PROBLEMS WITH ACCESS TO MEDICAL HELP
Photos, audio & texts - Hanna Jarzabek
Interview with OLA G.
Rescuer helping refugees in the Bialowieza Forest
(March 21, 2023)
My name is Ola, and I am a medic of the Granica Group. I regularly spend around 10-12 days each month at the border and in the forest, providing medical assistance to people on the way.
The most common problems we encounter, of course, vary depending on the season, but generally include hypothermia, hypoglycemia, dehydration, and people getting poisoned from drinking water from the swamps. The lack of potable water in the forest is a major issue, and in desperation, people often drink water heavily contaminated with E.coli bacteria, which is much more harmful than drinking water from a puddle in a village. This leads to symptoms such as diarrhea, vomiting, and severe stomach pains, which exacerbate their dehydration and prevent them from continuing the journey.
Most often, I connect them to a drip that quickly hydrates them and I give them drugs to inhibit the growth of bacteria. I also administer painkillers, and after the drip, they are usually able to continue on their way.
There was a time when I had to call an ambulance for a man who had been poisoned with swamp water and was hypothermic. Despite receiving a large amount of painkillers and diastolic drugs, and fluids, he was still unable to continue his journey.
Usually, the ambulance doesn't come, but instead, the police and the border guards come, who don't have any medical personnel with them. This is unthinkable to me because if a situation is life-threatening, an ambulance should be dispatched. If the ambulance is unable to physically reach the location, I believe that the border guards should have people with medical education in their car to assess and provide assistance during the transportation, as they are not able to provide medical care to the person in need.
It is a strange situation that they do not have a medical personnel with them in the car when responding to a call, with five people showing up for just one man in the forest - three from the Border Guards and two police officers - as it was the case in this situation. And there are simply no medical personnel on board to assess and treat the person. When I offer to come along as a medic, they always refuse and say that there is no way to transport the person medically through the forest, so they put him in the car and drive away. We have a hospital group that looks after all people from the forest who are sent to the hospital. This allows us to follow up with the person and know what is happening with them. The most optimal scenario is that the person is admitted to the hospital, where they can apply for asylum. They sign the necessary papers in the hospital, and depending on the decision of the border guards, they are either directed to a closed or open center for foreigners. However, in the worst case, if the person is deemed healthy by the Border Guards, he is simply push baked to Belarus.
Photo below: Two volunteers, one of them a doctor, provide assistance to Y.K (25 years old, engineer), a Syrian refugee in a state of second-degree hypothermia. The volunteers called an ambulance to ask for help for Y.K., but 4 hours passed before the fire brigade and the Border Guard arrived, with no doctor on board. Y.K. was taken to the Border Guard post, rather than to the hospital as recommended by the doctor. December 12, 2022
The specific medical problems we encounter have changed recently. We now see more cases of people falling from a height. The wall is 5 and a half meters high and these people just fall off it. These falls result in injuries to the lower limbs, such as fractures, sprains, and bruises.
We primarily see young men in the forest, which is related to the specificity of migration. Those who migrate are often the ones who are most likely to survive the journey and support their loved ones who have stayed in their country of origin. Therefore, young men endure the difficult journey. However, we also encounter young women, who are very often pregnant, and children.
It is more common to encounter children in spring, summer, and autumn when the road is relatively safer to travel. I didn't meet children in winter, but in summer yes, I did. I have three children and I can’t help but think about the children who are the same as my own. But these children are fighting for their lives alongside their parents, and they know what is at stake if they fail, and they're just determined to reach their destination.
Most of the women who crossed the border reported being in early pregnancy and believed that it would protect them as pregnant women often afford more protection in many cultures. Unfortunately, this is not the case at the Polish border, as even those who report being pregnant are often pushed back. (Read more about push backs)
Photo below: An injection that a rescuer had to give to a woman from Iran during the intervention in the forest. March 18, 2023
I once helped a woman who was already quite far along in her pregnancy, probably in her third or fourth month. I have visited this group in the forest several times. The group consisted of a married couple, likely from the Congo, with their two children - a three or four-year-old girl and a seven-year-old boy. At one point, when they were preparing to move on, the woman's water broke and she started miscarrying. I stayed with her from beginning to end, connecting her to a drip, giving her painkillers, and waiting until the miscarriage was over, with the children and her husband by her side. Since there was no way to separate them, they were all aware of what was happening.
