The IPA, entered into force in January 2020, has made significant amendments to the definition of vulnerable persons and persons in need of special procedural guarantees.
According to Articles 39(5)(d) and 58(1) IPA the following groups are considered as vulnerable groups: “children; unaccompanied children; direct relatives of victims of shipwrecks (parents, siblings, children, husbands/wives); disabled persons; elderly; pregnant women; single parents with minor children; victims of human trafficking; persons with serious illness; persons with cognitive or mental disability and victims of torture, rape or other serious forms of psychological, physical or sexual violence such as victims of female genital mutilation.” Persons with post-traumatic stress disorder (PTSD) have been deleted as a category of persons belonging to vulnerable groups.
According to Article 58(2) IPA “The assessment of vulnerability shall take place during the identification process of the Art. 39 of this law without prejudice to the assessment of international protection needs”. According to article 58(4) L 4636/2019 “Only the persons belonging to vulnerable groups are considered to have special reception needs and thus benefit from the special reception conditions”. Article 58(3) IPA provides that “[…] the special condition of applicants, even if it becomes apparent at a later stage of the examination of the application for international protection, is taken into account throughout this procedure […]”
According to article 67 (1) IPA relating to special procedural guarantees “The Receiving Authorities shall assess within a reasonable period of time after an application for international protection is submitted, or at any point of the procedure the relevant needs arise, whether the applicant requires special procedural guarantees, due to their age, gender, sexual orientation, gender identity, psychological disorder or because they are a victim of torture, rape or other serious forms of psychological, physical or sexual violence.”
The number of asylum seekers registered by the Asylum Service as vulnerable in 2020 is as follows:
|Vulnerable persons registered among asylum seekers: 2020|
|Category of vulnerability||Applicants||Pending end 2020|
|Persons suffering from a disability or a serious or incurable illness||543||1,963|
|Pregnant women / new mothers||708||1,138|
|Single parents with minor children||834||1,262|
|Victims of torture, rape, or other serious forms of violence or exploitation||99||235|
|Victims of human trafficking||1||0|
|Minors accompanied by members of extended family||93||106|
Source: Asylum Service, 31 March 2021. Overlap in some cases is due to applicants falling in multiple vulnerability categories. The numbers refer to cases classified under these categories at the time of registration and not to the number of cases in which the vulnerability arose at a later stage.
The number and type of decisions taken at first instance on cases of vulnerable applicants are as follows:
|First instance decisions on applications by vulnerable persons: 2020|
|Category||Refugee status||Subsidiary protection||Rejection|
|Persons suffering from a disability or a serious or incurable illness||387||49||659|
|Pregnant women / new mothers||662||120||235|
|Single parents with minor children||646||24||184|
|Victims of torture, rape, or other serious forms of violence or exploitation||99||11||65|
|Victims of human trafficking||1||0||0|
|Minors accompanied by members of extended family||32||3||15|
Source: Asylum Service, 31 March 2021.
During 2020, only 2,228 out of 9,470 (23.5%) first instance decisions granting refugee status concerned vulnerable persons. 292 out of 7,275 (4%) first instance decisions granting subsidiary protection concerned vulnerable applicants.
Screening of vulnerability
Vulnerability identification in the border regions
The identification of vulnerability of persons arriving at the border regions shall take place, according to IPA, either by the RIS before the registration of the asylum application or during the asylum procedure.
Vulnerability identification by the RIS
According to Article 39(5) (d) IPA, in the context of reception and identification procedures carried out by the RIS, “[…] The Manager of [RIC] or the Unit, acting on a motivated proposal of the competent medical staff of the Center, shall refer persons belonging to vulnerable groups to the competent public institution of social support or protection as per case. A copy of the medical screening and psychosocial support file is transmitted to the Head of the institution where the person resides or is being referred. In all cases the continuity of the medical treatment followed shall be ensured, where necessary. The assessment that a person is vulnerable shall have as only consequence the immediate provision of special reception conditions.”
According to Article 75 (3) IPA “In case of doubt, the competent Receiving Authorities shall refer the unaccompanied minor to the age assessment procedures as per the provisions in force. In the case where the above-mentioned referral is considered necessary and until the completion of the procedure, special attention should be paid to the particular characteristics of the minor, especially those related to their gender or cultural peculiarities” (see below).
Since the end of 2019, the authority competent for carrying out medical checks is the National Public Health Organisation (EODY) which was established by the L 4633/2019 as the successor of KEELPNO.
The number of asylum seekers identified as vulnerable by the Reception and Identification Service in the border regions in 2020 is as follows:
|Category of Vulnerability||KOS||LEROS||LESVOS||SAMOS||CHIOS||FYLAKIO (EVROS REGION)|
|Elderly (over 65 years old)||4||0||19||11||4||2|
|Pregnant women/ women who have recently given birth||2||6||49||37||18||6|
|Single parents with minor children||17||6||139||115||70||42|
|Victims of sexual violence||14||0||27||2||18||0|
|Victims of human trafficking||0||0||0||0||0||0|
Source: Information provided by the Ministry for Migration and Asylum, General Secretariat for Reception of Asylum Seekers, 26 February 2021.
According to the International Rescue Committee (IRC) “Three out of five (60%) of the people who attended the IRC mental health program were categorized as presenting with a vulnerability or multiple vulnerabilities. About one in six (16%, 142 people) had survived at least one incident of gender-based violence, either in their country of origin or during their journey. At least one in six (15%, 139 people) were victims of torture. A further 29 people (3%) reported being subjected to both gender-based violence and torture. Of those referred to the IRC for psychosocial support, one in twenty (5%, 47 people) identified as members of the LGBTQI community and explained that they had faced difficulties as a result, while another one in twenty (5%, 46 people) were survivors of shipwrecks or relatives of shipwreck victims.”
In 2020 the average time between the completion of a 14-day quarantine period imposed upon arrival to all newcomers and the completion of the medical/psychosocial examination/ vulnerability assessment in the border regions is as follows:
|Location||The average time between the completion of a 14-day quarantine period imposed upon arrival to all newcomers and the completion of the medical/psychosocial examination/ vulnerability assessment|
|RIC Lesvos||10 days|
|RIC Chios||1-2 days|
|RIC Samos||1 day|
|RIC Leros||1 day|
|RIC Kos||1 day|
|RIC Fylakio (Evros region)||1 day|
Source: Information provided by the Ministry for Migration and Asylum, General Secretariat for Reception of Asylum Seekers, 26 February 2021.
Even though in 2020 there were no long delays between the arrival and the vulnerability assessment (as was the case before) the low quality of the process of medical and psychosocial screening remained a source of serious concern. Until now, alarming reports indicate that vulnerabilities are often missed, with individuals going through the asylum procedure without having their vulnerability assessment completed first. UNHCR reported that “access to health care for asylum-seekers and refugees continued to be limited at several locations across Greece, in particular on the islands, mainly due to the limited public sector medical staff and difficulties in obtaining the necessary documentation.”
