無國界醫生來自歐洲前線的觀察：對難民的決心感到震撼！

文／無國界醫生（MSF Taiwan）提供

無國界醫生（Doctors Without Borders/Médecins Sans Frontières）的救援人員埃切瓦里亞（Jota Echevarría）剛從匈牙利、塞爾維亞和克羅埃西亞回來，最近幾週，無國界醫生的隊伍在那裡已向數千名難民提供醫療服務，難民大部份來自敘利亞，因戰亂而逃離該國並試圖抵達歐洲的中心。

▲前晚露宿於塞爾維亞邊境的四歲女孩，正準備與家人一起入境克羅埃西亞。（圖／©Achilleas Zavallis）

為了要抵達能夠找到安全庇護的國家，他們長途跋涉，自土耳其到希臘，再從希臘步行或搭乘巴士穿越馬其頓及塞爾維亞。埃切瓦里亞闡述了他所治療的人們的決心，以及在一個極度動盪的情境下援助病患的困難。

問：無國界醫生現正做什麼？

答：我們先在匈牙利一個中轉營地工作，營內的人其後遭當局撤離，而我們現正在塞爾維亞，援助由塞爾維亞前往克羅埃西亞的難民。我們在鄰近邊境的奧巴托瓦奇（Opatovac）營地工作，設有一間診所。那裡先前是一個軍營，後來被當局設為臨時營地，難民們最多只能在此停留一天。我們也在營地以外的地區工作，援助那些因為營地已滿，而在外面等待登記的人們。由於過境站經常改變，開放與關閉時間不定，我們於是設立流動隊伍，於15分鐘內就能出動，亦可以在夜間工作。

問：你看到有哪些病患？

答：以兒童來說，他們佔了遷徙人口約10%，佔我們的病人人數四分之一，主要有呼吸道問題或支氣管炎（都是因露宿戶外以及天氣寒冷所致），遇有感冒以及一些腹瀉病例。我們也為許多孕婦看診。大多病人是男性，主要是因長期步行造成的外傷或雙腿腫脹瘀青。我們也接收了許多糖尿病或高血壓等長期病患者，原因之一是他們已沒有藥物可服用（由於物資已經用罄、或是逃難時被迫放棄行李或是遺失了）。有時當他們來到診所時，已十分虛弱。但基本上他們都脫水，並且因為旅途而精疲力盡，非常非常疲累，非常需要心理社交支援。

▲即將進入寒冬導致地中海區域的難民更為艱難，一位剛抵達克羅埃西亞邊境的難民，正在從捐贈物資中尋找長褲。（圖／©Achilleas Zavallis）

問：你們為這方面做了什麼工作？

答：我們除了提供基本治療給需要的人，其實很多個案是他們需要有人傾聽，將他們的故事告訴可以理解他們的人。那樣很有幫助。你要記著，很多時他們決意要抵達德國、丹麥或荷蘭，而他們已經穿越了太多邊境，他們不知道身處於哪個國家，甚至是不知道現在哪一天。他們唯一的念頭就是：抵達、抵達，在兩到三天內抵達。

問：你有沒有什麼特別的故事能夠與我們分享？

答：所有我們看到的個案，有數以千個。其中有一個是來自阿富汗的家庭，帶著一個患有肺炎的小男孩，我們必須讓他要住院。醫院希望讓他住院三天。他父親則希望男孩可以跟他一起，因為他相信，他們將會在三天內抵達德國，在那裡男孩會得到治療。這個故事受到德國媒體關注，一間在慕尼黑的診所作出安排，以便男孩一抵達慕尼黑就立即送他入院。但其實還有數以千個的故事，數以千計的家庭、數以千計的人，正在走獨一無二的旅程。我們在塞爾維亞、克羅埃西亞和匈牙利這三個國家共診治了 2,577 人，他們都代表了 2,577 個關於人們逃離恐懼與戰爭的獨一無二的故事，因為他們再也無法忍受看不到盡頭的困境。

問：難民彼此間有無差異？

答：他們來自不同的國家，不只來自敘利亞。我們遇到的敘利亞人當中，部分人仍然有些購買能力，而那些走私者卻對他們欺騙斂財。為了避開馬其頓，他們付出不合理的高價，以搭乘巴士穿越國境。那些走私者們卻把他們丟遺在塞爾維亞，告訴他們已經抵達克羅埃西亞首都札格瑞布。

