In a fresh blow to refugees and migrants experiencing dire conditions in Greece, frontline medical charity Médecins San Frontières (MSF) on Thursday announced it has been forced to closed its Covid-19 isolation centre on Lesbos after authorities imposed fines and potential charges.

From the island of Lesbos to the Greek capital of Athens, asylum seekers and recognised refugees, some with serious medical conditions, are unable to access healthcare or see a doctor as treatments are disrupted by new regulations.

Asmaan* from Afghanistan is 10. For eight months she has lived in a makeshift tent with her family on the outskirts of the olive grove surrounding the Moria camp on Lesbos. She is one of more than 17,000 asylum seekers and refugees who have been living under lockdown here since 23 March.

Asmaan is a familiar face at the paediatric clinic run by MSF just outside the main gate. “She was vomiting, shivering through the nights and became apathetic,” said her mother Sharif*. “We really became alarmed when she was bleeding going to the toilet.” Diagnosed with an acute inflammation of her kidney, Asmaan was transferred to the island’s hospital. Sharif said staff wanted to send her daughter to the mainland for treatment. But the family cannot leave Lesbos until their asylum procedure is completed.

“Only highly severe cases can be transferred to the mainland,” Babis Anitsakis, director of infectious diseases at the hospital in Mytilene, told the Guardian. “This is also the case for the local population.” Such cases often involve a wait of two to three months in the camp before a transfer can be arranged, he said.

“We are confronted with patients from Moria daily who have sicknesses like tuberculosis or HIV. We are simply not equipped for these treatments. On top of it, we face tremendous translation difficulties. At night the medical staff work with a phone translation app to communicate with the patients, which can be disastrous in an emergency situation.”

For Giovanna Scaccabarozzi, a doctor with MSF on Lesbos, Asmaan’s case is typical of a system where refugees and asylum seekers find it increasingly difficult to access proper healthcare, often despite being in desperate need.

“Even survivors of torture and sexual violence are now left to themselves with no one to talk to and with no possibility to escape the highly re-traumatising space of Moria,” she said. The camp’s lockdown has meant fewer people have been able to attend MSF’s mental health clinic in Mytilene.

“From five to 10 appointments a day, we are now down to two to three a week in the torture clinic in town,” Scaccabarozzi said. Even when people reach the clinic, “it feels like treating someone with a burn while the person is still standing in the fire”.

The closure of the Covid-19 isolation unit on Thursday is down to the island’s authorities enforcing planning regulations, MSF said. “We are deeply disappointed that local authorities could not quash these fines and potential charges in the light of the global pandemic, despite some efforts from relevant stakeholders,” said Stephan Oberreit, MSF’s head of mission in Greece. “The public health system on Lesbos would simply be unable to handle the devastation caused by an outbreak in Moria – which is why we stepped in. Today we had to unwillingly close a crucial component of the Covid-19 response for Moria.”

Athens has become a beacon of hope for those living in the island’s overcrowded camps, but a recent policy change has seen people who arrive in Athens with refugee status left virtually destitute, many with ongoing healthcare issues.

The changes, which mean cash assistance and accommodation support end a month after refugee status is granted, affect around 11,000 refugees in Greece. MSF told the Guardian it is concerned that a number of patients face eviction and many refugees in Athens are sleeping on the streets as a result.

Hadla, a 59-year-old from Aleppo who had had multiple heart attacks, died within days of leaving the apartment she shared with her daughter Dalal in Athens. She had been asked to leave repeatedly. “I told them that my mother is terribly ill and showed them the medical files but they told us that they cannot do anything about it and that the decision had come from the ministry,” said Dalal.

Fearing eviction, Dalal took her mother to Schisto refugee camp on the outskirts of Athens, where her brother was staying. Two days later Hadla had another cardiac arrest and died. Dalal is still in the apartment with the rest of her family but continues to face eviction. “We have nothing and nowhere to go,” she said.

Kelly Moraiti, a nurse at the MSF daycare centre in Athens, said evictions put patients’ health at risk, particularly those living with diseases such as diabetes. “Someone who is facing a lifelong disease should have uninterrupted permanent access to treatment. They need to have access to a proper diet and a space to store medications, which should not be exposed to the sun; to be homeless with these conditions is extremely dangerous.”

MSF urgently called on the Greek government and the EU to help house refugees sleeping rough in Athens and to halt evictions of vulnerable people.

Some of the refugees on the streets of Athens are heavily pregnant women and new mothers as well as survivors of torture and sexual violence. Many have significant health conditions often complicated from their time in camps such as Moria.

The Greek migration ministry did not respond to requests for comment.

* Names changed or shortened for privacy reasons