Τhe following issues exacerbate problems in the identification of vulnerabilities:
Staffing deficit/ lack of treatment space, medicines, equipment
The number of healthcare professionals involved in the provision of medical and psychosocial services at different Reception and Identification Centers in the border regions is as follows:
Source: Information provided by the Ministry for Migration and Asylum, General Secretariat for Reception of Asylum Seekers, 26 February 2021.
According to IRC, “EODY consistently deals with staffing deficits and EODY staff on the islands consistently report a lack of treatment space, medicines, and equipment. This creates significant delays and backlogs, which adversely impact the health and mental health outcomes for asylum-seekers in the hotspots. […] With limited numbers of EODY staff to conduct these assessments, people’s symptoms, especially the more ‘invisible’ ones, including those related to mental health, are often missed. When people are identified later, their symptoms have frequently worsened. EODY staff has explained to the IRC that their organization lacks sufficient numbers of specialized medical staff, such as psychiatrists, child psychiatrists, dermatologists, pulmonologists and dentists, to meet some of the most urgent needs identified in the hotspots. EODY also reported a lack of essential equipment, such as x-ray machines, defibrillators and gynecological chairs. This means that doctors have to make referrals from the camp to the hospital for examinations they should have been able to perform in the hotspots. This delays critical diagnoses and treatments and creates further backlogs in hospitals. In addition, as a result of poor layout and consistent overcrowding in the camps, there is insufficient space to see and treat the numbers of people who require basic care there. So even when there are more staff available, limited space prohibits concurrent appointments. For the last four years, the medical response on the islands has relied heavily on volunteer medical staff and NGOs who have sought to fill critical staffing gaps. In Moria camp, for example, all primary health care was provided by NGOs before the September fires. However, the number of volunteers and funding for NGOs can fluctuate, so this is not a sustainable response to the real healthcare needs of asylum-seekers on the islands. Added to this, doctors who are not registered in the Greek system do not have permission to perform some key duties, such as making referrals to hospitals or providing prescriptions for medicine.”
Provision of psychosocial assessment upon request/ no provision of psychosocial assessment
Despite the relevant provision in national law which states that all newly arrived persons should be subject to reception and identification procedures, including medical screening and psychosocial assessment, it has been reported that during 2020 a psychosocial assessment was not offered to all newly arrived persons registered by the RIS. In fact, in some cases a relevant request of the applicant or a referral by the competent RAO, Health Unit SA (Ανώνυμη Εταιρεία Μονάδων Υγείας, AEMY), or civil society organisations needed to be made. According to IRC, “There are insufficient counseling services available externally to meet the needs of all the people who require this support. While there are state-provided psychologists in the hotspots who can refer people to counseling services outside, such as those run by the IRC, they do not provide any counseling themselves. However, one of the most glaring gaps in mental health care provision is the shortage of psychiatrists for people in the RICs. As of November 2020, there were no psychiatrists working inside any of the island hotspots, while NGOs providing mental health services that included support from a psychiatrist continued to operate at full capacity and with considerable waiting lists. The situation is equally serious outside of the RICs. This reflects the reality that there is a shortage of mental health staff and specialists throughout Greece”.
Difficulties regarding referrals to public hospitals
As noted by several civil society organisations “Where needed, EODY may issue a referral note (παραπεμπτικό σημείωμα) to a public health institution for the person to undergo the necessary examinations for identification and/or receive care. In the meantime, however, the RIS declares the person as non-vulnerable before the outcome of medical examinations. Requesting a re-assessment may be difficult in practice, especially for applicants who do not benefit from legal representation. As regards applicants suffering from disabilities or chronic diseases in particular, to the knowledge of the authors, the RIS has never referred an applicant to undergo a medical examination so as to identify the exact nature of disability and to medically certify its percentage by the competent disability certification centre”
Low quality of medical screening and psycho-social support
As noted by several civil society organisations: “The RIS issues a Foreigner’s Medical Card (Κάρτα Υγείας Αλλοδαπού) containing basic medical information. However, in several cases on the islands, medical problems are not recorded on the Foreigner’s Medical Card. The lack of recognition of medical issues renders access to special care and facilities extremely difficult. In addition, medical assessments are often transmitted incorrect, even for visible conditions such as mobility problems. […]. Appropriate care and protection are systematically not provided to vulnerable persons undergoing reception and identification procedures. In addition, when the RIS authorities identify an applicant as belonging to one of the ‘evident’ categories of vulnerability e.g. pregnancy, single-parent family, elderly, they certify them as vulnerable, without however assessing the applicability other vulnerability categories prescribed by law, which may not be visible e.g. victims of violence or torture. Accordingly, the RIS does not provide the applicant with appropriate special reception conditions. Moreover, as stated above, due to capacity gaps and delays in the conduct of medical checks and vulnerability assessments, many asylum seekers have undergone asylum procedures without prior identification of vulnerability. Relevant vulnerabilities are thus not identified until the applicant has completed their asylum procedure.” The NCHR is also concerned “about the deficiencies and difficulties in the process of identifying persons with serious diseases and/or persons with mental and intellectual disabilities during the process of reception of applicants for international protection.“ According to GCR’s observations, mental health issues or “not obvious” diseases, were not, in many cases, identified and, thus, people were not considered as vulnerable.
Classification of vulnerability and non-vulnerability
Since the end of 2017 a medical vulnerability template, entitled “Form for the medical and psychosocial evaluation of vulnerability”, was adopted by KEELPNO. Before the entry into force of IPA, this template included, in the beginning, two levels of vulnerability ((A) Medium vulnerability, and (B) High vulnerability), and then three relevant indicators to be used by the medical unit of each RIC [“(A) High vulnerability”, “(B) Medium vulnerability” and “(C) No vulnerability”]
Since January 2020, a new classification was introduced by EODY, despite the fact that such provision is not included in the IPA:
- (A) Vulnerable: The vulnerability is evident. The continuation of assessment and the development of a care plan are recommended. A referral for support should take place.
- (B) Non-vulnerable with special needs of hospitality: The following-up of his/her condition is recommended. If preventive measures for support are not provided, these persons could be vulnerable due to their clinical and/or psychosocial condition.
- (C) Non-vulnerable who doesn’t need any care: Non-vulnerable person who also don’t need any support.
Lack of information on the outcome of the procedure
Since the end of 2018, applicants are not informed about the outcome of the vulnerability assessment and are not provided with a copy of the vulnerability assessment template unless a relevant application is submitted by his/her lawyer. However, even in that case, the applicant is informed only on the final assessment, namely if he or she has been identified as “vulnerable”, “non-vulnerable with special needs of hospitality”, or “non-vulnerable without need of care”. Thus, there is no access to the medical documents/psychosocial reports. The RIS informs directly the Asylum Service regarding the outcome of the assessment, but the latter omits to provide information to the applicant. As noted by several civil society organisations:  “Crucially, asylum seekers on the islands do not have access to their medical case file, unless an application is filed by their legal representative. Medical documents and psycho-social reports, whether submitted by the applicant or passed on by public health institutions to the RIS, are in most cases not transmitted to the legal representative. Vulnerability assessment forms and recommendations of the EODY Medical and Psychosocial Unit are often withheld on the islands, on the ground that these documents are only internally to the Asylum Service.”
