On a recent trip to Athens, Solidarity visited a “solidarity health clinic” run by volunteers to provide healthcare for those unable to access it. We spoke to Constantine Kokossis who volunteers at the clinic in Omonia, central Athens.
Solidarity for All, a fund set up five years ago using the money from Syriza MPs, helped set up clinics like this one. This clinic has been working for three years, providing primary care to everyone in need.
Our clinic is a community — everybody is providing services for free. The idea of solidarity is our inspiration. We have a staff of about 80. There is a group of doctors, generalists like myself, but also dentists, pharmacists and so on.
About 90% of what we have is donations from foreign colleagues and like-minded people — from France, Austria, Germany. We have an entire room fitted with gynaecology equipment donated by like-minded people in Germany. We also get donations to pay the rent on the apartments we have the clinics in. For medicines we rely on donations from people who had a prescription but don’t need them any more, or who have relatives who have died and had left over medicines. We buy a small amount of what we need that we can’t gather from donations — for example dental fillings.
This clinic is open from 11am to 6pm, we get 30-40 patients a day. Physicians, dentists, and pharmacists come here once, twice or three times a week. There is no differentiation, no discrimination between Greeks and foreigners. We also don’t mind whether or not a foreigner has papers. If they are illegal, that is no crime as far as we are concerned. We just want a name and a mobile number.
The composition of our patients is half Greeks, half foreigners. There is an ever-increasing number of both. The Greeks are usually working in the black market, without social security and medical cover, in which case they cannot afford to buy medicines, have tests, and so on. For foreigners, the situation is much more simple, and tragic. They are people who either work in the black market, or they do not have papers of any kind, for anything.
We are dealing with people who have been suffering for a long period of time, often in the late stages of an illness. So when they come here, they are already deteriorated. This is not only the case with dental complaints, but also with cancer, chronic illnesses, blood diseases, and so on. We ask them, why didn’t you get this dealt with sooner? They say, “I couldn’t, I had no money, I couldn’t afford treatment, but now the pain is unbearable, so now I have decided to come”.
If you have two or three people in a family with no job, this is serious. People come with children who have not had the vitamins they need for a long time. We get children who have not been vaccinated. This is a time-bomb for society. Before the crisis, the state vaccinated all children. But after the crisis, this stopped. I think they have now decided to get going with the programme again. If you have money, you don’t care about the absence of the vaccine. You buy it for your family at the pharmacy.
Some people could afford the €5 to be examined but then not be able to afford prescriptions or tests. A patient who had no insurance could receive a prescription but without insurance they would have to pay the full price of the medicines. So they come to us and say, “this is the prescription, I can’t pay for it.” Sometimes hospitals don’t have the medicines themselve.
Others can’t afford the tests. There are tests which are very cheap, like blood tests, but some tests are very expensive. And then there are tests which must take place every three months or so — like heart tests and so on. So we have a network of people in hospitals who will do tests for us.
The government has decided that everyone, Greek or foreigner will have free access to all areas of the health system. But this must take reality into account. You may have to wait for 3-5 days to get an appointment, your complaint then becomes severe, so you have to go to the emergency department. But emergency departments are full. So how will the existing infrastructure, which is terribly under-staffed, cope with the influx of people since the lifting of the €5 fee? You can’t have 100 X-rays a day — at best you could do twenty.
Because of all the shuffling and reshuffling of the health system, there are certain parts of it which do not exist. The GP system is over-loaded, all sorts of specialist clinics have disappeared. Therefore people resort to going straight to the hospitals. So the hospitals are over-subscribed.
That’s why there was an appeal by the government to the solidarity clinics, to say, please don’t close down, we need your supplementary services.
What is encouraging is that people have now heard about us, and they bring us plastic bags full of medicines. But we always have shortages. Some drugs get used up very fast. In particular, drugs for diabetics, which have to be taken several times a day, every day.
The biggest problem we have, in spite of our Mediterranean reputation, is stress. Many stress-related illnesses at first appear to be skin conditions, infections, eczema and so on. But then we find that they are actually caused by people scratching themselves as a nervous habit.
The decision by the previous government was to cut many mental health wards, keeping as in-patients only the most severe cases. But if you stroll in the city, you will see many people who have been pushed out of the mental health in-patient units to reduce numbers. Local and regional authorities have closed these organisations.
People who have lost their jobs and homes are asking for psychological support — in most cases, talking therapy. In some cases we arrange their referral to the psychiatric units.
The wholesale restructuring of economic life is a major cause of stress. The more jobless people who exist, the more people have the feeling that they have failed.
We have been proud of the welfare state, public services and so on. But in the last few decades all these things have been demolished. To be sure there were holes in the previous system. But now in the street there are people who just have nothing. Nothing is of any use if the economic situation does not change. The Minister of X, Y or Z must find the money. Without extraordinary measures, it will be hard to cover all the deficits of the health system.
It is very hopeful and very promising that the government has made this commitment to say, “we are not going to leave anyone behind, even foreigners”.
I think the government are trying hard to fulfil their promises. For me, there is a problem that because of this delay in finding a solution in the overall situation, there is a delay at the lower levels, including health. For example, if the Troika, “institutions”, whatever they are called, block funding, then you can say that you will give cover to everyone but you have a problem of achieving it. How will it work? There is a problem if you promise to abide by the commitments that you give to these institutions.
If the institutions call for you to make a payment, then you should say, OK, first I will pay the salaries and the pensions.
I think that tax evasion has created a deficit. This has created a social deficit. But the whole system allowed tax evasion to happen.
I was reading the words of an old economics professor, I think his name is Schneider. He said, there are at least €100 billion in assets, in offshore companies, bank accounts and so on. And this is untaxed. The rich say, the money will leave the country. But it has already left the country. You’ll hear threats of the rich Greeks withdrawing their money. But lots of that money is not out of the country, it is just under their mattresses.
The government must say that their first priority is society. It is impossible for us to go on with austerity. My pay was decreased by 33% last month. If you get a pension or a salary of, let’s say, €1,000, how much less can you do with?
Tighten your belt — but how far can it be tightened? We are skeletons.
