GREECE: Refugees with Disabilities OveRlOOkeD, … with Disabilities OveRlOOkeD, unDeRseRveD ... gReece: Refugees with Disabilities OveRlOOkeD, ... “Amra,” a 19-year-old woman

GREECE: Refugees with DisabilitiesOveRlOOkeD, unDeRseRveDIdentify People with Disabilities; Ensure Access to Services

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Refugees, asylum seekers, and other migrants withdisabilities are not properly identified and do notenjoy equal access to services in reception centers ingreece. together with thousands of other migrantsand asylum seekers, they remain unprotected fromfreezing temperatures. Refugees, asylum seekers, and other migrants with disabili-ties are not properly identified and do not enjoy equal accessto services in reception centers in Greece. Together with thou-sands of other migrants and asylum seekers, they remain un-protected from freezing temperatures.

The European Union has provided significant funding to theGreek government, and to United Nations and nongovern-mental agencies, to operate the centers on the Greek easternAegean islands, known as “hotspots,” and camps on themainland. But asylum seekers and other migrants with dis-abilities have particular difficulties getting basic servicessuch as shelter, sanitation, and medical care, and like othervulnerable migrants, have limited access to mental healthcare. For example, one older woman who uses a wheelchairhad not been able to take a shower for a month.

People with disabilities are being overlooked in getting basicservices, even though they are among the refugees and mi-grants most at-risk. While some efforts have been made to re-spond to the needs of asylum seekers and migrants withdisabilities, Greek authorities, the EU, the UN, and aid organ-izations should make sure that people with disabilities are nolonger an afterthought.

The UN refugee agency (UNHCR), eight international aid or-ganizations, and one local group operating in refugee sites inGreece all told Human Rights Watch they have little to no pro-grams to respond to the rights and needs of asylum seekers,refugees, and other migrants with disabilities.

The deeply flawed EU deal with Turkey to return asylum seek-ers there, border closures along the Balkan route, misman-agement, and a lack of coordination among EU governmentshave left approximately 62,700 asylum seekers and other mi-grants bottle-necked in Greece. According to the EuropeanCommission, as of January 12, only 7,448 people have beenrelocated or are scheduled to relocate under the EU Reloca-tion Mechanism – about 12 percent of the 66,400 placesagreed upon in 2015. Those left in Greece live in deplorableand volatile conditions, without access to adequate servicesand accommodation. Thousands of refugees are enduring ex-tremely harsh winter conditions in flimsy tents across Greecewith temperatures as low as -14 degrees Celsius. People withdisabilities are among those at particular risk.

On the basis of research carried out in mainland Greece andon the Greek islands in October 2016 and January 2017, andfollow-up phone interviews in December 2016 and January

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gReece: Refugees with Disabilities OveRlOOkeD, unDeRseRveD

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lagkadika camp, thessaloniki, home to234 asylum seekers and other migrants,as of January 5, 2017. the rocky terrainin many camps makes it difficult forpeople who use wheelchairs to moveindependently, including to access basicservices such as toilets or showers. Photograph by Emina Cerimovic. © 2016 Human Rights Watch

2017, Human Rights Watch found that asylum seekers andrefugees with disabilities are not properly identified inGreece, in part because of a rushed reintegration process anda lack of proper guidance for staff. Without an adequate un-derstanding of the scale and needs, aid agencies cannot re-spond effectively.

Mental health services, much-needed by asylum seekers andother migrants, are also seriously inadequate. Half of the 40migrants Human Rights Watch interviewed said they or familymembers are coping with trauma, anxiety, or depression asa result of the violence in their home countries, their treach-erous journeys, family separation, or the uncertainty and in-security in the camps.

“Amra,” a 19-year-old woman from Afghanistan, said she hadasked to see a doctor in the Kara Tepe camp in Lesbos abouther suicidal thoughts. “I don’t want to hurt myself, I strugglemyself,” she said. An aid group working in the camp coun-seled her twice, she said, then told her they couldn’t help herfurther. She had a couple of sessions with a psychologistafter the Human Rights Watch visit.