Also, “Several obstacles hinder effective referral from the RIS to the Asylum Service, however. As authorities do not have coordinated access to the national asylum database (Αλκυόνη) maintained by the Police, vulnerability assessments done by the RIS are not immediately visible to the Asylum Service.” RSA & Stiftung PRO ASYL mention that “There have been reported cases of asylum seekers having to receive copies from the RIS to produce them before asylum authorities”. At the end of 2020, the government announced its plan to develop a new integrated asylum database (Αλκυόνη ΙΙ) with financial support from the Internal Security Fund (ISF).” According to MSF, RSA and Pro Asyl, “an illustrative example of the deficiencies in the coordination between the different branches of the administration is that, even though the applicant had been recognised as vulnerable by the RIS several months prior to the interview summons, the Asylum Service was never informed of the aforementioned recognition.”
The following examples of the situation at the Eastern Aegean Islands reflect the aforementioned issues regarding the vulnerability assessment in the context of reception and identification procedures by RIS:
Lesvos: According to GCR’s observations, on Lesvos the quarantine period imposed upon arrival could last from two weeks up to about two months depending on several factors, such as the availability of EODY and RIS staff, the number of Covid-19 cases, etc. Furthermore, only evident vulnerabilities were identified given the low quality of the medical screening. Psychosocial support was conducted only upon request and mostly after the first instance interview. Given that most of the medical documents were in hard copy, many of them were lost following the destruction of the RIC of Moria in September 2020. Due to these shortcomings, a considerable number of newcomers and asylum seekers had never been (properly) assessed regarding potential vulnerabilities.
Chios: As mentioned by Equal Rights Beyond Borders in a letter submitted to the European Court of Human Rights on 6 May 2020, in a case regarding an applicant represented by Equal Rights, the Greek government reported the following medical services at Vial: “an infirmary of the National Public Health Organization (EODY), staffed with three doctors and six nurses, provides primary medical care. The NGO Salvamento Marítimo Humanitario, staffed with one doctor and one nurse, provides for complementary services in the afternoon. The infirmary is in contact with the Chios General Hospital by making referrals in case of cases which cannot be dealt with on the spot.” The Greek government further explained that the Chios General Hospital suspended its regular operations in order to prevent the spread of COVID-19. Beginning on 16 March 2020, the hospital only accepted emergencies referred to them directly by Vial’s medical unit. One camp employee explained the situation in the following way: “We have to minimise referrals and transports to the hospital unless it’s extremely urgent and necessary.”
Samos: Shortcomings related to understaffing and other issues mentioned above, apply also for Samos. Even though during 2020 the medical screening was conducted a few days after the arrival, in most of the cases it was insufficient and of bad quality. Additionally, prioritization was given to the vulnerability assessment of newcomers (arrivals of 2020) and thus, there was a big backlog of cases of 2019. It was also observed that in some cases the psychosocial support was carried out even after the registration of the asylum application by the RAO. According to GCR’s findings, in Samos RIC, during 2020 there were one or two doctors of EODY. At the same time, the NCHR mentions that “the situation regarding the reception and living conditions of asylum seekers in and around the Reception and Identification Center in Vathi was out of control and abolished every aspect of human dignity of those living in its premises”.
Leros: Difficulties in access to the psychosocial support and the outcome of the vulnerability assessment and other issues mentioned above, apply also for Leros.
Kos: Shortcomings related to understaffing mentioned above, also apply for the medical and psychosocial division of RIS in Kos, as during 2020 there was only one doctor of EODY, According to GCR’s findings. Additionally, even though newcomers were subjected to medical screening one day after the completion of the 14-day quarantine period imposed upon their arrival, the medical examination conducted was superficial and insufficient. It is also mentioned that in many cases the applicants received a copy of the vulnerability assessment no earlier than the conduct of their interview before the Asylum Service or the completion of the examination of their asylum application at 2nd instance.
Rhodes: Even if Rhodes is among the Eastern Aegean islands and constitutes an entry point, together with other islands neighboring to Turkey (eg Simi, Megisti, Kastellorizo), there is no RIC, no medical/psychosocial screening and the RAO does not examine asylum applications lodged by newcomers. The majority of third-country nationals, who entered Greece through Rhodes or the nearby islands during 2020, were transferred –after the 14-day quarantine period imposed upon their arrival- to Kos and Leros Island where they were either detained or subject to reception conditions at the RIC. However, According to GCR’s knowledge, there were cases of asylum seekers who, due to the Covid-19 measures, were transferred to Kos or Leros several months after they arrived and, in the meantime, they remained under administrative detention in Rhodes without having been subject to any vulnerability assessment.
Lift of the geographical restriction (see also Freedom of movement)
Under IPA, the recognition of vulnerability of asylum seekers has no bearing on the asylum procedure under which their application is examined. Therefore, vulnerable groups, even when identified as such, are no longer referred to the Regular procedure, unless it is proven that no appropriate health care regarding their individual medical problem is available on the island where they reside (See below). In the latter cases, the geographical restriction imposed upon arrival is lifted and persons are transferred or allowed to travel to the mainland. In light of this, the exemption of vulnerable individuals from the Fast-Track Border procedure has become much more difficult.
More precisely, for asylum-seekers who entered Greece through the islands of Lesvos, Chios, Samos, Kos, Leros, and Rhodes during 2020, a restriction of movement within each island (‘geographical restriction’) has been imposed as per the Ministerial Decision 1140/2.12.2019 (GG B’ 4736/20.12.2019) which has been in force since 1 January 2020. Greek law transposes Article 7 RCD allowing Member States to impose a restriction of movement to asylum-seekers within a specific area assigned to them, provided that it does not affect the unalienable sphere of private life and that allows sufficient scope for guaranteeing access to all benefits under the Directive. Until 31 December 2019, the geographical restriction could be lifted, inter alia, in respect of vulnerable persons. Following amendments to the law, after 1January 2020, the geographical restriction may inter alia be lifted by a decision of the Manager of the RIC for vulnerable persons or persons in need of special reception conditions if appropriate support may not be provided within the area of restriction, without sufficiently describing what such appropriate support entails.
The number of decisions of lift of geographical restriction per RIC and per category of vulnerability (or other cases) is as follows:
|Reasons for the lifiting of the geographical restriction during 2020||Kos||Leros||Lesvos ||Samos||Chios|
|Persons with cognitive or mental disability||8||5||10||91||12|
|Persons with serious/incurable illness||79||202||57||272||63|
|Single parents with minor children||35||0||65||550||21|
|Victims of torture, rape, or other serious forms of psychological, physical, or sexual violence (FGM, etc)||30||7||15||11||39|
|Victims of human trafficking||14||2||0||1||0|
|Vulnerable persons and persons in need of special reception conditions (Art. 58 and 67 L. 4636/2019)||30||0||987||0||281|
|Direct relatives of victims of shipwrecks (parents and siblings)||15||0||0||0||0|
|Persons falling under the family reunification provisions of Articles 8-11 of Dublin Regulation (after the person is accepted by the concerned member state)||7||7||0||0||6|
|Persons whose applications for international protection are reasonably considered to be founded||18||0||0||0||9|
|Other reasons (eg urgent needs due to increased flows, family union, etc)||0||32||0||0||742|
|Total amount of lifts of geographical restriction per RIC during 2020||305||457||1,513||1,777||1,491|
Source: Information provided by the Ministry for Migration and Asylum, General Secretariat for Reception of Asylum Seekers, 8 March 2021.
