Refugee Camps in Greece: Conditions in Reception Facilities on Gender Perspective

Abstract

An attempt to objectively and comprehensively record the modern living reality of asylum seekers based on their own perspective and the views expressed by the academic and administrative staff employed at accommodation structures has been made. Emphasis is placed on women, and the common problems they encounter regardless of gender, but also on individual differences identified between female and male asylum seekers. Therefore, the present paper focuses on the living conditions in temporary accommodation centres and on the existing social relationship structures being shaped at such centres, with special emphasis on the dimension of gender (single women, single mothers). The aim of this paper was, then, to collect documented material and evidence on current practices concerning specific vulnerable groups, on the grounds that such groups still remain in obscurity to some extent and their survival is hugely dependent on individual initiatives and occasional assistance received. Our motive was the lack of comparative data, drawing attention to specific vulnerable groups in temporary accommodation centres and hostels in Athens and Lavrion and to their living conditions. Consequently, the realization of this research, for the implementation of which a combination of quantitative and qualitative methods has been employed, is considered to be a minimum prerequisite for the creation of a humanitarian policy addressing refugees in Greece, as a Member State of the EU. The findings highlight the concerns about the service quality including: (1) the lack or variations in the frequency of funding, (2) the absence of women’s participation in decision-making as their responsibilities residing in these centres usually fulfill their “stereotypical” roles: child care, cooking and cleaning, (3) the difficulties in recording/identifying specific incidents are mainly due to a lack of knowledge and a lack of staff, which is typical of the centres surveyed by Doctors Without Borders in Europe, but also due to the fear overwhelming violent victims, preventing the disclosure of facts and contributing to the maintenance of this bleak picture of the victims. (4) the need for psychological support due to problems that can become more severe after long periods of waiting at centres due to the uncertain outcome of asylum procedures hindering their adjustment. (5) the lack of childcare provisions inhibits employment for women. In addition as the vast majority of female refugees are poorly educated and cannot easily find a (legitimate) job—until after a long stay—they basically get employed at the informal home-based work sector and/or at other marginalized sectors of the labour market. The present research may contribute to the: (a) provision of a clear-cut picture of the gender dimension within the refugee context, (b) identification of the female refugee population’s needs and the detection of the problems they encounter, (c) the evaluation of the effectiveness of services and structures supporting refugees and (d) exploitation of results and findings for policy design.

1. Introduction

A key finding with reference to refugee and asylum seeker reception centres, undoubtedly, involves the location of such centres and, by extension, the place destined for their temporary settlement in our country. A triple typology has practically been induced: to the present moment, urban, semi-urban and rural centres are present. The criterion for the first and third group is rather obvious, provided that both the “city” and the “rural area” respectively, as socio-cultural contexts of living within traditional conceptual approaches of the terms, presently constitute widely acknowledged matters. On the other hand, suburban areas are those whose population does not exceed the number of permanent residents. The National Centre for Social Solidarity in Thessaloniki and the Sperhiada centre used to be active in the past, as well as the Lavrion centre, constituting one of the structures where our research has been conducted, embody three typical cases rendering the identified groups [1] more concrete.

Centres falling under the first group, are, by necessity, all housed in blocks of flats, old buildings, which are considerably damaged and lack maintenance provisions; they are devoid of special areas for joint activities and arranged in multiple layers that render their internal functionality problematic. Centres included in the second group are usually located in open spaces fronted by building perimeter and include space in the courtyard or adjacent sites for exercising collective action; they also encompass special areas allotted to the administrative and other departments of the centre, a separate classroom for children or adults, clinic and so on. The infrastructure of centres being part of the third group, however, is not elaborated on within the context of the present paper and therefore a comprehensive reference to it was deemed unnecessary.

It is worth mentioning that, under the restrictive measures taken by the European Union, existing centres are transferred from urban to rural areas, close to their external borders or new centres are established in them. Such measures are also roughly applied by the new member-states of the European Union such as Poland, where refugee centres are founded in its sparsely populated southeastern side (Pontlach), Slovenia and Lithuania [1].

A diversity of heterogeneity categories is evident in centres, comprising ethnic heterogeneity (with reference to the nation-state), political (political differences, given that political refugees are primarily involved), cultural (different culture and civilization), social (directly related to legal and economic heterogeneity) and economic, legal heterogeneity (resulting from the legal recognition and exemplifying an existential character), ascribing the corresponding status to refugees. Collective heterogeneity can also be witnessed (with the family serving as a central match point, e.g. a single-parent family or another type of grouping, e.g. coming from the same village) and individual heterogeneity (refugees are usually sorted by gender or age). The last heterogeneity category is sociologically explained by reference to the “ascribed status” (e.g. sex—woman, race—black) and the “achieved status” (e.g. education— lawyer) [1].

Security provision should be a prioritized service offered to refugees at each centre. The latter feel very insecure and are taken over by feelings of persecution; they fear the unknown, which is justified considering their living conditions in their home country and their attempt to escape from this country. These concerns are related to their effort to preserve their “mental health” and health “care”, and should be provided at these centres. Therefore, the ground should be laid so that further health problems do not emerge and unpleasant situations can be prevented (e.g. preventive medicine-medical examinations).