Since 2015, the European Commission provided over €125million to the Greek government and almost €370 million toaid agencies and international organizations to assistrefugees, including the UNHCR. The Greek government andthe UNHCR have been criticized for failing to use the EU fund-ing to adequately improve conditions at the camps before theonset of winter, leaving thousands sleeping in freezing con-ditions.

The UNHCR and the Greek government should ensure that theallocated funds benefit all refugees without discrimination,including people with disabilities, Human Rights Watch said.The EU should request information from its implementingpartners to ensure that programs it funds benefit people withdisabilities and other at-risk groups. The EU and its memberstates should strengthen its efforts and provide additionalresources to Greece, which is also coping with economicproblems, and ensure that the aid is spread equitably acrossthe camps.

Greek authorities, with support from other EU member states,the UNHCR, and aid groups, should immediately ensure thatpeople with disabilities and other at-risk groups, includingchildren, have equal access to assistance provided in refugeeand migrant centers and camps – including water and sani-tation services, food distribution, shelter, and health care in-cluding mental health and psychosocial support. Failure todo so is discriminatory and violates the UN Convention on theRights of Persons with Disabilities and EU law.

The UNHCR and the Greek government should issue clearguidance to field staff on identifying and registering peoplewith disabilities, including disabilities that are not readilyidentifiable, such as intellectual disabilities or mental health

conditions. The Reception and Identification Services and of-ficials conducting asylum procedures should be trained onhow to identify and respond appropriately to the needs ofpeople with disabilities and to ensure access to servicesthroughout the process. Refugees, asylum seekers, and mi-grants with disabilities should be included and consulted inthese efforts.

With current winter conditions, the Greek government, withthe support of the UNHCR, should prioritize urgently movinganyone with a disability, along with other at-risk groups suchas pregnant women, children, and older people, who are stillin tents to heated prefabricated housing units with hot water.All persons currently living in tents should be moved to ap-propriate accommodation as soon as possible.

In the long-term, the Greek authorities, with the support ofthe EU and the UNHCR, should end encampment for everyoneand provide accommodation in the community. Living incamps can perpetuate the trauma of displacement and in-crease other critical protection risks, including physical andsexual violence and health concerns.

According to the UN, people with disabilities make up one-seventh of the world’s population. The dire situation for asy-lum seekers and migrants with disabilities in Greece is awake-up call for the UN and the EU to start taking the issuemore seriously

Need for Better Identification ofPeople with Disabilities The Greek Reception and Identification Service (RIS) is re-quired to provide for the reception of third-country nationalsentering the islands under conditions that guarantee humanrights and dignity in accordance with international standards.The service is responsible for referring asylum seekers to so-cial services and providing psychosocial support and infor-mation on the rights of migrants and asylum seekers. The RIS,supported by EU agencies such as Frontex and the EuropeanAsylum Support Office (EASO), as well as by the UNHCR, isalso responsible for identifying and registering people whobelong to “vulnerable” groups upon their arrival, whichshould include people with disabilities, including mentalhealth conditions.

A number of aid organizations told Human Rights Watch, how-ever, that the registration process fails to systematically iden-tify people with disabilities. A medical professional workingfor Médecins Sans Frontières (MSF) in Greece said: “There isa lack of resources, time, and expertise dedicated to the iden-tification of vulnerable people. During the registration, if youdon’t say it yourself, no one will ask you. If it is a disabilitythat is not obvious, visible, even if a refugee reports it – it



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Yasami and ali habibi from afghanistan, their 6-year-old twins and 2-year-old son, and ali's 14-year-old brother, have all lived in this tent ateiliniko camp in athens when human Rights watch visited them inOctober 2016. their 6-year-old son has a learning disability anddifficulties walking. Photograph by Emina Cerimovic. © 2016 Human Rights Watch

won’t be registered.”

