An urgent call to advance the rights of refugee and migrant women in Greece

A woman and her child at the Skaramagas refugee camp in Greece (photo by Julie Freccero).

A dozen international and national aid agencies working in Greece’s refugee and migrant camps have recently signed a Call to Action to improve gender-based violence protection, increase access to sexual and reproductive health services, and promote women’s empowerment.

“This call is a one of a kind because it’s the first time that the key actors have agreed to messages around women’s rights,” said Nina Gora, formerly Gender Lead for Oxfam, who helped to draft the document. “It’s setting a precedent. It’s sowing a seed of the relevance and importance of gender in humanitarian responses.”

The Call to Action “intends to transform the way in which women’s rights and gender equality are considered and addressed in the Greece refugee and migrant response through the collective action of the undersigned agencies.”

Organizers say that women and girls in Greece are disproportionately affected by an overburdened system and troubled humanitarian response. The European Union-Turkey agreement forged last year effectively halted the flow of refugees out of the country, setting the stage for protracted crisis and response.

“After repeatedly asking refugees for their time, thoughts, and opinions, it’s our responsibility as humanitarian agencies to ensure that their voices are heard and directly inform our response.”

Led by Oxfam and the United Nations Population Fund (UNFPA), the Call grew out of a roundtable discussion for women’s rights in Athens last November that brought dozens of aid workers, advocates, and leaders, together to discuss research, advocacy, and direct service in some 50 camps scattered around the country. To combat a lack of organization in the humanitarian response in Greece, Oxfam and UNFPA wrote a briefing paper to summarize relevant studies conducted in Greece since the EU-Turkey agreement came in to effect. The paper stimulated the discussion and prompted the Call to Action.

Leaders say getting responders on the same page could be a first step.

Saba Zariv and Julie Freccero at the Skaramagas camp in Greece.

“We started this initiative after seeing that multiple assessments over time were highlighting the same gaps in women’s health and protection — and so little was changing,” said Julie Freccero, associate director of the Human Rights Center’s Sexual Violence Program, deployed in Athens by the United Nations Population Fund to improve the response to gender-based violence in the camps. “After repeatedly asking refugees for their time, thoughts, and opinions, it’s our responsibility as humanitarian agencies to ensure that their voices are heard and directly inform our response.”

“With so many immediate needs right in front of us to address, stepping back to do the advocacy can be hard, but it’s important,” Freccero added.

Some of the Call’s multiple action items include:

· Ensure female cultural mediators and interpreters are available to provide accompaniment and interpretation for refugees and migrants seeking health services at facilities within and off sites.

· Ensure the integration of gender based violence prevention and response measures in the identification, planning, and allocation of urban sites.

· Provide childcare and organized activities for children during implementation of programs and activities to enable full and meaningful participation by women with care responsibilities.

· Ensure access to clinical management of rape services for all field sites by supporting health providers with requisite medicines, commodities, and training to deliver survivor-centered care.

Researchers Yanna Petraki and Ania Louka recently conducted an assessment of sexual and reproductive health in camps in Attica region around Athens for the Hellenic Center for Disease Control and Prevention. On the verge of releasing their report, the researchers recount the story of a Syrian woman in an Athens hospital, where policies mandate that only doctors and midwives be present during delivery (no family members). The woman was to receive an epidural — a numbing process that requires the patient to lie still when a needle is inserted or risk severe medical consequences — but no Arabic speakers were on hand to explain the procedure.

“It’s a great problem that a woman is having a C-section and no one can explain what is happening to her,” said Louka.

The researchers cite another case of an unaccompanied minor in Greece, a boy, who was raped by multiple people. A few days after reporting the crime, the boy was sent to a forensic doctor who confirmed the rape, but offered no further treatment. At risk for HIV and other sexually transmitted infections, the boy was not treated for any possible STD — a serious misstep considering that treatment is time sensitive.

“The first thing that should be done when someone goes to the hospital and says they’re a rape victim — no matter if proven or not — is that they have to follow a path. He can’t wait for the forensic doctor or two days. It’s not only about the individual case and the personal problems — it’s a matter of public health. It’s a huge gap and a huge challenge.”

The researchers note that the crisis in care for refugees is part and parcel of an already overburdened Greek infrastructure. For example, transportation from the camps to hospitals and clinics in Athens is difficult to come by. If a woman has a morning appointment, she sometimes has to wait until the end of the day for transportation back to the camps.

Within the camps — which range from small settlements in the north to official and informal camps in Athens to detention centers on the islands — service providers flag a host of gaps related to gender-based violence and sexual and reproductive health. Problems differ significantly from camp to camp, with a rise in reported cases of gender-based violence in the over-crowded island camps recently where people feel trapped and powerless.

Freccero says one of the main issues is that there is not adequate security in the camps and that the design of the sites exacerbates risks: from poor lighting to toilets far away from living spaces, many women are afraid of even going out to the bathrooms at night. In fact, the Call to Action has already prompted a UNHCR-led working group on shelter to create new guidelines for building safer camps.

Unequal gender roles among refugees also complicate the response. For example, the use of “cash transfer” programming offers the possibility of giving refugees greater personal autonomy and at the same time supporting the local economy — a potential win win. However, giving cash to “heads of households” often means that women will not equally access or benefit from cash transfer programs, exacerbating existing gender inequality. For this reason, Freccero and her colleagues at CARE and Oxfam came up with guidelines for the cash programs to make them more equitable to women.

Clare Lofthouse works with Lighthouse Relief, a Swedish NGO, in Ritsona, a refugee camp housing approximately 800 refugees, north of Athens.

Lofthouse seeks to respond to sexual and reproductive health needs of women and girls as well as to gender-based violence in the camps. Lofthouse has spearheaded education and information projects in Ritsona, including community conversations about menstrual health, pregnancy, sexually transmitted diseases, and increasing nutritional access for infants, pregnant and breastfeeding women.

On the pulse of women’s needs in the camps, Lofthouse says a main concern is preventing unplanned and unwanted pregnancy. “Regarding contraception, it’s been a huge block, a huge gap that leads to a large volume of unwanted pregnancies,” she said.

Lofthouse says women in Ritsona advocated for on-site gynaecological services that could provide IUDs. International Medical Corps (IMC) were able towards the end of 2016 to help fill this gap and serve women once or twice a week, but the popular service ended abruptly when IMC pulled out of Greece at the end of the year.

“It’s quite disappointing, but it’s two months better than none,” Lofthouse said, noting that she hopes the Red Cross might take over the services at some point. In the meantime unwanted pregnancy continue to rise again.

Leaders don’t expect the Call to Action to be a panacea for these deep resource-related problems, but they hope it will focus organizations on key priorities.

“There’s the hope that the right people are going to hear it,” says Petraki. “and that this push is going to affect policies.”

Petraki says the Call is important but that nothing will truly change until people can move about freely and not remain stuck in camps where life is anything but normal.

Freccero sees an urgent need to support the Greek government in making services more accessible to refugees and migrants and interpretation at shelters and counseling centers more readily available. “At this point we need to be focusing on integration, to ensure that as international organizations continue to withdraw from Greece, we’re leaving behind systems that are better prepared to meet the needs of refugee and migrant communities,” she said.

Petraki says change comes with political will — something that’s hard to manifest. In the meantime, she echoes the views of others who say improving sexual and reproductive health and the response to gender-based violence in Greece’s refugee camps, depends on effective organizing and keeping the crisis in the public eye.

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