appalling and overcrowded conditions in Greek refugee camps, and requiring follow-up care, as a result.

–        Lack of access to adequate housing – living conditions. Refugees in Greece live in tragic conditions at the mercy of extreme winter conditions, either in tent encampments or in poorly constructed dwellings (e.g., containers lacking fundamental housing amenities, such as heating), isolated from social and health infrastructure. As such, the living conditions in refugee camps create dangerous unhealthy conditions, which are harmful and detrimental to the health and development of refugees in Greece, starting from the youngest refugee children, as aforementioned.

–        Limited access to safe potable water and basic sanitation.

Arguably, this disturbing situation clearly reveals that the vulnerable living reality of refugees in Greek refugee camps is not taken into account by the Greek State and its respective authorities. In essence, their living reality does not influence the process of identification and development of comprehensive context-sensitive national policies for refugees. Despite several repeated calls for action expressed by the European Commission and international organizations, as aforementioned, the Greek State takes only sporadic measures, which are not targeted to the specific needs of the refugees, especially women and children, persons with disabilities, and the elderly, as well as to the determinants of refugee health. In fact, participation of the refugees in the process of design, implementation and assessment of such interventions is completely absent.

All in all, the existing appalling conditions in Greek refugee camps and most importantly the deaths and the attempted suicides of refugees in those camps vividly demonstrate that the Greek State should act immediately and that there is no time left for excuses on the part of the Greek State. Unless within the scope of its powers the Greek State ameliorates the current alarming and life-threatening situation for (Syrian) refugees, this will constitute not only a clear limitation, but also a violation of the right to health of (Syrian) refugees due to an apparent lack of political will.