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		<title>Greece’s map for predicting wildfires is anachronistic and inadequate</title>
		<link>https://miir.gr/en/greece-s-map-for-predicting-wildfires-is-anachronistic-and-inadequate/</link>
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		<pubDate>Fri, 15 Sep 2023 14:12:10 +0000</pubDate>
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					<description><![CDATA[<p>Scientific gaps and other serious shortcomings characterize the unknown process of issuing the risk prediction map by the Civil Protection in Greece that determines the response of the authorities to fire incidents.</p>
<p>The post <a href="https://miir.gr/en/greece-s-map-for-predicting-wildfires-is-anachronistic-and-inadequate/">Greece’s map for predicting wildfires is anachronistic and inadequate</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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						<h1 class="et_pb_module_header">Greece’s map for predicting wildfires is anachronistic and inadequate</h1>
						<span class="et_pb_fullwidth_header_subhead">An investigation of MIIR </span>
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<p style="text-align: center;">By Kostas Zafeiropoulos</p>
<p>&nbsp;</p>
<p style="text-align: center;">4/8/2023</p>
<h6 style="text-align: center;"> </h6></div>
						
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<h6 style="text-align: right;"><em>Photo: The spread of the deadly Mati fire in 2018, as it was simulated by the IRIS 2.0 rapid response forecast system.- Source: Meteo.gr, 2021</em></h6></div>
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				<div class="et_pb_text_inner"><p>In the space of just 13 days in July 2023, 470,000 acres of Greek forest were burnt to ashes. Greece’s state machinery is proving inadequate to deal with extreme weather phenomena. In Rhodes, 15% of the entire island was ravaged in the worst fire in decades. From 1 January to 1 August 2023, according to the European Forest Fire Information System (EFFIS), a total of 550,000 hectares were burnt in the 22 largest forest fires. This is more than four times the average amount of land burnt in the years 2006-2022.</p>
<p>In <a href="https://miir.gr/ta-aporrita-kondylia-sti-geniki-grammateia-politikis-prostasias-kai-i-apotelesmatikotita-toy-systimatos-dasopyroprostasias/" target="_blank" rel="noopener">an earlier survey by MIIR in collaboration with WWF on the economics of forest-fire protection</a> we showed that, for the period 2016-2020, only 16.05% of public funds for fire protection were spent on fire prevention. Most, 83.95%, was spent on fire suppression. This ratio has not changed significantly since then: the Greek state has continued to invest in suppression instead of prevention. Another major problem can be found in the state’s inadequate use of scientific data during the fire season.</p>
<p>A typical case is the notorious fire-risk forecast map, which is <a href="https://civilprotection.gov.gr/arxeio-imerision-xartwn" target="_blank" rel="noopener">published daily</a> at 12.30pm by the General Secretariat of Civil Protection, in a rather opaque manner. This map is reproduced by all the media and forms the basis of the national Fire Service’s operational planning. It started to be used in 2003 and is published daily from 1 June to 31 October each year, under the purview of the Civil Protection. However, for twenty years now, none of the experts has known exactly what data and scientific methodology is used to produce this map.</p></div>
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				<span class="et_pb_image_wrap has-box-shadow-overlay"><div class="box-shadow-overlay"></div><img fetchpriority="high" decoding="async" width="1029" height="1080" src="https://miir.gr/wp-content/uploads/2023/08/230718.jpeg" alt="" title="230718 - xartis PP rodos" srcset="https://miir.gr/wp-content/uploads/2023/08/230718.jpeg 1029w, https://miir.gr/wp-content/uploads/2023/08/230718-980x1029.jpeg 980w, https://miir.gr/wp-content/uploads/2023/08/230718-480x504.jpeg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1029px, 100vw" class="wp-image-14452" /></span>
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				<div class="et_pb_text_inner"><h6 style="text-align: center;"><em>Photo: The Civil Protection&#8217;s fire risk forecast map for 18 July, the day the huge fire broke out in Rhodes. The risk level for the island and the rest of the Dodecanese region was placed in the middle of the scale, which is classified as &#8220;high&#8221;. &#8211; Source: Ministry of Climate and Civil Protection.</em></h6></div>
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				<div class="et_pb_text_inner"><p><strong> Intuition instead of data</strong></p>
<p>“The map circulated by the Civil Protection, whose derivation we do not know, has no scientific sources, does not mention how the different categories are regulated, nor what it takes into account. My assessment is that the Civil Protection map comes out on the basis of simple intuition,” says Kostas Lagovardos, meteorologist and research director at the National Observatory of Athens.</p>
<p>The map’s first drawback, according to experts, is this lack of clarity about the exact scientific data used.</p>
<p>The main problem, however, is that it is issued once a day (covering the next 24 hours) and so does not take into account the very frequent variations in weather conditions during the day. As confirmed in <a href="https://www.nomotelia.gr/photos/File/A1284-23.pdf" target="_blank" rel="noopener">a circular of the Civil Protection</a>, once the map is issued, it does not change in any way.</p></div>
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				<span class="et_pb_image_wrap has-box-shadow-overlay"><div class="box-shadow-overlay"></div><img decoding="async" width="1920" height="351" src="https://miir.gr/wp-content/uploads/2023/08/egkyklios-pp-2023.png" alt="" title="egkyklios-pp-2023" srcset="https://miir.gr/wp-content/uploads/2023/08/egkyklios-pp-2023.png 1920w, https://miir.gr/wp-content/uploads/2023/08/egkyklios-pp-2023-1280x234.png 1280w, https://miir.gr/wp-content/uploads/2023/08/egkyklios-pp-2023-980x179.png 980w, https://miir.gr/wp-content/uploads/2023/08/egkyklios-pp-2023-480x88.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1920px, 100vw" class="wp-image-14450" /></span>