Furthermore, centres’ contribution to finding a job, and thus to providing the potential for a dignified living, is critical. The provision of legal support by the centres is imperative, given the insufficient knowledge of the language, ignorance of the prerequisites demanded by the bureaucratic certification system, the multiple endogenous pathogenic nature of the Greek bureaucratic system, the feeling of insecurity among refugees and the inability to move. The centres’ staff contribution may lead to the acquisition of one’s legal status. Besides, the assistance provided by psychologists and specialized personnel could help resolve refugees’ individual and family problems and adopt a more positive approach to this population.

Another significant provision could involve the interconnection of refugees with the world outside the Greek territory through the use of mobile phones to communicate with people in their families or via satellite television to learn what is happening in their country of origin.

Finally, learning the Greek language is a key concern for refugees and ensuring classrooms and teaching staff is remarkably crucial. Likewise, the provision of opportunities for cultural expression, religious worship and entertainment are also considered fundamental.

In Greece and less often in the rest of Europe, two types of administrative detention centres can be identified. More specifically, we come across:

• closed centres for illegal immigrants who are under administrative detention,

• open centres for asylum seekers (usually people who apply for asylum, while already detained in closed centres, do not move to open centres but remain detained in the closed ones instead).

In relation to the number of detention centres (closed) in Europe, intended for illegal immigrants under administrative detention in Morocco, Belgium, Malta, Greece and other countries, the number of reception centres (open), as often referred to, is not huge.

Open centres to accommodate Third World nationals are usually part of the package of measures for asylum seekers, or more generally for the Third World nationals requesting international protection.

The Doctors without Borders [2] research revealed the existence of different types of open centres for asylum seekers in some countries, displaying the following functions:

• reception: detection of the category the foreigner belongs to, initial examination of acceptance in the process of applying for asylum—reception and accommodation of asylum seekers during the asylum procedure.

• return preparation for those whose application for asylum has been rejected.

In this way, in Denmark, for instance, asylum seekers are initially sent to reception centres, then to accommodation centres and eventually to return centres in case their application is rejected.

The centres are located in different places, but while this research was being conducted, several ones were reported to be found in relatively isolated areas: some industrial areas on the outskirts of cities, but also in the suburbs, in places that are difficult to access. In many countries, geographic isolation (centres located in sparsely populated areas, even in forests) and difficulties in accessing some of the centres (extremely poor public transport) constitute real problems for asylum seekers.

As being the case for closed centres, a number of open centres were operated in existing facilities that were “recycled” to accept asylum seekers. Problems arise in readjusting the use of facilities, designed for other uses that sometimes differ greatly from social housing ones. Except for delaying asylum seekers’ integration into the host society, distant centres geographically create the feeling of being marginalized and abandoned, thus not meeting the demands of a dynamic individual and collective approach.

The concentration of a large number of asylum seekers in large centres for long periods of time appears to trigger problems such as conflictual relations, devoid of humanism, both within centres and outside of them, considering that there are countries whose indigenous population is hostile to the concentration of foreigners in their country, due to its not being familiar with people of different origins and cultures.

Numerous cases of psychological depression have, therefore, been observed to a greater extent at distant and/or large centres. On the assumption that people can be kept in reception centres for several months, or even years, physical conditions can have a significant influence on the quality of the residents’ lives. When these conditions are not adapted to their needs or deteriorate, they can damage personal or family relationships irreparably and create or exacerbate vulnerable situations due to problems comprising lack of privacy, violence and so on. Excessive restrictions imposed on the freedom of movement encourage residents’ withdrawal and isolation, who may feel that they are kept unfairly “locked”. This is considered to be an additional obstacle impeding residents’ smooth integration into the host society.

Throughout the studies conducted [3], the fact that women require special attention because of their greater vulnerability to different types of violence within centres has been highlighted. The issue of domestic violence has already been mentioned. This type of violence is exceptionally difficult to identify, as it is aided by the lack of privacy while the way of living at the centres due to overcrowding and other factors appears to cause tension and multiple problems. The difficulty emerging in identifying incidents of violence and sexual abuse against women was reported throughout our research. Single women, living in extremely vulnerable situations, are greatly exposed to various forms of abuse, especially sexual ones. Such risks were observed in countries such as Hungary, Poland and Slovakia. The risk of violence in general and the risk of violence against women in particular increases as a result of the large number of single, not engaged in activities, and isolated men at these centres.

Conducting a comparative review of the reception status and conditions for asylum seekers in selected European countries, it could be argued that attempts to harmonize the reception system for asylum seekers in European countries, could definitely be attributed to existent, significant differences that can decisively impact the distribution of “asylum demand” to various Member States of the European Union. However, such divergences and disparities cannot be utterly eliminated, since internal conditions, geographical and transportation data, the standard of living, the level of social benefits, unemployment problems, problems related to crime/public safety and so on vary greatly in different regions of the continent.

