City: Helliniko, Attica, Greece
The Metropolitan Community Clinic at Helliniko provides free medical assistance to the unemployed, and poor civilians with no social security or with very little income.
Photo courtesy of mkie-foreign.blogspot.fr
Holding Organisation: Metropolitan Community Clinic at Helliniko Status: free association People involved in the project: 200 volunteers of different specialisations. The stakeholders are thousands of people every month from the region of Attica who are unemployed, without any social security, migrants, low-wage persons and struggling pensioners. Public partners: NO Private Partners: ΝΟ Sources and links: http://mkie-foreign.blogspot.gr/ (English); http://mki-ellinikou.blogspot.gr/ (Greek)
The idea emerged in 2011 during the concentration of Greek “indignados” in Syntagma Square, searching for a need to find new ways to resist what the Greeks were experiencing and continue to experience due to the International Monetary Fund (IMF). There was the necessity to support citizens’ basic needs, such as health, in order that they may fight and resist destructive measures of the IMF and the Troika. As Mikis Theodorakis, a famous Greek composer and historical person of the Left said: “No Greek should starve, no Greek should be left without a doctor”.
The local context:
In May 2010 Greece joined the IMF, followed by the signing of a series of memoranda with heavy financial measures for the population, forcing a large part of the Greek population into poverty and exclusion from access to the public health system. A high percentage lost their health insurance or can no longer afford to pay for it. Moreover, there are 1.500.000 unemployed people in Greece with no health security and an unknown number of people who work in the black market.
The starting point:
From the assemblies of Syntagma Square in 2011 emerged the need for new ways of resistance to what is happening in Greece. One of them was the support of the population in basic human needs such as health, an idea that was started by a group of 6-7 people and quickly followed by 60. The Municipality of Helliniko provided the buildings and agreed to cover the operating expenses; and the first community clinic in Greece started its operation in December 2011.
Steps and development of the action:
- May 2011: first ideas developed during the meetings in Syntagma Square
- September 2011: first meetings of the team to create the Metropolitan Community Clinic at Helliniko (MCCH)
- December 2012: starting of the Community Clinic
How does it work?
The MCCH has no legal status, nor is it officially recognised by the State. The Central Management Authority is the General Assembly of its members, while there is a Coordinating team of 9 people who organise the various individual actions. The actions are carried out by smaller groups, such as secretarial, communications, pharmaceuticals and a materials management team. Depending on the needs of the clinic and its clients, new management teams can be created.
The MCCH serves daily requests for medical assistance from the Attica region, with an emphasis on the Municipality of Helliniko. Here, about 100 people volunteer as medical staff and another 100 work voluntarily in various administrative and other positions. Its philosophy of creation and function is based on three pillars:
- MCCH accepts no monetary donations from anyone. Donations are accepted in the form of goods or services only.
- MCCH refuses to meddle in political or “party” activities and will not allow any faction to use the efforts of the volunteers to project their own political/personal viewpoints or to benefit in any way from the efforts of the volunteers.
- MCCH will not advertise the contribution of any donor
The operating costs are covered by the municipality and by the contributions of the members. Sponsorships can be made in articles and materials and if someone wants to make a financial donation, this is done through pharmacies that purchase drugs and materials where needed and which are then donated to the MCCH.
Examinations of primary care are performed in the offices of MCCH. For more specialised tests, the MCCH is collaborating with the medical staff of public hospitals, with private examination centres operating free trials, agencies, associations or citizens who can meet the financial costs of particular tests. For example, the club employed by the Bank of Greece covers the cost of 10 monthly blood tests.
Uninsured patients must present their expired booklet, the unemployed their unemployment card and people who live in poverty must bring their welfare booklet. In cases where this is not possible, a document from the City Social Service or any NGO which ensures that the patient meets the criteria to be considered by the NPI is required. Of course, there are exceptional cases concerning low-income citizens.
Added value of the project and making resources available:
- Economic benefits: uninsured, unemployed and poor patients receive primary healthcare services and medication
- Social benefits: it supports and empowers patients who are in a difficult economic situation, integrating them (back) into society and offering a sense of “belonging”. Moreover, it weakens the targeting of poor people as being responsible for their own situation.
- Shaping policies: the MCCH is involved in a daily struggle to prevent the collapse of the public health system and the disintegration of social cohesion. It is making proposals to the Ministry of Health for a radical reorganisation of the public health system and therefore, it has drawn the attention of international media and international institutions and lawmakers.
On the 26th of June 2013 the Parliamentary Assembly of the Council of Europe unanimously adopted a resolution recommending that all citizens have equal access to public health care, taking into consideration the example of the MCCH (see http://assembly.coe.int/ASP/Doc/XrefViewPDF.asp?FileID=19776&Language=EN).
The biggest challenge is the rapidly increasing number of patients, which raises demands and needs of the Clinic. Moreover, there is a difficulty in finding drugs, particularly those that are more specialised and expensive. Another difficulty is how to immediately treat the serious cases that require long hospitalisation or surgery, or difficult and costly treatment.
Another issue is the difficulty of identifying the NPI received from the State if it has no legal status. However, the operation is covered by the Constitution and the oath to Hippocrates, and is recognized in the eyes of citizens and international organizations and SMEs that have expressed interest in the action and have published articles about it.
A key concern of MMCH is not only to meet the medical needs of the population, but to fight for a secure public health system for all citizens that is provided by the State. Therefore, it is in constant confrontation with the Health Ministry, which is denouncing the problems that exist. Recently, plans to establish a Health Observatory for the registration and documentation of problems in the public health system have been initiated with the help of citizens and the cooperation of several participants, such as patients' associations. This is expected to lead to an open conflict with the Ministry of Health in the fight for free access for all to the country’s health system.