MdM-Greece is loyal to its medical and humanitarian mandate, by continuing its operations , targeting the most vulnerable in the context of COVID19 response as follows:
Protection and care of homeless persons:
MdM-Greece deployed street-work teams in Athens and Piraeus aiming to assist and support those who have no home to stay into and hence are in a very precarious situation. This means ensuring continuity in their access to care which they can access at consultations. The mobile teams are distributing also hygiene kits (soap, hand sanitizers, gloves, masks) while they are also provide information and messages to people that have no access to information. MdM-Greece already maintains an extensive mapping of homeless and drug-users’ gatherings and meeting points as well as ground relations with this population forged on its ongoing street work component and long standing intervention “Streets of Athens”. In Thessaloniki and Athens Open Polyclinics, MdM adjusted its operations in order to avoid crowding and to continue to support the most vulnerable and severe of the cases.
Psychosocial Support and visits to poor households of seniors in Attica
The psychosocial support services are provided currently through telephone or internet while the social workers are scheduling and conducted visits along with nurses to persons over 60years old with chronic health conditions in order to eliminate the psychosocial burden and the health risks that might arise from the restriction of freedom of movement due to the current status quo of urgent public health measures. The main idea is to keep them safe at home and to protect them from Covid-19. The project’s purpose is to reach all the isolated elderly people who live in the capital city. These people also have other chronic diseases (e.g. diabetes, cardiovascular etc.) and they are extremely vulnerable. MDM staff communicate with them by phone, the doctor gives medical advice and the psychologist and the social worker support them in order to prevent depression. Drivers, social workers and nurses go door to door when needed to provide them with the necessary medicine. This way the elderly people don’t have to go to the pharmacy and to expose themselves to the virus.
ROMA communities in Greece:
MdM-Greece is working with ROMA people, supporting communities’ social empowerment and accountability in the area of Dendropotamos in the vicinity of Thessaloniki. During March in cooperation with its local partner, the ROMA women’s association of Dentropotamos, MdM-Greece has actively supported the population in terms of advocacy and information: A letter dully signed by the Director General of the organization, making specific reference to relevant national law provisions and articles, has been sent to local Mayors and respective authorities including the vice-governor of Central Macedonia Region, the Secretary General for Social Solidarity and Poverty alleviation and the Secretary General of EODY/ MoH. Following its submission, the Secretary General for Social Solidarity dispatched specific instructions in regards to ROMA populations’ protection to all respective Municipalities and Regions.
Asylum Seeking Population:
The situation is of particular concern, especially on the main entry points such as Lesvos. MdM-Greece is present on Lesvos, in Kara Tepe site provided primary health care, psychosocial support and sexual and reproductive health services to vulnerable asylum seekers. Currently the implement a new operational plan for the continuity of services in Kara Tepe center which incorporates specific public health measures for the protection of the population in the accommodation center including the personnel and the volunteers.
Isolated national population with geographical obstacles to services
MdM-Greece maintains the support of the operation of primary healthcare facilities for the appropriate provision of medical services to isolated local inhabitants of the small Islands of Dodecanese and southern Cyclades such as Chalki and Folegandros.
Hotline and Interface
MdM-Greece assesses the possibilities of operating a hotline emergency line and the option of a web-based platform in the context of #digitalsolidaritygreece that is provided for free by the “Booking-clinic” company in order to keep on informing people on the health prevention but also to maintain the provision of medical services to chronic patients through teleconference. In collaboration with Booking Clinic, MdM will provide medical advises to people with regards to Covid19 symptoms while a new pilot activity will be implemented for lonely seniors through online communication groups under the coordination of MdM psychologists.
Complementarity with National Authorities, Municipalities and NGOs
MdM-Greece working closely with the all the relevant stakeholders in order to protect the most vulnerable groups of the population while design new activities under the coordination of National Public Health Organization in the emergency context of response to COVID19 to protect the general population. At the same time MdM-Greece proceed with the donation of equipment to Municipality of Athens for the immediate operation of a new shelter and a new clinic for homeless persons in Athens.
On Friday, March 27th 2020 the president of the National Committee for Public Health, officially announced that Doctors of the World-Greece will contribute to the efforts of the National Public Health Organization with scientific staff to cover all affected areas countywide.
Challenges and Risks:
The condition of lockdown in parallel with the restrictive measure on freedom of movement have create the condition of distance management while the coordination of work is becoming even more challenging in light of the pandemic. Additional admin, communications and IT costs are required in order to rapidly and efficiently correspond to the situation.
On the field MdM-Greece operations haven’t stopped but adjusted according to the needs of the vulnerable people and the public health protective measures, which mean increased needs of personnel and extra costs for additional supplies for the protection of the beneficiaries.
As days go by, medical staff of the national health system is getting exhausted. In case there is a rapid increase of cases, there are evident fears that the Greek Health system will not be able to manage and will collapse under pressure.
Implementation and respect of the preventive measures as well as the immediate protection of the most vulnerable persons are the current operational priorities of MdM-Greece.
Safety and protection of Staff
MdM Greece has paused to invest in volunteers belonging to high risk groups, such as those over 65 or volunteers suffering from chronic diseases and/or disabilities. The personnel works in rotation, avoid crowding within the offices and the clinics. All the necessary equipment has been provided to the personnel as well as antiseptics, masks and gloves while on a frequently basis all the dormitories as well as the clinics and offices are disinfected and on a daily basis twice are cleaned.
The front-liners of MdM-Greece are taking all the necessary measures in order to avoid the exposure to Covid19.
Operational Context
The Greek health system has undergone major transformations during the last decade thus moving slowly towards a more modern, efficient and sustainable system. However several challenges still remain such as ensuring adequate funding and personnel, maintaining the aspect of universal health coverage and access to health services while a shift of investments towards prevention and primary care is highly needed. Additionally great work still needs to be done in order to strengthen the health system’s overall planning, performance, coordination and governance.