A large-scale exercise to pre-register asylum seekers on main-land Greece by the Greek Asylum Service, with the assistanceof the UNHCR and the European Asylum Support Office, inJune and July found that only one percent of the over 27,000people had a disability – which the UNHCR officials acknowl-edged to Human Rights Watch is an underestimate. The hor-rific violence in Syria and Afghanistan, which accounts for 47and 24 percent of refugees in Greece, respectively, hascaused physical disabilities and mental health conditions, inaddition to the normal expectation of 15 percent.

Under Greek law, people such as pregnant women, children,victims of torture, and people with disabilities are considered“vulnerable” or at-risk, requiring access to special protection.This includes being exempted from the accelerated borderprocess under the EU-Turkey deal, which is intended to sendmost asylum seekers back to Turkey. Furthermore, they shouldbe given priority in the regular Greek asylum system and is-sued an asylum card while their case is being considered toallow them to move freely within Greek territory, including tothe mainland, where they could have easier access to serv-ices.

However, in early December, the EU suggested measures thataimed to increase the number of returns to Turkey, includingabolishing the exemption of “vulnerable” people from admis-sibility assessment.

On January 6, at a media briefing in Geneva, the UNHCR saidthat the slow registration and identification of “vulnerable”individuals has delayed transfers of asylum seekers from theislands to the Greek mainland before the onset of freezingtemperatures.

In the fall of 2016, the UNHCR adopted a policy to provide 20percent of its housing for asylum seekers on track for reloca-tion within the EU in private apartments and hotels to “vul-nerable” people. According to the UNHCR representative inGreece, as of December, 30 percent of this housing had beenprovided to “vulnerable” refugees. As many people with dis-abilities remain unidentified, according to aid organizations,they cannot benefit from this housing and continue insteadto live in deplorable conditions in camps.

Yasami Habibi and her husband, Ali, from Afghanistan, ar-rived in Greece in March 2016 and were living in the Ellinikocamp in Athens at the time of the interview. She said they hadtried to register their 6-year-old son, who cannot speak andhas difficulty walking, to no avail. Their son had not receivedany services, including much-needed medical care and reha-bilitation services. With his two siblings, he sleeps on thinblankets inside one of the hundreds of tents that fill a base-ball stadium in Elliniko camp.



amin, 24, a syrian deaf man in front of his tent inlagkadikia camp, thessaloniki. amin rarely left this tentfor months because he did not have his hearing aids,which were damaged on his journey to greece. Photograph by Emina Cerimovic. © 2016 Human Rights Watch

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Lack of identification particularly affects people with invisibledisabilities, such as intellectual or psychosocial disabilities,but even some people with visible disabilities had difficultiesregistering. Ahmed and Fatima, an Iraqi couple in their latetwenties, both have physical disabilities that make it very dif-ficult for them to stand or walk. They said they were not al-lowed to register their disabilities because they did not havea medical certificate for proof. “When we went to register [onSamos Island] they asked us for proof that we have disabili-ties even though they can see we do,” said Fatima, who nowuses a wheelchair.

A Norwegian Refugee Council representative said: “One of theproblems is that inexperienced humanitarian staff are notfully trained in identifying disability. I was present when one



an older woman and man from afghanistan, both with physicaldisabilities, live in kara tepe camp, on lesbos and were unaware of thehousing scheme for “vulnerable” groups. both have had difficulty gettingmedical care. Photograph by Shantha Rau Barriga. © 2016 Human Rights Watch

unaccompanied child asked if he should be registered as dis-abled because he had severe burn injuries that affected hismovement, and the person doing registration had not consid-ered this as a disability and said, ‘He is not in wheelchair, heis not disabled.’” The representative said the boy said he hadreceived painkillers from medical staff, but no other medica-tion.

