Correspondence


Letter to the Editor 

A solution to refugee children healthcare in Greece 

 

 

Two key emerging issues relevant to the high numbers of refugee children reaching 

host countries in Europe are the challenges facing the local healthcare and state 

systems and the increase in stigmatising behaviours and discrimination (1). This is 

also the case in Greece. Around 60,000 Syrian, Afghan and Iraqi refugees, with many 

children among them, are currently stranded in Greece facing considerable 

inequalities and non systematic access to healthcare (2). Since October 2016, in a first 

attempt towards integration, the Greek government has been rolling out a plan to offer 

education to around 10,000 refugee and unaccompanied asylum seeking children 

(Official Gazette of the Hellenic State, 29 August 2016, No 2687). However, some 

opposition has been raised by certain school and parental boards, citing hygiene and 

infection risks. Notwithstanding the underlying discrimination, we are proposing a 

pragmatic solution to this proposed risk, and the wider healthcare provision problems, 

which is consistent with plans proposed to address the rapid changes in the 

epidemiology of multiple conditions seen in countries with high immigration rates (1). 

 

This solution is the establishment of a mobile paediatric unit to offer screening, 

immunisations, recording of health history and general preventative care. Under the 

principle of using the best available evidence (1), Greece can use the experience of 

paediatric healthcare provision through a mobile medical van in Dominican Republic 

for children of impoverished migrant Haitian workers (3). Further, the mobile unit can 

undertake the registration of refugee children entering schools, and combine it with 



the routine examination and care (4). Lastly, in the event of reported hate crimes, 

access to mental health services and social care can be in place via a triage system in 

the mobile unit, as children are especially vulnerable to emotional trauma (4).  

 

From a financial perspective, the most beneficial model for acquiring such units for 

not for profit purposes seems to be through direct ownership, though adjustments in 

monthly payments would make leasing competitive (5). Overall, it is the use of the 

asset that is more important than ownership, hence, an exit strategy should be in place 

to close the unit once the cost of running it exceeds the cost of referring those children 

to the hospital via the normal routes (4). In this context, use of such a mobile 

paediatric unit could be an interim step before attempting integration in the national 

healthcare system and while the government is attempting to implement this 

education bill at pace. 

 

 

 

 

Ethical statement: 

 

The authors declare that: 

a) there is no potential conflicts of interest 

b) The research does not involve Human Participants and/or Animals 

and c) The research was reviewed and approved by will to come under this category. 



References 

 

1. Friedrich MJ. Growing Numbers of Refugees Worldwide Are Children. JAMA. 

2016;316(19):1956. 

2. Kousoulis AA, Ioakeim-Ioannidou M,  Economopoulos K. Refugee crisis in 

Greece: not a one-country job. Int J Public Health. 18 Oct 2016 [Epub ahead of print]. 

3. Crouse HL, Macias CG, Cruz AT, Wilson KA, Torrey SB. Utilization of a mobile 

medical van for delivering pediatric care in the bateys of the Dominican Republic. Int 

J Emerg Med. 2010;3(4):227-232. 

4. Sirbaugh PE, Gurwitch KD, Macias CG, Ligon BL, Gavagan T, Feigin RD. Caring 

for evacuated children housed in the Astrodome: creation and implementation of a 

mobile pediatric emergency response team: regionalized caring for displaced children 

after a disaster. Pediatrics. 2006;117(5 Pt 3):S428-438. 

5. Arevalo O1, Saman DM, Bonaime A, Skelton J. Mobile dental units: leasing or 

buying? A dollar-cost analysis. J Public Health Dent. 2010;70(3):253-257.