On the ferries: the unmet health care needs of transiting refugees in Greece

Background: In 2015, over 850 000 refugees, asylum seekers and migrants arrived in Greece. In response to an overwhelming need for access to healthcare for them, Doctors of the World established the Refugee Ferry Project, which comprised of a clinic providing primary health care, and integrated mental health and psychosocial support on board a commercial ferry. Methods: Of the 1405 service users, 87.5% (1229/1405) originated from Syria, Afghanistan and Iraq. The majority were women 801/1405 (57%) and children 511/1405 (36%), including 50 pregnant women and 19 unaccompanied minors. Results: The most common diagnoses were respiratory tract infections, dehydration, nausea and vomiting, and musculoskeletal pain with 39.4% of the disease burden being classified as non-communicable. Exposure to violence was associated with an increased risk of developing mental health issues. Conclusions: Humanitarian actors face huge challenges trying to respond to the needs of transiting populations. It is only by continuous reassessment and having the capacity to mobilize and adapt to an ever-evolving situation that we can try to meet these needs. Having an integrated, flexible and multidisciplinary approach remains crucial, despite the shift from a transit to static population. With over 62 000 refugees stranded in Greece, the need to develop innovative ways to respond to their needs is greater than ever.