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Reflections on volunteering in Calais

By Dr Rosanna O Keeffe (GP trainee, North Dublin City GP Trainee) with Ellen O' Keeffe (4th year Sociology, TCD)

This inspirational presentation left GP trainees and tutors with little to say but with the feeling that they like the young doctor should ‘do’ something. As a result an advocacy strategy is being devised within the Scheme. Dr O’Keefe’s inability to do nothing meant that she found herself in Calais providing basic first aid and care to hundreds of people living in appalling conditions in Calais refugee camp. Dr Aidan Halligan another great speaker once said “you won’t remember what I said but you’ll remember how I made you feel”. This transcript of Dr O’Keefe's reflections on her experience is so that we also remember what she said. (PHE staff writer: 17.06.16)

I’m going to speak about Calais where I have volunteered twice over the last few weeks. 


To start I’m going to give some background information. I assume most of you know this already but it’s important to remind ourselves of the scale or this humanitarian crisis. Of course migration is a human reality and essentially the history of humanity is the story of migration. Yet still we have a crisis. Frontex put the figure crossing into Europe in 2015 at more than 1.8 million people. Most head for Greece taking the relatively short voyage from Turkey to the Greek islands in rubber dinghies or small boats. Currently in Greece there are 50,000 refugees stuck in limbo in camps and detention centers. There are at least 8,500 people in Idomeni, an informal camp that is being evicted this week. That is 8,500 people seeking to enter Europe that are displaced once again while they wait for the borders to open. Currently in Calais refugee camp, which broadly speaking is an unofficial slum/ massive scale homeless crisis there are over 5,000 people. A few miles down the road in Dunkirk there are another 2,000 people languishing. The reality for all of these hundreds of thousands of people seeking refuge, living in avoidable deprivation and squalor within the borders of Europe is now coloured by the recent seriously flawed, and questionable from a human rights perspective, EU - Turkey deal. This deal stipulates that “illegal migrants” will be sent back to Turkey to be processed in detention centers, in a country that is not safe for them. 


People are of course fleeing war, poverty, discrimination, famine and climate change, all of which are forms of violence and oppression. People are looking for a better life, which they believe they can find in Europe. As the now well-known quote reminds us  - “you have to understand that no one puts their children in a boat unless the water is safer than the land”.  In Calais I met people from Afghanistan, Iraq, Iran, Pakistan, Egypt, Sudan, Syria, Libya, Ethiopia and Eritrea. What they had in common was that they all had to undertake precarious, dangerous, potentially life threatening and often humiliating journeys to arrive in Europe.


I learned in Calais that a typical journey can involve fleeing unprepared in a state of emergency or sometimes it involves an entire community or extended family coming together to provide usually a young fit healthy man with financial support to begin the journey. A smuggler is usually paid thousands of euros to facilitate ‘safe’ border crossings. The journey of thousands of miles is covered by foot, train, bus, boat and any other method available. When we met people and asked them how they got here a typical exasperated response was “I left Afghanistan and passed through Iran, Iraq, Turkey, then crossed the Aegean Sea to Greece, then on to Bulgaria, Serbia, Hungary, Austria, Germany, France. En route there is constant threat of violence, hunger, detention, exposure related illness and torture. Safety can never be assured and obviously this has a really significant detrimental effect on physical and mental health. Clearly no one would choose this journey without absolute necessity. We are so used to being able to legally hop on a plane and go pretty much wherever we want in the world simply by virtue of our nationality. Most of these people have no passport. Those that do have a passport know that their passport means virtually nothing, they will never be granted a visa to travel. The irony of me being able to jump on the next flight back to Ireland was not lost on me while migrants remain trapped in refugee camps in Europe because they are not entitled to freedom of movement. 


Calais refugee camp as you can see in the photos is a makeshift community of tents and weak structures made out of tarpaulin. It is nestled under the motorway at the entrance to the Channel Tunnel to the UK. Calais has come to be out of choice-less necessity. It has exploded in size over the last twelve months. The numbers are increasing every week; everyday new arrivals come with nothing but the clothes on their back. The reality is brutal for people living there. No peace, no privacy, no security, no basic living conditions like cooking facilities, clean water or adequate sanitation. 