Dearth of Mental Health andPsychosocial SupportHuman Rights Watch found a lack of access to adequate andappropriate mental health care across the camps in Greece.Nearly all refugees and asylum seekers interviewed reportedhaving headaches, losing sleep and appetite, and feeling de-pressed. Children had regressed to bed-wetting.

Only three of 20 people interviewed who reported being in ur-gent need of psychosocial support could get it.

The conditions in the camp and uncertainty about their futureare key factors in the high numbers of people in need of men-tal health services. “What is worrying is that the needs are in-creasing every day,” a representative of Médecins SansFrontières (MSF) in Greece said. “The main daily stressors ofthe individuals that we meet are the lack of certainty over thefuture, the access to asylum procedures, which is stalled, theliving conditions. Concretely if there are no improvements,the needs will be even bigger.”

Eleni Perraki, a psychologist with the humanitarian organiza-tion Doctors of the World (MdM), working in Lagkadikia campin the Thessaloniki region, said: “We see many people withpost-traumatic stress disorder, people who are traumatized,stressed […] Some mental health conditions are the result ofnothing else but daily life in the camp.”

Amer Omar, a psychologist with the humanitarian organiza-tion WAHA, Women and Health Alliance, has been working atSouda camp on Chios since March 2016. He said he thoughtnearly all of the 1,150 people there needed psychological sup-port and mental health care: “Because life is very hard here...They have been in the camp for more than eight months – suf-fering the cold in winter, the heat in summer. They have theirproblems already from back home and journey – we have hadseveral situations of nervous breakdowns.”

On several occasions, Human Rights Watch witnessed chil-dren, women, and men crying uncontrollably, or appearing ag-itated or distressed. Some said they had suicidal thoughts. Afather of an 8-year-old boy with kidney disease said: “We arestuck in a place worse than Afghanistan. With the conditionslike this, they push you to go back to Afghanistan. I would go,but I can’t because of security issues. Maybe at the end I will

take my family and die in the sea in the same way as we camehere.”

In Athens, “Hadad” a 16-year-old boy, and his 55-year-oldmother “Afia,” from Afghanistan have been living in Schistocamp since March 2016. Hadad said: “We live trapped here.Like inside a prison. We cannot move, no one is saying whatwill happen to us.” Afia said that her son had disappeared forsix days and was found by the police and the UNHCR in thenearby forest. “He has so much anger,” she said. “Sometimeshe starts beating himself against the wall, causing himself in-juries.”

Afia said that the only help her son received was medicine“that makes him sleep a lot.” She said that he had not beenable to see a psychologist and that the situation was toomuch for her to bear: “Where? Who? Where are people tospeak with?”

In contrast, “Suzan,” a 50-year-old woman from Syria at Softexcamp in Thessaloniki, was able to access help from a mentalhealth professional and said that it had helped her greatly: “Iwent to a doctor for my back, and told him that we were dyingin Syria and how tired I am of life. When he heard this, he tookme to a psychiatrist here in the camp. The doctor was verykind, gave me advice, and I am better now.”

Suzan said that the unsafe conditions in the camp and thedaily worry of whether someone may harass her and her twochildren is the source of her depression.

For some, the trauma of what they experienced or witnessedin their war-torn home countries was the catalyst for mentalhealth conditions. “Hannah,” a 47-year-old single mother ofthree, who together with her children was detained by ISIS inSyria for a week in September 2015, said: “My 11-year-old sonstill has psychological problems... [He] pees his pants. He istall and robust but from the shock he is peeing his pants.”

Her daughter “Lamye,” 24, who was in her fourth year of med-ical school back in Syria, said she is having panic attacks: “Ican’t sleep. When I got to bed I feel like I am in a tomb. I feellike I’m choking and dying. I hear discussions about the warand I run away.” Lamye said she now has an irregular men-strual cycle, which she attributes to the stress. She is one ofonly three people interviewed who reported seeing a psychi-atrist or a psychologist twice a week.

