A Greek doctor’s report: “Those who have no money, die”

A Greek doctor’s report: “Those who have no money, die”

Interview with Dr Giorgios Vichas* by Harald Schumann

Greece needs to save, and it looks like this: cancer patients remain without help, polio returns, diabetic patients go blind. Dr Giorgios Vichas reports from the field.

Harald Schumann: Mr Vichas, don’t you worry about having a heart attack?

Dr Giorgiops Vichas: No, why should I?

Because you are doing two full-time jobs at the same time. You are a salaried cardiologist in a hospital and furthermore, you conduct a facility where you and your colleagues voluntarily treat thousands of patients who otherwise would no longer get any medical help. No one will go like that for long.

I work a lot and I sleep just five hours per night, that’s right. But I’m fit, and I would definitely get really sick if I did not do it and stood on the sidelines, while many of our compatriots have to fight so hard.

Your family is supporting this?

My daughters stopped asking when the crisis will come to an end, six months ago. And my wife is also working with us, since she sees how badly we are needed.

How did you come to found a clinic with volunteers for free medical treatment?

I had been working for many years in a public hospital, and therefore, in spring of 2011, I saw the consequences what it means when hundreds of thousands of people suddenly loose their jobs and therefore their health insurance, as well. At that time I had a 52-year-old heart patient who nearly died because he couldn’t get the necessary drugs for half a year. That struck me deeply, I felt guilty.

Why? It was not your fault?

I saw how the people suffered, and I couldn’t do anything about it, because I did not know what to do. This changed in August 2011. I was at a concert with Mikis Theodorakis, our great composer. He gave an impassioned speech saying, among other things, what I had been thinking all along, that doctors in particular should do something at last to care for the people in their distress and anxiety without insurance coverage. That shook me up deeply. The concert took place here on the site of the old airport, and that was where I got the idea: There were all these empty buildings, and I thought that it might be possible to set up an outpatient clinic with free medical treatment in one of these buildings. Luckily, the mayor of the district supported us. He gave us this house, electricity and water are being paid for.

Does your employer let you do another job on the side?

The managing director of our hospital was the first one whom I convinced. He saw the misery and even set to work with us, as well. The funding for the National Health Service has been cut by more than 40 per cent due to the requirements of the creditors and their Troika of International Monetary Fund, ECB and EU Commission. Half of all doctors in the public hospitals and outpatient clinics were fired. At the same time about one quarter of the population lost their health insurance together with their jobs. And even those who are still getting wages or pensions, often have so little money that they cannot pay the high additional costs for drugs or treatments.

What is the practical implication for somebody who has no longer any insurance?

Imagine, you became ill and should go to a hospital for an operation or medical treatment. Later on you receive a bill about some thousand euros. If you were not able to pay, the Tax Office would declare it as your debt to the state. The officials might initiate proceedings against you and your house or your pension would become put in pawn, or you would be thrown into prison.

Did this really happen ever before?

Luckily, only very seldom. Nevertheless, this threat is real and has bad implications: the people try to avoid medical treatments as long as possible. Due to this, many illnesses become aggravated and more severe than they would have been with an early treatment.

In Greece people die, only because they no longer have an insurance?

Yes, that is right. But this is not documented statistically. However, we have seen it in our daily practice. During the first three years we treated two hundred patients suffering from cancer. Ten per cent of them came to us in a very late stage of the disease. Half of them had to die because they where treated much too late. Our colleagues from other volunteer medical centres report the same experiences. We have to keep in mind that thousands of people have died because they received no medical treatment.

Are there disorders which are typical for the crisis?

AIDS, tuberculosis, and hepatitis. The infected persons are mainly the poor ones who cannot afford a medical treatment. Due to this, they transmit the infection to other people and the infection spreads. It is also hard for people with diabetes when they cannot keep on their diet or do not get enough insulin: there is the risk of blindness or amputation. And, increasingly, we can see malnourished mothers, babies, and children. This will damage many children for their whole life.

If this is the truth, then the financial restrictions themselves, analysed by economical criteria, are completely irrational.

Yes, that’s the strange thing. In the end, the financial restrictions will cost the Greek national economy much more, than the Greek treasury will benefit from. The money which was “saved” in the case of diabetic patients during the three years from 2010 will create a rebound of additionally 200 million euros. This was precisely shown by a study.

And the responsible parties really don’t worry about that?

Listen, last year until August we had a Health Minister who gave the order that hospitals should not hand the newborn babies to their mothers as long as the mothers did not pay the bill. He did not worry!

You exaggerate!

No, this really happened. It was practised for six months in public hospitals. Even worse is the fact that money for vaccinations was restricted. Most children who come to us are not vaccinated. Due to that we will have to expect a new breakout of polio, the infantile paralysis. This bears a risk across Europe. The pathogens don’t respect borders.

Did you ever talk to lenders’ representatives from the Eurozone or to the Troika about how counterproductive these cutbacks are?