People are there because every night, day in - day out they try their luck at gaining access to the UK. This means leaving the camp, passing the intimidating and dangerous riot police, going around the 20 foot fence with barbed wire lining the motor way (paid for by the UK) and trying to usually get on top of a truck, under a truck, in a truck or find another way of getting through the Tunnel and pass the three high intensity security check points before arrival. The vast majority of the time people are caught, either by the driver or by the police. They try to run. If they are caught they are often physically assaulted and depending on the mood of the police either allowed return to the camp or be taken to a deportation center/prison. Despite the demoralizing failure and temporary defeat every night they try again. 


We were working with a grass roots first aid team. Three caravans were donated to a group of medics travelling to Calais last September. This was needed as there was no medical care on the camp at all for the weekend, and during the week there was only the official French government clinic which people are often afraid to go to. 


Every day hundreds of people came to our clinics. The line outside was never ending. The medical care we provided was very basic. Mostly first aid and giving over the counter medications. The common presentations were viral upper respiratory tract infections and wounds and muscular injuries resulting from the night before. Unfortunately our treatments were not curative. No matter how many pain killers, gels, heat packs, heat sprays, and cold sprays we give we will never be able to cure the myalgia’s and arthralgia’s of someone sleeping on the ground without a mattress or pillow, running for miles every night in no shoes or bad shoes, jumping and falling on and off trucks and regularly being physically assaulted.  Any advice that we would give at home was rendered invalid. To someone presenting with a viral infection, advice like rest, keep warm, plenty of fluids etc. was impossible. They are living outside, in the cold and damp, not sleeping at all and unable to drink the dirty water. What could we advise?


We saw lots and lots of presentations resulting from police violence. Endless soft tissue injuries from rubber bullets and beatings with batons. So so many lacerations from climbing barbed wire fences and falling while running on the dark road away from police and also lots of trauma from falling from trucks. 


We saw mostly men. Men usually go first to make the dangerous journey and then the plan is to send for their families. The average age was 20. These are men like our brothers and friends. Friendly, kind, courteous, and joyous like any young man you know. The courage, resilience, strength of character and their outstanding ability to try to maintain some level of dignity in this degrading situation is remarkable. 


We also saw children. There are thousands of innocent, vulnerable unaccompanied minors undocumented in Europe at the moment. There are 10,000 children currently completely unaccounted for in Europe. It is easy to become separated in the mayhem of border crossings.  Last week we had a twelve-year-old boy who came in alone presenting with a rash. He had travelled from Eritrea. He didn’t speak a word of English so an Eritrean man who was waiting in line outside translated for him. He had come with a smuggler to Europe. He travelled up through Europe alone and arrived in the camp 5 days previously. He had no friends. No family. No one looking out for him. No one in the UK. He was speaking to us like an adult. He was no longer a child.  He didn’t want us to call the children’s center because he was afraid that they would stop him trying to jump on trucks every night. How can a situation like this be okay, acceptable by our governments and our laws? 

We learned as the days went by that many people were coming to our caravans for a daily visit. Often for things like putting a plaster on a tiny cut that we could no longer see. We started to realize that people were coming for a chat, a chance to talk, a chance to get some caring human contact. Wanting to feel cared for and respected like everyone should be entitled to. When so often these people are rendered invisible, made “illegal” by our border laws visiting the doctor can maybe restore some sense of normalcy, humanity, identity and afford them a space to voice their worries and concerns and be listened to and heard. To be honest that is what I learned and I felt about our role as medical professionals in Calais. 


You quickly realize that despite your best intentions you are not able to really ‘help’. Our role as medics is to provide the best possible and safest medical care, and we still were able to refer people to hospital when they were seriously unwell but our ability to provide care is seriously constrained and curtailed by the harsh reality of the situation. Politically and legally it essentially impossible for us to fully provide and implement the treatments that these people deserve and are entitled to because what they need is a safe space to call home, not a cold, wet, tent in the dirt. Our typical role as doctors, giving advice and solving problems was abruptly interrupted when faced with questions such as “Why are we here?”, “Why will they not let us in?” “Why are we being treated like animals?”  I still haven’t met someone who figured out how to answer.


