On the morning of Sunday 13 September 2015 yet another boat packed with refugees, mostly Syrian, entered European waters, battling heavy waves. It overturned near the rocky islet of Farmakonisi (pop. 10). The Greek coastguard rescued 68 from the sea and a further 34 managed to swim to shore, but 34 drowned, including 4 babies and 11 children. The bodies were taken to Rhodes, the administrative capital of the Dodecanese, and the survivors were taken to the island of Leros, where they were housed temporarily, pending identification procedures and issue of the documents required to continue their journey. Many of them will have to go first to Rhodes for their own, heart-rending identification procedures.
They are not the first refugees for whom Leros was the introduction into Europe. When Yiayia visited the island in 2000 there were already a few – including a young African woman whose baby, born in the excellent maternity department of the island’s general hospital, was provided with a full layette by the hospital staff. Although the larger islands, particularly Lesvos and Kos, have received greater numbers since the Syrian hostilities, Leros, with a population of less than 8,000, has been inundated. Like the other islands, it was unprepared for such numbers, and they have been camping in the hospital grounds, and in the surrounds of the island’s other hospital, the Κρατικό Θεραπευτήριο Λέρου (Leros Kratiko Therapeftirio – the Psychiatric Hospital) – in spite of protests by its board and some of the local community.
A bit of background on Leros. Leros is one of the many small beautiful islands in the Aegean, with its ruined temple, in this case dedicated to Artemis, its castle on a hilltop, its row of windmills along a ridge (now converted into studio holiday apartments), its scattered little white churches (perhaps the most picturesque is the Panaghia Kavouradena, in a cleft in the rock just above the sealine, like the crabs it takes its name from). It also has a well-tended British Military Cemetery by the sea – reminder of the World War II Battle of Leros in November 1943, when the German paratroopers took the island from the British, but not before the Aegean had claimed another victim – a downed Junkers was brought up from the bay in 2003.
Leros has all these, and more. It was under Italian administration for over 30 years, from 1912 to 1943, and because of its fine natural harbour at Lakki, extensive facilities were installed for the Italian fleet, including a whole art deco seafront and mass planting of eucalyptus trees. In 1948 Leros was united with Greece, its Italian legacy being a multiplicity of well-constructed buildings, and a scattering of Italian names. The buildings have been put to a variety of uses, including a Queen Frederiki’s craft school after the Greek civil war, and detention of political prisoners during the military Junta years. The general hospital is still housed in one complex, but the best known institution to take over the empty Italian naval buildings was the Leros “Colony of the Mentally Ill”.
The Leros Colony of the Mentally Ill opened its doors to its first 400 patients on 2/1/1958 according to Royal Decree 452/1957. Its purpose was to relieve pressure on the urban psychiatric hospitals by housing long-term patients and also to provide employment for the local population. Over the years, to the patients with chronic mental illness were added people with severe mental retardation, including children who grew up within the Colony. By the 1970s the patient population had reached 3,379. The care they received was mainly custodial. They were cut off from their families by the prohibitive cost of travelling from other parts of Greece, but well before tourism found Leros, a small industry had developed around providing for those relatives who persisted in visiting. In 1976, Presidential Decree 133/1976 renamed the institution “Leros Psychiatric Hospital”. The 1980s movement for psychiatric reform, with the EEC Regulation 815/1984, promoted deinstitutionalization of people in long-term mental health facilities. In the case of Leros this was hastened by prominent coverage in the British press and a widely broadcast investigation by Channel 4’s “Cutting Edge” documentary series.
“Reclassification” of patients was initiated, and funds were found for relocation of some in various forms of sheltered accommodation, preferably closer to their homes, and better care of those who needed continued hospitalization. Around 200 of the more seriously ill patients remain hospitalised in the Leros facility. Although there were many “success stories”, and as in other countries, psychiatric reform may have led to decongestion of the old “asylums” (see note on political correctness below), it has undoubtedly contributed to an increase in the numbers of homeless. The crisis and its paring down of public expenditure have resulted in loss of funding for hostels and care-in-the-community and reduction in the staffing of psychiatric hospitals. At the same time, there is evidence of a marked increase in mental illness in Greece since the beginning of the crisis. Earlier this month, while Syrian families were struggling ashore in eastern Greece, and Afghanis were camping in the parks of Athens, a young patient started a fire in one of the remaining city psychiatric hospitals, which killed three other seriously ill patients. This occurred in a high security ward where the patients were restrained in their beds “to prevent them harming themselves”. The hospital spokesman claimed that they are severely short of staff.
The language of mental illness has never been famed for its political correctness, and perhaps it is a sign of progress that the word “asylum” is now associated with refugees rather than “lunatics”. The word “lunatic” has been replaced by supposedly less stigmatizing alternatives; but no euphemisms can hide the fact that Greece, while being called upon to respond to the waves of refugees being washed up on its shores, is in the midst of its own humanitarian crisis with the collapse of psychiatric reform. It is ironic that the victims of both crises find themselves cohabiting at close quarters on a tiny island out of the stream.
There will always be an unfortunate minority of people, by whatever label, whose mental capacity does not enable them to care for themselves. Many have other serious health problems which preclude care at home. Leros was called upon to provide custodial care to such people in the past, however outdated the conditions seem by today’s standards, and rose to the challenge of adapting this in line with the principles of psychiatric reform. The people of Leros are now responding to needs of its refugees, but where are the resources to support them, on either front?
Image: Alex Majoli, taken shortly after the closure of Wing 16 of the Leros Psychiatric Hospital, from thepressproject.gr. The grafitti reads “We’ve closed it and we’re leaving, 6/5/94, time 10:30, Goodbye.”