With reference to Greece and based on research carried out by the Doctors without Borders [2] it can be concluded that immigrants’ living conditions at the detention centres are unacceptable, hygiene and the distribution of relief items are inadequate, there is a lack of information, interpretation and medical monitoring that complicate detainees’ lives. However, the situation is expected to improve as a result of new centres’ opened in areas, such as Amygdaleza, Corinth and in other parts of Greece, provided, of course, that the conditions and procedures for foreigners’ placement in these areas will be appropriate.

As regards asylum seekers’ accommodation structures, which were thoroughly investigated by Tsovili and Voutira [3], it is indicated that there are no provisions for psychological care and medical examinations, as well as legal support. Training is essentially confined to seminars teaching the Greek language while job finding is not actively encouraged. Furthermore, there is no participatory approach to guests and none of the centres has presented awareness-raising programs on intercultural issues. Leisure activities are also limited and the guests’ psychology is poor due to insecurity and anxiety while no restrictions are exerted on their exercising their religious duties and the freedom of movement. The main problem is the lack of stable funding, which generated changes to service quality.

As for the specific problems women are faced with, the maintenance of their stereotypical roles, involving lack of participation in decision-making and limited access to higher education and vocational training programs, is observed. Further, women’s specific health needs are only met when requested and their employment is not actively promoted.

The data collected for the current host practices relating to single women and female-headed single-parent families hosted at the:

1. Temporary Accommodation Centre for Asylum Seekers in Lavrion, under the auspices of the Greek Red Cross,

2. Medecins Du Monde hostel,

3. Roof program (autonomous pensions) run by the Praxis NGO,

4. newly established Refugee Shelter of the Arsis NGO and

5. recently founded E.K.Po.S.P.O. Nostos Hostel during the period between November 2011 and March 2012.

The research hypotheses for the questionnaires were formulated based on the research objectives, the relevant literature and the knowledge and experience we have acquired as regards the organization and operation of asylum seekers’ temporary hosting structures. Two central research hypotheses have been proposed with reference to the questionnaire addressed to the professionals (structures’ academic and administrative staff):

1. The Guiding Principles of the UN High Commissioner for refugees on women’s safety issues (e.g. spatial arrangements) are applied but there is a lack of counseling/psychological support within all structures; participatory approach to asylum seekers and adoption of intercultural programs are non-existent.

2. Lack of funding, as a major problem structures are faced with, involving less quality services to asylum seekers and minimal provisions for people in need of financial assistance.

2. Research methodology

The research methodology followed comprises a set of research tools, both quantitative and qualitative. The qualitative and quantitative methods share common ground in that the collection of accurate information on social phenomena is attempted but tends to differ in terms of the type of information and the way the latter is being gathered. The combined and complementary use of quantitative and qualitative methods is considered to be the most effective methodological approach towards achieving a thorough presentation and delineation of the social reality dimensions.

There was a combination of quantitative and qualitative methods, involving desk research in libraries and archives, fieldwork comprised of qualitative data collection by in-depth interviews and quantitative data collection with face-to-face interviews and structured questionnaires to be completed by the interviewees (centre management, specialized staff and asylum seekers, regardless of gender) within a time frame of 15–20 min. By means of combining open and closed-ended questions with quantitative and qualitative data analysis respectively, an effective and comprehensive approach towards social reality was attempted. Furthermore, through reconciling and combining two research methods, the in-depth interviews and the questionnaire technique—tools whose exploitation was compelling as already mentioned—have been used as part of the qualitative and quantitative approaches respectively. The in-depth interviews conducted before the quantitative interviews significantly contributed to the preparation of the structured questionnaires, which had to be stated in alignment with the particularities of the population in question. In addition, my personal involvement as a researcher and as an interpreter prevented this research work from becoming a mere compilation of typically completed questionnaires. After getting the permission of each centre, the interviews were conducted in the morning and the afternoon at the centres of Accommodation using random sampling selection of the refuges being present on the days of the visit, with a view of involving the largest possible number of residents during the period of 22/11/2011 till 20/03/2012. Each of the aforementioned techniques entails a host of advantages and disadvantages but their combined use was considered to be most effective.

The population number i.e. the total number of asylum seekers accommodated at the five centres of the research, during the period of Nov 2011–March 2012 amounts to 308 adults (66.5% males, 33.5% females) and 162 children. The total number of professionals employed by these centres is 55.

The size of sample comprised 207 asylum seekers, 89 females (42.99% and 118 (57.01%) males, coming from countries, such as Turkey, Afghanistan, Iraq, Iran and Syria, as well as 37 professionals (scientific and administrative staff) of the structures participating in the research. Participants’ ages ranged from 18 to 46 years.

The sampling technique applied was stratified random sampling, where the population under study was divided into two relevant subgroups/strata (guests hosted, professionals) and from each subgroup the sample was drawn randomly.