While the preponderance of reforms implemented so far have focused on reducing costs, the recent Health Systems in Transition (HiT) report of the European Observatory on Health Systems and Policies of WHO recommends that there is a need for the country to focus into longer-term strategic reforms that enhance efficiency while guaranteeing the delivery of health services and improving the overall quality of care while it recognizes that the weak primary care system in Greece is a major challenge for the delivery of services[1]. Moreover the implemented policies which aiming at cutting waste and enhancing efficiency, contributed to a rapid decrease in health expenditure during the economic crisis, with spending levels stabilizing since 2015. Although access to health services is still a major challenge in Greece since the advent of the crisis, with access deteriorated markedly between 2009 and 2016, particularly with the loss of health coverage by the unemployed and self-employed who could not afford to pay social health insurance contributions. During this period, the number of people reporting unmet needs for medical care, particularly for reasons of cost, increased markedly, particularly among the poorest segments of the population. Informal payments are continuing to widespread in both inpatient and outpatient care, in the public and private sectors, thus adding to the direct financial burden on patients to pay for required health services. Moreover, access to medicines, principally some high-cost cancer and psychiatric drugs, has been an issue because of delays or disruptions in the supply chain. Finally, shortages of both personnel and supplies in public sector hospitals and medical facilities have had an impact on access, as have waiting times, the uneven distribution of health. In 2017, Greece spent EUR 1 623 per person on health care, well below the EU average of EUR 2 884. This equates to 8 % of GDP, also below the EU average (9.8 %). Over a third of health expenditure comes from households (including informal payments), one of the highest rates in the EU, and is due to high out-of-pocket spending on pharmaceuticals, outpatient (or ambulatory) care and hospital services[2].
National Capacity on Intensive Care Units
Specialist doctors, nurses and modern medical equipment are the main components of the intensive care unit (ICU) where a significant number of patients win the battle for life. In Greece, ICUs suffer from understaffing: 20% of the ICUs beds remains closed due to this reason. High dependency Units (HDUs) are “non-existent”. The above were stressed during a press conference, in the context of the 17th Pan-hellenic Conference of Intensive Care representatives of the Hellenic Society for Intensive Care (ΕΕΕΘ)[3]. As they said, we have about 750 ICU beds and 680 are open.”It is characteristic that in Greece, in the last 20 years there are 2.2 nurses per bed, when the ratio at European level is 5-6 nurses per bed“, while the waiting time for the patient’s admission to the ICU is 24 hours in Athens and 2-4 hours in Thessaloniki. It is also to be noted that while the percentage of patients that survive after hospitalization in ICUs is a high as 75%, it should be highlighted that of crucial importance is also the existence of a system of timely reception of patients that remains a grave challenge in Greece.
As of March 31th, 49 patients of Covid19 have passed away while Greek NHS has recorded a total number of 1314 confirmed cases. The number of cases in ICUs is 85 patients and the average age of patients that passed away is over 70years old. The active cases on March 31th was 1065.
Long term Global Socio-economic Impact
United Nations Secretary-General Antonio Guterres warned that the world faces the most challenging crisis since World War II, confronting a pandemic threatening people in every country, one that will bring a recession “that probably has no parallel in the recent past.” There is also a risk that the combination of the disease and its economic impact will contribute to “enhanced instability, enhanced unrest, and enhanced conflict”, the U.N. chief said that: “We are facing a global health crisis unlike any in the 75 year of history of the United Nations – one that is killing people, spreading human suffering, and upending people’s lives but this is much more than a health crisis. It is a human crisis. The conovirus disease (Covid19) is attacking societies at their core”. In tackling the devastating social and economic dimensions of the crisis, the UN chief pushed for a focus on the most vulnerable by designing policies that, among other things, support providing health and unemployment insurance and social protection while also bolstering businesses to prevent bankruptcies and jod losses[4].
Ways to Support Us
Completing 30 years of work on the field in 2020, we would not have made it without our donors and supporters. In this current emergency context we need you more than ever in order to continue to be active in the current COVID19 urgent response and protect the most vulnerable. You can support us by making a donation with one of the following ways:
By debit / credit card and PayPal
You can make your donation online through your debit / credit card or PayPal account.
Through Web-Banking
You can make your donation through web banking to one of the following accounts:
Through Web-Banking
You can make your donation through web banking to one of the following accounts:
NATIONAL BANK OF GREECE
Account no.: 141/29611217
IBAN: GR27 0110 1410 0000 1412 9611 217 / SWIFT: ETHNGRAA
ALPHA BANK
Account no.: 199-00-2002-002401
IBAN: GR06 0140 1990 1990 0200 2002 401 / SWIFT: CRBAGRAAXXX
PIRAEUS BANK
Account no.: 5018-005706-640
IBAN: GR03 0172 0180 0050 1800 5706 640 / SWIFT: PIRBGRAA
As soon as you complete your donation, please contact us at donations@mdmgreece.gr for your donation receipt.
Thank you for your trust and support!
Doctors of the World-Greek Delegation #30years_action
[1]Economou C, Kaitelidou D, Karanikolos M, Maresso A. “Greece: Health system review”. Health Systems in Transition, 2017; 19(5):1–192. European Observatory on Health Systems and Policies, 2017. Available at: http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits/full-list-of-country-hits/greece-hit-2017
[2] https://ec.europa.eu/health/sites/health/files/state/docs/2019_chp_gr_greece.pdf
[4] UN Secretary-General, Antonio Guterres media briefing on the socio-economic impacts of the Covid-19 pandemic. Available at: https://news.un.org/en/story/2020/03/1060702
