In 2015 alone, more than 450,000 Syrian refugees crossed the Mediterranean. Many travel from Turkey, to the Greek islands, from where they were typically transferred to mainland Greece within one to three days before they continued on to the Western Balkan transit route. While they acute care during the emergency phase seem to work well, challenges we're seeing with regard to chronic illnesses or non-communicable diseases. The large influx of refugees made the international society support the government and local authorities to provide humanitarian assistance, including medical relief. Numerous national and international non-governmental organizations were mobilized to provide health services. Most of the treatment was limited to acute diseases such as infections, hypothermia, or wounds, for which pain medication and antibiotics were prescribed. So, what was the experience with regard to NCDs? In Lesbos, the setting was that this was a picture of people on the move. It was different nationalities. It was not all Syrian refugees but they were major group when I was there. Syrians have been used to having high standard care. So, they have been used to being treated for their NCDs, but now they had to flee leaving them also with unreliable access to their medicine. Also, the problem of if you were a diabetic needing insulin, you can't really take that out if you're fleeing, because you need to keep it cold. So, they would take some, and then when they came to us, what we could do is again we could give them a stock of what the medicine that they needed, but not knowing really if you give the three week, so you're guaranteed that in three weeks this person will be in a place where they can give them something new. Another thing is that these people, their main agenda was to save their life. It wasn't to think about the long consequences of diabetes or hypertension. So, if they came they were fleeing from Turkey to Lesbos, and then they were heading onwards to the mainland. If you had five hours, okay, you can go to the doctor in the waiting time. But if the ferry is leaving, you take your kids and your wife and you leave. Then you just hope that somewhere along the line, there will be time for something that's secondary when you're fleeing for your life. Changes in migration policies in late 2015, in both Greece and Macedonia, meant that Syrian refugees had to move on quickly. Almost all of the refugees intended to continue along the Western Balkan migrant route, and were therefore reluctant to take up local referral in Greece for fear that would delay their passage. This meant, limited time for treatment despite some refugees needs for longer term care. We did see a lot of patients and obviously sometimes someone would come in with these complications that you would normally admit to the hospital for treatment, but they would refuse. So, you just have to quickly do a little something, it could be someone with a lung disease, asthma or something, you can give them oxygen, you can give them some inhalations, you can start the antibiotics if it's chronic obstructive disease and you think that they also had a slight infection, and then send them on their way. But normally, you would keep them in hospital and treat until this was better but they would refuse to get hospitalized because they had a different agenda. They had to move on, the borders were closing. As a consequence of the change in migration policies, tens of thousands of individuals predominantly from Syria, stranded on the Greek mainland and islands, waiting for their Asylum claims to be processed. This created a need for long-term care for the more than 60,000 refugees living out and inside seven refugee camps in Greece. According to the WHO, "The most common diseases and conditions recorded recently have been respiratory infections (upper and lower), and asthma, musculaskeletal issues, chronic diseases such as diabetes mellitus, thyroid disorders, heart disease and other circulatory disorders, hypertension, gastrointestinal infections and scabies." Even though the Greek health authorities are now offering public health services designed to address the healthcare needs of migrants and refugees, there is still a need to adapt the medical response to the increasingly complex needs for the refugees on the move.