Illustration by Rebekka Dunlap.

The conditions at the makeshift refugee camp at Piraeus Port in Athens were bad in any weather. Torn, battered camping tents arranged under highway flyovers, on a stretch of concrete and in a massive, abandoned stone warehouse. Three rows of port-a-potties available for more than 2,000 people. Lines for everything—shampoo, the oily chickpea soup served for dinner, doctors, clothes, registration. A scabies outbreak emerged in the stone warehouse; foreign volunteers were assaulted at night and in the shadows of tents. There were knife fights and rumors of rapes of young children.

The most popular route for refugees and migrants from the Middle East and Asia involves a treacherous crossing of the Aegean Sea from Turkey to the Greek Islands. From there, thousands continued overland to European countries with better job prospects than Greece, which has the highest unemployment rate in Europe (23.4 percent). But the Former Yugoslav Republic of Macedonia (FYROM) and other countries along the migrant trail closed their borders March 20. Now, nearly 60,000 refugees are stuck in Greece in camps, shelters and on the street.


This is the place where a 16-year-old Syrian woman learned to nurse her week-old daughter in the cramped quarters of a caravan. This is where an Afghani woman miscarried after being served spoiled food from the Greek military that led to the hospitalization of dozens. This is where a mother of four children under the age of seven cried in the shade of a tent, bent over in pain and four months pregnant, but terrified to go to a hospital where she would not understand the language. Save for the woman who miscarried, which was reported by long-term volunteers, I saw all of this while volunteering in Athens for six weeks this summer. These were just a few of the complications that arise among pregnant refugees and young mothers.

In the 2016 fiscal year, the United States admitted about 85,000 refugees—the most of any year during the Obama administration—with 12,587 entrants coming from Syria, and 7,853 from Iraq. President Donald Trump’s determination to stop the flow of Muslims entering the United States will eliminate opportunities for refugees in the Middle East and the vast waiting room of Mediterranean Europe to find a permanent home.

The European Union has relocated just five percent of refugees and migrants registered in Greece and Italy; in mid-January, Germany announced it would begin returning asylum seekers to Greece in mid-March.


At the beginning of 2016, the United Nations Populations Fund estimated that one in ten refugees traveling through Europe is pregnant, and around 70,0000 of the four million refugees globally are estimated to be pregnant.

That means that in Greece alone, where Medicins Sans Frontiers and Greece’s own Center for Disease Control have called attention to unsanitary situations at refugee camps, there are about 6,000 pregnant women in camps, temporary housing, squats or on the street. And the number is likely to rise.

To flee one’s homeland—to choose the trials of a refugee over the trials of a war-torn city—is to live with hope for the future. Maybe that’s why so many of the women in the camps, and scattered across the migrant trail, traveled with kids in tow or on the way.


The United Nations Populations Fund visited Greece last November and found a notably high number of pregnant women, and based on the number of infants in camps and centers, likely a high percentage of breastfeeding mothers as well.

“Most of these women have suffered severe physical and psychological stress and hence, even if otherwise healthy, are at higher risk of complications, preterm delivery or even death,” the UNFPA said.

The organization noted a dearth of services to meet the growing number of refugees and expressed concerns about lack of information and poor coordination between government bodies. Greece was underprepared and underfunded to respond accurately, and non-governmental organizations—staffed by unpaid volunteers, funded by individual donations—were the best option for many seeking support.


I arrived in Greece in mid-June 2016 after a few months of traveling and freelancing. The plan was to join the hundreds of volunteers that had flocked to the country in hopes of making some sort of a dent in a crisis that seems daunting from far away, and inconceivable from up close.

Amurtel, a for-women, by-women grassroots organization, was looking for volunteers at Piraeus, one of the many informal camps that had popped up around the country in late 2015. At its largest, Piraeus held more than 5,000 refugees, most of them Afghani and Syrian, who waited for transfer to formal government camps and shelters. There they could begin the official process of applying for asylum, relocation, or family reunification.

The Greek government had tried to completely clear the Port and settle refugees in camps as of early spring. But lack of room and pushback from refugees kept Piraeus inhabited for much of the summer, and the last residents were finally resettled elsewhere in the country on July 27, 2016.


In the weeks before the resettling, and right after I arrived, the heat turned conditions from wrenching to almost unbearable. The bathrooms became swampy and stifling. A young mother kept her two young sons waiting outside the showers as she reluctantly swept piles of trash and human waste from the wet floor onto UNHCR wool blankets. Teens escaped the heat by jumping off the edge of the port into the Mediterranean Sea, ignoring the massive cruise liners nearby and the Greek police. The temperature in Athens nears 100 degrees in the summer, and on the expansive, shadeless stretch of concrete, it felt 10 degrees or more hotter.