I knew that I would be with this woman, and I was prepared to call for help if her condition worsened, such as if she experienced uncontrolled bleeding. However, I also knew that if I had called an ambulance earlier, the woman would have been hospitalized, but her husband and children would not have been allowed to stay with her. Given that this family had been pushed back several times before and that it was their third or fourth attempt to cross the border, I’m pretty sure that they would have been separated, and the husband and children would have been pushed back to Belarus without the possibility to request asylum. I knew that separating them could have meant that they would never be reunited.
Such situations happen when families are separated and pushed back to Belarus, and that's why we decided not to call an ambulance. We chose to stay with this woman and see how things developed. We took care of her during this time and when miscarriage was over, they went on their way.
As long as I am in Podlasie and employed as a paramedic, I approach my work as a task. I need to be prepared to leave quickly with my backpack packed, assess the situation, assist the individual and return. I am accustomed to this due to my over 10 years of experience working in neonatal intensive care, which was also mentally demanding job. As a paramedic, encountering difficult situations is a part of the job, and we learn to maintain a certain level of distance from it. It is something we may reflect on later, but it does not typically traumatize or break us down. However, I do question whether I could have done more or made different decisions, as I am solely responsible for medical decisions and I have no one to consult with.
In fact, my most challenging medical interventions as a paramedic in the forest have been when there was no prior notification of an emergency. This work is highly unpredictable, with sudden periods of intense activity followed by long periods of quiet. I am always on alert, waiting for the next emergency, and I am frequently on the phone, ready to spring into action at a moment’s notice. As a result, I must be prepared at all times, ready to put on my shoes, jacket, and head out into the forest whenever necessary.
Volunteering is the foundation of our work and I believe it would be beneficial to have another paramedic who can take over my duties when I am not available. Unfortunately, this is not currently the case, and we lack a paid professional to fill this role. In my opinion, it should be organized and systematized professional help rather than relying solely on good intentions. However this is unlikely to happen here.
Photo below: Ola giving pain killers to one of the refugees in the forest, November 2, 2022
Reaching my patients in the forest can be a challenging task, and at times it feels like a guerrilla operation. Typically, we walk through the forest, and it is important to assess the type of forest we will encounter - whether it is a swamp, alder forest, or a dry forest that will allow for easier access. However, the forest and its conditions change depending on the season and weather, and what we thought would be a straightforward route can turn out to be challenging. Sometimes, we expect a difficult path, but find the forest dry and pleasant to traverse, almost like a picnic. Other times, we can cover only 200 meters in an hour, an unimaginable feat in a city setting. Such journeys leave us bruised, we arrive tired, and it is just the beginning of our work.
What's bothering me? That I never know if I'll make it to that group or not. Of course, this job is also physically tiring for me because I have to carry a very heavy backpack that contains all my medical supplies, as well as other items that the group might need, such as water and clothes. So the backpack is just heavy. Additionally, I am tired of knowing that this situation will never be resolved. Our government is known to be right-wing and totally against helping those refugees, criminalizing our activities and the migration situation at this border. This is of course also with the consent of the European Union. Even if the government in our country changes to a more neutral one, there will never be a situation where these people can ask for asylum in a normal way and receive it in accordance with the law, under human conditions. This situation will not be resolved. This road has been opened, and it will continue like this.
Photo below: The Bialowieza Forest, March 9, 2023
The image of refugees in Polish society is shaped by what people hear in the media. The message conveyed in the media is that these are dangerous people with bad intentions, who want to impose their religion, culture, etc. on us. This is, of course, nonsense. No one talks about the fact that many people from African countries are Christians. They are not dangerous in any way. Usually, women provide humanitarian aid at this border, so frequently I have been with two female colleagues in a group of 10-15 men, and I have never felt threatened by any inappropriate behavior, comments or gestures from them. Never, just never. I always felt 100% safe around these people.
It’s embarrassing when they thank me because the whole situation is awkward for me. It should be normal for someone to give them help. But when, for example, they spread a piece of foil somewhere for me to kneel down or sit, or when they give me a hand to help me go over a tree, it’s a gallant gesture that shows their respect and gratitude. It’s all they can do at this moment. These are simple human instincts.