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				<div class="et_pb_text_inner"><h6 style="text-align: center;"><em> Photo: Excerpt from the Circular of the Ministry of Climate Crisis and Civil Protection on the issue<br />daily Fire Risk Prediction Map from the G.G.P.P. during the 2023 fire season.</em></h6></div>
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				<div class="et_pb_text_inner"><p>Andrianos Gourbatsis, a lieutenant-general and former deputy chief of the Fire Service, explains: “This is a big mistake, because the meteorological data may get worse, it may get better, so how is it possible not to change the map? What if you issue a hazard index of 3 for tomorrow, and suddenly in the evening the wind comes in, the temperature drops and the hazard becomes 5? This is the biggest disadvantage. There is another issue: the people who issue the map every noon then proceed to get off work, they go home, they do not follow the meteorological data of the National Weather Service.”</p>
<p>Another shortcoming of the map is that it treats entire regions, prefectures and other subdivisions as single units, without taking into account their different climatic conditions as pertaining to fire.</p>
<p>Kostas Lagovardos explains: “On the map, every region has one colour, which has no bearing on reality. For example, the winds in southern Crete are much stronger and have no relation to the winds in northern Crete. So in heavy weather, which is a typical summer event, you have a huge difference in the pyro-meteorological situation within the same prefecture. You can’t have entire regions having the same level of alert everywhere.” This means a dispersal of the firefighting forces on the ground, with all the devastation that might result.</p>
<p>After all, this fire-risk map is directly connected to the operational plan for fighting fires.</p>
<p>In the catastrophic fire in Mati in 2008 (which killed 102 people), the fire-risk map indicated a level of 4 (the maximum is 5). Andrianos Gourbatsis, who is also knowledgeable about the fires in Mati (2018) and Varibobi (2021), elaborates: “The conditions were for an index of 5 at the time. With an index of 4, the Fire Service’s state of readiness was not the maximum. If it had been 5, the Fire Service would have brought out an additional 25 units, from the 86 it had, while more fire stations would have been staffed for more hours, i.e. people would have been more ready.”</p></div>
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				<span class="et_pb_image_wrap has-box-shadow-overlay"><div class="box-shadow-overlay"></div><img loading="lazy" decoding="async" width="830" height="872" src="https://miir.gr/wp-content/uploads/2023/08/180723-2.jpg" alt="" title="180723" srcset="https://miir.gr/wp-content/uploads/2023/08/180723-2.jpg 830w, https://miir.gr/wp-content/uploads/2023/08/180723-2-480x504.jpg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 830px, 100vw" class="wp-image-14464" /></span>
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				<div class="et_pb_text_inner"><h6 style="text-align: center;"><em>The Civil Protection&#8217;s Fire Risk Forecast Map for 23 July 2018, the day the deadly fire broke out in Mati. </em><em>Source: Ministry of Climate and Civil Protection.</em></h6></div>
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				<div class="et_pb_text_inner"><p><span style="font-weight: 400;">In the catastrophic fire in Mati in 2008 (which killed 102 people), the fire-risk map indicated a level of 4 (the maximum is 5). Andrianos Gourbatsis, who is also knowledgeable about the fires in Mati (2018) and Varibobi (2021), elaborates: “The conditions were for an index of 5 at the time. With an index of 4, the Fire Service’s state of readiness was not the maximum. If it had been 5, the Fire Service would have brought out an additional 25 units, from the 86 it had, while more fire stations would have been staffed for more hours, i.e. people would have been more ready.”<br /></span></p>
<p>When there is a category 4 or 5 risk in an area, the Fire Service must effect an aerial surveillance. If the patrol sees a fire, the Fire Service must intervene immediately. In the catastrophic fire in Varibobi in the summer of 2021, two Air-Tractors were patrolling the area from 11 am because of the danger index. Gourbatsis notes that “Mr Hardalias [deputy minister for civil protection at the time] gave an order for them to land at 13.00 and stand by ‘if needed’. The fire in Varypobi subsequently broke out a kilometre from the airport. The planes had been on standby for 20 minutes, and precious time was lost as they got back in the air.”</p>
<h4 class="fusion-responsive-typography-calculated" data-fontsize="20" data-lineheight="29px"><strong>Civil Protection ignoring the National Observatory</strong></h4>
<p>Phoebus Theodorou was for years the person who signed off on the maps of the General Secretariat of Civil Protection. He is a forester, not a meteorologist. He retired some time ago, but according to MIIR’s information, he remains an advisor to the Ministry of Climate and Civil Protection and continues to be involved in the publication of the disputed map. It is no longer approved by him, but by the scientific team at the Civil Protection secretariat. The individuals who make up this team have not been identified.</p>
<p>Andrianos Gourbatsis argues that “Civil Protection is stuck with the charter that was issued in 1995 when the service started. A lot of things need to change. On the weekend, these Civil Protection officials are at home, yet they still issue a map. This is not serious. They check EFFIS data every day, they see where it ‘blackens’ and issue the map accordingly”. Since the 2000s, as deputy chief of the Greek fire service, he has been asking politicians to have the map issued instead by Greece’s meteorological agency, EMY. His suggestion has gone unheeded and EMY is now doing even less work than before. It used to issue a special daily map of the conditions in the burnt areas.</p>
