"So how would you describe your time so far?"
Like a long game of charades.
One of the most important skills here is the ability to translate. As we are told in the medical world, with a good history you have a diagnosis but when you are unable to communicate with the patients it makes this very difficult. My rudimentary Urdu is getting me surprisingly far (and advancing rapidly) and the smiles on their faces when I say “App khessay hain?” (How are you?”) brightens both my day and theirs. However, without the help of refugees who can speak multiple languages we'd be lost. Frustratingly for us we are unable to provide them with monetary compensation for their time due to their legal status in the country but it seems that they genuinely want to help and be useful. Additionally, technology has made our lives either both with obvious outlets with Google Translate but also numerous WhatsApp groups filled with ad-hoc translators available 24/7. One day we had an elderly man desperately pointing at his finger and jabbing it but none of us could figure it out and our translator didn't know the English for what he wanted. It was only after looking at his finger and asking about splinters and mosquito bites that we eventually concluded that he wanted blood sugar lancelets as he was diabetic and had run out. Then when he finally came to clinic it was actually the measure strips he wanted. Additionally the questions I have to ask have to include a different level of empathy; I quickly learnt that asking “How did this happen?” is often followed by “bomb blast.” My first patient on the first day reacted in this way but also told me how they’d lost their family too. Another Syrian man was barely able to get onto our ambulance (we aren’t blessed with a ramp/lift) because a bomb blast near his home 6 years ago has left him in too much pain to walk without medication and physical therapy - or so that’s what we gathered from our translation from Turkish to Farsi then to English.
|Most of my pictures are of food as I can't really post photos of refugees and where they live due to their status in the country and many are arrested due to lack of papers.|
Therefore it’s not only difficult to ascertain what has actually happened to the patients it’s also very hard to find the correct care. Other than our wonderful doctors in the ambulance and our stock we are limited. We have one clinic from Medicins de Monde we can refer patients too but like our man with back pain, the physiotherapy he requires will be hard to obtain due to his status as a refugee. Many clinics and hospitals don’t take patients until they have a certain level of registration in Greece - which often requires a proof of address which many of our patient’s don’t have. Therefore our clinic can fill this gap but we are still limited in what we can offer - long term mental and physical therapy is somewhat outwith our control. However we do provide a holistic approach to care where we provide them with some social interaction and food- I think my homemade barfi(Asian sweet) went down well!
The style of practice has also needed a lot of adaption. I’m used to working in an emergency setting and this is much more of an urgent care setting. The majority of my work has been urgent care and specifically in wound management. These are relatively small issues but due to the fact most of our patients are homeless they can grow to be debilitating unless cleaned and dressed regularly. There has been the odd chest pain case but this is often related to indigestion triggered by the recent stress -however we don’t have an ECG to confirm this. The clinics we run are generally based in a car park next to an abandoned building. Absolutely nothing glamorous about it, in fact the ground is strewn with condoms as it’s at the epicentre of Thessaloniki’s red light district. Another site is ironically named “The mansion” and is several derelict warehouses which is home to several Pakistani men as well as homeless Greek families. The majority of refugees left are male as women and children are more likely to obtain housing. The patients we see are mainly homeless who sleep in shelters or abandoned buildings, however one morning we arrived to find that 50 men had been arrested following an evening meal distribution because they were sleeping in a building that was privately owned.
Other than my Urdu, my driving skills have been profoundly useful. I am the first person in a long time to be so equipped to drive a Mercedes Sprinter Ambulance with the gear traction of the finest Iveco in the fleet. Despite the fact it is both a left hand drive and manual ambulance, the amount of pot holes in the road here make me feel somewhat like I’m driving back in Oxford. Despite the fact that driving is one my most anxiety inducing parts of my job back in the UK I feel surprisingly relaxed here - something about having laxity on driving rules means I don’t feel like I am breaking them. Additionally the ambulance already has numerous scratches so they aren’t as concerned if I add to them! However, on day 5 we got in the ambulance to start our clinic and the thing wouldn’t start. There had been some beeping over the last few days that I’d put down to a low battery despite keeping it running (work has taught me something!), it got too low and the ignition broke as well. As we all sat in the rain with the hood open, crossed arms and puzzled looks on our faces we were blessed to be greeted by Jonny, our local Greek hero mechanic who happened to be driving past. He tried to jump start the truck and failing that called his friend over with his “tractor” (see below) to tow us to his garage and then he drove us to clinic. A perfect example of Greece hospitality. We had to run clinic that day out of the back of a Citreon Berlingo on one of the wettest days so far. Thankfully we should have the ambulance back tomorrow!
Despite reports that there were no mosquitos in Greece in November, the chief of the mosquito brigade had been on the phone to his troops and my face and arms were massacred by the best mosquito response team. The weather in general has been cold and rainy but on my first day I had time and the sun was out so I had a chance to explore the city of Thessaloniki. The city is a bit rough round the edges but the waterfront and central strip are relatively well developed. We are staying in a suburb called Diavata and the road into the city is lined by seemingly hundreds of service stations and abandoned buildings. With pain comes reward and the old town sits atop a large hill and the winding streets and sunset views from the castle are wonderful. Also watching Greek students climb along the crumbling castle wall to get a better view filled my somewhat safety conscious side with the envy of a Health and Safety inspector who is desperate for a greasy doner from Hussain’s Kebab.
Tomorrow we have a clinic in towns outside of thessaloniki which are closer to areas where Syrians have been housed so will include more women and paediatric cases. Additionally one of my colleagues has arranged a football match with teams made up of volunteers and refugees. There will be some changes in the team members and changes to patients and dynamics so I should have plenty for the next update :)