They are the same people as us, only in an unusual situation. When we sit, talk and smoke cigarettes after feeding and watering them, we see that they are the same as us with the same problems, except that they are in a very bad situation at that moment.
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Podcast (in polish)
Interview with Lucyna Marciniak
doctor at the Communal Health Center in Bialowieza
(October 18, 2022)
“My name is Lucyna Marciniak, I am a doctor at the Communal Health Center in Białowieża. I am an Internist pulmonologist. I have been living in Białowieża for 6 years.
We knew that something was starting to happen at the border but we were completely unprepared for the situation that on September 2 we were locked in the so-called zone. As a result, we were completely cut off from any possibility of outside help. And suddenly, refugees who crossed the border with Belarus began to appear in our zone. And these people found themselves in our forests and needed help that there was no one to give them. The top-down official narrative was based on the saying ''Murem za mundurem” which means stay firm behind the uniform. So we were supposed to support all uniformed services: border guards, army and police. While helping refugees, for whatever reason they find themselves on our side, was considered a crime. This caused us great moral dilemmas at the beginning because we quickly realized that reporting the presence of refugees to the Border Guards does not mean helping them, but means taking them back by the Guards to the fence and throwing them to the Belarusian side. So the first situation where a decision had to be made was that we had to stand against uniformed forces and officials, because their actions were not for the good of the refugees. But as there were more and more people, the weather was getting worse and more and more often we had contact with people who were simply exhausted from the march, dehydrated in wet clothes, so there was nothing to discuss because it helped at the level of meeting the basic needs of another person. Therefore we have decided here among the inhabitants of Białowieża that we will help as much as we can.
Officially I really couldn't do much. But because it was a restricted zone, there was no possibility for any rescue services to enter here, so I was just used to roughly assessing the condition of the people in the forest. Of course it is not some deep diagnostics. It is simply an assessment of basic vital functions and a decision whether this person is able to function on his own or whether he just needs to be hospitalized. If he was admitted to the hospital, he was given all the medical help he needed. It also usually gave a few days time to evaluate his situation, so that this man had a chance to say why he was here, if he wanted to apply for international protection and try to handle all these matters from the formal and legal side. Unfortunately, there were also situations when the patient recovered enough to be discharged from the hospital, the Border Guards came for him and took him back to the border leaving him in the forest.
At the beginning, when we met these people in the forest, we tried to somehow quickly give them the appropriate documents to sign, so that before they got into the hands of the Border Guards, they would have a proxy. But in many situations it turned out that these documents probably went to the trash. There were also problems that those people who declared themselves as plenipotentiaries had no access at all to their, let's call them, charges who were in the Border Guard facilities. There were a lot of troubles and besides it was also completely new things for us, new procedures as it was done in the forest, in the dark. You are terrified and nervous and if we add the language barrier to this ... Of course, people who worked as translators on the lines helped, but sometimes in the forest there was simply no coverage. So there was a problem every step of the way and placing somebody in the hospital seemed to increase the chance for meaningful help.
The official procedure was that a refugee found by the Border Guards in the forest had to be transported back to the Belarusian side, meaning he was packed in a truck, taken to the fence and somehow pushed or, let's say, persuaded in a more or less direct way (read about pushbacks) to cross this fence back to the Belarusian side. There, of course, the Belarusian Border Guards were waiting there, and they pushed these people back using usually quite brutal methods. There were people who did this route back and forth several or a dozen times. I think that every such failed attempt, apart from the physical effort that needs to be put into it, is also depriving a person of some sense of their own dignity. And this is doing such terrible mental harm that I can't even imagine. It’s a drama.
I cannot say with a clear conscience that they were treated well by our services. Recently there was even a film with a man who was hanging on the fence and we all saw how the uniformed services, instead of helping him in any way because they knew that he would fall off the fence in a moment, calmly stand and wait and actually had a lot of fun watching him hanging and then falling. Well, I can't understand it.