<p>Phoebus Theodorou, the official formerly in charge of issuing the Civil Protection maps, has claimed (<a href="https://www.grtimes.gr/ellada/chartis-provlepsis-kindynoy-pyrkagias-pos-prokyptei-kai-poy" target="_blank" rel="noopener">GrTimes.gr,</a> 08/06/2021) that they are based on the Forest Fire Weather Index (FFWI) of the Canadian Forest Service, as well as other geographic information systems and software. The National Observatory of Athens refutes this assertion. Kostas Lagovardos, at the Observatory, is categoric: “It can’t be using the Canadian index, because if it did, it would produce the results that we do. Southern and northern Crete would almost never have the same hazard index when they have different scores of 4 and 5 on the Beaufort scale.”</p>
<p>We contacted Phoebus Theodorou in order to answer questions about this, but to no avail. In addition, we sent written questions to the General Secretariat of Civil Protection but received no response by the time this article was published.</p>
<p>At the moment, the most authoritative daily fire-risk map in Greece seems to be that of the National Observatory of Athens. It is based on the Canadian pyro-meteorological index and takes into account temperature, humidity, wind, drought, how many days it has not rained, in order to produce a number to quantify risk. It offers a better analysis than the corresponding Civil Protection map, since it reaches a 2×2 km level of resolution in each region of the country. However, the fire service – at least officially – bases its planning on the Civil Protection map.</p>
<p>Vassiliki Kotroni, director of research at the Athens Observatory, comments that “we don’t know how the Observatory data is used by the General Secretariat for Civil Protection. We do know that our weather monitoring uses a network of 550 weather stations that we operate throughout the country. Since this data is freely available, it is possible that the Civil Protection monitors our stations. But this is not based on a memorandum of understanding, on any formalised system that would oblige us to operate in a certain way. We are doing this without any obligations. In a properly organised country, things should be a little different.”</p>
<p>Dr Kotroni is the scientific director of the Observatory’s Meteo team, which has pioneered a mechanism to forecast the spread of fires. Called IRIS, the system is innovative at both Greek and European levels. It aims to facilitate rapid responses to active forest fires. Knowing the location and time of the start of a fire, the system can, within 20 minutes, provide a forecast of how the fire front will develop over the next few hours. Within half an hour, it can provide a forecast for the next 24 hours. The system takes into account both the meteorology and the changing weather conditions caused by the fire itself. In 2019-2020 it was successfully used in cooperation with the Civil Protection and the Fire Service in over 200 forest fires. However, for two years now, explains Dr Kotroni, “for reasons we do not know, the cooperation has faded away, and unfortunately since 2021 it has not been sought by the Civil Protection or the Fire Service”.</p>
<p>Although it was available, IRIS was not used during the major fires in Varibobi and Evia in 2021. In a post after the fire in Varibobi, Meteo.gr stressed that it had carried out an “ex-post forecast”, adding that “the forecast that IRIS 2.0 could have provided operationally if it had been requested is very close to the actual spread of the fire”. Today, the IRIS system is still being developed with the Athens Observatory’s own resources, without any involvement of the state. It was not used by the Civil Protection even during the catastrophic fires of July this year.</p></div>
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<h6 style="text-align: center;"><em><br />The video shows the spread of the Varybompi forest fire in 2021, as simulated vy the IRIS 2.0 rapid forecasting system. Source</em><em>: Meteo.gr</em></h6></div>
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				<div class="et_pb_text_inner"><p><i data-stringify-type="italic">This material is published in the context of the &#8220;<a href="https://fire-res.eu/" target="_blank" rel="noopener">FIRE-RES</a>&#8221; project co-funded by the European Union (EU). The EU is in no way responsible for the information or views expressed within the framework of the project. Responsibility for the content lies solely with EDJNet. </i><a href="https://www.europeandatajournalism.eu/wildfires-in-europe/"><i data-stringify-type="italic">Go to the FIRE-RES page</i></a></p></div>
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<p>The post <a href="https://miir.gr/en/greece-s-map-for-predicting-wildfires-is-anachronistic-and-inadequate/">Greece’s map for predicting wildfires is anachronistic and inadequate</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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		<title>Huge gap between anti-discrimination legislation and Greek reality</title>
		<link>https://miir.gr/en/huge-gap-between-anti-discrimination-legislation-and-greek-reality/</link>
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		<dc:creator><![CDATA[kostas]]></dc:creator>
		<pubDate>Fri, 14 Oct 2022 14:09:05 +0000</pubDate>
				<category><![CDATA[Our Network]]></category>
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		<category><![CDATA[Justice]]></category>
		<category><![CDATA[discrimination]]></category>
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					<description><![CDATA[<p>The number of reports of discrimination to the Greek Ombudsman is dramatically low.<br />