Du’aa, a 56-year-old Syrian mother of three, witnessed ashooting in front of her home in 2013 that injured two boys.Du’aa and her daughter tried to rescue them but didn’t suc-ceed and both boys died. Her son, Tarek, 25, told us, “Shenow has psychological problems because she couldn’t rescuethem.” Following this incident, Du’aa began to display symp-toms which were later diagnosed as Parkinson’s. She lost theability to speak and has difficulties walking.

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Since then, Duaa’s physical and mental health have deterio-rated. Tarek said Du’aa did not receive any psychosocial sup-port in Kara Tepe camp on Lesvos, where they were living untilDecember 2016. “I am obliged to help her, talk to her, makeher laugh, otherwise she would have negative thoughts all ofthe time,” Tarek said.

A representative of an international aid organization con-firmed that because Du’aa can’t speak, they were unable toprovide her psychosocial support. In December, Tarek told aHuman Rights Watch researcher that the UNHCR has movedhim and Du’aa to an apartment on Lesbos.

Omar, the psychologist from WAHA, explained how difficult itwas to provide psychological support to people who need it:



naima, 70, an older woman with a disability from aleppo, syria, with herdaughter hasne, in front of the shower area in cherso camp, thessaloniki.the showers are not accessible for people who use a wheelchair. Photograph by Emina Cerimovic. © 2016 Human Rights Watch

“The basic rule in psychology is that the patient must changethe environment around him and oblige himself to change hisway of thinking. Here it is very difficult. I can’t make refugeesaccept the life under sun, rain, hot, cold...”

Perraki, the psychologist with MdM in Lagkadikia camp inThessaloniki, described some of the practical difficulties inproviding adequate mental health care to people in need:“We did not even have a safe space where people would cometo and speak about their problems. We were working outsidefor five months, in the heat, flies flying around. Now, we fi-nally received a [transport] container which provides us witha place where people can feel safe behind closed doors.”

A representative of one international organization said thatsome safe spaces in camps where women and children canreceive psychosocial support are not accessible to peoplewith physical disabilities: “For example there are no ramps tomake them accessible,” she said.

While some aid agencies assert that mental health serviceshave increasingly been made available in refugee sites acrossGreece since June 2016, they recognized that it is not suffi-cient.

Omar, who is working at Souda camp in Chios, which held1,150 people when Human Rights Watch visited, said that themental health of people in the camp is getting worse everyday and that violence, inadequate food, and lack of access toeducation affects the mental well-being of migrants and asy-lum seekers: “The situation is getting worse and violence iseverywhere, even against women and children. It is traumaticfor all children here because every day there are fights.” Se-vere overcrowding, appalling conditions, lack of access tobasic services, insecurity, and the failure of police to protect,are all reasons behind violence and harassment in the camps.

Lack of Access to Water,Sanitation, Hygiene FacilitiesThe availability of accessible toilets is one need that that aidgroups have focused on, but even then only two of 15 campsof which Human Rights Watch has direct knowledge hasramps to the toilets, and uneven, rocky terrain and long dis-tances prevented some people with disabilities from reachingthese “accessible” toilets. One of the two camps that hasramps is a volunteer-run camp, PIKPA, on Chios.

“We have this wheelchair [for my 75-year-old father] but wecannot use it because of the terrain,” said a 25-year-oldwoman from Afghanistan in Moria camp.

The outdoor taps and showers in camps that Human RightsWatch visited were also not accessible for people who use a

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an accessible toilet in the volunteer-run PiPka camp, lesbos, one of thefew camps with accessible toilets for persons with physical disabilities Photograph by Shantha Rau Barriga. © 2016 Human Rights Watch

wheelchair. In one case, an older woman who uses a wheel-chair had not taken a shower for a month.

