The Mavrovouni refugee camp near the former Moria camp on the island of Lesvos, Greece, housed approximately 3000 asylum-seekers including children as of October 2021. The camp was built on the site of a military shooting range. This study aimed to characterize the soil contaminants and assess the risk of toxic environmental exposures for children living in Mavrovouni. Methods: Samples of surface soil (0–2 cm depth; particle size < 2 mm) from eight locations inside the camp were compared with two reference samples. Soil samples were microwave digested using a mixture of nitric and hydrofluoric acids and analyzed for lead (Pb), antimony (Sb), bismuth (Bi), and other metals using inductively coupled plasma mass spectrometry. These values were compared with action limits established by the Norwegian Environment Agency for kindergartens, playgrounds, and schools. Findings: Five of eight soil samples from inside the camp exceeded Pb levels of 100 mg/kg, which is currently the maximum acceptable value of Pb in soil for playgrounds in Norway. Two sites had extreme soil Pb levels of approximately 8000 mg/kg and 6000 mg/kg. The concen-tration of Sb and Bi in the surface soil of the firing range area strongly indicated environmental contamination, most likely from previous military activity and ammunition residue that has re-mained on the surface soil. Concentrations of arsenic (As), cadmium (Cd), copper (Cu), and zinc (Zn) in surface soil were lower than action limits. Discussion: Extremely high levels of Pb, together with high levels of Sb and Bi, were identified in soil where children live and play in the Mavrovouni refugee camp. This is the first independent study of environmental contamination at this camp and adds to the limited evidence base documenting Pb exposures prior to migrant and refugee reset-tlement. On top of the multiple existing public health crises and traumas that these asylum-seeking families face, exposure to toxic ammunition residues may have profound impacts on children’s development and health for years to come.
An unresponsive paediatric patient may present a diagnostic challenge for health professionals, as rapid identification of the cause is needed to provide proper interventions. The following report details a challenging diagnosis of unresponsiveness in a refugee child. In the migratory context, observed unresponsiveness states are frequently attributed to psychologic factors, and overlapping psychiatric classifications (resignation syndrome, functional coma and catatonia) are common. Our patient fell into an unresponsive state for 6 months after witnessing a traumatic event. Diagnostic workup for multiple medical comorbidities led to surgical intervention for tethered cord syndrome. Shortly after that, the patient’s responsiveness improved, putting to question her condition’s underlying cause. This case highlights the need for a biopsychosocial approach in such cases, reflected in thorough clinical examination and diagnostic investigations. A multidisciplinary perspective and expertise proved crucial and may help in the rehabilitation of children in similar situations.
Katrin Glatz Brubakk er barnepsykolog og feltarbeider for Leger uten Grenser i Moria. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Barn går til grunne i flyktningleirene. Og det skjer på vår vakt. «Gholam» har ikke rukket å bli tenåring enda, men armene er allerede sterkt merket av at han sliter. Det er gamle arr og nye sår der barberbladet har skåret seg inn. Den lange panneluggen stikker frem under hetten og ryggen er krumbøyd som hos en 80-åring. Han ser ikke på meg og mumler alle svarene. De sirkulerer rundt de samme temaene: «Det er ikke håp for meg» og «Jeg er for sliten til å orke mer». Jeg har sett inn i utallige tomme barneblikkDessverre har jeg hørt akkurat de ordene så altfor mange ganger her i Moria, flyktningleiren på en av Hellas vakre ferieøyer. Jeg har sett inn i utallige tomme barneblikk. Uten vitalitet, nysgjerrighet og vitebegjaerlighet. De har ikke mer kraft. I 2020 behandlet vi 50 barn med alvorlig og akutte selvmordstanker, en del av dem med reelle forsøk bak seg, noen så unge som åtte år gamle da de prøvde å henge seg. Har man først holdt hendene til disse barna og prøvd å hjelpe dem til å gjenfinne livsgnisten, glemmer man det aldri.
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