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  Nr. 77 - Dec.' 04-Jan. '05
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A New Era in Healthcare

by Vicki Preston, December 2004
Many changes are under way at our local Health Centre (Kentro Ygeias) in Paroikia since John (Apostolos) Polyzoides was appointed the new Chief Executive of Medical Services for Paros and Antiparos.

The son of Greek parents, John was born in Egypt in December 1934, grew up in Alexandria and was educated at Victoria College (an English school modelled on the famous British public school Eton) with classmates who included Saudi princes, children of the exiled royal families of the Balkan states and the young Hussein, later to become King of Jordan. After school, John's medical training (which was in English) at the University of Alexandria was interrupted by the Suez War of 1956 when he served briefly as a volunteer in the Egyptian Army. After completing his training, he served one year at the Alexandria University Hospital in general medicine, surgery and orthopaedics and then travelled to England to take his first job as Senior House Officer in Orthopaedics in Wolverhampton.

"I immediately fell in love with the British health service", he says, "I couldn't believe there could be anything so perfect!"

From Wolverhampton, he moved on to Coventry, working for two years in orthopaedics and two years in general surgery while studying hard to take the exams to become a Fellow of the Royal College of Surgeons (FRCS) of England. Following this he taught orthopaedics and trauma in Bristol for two years and then became Senior Registrar at the Royal Orthopaedic Hospital in Birmingham, which position he held until 1972 when he was appointed Consultant Orthopaedic Surgeon and Senior Lecturer for Birmingham and Solihull. Before taking up this post, he spent some months in Basle, Switzerland, working and studying the new techniques that were being developed there for faster and better healing of fractures.

On his return to England he began working on developing new types of joints for the wrist and hip, and then - what would become his area of primary interest - the knee. Seeing many failures in knee replacements (they lasted between only 2 and 8 years), he began working on trying to improve the design of artificial knee joints.

He explains: "The first knee replacement in the fifties was a hinge design, but because the knee is not a hinge joint physiologically - it has a rotation element - this didn't work.
The knee would try to rotate and abnormal forces would be transmitted in the joint causing it to loosen, move inside the bone and produce pain. Then metal on plastic joints came into use but, again, these did not last, wore out and loosened after about 5 years, so 40,000 knee replacements in Europe had to be revised. This was why I and my Registrar, Dr Thanassis Tsakanos, began work on a new concept to design a knee replacement joint with rotation."

The "Eureka" moment came when he and Thanassis were on holiday on the island of Thassos - an island with ancient links to Paros, though this was before John had any connection yet himself to our island. Sitting on a stony beach discussing the design problem, they were toying with the pebbles on the beach when the solution suddenly became clear. "Thanassis, you know what we have to do?", he exclaimed, and, balancing three pebbles one on top of the other, showed him how they could take the movement one level up, using three sections in the design to allow the top and bottom parts to glide and rotate without causing obstruction. It took another 10 years, until 1988, before his prosthesis "Rotaglide" was on sale throughout Europe. His design, inspired by the pebbles from Thassos, mimics the physiological movement of the natural knee joint, reduces wear dramatically, and is easy to revise if necessary, though when properly aligned and spaced, it now meant that knee replacements could last between 15 and 20 years.

Whilst working in Solihull John founded a charity to raise funds for a hospital and for the SIMTR Medical Research Centre where the main lecture room bears his name. He remained in Solihull for 23 years until he retired in 1996.

Moving to Athens, he worked until 1999 at the Ygeia Hospital, then came to live on Paros where he worked part-time at the private Medical Center, but has also treated countless patients free of charge at his home in Krios, built on land he purchased in 1988.
He had been visiting the island every few years since Andreas Beldekos, a doctor from Paros who John trained 20 years ago in Birmingham, invited him to visit Paros to take a break from his rigorous working schedule.

Since then he and his wife Jean have developed an extraordinary attachment to the island and have both been working tirelessly to find ways in which they can benefit the local community. "It's difficult to put into words," Jean says, "but we feel an affinity for this place and the people here. And when we decided to get married here, of course that made Paros very special to us."

John's "retirement" on Paros has included organizing two international conferences here - one for orthopaedic surgeons in 1994 with 150 participants from all over the world and another for physiotherapists in 1998 on the McKenzie technique for spinal manipulation. As current President of the McKenzie Institute for Greece & Cyprus, he is also responsible for organizing a 1,000-participant conference next year in Crete. In 1999 he founded the "Association of the Friends of the British Committee for the Restitution of the Parthenon Sculptures" and has arranged a number of highly-successful fund-raising events for the Association.

