EPs on the Front Lines of Europe’s Refugee Crisis


An American emergency physician practicing in Vienna provides ground-level observations about the medical – and social – impact of Europe’s latest asylum seekers.

A teenager pushes his grandfather across the desert in a wheelchair. A thin line of asylum seekers stretches ahead and behind him. A journalist asks the teenager where he is from, and his only response is, “It’s hot. It’s hot.”

Asylum seekers are a leading news story in Europe. In Sicily, the streets are inundated with asylum seekers who loiter, are unemployable, and steal food from the locals, even in the shops. The police are overwhelmed, and the Mafia don’t help (in fact, they encourage asylum as the human smugglers represent a new income stream). As of this writing, several million people are heading toward Europe from the Middle East and Africa. They are escaping war, rape, murder, and genocide motivated by greed, fundamentalist fervor, tribal dispute, and criminal zeal. It is a mass casualty event of epic proportions, and its effects will be felt for generations.


The health and welfare of the asylum seekers are embedded in the politics and social erosion of their homelands. They don’t want to leave their home country, but they must in order to survive. As of now, only the generally healthy are arriving; the exodus is killing off the weak or unfortunate. Their route is through Libya from Africa, or through Hungary via Serbia, and Macedonia from Lebanon. One quarter of the population of Lebanon are transient asylum seekers. Syrians, Kurds, and Afghanis are in the majority, but there are a great many more ethnicities and languages included in the mix.

When they finally come to rest, asylum seekers are not welcomed with open arms. Not only the Neo-Nazis but the average European fears that they will erode their way of life. And not without reason; certain changes will be inevitable. Asylum seekers are driving up taxes that are already extreme for the average worker. Governments are slow to respond, budgets are tight, and NGOs spend more time watching than assisting. Volunteers are few and easily thwarted by rigid restrictions. Physicians who are asylum seekers themselves are not allowed to practice in the refugee camps where they live owing to Medical Boards’ refusal to license them.

As a board certified physician from the United States, I have worked in Afghanistan, in the Middle East, and Africa, from where many of these folks are traveling. Wanting to assist them here in Austria where I currently practice, I decided to approach Doctors Without Borders. Their plan was to send me to South Sudan. Instead, I signed on with the Rotes Kreuz (The Red Cross), and began working with asylum seekers a mere ten-minute ride from my home. Here is what I witnessed.


Click here to read the full article on EPIJournal.com



Keith A. Raymond, MD has practiced medicine in 8 countries in 4 languages. He currently lives in Austria assisting Asylum seekers with the Red Cross. He has multiple journal publications and is writing his first two novels.


  1. Wael Hakmeh DO on

    Generalizing refugees of war torture and rape as collectively being “asylum seekers who loiter, are unemployable, and steal food from the locals, even in the shops” is utterly disgusting, biased and only serves to diminish what little sympathy these mostly Syrian refugees get. This is analogous to saying all members of the media are contemptuous child-kicking monsters like the Hungarian right-wing journalist who was terminated. When discussing morbidity and mortality, the author would be better served by placing this crisis in context and mentioning that more people have died in escaping the war, systematic gang rape and torture in attempts to cross the Mediterranean Sea than people died on 9/11. Think about that. Let’s talk about Aylan Kurdi, the 5 year old boy whose body washed up on a shore face down and the thousands of people drowning and dying of starvation, the public health problems they’re facing and how it’s manifesting in urgent and emergent medical conditions. Turkey is already hosting 2 million refugees, more than all of Europe combined, and have spent much more. Interesting its contributions weren’t even mentioned. More interesting is that the Turks don’t consider their humanitarian relief and medical work as a crisis. I find their service to others refreshing in this day of age.

    Interesting that this article cites the European refugee crisis when the real crisis is the one that drove people to the point of leaving everything they own, taking treacherous trips that has killed thousands, splitting families apart, inflicting great social, economic, medical and financial costs. Having worked in Syrian field hospitals in Aleppo twice in the past 18 months, I saw the utter destruction from weapons of mass destruction being used against civilians, mainly through barrel bombs, unguided oil drums filled with half a ton of TNT and shrapnel that veer blindly in the wind until they kill by blast and penetrating injuries. We had many patients including a unconscious young man with a skull fracture that needed a CT and Neurosurgical evaluation but couldn’t be transferred at night because the government jets bomb any cars or objects that emit light at night. Women that have been gang-raped by 5 or 6 government soldiers. Men hung with their penises cut off, bleeding to death. Policies of mass starvation employed against civilians in the cities of Homs for a year and now in the Damascus suburb of Ghouta, noble people reduced to eating grass and dog to stay alive. Thousands of the meticulously documented cases of torture are on display at the Holocaust Museum in Washington DC, snuck out by the defector being called Caesar who has testified in Congress. Those stories and their medical sequelae are the ones that should be told, not the superficial nonsense about a few people taking food trying to survive.

    • I encourage all medical professionals who are concerned about rape, torture, and other human rights abuses in the world to check out the work the Physicians for Human Rights is doing. They have been sending people to various locations for the purpose of documenting abuses, in hopes of holding those responsible to account.

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