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A Health Care Tragedy Plays Out In A Greek Port

Perama was once a prosperous town and a center for ship repair. But the industry moved to Turkey and China — taking the town's jobs with it. (NPR)

Near the port of Piraeus and about 10 miles west of Athens, Perama developed after the Greek civil war of the 1940s, growing prosperous in the 1980s thanks to the ship-repair industry.

But now, the once-bustling piers are deserted. A few rusting skeletons of unfinished boats stand outside empty, abandoned warehouses.

That's because business migrated to low-cost Turkey and China, and in a few short years, industry jobs dropped from 4,500 to 50.

The official unemployment rate in Perama is 80 percent. But actual joblessness is higher — even the underground economy that gravitated around the shipping industry has shriveled up.

As a result, health care is increasingly out of reach for many people. Under new austerity measures in Greece, citizens lose their entitlement to state-funded health care after a year of unemployment. And many would-be patients can't afford new fees for doctors' visits and medicines.

In Perama, one of the hardest hit places, an international NGO has shifted its focus from foreign war zones in order to fill the gap.

Like A Third World Country

On a recent day in the reception room of a Perama clinic, several women and children wait to see doctors. Others come to get parcels of food and diapers, all provided by this free clinic run by Doctors of the World.

Nikitas Kanakis, director of the aid group's Greek branch, says the situation in Greece is like that of a developing country.

"People in queues trying to find food, trying to find medicine, homeless people in the middle of nowhere — it is a humanitarian crisis," he says.

The Greek public health system was bloated and rife with corruption. But since 2009, a 13 percent budget cut has led to a shortage of medicines and deteriorating hospital conditions, prompting a team of English researchers to warn of a health tragedy in the making.

The cash-strapped government introduced a new fee of $6.50 for each hospital visit, making it costly for the 30 percent of Greeks living under the poverty line.

In Perama, the free clinic is filling a vacuum left by the state. The clinic sees about 90 patients a day and distributes free medicines. About two months ago, it started distributing food parcels to the very needy.

Chionia Manousakidou, a 25-year-old mother of three, comes for a weekly package of milk, pasta, rice and sugar. She and her husband used to work at traveling fairs, but they can no longer afford the fee to manage a stand.

"We had to give up our house and now live at my mother-in-law's," she says. "We all sleep in one room. This clinic is the only place we can come for help."

Psychological Impact

The economic crisis has led to an increase in personal and family problems. In October, the Perama clinic started offering free visits with a psychologist, Katerina Goblia.

"A symptom I encounter very frequently is panic attacks and agoraphobia," she says. "They have difficulty [leaving] their home. And all kinds [of] depressive symptoms, like feeling helpless and unworthy and guilty, they have a lot of despair."

One of the volunteers at the clinic is Antigone Varkianou, 49, an unemployed graphic designer. Her husband used to work in the shipping industry, but is now jobless.

Varkianou says they belong to a generation that has a memory of poverty and can cope with hardships.

"The problem is young people, 25 to 35 years old, raised in prosperity, who never imagined they would reach this point," Varkianou says. "They're the ones at risk. They have no practical knowledge, they don't even know how to light a fire if they need to, or how to go to the mountain and collect greens and cook them. They don't even know how to knock on someone's door and ask for help."

The Greek parliament has just cut the minimum wage by 20 percent, reducing it to $780 a month.

At the clinic in Perama, only one thing is certain about the future — trying to survive is going to get harder and harder.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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MELISSA BLOCK, HOST:

In explaining the Greek crisis, it's easy to get caught up in the billions of dollars involved and the percentages that bondholders will lose on their investments. For the Greek people, the bottom line is things are really tough. Unemployment is nearly 20 percent. And at the same time, new fees for doctors' visits and medicines are putting state-funded health care out of reach of many.

NPR's Sylvia Poggioli reports from the port town of Perama, where an international relief group has shifted its focus from foreign war zones to poverty at home.

SYLVIA POGGIOLI BYLINE: The long, wide piers are deserted. A few rusting skeletons of unfinished boats stand outside abandoned warehouses. Near the port of Piraeus, Perama developed after the Greek Civil War of the 1940s. It grew prosperous thanks to the ship repair industry in the 1980s. But the business then moved to low-cost Turkey and China. In a few short years, jobs dropped from 4,500 to 50.

The official unemployment rate in Perama is 80 percent but actually, it's much higher. Even the underground economy that gravitated around the shipping industry has shriveled up.

And under new austerity measures after a year of unemployment, citizens lose their entitlement to state-funded health care.

Several women and children are waiting to see doctors. Others come to get parcels of food and diapers. The supplies are provided by this free clinic run by Doctors of the World.

Nikitas Kanakis, director of the Greek branch of the NGO, says the situation in Greece is like that of a Third World country.

DR. NIKITAS KANAKIS: People in the queue trying to find food, people who try to find medicine, homeless people in the middle of nowhere. It is a humanitarian crisis.

BYLINE: The Greek public health system was bloated and rife with corruption. But since 2009, a 13 percent budget cut has led to lack of medicines and deteriorating hospital conditions, prompting a team of English researchers to warn of a health tragedy in the making. The cash-strapped government introduced a new fee of $6.50 for each hospital visit, making it too costly for the 30 percent of Greeks living under the poverty line.

Here in Perama, the free clinic is filling a vacuum left by the state. It has some 90 visits a day and, along with free medicines, two months ago it started distributing food parcels to the very needy.

Twenty-five-year-old Chionia Manousakidou, a mother of three, comes for a weekly package of milk, pasta, rice and sugar. She and her husband used to work at itinerant fairs but they can no longer afford the fee to manage a stand.

CHIONIA MANOUSAKIDON: (Through translator) We had to give up our house and now live at my mother-in-law's. We all sleep in one room. This clinic is the only place we can come for help.

BYLINE: The economic crisis has led to an increase in personal and family problems. In October, the Perama clinic started offering free visits with psychologist Katerina Goblia(ph).

KATERINA GOBLIA: A symptom that I encounter very frequently is panic attacks, and also agoraphobia - they have difficulty to leave their home. And all kinds of depressive symptoms, feeling helpless and unworthy and guilty. They have a lot of despair.

BYLINE: One of the volunteers at the clinic is 49-year-old Antigone Varkianou, an unemployed graphic designer. Her husband used to work in the shipping industry, but is now jobless. They belong to a generation, Varkianou says, that has a memory of poverty and can cope with hardships.

ANTIGONE VARKIANON: (Through translator) The problem is young people, 25 to 35 years old, raised in prosperity, who never imagined they would reach this point. They're the ones at risk. They have no practical knowledge. They don't even know how to light a fire if they need to or how to go to the mountains and collect greens and cook them. They don't even know how to knock on someone's door and ask for help.

BYLINE: The Greek parliament has just cut the minimum wage by 20 percent, reducing it to $780 a month. Here at the clinic, there's only one certainty about the future - that for Greeks, trying to survive is going to get harder and harder.

Sylvia Poggioli, NPR News, Athens. Transcript provided by NPR, Copyright NPR.

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