Now, as Director of Medical Services at the Paros Health Centre - an unpaid, voluntary position - John works every morning and often afternoons and evenings too, offering his experience and expertise to our local health service. He has already arranged delivery of a new ambulance for Paros and three new paramedics from Athens are promised from the Ministry of Health's EKAB service. The garage has been converted into an office for the ambulance drivers with the ambulances parked beside it. John has written to the shipping companies to ask for an emergency room equipped with oxygen to be made available on each ship, instead of patients having to be transported in open areas wherever there is space for a stretcher, and has requested help from the Harbour Master to transfer patients onto ships. Volunteers are making curtains to provide privacy for the beds on the wards, training sessions by senior doctors for the junior ones and regular meetings between staff members have been set up. A major project to drastically reduce waiting times for blood tests in the biopathology department is under way.

Funding for the Health Centre comes partly from the Ministry of Health (via the regional authority in Syros, the "PESY"), partly from the Velentzio Foundation (60,000 euros per annum) and some from individual private donations and from the 180-member association "Friends of the Health Centre" founded for this purpose in 1999 (see the March 2001 issue of Paros Life for further details). John called a meeting on November 10th with staff members, representatives from the international community and the board of the Association to discuss ways of raising additional funds. Giannis Chaniotis, President of the Association, explained that the group had not been active in fund-raising for some time, firstly because a lot of money and equipment was donated after the Samina Express disaster and also because the PESY was set up in the meantime to supply the needs of the Health Centre. Now that there are new projects requiring funds, they are ready to reactivate the Association and the board plan to hold elections shortly. They expressed their desire for one or two members of the foreign community to be willing to stand for election and to bring fresh ideas for fund-raising. Anyone interested to join the committee can contact John on 22840-23809.

John stresses, however, that we cannot expect the Health Centre to function as a hospital. The medical staff - a Director of General Practice, general physician, gynaecologist, two paediatricians, an orthopaedic surgeon and, from 1st December, a cardiologist - provide emergency services for trauma and medical care. An extensive programme for preventive medicine for adults and children, a gynaecological service, preventive dentistry and emergency dental work are also available. It is possible to stay in one of the Health Centre beds only for 2-3 nights, after which the patient is transferred to Syros or Athens for more investigations and treatment. There is also a very good physiotherapy department and there are social workers, occupational therapists and psychologists attached to the facility. Paediatrician Katerina Stavrakaki-Frangouli has been appointed Medical Director and looks after the medical staff. She succeeded Dr Antonis Arkas who worked tirelessly for 8 years in this post.

"Although I believe our Health Centre to be one of the best in the Cyclades, with 12 doctors for Paros and Antiparos, plus another 8 junior doctors who also cover the medical stations in the villages, we want to improve services as much as we can with the existing infrastructure. I'd also like to emphasise that I have never seen a team of such devoted nurses as the five girls who work beyond endurance to ensure care is available around the clock. The X-ray department too works day and night and the volunteer team were also invaluable during the summer months - I hope they will be willing to continue again next year", John says.

"I'm extremely fortunate to have the help of Despina Polou, a senior nurse who worked at the Health Centre for 25 years and knows everything about the daily running of the facility. I only agreed to take this post on the understanding that Despina would be my deputy. She is an exceptional person, hardworking and practical with a deep affection for the community of Paros. She has spent her life devoted to helping people.

"But taking into account the growth in the population of Paros (estimated at around 20,000), we need to consider having a new hospital to fulfil all the needs of the growing community. I will start working in the new year on a long-term plan to raise funds to build a hospital.

"In the meantime, there is a new atmosphere in the Health Centre - the staff are commenting on it. I come home tired, but also energized from my work here. I feel that the young people in Greece are very different from how they were in the past. The old "public employee" attitude is changing and they are engaged in what they do. I see a new energy in them - they want to be employed, they're not into corruption, there is something sensitive about them, they're thirsty for knowledge and they're hardworking.

"I think that with the experience I've had from my years in England and Greece working in many hospitals, I have the possibility to make a contribution here. There is a new ethos in these young people. I'm very impressed and I'm very optimistic."
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