Mavrovouni Closed Controlled Access Center (CCAC) in Lesvos, Greece, is one of the largest refugee camps in Europe. It currently hosts an estimated 5,500 refugees, 26% of which are women. In recent months, there have been 200 new arrivals each week, resulting in increased pressure on already strained resources, such as those related to nutrition and medical care. Refugee women are a crucial minoritized and invisibilized group that experience increased risks, such as being exposed to gender-based violence and experiencing mental health conditions.
In response to the urgent need for a situation analysis in European refugee camps, a Vrije Universiteit Athena project, led by Dr. Jamilah Sherally, a PhD candidate and Global Health MD, involving researchers from diverse institutions, was initiated to address the critical circumstances. The project addresses sexual and reproductive health (SRH) needs, opinions and challenges for refugee women residing in Mavrovouni CCAC. Data collection took place from June 2023 to November 2023, involving quantitative and qualitative methods.
Our research was rooted in a participatory action research (PAR) approach, in which the majority of our research team – 10 out of 15 – were co-researchers from the refugee community on Lesvos. As the refugee women population in Mavrovouni CCAC is diverse, with primary countries of origin being Afghanistan, Somalia, Eritrea, Yemen, Palestine and Democratic Republic of Congo, the co-researchers represented six different language groups, including Farsi, French/Lingala and Amharic.
All team members were involved in designing the methodologies and tools of the study, collecting and analyzing the data, and co-creating solutions. For example, our team worked tirelessly for three weeks in June to co-create our 119-question-long household survey. From identifying overarching SRH focus areas to nitpicking the wording of each question, we laughed, cried and ultimately prevailed at launching and translating the survey into seven languages.
Co-creation of solutions for SRH-related challenges faced by refugee women in Lesvos
As the population of the camp had more than doubled since starting data collection in 2023, there was an urgency to act, so our team released preliminary research results and called for two workshops that took place on December 6 in Lesvos and December 8 in Athens. Workshop participants included women and community leaders living in camp, high-level policymakers, healthcare service providers, academics and other key stakeholders.
During the workshops, refugee community participants spoke about their concerns regarding conditions in the camp, including access to education, accommodation privacy and racism in the healthcare system. In the context of day-to-day life in Mavrovouni CCAC, one representative expressed feeling constrained, stating, “I do not feel I am in a suitable environment to use my power and knowledge so that I can contribute”.
The strain on the Greek system and the burnout of workers also came up frequently during exercises. A state actor mentioned that she frequently sees “doctors coming in the middle of the night after a shipwreck” and noted that “even a very big hospital in America or France could not handle such an emergency.”
Techniques such as games and brainstorming exercises were leveraged to co-create 10 concrete solutions, which touched on issues ranging from empowerment on the ground to high level policy change. Collective commitment was reinforced by publishing a communal statement that coincided with the 16 Days of Activism against Gender-Based Violence.
Emphasizing lived experience to generate knowledge-for-action
Our project shows that multidisciplinary participatory action research can be done in rapidly evolving humanitarian contexts, with “hard to reach” populations, such as refugee women, leading the way. Involving refugees as collaborators in the research process enhances research quality and relevance, strengthens community capacity, and ultimately challenges existing harmful, colonial power structures.
The multidisciplinary, diverse spirit of our research project is integral to facilitating its ongoing success. During a final workshop reflection, an NGO representative was excited that representatives from the public hospital, the UNHCR, the European Commission and “the people of the community themselves” had all contributed. A state actor noted that “we all share the same goals” and that “our different perspectives allow us to think well together.”
In conclusion: the political backdrop and implications of research findings on EU approaches
While Greece has faced condemnation regarding various facets of migration and asylum, such as treatment of migrants by border authorities, conditions at reception and accommodation centers, and criminalization of humanitarian workers, this reflects the broader – increasingly right-leaning – political landscape in the EU. Recent EU migration measures that have potential to (further) reduce asylum seekers’ rights point in the same direction.
Centering findings and solutions from participatory and diverse grassroots initiatives is crucial to drive impactful and inclusive immigration policy adjustments. As we are gearing up for the European Parliament elections in June, policymakers could benefit from integrating outcomes from studies similar to ours to develop a comprehensive and equitable policy framework that prioritizes human rights protections.