Under-reporting especially concerns cases of discrimination based on racial origin and sexual orientation.Unwillingness to strengthen procedures for fighting discrimination against Roma people.<br />
Equal treatment seems to be the preserve of wealthy Europeans only.<br />
Elli Zotou, October 17, 2022</p>
<p>The post <a href="https://miir.gr/en/huge-gap-between-anti-discrimination-legislation-and-greek-reality/">Huge gap between anti-discrimination legislation and Greek reality</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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						<h1 class="et_pb_module_header">Huge gap between anti-discrimination legislation and Greek reality</h1>
						
						<div class="et_pb_header_content_wrapper" data-et-multi-view="{&quot;schema&quot;:{&quot;content&quot;:{&quot;desktop&quot;:&quot;&lt;ul&gt;\n&lt;li style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;&lt;b&gt;Compared to the real-life situation, the number of reports of discrimination to the Greek Ombudsman is dramatically low. &lt;\/b&gt;&lt;\/span&gt;&lt;\/li&gt;\n&lt;li style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;&lt;b&gt;Under-reporting especially concerns cases of discrimination based on racial origin and sexual orientation. &lt;\/b&gt;&lt;\/span&gt;&lt;\/li&gt;\n&lt;li style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;&lt;b&gt;There is a persistent unwillingness to strengthen procedures for fighting discrimination against Roma people. &lt;\/b&gt;&lt;\/span&gt;&lt;\/li&gt;\n&lt;li style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;&lt;b&gt;Ultimately, equal treatment seems to be the preserve of wealthy Europeans only.&lt;\/b&gt;&lt;\/span&gt;&lt;\/li&gt;\n&lt;\/ul&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;Elli Zotou&lt;\/span&gt;&lt;\/p&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;October 17, 2022&lt;\/span&gt;&lt;\/p&gt;&quot;,&quot;tablet&quot;:&quot;&lt;ul&gt;\n&lt;li&gt;&lt;b&gt;Compared to the real-life situation, the number of reports of discrimination to the Greek Ombudsman is dramatically low.&lt;\/b&gt;&lt;\/li&gt;\n&lt;li&gt;&lt;b&gt;Under-reporting especially concerns cases of discrimination based on racial origin and sexual orientation.&lt;\/b&gt;&lt;\/li&gt;\n&lt;li&gt;&lt;b&gt;There is a persistent unwillingness to strengthen procedures for fighting discrimination against Roma people.&lt;\/b&gt;&lt;\/li&gt;\n&lt;li&gt;&lt;b&gt;Ultimately, equal treatment seems to be the preserve of wealthy Europeans only.&lt;\/b&gt;&lt;\/li&gt;\n&lt;\/ul&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;Elli Zotou&lt;\/p&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;17\/10\/2022&lt;\/p&gt;&quot;,&quot;phone&quot;:&quot;&lt;ul&gt;\n&lt;li&gt;Compared to the real-life situation, the number of reports of discrimination to the Greek Ombudsman is dramatically low.&lt;\/li&gt;\n&lt;li&gt;Under-reporting especially concerns cases of discrimination based on racial origin and sexual orientation.&lt;\/li&gt;\n&lt;li&gt;There is a persistent unwillingness to strengthen procedures for fighting discrimination against Roma people.&lt;\/li&gt;\n&lt;li&gt;Ultimately, equal treatment seems to be the preserve of wealthy Europeans only.&lt;b&gt; &lt;\/b&gt;\n&lt;p&gt;                                   Elli Zotou&lt;br \/&gt;                                 17\/10\/2022&lt;\/p&gt;\n&lt;\/li&gt;\n&lt;\/ul&gt;&quot;}},&quot;slug&quot;:&quot;et_pb_fullwidth_header&quot;}" data-et-multi-view-load-tablet-hidden="true" data-et-multi-view-load-phone-hidden="true"><ul>
<li style="text-align: center;"><span style="font-weight: 400;"><b>Compared to the real-life situation, the number of reports of discrimination to the Greek Ombudsman is dramatically low. </b></span></li>
<li style="text-align: center;"><span style="font-weight: 400;"><b>Under-reporting especially concerns cases of discrimination based on racial origin and sexual orientation. </b></span></li>
<li style="text-align: center;"><span style="font-weight: 400;"><b>There is a persistent unwillingness to strengthen procedures for fighting discrimination against Roma people. </b></span></li>
<li style="text-align: center;"><span style="font-weight: 400;"><b>Ultimately, equal treatment seems to be the preserve of wealthy Europeans only.</b></span></li>
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<p style="text-align: center;"><span style="font-weight: 400;">Elli Zotou</span></p>
<p style="text-align: center;"><span style="font-weight: 400;">October 17, 2022</span></p></div>
						
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				<div class="et_pb_text_inner"><p>An unemployed Roma woman with a disability, or a transgender Muslim refugee. How many layers of exclusion and discrimination can be packed into just a few words?</p>
<p>How many legal provisions would one have to invoke in a simple interaction between these two citizens and a public service or a private company in order to obtain equal treatment with a well-off white male European citizen? Perhaps a law student would find the question difficult to answer. But in the context of a Europe where people have seen their lives get harder for the last decade, and where after two years of pandemic they find themselves looking forward to a winter without heating or electricity, the debate about anti-discrimination is becoming difficult. And it goes beyond law.</p>
<p>In Greece, the implementation of anti-discrimination laws is supervised by the Greek Ombudsman. Every year he issues a special report on “equal treatment”, following Laws 3896/2010 and 4443/2016, as well as the recent 4808/2021 all of which incorporate European law.</p>
<p><b>Half of the reports concern discrimination against women</b></p>
<p>The Ombudsman’s most recent report, for 2021 and published in June, recorded 1,054 complaints, 11% more than in 2020. Of these, 49% concerned discrimination on grounds of gender, while 25% related to disability or chronic condition, 12% to marital status, 4% to age, 3% to national or ethnic origin, 3% to social status, 2% to religious or other beliefs, 1% to race or colour, and 1% to sexual orientation, identity or gender characteristics.</p>