Lesvos: According to GCR’s knowledge, following the Moria fire on 9 September 2020 and the destruction of many documents in the RIS, there were cases of applicants identified already as “vulnerable in need of special reception conditions” who, upon notification of the first instance decision, could not file an appeal because Lesvos RAO had informally suspended – without the issuing of a relevant legislative act, therefore infringing the vital principle of legal certainty – the deadline for the submission of appeals for the first instance rejections that had been notified until 8 September 2020. Thus, RIS did not proceed to the lift of the “geographical restriction” of the aforementioned persons despite their vulnerability because the latter were considered as “non-applicants” as they were notified of a first instance rejection but an appeal was not submitted in due course. On 11 January 2021, and for the first time in 4 months, Lesvos RAO would begin notifying applicants on Lesvos with first instance rejections and would start accepting appeals against these decisions. However, following the concerns expressed by legal actors, the notification of first instance rejections was postponed due to lack of legal assistance. According to GCR, up until March 2021 there are still vulnerable persons with first instance rejections who are not able to submit an appeal due to lack of legal aid, and thus their geographical restriction is still not lifted.
Chios: An example of the shortcomings related to the identification of vulnerability and the respective lift of geographical restriction is the following: In the case of a Syrian family of Palestinian origin consisted of the mother, two minor children, and a 20-year-old daughter, residing at Chios RIC (VIAL), a decision of vulnerability and lift of geographical restriction was issued only for the mother and the minor children (“single parent with minor children”). It was only after the intervention of the Greek Ombudsperson , based on a request by GCR to all the competent Authorities (RIS, Chios RAO, UNHCR, Greek Ombudsperson), that the geographical restriction of the older daughter was also lifted and the whole family was transferred to the mainland. GCR and thus the Greek Ombudsperson made the abovementioned request on the grounds of a) family unity, b) vulnerability of other family members, c) dire living conditions at Vial camp and need for preventive measures against Covid-19 for the protection of vulnerable persons, e) need for preventive measures so that young woman will not be exposed to any risk related to her gender/need to protect women and girls during reception procedures.
Samos: According to GCR’s observations, in principle, during 2020 the geographical restriction was not lifted for vulnerable persons, except for very few cases or for vulnerable cases running “the risk of exposure to Covid-19”. Even though there were no decisions of lift of geographical restriction “due to increased flows” according to the information provided by the Ministry (see above), according to GCR’s findings during 2020 such decisions were issued for several vulnerable persons who had arrived at Samos during 2019 (eg. pregnant or single women). GCR asked on 2 October 2020 through a Letter – Intervention, addressed to the Ministry of Migration and Asylum, the Greek Ombudsman, Samos RIC and RAO administration for immediate measures for the protection and removal from Samos RIC of high risk groups due to exposure to Covid-19, in view of the daily increase of Covid-19 positive cases within Samos RIC and the extension of Samos RIC lockdown. The announcement of the transfer of some urgent vulnerable cases both to ESTIA apartments on the island and to the mainland followed.
Kos: According to GCR, during 2020 the geographical restriction was not lifted for all persons identified as vulnerable, but only in cases where “appropriate medical support could not be provided within the island”. Also, even though the geographical restriction was lifted by a decision of the Manager of the RIC, the departure could not take place without the approval of the Asylum Service. In some cases, a decision of temporary lift of the restriction was issued for the person to visit a hospital in Athens and then return to Kos. The following example of a family of Syrian origin (pregnant mother, father, two minor children) arrived at Kos in October 2019 reflects the numerous issues arising in regard with the vulnerability assessment and the lift of the geographical restriction: For 9 months, until June 2020, the registration and identification procedures were not carried out by RIS and the family was staying at Kos RIC despite the mother’s pregnancy, the father’s several health issues and the young age of the other two members of the family. It was only after the intervention of the Greek Ombudsperson that the family was identified as vulnerable and transferred to the mainland. Through the abovementioned intervention the lift of geographical restriction was requested on the grounds of a) pregnancy, b) serious disease of the father (mental and physical health problems), c) vulnerability of the children, d) harsh living conditions, e) need for preventive measures against Covid-19 for the protection of vulnerable groups.
Vulnerability identification in the asylum procedure
According to Article 72 (3) IPA “During the Reception and Identification procedure or the border procedure of art. 90 of this law, the Receiving Authorities or the Decision Authorities and especially the Regional Asylum Offices or the Autonomous Asylum Units shall refer the applicant for international protection to doctors of Public Hospitals or Public Mental Health Institutions or other contracted physicians or the Medical Screening and Psychosocial Support Unit of the RIC for the vulnerability assessment under the article 39(4) of this law. Upon the completion of medical and psychosocial assessment, the Unit, acting on a written motivated proposal, shall inform the Head of the competent RAO. The above-mentioned proposal is also notified to the Manager of the RIC. That assessment shall have as only consequence the immediate provision of special reception conditions and special procedural guarantees to the applicant.”
According to Article 75 (3) IPA “In case of doubt, the competent Receiving Authorities shall refer the unaccompanied minor to the age assessment procedures as per the provisions in force. In the case where the above-mentioned referral is considered necessary and until the completion of the procedure, special attention should be paid to the particular characteristics of the minor, especially those related to their gender or cultural peculiarities.” (See below)
Article 67(1) IPA provides that “The Receiving Authorities shall assess within a reasonable time after the application for international protection is lodged or at any point of the procedure the relevant need arises, whether the applicant requires special procedural guarantees as a consequence, inter alia, of age, gender, sexual orientation, gender identity, mental disorders or as a consequence of torture, rape or other serious forms of psychological, physical or sexual violence”. According to Article 67(3) IPA “When adequate support cannot be provided [to the applicants] within the framework of the accelerated procedure (art. 83 (9) IPA) and border procedure (art. 90 IPA), especially when the applicant needs to be provided with special procedural guarantees as a consequence of torture, rape or other forms of serious psychological, physical or sexual violence, the abovementioned procedures do not apply or cease to apply […]”
Also, according to article 58 (5) IPA “In case the competent Authorities identify victims of human trafficking, they are obliged to inform as soon as possible the National System of Recognition and Referral of Victims of Human Trafficking in accordance with the article 6 L. 4198/2019”
Despite these provisions, the shortage of medical and psychosocial care can make it extremely complicated and sometimes impossible for people seeking asylum to be (re-)assessed during that process. Following the medical and psychosocial assessment, the medical psychosocial unit of the RIC should inform the competent RAO or AAU of the Asylum Service.
Accordingly, where vulnerability is not identified before the asylum procedure the initiation of a vulnerability assessment and further referral for vulnerability identification lies to a great extent at the discretion of the caseworker. As mentioned above, due to significant gaps in the provision of reception and identification procedures in 2020, owing to a significant understaffing of EODY units and other issues, GCR has found that for a considerable number of applicants the asylum procedure was initiated without a proper medical screening and/or a psychosocial assessment having been concluded.
