First hand stories from aid workers as governments and agencies struggle to cope with the influx of refugees
LONDON, Nov 13 (Thomson Reuters Foundation) - About one million migrants and refugees fleeing war and poverty are expected to arrive on Europe's shores in 2015, with governments and aid agencies struggling to cope.
Around half the Mediterranean arrivals this year have been Syrians fleeing civil war. The next biggest contingents are from Afghanistan, Iraq and Eritrea.
With winter approaching, frontline aid workers share their thoughts on how they are planning to keep refugees and migrants safe, warm and alive as temperatures plummet.
These first hand stories start on the Greek island of Lesbos in Europe's southeastern corner, then move north and west through Macedonia, Serbia and Croatia to Austria, on Germany's southern border.
Caroline Anning, humanitarian media manager at Save the Children, is on Lesbos
The boats come ashore at Lesbos throughout the day and night, small dinghies full of anxious families, with women and children in the middle and men sat round the edges.
Even on a calm day people tend to get soaked when they splash ashore with little more than the clothes on their backs. In rough seas the boats often capsize, leaving children shivering in the water until the coastguard can rescue them.
As the colder winter weather bites, there is a very real risk of hypothermia. We're already seeing children with respiratory illnesses, and during a recent cold spell our teams met kids with blue hands and lips, shivering in the lashing rain.
The conditions in the transit camps are totally inadequate. They turn into seas of mud when it rains and there isn't enough shelter for everyone, leaving families to sleep outdoors exposed to the elements.
Ljubinka Brashnarska is a spokeswoman for the United Nations refugee agency (UNHCR) in Macedonia
This summer, we were fighting against scorching temperatures of above 40 degrees Celsius, whereas we expect levels as low as minus 20 degrees in January and February. As the weather conditions change, so does the need for medical assistance.
During the summer the Red Cross medical teams funded by UNHCR were treating cases of heatstroke and sunburn. Now the mobile teams usually assist refugees, including children, with cold and respiratory infections.
Brenda Yu is a spokeswoman for World Vision UK, most recently based on the border between Serbia and Croatia.
I recently visited refugee camps in Jordan and Lebanon. I never thought I would put "camps" and "lucky" in the same sentence.
But working on the border between Croatia and Serbia, a no man's land where many have been sleeping outside, has filled me with complete despair, especially as we enter the winter months.
I spoke with a mother whose eight-year-old daughter told her she wanted to die after standing on a boat for twelve hours from Turkey to Greece.
I also saw several families sleeping helplessly on the freezing ground with nothing but their thin jackets.
With temperatures dropping as low as minus 20C in the next few weeks, refugees' journeys will become more and more deadly.
Many thought the influx would slow with the arrival of winter, but the U.N. refugee agency expects up to 600,000 to arrive in Croatia, Greece, Serbia, Slovenia and Macedonia between November and February.
We urgently need more shelters, blankets, winter clothing, water and food. Otherwise, we are likely to see refugees dying of hypothermia, pneumonia and other diseases.
Iljitsj Wemerman, CARE International's emergency response team leader in the Balkans, was in Croatia this week
The situation changes very quickly when temperatures drop. We immediately hear more coughing and there are more people in need of medical assistance.
We are seeing more and more small children, and I am particularly concerned for them. There is no adequate water and sanitation facilities, there is a lot of garbage lying around, and diseases spread easily.
There have been slight improvements over the last weeks, with better transport through Serbia and into Croatia, but we are still far from being prepared for a situation where people cannot stay outside for longer periods.
Without sufficient shelter, people will suffer immensely. They often arrive without warm clothes. They are tired from arduous journeys, and what strikes me more than anything when speaking to them is that they have no information.
They ask: Where are we? What is happening? Why do we have to wait? I fear very serious consequences if we don't get better prepared for winter.
Michael Kühnel-Rouchouze, a doctor, is a medical chief for the Austrian Red Cross
Humanitarian needs are changing here with the arrival of cold winter weather, which many refugees have not seen before. People arrived with sandals and inappropriate clothing, so providing these is very important.
Although refugees pose many unique challenges, most of the people arriving have the same health problems as Austrians, such as tooth problems, tonsillitis and diarrhea.
Most of the Syrian refugees have been vaccinated at home, so I doubt they will suffer from things like measles. However Syrian children, and refugees from countries with weak health systems, need to be vaccinated against diseases like measles and polio as soon as possible.
Earlier in the year people sometimes had to sleep on the ground, which is now inconceivable because of the cold. When it is cold - minus 10 to 15 degrees is common at the moment - people will face illnesses like pneumonia. We are likely to see people dying soon.
(Reporting By Joseph D'Urso; Editing by Ros Russell; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's rights, trafficking, corruption and climate change. Visit www.trust.org)
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