I did so but only with parliamentarians of the national parliaments and of the European Parliament. Only once a delegation of the German “Bundestag” was here. They then admitted that they themselves had bad experiences with austerity measures, and the latter had to be taken back because of that experience. I told them that they please should persuade the government of Ms Merkel to urge for the withdrawal of economy measures, meaning cutbacks in the Greek health system. I received the answer that the Troika was responsible for this, not the German government.

But it is the German government, isn’t it, together with the governments of the other euro states which instructed the Troika to enforce those measures in Greece.

That’s right. Nevertheless the parliamentarians didn’t feel responsible.

Not even those of the ruling parties CDU (Christian Democratic Party) and SPD (Social Democratic Party)?

No, not even them. Instead they offered us donations for our clinic.

There were good reasons to thoroughly reform the old system. After all, it was highly wasteful and corrupt.

Sure, reforms were urgently necessary, but it was not reformed, the whole system was destroyed. One should have better distributed doctors and practices all over the country, one should have made the purchase of medical drugs cheaper and push back the influence of the pharmaceutical companies. And of course corruption had to be combated. All this has not happened, there were simply cutbacks and dismissals.

But was this the fault of the creditors from Germany and the Eurozone? The responsibility rather lies with the former Greek government of conservatives and social democrats.

Sure, formally the main responsibility lies with the former Greek governments. And the officials of the Troika will always say just that. Only, if you read the memoranda and the reports of the Troika, you see, that they have planned this brutal programme down to the last detail.

Why should unconcerned officials in Brussels or Washington want things like this if there is no advantage to take of them?

I often asked this myself. Why do they enforce such radical spending cuts although it leads to even more debts? In the end there was only one explanation left: It is a matter of implementing an ideology which says: Who owns money is allowed to live, who doesn’t, dies.

Earlier Greek doctors demanded money from their patients additional to their state salary. Are you doing that as well?

No, I never did. It is unbearable that this happens even today – and none of them was brought before court up to now – not even one! I have been trying for months to persuade the responsible commissions of the Medical Association to take action against that. But up to now unfortunately without success.
At the same time, there are many who are trying to mitigate the misery. How many doctors are doing unpaid work here?
We are 100 doctors here, from all fields, plus 200 nurses and assistants.

And how many of these free outpatient clinics for needy persons do exist?

There are 50 all over Greece, eight of them in Athens.

How are you financing this?

As a principle, we are not accepting money, only donations in kind. Fortunately we are getting a lot of them from citizens all over Europe, mostly from Germany and Austria. A smaller fraction is also coming from France and Italy. Last month we were able to hand over two full truckloads to public hospitals.

The donations are coming from Greek citizens abroad?

No, not from the Greek, our donors are normal people from other European countries.

So these citizens practise solidarity where their governments are refusing to do so?

Also in Germany and France there are those who reject this policy. I have met many who feel embarrassed by what their governments have imposed on Greece.

Are you and your colleagues in the other volunteer health centres now able to provide the care which is lacking in the public system, due to the cutbacks?

Oh, we dare not even think of that. We can mitigate the misery, but this does not replace a decent health care. It is really a tragedy. The public hospitals are lacking everything, not only doctors, but even dressing material or disinfectants. This has severe consequences. Last year, for example, no real umbilical clamps were available in a birth clinic in northern Greece. This almost killed a lot of babies.

If the situation is so bad, there are probably a lot of people calling you every day, asking urgently for help. How do you cope with that?

Sometimes it is terrible. Then I wake up in the middle of the night, thinking of the mother who cannot save her child or the cancer patient who is in need of an expensive treatment which we cannot provide. There are days when I am very frustrated and depressed.

The new left-wing government has promised to tackle this humanitarian emergency situation. Hasn’t the situation improved since February when it took office?

Well, when a car is going downhill with full throttle, and you change the driver, the downhill course will not immediately be changed. At least there are now food vouchers and electricity for the really poor. The new government has also passed a law which provides access to public clinics also for non-insured persons. In practice this does not really help because the public system is completely overstrained, lacking staff and equipment.

There is a lack of physicians and nurses?

Sure. 4,000 physicians have gone abroad, 2,500 of them to Germany. And even if people get an appointment, it does not mean that they can be helped. Often the necessary equipment is missing or the pharmaceuticals are excessively expensive. So we have to go on fighting, all the time, putting pressure on the government.

Chances are not high for an improvement of the situation?

Frankly, I do not expect much from governments; neither here nor in the rest of Europe. The situation is too messy and heated. What gives me the biggest hope is the immense solidarity of the people here and the big support from our friends in Germany and the other European countries. This is what encourages me.

Have you ever considered going into politics in order to change the system?

Yes, I have. More out of despair than out of conviction. In the recent elections, I have even been nominated for SYRIZA because I felt I was obliged. But I did not tell any journalist about it, I did not conduct any campaign and so I did not get elected. But I am not sad about this. I should be with those who are ill, they need me the most.     •

You can find more about the “Metropolitan Community Clinic” on the website: www.mkiellinikou.org/en/

Source: www.tagesspiegel.de/weltspiegel/sonntag/ein-griechischer-arzt-berichtet-wer-kein-geld-hat-der-stirbt/11844930.html, 2 June 2015. Reprinted with kind permission of the author.

(Translation Current Concerns)

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