“Time is of the essence”: Preparing for COVID-19 in a refugee camp

Self-isolation is key to stopping the spread of COVID-19. But when thousands of people are stuck living in overcrowded tents, it’s simply not an option. As lock-down eases in Greece, Anton explains how his team are helping one camp prepare…

I was warned before coming here that the workload would be extremely high.

I’m in Lesbos, Greece, working on setting up and running a COVID-19 isolation centre for people living in a refugee camp. Almost one in five people on this island are refugees.

As the Greek authorities begin relaxing some “lock-down” measures, there will be more visitors to this beautiful island, and an increase in the risk of COVID-19

Today is Sunday, and in the time I've been writing this on-site, I've seen everyone from our watchmen and women to our project coordinator helping out with our final set-up. The workload is high, but fortunately the MSF spirit is second to none.


Most difficult circumstances in Europe

In Moria camp, where I’m working, around 17,000-20,000 people live in what must be some of the most difficult circumstances in Europe today.


tents in Moria camp, Lesbos, Greece
Moria Camp

Many live in crowded tents, without consistent access to basics like water. Temperatures in winter get below freezing. People survive like this while they go through a challenging legal process to get their refugee status settled, often with many rounds of hearings and appeals.

I can't imagine what this would do to my health and well-being, let alone the impact on the people most vulnerable to COVID-19.


Preparing for a pandemic

So far the COVID-19 cases on Lesbos have been limited to just a few people returning from international travel. This is great news; it gives us some time to prepare.

But as the Greek authorities begin relaxing some of the “lockdown” measures that have been in place, there will be more visitors to this beautiful island, and an associated increase in the risk of COVID-19.

Given the conditions here, we have to be ready.


When self-isolation is impossible

In the UK and many other countries there are guidelines for people to “self-isolate” when they notice they are sick – staying away from other people as much as possible.

But self-isolation is impossible for people here, who are often living in a small tent with their entire extended family.

The MSF COVID centre gives people hope that they can avoid spreading the disease to their families, by giving them a facility to stay at while they are unwell.

To ensure each person’s dignity is fully respected during their stay at the centre we've been working with the different community leaders in the camp. We’ve had to think about factors like the food menu, having a safe visiting area and respecting the norms of patients' different cultures.


My job

But the isolation centre isn’t the only part of our plan. As MSF’s water and sanitation manager here, I'm responsible for many aspects of infection control on site.

It’s a big job.

I’m training and managing a large team of "Hygiene Agents" who will perform specialist cleaning and disinfection procedures on site; working with the logistics department to make sure the site design and layout creates a safe environment for all; and working closely with the medical department to ensure they have everything they need to do their job safely.


It doesn’t stop there…

We've got a team of health promoters out in the camp’s communities every day, spreading messages about the symptoms of COVID-19, what people can do to prevent transmission and how MSF can help.

We're also advocating for COVID testing to be available, which can make a particularly huge impact for people living in such overcrowded conditions where "distancing" measures are often impossible.

And we’ve worked with organisations from the Greek government through to voluntary organisations to set up a screening point for anyone seeking medical care.

It's all a huge amount of work, but I think this kind of cooperation is crucial to be able to effectively control COVID-19 in a camp setting like Moria.


A new disease, a new challenge

I am fairly nervous as my team comprises of 18 people, all hired within the last few weeks. COVID is new for me, for our medical team and for the experts in our HQ who are supporting us remotely.

The COVID isolation centre runs 24 hours a day and unfortunately, I can't be here and working for all that amount of time, although I think I've accidentally tried to do that a few times recently!

But it's wonderful to be on a team where even the most senior managers are on-site.


What keeps me motivated

The main motivating factor keeping me going is remembering that I am so lucky to be somewhere where - for now - we have some time to prepare for COVID.


Read more: Powerful stories from the frontline of COVID-19

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