Seven people with physical disabilities said they relied onfamily members or friends to bring them food and other items,such as hygiene items, from the distribution sites because ofthe inaccessible terrain.

Fifteen asylum seekers and migrants with disabilities toldHuman Rights Watch that they or their family members werenot able to use toilets and other hygiene facilities becausethey were not accessible.

Naima, a 70-year-old-woman from Aleppo, Syria, who has di-abetes and uses a wheelchair, has difficulty accessing the toi-let and wash area in Cherso camp in Thessaloniki. Herdaughter Hasne said: “It is very difficult to take my mother tothe toilet. She crawls from the tent to the wheelchair – shecan’t take one step. I put her in the wheelchair, I fill the bagwith bottles that I use to help her wash her hands and takeablutions [the Islamic practice of washing before prayer] be-cause she can’t reach the existing taps in camps from thewheelchair nor can she stand up.”

Naima and Hasne said that accessing showers is no easier asthere is a step at the entrance to the shower area: “My sonhelps us,” Hasne said. “He puts another chair in the showerand helps me carry in my mother. He then waits outside. Everytime I help her shower I get all wet so I also have to take ashower. We never have warm water and now it is very coldhere so it is very difficult. And my mother, she is heavy.”

In Oreokastro camp in Thessaloniki, an 85-year-old Syrianwoman in a wheelchair said she hadn’t taken a shower in amonth because of the difficulties in accessing the showerarea and there is no warm water. Human Rights Watch re-searchers observed a barrier to the entrance to the women’sshower area and steps in front of each shower.

The Schisto and Eiliniko camps in Athens and Lagkadikiacamp in Thessaloniki had no accessible toilets or showerareas when Human Rights Watch visited in October.

Eight-year-old Ali from Afghanistan, who uses a wheelchairand lives in the Elliniko camp in Athens, did not have accessto an accessible toilet. “It is very difficult for us to take him tothe toilets,” said Ayesha, Ali’s mother. “I cannot do it by my-self and other women in the camp protest if my husband en-ters the female toilet to help me with Ali. So we finally decidedI would go to the men’s toilet, with Ali and my husband help-ing. Then, men got angry and protested, ‘Why is a woman in-side a men’s toilet?’”

She said the toilets are also dirty and unsanitary. “We alwayshave to first clean them before allowing Ali to use it.” Becauseof these problems, they made a difficult decision to put Ali indiapers when they can get them.

While families of people with disabilities play a crucial sup-port role, people with disabilities have an equal right to ac-cess water, sanitation, and hygiene facilities in the camps,independently and with dignity.

Guardian analysis of data provided by the EU shows also that19 camps receive no designated EU funding for water-relatedinfrastructure such as toilets and showers.

Lack of Adequate Housing,WinterizationIn January, temperatures in Greece have dropped to -5 de-grees Celsius on Lesbos, and to -20 degrees Celsius in otherparts of Greece. Heavy snowfall covered the tents in the Moriarefugee camps on Lesbos on January 9, where thousands ofasylum seekers lived, according to aid organizations. Mediahave reported that refugees, including children and peoplewith disabilities, are freezing in flimsy tents.

In December 2016, the EU, the UNHCR, aid groups, and theGreek government were accused of failing to use €90 millionworth of EU funding to “winterize” the camps before the firstsnowfall.

On December 22, the UNHCR told Human Rights Watch it hadprovided heated containers to eight government-run sites forrefugees in Greece and that 21,000 people have been accom-modated in apartments, hotels, or other buildings. TheUNHCR confirmed, however, that many people continue to livein tents.

According to the UNHCR website, as of January 10, more than33,000 asylum seekers and migrants continued to live in in-formal and formal refugee sites.

Winter and the freezing temperatures are a source of anxietyand stress for camp residents. The weather affects everyone,but particularly at-risk groups such as pregnant women, chil-dren, older people, and people with disabilities. Cold weathercan also affect respiratory and circulatory systems, and it isespecially hard for some people with disabilities to maintainbody heat.

