Greece

GREECE, occupies an area of 147,634 km² with a population of 6,199,000 (census of 1926). The mechanical increase in population, due to territorial expansion as a result of wars, immigration of Greek refugees from Asia Minor, and exchange of Turkish population of Macedonia for Greek population of Asia Minor, has been very significant in the last 15 years. In general, the population increased as follows: in 1912 there were 2,632,000, in 1913 - 4,810,000, in 1923 - 5,810,000, in 1926 - 6,199,000. The mass immigration of Greek population (1922-1924) - the total number of immigrants amounted to about 1,500,000 people - was the most important socio-economic factor that affected the entire life of the country and in particular its sanitary condition. Data on birth and death rates are very inaccurate due to the weakness of registration and the fluidity of the population. The epidemic situation in Greece, which sharply deteriorated during the war period (cholera epidemics in 1913 in Macedonia - 5,200 cases, in 1915-16 on the island of Corfu among Serbian troops - 15,000 cases) and due to the wave of refugees (epidemics of typhus, smallpox, dysentery in 1923), has improved in recent years. Below are figures on acute infectious diseases for 1923-1927. Morbidity from diseases in 1923-1927 (absolute numbers). Diseases Typhus . . . Smallpox....... Dysentery . . . Typhoid fever and paratyphoid . . . Scarlet fever . . . Diphtheria .... Measles....... Malaria..... Influenza ...... Cerebro-spinal meningitis . Leprosy..... Plague....... 1923 1924 1925 1926 1927 - - Plague in Greece is observed mainly in ports, of imported origin. In the autumn of 1928, Greece experienced a major epidemic of dengue (see), the strongest epidemic of this disease known in the history of medicine. Trachoma affects 6-7% of the population, in some areas (Peloponnese, Thessaly, island of Chios) - up to 40%. The organization of healthcare is under the jurisdiction of the Ministry of Hygiene, Social Welfare and Public Assistance, founded in December 1922 (liquidated in January 1926 and restored in August of the same year). The Department of Hygiene, which is part of the aforementioned ministry, is divided into 3 sections: 1) infectious diseases, 2) social hygiene (protection of motherhood and infancy, fight against tbc, venereal diseases, alcoholism, etc.), 3) medical care (disease insurance, medical care for the poor and especially refugees, supervision of hospitals, pharmacies, etc.). At the Department of Hygiene, there functions a higher sanitary council as a consultative body, and an inspection consisting of 4 inspectors: sanitary, for venereal diseases, for malaria, and for pharmaceutical affairs. The Ministry of Hygiene does not unify all healthcare matters: medical care in places of detention and forensic medicine is under the jurisdiction of the Ministry of Justice, school hygiene and physical education - the Ministry of Religion and Education, medical care for the gendarmerie and police - the Ministry of the Interior, healthcare of the army - the War and Navy Ministry. In each of the 33 districts into which the republic is divided, as well as in the city of Piraeus, there is a district physician. The activities of these physicians are controlled by state sanitary inspectors. In cities and communes, for every 10,000 inhabitants, communal physicians are appointed by communal councils. Each district, city and commune has its own local sanitary council. Sanitary protection of sea borders and ports is under the jurisdiction of the General Directorate of the Merchant Marine and is carried out by port physicians subordinate to the port administration. Communal improvements. No city in Greece has a sewerage system. The water supply for Athens and Piraeus was not yet completed in 1926. The housing question is in a difficult condition, especially in connection with mass immigration. The Ministry of Hygiene built for refugees up to 1926 36 temporary settlements for 8,744 apartments and 40 permanent ones for 9,941 apartments, which provided shelter for 100,000 families. The Commission for the Settlement of Refugees built permanent urban settlements for 17,831 apartments, occupied by 23,363 families, and rural settlements for 47,724 apartments, occupied by 147,241 families. Fight against infectious diseases. Acute infectious diseases are subject to mandatory notification. By the law of 1915, compulsory vaccination of smallpox for children under 1 year and revaccination for children at 10 years of age was introduced. In January of each year, lists of persons subject to vaccination are sent to district physicians who regulate the work of vaccinators. Smallpox vaccine is produced by the state smallpox institute in Athens. The fight against malaria is carried out by quininization (therapeutic and preventive) and by hydraulic engineering works. In 1924, a law on the drainage and improvement of swamps was issued. Treatment of persons bitten by rabid animals is carried out by two Pasteur stations: in Athens (in 1926 it admitted 1,569 people) and Salonika (720 hours).