The research tools employed involved two differently structured questionnaires. In order to best cover different parameters and attitudes on the quantitative questionnaires, the qualitative method of three in-depth interviews preceded. With regards to the structured questionnaires, the first one was to be completed by the guests hosted at the centres and shelters and it included initially 22 questions all closed except the last, with a significant number of multiple choice questions, questions of scale. Specifically to investigate the needs of women were added four more open-ended questions, were addressed only to women.

The questionnaire addressed to the target group was structured on the following themes:

• The social and economic characteristics of the respondents.

• Their experiences in migration and arrival in Greece.

• The living conditions of women and men asylum seekers (assistance and protection from the centre and from NGOs, sense of security, nutrition issues, health and leisure) in order to make comparative approach.

• The employment of asylum seekers and their education.

• The perceptions and attitudes of asylum seekers about their life in Greece and the conditions prevailing in Greek society.

Similarly, the questionnaire addressed to the administration and clerical staff of the centre, which was answered by 37 professionals, included 29 questions, all closed except one, with a significant number of responses YES/NO and scale questions. The open-ended question asked respondents to report the three most common problems encountered in the structures when it comes to single women and women heads of families.

The questionnaire addressed to professionals is structured on the following themes:

• The benefits offered to the target group and the obligations of the guests.

• The mapping of staff knowledge about the demographics of the target group and the activities carried out and needs to be met.

• The opinion of professionals about the risks and problems faced by women asylum seekers and the difficulties of their own.

The completion of the questionnaires did not necessitate the inclusion of personal data in order to ensure participants’ anonymity. To create case-appropriate research tools, the study of the UNHCR questionnaire, following the design of the UNHCR Guidelines on the Protection of Children and Women Refugees, was deemed necessary. Accordingly, the UNHCR interview form, whose design resembles the one of the UNHCR questionnaire, was taken into consideration while creating the interviews content.

The grounds for selecting the specific tools vary. Our decision has primarily been founded on: firstly, it’s being a weighted, valid and reliable tool; secondly, it’s being used in similar studies; and thirdly, the provision of a wealth of information in areas related to the content of the current research.

3. Findings

Data for our analysis comes from 207 questionnaires completed by adult asylum seekers, 89 females and 118 males as well as from 37 questionnaires completed by professionals at five temporary accommodation centres for asylum seekers: at the Lavrion centre, at the Doctors of the World, Nostos, Praxis and Arsis NGOs. At the same time, professionals employed at these centres—administrative and scientific staff—were interviewed on the issue of refugees’ way of living at the abovementioned structures.

Specifically, the issue of space was given prominence at the Lavrion centre, as precast settlements with container houses have already been set up at a location, named Neraki, providing the bare essentials for dignified living (i.e. air conditioning, kitchen and toilets). Refugees residing in the existing facilities at the Lavrion centre do not wish their being transferred at the time being, for they consider the town to be well out of reach while their representatives have already visited the new facilities and put forth their demands (e.g. exterior lighting, fencing and so on). Based on the existing planning schemes, 80 men are to be transferred to the new settlement premises. The existence of a public transit service (public bus) every half an hour to facilitate their access to the city centre was also accentuated. At the existing building, Kurdish and Afghan asylum seekers reside in separate rooms, while single men and women live separately from their families. At the same time, the issue of stable, reliable and flexible funding was raised, in collaboration with social services, as the central problem facing the centre. In most cases, variations in financing bring about variations in service quality. The delay in granting political asylum along with the termination of welfare benefits and employment opportunities for refugees was also acknowledged. Finally, the insufficient staff catering for asylum seekers’ needs, embodies an additional adversity.

The most significant problem all centres are confronted with involves the lack of funding. With reference to the Arsis centre, the incorporation of educational activities such as learning the Greek language, supporting teaching for preschool and school-age children, opportunities for creative play in children etc. were reported. The majority of such activities are performed on a voluntary basis in consultation with stakeholders and the municipality. A range of services including legal support, updates received from employment counselors, and psychological support both inside and outside the centre in direct contact with professionals are offered while the role social services hold on families’ responsibilities-organization, medical issues and, in general, the satisfaction of refugees’ needs is of tantamount importance. Recurrent problems encompass the absence of permanent doctors resulting in medical care being offered at hospitals with interpreters’ unavoidable mediation and the coverage of guests’ fundamental needs or provision of sanitation supplies through the centres’ own resources and donations.

The problem emerging from the lack of funding is discussed with the Doctors of the World staff, along with the issues of the provision of relief items and the termination of welfare benefits. Guests are temporarily hosted in the Doctors of the World centre for a short period of time (2–4 months). Families residing in the facilities of the same centre, are placed on a different floor from the one single men or men suffering from problems are staying at (victims of torture, damaged health); there is a specially designed space destined for creative activity (Greek language courses, craft workshops and so on). Refugee children attend schools situated in the area (cross-cultural).

At the Nostos centre the lack of staff (auxiliary, scientific) is reported as a major problem and refugees’ participation in the weekly scheduled work of the centre is also noticed. The Nostos centre provides legal support to refugees.