Photo: A local volunteer, shows on her phone the image of the video in which a refugee was left hanging upside down on the fence, with one leg caught in the concertina above. October 26, 2022
I also know, on the other hand, that many people serving in the Border Guards, the police or the army, were mentally exhausted. Because I also had situations where they came to me and asked for some help, most often in the form of giving them leave so that they could return home because they felt that they simply could no longer bear the burden of this service that was imposed on them. This is also a group of people who have their own problems and you can't throw them all into one bag saying they were all bad. In turn, the whole situation was so steered that they were as if boosted to have mental strength to do what they did. They were incited by the government to act against all those who help in a way that we would jump at each other's throats. Doing it within one nation in a relatively small space where we all live next to each other, it is just despicable.
Fortunately, I personally have not had any such confrontational situations with the uniformed services, but I know from my friends that the ways of treating the so-called activists, meaning the people who ran around the forest with these backpacks and brought help, were sometimes, well, it was a drama. They were telling us that we were committing a crime so that we might face some kind of punishment for it. Often people were treated in such a way as to make them feel humiliated, they were thrown to the ground and treated simply like bandits. And I understand that they also had their duties to fulfill, but it could have had a human face and then I think that even taking into account that these were extreme situations, it could have been solved differently.
I personally participated in a situation where we took a sick child out or the forest (read her story) and we carried the child out. An ambulance arrived, but the first to arrive was a Border Guard who, by the way, is a resident of our village. And the way he addressed us, how he shouted, how he threatened us that we would incur the costs of medical transport, it was just a nightmare scene. Finally, he asked why the baby was lying there. So we say that the child is lying down because she is sick and simply cannot walk at all for neurological reasons. Well, that was embarrassing. It's just not how I imagine the state services should act, especially in the situation where there is a sick child. Well, I don't know, a sick child or a pregnant woman. These are traditional things that are so sacred with us. Here it does not look like.
Photo on the left: Eliza kowalczyk
We, as residents, have been relieved now a little from helping. In addition, there is no longer a closed zone so people from outside can also come and help. But it is known that if Border Guards cars appear at the exit from the forest and a helicopter flies over us in the evening, it means that people are coming. And there's a lot of it. There are definitely more injuries now, because when they go over this fence, they just either jump or hurt themselves. As a doctor of the municipal health center, I also provide such services here that when the Border Guards bring me refugees who they have at their facility and, for example, they want to transport them somewhere further, I have to give an opinion that this patient is suitable for this transport. They brought me two people who were just crossing the fence and hurt themselves with this razor wire on top. You can hardly imagine the amount of wounds on their hands, forearms and thighs. It was like making razor cuts literally every half-inch. Just the degree of suffering of these people... It was a young girl and a young boy. We made dressings for them in our clinic, almost, so to speak, covering those wounds with our tears. Imagine, you cut a finger, you just have one wound but you know how disturbing it is. And there were dozens of these….. Well, and now winter is coming again, the profile of these health problems will probably change again.
This is absurd from every point of view. For months while the fence was being built, here again as the only medical provider, I was giving medical advice to fence builders and those who were in charge of the materials and so on. And there was usually some sort of conversation with everyone about what they were doing there. I haven't met a single person who said it made any sense. This is, of course a devastation of nature, a destruction of the forest in many places and it is indisputable at all. What is more, we know that different walls in the world stand in different places and no wall solves the problem. Of course there is a physical barrier, but with a little ingenuity it can be overcome in many different ways. However, the costs are huge and the solution to the problem, well, probably none.
I was brought up in such a way that if there is a law or a rule, it is there to be obeyed. But if this law or these recommendations imply that while helping a person who is sick, hungry, overtired or wounded I commit a crime, then I say to myself - I think we've gone too far here and this is something wrong. And at some point I thought, I simply don’t care what they call it. In the end, I swore with my medical oath that I would always help and I'm sticking to it. Looking into the eyes of such a man makes even the toughest guy just melt away. And you can argue whether they should come here or not or if they should go to Germany, but at the moment they are here, they have to get help at the basic level. It’s something that should not even be discussed.
We know that there are dozens of people missing in this area and we also know how many bodies have been officially found (read about deaths and disappeared). These numbers are strongly disturbed and there are many people who simply disappeared without a trace in swamps somewhere in peat bogs and we will never find them again."
Photo: In the Bialowieza Forest, there are several swamps, and some of them are extremely dangerous. On several occasions refugees have become trapped and have required rescue. Some drowned. November 11, 2022
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