“Continuing and increasing morbidity affecting the health structures in the Aegean islands”

Problematization of the regional faction “OPEN HORIZONS IN THE SOUTH AEGEAN

“Continuing and increasing morbidity affecting the health structures in the Aegean islands”

Throughout Greece, health structures are plagued mainly by understaffing and a lack of equipment. Despite all the annoyances and protests of the health staff, even of Hospital administrators who resigned after the “overburdened situational criticality of the Hospitals” as pointed out by the resigned Director of the Medical Service of the Venizelio Hospital of Rethymnon, and also after mobilizations of the local communities on the islands and in Athens, the state has not been able to take decisions that support the good of Public Health Care.
The same pattern is followed by the islands of the South Aegean, in which, however, the peculiarities resulting from insularity intensify the situation. The shortages of doctors, nurses, technicians, auxiliary and administrative staff in all the hospitals and Health Centers of the islands of the S. Aegean are indescribable. Therefore, the difficulty that governs the working conditions of the limited health personnel who serve on the islands is indescribable, since their daily working life is unbearable, especially during the summer months, when the population of the islands multiplies due to tourism. Bright examples? The dramatic situation experienced and experienced by a pediatrician in Leros with a recent event, the “dive into the sea” while transporting an infant, which highlights the lack of professional dignity these people face. In addition, in Kastellorizo, two recent incidents reveal the indescribable situation that prevails. A boy and a girl of toddler age were taken to hospitals in Turkey after being injured, as the exchange of information and communication with the Rhodes hospital proved unsuccessful. These incidents collectively represent the risky situations that health personnel on these islands are called upon to manage as they try to cope with increased needs, especially during the tourist season.
The fact that doctors and nurses do not choose the insular health structures, with the result that the minimum announcements become barren, is due on the one hand to the knowledge that by assuming their position they will be forced to cover large “debts” in leave for those already servants. It is a common secret that the health workers overfill the maximum number of on-calls defined by the law, endangering their health, as well as that of the patients, as is done in the anesthesia departments of most hospitals (e.g. Rhodes and Syros). One-man specialties for doctors also act as a deterrent to filling positions. On the other hand, in the island structures in 2023, there are no basic medical specialties, such as cardiologist (e.g. Kalymnos Hospital), pathologist (e.g. Kos Hospital), pediatrician (e.g. Nisyros), dentist (e.g. .e.g. Leros), gynecologist (e.g. KY Paros) etc. This leads the doctors who serve to be unable to cope even with the basic interdisciplinary demands of the patients. Until now, the Ministry of Health and the Ministry of Health and Human Services are trying to cover the gaps by moving doctors and nurses from island to island and through contracts with private doctors, creating inevitable new ones. Of course, other strange things happen in the staffing of hospitals, such as the existence of three ophthalmologists in the hospital of Kos, while the one in Karpathos entered into a contract with a private ophthalmologist (“with a block”). To the list of adversities are added: difficulty finding accommodation (due to conversion to airbnb), expensive rents, expensive air-coastal tickets, great punctuality in island Greece, etc. And who is to blame for this situation? the “demanding” health workers, who do not respond to job announcements.
Thus, from a short trip to the health facilities of the South Aegean, the following results emerge:
“Vardakeio and Proio” of Syros General Hospital: Its understaffing (as in the artificial kidney unit) is huge, which together with the removal of the EKAV helicopter from the island’s flying base, cause strong protests from health workers and society. These concerns were unfortunately confirmed by the death of a 22-year-old man from Naxos (5/11/2023). The patient – while waiting in vain for a helicopter from Syros – was scheduled to be transported by a helicopter that was already airlifted from Andros, which had to return from Elefsina, pick up doctors from Syros and, with a long delay, pick up the unfortunate young man, the who breathed his last at the General State Hospital of Nice.
Karpathos Hospital: Faces many shortages in medical and nursing staff based on the organizational chart and the announced new departments (such as the CT scanner). Still pending is the artificial kidney unit despite the needs of the island, the construction of infrastructure for the removal of rainwater, so that the phenomenon of flooding does not repeat itself and the completion of the road junction in front of the Hospital which now leads to serious accidents.
Santorini Hospital (Thira): This long-suffering hospital has been characterized as a “pass-through center”, with many gaps in medical staff, which are temporarily filled by moving from other hospitals, such as anesthetists, cardiologists and microbiologists. Out of “desperation”, this time the notices limit the period of service, such as that of the cardiologist for six months and the Microbiologist for ten months (5/11)!!! There is still a necessary specialty missing: that of the mortician-shroud-bearer, which combined with the broken refrigerator gave the extreme news of a rotting corpse (7/11) public, while its functional problems are also abundant (e.g. clothing, cleaning, feeding patients, etc.)
Vouvallio Hospital of Kalymnos: It faces serious problems of understaffing, in medical, administrative and nursing staff (e.g. the needs of the Cardiology clinic are covered by private cardiologists “with a pad” or by transfer from other hospitals).
KY Milos: It is seriously understaffed in relation to the needs of the island and its organizational chart, while a Pulmonologist and a Pediatrician were recently transferred from it to other units in the Cyclades, without care to cover these positions.
Rhodes Hospital: It is experiencing severe understaffing in medical, nursing, technical and auxiliary staff that reaches 50% of the positions, as defined by the organizational chart. but also from the needs of Rhodes, the islands of the regional unity of Rhodes, as well as tourists during the summer months.
KY Paros: its operation is determined by the superhuman efforts of management and medical-nursing staff who are experiencing serious shortages (e.g. gynecologist and radiologist)
Kos Hospital: it is seriously understaffed based on the organizational chart and the needs of the island, since they serve: a radiologist-cardiologist-pediatrician and its pathologist has been transferred from another institution, despite the needs of the island, tourists and the Kos Reception and Identification Center for applicants asylum and immigrants.
State Hospital of Leros: There are serious shortages in medical (e.g. dentist, nephrologist with a “block”), nursing (nurses are required to cover three clinics to implement the daily schedule) and other staff. It should also be emphasized that the KTHL also serves the Leros Reception and Identification Center for asylum seekers and immigrants.
EKAV: has been operating for 4 years with low staffing (e.g. Symi and Nisyros) and an obsolete fleet, as in the whole country. Tragic are the results of dealing with emergencies, some of which have turned out to be fatal (as in Kos and South Rhodes), despite the intention to cover positions – through an act of legislative law by the government – from the already understaffed Fire Brigade and the Army!
It shares the problems of all the other islands, with Municipal, Regional and Rural clinics staffed by few doctors, exhausted by on-calls. Therefore, first-class care is also discredited from one end of the South Aegean to the other. The tactic of moving doctors from other islands (e.g. from Rhodes to Tilos) seem like patches in front of the needs. The contracts with private individuals do not cover the health requirements, nor the characteristics of transparent, public care, for the islanders. There are not even words for the absolute lack of mental health infrastructure! In this way, the constitutionally enshrined institution of insularity has been completely discredited.