On my first day at the camp, I met Didi Ananda Uttama, a soft-spoken, gray-haired New Englander in charge of Amurtel’s Greece response. I quickly settled into daily shifts with the group.

Amurtel is the social service arm of Ananda Marga (Didi took a part of the organization’s name in her name, as is custom), a socio-spiritual organization founded in India in the 1950s, and Uttama first worked with the group in a Kosovar refugee camp in Albania. She set up a local response after the Athens earthquake in 1999, and last August Uttama and a group of Greek volunteers began on-the-ground assessments of needs among refugees. They quickly found that care was minimal and lacking and there were no midwives or OB/GYNs in camp medical units.


“We saw woman after woman who were dazed, shell-shocked from the trauma of the trip, worried and afraid for the welfare of their children,” she said.

Amurtel set up shop at Piraeus in two donated camper vans parked behind the warehouse, sandwiched between dozens of refugees tents and the sea.

During Amurtel’s first six months stationed at Piraeus Camp, approximately 500 pregnant women and mothers came for a variety of services, according to Uttama. The Amurtel staff saw women in premature labor giving birth in hospitals where they could not communicate with anyone. They comforted women who had miscarried and were shouldering the grief without their family around. They distributed pregnancy tests to women of all ages who found themselves torn between wanting to feel happy about a positive result but desperate not to have a child in these conditions.


The women came consistently, to bathe babies in the donated tub at the back of one caravan or to cry into the arms of Martalycia Patsi, the ceaselessly cheery Greek midwife, who spoke no Farsi or Arabic yet was beloved by all. One woman wanted to throw herself into the sea; another wanted to be smuggled back to Afghanistan. One spoke of the beauty in Syria, of luscious green parks and of houses with a room for every child, and then gestured out to the concrete expanse ahead and shook her head. “This life is difficult,” another responded in Arabic, after visiting volunteers offered words of sympathy and support. Everyone—volunteers and refugees alike— lamented the heat. Pregnant mothers in their early 20s complained of back pain from sleeping on concrete during pregnancy. Others spoke, in hushed tones or in sobs, of domestic violence.

From what Patsi has seen, the government doesn’t do much about refugee health in general, she said. Some refugee health struggles are directly related to unsanitary conditions provided in government facilities. Other struggles remain because of a lack of resources; in July, Médecins du Monde reported to Foreign Affairs that one in three patients in the camps has a medical condition that cannot be treated out of an NGO tent or truck.

Amurtel refers women to the hospital if the case is serious, but ambulances often take hours or don’t show up at all. Patsi saw complications from illness caused by weather, cold showers, bad hygiene, lack of water and spoiled food, infections because of hygiene and lack of clean underwear.


“The people that go to hospitals are not given diagnose papers back with them, because they’re not allowed, as they don’t have public insurance,” Patsi said. “It’s a little insane. Some doctors give unofficial papers though, which is great… how can we work with them when they come back without knowing what happened, what medicine were they given, etc.?”

On my first day of training with Amurtel, I watched an Afghani woman with sharp eyes approach Patsi and thrust her toddler toward her open arms.


“How’s mama today?” Patsi asked her. As she leaned in to kiss her on the cheek, the woman broke down in tears, burying her face into Patsi’s shirt. She was 25, my age, but married since her early teens with an abusive husband. Patsi held the toddler as we crouched in the shade of a wooden shed, and the woman spoke to a Farsi translator on the phone, discussing her limited options.

The routine, for five days a week, was brutal but consistent. We handed out bags of food with water, cucumbers or apples, raisin, sardines and the occasional sweet, and jars of baby food for toddlers. Patsi and other midwives saw women for routine pregnancy checkups and treatment for infections they felt uncomfortable discussing with the majority male doctors provided by the government. The caravans were a safe, female-only space, and women far past pregnancy and infant children came to visit, chat or seek safety from domestic violence. Condoms, prenatal vitamins and some medicine was available through donations, and underwear and bra distribution was always popular, particularly among pregnant women always looking for a larger size.