At the Praxis centre socially vulnerable women take precedence over the rest of the guests while cases of psychiatric diseases and unaccompanied minors cannot be attended to. The integration program adopted is biannual and rests on learning the language and seeking job opportunities. Single-parent families from Africa and men suffering from serious health problems are also hosted in the centre. Creative activities include individual and group sessions; the centre’s spatial arrangement is dependent on the guests’ different features (sex, country of origin, etc.). Praxis offers accommodation but meals are not provided since the independent survival and activation of refugees is set as a strategic goal by the centre. Donations for bare necessities are crucial for all centres, including Praxis. The polyclinic inside Praxis and hospitals offer their services whenever medical issues emerge. When medical incidents turn up at hospitals, the problem of not having an interpreter becomes apparent.

Our initial hypothesis is that hosting structures share common problems, such as stable funding, leading to staff strikes—similar to the one the employees at the Lavrion centre went on due to long-term deprivation of their legal earnings—or hunger strikes that asylum seekers at the same centre embark on, is verified. Besides, staff shortages and lengthy asylum procedures hold the centres’ work back.

The centre’s staff was encouraged to respond to the same questionnaire, containing a set of 32 open and closed-ended questions. The total number of respondents was 37, including 7 from the Doctors of the World, 6 from Nostos, 9 from Praxis, 7 from Arsis and 8 from the Lavrion centre.

With reference to the recruitment/training frequency, women hosted in the structures are employed as staff members during program design and implementation so that their participation in issues of their immediate interest can be prompted within the participatory approach. 46% of the respondents replied that they rarely recruit/educate women hosted in the centre (Figure 1).

Figure 1.

“How often are female of asylum seekers recruited/educated as staff members of the accommodation centres in order to participate in the design and application of accommodation programs?” (Footnote question #2) Sample = service provider (professionals).

It can be argued that women’s participation in decision-making is basically non-existent at the centres where the present research has been carried out. Women’s responsibilities residing in these centres usually fulfill their “stereotypical” roles: child care, cooking and cleaning. Traditionally, women are not encouraged towards decision making and holding central positions in other walks of life that are equally important, encompassing their education or their children’s education, professional opportunities, etc.

As for the respondents’ view on the extent women hosted in the structures enjoy the same freedom as men, especially single or single mothers, 86% of the respondents provided a positive answer while negative responses to this question were recorded at the centres of Lavrion and Arsis (Figure 2).

Figure 2.

(Footnote question #3) Do female asylum seekers, especially single or single mothers hosted in the structures enjoy the same level of freedom as males? Sample = service provider (professionals).

Therefore, no restrictions on both sexes’ freedom of movement are observed, a fact that could kindle the feeling of isolation and thus hinder asylum seekers’ integration into the host society.

As regards spatial arrangements at hosting structures to ensure that single women and mothers are well protected and safe, 86% of the responses of the staff gathered were positive while negative answers were only recorded at the Lavrion centre (Figure 3). The results demonstrate that the UNHCR guidelines are applied in support of women’s safety.

Figure 3.

(Footnote question #6) Do spatial arrangements applied at the accommodation structures make female asylum seekers hosted at the centres feel safe and well protected? Sample = asylum seekers.

Moreover, as evident in Figure 4 based on the law percentage of reported incidents, there are several difficulties in identifying the incidents of violence, such as sexual harassment against female asylum seekers, mainly due to lack of knowledge and a lack of staff, which is typical among the centres surveyed by the Doctors Without Borders in Europe, but also due to the fear overwhelming violence victims, preventing the disclosure of facts and contributing to the maintenance of this bleak picture of the victims.

Figure 4.

Question #7: At your knowledge, which one, if any, of the following incidents of violence against female asylum seekers has been identified/reported to your centre? Sample = Service provider (Professionals).

To the question concerning the types of women assumed to be more susceptible to prostitution or trafficking, the results generated, after having been qualitatively and quantitatively processed, are presented.

From the responses compiled, the highest percentage of respondents felt that single, underage (50%) women are more susceptible to prostitution. Single women with or without children, Afghan and African women were recorded to be at risk (it needs to be mentioned that this response was only recorded at Praxis, hosting Afghan and African women).

The initial hypothesis that single women living under exceptionally precarious conditions, are principally exposed to various forms of abuse, especially sexual one is verified. These risks are also mentioned in the Doctors without Borders [2] research for countries such as Hungary, Poland and Slovakia.

With reference to instances of single women or mothers seeking help to face psychological and adjustment problems, serious psychological problems stemming from torture or sexual abuse, and problems due to xenophobic and racist reactions, it is revealed that:

As far as the request for treatment for psychological/adjustment problems is concerned, the majority of respondents replied that such instances are a recurrent phenomenon (54%, Figure 5).

Figure 5.

Question #15: At your knowledge, which one, if any, of the following type of psychological type of assistance has been recorded after a request from female asylum seekers hosted at the centre? Sample = 37 Service providers (Professionals).