<p>It is interesting that the majority of gender discrimination was suffered by working women with children. This comes at a time when conservative and rightist circles are questioning the right of women to control their own bodies, on the grounds of “protecting the life of the unborn child”.</p>
<p>“Over a five-year period, 50% of the reports received annually by the Ombudsman […] concern issues of discrimination between men and women”, highlights Kalliopi Lykovardi, Assistant Ombudsman for the discrimination portfolio. “What we have seen is a steady annual increase in reports on disability discrimination issues, but also a gradual increase concerning discrimination on the grounds of marital status – for example, different treatment if a person is in a civil partnership rather than married, or a single parent, or a foster parent. In contrast, there is a consistent under-reporting of issues relating to ethnic/racial origin, religious beliefs, sexual orientation, identity or gender characteristics”.</p>
<p>In the cases of Roma people and refugees, where the source of discrimination is their different ethnic or racial origin, what the Greek Ombudsman is trying to highlight are the underlying structural problems and the particular vulnerability of this population group. […] “The inequalities and social exclusion of Roma are extremely complex and difficult to resolve”, Lykovardi says. […] “An explosive cocktail is created by the confluence of different identities in the same person, such as Roma woman, refugee woman, LGBTI refugee, refugee with disabilities, etc., where the potential for multiple and intersectional discrimination is always present and acts as an aggravation”.</p></div>
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				<div class="et_pb_text_inner"><p><b>Under-reporting of discrimination based on ethnic/racial origin and sexual orientation</p>
<p></b>The specific legislation on discrimination comes in the form of an incorporation of EU law. This legislation seems to be more of an attempt to transfer law rather than to accommodate the domestic needs and data of the Greek reality. A big problem in Greece is the fact that there is no official relevant data. This fact affects both the design and implementation of policies and laws.</p>
<p>“It is obvious that this also makes the work of the Ombudsman more difficult” Lykovardi comments. “Policies for Roma cannot be effective if you do not know their exact number or the number of individual groups (e.g. Roma with disabilities). The legislation sets out a framework for protection and this is positive. It can be a starting point for further development and gradual progress”.</p>
<p>At the same time, the current framework has problems in its implementation. The main one is under-reporting.</p>
<p>“One can note an obvious discrepancy between real-life discrimination and the numbers of reports, i.e. 1,000 reports per year” Lykovardi admits. “This especially concerns certain fields, such as ethnic/racial origin, and sexual orientation. We know empirically that the discrimination suffered by these people is much more than what is recorded in terms of complaints”.</p>
<p>Another aspect is the issue of judicial protection and access to justice, where the costs are high. Legal aid is not always adequate and is often extremely time-consuming and therefore ultimately ineffective.</p>
<p>“Justice could provide answers to many questions” Lykovardi says. “But the administrative route is not always easy either. The communication gap between victims and the relevant institutions is wide. This is where the institutions themselves and civil-society organisations need to help.</p></div>
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				<div class="et_pb_text_inner"><p><b>Reluctance to strengthen the institutional framework against Roma discrimination</b></p>
<p>Andreas Takis is Chairman of the Board of the Hellenic Union for Human Rights, and Assistant Professor at the Law Faculty of the Aristotle University of Thessaloniki. He has served as Secretary General of Immigration Policy of the Ministry of Interior (2009-2011) and Assistant Ombudsman, in charge of the Human Rights Circle (2003-2009). Regarding the implementation of anti-discdimination policies in Greece, Takis underlines that  “the legislation has certain problems because what is not obvious is that discrimination concerns daily routines in the country that go beyond the Ombudsman’s control. […] His function is not of a coercive nature, it is advisory. Further, we have a huge number of daily discriminations that intertwine with each other and exclude entire populations, as in the case of the Roma. There has been a lot of talk for years – politically it is constantly being undermined at EU level by countries with large numbers of Roma people – to finally come up with a directive which improves the existing European directives concerning the conditions of Roma in Europe”.</p>
<p>Unfortunately, given the social precarities of our time, horizontal tensions are increasing. The organs of the state that administer daily life, such as the police, often have a huge range of discriminatory behaviours.</p>
<p>But not everything goes in the wrong direction. Takis recalls the effort to renew legislation in other areas, such as LGBTQ groups. “In our country this was focused on the iconic issue of civil partnership”, remarks.</p>
<p><b>Discrimination against non-Europeans</b></p>
<p>There is another huge hole in European legislation. The idea of fighting discrimination in the EU, which is a single area of justice, security and freedom – this is something that refers solemnly to human rights, to equal treatment. But the underlying concept concerns the free movement of persons within the European area as workers.</p>