For example, on Chios the understaffing of state authorities in combination with the constant pressure to process more asylum applications more quickly, resulted in a serious undermining of procedural legal safeguards and thus to decisions of poor quality and unjustified rejections in many cases. GCR has documented many cases where the asylum interview took place before the medical examination of the asylum seeker, who was afterwards rejected as non-credible because of his/her inability to provide all the dates and details of certain events and narrate his/her story in a chronological order, although the person suffered from acute psychiatric problems (e.g. psychosis), as was later proved.
As it was mentioned above, according to GCR’s observations, most of the time on Samos the vulnerability of the person in concern had not even been examined, meaning that interventions and referrals to medical and psychosocial staff, both of public services (Samos RIC and Samos General Hospital) and NGOs providing medical care and/or psychological support, had to precede the legal request to Samos RIC Administration for a lift of geographical restriction. Between the exceptional cases has been the case of a deaf and with reduced vision young asylum applicant from Ghana, whose vulnerability, according to responsible services, could not be proved due to the absence of a medical diagnosis. Indeed, there was no specialized doctor- otolaryngologist in Samos General Hospital to examine the asylum applicant and diagnose his auditory disability. GCR represented the vulnerable beneficiary during his interview, noted beneficiary’s disability (which was challenged by EASO interview operator on the basis of no proof) and the violation of procedural guarantees and requested his case referral to regular asylum procedure, the lift of geographical restriction and his transfer to the mainland, in order to have access to medical care in a tertiary care hospital and continue his interview after his vulnerability recognition and with possible proper technical support and psychosocial support. Nevertheless, Samos RAO had been examining the possibility of issuing a decision from asylum applicant’s file data, which would definitely lead to a rejection, as there were no documents proving neither beneficiary’s personal story nor beneficiary’s vulnerability. After repeated interventions by GCR, over a period of months, a decision to lift the geographical restriction was issued despite the absence of medical documents and the case was referred to the regular procedure.
According to GCR’s observations, article 67(3) IPA (exemption from the fast-track border procedure and referral to the regular procedure due to vulnerability) was not applied by the Asylum Service to any case without a prior lift of the geographical restriction. On Samos, According to GCR’s knowledge, after the lift of geographical restriction for reasons not related to vulnerability, article 67(3) IPA was applied and the case was referred to the normal procedure without the person being identified as vulnerable by the RAO. If the interview of first instance had already been conducted before the decision of lift of geographical restriction and the referral to the normal procedure due to vulnerability, it was not conducted again in accordance with the guarantees provided by article 67(2) IPA.
RSA, Pro-Asyl and MSF also reported that “The gravity of non-compliance of the Greek authorities with the above obligations is reflected in the case of a particularly vulnerable asylum seeker, survivor of serious and repeated violence. Despite having been recognised by the Reception and Identification Service (RIS) as a survivor of torture, rape or other form of violence, the applicant was repeatedly summoned to conduct the asylum interview within the border procedure. The authorities’ indifference to his already fragile psychological state led to systematic re-traumatisation on four different occasions ending up to repeated urgent transfers from the Asylum Service offices to the hospital’s emergency ward culminating to the deterioration of his mental health condition. The Asylum Service at no point assessed whether the applicant was in need of special procedural guarantees on account of his health condition, and whether or not adequate support could be provided in his case, despite the prior submission of medical documents from the public hospital, documents attesting the person’s inability to follow the demanding process of the asylum interview and recount extremely traumatic experiences, as well as documents highlighting the deterioration of his health condition stemming from the interview process. As a result, his case was not exempted from the border procedure as required by the law, even though the competent authorities were fully aware of the state of his health.”
Vulnerability identification in the mainland
In the Attica region, depending on their nationality, vulnerable groups are referred to the RAOs of Attica, Alimos, or Piraeus. In the rest of the mainland vulnerable groups are registered by the RAO competent for the area they reside in. According to information provided by the Asylum Service, during 2020 4,196 vulnerable asylum seekers were registered by RAOs and AAUs in the mainland.
However, obstacles to Registration through Skype in the mainland also affect vulnerable persons. As referrals of vulnerable persons to the competent RAOs in order to be registered are taking place through NGOs or other entities, GCR is aware of cases of vulnerable applicants who, before being supported by NGOs or other entities and have an appointment fixed, have repeatedly and unsuccessfully tried to fix an appointment themselves to register their application through Skype. Moreover, appointments for the registration of vulnerable persons in the mainland can be delayed due to capacity reasons or due to the suspension of services provided by the Asylum Service due to the preventive measures against Covid-19 (See above, “Registration”).
In case that indications or claims as of past persecution or serious harm arise, the Asylum Service refers the applicant for a medical and/or psychosocial examination, which should be conducted free of charge and by specialised scientific personnel of the respective specialisation. Otherwise, the applicant must be informed that he or she may be subject to such examinations at his or her initiative and expenses. However, article 72(2) IPA provides that “Any results and reports of such examinations are deemed as justified by the Asylum Service where it is established that the applicant’s allegations of persecution or serious harm are likely to be well-founded”.
Currently, there are no public health structures specialised in identifying or assisting torture survivors in their rehabilitation process. As a result, it is for the NGOs running relative specialised programmes, to handle the identification and rehabilitation of victims of torture. This is rather problematic for reasons that concern the sustainability of the system, as NGOs’ relevant funding is often interrupted. In Athens, torture survivors may be referred for identification purposes to Metadrasi in the context of the programme “VicTorious: Identification and Certification of Victims of Torture”. However, those referrals take place mostly by other NGO’s.
Also, according to article 58 (5) IPA “In case the competent Authorities identify victims of human trafficking, they are obliged to inform as soon as possible the National Referral Mechanism (NRM) for the identification and referral of victims of Human Trafficking in accordance with the article 6 L. 4198/2019”.
The following case supported by GCR mirrors several of the aforementioned issues arising in the context of vulnerability identification by RIS and during the asylum procedure both at the border region and on the mainland:
A single woman from the Democratic Republic of Congo, victim of sexual and gender-based violence in her country of origin, arrived on Chios Island in June 2019 and applied for international protection before the competent RAO. A month later she was sexually assaulted by a man and she tried to report the incident to the local Police but to no avail. She then addressed to “Médecins sans Frontières” who referred her to the public hospital due to severe gynecological problems. In October 2019 she breached the geographical restriction and she arrived at the mainland. It is mentioned that until her departure she was residing at Vial camp (Chios) in inhuman and degrading conditions without having been subject to any adequate medical support, psychosocial assessment and vulnerability identification by the RIS. Her interview before Chios RAO was still pending at that time. In July 2020 she was arrested on the mainland and remained in administrative detention with a view of return to Chios Island and without her asylum application being taken into consideration. Despite the several requests submitted by GCR to Chios RIS and RAO in order for the geographical restriction to be lifted and her case to be channeled to the regular procedure in accordance with article 67(3) IPA on the grounds of a) vulnerability (victim of sexual violence-mental health problems), b) need of special reception conditions given that appropriate support could not be provided within Chios, c) need for preventive measures so that young woman will not be exposed to any risk related to her gender/need to protect women and girls during reception procedures, the applications were rejected or remained unanswered. Following a suicidal attempt committed in the PRDC of Amygdaleza (Athens), the young woman was released by the Police and stayed in Athens where she was supported by several NGOs. The Police Directorate of Chios proceeded to the lift of geographical restriction for reasons other than the vulnerability. Despite a new request by GCR to RAO Chios and RAO Alimos (Athens) in order for the applicant to be exempted from the fast-track border procedure and for the asylum procedure to be continued in Athens due to the fact that the geographical restriction was already lifted, that the person in question already resides in Athens and is in need of special conditions and procedural guarantees due to her vulnerability, the Asylum Service, despite GCR’s several requests and the Greek Ombundsperson’s numerous interventions, has not replied to that demand up until May 2021 and the young asylum seeker remains in Athens in legal limbo.