Mohammed, father of five children, including a 2-year-old boyand 13-year-old daughter with diabetes, have lived inLagkadika camp in Thessaloniki since May 2016. In October,he expressed deep concern that despite dropping tempera-tures then, they had not yet been transferred from tents tocontainers. “We need [transport] containers now,” he said.“When my children wake up in the morning, their little handsare blue, like ice from the cold.” In a phone conversation withHuman Rights Watch on December 21, a UNHCR representa-tive said the Lagkadikia camp tents have been replaced bycontainers.



Du’aa, 56, and her son tarek, 24, from Damascus, syria,at the kara tepe camp, lesbos. Du’aa, who hasParkinson’s disease and mental health conditions, hasdifficulties accessing psychosocial support, October 2016.Photograph by Emina Cerimovic. © 2016 Human Rights Watch

Delayed Access to Health Care,Lack of Adequate MedicalServices Among the biggest problems all refugees, asylum seekers,and other migrants face in Greece is access to timely and ad-equate health care. Hospitals even struggle to provide ade-quate health care for Greek citizens, due to the generalbreakdown of the health care system, and a lack of resourcesamid the economic crisis. For example, on Lesbos, there isonly one permanent psychiatrist in the public healthcare sys-tem for the entire island population.

However, asylum seekers and migrants with disabilities, whomight require specific health or rehabilitation services or as-sistive devices, face particular obstacles and often struggleto get medical treatment or specialized care. Those inter-viewed described prolonged delays in seeing a primary carephysician in the camp, high transport costs to local hospitals,administrative barriers, lack of information, and general lackof availability of specialized services, including rehabilitationcenters.

While Greek law has extended the right to free health care, in-cluding in local hospitals, to asylum seekers, Human RightsWatch found that asylum seekers, refugees, and other mi-grants with disabilities who need both primary and special-ized medical attention are not able to access it. People whorequire orthopedic surgery, rehabilitation services, or medi-cines for chronic physical and mental health conditions suchas epilepsy are particularly affected.

Five asylum seekers interviewed said they or their familymembers with disabilities had to wait up to a month to see adoctor in the camp. Tarek, the 25-year-old man from Syria whois supporting his mother Du’aa, 56, who has multiple disabil-ities, told us at the time of the interview that his mother hadseen a doctor only once since they arrived in Greece in lateAugust. “When we asked to see a doctor in Kara Tepe [campwhere they are living] we were told to come in a month… Eventhe medicine she needs – I got it with so many difficulties.”

Davud, a 45-year-old man from Afghanistan in Schisto campin Athens, has tremendous pain in his leg that keeps himawake most nights. He requires crutches to walk. He had beenliving in Greece for eight months but had not seen a doctor ina hospital yet. He said that doctors at the camp give himpainkillers:

I went to doctors in the camp and they told me tospeak with officials in the camp to get permission to goto the hospital but it has been three months since andnothing has happened. I went to ask again one monthago, then 15 days ago – nothing. Lately I’ve not been todoctors. It is crowded, they don’t see me easily. Theyonly do painkiller injection, nothing else. I will end uphaving a permanent disability.

Twelve other people interviewed said that doctors in hotspotsand camps just provide painkillers. A 25-year-old woman fromAfghanistan said: “When I go to see doctors here, they justgive some painkillers. Nothing else. Whatever problem youhave, they give you painkillers.”

At Schisto camp in Athens, the father of Mahmud, an 8-year-old boy from Afghanistan, said that camp doctors had diag-nosed the boy with kidney disease and said he needstreatment he cannot get in the camp. “I just want him to getwell,” his father said in a trembling voice.

Human Rights Watch did not have an opportunity to investi-gate with medical staff the issue of available treatment in thecamps.