<p>“The issue is the interchangeability of all those living within the EU, as elements of a large market. However, this primarily concerns Europeans”, Takis asserts. “It is not clear how equal treatment concerns so-called third-country nationals, non-European citizens. This is a crucial fact given that for 20 years we have been living with mass migration, whether in the form of refugees or economic migration, and with multiple forms of integration of people into the social fabric of European countries, especially on the basis of accumulated years of residency.</p>
<p>We have people who have been residents for 30 years, 20, 10, 5 years or a few months. What is the point at which these people can benefit from the equal treatment promised by European legislation? In practice it is only if they become European citizens”, Takis points out.</p>
<p>For everyone else, Takis wonders, “is there a point at which discriminatory behaviour is something to be fought regardless of whether you are European, even from the first day you are here? Being treated inhumanely by the police because they just found you in Evros, does that have nothing to do with discrimination on the basis of race or origin or ethnicity or religion?</p>
<p>So this is the heart of an intractable issue of diversity in the EU, and whether being a space of democracy and freedom means anything. These will be hot issues in the coming years. I am not optimistic”, concludes.</p>
<p><b>Political will and ideological progress is required</b></p>
<p>For Dimitris Christopoulos, Professor of Political Science at Panteion University, former president of the International Federation for Human Rights, there will always be  patterns of discrimination in a class-based society. “Some are always below others. Sometimes it’s the gender criterion, so at one point it was women” Chirstopoulos comments. “Then new groups came into the story, minorities. All these groups have their own internal stratifications – i.e. the refugee woman, the unemployed Roma  woman. Multiple characteristics that are superimposed, creating a crust of discrimination that is practically impenetrable”.</p>
<p>To begin to address this, it is not enough to say that we have laws, according to Christopoulos. “It takes a lot of political will, a lot of ideological progress. Only then will society start to accept that an elected government’s role is to reduce and mitigate social discrimination”, concludes.</p>
<p>&nbsp;</p>
<p>This article has been produced within the project “<a href="https://www.projectingrid.eu/en/ingrid-english/">INGRID. Intersecting Grounds of Discrimination in Italy</a>” financed by the European Commission, Rights, Equality, Citizenship programme 2014-2020.</p></div>
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<p>The post <a href="https://miir.gr/en/huge-gap-between-anti-discrimination-legislation-and-greek-reality/">Huge gap between anti-discrimination legislation and Greek reality</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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		<title>COVID: How Europe&#8217;s prisons have fared in the pandemic</title>
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		<pubDate>Wed, 08 Dec 2021 12:54:17 +0000</pubDate>
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					<description><![CDATA[<p>The post <a href="https://miir.gr/en/covid-how-europe-s-prisons-have-fared-in-the-pandemic/">COVID: How Europe&#8217;s prisons have fared in the pandemic</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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						<h1 class="et_pb_module_header">COVID: How Europe's prisons have fared in the pandemic</h1>
						
						<div class="et_pb_header_content_wrapper" data-et-multi-view="{&quot;schema&quot;:{&quot;content&quot;:{&quot;desktop&quot;:&quot;&lt;p&gt;&nbsp;&lt;\/p&gt;\n&lt;p&gt;&nbsp;&lt;\/p&gt;\n&lt;p&gt;Prisons are breeding grounds for viruses, yet carceral administrations have revealed little about COVID-19 cases, deaths and vaccinations in Europe&#8217;s prisons. Data from 32 countries show the pandemic&#8217;s impact on prisons.&lt;\/p&gt;\n&lt;p&gt;&nbsp;&lt;\/p&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;8\/12\/2021&lt;\/p&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;&quot;,&quot;tablet&quot;:&quot;&lt;p&gt;Prisons are breeding grounds for viruses, yet carceral administrations have revealed little about COVID-19 cases, deaths and vaccinations in Europe&#039;s prisons. Data from 32 countries show the pandemic&#039;s impact on prisons.&lt;\/p&gt;&quot;}},&quot;slug&quot;:&quot;et_pb_fullwidth_header&quot;}" data-et-multi-view-load-tablet-hidden="true"><p>&nbsp;</p>
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<p>Prisons are breeding grounds for viruses, yet carceral administrations have revealed little about COVID-19 cases, deaths and vaccinations in Europe&#8217;s prisons. Data from 32 countries show the pandemic&#8217;s impact on prisons.</p>
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<p style="text-align: center;">8/12/2021</p>
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				<div class="et_pb_text_inner"><p>Vangelis Stathopoulos, who is in Greece&#8217;s Larissa prison, is one of more than half a million people incarcerated in Europe amid the COVID-19 pandemic. And, like so many others, the prison where he is being held is an ideal breeding ground for viruses: it&#8217;s overcrowded, with cramped living arrangements, and often poor hygiene conditions.</p>
<p>&#8220;When I got COVID last December, around half of the prisoners in here were sick at the same time,&#8221; Stathopoulos says. &#8220;We were put into a ward with 60 people, in a space of around 110 square meters (1,200 square feet). It was a roll of the dice whether you were going to be severely or just mildly ill.&#8221;</p></div>
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				<div class="et_pb_text_inner"><p>Korydallos prison in Greece</p></div>
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				<div class="et_pb_text_inner"><p>During the pandemic, we have become accustomed to meticulously updated COVID-19 dashboards and kept a close public eye on settings vulnerable to outbreaks, such as care homes. Yet little data has been made public about the spread of the coronavirus in carceral facilities.</p>
