Lesvos: The struggle of healing in poor living conditions
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The MSF team on Lesvos island, Greece, conducted over 1,500 mental health consultations between January and August 2024. Our psychologists report that most patients suffer from posttraumatic stress disorder, depression, and acute stress disorder. People’s symptoms include difficulty sleeping, flashbacks, chronic fatigue, despair, depersonalisation, and helplessness, among others.
The undignified living conditions in the Closed Control Access Centre (CCAC) which hosts about 1,200 people, compounded by the increasing securitisation and restriction of movement for the residents, have a devastating impact on their physical and mental health conditions. This adds to the suffering endured during their journey.
First-hand piece by the MSF mental health and social worker team on Lesvos island, Greece:
For vulnerable people, like those seeking safety arriving on Lesvos and living inside the Closed Control Access Centre, 10 October, World Mental Health Day, is a day to acknowledge the struggles they face due to their poor living conditions and the impact these conditions have on their mental well-being. We also want to take this opportunity to emphasise the importance of community support, what that can do to foster resilience and aid in recovery.
The living conditions our patients face are often dire and take a heavy toll on their mental health. Many of the individuals we support not only carry the scars of their journeys or their experiences in their home countries, but also the weight of uncertainty about their future. People feel stripped of their freedom to choose or control their choices. Every decision is made for them – from the food that they eat to what time they can shower based on the available water. The limited access to basic necessities – water, food, healthcare, and clothes, for instance – creates a constant state of insecurity.
Meanwhile, the living conditions themselves can serve as reminders of past trauma, triggering distressing memories and feelings.
Have you ever considered that even the sound of strong winds and fierce sea waves could evoke memories of a traumatic journey in a small boat across the Aegean for a person who has sought safety on Lesvos? And now, living in a tent next to the sea, our patients relive this nightmare every night.
Témoignage de l’équipe de travailleurs sociaux et de santé mentale de MSF :
Pour les personnes vulnérables, comme celles en quête de sécurité qui arrivent sur Lesbos et vivent dans le Centre fermé d’accès contrôlé, le 10 octobre, Journée mondiale de la santé mentale, est l'occasion de reconnaître les difficultés auxquelles elles sont confrontées en raison de leurs mauvaises conditions de vie et de l'impact de ces conditions sur leur bien-être mental. Nous souhaitons également profiter de cette occasion pour souligner l'importance du soutien de la communauté et de ce qu'il peut faire pour favoriser la résilience et aider au rétablissement.
Les conditions de vie auxquelles nos patients sont confrontés sont souvent terribles et pèsent lourdement sur leur santé mentale. Nombre des personnes que nous aidons portent non seulement les cicatrices de leur voyage ou de leur expérience dans leur pays d'origine, mais aussi le poids de l'incertitude quant à leur avenir. Les personnes se sentent privées de leur liberté de choisir ou de contrôler leurs choix. Chaque décision est prise pour eux - de la nourriture qu'ils mangent à l'heure à laquelle ils peuvent se doucher en fonction de l'eau disponible. L'accès limité aux produits de première nécessité - l'eau, la nourriture, les soins de santé et les vêtements, par exemple - crée un état d'insécurité permanent.
Par ailleurs, les conditions de vie elles-mêmes peuvent rappeler des traumatismes passés et déclencher des souvenirs et des sentiments pénibles.
Avez-vous déjà pensé que le simple bruit de vents forts et de vagues violentes pouvait évoquer le souvenir d'un voyage traumatisant dans une petite embarcation à travers la mer Égée pour une personne qui a cherché la sécurité à Lesbos ? Aujourd'hui, vivant dans une tente au bord de la mer, nos patients revivent ce cauchemar chaque nuit.
En outre, l'incertitude entourant la procédure d'asile ajoute au fardeau psychologique de la personne. Le manque de clarté concernant leur demande peut accroître l'anxiété et la peur. Les procédures accélérées ou les longs processus bureaucratiques sont aggravés par les barrières linguistiques et les différences culturelles, qui compliquent l'accès aux services et empêchent de comprendre l'aide disponible. Il est alors plus difficile pour une personne de défendre ses besoins.
Through our roles as psychologists and social workers on Lesvos, we strive to create a safe and supportive environment, where patients can share their stories. People come to us with feelings of stress, fear, loss, and hopelessness. It’s disheartening to see how all the previous and current experiences harm their well-being, often leading to post-traumatic stress disorder, depression, anxiety, and psychosis.
We try to build trust with our patients, understanding that for many, sharing their story is scary and hard. It also requires time for each person individually, which often is not possible because people can be suddenly transferred from the camp to the mainland. Still, each interaction with them brings new insights into the resilience of the human spirit. It also exposes us to the harsh realities of life in the camp.
What can you tell a young mother who, after spending time homeless and alone, sleeping in a park in Türkiye while pregnant, has now ended up in an overcrowded camp where she has no idea about her and her baby’s future?
These experiences underscore the urgent need for comprehensive mental health support. The living conditions many face are not just physical challenges - they are mental health crises waiting to unfold. It is crucial that we advocate for improved living conditions and access to mental health resources for people who have reached Lesvos.
We need to create a space where mental health is prioritised, where healing is possible, and where the dignity of every individual is upheld. Let us continue to work together to ensure that mental well-being is recognised as a fundamental aspect of health — especially for those who have endured the unimaginable.
Testimony from Wilma van den Boogaard, researcher at the Operational Research Unit in Luxembourg (LuxOR)
In 2018 MSF published a qualitative research1 which explored how, and by what factors, the mental health (MH) of migrants on Lesbos Island were affected due to the EU/Turkey-deal which meant that migrants got stranded in the notorious, but “open” Moria camp. The main results shown in three themes were:
1) “institutional abuse” being expressed by inhumane living conditions, lack of information in order to make future decisions, humiliation and depersonalization, which led to :
2) “continuous traumatic stress” (CTS) that was expressed through being in a state of permanent emergency under lack of protective measures, and :
3) “mental health (MH) service provision” being totally inadequate as MH perceptions amongst migrants are very different, long delays in appointments and lack of psychiatric care.
Today, in 2024, migrants are now in closed detention centers, and none of the three earlier mentioned themes have changed, or in fact it has, they have become worse!
(1) Eleftherakos, C., van den Boogaard, W., Barry, D. et al. "I prefer dying fast than dying slowly", how institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos island following the implementation of EU-Turkey deal. Confl Health 12, 38 (2018). https://doi.org/10.1186/s13031-018-0172-y
