For people on the move, travelling to Bulgaria through Türkiye on foot in winter is particularly gruelling. The harsh weather conditions and the lack of access to shelter, food and sanitation have a negative impact on their physical and mental health. Upon arrival in Harmanli, existing health problems are compounded by the dire living conditions and poor hygiene in the reception centre.

MSF started to deliver medical care in Harmanli reception centre in July 2023. Since then, our teams have provided general and sexual and reproductive healthcare, as well as treatment for patients with chronic diseases, and implemented infection prevention and control measures to curb the spread of infections in the centre. Our staff also coordinate with the health authorities to refer patients requiring specialist care to hospitals.

Bulgaria has a shortage of medical professionals, which reduces the authorities’ ability to mount an effective medical response in Harmanli. People on the move are entitled to free specialised healthcare with a referral from a registered general practitioner (GP), but the irregular availability of GPs in the centre often makes it difficult to obtain a consultation and a referral if needed.

There is also a need in Harmanli for mental health support, socio-legal services, and interpreters to help refugees and asylum seekers deal with administrative processes, registration and medical consultations. Protection is another key issue in the centre, as safe zones for unaccompanied minors are still under development.

Many people in Harmanli had left countries caught up in conflict or unrest, such as Syria and Afghanistan, and made their way to Türkiye in search of safety and protection. However, following the devastating earthquakes that hit the south of Türkiye in February, many felt they had no option but to continue their journeys.