I was a medic in the Calais refugee camp. Good riddance to it
“Careful of the curtains, they must be full of scabies by now,” the nurse said. I smiled and perched on the edge of the bench as far away as I could. It was 10.30am in the refugee camp and our Refugee Support First Aid and Care Team caravan was open for business. The team for the day was a GP from Leeds, a junior doctor, a trainee nurse and four medical students.
The first patient came in with his friend and the translators, Mustafa and Ahmed. I asked how I could help and then sat silently as Mustafa and my patient had a long conversation, often laughing, sometimes an indignant shake of the head and once a broad smile at me. When it seemed to be dying down I looked expectantly at Mustafa: “He’s got jungle lung.”
The most common problems we encountered were this range of coughs and colds and lung irritation caused by smoke and tear gas. also featured high on the list, as did diarrhoea. We saw all manner of minor traumas: burns from the endless fires in camp; bruising; stab-wounds and broken bones from fights either between residents of the camp, or between residents and the CRS, the French riot police. Such ailments formed the backdrop to the living conditions and politics there, all underpinned by endless mental health problems. Mental health care in the camp was largely non-existent, despite the miseries that almost every member of the camp described, from separation to starvation to rape. We had nothing to offer, not even a quiet room to talk. Analgesia and wound dressings were the best we could do.
More serious conditions, particularly pneumonia and tuberculosis, sat alongside those less severe complaints, and many people couldn’t make it to the caravans, either because they were too injured or too ill. Some didn’t want to because they were scared of being detained. We saw one patient who was bright yellow from hepatitis A, a disease that spreads quickly in the cramped and unhygienic conditions. A case of appendicitis required a volunteer to drive the patient to the Calais hospital because the ambulance wouldn’t come, and, later that day we met a man who was too badly beaten to move – truncheon-shaped bruises covered his back. These are all potentially life-threatening conditions when basic provisions such as drips or antibiotics aren’t available.
One day someone came running over to us shouting that they needed a doctor – there had been a fight. Near the edge of the camp a group of CRS officers were standing around two men who sat slumped against each other, covered in blood. At first the CRS refused to let us through, but relented when the doctor showed his NHS badge. One of the men was holding his side, blood seeping between his fingers, and the other was vomiting between his legs while his kaftan saturated with blood. A knife fight had ended with each making punctures in the other. By the time we arrived a non-medical volunteer was putting pressure on the stab wound in the first man’s back, and she insisted that all the blood on the other’s kaftan was from this man. She said the vomiting man was drunk and had started the fight.
As she spoke, the latter got up and staggered off. Forgetting our training, we allowed him to leave and focused on the man in front of us. After a few minutes, the fire service – apparently the only paramedics who will come to a trauma call in the camp – arrived and walked straight past us. We turned to find the vomiting man we had dismissed had staggered around the corner and collapsed from blood loss. His blood pressure was dropping and he was taken into the mock ambulance, the sicker of the two by far.
Among the tide of minor ailments, it was easy to imagine missing serious pathology, particularly when some of the basic tools for assessing a patient, such as thermometers and blood pressure machines, are faulty or unavailable. And even though there was good done – the patient sent with suspected appendicitis was taken for surgery the same evening – it seemed possible that we were doing more harm than good. The junior doctor admitted to having been almost unable to return after the first day, terrified that, with a paucity of resources and experience, she might give false reassurance to a sick patient who then wouldn’t seek proper care. Equally, the presence of NGOs like ours may have ensured that medical catastrophe was sufficiently averted that the French government wasn’t shamed into action; our presence facilitating the French government’s absence.
The French government had insisted leave in spring of this year, maintaining that the existing French provision was sufficient. But that provision lasted just a few weeks before it had to be expanded, and MSF was reinstated. In a country that has an average doctor to population ratio of 1:300, the camp’s residents were living with a ratio of 1:4,000, a situation exacerbated by the unhygienic conditions.
François Hollande, the French president, admitted that , while at the same time refusing either to improve them or to afford it the “refugee camp” status that would enable aid agencies to operate there fully. The head of MSF UK said the conditions in Calais were the in her 20 years of humanitarian work.
The Calais camp didn’t sit in the middle of a war-torn state, but on the border of two of the wealthiest countries in the world, countries which purport to be champions of human rights. The conditions and the images of its life, as well as its destruction, should serve to shame .
On our final day we ate lunch in one of the camp’s makeshift restaurants, a large tent backing on to an unexpected lake. We sat on the raised bench around a table with Ahmed. Mustafa was ill that day. Ahmed showed us photographs of his family in Afghanistan, and his Facebook newsfeed showed adverts for shops in London and flats in Bournemouth, giving an indication of his internet searches. He said he would visit us in the UK soon, but without much conviction. He had given up trying to get into the UK at night, jumping onto the back of lorries.
The demolition of the camp was overdue. Watching the bulldozers go through the rotten caravans we worked in, there was a strong sense of good riddance. A water table saturated with sewage, health clinics as likely to give you disease as cure you, and whole families living in tiny kerosene-stained tents felt beyond repair. The new centres must guarantee a basic level of living. This eviction must be an abolition of this camp and its appalling conditions, not simply a relocation to a deeper, darker part of and a more distant corner of Britain’s guilty conscience.