By Vicki Triantafillou, M’18
Special to the Hellenic News of America
Growing up in a Greek family meant that twice a week after school, I attended Greek school to formally learn how to read, write, and speak Greek, with a sprinkle of history and traditional Greek dance lessons. This was non-negotiable, and no amount of feigning being sick was enough to get me out of going. Despite the half-hour struggle on the car ride there—during which I tried to convince my mother that I really was sick—I do fondly remember learning about ancient Greece’s contributions to science and medicine and about Hippocrates, born on the Greek island of Kos around 460 BCE and widely regarded as the “Father of Medicine.”
This summer, after my first year of medical school, I found myself walking up to a gray stone, yellow balcony-lined building in the middle of Athens, thankful for my ability to speak and read Greek and yet second-guessing that I had properly read the sign “ΝΟΣΚΟΜΕΙΟ ΠΑΙΔΩΝ Η ΑΓΙΑ ΣΟΦΙΑ” (Aghia Sophia Children’s Hospital) because this was unlike any hospital I had ever seen.“It’s in your hand” – Vicki and her on-site mentor, Stefania Maroudi-Manta, standing with one of CLEO’s posters.
I went to Greece to work on a research project born here in Philadelphia under the mentorship of Julia Szymczak, PhD, a medical sociologist and postdoctoral fellow in the Division of Infectious Diseases at The Children’s Hospital of Philadelphia (CHOP), and Theoklis Zaoutis, MD, MSCE, Chief of the Division of Infectious Diseases at CHOP. With funding from Penn’s Center for Global Health, I spent six weeks at the Sp in Athens, visiting the neonatal intensive care units (NICU) of three of Athens children’s hospitals and interviewing their doctors and nurses about health care-associated infections (HAIs) and antimicrobial resistance as a first step in understanding barriers to improving infection control practices and promoting the judicious use of antibiotics. Established in 2011 by Dr. Zaoutis, CLEO specifically addresses HAIs and the growing threat of antimicrobial resistance: two major problems in Greece.
While HAIs and antimicrobial resistance are a growing global problem, Greece in particular stands out with one of the highest rates of antimicrobial use—and resistance—of all European countries. It is hoped that identifying health care worker attitudes and beliefs around these topics may allow us to design and implement interventions that will be more effective and more likely to be adopted because they fit within the culture of medicine as it is practiced in Greece. In addition to improving patient outcomes, reducing the financial burden associated with HAIs is particularly significant for a country whose hospitals are already struggling to provide basic services.
Since 2008, health care spending in Greece has been cut by 25% according to the Organization for Economic Co-operation and Development, and Greek hospitals have faced shortages of personnel, medications, and even the most basic supplies, such as gloves and paper towels, as the country’s health care system teeters on the brink of collapse. Hospitals and clinics have closed; 30,000 health workers have been laid off; and many young, talented doctors have left the country. At the same time, Greece has seen more refugees from the worst global conflict zones than any other country in Europe, which, coupled with imposed austerity measures has left Greece struggling to cope with multiple national crises.The stone facade and balcony-lined entrance to Aghia Sophia Children’s Hospital in Athens, Greece.
Living and working in Athens this summer, I was able to understand for the first time the heavy cloud of uncertainty and worry that shrouds the country. From my conversations with hospital staff, it is clear to me that the only reason the hospitals in Greece continue to function is the tenacity and integrity of the people I had the opportunity to interview: doctors and nurses that are tired, but truly love what they do, and work each day with every ounce of their being. Their response to the crisis can be summarized by a Greek word the meaning of which encompasses the values that form the very foundation of Greek culture and identity, a word the meaning of which cannot be adequately captured by any translation: Φιλότιμο (philotimo). Roughly, it is a way of life rooted in dignity, respect, compassion, and gratitude; it is an overwhelming, intrinsic sense of duty and social responsibility to one’s self, one’s country, and one’s fellow human beings.
As I reflect on my experience in Greece working with CLEO, I feel lucky to have had the incredible opportunity to witness medicine as it is practiced in another country, an experience through which I learned more about the practice of medicine itself—a couple of humbling lessons that have a permanent place in my white coat pocket. I have returned to Philadelphia with humility in the face of what health care practitioners are facing in Greece, and a newfound gratitude for all that I take for granted as I grow into a doctor in the era of medicine as it is practiced in the US today.
Despite the apparent differences at first glance—yellow balconies and open windows, “Thank you for not smoking” signs posted not around the hospital grounds but in the hospitals themselves, and handwritten lab results—I have seen that medicine at its core, the commitment to healing, is the same.