Refugee and Asylum Seeker Support, Serbia Reporting period: April 1, 2017 – June 30, 2017 Prepared by: Reporting Officer Marjan al Mahamid, with input from RMF Project Director N’Deane Helajzen and Project Manager ŽarKo Stanić, and RMF Serbia’s Medical Officers: Dr. Andrijana Ljubojević, Dr. Dragana Marković, Dr. Daniel PejKović, Dr. Jovana Milić, Dr. VinKa StojKović, and Dr. Sofija ManjaK Organization: Real Medicine Foundation Serbia (www.realmedicinefoundation.org) Project title: Refugees and Asylum SeeKers Support Project location: Belgrade, Obrenovac, and Adaševci, Serbia 1 TABLE OF CONTENTS 1 OVERVIEW 3 1.1 Current ConteXt in Serbia 3 1.2 Project Challenges and Operating Environment 4 1.3 Emergency Health Coordination 5 2 ACHIVEMENTS AND IMPACT 6 2.1 Summary of Accomplishments 6 2.2 Individual Cases 6 3 MORBIDITY REPORT APRIL–JUNE 2017 10 3.1 Demographic Distribution 10 3.2 Primary Health Care Statistics 11 4 TOTAL NUMBER OF PATIENTS APRIL–JUNE 2017 15 5 ANNEX 22 5.1 WorKing Locations of the RMF Medical Teams 22 5.2 Project Photos 26 2 1. OVERVIEW 1.1. Current Context in Serbia During the second quarter of 2017, increased numbers of refugees tried to re-enter Western Europe through Croatia, and a new trend appeared: more and more refugees tried to enter through Romania, while a large number decided to return to Greece through Serbia, then FYR Macedonia, due to the restrictive policies in many European Union countries, which have closed their borders to refugees. Additionally, a high number of pushbacks from the Hungarian border into Serbia continued throughout this period. The most recent data show that the number of refugees, asylum seeKers, and migrants in Serbia is about 6,000. Of these, more than 5,000 (about 83%) were accommodated in one of five asylum centers or thirteen reception centers as of June 2017, and the majority are from Afghanistan, followed by nationals of PaKistan, Syria, and Iraq. Serbia-Hungary Border During this reporting period, refugees were increasingly frustrated by the long wait times to enter Hungary, as well as management of the Hungarian ‘’waiting list’’ to cross the border. According to UNHCR data in June 2017, 54 asylum seekers, mainly families from Afghanistan, Iraq, and Syria, were admitted into Hungary. Only three asylum seekers were camped at the Horgoš and Kelebija border points awaiting admission to Hungary. On April 5th, authorities transferred the first group of refugees to a new transit center near Kikinda. Subotica Transit Centre sheltered 124 asylum seekers, Sombor Transit Centre 178, and the new KiKinda Transit Centre sheltered 252 asylum seekers, mostly families from Afghanistan, Iraq, and Syria. Near the Border with Croatia Two tragic accidents occurred in western Serbia during this reporting period. First, an unaccompanied minor from Afghanistan was Killed on the highway near Adaševci Transit Centre, and his 16-year-old friend (also from Afghanistan) was seriously injured and hospitalized in Belgrade. They had jumped from a high-speed cargo truck when they realized that it was not heading to Croatia. The second accident occurred when a man from Algeria was hit by a train and seriously injured trying to cross railway tracks near Šid. About 200 refugees and migrants were relocated from Šid Transit Centre and transferred to other centers by the end of April, because Šid Transit Centre was closed. According to UNHCR data from June, transit centers in western Serbia sheltered 1,183 refugees and migrants: 830 in Adaševci and 353 in Principovac. The population is mainly from Afghanistan, followed by Pakistan, Iraq, and Syria. Near the Border with Bulgaria According to UNHCR data from June 2017, 497 refugees and migrants were accommodated in four reception centers of eastern Serbia: 57 in Dimitrovgrad, 46 in Bosilegrad, 190 in Pirot, and 204 in Divljana. Most are from Iraq, followed by Afghanistan and Syria, while around 50% are children. Near the Border with FYR Macedonia According to UNHCR data in June 2017, 836 refugees and migrants were accommodated in three reception centers of southern Serbia: 609 in Preševo, 134 in Vranje, and 93 in Bujanovac. Most residents of Preševo RC are from Afghanistan (43%), Iraq (28%), and Pakistan (19%), while 43% are children. In Bujanovac, most are from Iraq (35%) and Syria (26%), while 53% are children. The residents of Vranje are families and unaccompanied/separated children from Afghanistan, and 55% are children. 