Age assessment of unaccompanied children by the RIS and in the asylum procedure
Until August 2020, two Ministerial Decisions provided for the age assessment procedure of unaccompanied children. Ministerial Decision 92490/2013 laid down the age assessment procedure in the context of reception and identification procedures and Joint Ministerial Decision 1982/2016 provided for an age assessment procedure for persons seeking international protection before the Asylum Service, as well as persons whose case was still pending before the authorities of the “old procedure”.
On 13 August 2020 the Joint Ministerial Decision 9889/2020 entered into force, which sets out a common age assessment procedure both in the context of reception and identification procedures and the asylum procedure. However, the scope of the JMD 9889/2020, as was the case with the previous ones, does not extend to age assessment of unaccompanied children under the responsibility of the Hellenic Police (meaning minors under administrative detention or protective custody) (see Detention of Vulnerable Applicants).
Article 39(5) (f) IPA related to reception and identification procedures refers to JMD 9889/2020. According to article 1(2) JMD 9889/2020, in case of doubt of the person’s age, i.e. when the authority’s initial assessment is not consistent with the person’s statements, the RIS or the Asylum Service or any authority/organisation competent for the protection of minors or the provision of healthcare or the Public Prosecutor should inform -at any point of the reception and identification procedures or the asylum procedure- the Manager of the RIC or the Facility of temporary reception/hospitality, where the individual resides, or the Head of RIS or the Asylum Service -if the doubt arises for the first time during the personal interview for the examination of the asylum application-, who, acting on a motivated decision, is obliged to refer the individual for age assessment. Age assessment is carried out by EODY within the RIC, by any public health institution, or otherwise, by a private practitioner under a relevant programme.
The age assessment is conducted with the following successive methods:
- Initially, the assessment will be based on the macroscopic features (i.e. physical appearance) such as height, weight, body mass index, voice, and hair growth, following a clinical examination from properly trained healthcare professionals (physicians, paediatricians, etc) who will consider body-metric data.
- In case the person’s age cannot be adequately determined through the examination of macroscopic features, a psychosocial assessment is carried out by a psychologist and a social worker to evaluate the cognitive, behavioural and psychological development of the individual. If a psychologist is not available or there is no functioning social service in the nearest public health institution, this assessment can be conducted by a specially trained psychologist and a social worker available from a certified civil society organisation but it cannot be conducted by an organisation in charge of providing care or housing to the person whose age is in question. The outcome of the age assessment at this point is a combination of the psychosocial assessment and the examination of the development of macroscopic features.
- Whenever a conclusion cannot be reached after the conduct of the above procedures, the person will be subjected to the following medical examinations: either left wrist and hand X-rays for the assessment of the skeletal mass, or dental examination or panoramic dental X-rays or to any other appropriate means which can lead to a firm conclusion according to the international bibliography and practice.
According to Art. 1(7) JMD 9889/2020 the opinions and evaluations are delivered to the person responsible for the referral, who issues a relevant act to adopt the abovementioned conclusions, registers the age in the database of Reception and Asylum, and notifies the act to the Special Secretariat for the Protection of Unaccompanied Minors.
After the age assessment procedure is completed, the individual should be informed in a language he or she understands about the content of the age assessment decision, against which he or she has the right to appeal in accordance with the Code of Administrative Procedure. The appeal has to be submitted to the authority that issued the contested decision within 15 days from the notification of the decision on age assessment.
In practice, the 15-day period may pose an insurmountable obstacle to receiving identification documents proving their age, as in many cases persons under an age assessment procedure remain restricted in the RIC. These appeals are in practice examined by the Central RIS. According to the data provided by the RIS, during 2020, 28 appeals were submitted against age assessment decisions. Out of 28 appeals, 1 was accepted, 19 were rejected and 8 were pending on 31 December 2020. The NCHR highlights that the applicants for international protection are often not notified of their decisions on age determination and as a result they are unable to file an appeal against that decision.
Several civil society organisations report that “Medical methods for age assessment are systematically used, despite well-documented concerns as to their accuracy and reliability. The authorities do not systematically comply with the procedure set out in secondary legislation”. Persons are subjected to an X-ray examination at the First-Line National Health Network Centre (ΠΕΔΥ) or general hospital, without prior assessment by a psychologist and a social worker. Moreover, EODY does not perform a step-by-step process starting from less invasive methods, as established by JMD 9889/2020. The alleged minors go through a one-time appointment, which includes an age assessment interview and a medical and psychological evaluation. Many are only asked about aspects irrelevant to age assessment such as their family relationships, country of origin, and reasons for fleeing. The sessions take less than 15 minutes and involve no explanation of the procedure or its outcome.”
In the same report, it is mentioned that “Errors in the registration of personal details e.g. name, parents’ names, date of birth, are frequently reported in the different RICs. […]. Particularly as regards the date of birth, the RIS frequently sets artificial dates such as 1 January. This is especially relevant in the case of alleged minors. In several cases, documents held by individuals are disregarded on the ground that the authorities cannot access the documents’ authenticity, and the authorities assign a new date of birth to the applicant. This practice is verified, for instance, vis-à-vis applicants from Afghanistan. [….] Complaints also relate to wrong registration of children as adults. Frontex officers are reported to systematically register declared minors as adults, without recording their declared age and without referring them to age assessment procedures.”
Moreover, UNHCR has also observed gaps in the age registration procedure followed by the police and Frontex as well as in the referrals to the age assessment procedure, which is applied contrary to the provisions provided in Greek law. The latter foresees a step-by-step and holistic assessment by the medical and psychosocial support unit in the RIC defining the referral to the hospital as the last resort and only if the medical and psychosocial assessment of the RIS is not conclusive. However, in practice, the medical and psychosocial assessment in the scope of the RIS is skipped and a referral takes place directly to the hospital for an x-ray assessment, which usually concludes the age assessment procedure. Furthermore, issues of concern are the gaps in the age assessment procedures that result in instances of repeated age assessments requested by different actors, a practice that prolongs the stay of unaccompanied children in dire conditions in RICs.
According to GCR’s findings, in practice, the age assessment of unaccompanied children is an extremely challenging process and the procedure prescribed is not followed in a significant number of cases, inter alia due to the lack of qualified staff. During 2020, the practice of not following the prescribed procedure persisted due to lack of specialized personnel.