Despite this our role is real and our role is important. I know this might seem conflicting and paradoxical but it is real. Having access to medical care is absolutely essential and is one of the most basic human rights. Even if we can’t provide the most optimal treatment plans a medical service in a limited capacity is at least more than nothing. 


For me, what I feel like my role is and what I’m expressing through my medical capacity in Calais is most importantly a show of solidarity with those living in the camp. With the constant dehumanizing treatment from the governments, the police, the media and the terrifying rise of the far right across Europe it is imperative for me to show them that I can see them, and hear them, and they are not invisible and that the pains and aches both mental and physical are real to me, and that I care. All of us that go to the camp are showing them that they are not forgotten. That despite the taller fences, the harder bullets, the all too frequent tear gas they are welcome here and that is not the type of world that I want to live in. Standing in solidarity shows our commonality and our shared humanity in the face of policies that seek to divide us. For me it is important to go and show to these people I am not okay with these policies being carried out in my name. 


This extract from the poem called Home by Warsan Shire encapsulates a lot of what I want to say


“You have to understand,
that no one puts their children in a boat
unless the water is safer than the land
no one burns their palms
under trains
beneath carriages
no one spends days and nights in the stomach of a truck
feeding on newspaper unless the miles travelled
means something more than journey.
no one crawls under fences
no one wants to be beaten

no one chooses refugee camps
or strip searches where your
body is left aching
or prison,
because prison is safer
than a city of fire
and one prison guard
in the night
is better than a truckload
of men who look like your father
no one could take it
no one could stomach it
no one skin would be tough enough”


Going to Calais is obviously not for everyone, and I don’t expect that everyone will jump on the next plane. But there are so many important things that we can do here at home. When we walk around Dublin, and within our scheme especially we can see that we have so many massive crisis’s here at home with the housing crisis and homelessness with three families becoming homeless every day this week and Direct Provision. All of these need our attention and need to be solved. However all of these fights are connected. All humans deserve to live a life of dignity. Our focus needs to be broad based. Groups like the Dublin Calais Refugee Solidarity Group, the Solidarity Alliance against Racism and Fascism, the Irish Refugee Council, Movement of Asylum Seekers Ireland and the Irish Housing Network are all working together to raise public awareness and mobilize people power and apply political pressure on our governments. This is unfortunately the only way that any real change or improvement is going to be realized in this situation. We can and we need to be part of this. 

Before I finish I think it's important to say I am speaking about the current situation affecting people seeking refuge and those migrating across Europe based on what I have witnessed, heard and read, and all of these people have their own lived experiences and their own voices. Because of the current horrific situation in which people are being stripped of their humanity as Europe continues to militarize and securitize its borders against people seeking asylum it means that it’s difficult for their voices to be heard when at every moment survival must be the priority. Therefore I think that when we have a platform it’s important that we amplify their voices and experiences. 


To finally finish I’m going to read a quote from Caoimhe Butterly who is an inspirational Irish activist 


“It is a journey that necessitates the recognition of the strength, the agency and the self-empowerment of those we are attempting to accompany. It is a solidarity that needs to be grounded in honesty and humility and that does not further erode the dignity of those we accompany.

It is an understanding of ‘refugee’ as an experience, not an identity for those who refuse to reduce down their lives, dreams and diversity to a de-personalized, homogenizing label. It is a discourse that challenges the false dichotomies of ‘worthiness’ used to undermine migrant communities on the move. It is a journey that recognizes those who we are walking with as the unbroken, though momentarily vulnerable, survivors that they are and that commits to echoing and amplifying that resilience. It is an affirmation that we cannot afford to leave any of our people behind.”

A typical shop in the camp

Dr. Joe arriving at the caravan

Young men wait to be seen

Limited space in the medical caravans

Many cases of secondary syphilis identified in the camp

Removing sutures following a razor wire injury

Scalp laceration from  an injury while running

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