The bare necessities: delivering first aid in the Calais ‘Jungle’

It’s 11:00 am and a group of 20 people are congregated in a small area between three caravans lined up to form a triangle. Amid the din of Arabic, Farsi and French, snatches of broken English can be heard complaining of sore throats or noses that are ‘closed’. A number of medical volunteers are busily trying to organise a queue, with shouts of ‘one at time’ having to be regularly made. This pandemonium could be any health professional’s idea of a nightmare, but this is just another day in the Calais ‘Jungle’.

These volunteers, made up of doctors, nurses, paramedics and students, have sacrificed their weekend to provide first aid within the refugee and migrant camp located on the outskirts of the city. They form part of the Refugee Support First Aid and Care Team, who since September 2015 have been delivering care from the heart of the ‘Jungle’.

Introducing a first aid team to the Calais ‘Jungle’

After hearing about the lack of basic medical care available to refugees and migrants in the ‘Jungle’ over weekends, Liz Gall, a luxury wedding planner and former retail bank manager, set up Refugee Support. Founded on 9 August 2015, the aim of the organisation is to take aid over to refugees and migrants residing in the Calais ‘Jungle’.

‘After living in the jungle at weekends for a month, it became apparent that there were no medical facilities available either at night or on a weekend,’ says Gall.

Current medical aid delivered in the camp is limited. As a result of the ‘Jungle’ not being recognised by French authorities as an official ‘refugee camp’, no large charities or humanitarian groups have a real presence on the ground.

Médecins du Monde (MdM) (Doctors of the World) has provided essential medical help to refugees and migrants living in and around Calais and Dunkirk since 2003, but withdrew from the ‘Jungle’ at the end of 2015 after a theft from their building. Médecins sans Frontières (MsF) (Doctors without Borders) has provided aid since early December and runs a health clinic that is open Monday to Friday. However, it is believed its contract ended on 1 March.

It was because of this that Gall felt the need to set up Refugee Support:

‘Following a conversation with Hassan Chaudry (GP) and Raid Ali (dentist) on return from Calais on 14 September, we decided that as there were UK healthcare professionals wanting to help, we would try and make it happen.

‘Our original aim was to provide care on weekends, when MdM were not in the camp. Refugee Support First Aid and Care Team and Refugee Support Dental Team were borne out of this.’

With help from Caravans for Calais, Gall arranged for a caravan to be sent to the ‘Jungle’ from the UK, with the aim of using it as a mobile clinic for refugees and migrants.

‘On Saturday 26 September we opened our first caravan and treated people on the street in the jungle,’ recalls Gall.

The caravan was funded by a group on Facebook called the Creative Collective for Refugee Relief, who had raised money by selling their artwork online. Two further caravans were sent over in the following 2 months to be used for first aid, as well as an additional caravan for dental care.

Volunteering in the ‘Jungle’

First aid shifts within the camp are coordinated through the Refugee Support First Aid and Care Team Facebook group. Health professionals input their dates of availability, as well as contact information and important details such as their registration number. Registration is then checked against the appropriate regulatory body and dates confirmed. Paramedics currently make up a relatively small percentage of the overall first aid volunteers, with the majority being made up of either doctors, nurses or medical students. So far, over 400 people have volunteered as part of the Refugee Support First Aid and Care Team at the camps located in Calais and Dunkirk.

Dan Evans is a final year medical student at Cardiff University overseeing the first aid caravans as team leader over March. He has been at the camp for 2.5 weeks as part of his medical elective and has another 2 weeks remaining.

‘The vast majority of work is making sure people aren’t unwell, aren’t septic,’ says Evans.

According to Evans, patients are predominantly treated for minor ailments such as colds, flu, sore throats and the nasty variety of chest infections referred to as ‘Jungle lung’. Additionally, broken bones, bruises, sprains and cuts are treated following altercations within the camp or with police, or failed attempts at crossing the border into the UK.

The three caravans used by the first aid team are situated towards the north end of the camp and offer patients a private space for consultations. Where possible, patients are treated there and then. In cases where additional care is needed or follow-up required, patients are referred to the clinic run by MsF. Outside, strepsils, cough medicine and bracelets made from tubigrip and cotton wool soaked in olbas oil are dispensed from a counter made of chipboard.

While the majority who come to visit the caravans receive some medicine and are sent on their way, a small number who turn up are considerably unwell. Notably on this weekend, a young man is seen crouched on the dusty floor, cradling his head in his hands. After an examination by a doctor in one of the caravans, it is recognised he has meningitis and is subsequently rushed to the emergency department in the city.