In regard to the request for treatment for serious psychological problems stemming from torture or sexual abuse, the majority of respondents replied that the appearance of such instances is quite regular (38%, Figure 5).

In regard to the request for troubleshooting these xenophobic and racist reactions the majority of respondents replied that such instances are rare (43%, Figure 5).

As a consequence, our initial hypothesis, assuming that asylum seekers, especially women, are in need of psychological support due to problems that can become more severe after long periods of waiting at centres and due to the uncertain outcome of asylum procedures hindering their adjustment, is confirmed.

Professionals were, then, urged to indicate the reasons for women’s refusal to visit a male doctor and identify the ways they handled such a phenomenon. Their responses were qualitatively processed and essentially involved the cultural background, fear of the male sex and shame. As for effective management ways, the latter encompass visiting a doctor outside the centre, persuasion procedures and appointments with female doctors and avoiding granting the request.

Cultural background emerges as the principal reason for refusing to visit a male doctor at 74% (Figure 6), while the typical approach towards handling refusal entailed female doctor appointment arrangements (54%). Not meeting the request only comes as a response from a single respondent at the Lavrion centre whereas fear of the male sex was only provided by a single respondent at the Nostos centre. Besides, as regards the Lavrion centre the most notable answers on handling the phenomenon were divided between the response provided by the external doctor and persuasion procedures (33% for each response, Figure 7).

Figure 6.

(Footnote question #17) What is the reason female asylum seekers hosted ATE centres avoid/refuse to visit a male doctor? Sample = service provider (professionals).

Figure 7.

(Footnote question #18) What measures have been employed by centres to assist female asylum seekers who refuse to visit a male doctor? Sample = service provider (professionals).

Responses are principally related to different cultures and the ways disease is approached by immigrants and refugees, as well as to the different perceptions of the professionals’ role in providing health services. Cultural differences among ethnic groups suggest that people perceive their physical and mental health in a different manner, potentially justifying differences in the exploitation of health services by immigrants. Quite often patients’ religious and cultural identity is not respected. For instance, medical incidents occurring in Muslim women should be treated by female doctors or nurses. However, all necessary measures to meet women’s demands appear to be taken at the structures in question.

In addition, as far as provisions for looking after working mothers’ children are concerned, 76% responded that there are no childcare provisions while positive answers were provided by Praxis and Arsis. Through correlating childcare welfare with employment frequency within the structure, the existence of welfare in the cases of women who have never or rarely worked at the centre, as suggested by the respondents, was apparent (Figure 8). Therefore, the hypothesis that the lack of childcare provisions inhibits employment is confirmed.

Figure 8.

(Footnote question #23) Do centres provide childhood provisions for working mothers and in what frequency? Sample = service provider (professionals).

As to the educational level of the majority of women hosted in the centre (university, secondary, compulsory education, illiterate, other), 2,7% of the Professional respondents maintain that only “few” women have obtained university education, 56.8% support that a limited/rare number of women have received secondary education, 37.8% suggest that several women have received compulsory education; 89.2% claim women to be illiterate and only 8.1% of respondents contend that a limited number of women have reached another education level (Figure 9).

Figure 9.

Question #24: How many female asylum seekers hosted at centres, have received a University, a Secondary, a Compulsory none/Illiterate or other education level? Sample = 37 Service providers (Professionals).

It is, thus, accepted that the vast majority of female refugees ([3]: at a higher percentage than the one possessed by men refugees) are poorly educated, and cannot easily find a (legitimate) job—until after a long stay—basically get employed at the informal home-based work sector and/or at other marginalized sectors of the labour market. This is becoming more complicated due to bureaucratic, lengthy and costly recognition procedures of their Greek language knowledge, and due to the absence of stable skill certification schemes.

However, at this point it is worth noting that a Multicultural Centre was run under the auspices of the Red Cross at the Lavrion centre, hence contradicting the research of Tsovili and Voutira [3], which highlights the absence of intercultural sensitivity.

The last question asked to both men and women is about who they think has the most problems. From the respondents’ answers, which were qualitatively processed, three options emerged, men, women and both in terms of the problems they face.

In particular, the answer that women have more problems was the most frequent answer.

As for those who said that men have more problems, the highest percentage of responses was from men. As regards those who answered that women have more problems, the highest percentage is again recorded among men, while as regards those who answered that both have problems; the highest percentage is again recorded among male respondents (Figure 10).

Figure 10.

Question #25: Who is facing the most problems? Sample = asylum seekers.

4. Discussion

Research conducted by the Doctors without Borders [2] revealed the existence of different types of open centres for specific functions in some countries. In the meantime, no distinction has been drawn between reception and accommodation centres in Greece, as in other European countries.

It was then confirmed that stable, reliable and sustainable funding, as argued in the research of Tsovili and Voutira [3], as well as the lack of consistent funding bringing about changes heavily impacting the quality of services provided, are central issues all centres keep encountering. Moreover, the termination of welfare benefits for a long period of time and delays in asylum recognition procedures, perplexing staff lives in the structures, constitutes another critical issue.

