If you heard a helicopter on Friday 9 January 2009, don’t worry, it wasn’t an accident or emergency being whisked off to Athens, it was the Greek National Minister for Health, Dimitris Avramopoulos arriving to present the people of Naxos with their new hospital.
He came because the hospital is finished... isn’t it Well, not exactly – it’s the hospital buildings that are finished, and finished on time! The long-awaited General Hospital in Naxos was officially handed over by Mr Avramopoulos just nineteen months after he had laid the foundation stone of the building, and pledged that he would return to Naxos at the end of 2008 on its completion.
The ceremony was attended by the Orthodox Bishop of Paronaxia, the Provincial Governor (the Eparchos), the Mayors of Naxos and Drymalia and members of the Council as well as many other Naxians.
This six million euro project has been realised through funding from the South Aegean Regional Operational Programme, or ‘PEP’ (Perifereiako Epixeirisiako Programma Notiou Aigaiou), which is largely financed by the European Union under its Community Support Framework.
This programme has funded the construction of the new hospital buildings and the ongoing conversion of the existing Health Centre (Kentro Ygeias), to provide and furnish surgeries, operating theatres, wards, nursing stations, offices and other support areas, as well as the provision and installation of medical and technical equipment, all conforming to European regulations. The result will be a general hospital serving Naxos and the surrounding islands, plus an upgrade of the existing Health Centre facilities.
So What Changes Can We Expect?
Enter through the gliding automatic glass doors of the hospital and it is a world away from our current crowded and chaotic Health Centre! Decorated in soothing pastel shades, the hospital has separate areas for doctors’ offices, surgical units, emergency treatment, administrative and auxiliary services. The emergency room, currently the only medical part of the building in use, is housed in a spacious area at the front left of the building. While currently functioning with only the same three beds as previously, new equipment such as monitoring devices and cardio-pulmonary apparatus is already in use, with more to come. Opposite the E.R. is an emergency operating theatre and plaster-cast room. An area of doctors’ offices leads to two more operating theatres, which are already equipped with technical installations such as theatre lighting, operating tables and monitoring equipment, with new equipment arriving daily. A dedicated gynaecological unit includes a theatre for births and an incubator, to allow a new generation of babies to be born here in Naxos rather than in Athens or Syros. The much-discussed kidney haemodialysis unit, including the machine donated by Blue Star Ferries over two years ago, will have a separate area housing both the dialysis machines and the additional equipment necessary, together with up to five beds for use by outpatients. The hospital will initially be able to accommodate 25 hospitalised patients, rising eventually to 40, in cheerful and well-equipped small wards of one to four beds, each with a private bathroom, all overseen by a central nursing station. Kitchens, staff rooms and laboratories are also provided for.
Passing the fully-operational and orderly administrative area, however, brings you to a hole in the wall leading back into the trailing wires, dust-tramped corridors and crowds of people mingling with workmen and staff in the existing health centre. Despite the disruption caused by the conversion and the process of being connected to the new hospital, the health centre manages to carry on functioning, albeit in a somewhat more chaotic fashion than before! When the work is finished, most of the existing pathologists’ offices will have been renovated and upgraded but will continue to operate as at present, while the old emergency room is being converted into a cafe and kiosk. Once the current cramped and inadequate ward area is moved to its delightful new home, the X-ray department will be extended into this area, towards the end of the conversion. A new X-ray machine will be installed, replacing the current machine which is estimated to have taken over 300,000 X-rays in its 23 years of service! Separate areas will also be provided for a new ultrasound scan machine and, crucially, for the mammography machine which was donated to the Health Centre several years ago. This is good news, as the fact that so very few women have been screened for breast cancer by this machine has been blamed on its being located in the same room as the X-ray machine, thus necessitating closing the X-ray department to take a mammogram. George Logothetis, General Director of the hospital, informs us that once the mammography machine is installed in its new location, there will be a steadily increasing number of mammograms performed, with the results continuing to be sent to the Aghios Savvas Hospital in Athens for analysis, for the time being. He added that there is still the problem of inadequate numbers of personnel to operate the machine.
Ah yes, personnel...
When is a Hospital Not a Hospital?
So it’s all moving on, and the drills, dust and ducting should be silenced and settled within six months. But does this mean that we can cancel our boat tickets to Athens the next time we fall ill? Sorry to say, but it looks like being a long process before we will reach that stage, if ever. Fully staffed, the hospital and health centre should have around 60 doctors, 70 nursing personnel, plus up to 70 auxiliary and administrative staff. At the moment there are about 20 doctors and 60 nursing/auxiliary staff (including those in the villages and the Minor Cyclades). In order for the hospital to function, the ‘Regulations of Organization’ (“Organismos”) are prepared to set out which departments are needed, what personnel and equipment are required to operate them, and the subsequent financial requirements. This must then be approved by the Ministry of Health, from where it is passed to the Finance Ministry to ascertain the funding available for operating the hospital, salaries, etc. and finally approval is sought from the Ministry for the Interior. It would seem that this process has now cleared the Health Ministry and is awaiting approval by the Finance Ministry, although during his visit to Naxos, Mr Avramopoulos announced that recruitment of a Cardiologist and Nephrologist may already go ahead. Once approval for the staffing is received, the process of recruitment and selection must begin which, in itself, presents a problem. Despite assistance with relocation and a salary weighting for working in a regional area, it seems that doctors are not queuing up to come to the islands. A recent campaign to employ four new pathologists in Naxos resulted in only three applicants, while a paediatrician post had to be re-advertised to produce just one applicant – hardly the scenario to allow selection of the best candidate. Additionally, doctors applying for a job in more than one state hospital before their official appointment may keep their options open and transfer to another hospital if they wish.
As many of the departments are dependent on each other for efficient functioning, this can obviously create many operational problems. A shortage of suitably skilled staff for senior nursing and technical positions may also create delays in the hospital becoming fully operational. For all these reasons, Mr Logothetis was reluctant to put a specific time on when we can expect to see the hospital ‘finished’, but did stress that it would be a gradual process, with initially the new equipment available improving the existing facilities and enabling the current medical staff to work more efficiently, then eventually new departments opening as they are staffed and equipped. As we all know, though, the wheels of bureaucracy can often turn very slowly in Greece, and getting the ‘Organismos’ approved by the government is the next step.
Meanwhile the current situation is far from satisfactory. Researching for this article I found it rather disconcerting to see presumably unwell people having to wait to see a doctor in a dust-filled atmosphere and filthy, tool-cluttered corridors, the ward area crammed with open trolleys of medications and bandages while labourers dismantle ceilings above. One wonders whether the new wards couldn’t have been finished before the new offices? Whether some functions might not have been temporarily transferred to the hospital while the Health Centre is under conversion? Whether security should be tighter surrounding the thousands of euros-worth of new equipment, standing in corridors and unlocked rooms? For sure there will be questions about whether the equipment being supplied is even now as technologically sophisticated as it could be, let alone in the – however many years it takes before it will become operational.
But let’s not be too harsh... we have reason to be pleased that things are starting to change in health care in Naxos, even if we are still a long way off having a fully-functioning hospital. Let us hope that the shiny new equipment being installed will not stand gathering dust, or quietly disappear from where it should be, and that excellent and skilled staff will be found for the new positions coming available. That way we may soon be able to hear the rattle of a helicopter without wondering where the accident was.
Thanks to Yiannis Vlahakis at Mesogeios Radio, Giorgos Logothetis, Director of KY Naxos, and staff at the KY Naxos for their help and information with this article.