Several civil society organisations also mention that “[C]oncerns […] as regards the involvement of Frontex experts in document checks are particularly relevant to age assessment. Besides, the Asylum Service only deems IDs, passports, and original birth certificates, translated and sealed by the embassy of the country of origin, as proof of the applicant’s age. Age assessment practice falls far short of legislative standards. Many alleged minors report arbitrary age assessments, conducted in dereliction of legal provisions. Starting from their first registration in the RIC, minors have claimed their minority but have not been considered credible and have been met with mistrust from interpreters and authorities. Responses include phrases such as “you do not look like a minor”. Several alleged minors have reported that they were not informed of the age assessment process or its consequences; they were only called to the facilities of EODY inside Moria on Lesvos. Furthermore, severe capacity shortages in medical staff on the islands result in prolonged delays in the conduct of age assessments. […] Individuals are not treated as minors during the age assessment procedure. On all islands, the Public Prosecutor does not appoint a guardian for the person, while alleged minors are excluded from safe zones in the RIC. Accordingly, on islands such as Kos, alleged minors remain in the pre-removal detention centre for prolonged periods pending the outcome of the process.”
According to GCR’s findings, during 2020, on Lesvos, big delays were observed regarding the age assessment procedure. The alleged minors were subjected to psychosocial screening by RIS and, then, the medical staff, depending on their estimation about the age of the person, referred him/her to the public hospital for hand and wrist X-rays. During his visit in the camp the pediatrician of the public hospital (once per month) signed the result of the aforementioned procedure; in practice it was a conclusion (minor/adult). On Samos, around twenty alleged minors were referred to the public hospital in order to be subjected to medical examinations for age assessment. However, since the entry into force of the JMD 9889/2020, the age assessment procedures are suspended for reasons that remain unknown up until March 2021. On Kos, minors were treated as adults unless their lawyer submitted a request for age assessment. It is also observed that, in case of doubt, the medical and psychosocial assessment in the scope of the RIS was skipped and the individuals were directly referred to the public hospital for X-rays.
Concerning the age assessment in the asylum procedure, the IPA includes procedural safeguards and refers explicitly to the JMD 1982/2016 (amended by JMD 9889/2020 since 13 August 2020) (see above).
More specifically, Article 75(3) IPA provides that “when in doubt the competent receiving authorities may refer unaccompanied minors for age determination examinations according to the provisions of the Joint Ministerial Decision 1982/16.2.2016 (O.G. B’ 335). When such a referral for age determination examinations is considered necessary and throughout this procedure, attention shall be given to the respect of gender-related special characteristics and of cultural particularities.”
The provision also sets out guarantees during the procedure:
- A guardian for the child is appointed who shall undertake all necessary action in order to protect the rights and the best interests of the child, throughout the age determination procedure;
- Unaccompanied children are informed prior to the examination of their application and in a language which they understand, of the possibility and the procedures to determine their age, of the methods used, therefore, the possible consequences of the results of the above-mentioned age determination procedures for the examination of the application for international protection, as well as the consequences of their refusal to undergo this examination;
- Unaccompanied children or their guardians consent to carry out the procedure for the determination of the age of the children concerned;
- The decision to reject an application of an unaccompanied child who refused to undergo this age determination procedure shall not be based solely on that refusal; and
- Until the completion of the age determination procedure, the person who claims to be a minor shall be treated as such.
The law also states that “the year of birth can be modified after the age determination procedure under Article 75, unless during the interview it appears that the applicant who is registered as an adult is manifestly a minor; in such cases, a decision of the Head of the competent Receiving Authority, following a recommendation by the case-handler, shall suffice.”
The JMD was an anticipated legal instrument, filling the gap of dedicated age assessment procedures within the context of the Asylum Service and limiting the use of medical examinations to a last resort while prioritising alternative means of assessment. Multiple safeguards prescribed in both the IPA and JMD 9889/2020 regulate the context of the procedure sufficiently, while explicitly providing the possibility of remaining doubts and thus providing the applicant with the benefit of the doubt even after the conclusion of the procedure. However, the lack of an effective guardianship system also hinders the enjoyment of procedural rights guaranteed by national legislation (see Legal Representation of Unaccompanied Children).
In practice, the lack of qualified staff within the reception and identification procedure and shortcomings in the age assessment procedure in the RIC undoubtedly have a spill-over effect on the asylum procedure, as the issuance of an age determination act by the RIS precedes the registration of the asylum application with the Asylum Service. While registration of date of birth by the Hellenic Police could be corrected by merely stating the correct date before the Asylum Service, this is not the case for individuals whose age has been wrongly assessed by the RIS. In this case, in order for the personal data e.g. age of the person to be corrected, the original travel document, or identity card should be submitted. Additionally, a birth certificate or family status can be submitted, however, these two documents require an “apostille” stamp, which in practice is not always possible for an asylum seeker to obtain. In practice though, in a few cases the employees in the RAOs proceed to the correction of the age of the person, based on documents without “apostille”. Alternatively, according to the law, the caseworker of the Asylum Service can refer the applicant to the age assessment determination procedure in case that reasonable drought exists as to his or her age. In this case, referral to the age assessment procedure largely lies at the discretion of the Asylum Service caseworker.
The number of age assessments conducted within the framework of the asylum procedure in 2020 is not available.
According to GCR’s knowledge, on Lesvos during 2020 in many cases the interview for the examination of the asylum application was conducted and the first instance decision was issued by the RAO of Lesvos before the completion of the age assessment procedure.
Several civil society organisations reported that “In one case on Samos, the Asylum Service referred an alleged minor to the General Hospital of Samos to undergo the examination in December 2019. The applicant’s lawyer was informed in October 2020 that the examination had not taken place until then because the General Hospital of Samos could only examine 8 persons and the Asylum Service had decided to give priority to minors who had submitted a family reunification request under the Dublin Regulation. Moreover, the General Hospital of Samos informed the lawyer that it had never received a request by the Asylum Service concerning her client”.
According to GCR’s findings, in a case of an unaccompanied minor of Syrian origin registered as an adult by Kos RIS, GCR submitted a copy of his national id card proving that he was under-age. Then, RIS referred the individual for age assessment to the public hospital where he was subjected to left-hand X-rays. According to the doctor’s opinion, the individual was 19 years old. In the meantime, the individual’s application for international protection was rejected at 1st instance as inadmissible (safe third country concept). Then an appeal was filed against the decision of 1st instance and the Appeals Authority (decision No 19885/11-08-2020) decided that the application for international protection should not be examined unless the age assessment was properly conducted. According to the 2nd instance decision, the three methods of age assessment were not applied successively and, in any case, left-hand X-rays should always be accompanied by left wrist X-rays, dental examination, and panoramic dental X-rays, in accordance with the JMD 1982/2016 that was in force at that time. Thus, doubts arose regarding the individual’s actual age and, the appellant was to be referred again for age assessment in accordance with the provisions of JMD 1982/2016.
