Free clinics, doctors try to patch growing holes in Greece's safety net

In a former American military base that is now used as a free clinic on the outskirts of Athens, 61-year-old Angelidis Kostondinos waits to see a doctor.

He’s unemployed, uninsured, and had major heart surgery a year ago. On top of that he has diabetes, and since he can't afford $55 a month for his prescribed medicine he obtains it for free at the volunteer-run Metropolitan Community Clinic in Helliniko.

“I went from a family man to a beggar,” says the former taxi owner and driver.

Kostondinos is one of the growing number of Greeks no longer able to rely on a healthcare system that is at breaking point due to the ongoing economic crisis and austerity cuts. 

Every day, many hundreds of Greeks walk through the doors of the clinic looking for help. Around a hundred doctors take turns donating their time to the clinic when they’re not otherwise working long hours at nearby public and private hospitals.

“We’ve been functioning for three and a half years. During these years things went from bad to worse,” says George Vichas, a cardiologist, sitting in his office surrounded by thermometers, gauze, and leg braces.

Much of the clinic’s equipment is supplied by retiring doctors, while the medicine comes from donations from within Greece and from people abroad. When the clinic runs short on specific drugs, it posts a message on their website and waits for the packages to arrive. 

“Funds for public health in Greece have been cut by 50 percent since 2010,” says Dr. Vichas, who opened the clinic in late 2011. “From where we stand now there will be another 20 percent more reduction. This will mean more hospitals closing, less doctors. Most importantly, the uninsured will not be covered – 30 percent of the population is uninsured right now."

Between 2008 and 2015, spending on hospitals fell from 6.3 percent of GDP to just 3.9 percent. Many doctors and nurses are being forced to work longer hours in under-resourced hospitals.

Losing doctors, losing benefits

Healthcare workers have been leaving to work abroad for years, but in recent times their numbers have grown: An estimated 5,000 doctors have left Greece since 2010, and cash-strapped hospitals haven't always replaced them. Basic supplies like gloves, syringes, gauze, and catheters are often in short supply; news reports have cited cases of hospital patients being sent out to pharmacists to buy medication.

A report published in The Lancet medical journal last year cited rises in Greek infant mortality rates, in HIV infections among drug users, and in cases of malaria during Greece's current economic crisis. 

“As the US is embracing universal health care, or trying to go there, we went the other way,” says Martha Frangiadakis, a volunteer at the Helliniko clinic.

The clinic, one of around 40 set up across the country in the last four years, is often the only option for those who have fallen on hard times. 

Health benefits in Greece are available for up to a year after someone loses their job, but after that individuals and families must pay for their own insurance or healthcare treatments. Greece’s unemployment rate is over 25 percent, and the economy is expected to contract further this year. 

“The first year of operation we saw 4,000 patient visits, by 2013 in the first three months we saw 4,000 visits. Now we are seeing 1,500 a month,” says Ms. Frangiadakis. “We have people who come in on the day their loved one dies and say ‘Here, give these [medications] to someone who needs it.’"

New cuts looming

In the Evangelismos General Hospital in the center of Athens, one of the largest hospitals in the country, the maze of corridors are filled with outdated hospital gurneys and peeling paint. A large banner, hand-painted on a bed sheet, is pinned outside the main entrance, demanding an end to austerity measures.

In a soup kitchen not far away, Konstantinos Dertinis, a former marble worker, slowly eats a bowl of spaghetti.

“I have heart problems,” he says, adding that he had government insurance until a year ago. Nowadays he tries to find the pills he needs to take from friends. “I can’t afford them from pharmacies,” he says. He’s also trying to get a small agricultural pension so that he will have insurance, but expects it to take “another six to ten months”.

Doctors and experts in Greece are worried about the short-term outlook if new austerity measures mean further cuts in government healthcare spending.

“The crisis has reduced access to hospital care by 25 percent,” says Lycourgos Liaropoulos, professor emeritus of health economics at the University of Athens.

We will just have to go without unless the government finds solutions,” he says. “So we will see more lines, more shortages, and perhaps a black market developing for access to hospitals.”