International aid organizations on the ground confirmed thehurdles people face in accessing health care, including spe-cialized care in local hospitals, partly due to administrativebarriers. To get health care in the community, people have toobtain tax registration and social security numbers, but theyare not told in the camps how and where to get the requireddocuments. Some refugees with disabilities said that the lackof affordable transportation or access to information on whereto get the needed treatment are other obstacles.

Getting assistive devices is hard for some people. Amin, a 24-year-old deaf man from Syria, in Lagkadikia refugee camp inThessaloniki area, said that his hearing aids from Syria weredamaged by water in the rubber boat when he crossed theAeagan Sea in February 2016, and later by rain in Idomeni, onthe border with Macedonia. Amin had received new hearingaids only two days earlier, in October. “The most difficult thingabout the camp is that Amin feels isolated from everyoneelse,” his father said. “He prefers to sit in the tent alone or goaround the camp alone because no one can understand him.”

Many chronic health conditions of people living in camps,such as hypertension, diabetes, epilepsy, and cancer, canlead to disability, increasing the number of people with dis-abilities. Access to rehabilitation services is particularly im-portant to maintain physical functioning and to preventdeterioration from failure of early treatment and developmen-tal disabilities among children.



Legal Obligations The UN Convention on the Rights of Persons with Disabilities(CRPD) requires countries such as Greece, which became aparty to the treaty in 2012, to ensure equal access to basicservices such as sanitation, housing, schools, and medicalfacilities in the camps, including in emergency situations.Failure to do so is a form of discrimination. The treaty statesthat countries should ensure the protection and safety of peo-ple with disabilities in situations of risk, including situationsof armed conflict, humanitarian emergencies, and natural dis-asters.

The European Council and Parliament Directive 2013/33/EU,which was transposed into law 4375/2016, sets out minimumstandards for the reception of asylum seekers. It states that“the reception of persons with special needs should be a pri-mary concern for national authorities in order to ensure thatsuch reception is specifically designed to meet their specialreception needs.” The directive also obliges member statesto ensure that asylum seekers have access to necessaryhealth care, including “at least, emergency care and essentialtreatment of illnesses and of serious mental disorders.” and“appropriate mental health care where needed.” EU memberstates also are responsible for taking into account the specificsituation of vulnerable people, which includes people withdisabilities and mental health conditions.

MethODOlOgYThe research presented here is based on interviews HumanRights Watch conducted between October 16 and October 23,2016, with 40 refugees, asylum seekers, and other migrants,including two children, in five facilities on the islands of Les-bos and Chios, which at the time was accommodating morethan 10,500 asylum seekers and other migrants, as well as infour facilities in Athens and the Attica region, four in Thessa-loniki and the surrounding area, and two in the western Epirusregion. The interviewees included 34 people with physical,sensory, intellectual, developmental, and psychosocial dis-abilities, or health conditions that might lead to disabilities,along with their families.

Each interviewee consented voluntarily to be interviewed byHuman Rights Watch and none received any payment or otherpersonal service or benefit in return for the interview. Namesof some of the interviewees have been withheld to protecttheir privacy and security.

This report uses the term “person with disability” inclusivelyto describe those with long-term physical, intellectual, devel-opmental, psychosocial, or sensory disabilities and thosewith mental health conditions.

Human Rights Watch also interviewed representatives fromthe office of the Greek ombudsperson, UNHCR officials, acamp manager, and representatives of the nine aid organiza-tions.

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H U M A N

R I G H T S

W A T C H

(cover) eight-year-old ali, with multiple disabilities, in front of hismakeshift shelter at elliniko camp in athens where he lived with hisparents and siblings and more than 3,000 other asylum seekers andmigrants in October 2016.

Photograph by emina cerimovic. © 2016 human Rights watch

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GREECE: Refugees with Disabilities OveRlOOkeD, … with Disabilities OveRlOOkeD, unDeRseRveD ... gReece: Refugees with Disabilities OveRlOOkeD, ... “Amra,” a 19-year-old woman