In light of the persisting gaps in child protection in Greece, including the lack of effective guardianship, lack of qualified staff for age assessment procedures, inconsistencies in the procedure followed, and the lack of any legal framework governing the age assessments conducted by the Police (see Detention of Vulnerable Applicants) the 2017 findings of the Ombudsperson are still valid: “The verification of age appears to still be based mainly on the medical assessment carried out at the hospitals, according to a standard method that includes x-ray and dental examination, while the clinical assessment of the anthropometric figures and the psychosocial assessment is either absent or limited. This makes more difficult the further verification of the scientific correctness of the assessment.”
Moreover, in the past, the Greek Ombudsperson had expressed serious doubts as to the proper and systematic implementation of the age assessment procedures provided by both ministerial decisions and the implementation of a reliable system. On 30 August 2018, the Greek Ombudsperson had sent a letter to the Director of the Asylum Service on issues that hinder access to the asylum procedure for the unaccompanied minors as well as other issues, such as delays, erroneous implementation of the age assessment procedure, etc. This document remained unanswered, thus the Ombudsperson sent a kind reminder on 30 September 2019, emphasizing that age assessments based on diagnostic examinations (such as a wrist X-ray scan) should not be accepted given the fact that the accuracy of these exams is questionable.
 Average number of staff at RICs throughout 2020.
 IRC, as above, p.17.
 Ibid, p. 18
 RSA, HIAS, GCR, Legal Center Lesvos, DRC, Fenix, ActionAid, Mobile Info Team, The Workings of the Screening Regulation. Juxtaposing proposed EU rules with the Greek reception and identification procedure, January 2021, available at: https://bit.ly/3fL8xFF, p.14
 Ibid p.18
 RSA and other civil society organisations, as above, p.14.
 Ibid, p.23.
 RSA & Stiftung PRO ASYL, Submission in M.S.S. v. Belgium and Greece and Rahimi v. Greece, July 2020, para 8.
 Equal Rights Beyond Borders, ‘Abandoned and Neglected’ – The Failure to Prepare for a COVID-19 Outbreak in the Vial Refugee Camp, November 2020 update of report 05/20, https://bit.ly/39NEGIZ, p. 26
 NCHR, as above, p. 23
 This act is based on Article 45 L. 4636/2019. It is worth noting that the act mentions that the geographical restriction is necessary for the implementation of the EU-Turkey statement
 Except for the case of vulnerable persons and persons in need of special reception conditions the geographical restriction may be lifted in the case of: a. unaccompanied minors; b. persons falling under the family reunification provisions of Articles 8-11 of Dublin Regulation, only after the person is accepted by the concerned member state; and c. persons whose applications for international protection are reasonably considered to be founded
 See Article 67 (2) L. 4636/2019 and Article 2 (d) of the Ministerial Decision 1140/2.12.2019.
 According to article 67 (2) L. 4636/2019, ‘[w]here applicants have been identified as applicants in need of special procedural guarantees, they shall be provided with adequate support in order to allow them to benefit from the rights and comply with the obligations of this Part throughout the duration of the procedure. Forms of adequate support shall, in particular, consist of additional break times during the personal interview in accordance with Article 77, allowing the applicant to move during the personal interview if this is necessary because of his or her health condition, as well as showing leniency to non-major inaccuracies and contradictions, where these are related to his/her health condition.’
 Except for Lesvos RIC, the numbers refer to individuals and not cases. Also, if a member of a family is considered vulnerable and thus the geographical restriction is lifted, it is lifted also for the same reason for the rest of the family (eg pregnant woman of 4-member family = 4 decisions of lift of geographical restrictions “due to pregnancy”).
 In the case of Lesvos RIC, numbers refer to individuals considered as vulnerable. Τhe category “Vulnerable persons and persons in need of special reception conditions (Art. 58 and 67 L. 4636/2019)” refers to members of families with vulnerable individuals and other cases.
 GCR and other civil society organisations, 11 January 2021, “Legal actors express serious concerns regarding the lack of state free legal aid for asylum applicants in Lesvos”, available at : https://bit.ly/3sWzU3j
 Ενημέρωση εξελίξεων σχετικά με το Δελτίο Τύπου 11.01.21 από την ομάδα εργασίας Legal Αid Working Group Lesvos, available in Greek : https://bit.ly/3oVmVxx
 Greek Ombudsperson, Letter of 30rd April 2020, No 277398/19259/2020, available in Greek at: https://bit.ly/3uoSGAH & Σύνοψη Διαμεσολάβησης Προστασία αιτουσών διεθνούς προστασίας ως ατόμων που ανήκουν σε ευάλωτες ομάδες και χρήζουν ειδικών διαδικαστικών εγγυήσεων, February 2021, available in Greek at: https://bit.ly/31Sgock
 Greek Ombudsperson, Letter of 17th June 2020, No: 279706/25934/2020, available in Greek at: https://bit.ly/3rTI37d & Σύνοψη Διαμεσολάβησης Προστασία αιτουσών διεθνούς προστασίας ως ατόμων που ανήκουν σε ευάλωτες ομάδες και χρήζουν ειδικών διαδικαστικών εγγυήσεων, February 2021, available in Greek at: https://bit.ly/31Sgock
 MSF, RSA, PRO-ASYL, as above.
 Asylum Service, 31 March 2021
 Article 72(1) IPA.
 Joint Ministerial Decision 1982/2016, Gov. Gazette B’335/16-2-2016.
 Article 22(A)11 JMD 1982/2016, citing Article 34(1) PD 113/2013 and Article 12(4) PD 114/2010.
 Joint Ministerial Decision 9889/2020, Gov. Gazette 3390/Β/13-8-2020.
 See Article 1(3) JMD 9889/2020.
 See Art 4 JMD 9889/2020.
 See Article 1(5)(a) JMD 9889/2020.
 See Art. 1(5)(b) JMD 9889/2020.
 See Art 1(5)(c) JMD 9889/2020. Contrary to MD 92490/2013 and JMD 1982/2016 which provided for left wrist, hand X-rays, dental examination and panoramic dental X- rays cumulatively and not alternatively.
 See Art1(9) JMD 9889/2020.
 Information provided from the Ministry of Migration and Asylum, General Secretariat of Reception of Asylum Seekers, 26 February 2021.
 NHCR, as above, p. 86.
 Psychosocial assessments appear to be conducted on Lesvos as of August 2020.
 RSA and other civil society organisations, as above, p.21
 Ibid, p.10-11
 Submission by the Office of the United Nations High Commissioner for Refugees in the case of International Commission of Jurists (ICJ) and European Council for Refugees and Exiles (ECRE) v. Greece (Complaint No. 173/2018) before the European Committee of Social Rights.
 RSA and other civil society organisations, as above, p. 20-21
 This was also the case on Lesvos when the pre-removal detention centre was in operation.
 Amended on 13 August 2020 by JMD 9889/2020
 Article 79(4) IPA.
 Decision of the Director of the Asylum Service No 3153, Gov. Gazette Β’ 310/02.02.2018.
 Article 75(3) IPA.
 RSA and other civil society organisations, as above, p.21.
 Ombudsperson, Migration flows and refugee protection: Administrative challenges and human rights, Special Report 2017, 25-25 and 75.
 Ibid, 25.