Solidarity clinics are something that the community does for their community. We all work together in an autonomous way for health … in a horizontal way from the base.
— Ilektra Bethymouti
In the fallout from the 2008 global financial crisis, the Greek government implemented severe austerity measures in exchange for a bailout from the European Union and the International Monetary Fund. Public health spending fell nearly 43 percent between 2009 and 2017, leaving hospitals severely understaffed and underequipped. Outsourcing of maintenance activities to private contractors and budget cuts hindering access to basic sanitation supplies impaired the quality of healthcare afforded to patients, and even increased hospital infection rates. As the government continued to pull funding from public health institutions, the cost of healthcare services shifted to patients. Hiring of healthcare professionals in the public sector froze, pushing many to leave the country in search of opportunities abroad, while patients were left overpaying for services that could take months to access.
Today, the healthcare system continues to fail to meet the needs of Greece’s many immigrants and refugees, who face a myriad of barriers to accessing basic services. In the wake of a 2011 hunger strike of immigrant workers demanding basic rights, healthcare workers (many of whom also belonged to social movements in northern Greece) began to discuss how they might meet the need for affordable, accessible healthcare services. One of the first solidarity clinics to be established was in Thessaloniki, the second largest city in Greece. It opened its doors in November 2011 and has cared for tens of thousands of people living in northern Greece without access to care.
The clinics’ centering of patients sets them apart from traditional healthcare providers.
Clinics such as this one recognize the ongoing nature of the migrant and refugee crisis and have created permanent autonomous structures to meet a widespread need.
The initial goal of the solidarity clinic was to provide care for people in Greece who had no social security benefits or rights to access the healthcare system—among other reasons due to their immigration status—who at one point represented as much as 30 percent of the population. The pressures of the system-wide breakdown of healthcare and the accelerating refugee crisis have combined to create an ongoing and widespread need for free and accessible healthcare.
Social solidarity clinics operate democratically in departmental and general assemblies. Decision-making occurs through consensus rather than voting. These clinics are also completely independent from the government. Their funding comes from donations and even the equipment used in the clinics is donated by members of the public or retired doctors. Donations come from local people and organizations, and organizations abroad with similar values and motives.
The clinics’ centering of patients sets them apart from traditional healthcare providers. Clinic staff members do not consider their work a form of charity, but a form of commoning—providing shared resources to those who need them. The staff see themselves as equal to their patients and even avoid the term “patient” in favor of “incomer.” To challenge the power imbalance between doctors and patients, clinic staff aim to treat those they serve as whole people who are more than their illnesses or healthcare needs. Additionally, psychologists and doctors collaborate to provide a wider range of services than what would be standard for the specific issue for which someone entered the clinic.
Two seemingly contradictory visions guide the clinics. One is of a future world in which these clinics are no longer necessary because the healthcare system properly serves people and provides quality care to all who need it. The other vision is of an improved healthcare system that is supplemented by social solidarity clinics, which will remain an important service for all people due to their autonomy, democratic structure, and community-building focus.
At their highest point between 2012 and 2016, about 40 solidarity clinics and pharmacies operated across Greece, communicating closely with one another and carrying out four national assemblies to share practices and talk about principles and goals. In a radically different political environment, about 10 of them are still in operation today. As of 2023, several of these clinics are participating in the establishment of a network of collaborative and social clinics across Europe.