3 Greater Belgrade On May 11, 2017, Serbian authorities evicted residents of “the Barracks,” located behind the main bus station in Belgrade. Until then, “the BarracKs” had been the largest self-organized refugee camp in Europe. As a result of this and other factors, many refugees and migrants voluntarily relocated to government shelters, where more than thousand people lived for several months in conditions that can be best described as degrading and inhumane. A vast majority; mainly from Afghanistan and PaKistan, and including many children; had voluntarily relocated to reception centers, and the number of refugees and migrants in the Belgrade city center shrank from 1,200 to an estimated 200. According to UNHCR data in June 2017, Krnjača Asylum Centre accommodated 851 asylum seekers, including 187 unaccompanied or separated boys, but mainly families from Afghanistan, Iraq, and Syria. 948 male refugees and migrants were sheltered in Obrenovac Transit Centre (including 203 unaccompanied or separated boys). Most are from Afghanistan, followed by PaKistan, with a few men and boys from Iraq, Syria, or other countries. Even after the emptying and demolition of “the Barracks” behind the main bus station, Belgrade remains an attractive and important center for migration, as refugees continue entering Serbia. 1.2. Project Challenges and Operating Environment A combination of factors has made the provision of support to refugees and asylum seeKers more challenging during this reporting period: • High numbers of unregistered refugees are still cause for concern. Because of security incidents involving unregistered refugees, citizens and local authorities successfully petitioned the government to close the transit center in Šid. • Some centers remained overcrowded, including Obrenovac Reception Centre and Adaševci Transit Centre, the two government-run refugee centers where RMF has a medical clinic. • There is a shortage of basic supplies in government administered facilities. • Refugees and migrants are eXposed to eXploitation, violence, and human trafficKing, often as a result of smuggling and violent pushbacks. • High numbers of refugees are unable or unwilling to successfully register themselves with the police. Registration is essential for legal visibility and at times (the policies rapidly change) is required for a place in the refugee camps throughout the country. Some avoid going to the camps for fear of being eXpelled from the country by authorities. • The unprecedented scale of refugees and asylum seeKers is placing increased stress on an already overburdened health system. • Refugees heading for Western Europe risk beatings and other forms of violence inflicted at Hungarian border crossings, as reports of police violence rise. There is a need to strengthen our teams’ capacity to respond to the provision of formal medical reporting of human rights abuses. This will be done by issuing formal medical certificates, which can be used as evidence in court if required. • Scabies infestation remained a challenge, especially in Obrenovac and Šid. • Insufficient dental care access, with poor oral hygiene, is leading to other health complications. • Incidents of violence inflicted on refugees by authorities are on the rise, and efforts to formally document cases for human rights advocacy groups and lawyers is necessary. • Integration mechanisms are absent. • There is urgent need for professional psychosocial support within the camps. Working Locations: • Greater Belgrade 4 • Obrenovac Reception Centre, Southwest Belgrade • Adaševci Transit Centre in Adaševci, Šid, Western Serbia Please see Annex 5.1 for a more detailed list of institutions and locations where RMF Serbia’s team is currently working. 1.3. Emergency Health Coordination At the end of April 2017, the Serbian Commissariat for Refugees and Migration called UN agencies, NGOs, and civil societies to an emergency meeting, where the main topic was the evacuation and relocation of refugees from “the BarracKs” behind the main Belgrade bus station to refugee centers. RMF Serbia was particularly involved in monitoring medical cases that had relocated to other centers. Following demolition of “the Barracks,” there were many emergencies, as well as a good deal of movement within the refugee population. Coordinated efforts tooK place, emphasizing the provision of health services in Obrenovac Reception Centre. Heath gaps were identified during the meeting, and a strategy for an effective response to health crises was developed and agreed upon. The agreed objective of RMF Serbia’s outreach team is to reduce the health consequences of crises and emergencies and minimize their economic and social impacts. Participants in the meeting agreed that RMF’s outreach team at Obrenovac Reception Centre plays an essential role by influencing the demand for health services, as well as increasing refugees’ access to health services. RMF continued to participate in monthly health cluster meetings conducted in Belgrade by the Ministry of Health and supported by the World Health Organization. The coordination