As regards the participatory approach adopted within the framework of the centres’ daily operation, it was found that the former is functional at an initial stage at several structures, while in others, including the Lavrion centre, it is not applied, especially in terms of participation in food preparation, hence confirming the conclusion of non-participatory approach within the centres’ daily function, drawn in the research of Tsovili and Voutira [3], thus complicating asylum seekers’ lives and leading to exclusion at the same time.

The hypothesis that no centre has presented awareness-raising programs on intercultural issues or study courses, aimed at getting all guests involved and contributing to the fight against social exclusion, is refuted since a Multicultural Centre under the auspices of the Greek Red Cross was in operation until mid-2011 at the Lavrion centre.

Furthermore, women’s participation in decision-making is almost non-existent at the centres examined, a fact that should not only be attributed to the lack of encouragement offered by the structures but also to each nationality’s culture, verifying the initial hypothesis and the UNHCR research conclusion, along the lines of which women residing in the centres fulfill their “stereotypical” role: child care, cooking and cleaning; nonetheless, they are not encouraged towards decision making and holding central positions in other walks of life that are equally important, encompassing their education or their children’s education, professional opportunities, etc.

The hypothesis that the lack of childcare services throughout the day largely prevents single women from attending language courses or other training and educational programs is confirmed, except for the Arsis NGO, where such a service is somewhat available.

Divergence of opinion between professionals and refugees as to whether women’s specific health needs (gynecological, psychological) are only satisfied upon request, that is, when a woman residing in the centre is in need of a doctor or nurse, as the professionals mention that preventive control is carried out whereas the refugees support that this control takes place only in the event of being requested by women. Opinions are also divided as to the availability of informative material or training courses on health and hygiene issues.

At some centres, the existence of non-specially trained and soundly qualified in asylum issues (legal, social and psychological) staff but also the lack of knowledge of the refugees’ actual needs and even difficulty in identifying violence and sexual abuse incidents have been revealed.

Controversy has arisen between refugees and professionals interviewed as to the spatial arrangements made and safeguarding women at the structures. The professionals responded that arrangements have been made so as to ensure women’s protection but female asylum seekers maintain that they do not feel safe and that they face more problems than their male counterparts.

At the Lavrion centre both male and female asylum seekers are faced with the same problem, involving their reaction to being transferred to a centre just outside the city. Besides, it is confirmed that in a suburban area, such as Lavrio, women’s employment/training as staff members is rare in comparison to employment opportunities offered at structures within urban centres, such as Athens [1]. The fact that employment opportunities are scarcer for female asylum seekers in semi-urban centres, such as the Lavrion centre, while the situation is the same for men regardless of their location, is also verified.

According to the staff at the structures examined, rarely has a female asylum seeker run the risk of being led to prostitution or trafficking; consequently, our hypothesis is refuted. However, as hypothesized, single women or minors are more susceptible to the risk of prostitution or trafficking. This is true for African and Afghan women at a particular structure, verifying the hypothesis of Foster, Micklin, Newell, Kemp [4] who argue that women refugees constitute a high-risk group for violence, sexual abuse and rape. A considerable amount of women are being abused in the host country or are victims of forced prostitution (trafficking), while others have already experienced a similar personal tragedy. As stated in Mac Williams [5], women coming from countries with political or social problems, experience high levels of stress and undergo “triple victimization” by the perpetrator, the authorities (e.g. the police) and the state or other bodies, whose attitude lessens or downgrade the importance of violence episodes. Ellseberg et al. [6] report that the war in Nicaragua has led to a long history of physical violence against women, which constitutes a predictor of the victims’ subsequent emotional distress and psychological problems.

Female asylum seekers, sometimes, report experiencing physical assault, rape and threats to the staff, hence verifying our initial hypothesis; nevertheless, they have never or rarely mentioned kidnapping, provision of sexual services in exchange for receiving documents or other assistance, prostitution, child trafficking, violence associated with military authorities and finally, the mention of sexual harassment is almost unheard of, partly confirming our hypothesis.

It has been observed that women do often face psychological and adjustment problems, serious psychological problems usually as a result of torture or sexual abuse and rarely as a result of xenophobic and racist reactions. Some illustrative cases involve those of women suffering from psychological problems as an aftermath of sexual abuse and torture by military authorities during their escape, domestic violence and murder of their family members.

Furthermore, at all structures counseling services and psychological support are provided and are often used by asylum seekers while there is provision for women’s special health needs, related to gynaecologic control and pregnancy. In addition, updates on health problems can be provided according to the structures’ staff, contradicting our hypothesis.

It is confirmed that women often refuse, with minor deviations among structures, to visit a male doctor, primarily because of their cultural background and different cultural values, but also due to the fear of the male sex and feeling ashamed. On the social workers’ part, the typical way of handling women’s refusal to visit a male doctor involves setting an appointment with a female one, although persuasion procedures hold an important role in this research, especially at the Lavrion centre.