Among the first aid volunteers at the ‘Jungle’ on the weekend of 12 March are a group of student paramedics from the University of Surrey, who between them raised over £1,000 to go towards medical supplies for the caravans.

They used part of the donations to purchase two paramedic rescue backpacks to enable them to act as a mobile clinic and provide first aid on foot to those in need.

Shadowing the students, it is apparent that being able to bring care to those who may not be aware of the existence of the caravans, or who might fear the implications on their claims for asylum by visiting a clinic and having their details recorded, offers the volunteers access to patients not possible before.

‘We have done something really good with starting an outreach programme which they didn’t have,’ says Javier Garcia-Marcos, a second-year student paramedic. ‘As student paramedics I think we are best placed to do that.’

On this weekend alone, a Sudanese refugee is treated for a burn after the tarpaulin used to make his tent caught fire; an Eritrean refugee who was stabbed in the back following an argument in the camp has his dressing changed; and a Kurdish woman who was afraid to visit the MsF clinic is revealed to be pregnant. Having been trying for a child for 5 years, she thanked the student midwife with tears in her eyes and proceeded to invite her inside her caravan for tea.

The general mood within the camp appears friendly, with many of the refugees and migrants all too happy to offer their seat or extend invitations for a hot drink. Yet despite this, there have been a number of reports of volunteers being attacked or intimidated.

When asked whether he feels safe, Evans pauses for thought:

‘There is a lot of crime as everything is unregulated, but I wouldn’t describe it as dangerous,’ he says. ‘If you are British and not wearing a police uniform, people know you are here to help,’ he adds.

The lack of police within the camp is evident and it is clear their presence is not welcome. Instead they stand in groups around the perimeter of the camp, clad from head to toe in riot gear and ready to intervene should any situation escalate.

Speaking to some of the other volunteers, they agree the overall feeling within the camp appears to be positive:

‘The general mood was quite good. I didn’t find any aggressive people and they were quite accommodating,’ says Omar Yusof, a second-year student paramedic at the University of Surrey.

‘I think people need to remember they are not just refugees, they are people,’ says Jordan Wheeler, a second-year student midwife at the University of Surrey. ‘They are just like us, it is naive to refer to them as locals.’

While the volunteers describe the experience as memorable, it has evidently not been without its difficulties:

‘You feel a bit useless as there is no referral,’ says Wheeler.

‘It is difficult to assess people properly due to very basic equipment, it is also difficult to communicate,’ adds Sam Wheeler, a second-year student paramedic at the University of Surrey. ‘However, it has given me a big boost in confidence. Working in a different environment you have to be inventive.’

When asked what advice the volunteers would give to those considering coming out to Calais, they give out a series of practical steps:

‘Bring your own diagnostics kit,’ says Yusof. ‘It would also be best to have people well trained in minor injuries.’

‘Come in teams as that is the way we are used to working. I think working in twos and threes works really well,’ says Garcia-Marcos. ‘Also, try to learn a few words in Arabic, it opens a lot of doors.’

Future plans

Refugee Support is currently in the process of registering as an official charity, and according to Gall, the future looks bright:

‘In 6 months what we have achieved is phenomenal. Our original aim was to provide weekend care, yet since December we have covered 7 days a week.’

However, the recent destruction of the southern section of the camp—which left up to 3 500 people without homes—and the proposed demolition of the northern section, has meant things have had to be taken one day at a time:

‘As the requirements within the camp change we must adapt with them,’ says Gall. ‘We were due to have a wooden first aid centre built in Calais, but this is currently on hold until we can be certain that the latest news to maintain the northern part of the camp is happening.’

As a result of regular evictions and demolitions, life in the ‘Jungle’ is constantly forced to change. On 4 March, a re-purposed double decker bus was delivered to the camp to replace the Women and Children’s Centre that disappeared when the southern part of the camp was destroyed. The aim of the bus is to offer a safe living space on the ground floor for women and children, and a dormitory upstairs intended for unaccompanied minors. Additionally, a vaccination clinic set up by Health and Nutrition Development Society (HANDS) International, who have been immunising against influenza and measles, was also forced to move.

However, this constant need for adaptation has not dampened the determination of the volunteers who come to Calais. There is no denying that in the short time since its inception, Refugee Support has gone from strength to strength, yet Gall emphasises it has only been possible because of the people who have dedicated their time to making it a growing concern.

‘We have the most amazing volunteers, and are so grateful to them. Because we are a small group and they are so compassionate, we can adapt at reasonably small notice,’ she concludes.

For more information, or to register your interest in volunteering, visit: www.facebook.com/groups/CRS.UKMEDTEAM/?fref=ts

Taken from Journal of Paramedic Practice, published 1 April 2016.