At the same time, huge sums are spent on the approximately 3,500 airlifts per year, which are often inefficient, especially compared to foreign standards. On top of this finding, the findings of the report of the Court of Auditors for the period 1.1.2021 to 30.4.2022 are added, based on which the “champions” in the process of direct assignments are the hospitals and the Health and Human Services. Only a small percentage of their contracts are awarded through competitive processes – due to systemic difficulties, combined with the urgent need to supply medicines and consumables. All of this, in addition to adding to the overall picture of opacity in public administration, costs more to the state, but also to the taxpayer.
The highlight of all is the government’s decision to grant 6.8 million euros to the Athenian canals of national scope, instead of investing in the health infrastructure of the islands of the South Aegean and the wider Greek area. This move reflects a political priority and confirms that available resources are not being used to improve health infrastructure, as health shortages remain untold despite pressing needs, especially in remote areas. Or that the resources earmarked for the critical health sector are purposefully insufficient, leading to the same question: Is there a POLITICAL WILL to improve the health infrastructure or exactly the opposite?
There is a solution; The local government, which is intimately aware of all this pathogenicity, must help directly, but also through exerting pressure on the central authority, so that financial incentives for health workers can be expanded and increased. The ones that are given now are meager and sporadic (they are NOT given to everyone, but to some rural doctors per Municipality or to a certain number of assistant doctors per hospital/C.Y.) in front of what would lead a doctor or nurse to dare to serve in a remote island. However, it is equally important to create a wider set of motivations, beyond financial ones: professional, educational, social, etc. However, none of the above will lead to the solution of the huge problems if the intention to increase the percentage of public health expenditures on GDP (as is the case in the rest of the developed countries), which will make mass recruitment in the health area. Neither applause (as during the Pandemic period), nor patches are enough!!!
So we join our voice, with that of local communities and health workers, in the mobilizations that continue, in order to demand health care conditions for residents NOT Second Class.

From the Press Office
9/11/23