At all structures Greek language courses are provided often in collaboration with other NGOs; nonetheless, according to the staff at the structures, women enjoy equal access to educational or other programs, refuting the hypothesis that women and children do not generally have access to higher education or vocational training. Additionally, while conducting the present research, the poor educational level of women residing in the structures, as opposed to that of men, is revealed.

Finally, based on the views expressed by the staff, women, at all structures, are informed about their rights along the lines of international, European and national law structures according to the research of the Doctors Without Borders [2] no sufficient information is offered to newcomers about their legal status, the detention system and their rights, as well as the opportunity to apply for asylum at detention centres.

5. Conclusion

The present research was conducted at asylum seekers’ accommodation centres during the period between November 2011 and March 2012 and has led to a series of interesting conclusions about the gender dimension in the investigation of asylum seekers’ needs.

From the perspective of the administrative and scientific staff of these structures, the lack of funding that perplexes the structures’ financing, the lack of staff to some extent, the termination of welfare benefits and delays in asylum procedures constitute major problems all centres, both urban and suburban, are faced with.

The staff was not fully aware of the exact number of guests, the existence of specific provisions for women’s special health needs and the free exercise of their religious duties. It was also reported that asylum seekers are rarely hired/trained in programs that benefit them directly and therefore the latter do not participate in decision-making processes.

At the Lavrion centre, women hold positions in active leading structures (such as the PKK). On all structures’ premises, spatial arrangements have been made to ensure women’s protection, who enjoy the same freedom as men and equal access to the bare necessities of life. The professionals do not consider women residing in the structures susceptible to prostitution and trafficking. However, minors, single women and women of African and Afghan origin run a higher risk. Additionally, women admitted to facing physical attacks when escaping their homeland.

Provisions for women’s special health needs are limited to gynecological control and pregnancy but updates and informative material on hygiene issues are provided. For women not wishing to visit a male gynecologist, a visit to an external, female doctor is rescheduled. In addition, counseling services are available at all accommodation structures and are often used by women, who face a host of problems and adjustment difficulties, including psychological problems due to sexual abuse and torture by military authorities.

Moreover, child custody services are not available at the majority of hosting structures, yet Greek language courses are provided. Unemployed, poorly educated women enjoy equal access to educational programs as men. There is freedom in religious expression and women’s meetings take place within the context of social groups. Their primary concern revolves around taking care of their children.

Finally, NGOs’ role in providing humanitarian assistance and support is fairly positive with the majority of respondents suggesting that help in everyday life stems from donations.

In conclusion, it could be argued that the structures’ role is extremely important in terms of providing assistance, counseling/psychological support, bare necessities and accommodation but the lack of knowledge evident in a small but significant proportion of professionals, the lack of childcare and work promotion services, as well as limited financing and the insufficient amount of staff employees need to be taken into consideration and addressed through new policies and proposals to the structures and the Greek state.

A number of critical suggestions associated with institutional reforms and services are mentioned below. The Greek state (and in particular the Ministry of Public Order and the Ministry of Health and Welfare) should:

• Take the minimum standards for asylum seekers’ reception into consideration and turn them into international law along the lines of the EU Directive on the minimum asylum seekers’ reception standards applying to Member States.

• Sign, validate and then implement European conventions and European Commission standards, while ensuring that detention procedures and asylum seekers’ reception comply with internationally recognized standards and the Greek law.

• Ensure compliance with international instruments for the protection of human rights. To further ensure the provision of statutory benefits such as the right to food, medical care, legal aid and access to interpretation services for all asylum seekers.

• Ensure the implementation of continuous updating procedures at a national level: keeping updated and educating the centres’ staff on admission criteria at all entry points and reception centres.

• Provide systematic assessment and evaluation of reception conditions at the entry points of all detention and reception centres in Greece.

• Demonstrate particular interest in the growing number of African and other single female asylum seekers. Their needs should be continually evaluated and they should be supported by any means so that sexual exploitation and trafficking can be prevented.

• Adopt an approach focusing more on sex and age, during evaluation procedures and the provision of services for all asylum seekers, and on the principle of participation while exercising needs assessment.

• Recruit trained and soundly qualified in asylum issues (legal, social and psychological) staff at all reception and detention centres. Police authorities should only be accountable for ensuring security at detention centres and for receiving asylum-seeking applications; they should be properly trained to deal with asylum seekers at detention centres.

• Have the thousands of pending asylum applications settled by the newly founded Asylum Service, which should be staffed by experienced professional personnel. Refugee Committees should operate as a supplementary crisis body.

Special recommendations addressed to the Greek Government and NGOs running reception centres (minimum standards and related issues):

• Establish minimum operation standards for all centres: provision of accommodation, food, recruitment of a social worker, nurse, psychologist, access to education, entertainment, legal and health services (including dental care provisions).

• Establish structures, wherever a shortage of custody services is identified in order to unburden parents, especially mothers and allow them to claim jobs and seek learning opportunities.

• Adopt a participatory approach regardless of gender. Engage women in decision-making in order to promote gender equality and prevent social exclusion.