Maria, 19, came in to get an ultrasound from Patsi when she was just about five months along, curious to see whether she was having boy or a girl. She was a Syrian from Aleppo who hoped, like thousands of others, to reunite with family in Germany. Patsi cleaned off the doppler equipment and motioned for Maria to lie down on the torn fabric of the second caravan, which was where most of the medical exams and tests were administered. “I’m pretty sure it’s a boy,” Patsi told me in English. “But the baby is moving around a lot, and the machine’s so old…”


This is too much for me to explain in Arabic, I told Patsi first in English, then in Arabic to Maria. But you’re probably having a boy. We all laughed loudly, sweltering in the tiny caravan. Of all the things I might have imagined of Athens, I couldn’t have thought up this scene: the Greek midwife standing over the Syrian refugee with an outdated ultrasound, the American volunteer clumsily translating.

Most of the Afghani families stayed around or in the stone warehouse by the water, and the Syrians, including Maria and her husband, camped out on the other side of the road. I started stopping by every other day or so after my time at Amurtel was done. Sometimes we talked about their journey. They had left Turkey in mid-February and arrived at Idomeni, on the border of Greece and FYROM, right as the borders closed. They waited up there for two months in hopes that the border would reopen. Maria took moody, filtered photos on the abandoned train tracks by the camp and lost her phone when the early spring rains drenched their two backpacks of belongings. There was minimal food and the weather was cold and wet. The Greek police mocked them, she said, and told them no one would cross into Europe “the short way.”

Sometimes we talked about other less serious things, like eyeliner and whether eggplants made you skinny and the tiny, tiny tattooed dots that Maria had in her eyebrows to keep them flawless. Sometimes I sat and answered their many questions about my country and my presence.


Where would I go if a similar war broke out in the United States? No idea.

Why was I here? Because I would hope that if my family was in this same situation, there would be volunteers who would want to help us.

Did I know which camp they would be taken to next, and did I know when? I don’t know. Most days, I wondered if anyone in the Greek government knew.


Would they be guaranteed a better camp, somewhere with no tents and no outdoor bathrooms, because Maria was pregnant? Probably not.

There was little consideration for the difficulties of pregnancy, or the ways in which the needs of women are different from the needs of a men in a humanitarian crisis. The government was struggling to provide these refugees with basic shelter; how would there be specialized medical care?

Multiple times, Maria and her husband attempted to contact the unofficial manager of the Port to request that they were transferred to a camp with caravans, which include indoor bathrooms and private rooms, because she was due to give birth at the end of November. Many pregnant or young mothers made similar requests. But the few that ended up in ideal living situations (most often rented apartments) got there because of independent volunteer donations. Refugees awaiting asylum are not allowed to find permanent housing or work. So they are dependent on the government resources, which were already strained in Greece after years of austerity.


Maria’s husband is present and caring; she is young and healthy and optimistic, so relatively speaking, she was one of the luckier pregnant refugees in Greece. When Piraeus Port was cleared, Maria and her husband were taken to a small, new camp up north where no independent volunteers are allowed to enter. Maria is unable to return home and unable to move forward.

Generations of women before her have sustained through equal or worse for the sake of their children, and generations ahead will as well. Pregnancy is both a burden and a force for these women; it brought them across sea and overland, and keeps them going every day. They have lost their own countries, and they will raise children born without their nations.

At the end of September, Amurtel successfully opened up a permanent center in the middle of Athens. They now have a formal examining room, sunlit sitting rooms with cushions and pillows for mothers to rest and a weekly schedule with underwear distribution, infant feeding and mother and child activities. The women greet Uttama with smiles and thanks each morning. At Piraeus, they offered extra food rations to volunteers and invited foreigners in for tea served in plastic cups. Patsi could rarely leave the camp without stopping by multiple tents for tea, or being offered extra food rations.


“The graciousness of these women humbled me all the time,” Uttama said. “Their resilience is a testimony to the human spirit and, at the sake of sounding grandiose, a hope for humanity.”

Maria gave birth to her son in early December. She named him after her favorite character from a mid-90s American movie, and sent me photos of him dressed in a light-blue hat and a bib with English words and a cartoon dog and fire hydrant. Her and her husband are registered in the relocation system, and wait patiently through the biting Greek winter for news on their application status.

In the same week that Maria’s son was born, her hometown was finally and fully seized by military forces from the Bashar Assad regime, signifying the imminent death of hundreds of thousands of civilians in rebel-held east Aleppo. Almost 1,500 miles away, Maria tends to her son—a Syrian born on Greek land, an infant with no nation—in a country that she never wanted, and does not want her.


Jacqueline Kantor is a freelance journalist based in New Orleans.