The Big Red School Bus – Advanced Practice Nurse Travels to Greece to Provide Care to Refugees

The Big Red School Bus – Advanced Practice Nurse Travels to Greece to Provide Care to Refugees



By Barbara Lockart, DNP, APN/CNP-AC, PC, CPON, Advanced Practice Provider in the Division of Pediatric Surgery and Division of Hematology, Oncology and Stem Cell Transplantation



Fleeing a war zone is a different type of horror than living in post-hurricane Haiti.  That became obvious after the first few days of working in the refugee camp in Thessaloniki, Greece. In August 2016 and January 2017, I volunteered in Thessaloniki with the Syrian American Medical Society (SAMS). As an advanced practice pediatric nurse and a veteran of 15 humanitarian trips, I naively thought this experience would be similar to my time in Honduras and Haiti. This was my first time working with displaced families, however, and I could not have been more wrong.

As I got to know some of the families in the camps, I began to understand the desperation that led them to flee their homeland. Their willingness to leave their country and seek asylum in a foreign place speaks to the atrocities left behind. To quote author Warsan Shire “no one puts their children in a boat unless the water is safer than the land.”

The statistics on the number of Syrian children fleeing their homes are staggering. The UN estimates 2.3 million refugees younger than 18 are living in Turkey, Lebanon, Jordan, Egypt, and Iraq. In Greece there are 26,400 refugee children; the majority of whom are Syrian. It is estimated 80% of refugee children are not attending school, many made to work in menial jobs in unsafe environments. Children are often the most vulnerable victims of war and this humanitarian crisis is no different. As a Pediatric Advanced Practice Nurse, this got my attention.

While some hold that the emotional and physical needs of displaced children can be brushed off, believing children are resilient, studies of refugee children show that is a misconception. It is reported that 45% of refugee children experience post-traumatic stress disorder related to forced displacement, school bombings, and death of family and friends.

Signs of PTSD were evident in the children I met. Many children complained of chronic abdominal pain, sleep disorders, bed wetting. Psychological support to deal with the trauma was overwhelmed by the number of refugees needing assistance and paucity of financial and manpower resources.

Despite the horrible conditions of life in a refugee camp, there was a rhythm to the day for the families and the healthcare providers that was comforting. One of the joys in my time in camp was the frequent visits from the children. In a camp full of children, scrapes, bumps, and bug bites are a “medical emergency.” My little box of hugs – band aids, antiseptic spray, and the fart app on my cell phone were necessary medicine to get children out of the clinic and back to playing.

Some of the children would routinely visit me in the afternoon. They would attempt to teach me Arabic and I would tutor them in English. By the end of my first week in camp, a regular afternoon visitor was a bright, bubbly nine year who fled Syria with her family in the winter of 2016. She shared the pictures she drew to help cope with the trauma of displacement. The drawings showed a range of emotions – joy, fear, despair, but became more hopeless as time progressed. One of the drawings was a child with the caption “I hope to go to school”. This bright, articulate child who once dreamed of becoming a doctor, now aspires to go to school.

Refugee camp in Thessaloniki, Greece

When I returned to Greece in January 2017, many of the camps in Thessaloniki were closing as families were gaining asylum or moving into more permanent housing. The camp was eerily quiet and I missed the sounds of children playing outside my window. “Chicago cold” weather meant the medical team spent days huddled around the electric heater and very few of the residents were leaving their tents.  Inadequate heating, dreary winter days, and snow made for a miserable January.

The sun finally emerged from clouds one afternoon. The medical staff and families ventured outdoors to enjoy the sunshine. Signs of hope finally became evident. The children were skipping around camp and playing. But one of the big signs of hope was the sliver of normalcy as several children attempted to form a queue for the big red school bus. They were counting off and climbing on the bus that would take them to school.

When I returned to Chicago and my job as a pediatric nurse practitioner, I received a phone call from a patient who was recently accepted into college. Seth was humble as we talked of his academic accomplishments despite a year-long disruption in school due to cancer. I am proud of this young man who went through a chemotherapy, surgery, and radiation treatment and gained acceptance into an Ivy League school.

I thought back to the young men who translated for the medical team in the refugee camps. These young men are the same age as Seth and are also bright, articulate, accomplished, and waiting for their futures to begin. When in the refugee camp, we did not speak much of hopes for their future beyond what country would grant them asylum. Oceans separate these young men and Seth, but all suffered unspeakable hardships and are deserving of a future.

My mind then wandered back to the joy I saw as the big red school bus left camp. The children were waving, smiling, bouncing in their seats. The routine and promise of school. The promise of a future had once again begun.

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