-Almost all lepers (over 300 people) are isolated in 4 leprosaria on the islands - Crete (the main focus of leprosy), Samos, Chios and Spina-Longa (240 beds). The fight against tbc is led by the Panhellenic Anti-Tuberculosis League (founded in 1901), the Anti-Tuberculosis Society (founded in 1926) and the Greek Red Cross, under the general guidance of the state. There are 7 tubercular sanatoriums and hospitals, the largest of which are the hospital "Sotiria" in Athens with 700 beds and "Asvetochori" in Salonika with 200 beds, and a number of tubercular dispensaries. The fight against venereal diseases is headed by the Central Commission under the chairmanship of the director of the Department of Hygiene. There are 10 venereal disease clinics, the largest of which is "Andre Syngros" (250 beds) in Athens, and several dispensaries. In connection with Greece's accession to the Brussels International Convention of 1924 on the free provision of treatment to merchant marine sailors suffering from venereal diseases, venereal disease dispensaries have been organized in the ports of Piraeus, Salonika and Patras. Prostitution in Greece is regulated; 160 brothels are officially registered. Protection of motherhood and infancy. According to the law of 1926 on the protection of childhood, every child under 2 years and every nursing mother, if she is deprived of means of subsistence, are under the protection of the state. Assistance to mothers and children is provided by a central commission in Athens and subcommissions in the center of each department and each commune. Maternity homes exist only in large cities (Athens, Piraeus, Salonika), maternity departments are available in most hospitals. The first nurseries were organized in 1919 by the American Red Cross. Currently, the network of nurseries is maintained by the Patriotic Society for Assistance, the largest charitable organization. 10 nurseries in Athens served 2,500 children in 1926. For war orphans and refugees, 38 orphanages and 1 house in Athens specifically for orphans suffering from trachoma and fungal skin diseases have been organized. - School hygiene is under the jurisdiction of the hygiene section of the Ministry of Religion and Education (founded in 1920), which exercises general sanitary supervision over schools through sanitary inspectors and school physicians. In recent years, main attention has been paid to the sanitary condition of school buildings and the fight against infectious diseases in school (vaccination, school outpatient clinics for the fight against tbc, for the fight against trachoma). In large cities, individual medical examination of schoolchildren has been established. Each newly hired teacher must undergo medical examination by the school physician. A course in hygiene has been included in the curriculum of normal schools. Leadership of physical education is concentrated in the "Administration of National Physical Culture" - a state commission organized in 1926. - Medical care is only in a small part in the hands of the state. In 1926, there were hospitals in Greece: 53 state, 45 communal, 24 belonging to various philanthropic societies, 109 private. Outpatient clinics: 69 state, 14 communal _; 58 Colonization Administration in Macedonia and 14 of the Greek Red Cross and various charitable societies. There were 3,612 physicians in Greece in 1926; they are trained at the medical faculty of the University of Athens. The state health budget in 1926/27 amounted to 143 million drachmas, which was 16.2% of the total state budget. 96 million drachmas were allocated to the Department of Hygiene (including 25 million drachmas for staff maintenance, 10 million for the fight against tbc, 5 million for the fight against venereal diseases, 4 million for quinine, 4 million for psychiatric hospitals, 35 million for medical-sanitary care for refugees), 0.8 million - to the Ministry of Justice, 3 million - to the Ministry of Religion and Education, 2.5 million - to the Ministry of the Interior, 3 million - to the War Ministry and 1.5 million - to the Navy Ministry.