<p>Together with 11 newsrooms in the European Data Journalism Network, DW has collected data from 32 countries that show how many cases and deaths were reported in prisons, how vaccinations progressed, and what measures were taken to curb the spread of the virus.</p>
<p>&#8220;Many prisons are overcrowded, with no possibility for physical distancing,&#8221; says Filipa Alves da Costa, a public health consultant for the World Health Organization&#8217;s Health in Prisons Program. &#8220;So, when the virus gets carried in, it gets transmitted much more easily.&#8221;</p></div>
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				<div class="et_pb_text_inner"><h3>Incarcerated people vulnerable</h3>
<p>Da Costa says the risk in prisons is similar to that faced by people living in congregate residential facilities such as care homes and shelters.</p>
<p>Many incarcerated people have multiple factors that put them at increased risk of severe COVID-19, including conditions such as HIV and histories of smoking or other drug use. Marginalization, poverty and poor access to health care often take their tolls on such populations even before incarceration, and prison conditions frequently have an exacerbating effect, the WHO has found. &#8220;We actually consider people in their 50s as elderly already in prisons, even though in the community they wouldn&#8217;t be,&#8221; da Costa says.</p></div>
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				<div class="et_pb_text_inner"><h3>COVID outbreaks in prisons affect everyone</h3>
<p>Outbreaks in prisons affect not only the people who are confined or working there, but also the surrounding communities. &#8220;It&#8217;s not a totally closed environment,&#8221; da Costa says. &#8220;People come in and out every day. Not only staff, but also service providers, lawyers, and prisoners themselves. So, if you’re not protecting prisons, you’re not protecting the community.&#8221;</p>
<p>In the US, where the coronavirus quickly swept through prisons in 2020, multiple <a class="icon external" href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00652" target="_blank" rel="nofollow noopener noreferrer">case studies</a> show how outbreaks in prisons spread to surrounding communities. A <a class="icon external" href="https://www.prisonpolicy.org/reports/covidspread.html" target="_blank" rel="nofollow noopener noreferrer">nationwide comparison</a> found that COVID-19 cases grew more quickly in counties with more incarcerated people, and linked mass incarceration to more than half a million additional COVID-19 cases inside and outside prisons.</p>
<p>The most recent Europe-wide <a class="icon external" href="https://wp.unil.ch/space/files/2021/02/Prisons-and-the-COVID-19_2nd-Publication_201109.pdf" target="_blank" rel="nofollow noopener noreferrer">data collection,</a> by the University of Lausanne, reported case numbers in prisons through September 2020. More than a year has passed since, with multiple waves, new variants and a global vaccination campaign.</p></div>
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				<div class="et_pb_text_inner"><h3>First responses shut down all activity</h3>
<p>A study by <a class="icon external" href="https://covid19prisons.wordpress.com/measures/" target="_blank" rel="nofollow noopener noreferrer">researchers in Barcelona</a> shows that most countries locked down prisons hard and fast at the start of the pandemic.</p>
<p>Visits were immediately stopped or severely limited in virtually all countries. In many prisons, sports, recreational activities and work were also suspended and prison leave schemes were put on hold.</p>
<p>&#8220;Even our letters were quarantined,&#8221; recalls Csaba Vass, who is in prison in Hungary. Countries such as Germany, Belgium and Hungary quarantined new arrivals and prisoners who showed symptoms.</p></div>
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				<div class="et_pb_text_inner"><h3>Prison infection rates follow the general population</h3>
<p>Data collected for this investigation now show that, at first glance, these measures seem to have helped avoid the worst: Prisons have, overall, not become runaway COVID hot spots. According to the data available, infection rates in prisons in many countries seem to roughly parallel those of the population in general. </p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="811" height="1080" src="https://miir.gr/wp-content/uploads/2021/12/59985369_7.png" alt="" title="59985369_7" srcset="https://miir.gr/wp-content/uploads/2021/12/59985369_7.png 811w, https://miir.gr/wp-content/uploads/2021/12/59985369_7-480x639.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 811px, 100vw" class="wp-image-12024" /></span>
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				<div class="et_pb_text_inner"><p>Where infection rates were high in the general population, they also tended to be high in prisons. This is true, for example, in countries such as Slovenia, Estonia and Belgium, where more than one in 10 people have tested positive already.</p>
<p>In countries such as Croatia and Greece, prisoners are infected at a much higher rate than in the general population. But, in many countries, reported cases in prisons remained below the level of the general population, according to the latest available data — even in Hungary and France, countries with notoriously overcrowded prisons.</p>
<p>Even in countries with lower infection rates, individual prisons can still be the sites of serious outbreaks. Just recently, <a class="icon external" href="https://www.midilibre.fr/2021/10/28/covid-54-cas-recenses-a-la-maison-darret-de-beziers-9896122.php" target="_blank" rel="nofollow noopener noreferrer">more than 50 people tested positive at Béziers prison</a> in France, which currently confines 638 people to a space built for 389. </p></div>
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				<div class="et_pb_text_inner"><h3>Cases and deaths may be underreported</h3>
