The Greek National Health system (IKA) is sick. It is badly in need of some intensive care and it's flickering pulse is fading fast.
This is not news to anyone who lives in Greece or reads Greek news but I, like most people who are not brought into personal contact with the reality of the situation, would read the ever worsening statistics and think "oh how sad" before moving on with my busy life.
My attitude changed this week when two incidents within two days brought me face to face with the realities of medicine in 2013 Greece.
On Monday, a friend was admitted into Evangelismos Hospital (
see photos taken in AHEPA at Evangelismos, fifth floor) and as she wanted a couple of friendly faces to accompany her to her angiography, I volunteered.
Expecting the worst, and having heard tales of horror surrounding the general disintegration of care at Evangelismos (Athens biggest hospital complex with beds for 1,100 patients) I was surprised to see that in one respect, state provided Greek medical care hasn't
changed at all. The doctors (grossly overworked and underpaid) continue to be generally wonderful. They are highly trained, caring
professionals who are trying to do their job against almost unbeatable
odds. Due to the crisis entire hospitals have been shut down, the
number of intensive care units has been slashed and there have been huge
staff cutbacks and salary cuts.
Having googled "angiography" before arriving at the hospital I knew that it is a fairly common procedure that investigates the flow of blood through the veins. It isn't really dangerous to the patient in any way but it does need careful post op care as you have to remain completely immobile in bed for 24 hours as any movement can cause an arterial wall rupture or other complication. I thought it odd that, after her procedure and as we (and by we, I mean literally me and another friend-there was no one else to do it!) were wheeling her up to her room, the doctor laid one of those typed pieces of paper on her bed with after-care instructions that are usually given to outpatients on their way home. I thought, "Why give us this? These vital precautions are only for the first critical 24 hours following the angiography and she will be here for those", but shrugged the thought away.
I was to discover why this paper was important a short while later as the standard of
nursing in any state hospital could charitably be described as appalling. Most Greeks
know this and don't expect to receive much care from hospital nurses and
prefer to hire slightly more qualified private caregivers or rely on
their relations to perform nursing duties.
Wheeling my friend into her none too clean looking room I noticed there was no nurse to greet her and make up an end of bed chart, or even read the piece of paper with the vital instructions on. After waiting a while I went to the nurses station and found the 'proestameni' or matron. She looked at me as if I was fairly barmy when I explained who I was, told her she had a new patient that, according to the written instructions, should have her vital signs checked right now. I also asked if her new patient could be allowed a drink of water as it wasn't clear on the instruction sheet. As she had no reply (at all) for me, I went and fetched the instruction sheet and showed it to her. "Ach," she said "I don't know, why not ask the doctor?" I hoped that in showing her the instructions, she might tell one of her nurses to follow them and check on my friend.
No such luck, and when I called her later that day my friend told me that despite it writing clearly that her bandages, blood pressure, drip and all vital signs must be checked at three hourly intervals, she was still waiting for a nurse to appear
six hours later. There were also no call buttons and as she was forbidden to move a muscle below her neck, it was lucky there were other people sharing the room who had the mandatory army of Greek relatives and friends who could walk to the nurses station and demand some attention for her.
By the time I left Evangelismos that morning I had spent six hours in hospital corridors and "waiting rooms" (four or five chairs usually placed in corridors outside the elevators). I was
desperate to either wash my hands or use some of the alcohol gel that in most
hospitals is provided in every waiting area and outside every room.
After visiting five different floors and six waiting rooms, I can say
that Evangelismos, as far as I know, has many locked bathroom doors and precisely one gel dispenser
outside the entrance to outpatients and nowhere else.
One, for the entire hospital.
When you cannot pay staff, when there are massive lay off's, when hospital wings are shut down and when there is no money to pump into better nurse training and education you see the sights I saw in Evangelismos.
Something that struck me hard was the ugliness of the surroundings and the lack of privacy. I watched a nervous patient wait to get some results from her doctors. I don't know what her ailment was but she wore a brightly coloured headscarf to cover her obviously bald head. After a ten minute meeting with doctors in a room off a depressing, dingy corridor (
pictured above) she reappeared in floods of tears. There was nowhere for her to go for privacy. She was told to wait on one of the five chairs outside the elevator banks. There she sat and cried and cried.
I am happy to report that my friend survived the lack of follow up care and the undoubtedly a germ ridden environment and was released from Evangelismos the next day.
That same day I received a tearful phone call from an Albanian woman who has lived in Greece for twenty years and has raised her seventeen year old son here. Between sobs she told me he had collapsed in the street from an unknown cause and had been admitted to, where else?, Evangelismos. Neither he nor she had state or private health insurance and after a morning of tests, her bill was already over 700 euros, a small fortune for a lady in her circumstances. This sum will keep mounting as the doctors perform more tests to determine the cause of her son's collapse. If she can't pay, no drugs can be given if needed and perhaps the cause will never be diagnosed.
The official government stance is that if you have no money to pay for medical care, the state will always cover the costs. This seems to be blatantly untrue and there are hundreds of patients with life threatening diseases that are dying simply because they are uninsured or can't afford treatment.
Greece is a European country in the twenty first century but in visiting a state hospital here you would be forgiven for thinking you had dropped into the 1900's in one of the farthest reaches of the third world.
My recent experience this week with the Greek health care system has shown me
that it is a body that is dying slowly as its limbs are amputated and
its vital organs slow down. The European Union seems to have blithely overlooked the growing health crisis here and those old clichés of uncaring New Yorkers stepping over bodies on their way to work seem to be resonating strongly with me at the moment. IKA is hanging on by its last
breath and it needs help
NOW.
I am attaching a link to the Metropolitan Community Clinic and I would ask anyone reading this who thinks I might be exaggerating the problem to have a look at what they have to say on the current state of Greek medical care.
Metropolitan Community Clinic
