The economic crisis in Greece is strangling the country's hospitals, where budgets have been slashed by more than half. As a result, nearly all doctors in both public and private hospitals have seen their pay cut, delayed or even frozen.
"On top of that, we lack basic supplies to do our jobs," says Vangelis Papamichalis, a neurologist at the Regional Hospital of Serres in northern Greece and a member of the doctors union here. "We run out of surgical gloves, syringes, vials for blood samples and needles to sew stitches, among other things."
Last week, the European Centre for Disease Prevention and Control said these shortages will contribute to hospital-acquired infection rates in Greece, which are already among the worst in Europe.
The Health Effects Of Unemployment
In Serres, the 100 doctors and 80 residents who work at the regional hospital often work up to 100 hours a week and see a rising number of uninsured patients for free.
The city is in a region with the same name located in the northern province of Macedonia, on the border with Bulgaria. The Regional Hospital of Serres serves the more than 200,000 people who live in the area.
A hand-painted banner decrying the budget cuts is draped on the main entrance. Inside, Charalambos Veliotis, a bespectacled, 42-year-old pediatrician, is examining a young brother and sister in matching track suits. They've been coughing for 10 days now.
"We only have five state pediatricians to serve the entire region," he says. "There should be at least 20."
The mother of the siblings works as a nurse at a village clinic and says her salary has also been cut. Veliotis says he often sees the effects of the country's 26-percent unemployment rate on his young patients.
"We're seeing children with severe malnutrition," he says. "We're seeing children who have fainted in school from hunger. Depression is common because their parents are unemployed."
His next patient is a 3-day-old infant girl with a cleft lip. He gives the baby's parents tiny syringes and shows them how to relieve her nasal congestion with saline.
"We ration supplies, medicine, everything," he says. "Sometimes we pay out of our own pockets to buy them."
Veliotis has been a pediatrician for eight years but makes just under $2,000 per month, after a 30-percent pay cut.
Papamichalis, the neurologist, says his pay has also been cut; he now makes the equivalent of $1,600 a month and often works 100 hours a week. On a busy morning recently, the bearded, serious, 40-year-old doctor checks out a patient's brain scan, then confers with a nurse about a backlog of medicine.
The state hasn't paid bills to pharmacies, so his epilepsy patients often wait days for their medication.
"In medical school, we were taught to give our patients the most modern care," he says. "But in reality, we're working under the same conditions as 50 years ago."
The Greek health care system already had problems before the crisis. Like other divisions of the public sector, it struggled with corruption and mismanagement. Those years of bad management, coupled with the worst economic crisis Greece has seen in half a century, means some hospitals now lack life-saving resources, Papamichalis says.
For example, last year, Papamichalis tried to save a 40-year-old man in the emergency room after he suffered a massive stroke.
"Because we don't have a stroke unit, we couldn't relieve his thrombosis. He died," he says, shaking his head. "I was so upset because if I had the resources to do what I needed here, this man could have made it."
Hardship At Home
Papamichalis says he wants to stay in Greece and fight to reform the health care system. But his colleague Dimitris Kokkinidis, a hematologist, says he's lost hope.
"Many days, we run out of vials for blood samples, or we don't have re-agents needed to test the blood," he says. "It's just tragic."
Kokkinidis' salary has been cut in half. He now makes about $1,200 a month.
That's what his family of five must live on. His wife, Despina Rizopoulou, works as a family doctor at a private clinic, but she hasn't been paid for 11 months.
Rizopoulou works at a Euromedica Red Cross clinic in the nearby city of Thessaloniki, where the couple lives with their three young children.
The Greek state owes Euromedica millions, as does the new government of Libya, whose war victims were treated here last year.
"All this floor, [the] third floor, was filled with Libyans, with no other patients," she says. "And they didn't receive the money that was agreed with the Libyans."
She tries to make extra money through a small private practice at a nearby village. It's not going well.
"I know more of my patients are unemployed or they live on a pension that is very reduced," she says. "Most of them don't have money to pay for the heating, especially with the winter here. It's not humane to make them pay."
She's not sure she will ever get her back-pay for her clinic work. So, she and her husband are now looking for jobs in England and Switzerland.
"I can't stand this insecurity," Rizopoulou says. "Everything here is collapsing: the health system, the educational system. We just can't imagine our children growing up in an environment like that."