問：目前救援隊最憂心的是什麼？

答：冬天的來臨及其影響。天氣已變得很快，夜晚已變得太冷，不適合露宿。目前最受影響的是成年難民，因兒童尚獲保護而未受凍，但是當嚴冬來臨之前，我們還可能有另一波難民會在非常寒冷的天氣下穿越歐洲。因此，我們擔心患上呼吸道和失溫的病人人數會增加。

▲無國界醫生表示，遍佈於巴爾幹多國數以千計的難民與移民，因為滯留於邊境與登記站而陷入困境，令他們的健康面臨重大威脅。（圖／©Achilleas Zavallis）

“THE DETERMINATION OF THE REFUGEES TO REACH THEIR DESTINATION IS SHOCKING”

Jota Echevarría has returned briefly from Hungary, Serbia and Croatia where in recent weeks MSF teams have been providing medical services to the thousands of refugees, mainly from Syria, fleeing war and trying to reach the heart of Europe. They have had a long journey taking them through Turkey into Greece, and from there on foot or by bus across Macedonia and Serbia, in order to reach countries where they can find safe asylum. Echevarría explains the determination of the people he has treated and the difficulties of assisting patients in the midst of an extremely mobile context.

QUESTION: What is MSF doing now?
ANSWER: After intervening in a transit camp in Hungary that was finally evacuated by the authorities, and in Serbia, briefly, we are now assisting the refugees crossing from Serbia to Croatia. We are working in the Opatovac camp near the border, a former military camp that the authorities set up as a transit camp where the refugees spend a day at most and where we have a clinic. We are also intervening outside the camp to assist those who get left outside when the camp is full, waiting to be registered. As the border crossings are always changing and they open and close at random, we have also established mobile teams that can be operational in 15 minutes and also work at night.

　
Q: What pathologies are you seeing?
A: Among the children, who are about 10% of the population on the move and constitute a quarter of our patients, there are many respiratory problems or bronchitis (caused by sleeping outdoors and the cold weather), colds and some cases of diarrhoea. We’re also seeing a lot of pregnant women and, among the men, who constitute the majority, we are registering injuries caused by walking or swollen and bruised legs and feet. We’re also seeing many people with chronic illnesses like diabetes or hypertension who, for one reason or another, don’t have any medication (because their supplies have run out, because they have been forced to leave their luggage behind, or because it got lost). Sometimes they are in very fragile condition when they arrive. But basically they’re dehydrated, exhausted from the journey, very, very tired and very much in need of psychosocial support.

Q: What are you doing about that?
A: In addition to the basic treatment that we can offer those who need it, in many cases what they need is someone to listen to them, to tell their stories to, who can understand them. That helps them. You have to bear in mind that on many occasions, such is their determination to reach Germany, Denmark or the Netherlands, and they’ve already crossed so many borders, that they don’t know which country they’re in or even what day it is. The only thing they have in mind is: arrive, arrive, arrive, in two or three days.

Q: Any story in particular you could share with us?
A: Thousands, from all of those we’ve seen. One in particular, about a family from Afghanistan, with a small boy suffering from pneumonia that we had to hospitalise. The hospital wanted to keep him admitted for three days. The father wanted the boy to stay with him because he was convinced that in three days they would be in Germany, where he could be treated. Their story came to the attention of the German media and a clinic in Munich made arrangements to admit him as soon as they arrived to the city. But there are thousands of stories, thousands of unique journeys for each family, each individual. We have treated 2,577 people in the three countries – Serbia, Croatia and Hungary – and they represent 2,577 unique stories of people fleeing out of fear, from war, because they can’t put up any more with a situation they see no end to.

Q: Are there differences between the refugees?
A: They come from different countries, not only from Syria. The Syrians that we’re seeing still have some purchasing power and the traffickers cheat and con them. To avoid Macedonia they pay extortionate prices to cross the country by bus. Then the traffickers abandon them in Serbia, telling them that they’re in Zagreb, Croatia.

Q: What is the biggest concern for the teams right now?
A: The arrival of winter and its impact. The weather has changed very quickly and the nights have become too cold for sleeping out in the open. For the moment, it mainly affects the adult refugees – children are the ones most protected from the cold – but before winter arrives in full force we may have another wave of refugees crossing Europe in terribly cold conditions. So, we fear that respiratory problems and hypothermia will increase in number.