Luiza Vafina & Roman Azadzoy

„Water is the only medicine
against all diseases"

How health care for refugees works in Hamburg
Samira and Leila are afraid to show their faces
Samira (16) and Leila (28) are living in a refugee camp in Wilhelmsburg, Hamburg. Samira is originally from Afghanistan and Leila from Iran. They both came on foot to Germany two months ago and were sent to the camp in Wilhelmsburg, where they currently live with Samira's grandmother. The family got split by the authorities— Samira's father and brother were sent to a camp in Bremen (Lower Saxony), which is 100 km from Hamburg.


Samira tells a lot about health care in the camp. The treatment is "bad and the doctors are useless," she says. Since the two young women don't have green cards, they must ask local authorities for medical care. These authorities decide whether treatment is necessary, even though they have no medical qualification.

Once Leila and Samira had headaches, backaches and gastrointestinal disease, but the doctor didn't give medicine to them, instead telling them that drinking water is sufficient. "I was crying in front of the doctor because of pain, but he refused to give me medicine and told me once more: drink water!" Sometimes she regrets her exhausting escape from Afghanistan.

"If I had known how bad the living conditions in German refugee camps are, I may not have taken this risky trip to Germany."

Nevertheless the sixteen-year-old girl tries to look attractive. This young lady wears a pink jacket and a pair of blue jeans, has a striped scarf on her head. Besides, she wears make-up and even her nails are done.
The living conditions in the camp are "really terrible," Samira says. Her tent is only 12 square meters big and has three double beds for six persons. Since autumn has arrived, it's getting cold inside. "We are sleeping with men in a tent as well, which makes us feel a lot uncomfortable." But one positive aspect is that Samira and Leila are living together with refugees from the same country, thus they have a chance to talk to people from their homeland.

One probably can't expect particularly high hygiene standards in the camp, but the actual situation is much worse than expected. There are only few toilets and showers for over 1,700 people. "We do not even have an opportunity to wash our clothes or to buy new ones, because we don't have money," claims Leila. To receive monthly payments, they need a green card, which is a sort of residence entitlement card for them. But this card is far away for both young women because, as they say, the authorities are working slovenly and slowly.

"There are moments when I just sit on my bed and cry," says Samira. "But at the same time I'm happy to be in Germany. I know that one day we'll leave this camp and live a better life then. Together with my brother and father."
"I was crying in front of the doctor because of pain, but he refused to give me medicine and told me once more: drink water!"

This is a place near the Central (Hauptbahnhof) metro station, where refugees can get medical treatment after their arrival.

Primary medical treatment

"No one should stay without medical care if needed"
Uwe Ram, Head of Department International Cooperation, Senate Chancellery Hamburg

Each migrant gets treatment in Hamburg, at least once. According to §62 of Asylum Procedure Law, it's necessary for all refugees to be examined at their arrival in Germany.

There are still many migrants who cross the border
being already ill.

5 STEPS

How to receive medical treatment for a refugee

1
to be registered in Germany

2
to get the standard vaccinations against diphtheria, tetanus and measles

3
to get a lung x-ray in order to rule out tuberculosis
4
to receive a yellow paper, which qualifies for further medical treatment after having consulted one of the local authorities or

5
to receive a residence entitlement card (green card), which allows for medical treatment without previously consulting local authorities. This green card also entitles the refugees to receive health-insurance.

WHAT IS NEW

Only two federal states in Germany offer an electronic health card and exemption from payment for medicine. Those are only issued by the statutory health insurance „AOK Bremen/Bremerhaven". With this the refugees have the right to visit a doctor by themselves and receive medical treatment. However, they only can obtain primary health care.

Want to help?

If you are a doctor or medical specialist and you want to engage in refugees' treatment, you can offer your help to health authorities (Gesundheitsamt) of Altona District, Hamburg. You can reach them by email: medizinische-versorgung-fluechtlinge@altona.hamburg.de

mental care

"We help refugees find happiness
in their lives"

"I'm afraid. Always," says Samir from Afghanistan. He's twelve.

"Earlier I was sad and just wanted to die," admits eight-year-old Mohammed from Syria.

These words are familiar to many refugees. They faced trauma in their homelands or on the way to Germany. To handle psychological problems and begin a new life – this is another part of medical treatment of refugees.

The refugee ambulance for children and youth, which works in cooperation with "Children for Tomorrow" foundation, has been fulfilling this task since 1996. It helps children and minors from birth to the age of 21 recover from traumas' consequences.
Cornelia Reher, certified psychotherapist, the head of the therapeutic department in the refugee ambulance at the University Hospital Eppendorf, talking about mental healthcare of refugees
"Many refugees start to take drugs or want to die. First of all, we try to stabilize them so that people can handle the feelings without harming themselves"
Wish tree made by young refugees during art therapy


One psychiatrist and several psychotherapists, who pay attention to speech therapy, take care of young traumatized migrants in the refugee ambulance. Social workers help solving refugees' social and financial problems as well. All of them have medical, psychological or pedagogical degrees.
"We don't work with volunteers any longer: they are so overwhelmed with stories of these people that we have to treat volunteers instead of refugees!"
Reher admits: she enjoys her job, especially watching people's recovery, even if the work itself is not that easy. Being in close contact with refugees for almost four years made her come to the conclusion: "Refugees have so much energy and potential!"
Project of the International Media Center at Hamburg University of Applied Sciences in cooperation with Saint Petersburg State University

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