It has been more than two months since Médecins Sans Frontières (MSF) started again to provide psychosocial support to undocumented migrants and asylum seekers in the detention center of Pagani, in the island of Lesvos, and the situation continues to be extremely worrying.

Poor living conditions, constant distress and uncertainty for the future are a living reality for the people detained in the center.

As a result, more and more often during the last weeks, the detained population is openly protesting about the living and sanitary conditions. Unfortunately, the more vulnerable groups detained - women, children, adolescents, and people with special medical needs - bear the consequences of these tensions and are suffering from the inhumane living conditions. Moreover, due to the unrest, the provision of psychosocial support to these vulnerable groups of migrants by the MSF team becomes extremely difficult.

“Tensions inside the detention center are seriously hampering our efforts to help the people who need our support,” said Martha Falk, the MSF psychologist working inside Pagani. “Every day I am faced with a worrying situation as people detained in the center are reaching their limits.”

Everyday Falk, with the help of two interpreters, is trying to provide mental health support to those in need, through individual and group sessions. However, the needs for psychosocial support are much greater and, day by day, the MSF team realizes that they could have provided much more help, if at least the basic humanitarian needs of the migrants were met.

Everyday the MSF team talks to people who come from war-torn countries, like Afghanistan, Iraq, Somalia etc., and have lived through traumatic experiences during their life in their homeland and also during their journey to reach Europe. Some people are suffering from post-traumatic stress disorder and symptoms of anxiety and agony.

Undoubtedly their mental health condition is greatly aggravated by the fact that they are detained in a place where living conditions and sanitation are extremely poor. Overcrowding in the cells and the deteriorating living conditions are posing a serious threat to the mental health condition of many detainees.

The number of detainees in the center is often more than 800 people, while a few weeks ago it had reached 1.200 people, in a facility which is not suitable to accommodate people at all and which according to local authorities has a maximum capacity of 300 people. Many of the detainees are unaccompanied minors, women with children under the age of five, pregnant women, and undocumented migrants with special medical needs.

“When I visited [on] October 21, I saw that, in the women’s cell, which is approximately 200 square meters, there were 211 people, approximately 140 women and 70 children,” said Micky van Gerven, head of mission for MSF in Greece. “Many of the children were under the age of five, or even younger, less than one year old. The conditions in the cell were awful, as the two toilets and the two showers are out of order and a considerable part of the floor is flooded with water. Most of the women and children are sleeping on dirty mattresses on the floor, that are covering all the surface of the cell.”

As conditions inside the detention center of Pagani continue to be extremely difficult, immediate actions should be taken by local and national authorities to address the humanitarian needs of this population, taking especially into account the needs of vulnerable groups of undocumented migrants.