1. Holistic approach of undocumented immigrants in Greece: access to dental and women’s health services. Yiannis Chantzopoulos, Medical Coordinator PRAKSIS Athens Polyclinic

2. PRAKSIS, among other existing programs, runs two Polyclinics in the urban areas of Athens and Thessalonica since 2004.

3. Aims of presentation To present our experience in the healthcare of undocumented immigrants in the fields of women’s health and dental services. To highlight the significance of multidisciplinary approach that will cover all aspects of healthcare for vulnerable groups.

4. Access to healthcare in Greece Registered asylum seekers have free access to National Health System. On the other hand, undocumented immigrants do not have access except for emergency problems.

5. Obstacles to access Lack of communication skills Fear due to lack of documentation of legal residence Ignorance of healthcare services and bureaucracy NHS staff racism or ignorance of the legal rights and special cultural characteristics of the target group.

6. Obstetrics-Gynaecology Clinic Our clinic offers OBG services Monday to Thursday on a weekly basis continuously for the last 6 years staffed by a part-time Gynaecologist.

7. OBG Clinic Services regular antenatal screening up to 7th month of pregnancy with foetal ultrasonography and appropriate referrals to National Health System and National School of Public Health for biochemical and microbiology laboratory tests. family planning counseling treatment of common gynecological problems preventive medicine with Pap test, breast examination

8. Target group Female undocumented immigrants are often: victims of trafficking (according to their testimony) single mothers the most vulnerable group for poverty and social exclusion Poor communication skills (language barrier) Cultural and religious aspects -Many Muslim women want to be examined by female doctors -Genitalia amputation for African women

9. Obstetrics-Gynaecology Clinic Annual number of beneficiaries Last 5 years totally: 3462 patients

10. Country of origin (2005)

11. Country of origin (2006)

12. Country of origin (2007)

13. Country of origin (2008)

14. Country of origin (2009)

15. Distribution to age groups

16. Dental services Our Polyclinic provides dental services for the last 6 years with consistency on a daily basis. Staff: 1 part-time dentist and 6 active volunteers that cover the weekly shifts.

17. Dental services  All the range of basic emergency, elective and preventive dental works except prosthetics: Endodontal therapies Fillings Extractions-surgery Periodontal treatment Examination-checking

18. Access to dental services in Greece The majority of dental works are provided by the private sector. National Health System dental services are limited and cover mainly emergency cases. NGO Polyclinics offer services for vulnerable groups.

19. Dental services Annual number of beneficiaries Last 5 year totally: 6767 patients

20. Dental treatments

21. Distribution to age groups

22. Country of origin (2009)

23. Conclusions There is an ongoing humanitarian crisis with multiple social implementations. Greece is in the center of this problem being the entry point to EU. Lack of access to healthcare causes a continuing risk for Public Health. As long as gaps exist in the legalisation procedure for immigrants, the role of the NGO interventions will be vital.

24. Conclusions The successful model (multidisciplinary approach) of intervention in the form of an NGO Polyclinic can cover to a percentage the gap regarding the fundamental right of access to primary healthcare. PRAKSIS Polyclinic has the main advantage of the consistent and reliable presence in the same place.

25. Thank you