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Published in: Conflict and Health 1/2017

Open Access 01-12-2017 | Research

A crisis of protection and safe passage: violence experienced by migrants/refugees travelling along the Western Balkan corridor to Northern Europe

Authors: Jovana Arsenijević, Erin Schillberg, Aurelie Ponthieu, Lucio Malvisi, Waeil A. Elrahman Ahmed, Stefano Argenziano, Federica Zamatto, Simon Burroughs, Natalie Severy, Christophe Hebting, Brice de Vingne, Anthony D. Harries, Rony Zachariah

Published in: Conflict and Health | Issue 1/2017

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Abstract

Background

Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma.

Methods

A mixed methods study among migrants/refugees attending mobile mental health clinics run by Médecins sans Frontières (MSF) between July 2015 and June 2016, in Serbia – a main transit hub to European countries. Clinics were conducted according to MSF guidelines by experienced psychologists who were supported by cultural mediators. The main outcome measures were violent events and associated physical trauma.

Results

Of 992 migrants/refugees attending MSF mental health clinics, the majority (72%) were from Syria and Afghanistan and included vulnerable groups (14%) such as unaccompanied minors and pregnant women. The most frequent mental health symptoms/signs were anxiety (29%) and adjustment reactions (26%). Of the 992 migrants/refugees, 270 (27%) had experienced violent events during their journey. Signs of physical trauma due to acts of violence were seen in 223(22%) of the 992 individuals, 144 (65%) being perpetrated by State authorities and involving women (11%) and children (13%).
Border closures along the Balkan route were associated with a dramatic decrease in registered migrants/refugee arrivals in Serbia. Conversely, among those that made it across the borders, an increasing linear trend in reported violent events was observed at MSF mental health clinics (X 2 for linear trend, P <0 · 001). Qualitative evidence corroborated with quantitative findings.

Conclusions

Nearly one-in-three migrants/refugees seen in MSF clinics experienced violent events including physical trauma along their journey. State authorities, including those in European countries were the perpetrators in over half of such events which were associated with border closures. There is “a crisis of protection and safe passage” which needs to change towards one of respect for the principles of international human rights and refugee law.
Literature
7.
go back to reference Andersson L, Laumont B. Guidelines on data collection for mental health activities. 2007. Medical Department, Médecins Sans Frontieres, Brussels Operational centre, Rue de l'Arbre-Bénit, 46, Brussels 1050, Belgium 2007. Andersson L, Laumont B. Guidelines on data collection for mental health activities. 2007. Medical Department, Médecins Sans Frontieres, Brussels Operational centre, Rue de l'Arbre-Bénit, 46, Brussels 1050, Belgium 2007.
8.
go back to reference Charlson FJ, Steel Z, Degenhardt L, Chey T, Silove D, Marnane C, et al. Predicting the impact of the 2011 conflict in Libya on population mental health: PTSD and depression prevalence and mental health service requirements. PLoS One. 2012;7(7):1–11. Charlson FJ, Steel Z, Degenhardt L, Chey T, Silove D, Marnane C, et al. Predicting the impact of the 2011 conflict in Libya on population mental health: PTSD and depression prevalence and mental health service requirements. PLoS One. 2012;7(7):1–11.
9.
go back to reference Hassan G, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci. 2016;25(2):129–41.CrossRefPubMed Hassan G, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci. 2016;25(2):129–41.CrossRefPubMed
10.
go back to reference Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.CrossRefPubMed Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.CrossRefPubMed
11.
go back to reference Nguyen AJ, Feo C, Idrisov K, Pintaldi G, Lenglet A, Tsatsaeva Z, et al. Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study. Confl Health. 2016;10:16.CrossRefPubMedPubMedCentral Nguyen AJ, Feo C, Idrisov K, Pintaldi G, Lenglet A, Tsatsaeva Z, et al. Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study. Confl Health. 2016;10:16.CrossRefPubMedPubMedCentral
12.
go back to reference MSF. Mental Health Policy Guideline. Psychological and mental healh interventions in humanitarian contexts. 2015. MSF International working group document. Brussels Operational Center, Rue de l' Arbre Benit 46, Brussels, Belgium. MSF. Mental Health Policy Guideline. Psychological and mental healh interventions in humanitarian contexts. 2015. MSF International working group document. Brussels Operational Center, Rue de l' Arbre Benit 46, Brussels, Belgium.
13.
go back to reference MSF. Trauma guidelines for psychological care, Médecins sans Frontières, Brussels, Rue de l'Arbre Bénit, Brussels, Belgium. 2004. MSF. Trauma guidelines for psychological care, Médecins sans Frontières, Brussels, Rue de l'Arbre Bénit, Brussels, Belgium. 2004.
14.
go back to reference MSF. Psychosocial mental health interventions in areas of mass violence. Amsterdam: Médecins Sans Frontières; 2011. MSF. Psychosocial mental health interventions in areas of mass violence. Amsterdam: Médecins Sans Frontières; 2011.
16.
go back to reference Shannon PJ. Refugees' advice to physicians: how to ask about mental health. Fam Pract. 2014;31(4):462–6.CrossRefPubMed Shannon PJ. Refugees' advice to physicians: how to ask about mental health. Fam Pract. 2014;31(4):462–6.CrossRefPubMed
17.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7.CrossRef
Metadata
Title
A crisis of protection and safe passage: violence experienced by migrants/refugees travelling along the Western Balkan corridor to Northern Europe
Authors
Jovana Arsenijević
Erin Schillberg
Aurelie Ponthieu
Lucio Malvisi
Waeil A. Elrahman Ahmed
Stefano Argenziano
Federica Zamatto
Simon Burroughs
Natalie Severy
Christophe Hebting
Brice de Vingne
Anthony D. Harries
Rony Zachariah
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2017
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/s13031-017-0107-z

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