<p>Official numbers may not always tell the whole story. Most prison administrations don’t collect data systematically, says Adriano Martufi, who researches prison conditions in Europe at Leiden University. &#8220;My feeling is that there is certainly a problem of underreporting,&#8221; Martufi says.</p>
<p>The Larissa prison in Greece, for example, had reported only 200 cases officially through July 2021. Stathopoulos says he has counted far more. &#8220;Just between December 2020 and now, I believe we’ve had more than 500 cases,&#8221; he says.</p>
<p>Underreporting might not necessarily be deliberate — it could also be the result of organizational challenges. &#8220;Health services in prisons are understaffed, underequipped,&#8221; Martufi says. &#8220;I’m not even sure whether they have the technical capability to collect and handle such data.&#8221;</p></div>
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				<div class="et_pb_text_inner"><h3>Low case numbers come at an exorbitant price</h3>
<p>Even if infection numbers are taken at face value, the restrictions imposed to curb the spread of the coronavirus often have side effects of their own. &#8220;The tragedy that we feared did not happen, but only with enormous sacrifices for the prison population: no more activities; an end to teaching; an end to what little work exists in prison, and so on,&#8221; Dominique Simonnot, who heads France’s independent public body for overseeing conditions at places where people are deprived of liberty. &#8220;In social terms the price is exorbitant.&#8221;</p>
<p>For the past 18 months, many prisons have established lockdown measures that put inmates in especially harsh conditions.</p>
<p>One <a class="icon external" href="https://www.maltatoday.com.mt/news/national/105560/prisons_solitary_confinement_division_will_be_retained_throughout_pandemic#.YannRdnML0q" target="_blank" rel="nofollow noopener noreferrer">prison in Malta</a> kept new arrivals in a cell with just a floor mattress and an open floor toilet 23 hours a day for two weeks, in conditions that the European Committee for the Prevention of Torture had already condemned in 2013. </p></div>
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				<div class="et_pb_text_inner"><h3>Quarantine confinements pose serious health risks</h3>
<p>The <a class="icon external" href="https://www.un.org/en/events/mandeladay/mandela_rules.shtml" target="_blank" rel="nofollow noopener noreferrer">UN&#8217;s Nelson Mandela Rules,</a> or Standard Minimum Rules for the Treatment of Prisoners, state that solitary confinement should only be used as a last resort, for as short a time as possible, and never for more than 15 days. But, during the pandemic, isolating prisoners has become a standard measure in many countries.</p>
<p>In <a class="icon external" href="https://www.irishtimes.com/news/crime-and-law/prison-diaries-give-insight-into-bleak-conditions-during-pandemic-1.4316027" target="_blank" rel="nofollow noopener noreferrer">Ireland,</a> where incarcerated people 70 and older or with chronic illnesses were automatically placed in solitary confinement between April and June 2020, detainees in such isolation reported feeling depressed and even suicidal.</p>
<p>In some facilities in Germany, pretrial detainees <a class="icon external" href="https://www.fairtrials.org/news/short-update-detained-defendants-must-stay-solitary-confinement-15-days-after-hearings-germany" target="_blank" rel="nofollow noopener noreferrer">were isolated</a> for 14 days after each court hearing. </p>
<p>In France, two-week isolation was mandatory after any leave of absence, family visit or outpatient medical treatment, says Dominique Simonnot, the country’s chief prisons inspector. &#8220;As a result, some are refusing these trips, with all the risks that this implies for their health.&#8221; </p>
<p>And even people who weren&#8217;t under quarantine were often restricted to their cells for large parts of the day and left with very little to do to pass the time.</p></div>
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				<div class="et_pb_text_inner"><h3>&#8216;Lifeline&#8217; for prisoners cut as visits stopped</h3>
<p>Prohibitions on visitors were also especially difficult for many incarcerated people.</p>
<p>&#8220;Visits are an immensely important lifeline for prisoners,&#8221; says Catherine Heard, director of the World Prison Research Programme. &#8220;It&#8217;s hard to overstate just how much of a difference it makes to them, being able to stay in touch with families and loved ones.&#8221;</p>
<p>Prisoners have a right to family life, according to the European Court of Human Rights.</p>
<p>In October 2020, people incarcerated at the Rec prison in Albania <a class="icon external" href="https://albaniandailynews.com/news/convicts-of-rec-prison-in-hunger-strike" target="_blank" rel="nofollow noopener noreferrer">launched a hunger strike</a> to protest the suspension of visits when the pandemic was declared. They had only been able to contact families by phone since that March.</p>
<p>In Hungary, Vass says, &#8220;We had two and a half hours of physical contact twice a month before the pandemic — the lack of that caused very serious mental problems.&#8221; The prison eventually set up video-calling options to at least permit virtual visits. &#8220;That made it easier,&#8221; he says. </p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="1019" height="1080" src="https://miir.gr/wp-content/uploads/2021/12/59985327_7.png" alt="" title="59985327_7" srcset="https://miir.gr/wp-content/uploads/2021/12/59985327_7.png 1019w, https://miir.gr/wp-content/uploads/2021/12/59985327_7-980x1039.png 980w, https://miir.gr/wp-content/uploads/2021/12/59985327_7-480x509.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1019px, 100vw" class="wp-image-12026" /></span>
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				<div class="et_pb_text_inner"><p>Most countries introduced measures for virtual visits, although low connection speeds and usage restrictions still pose problems. &#8220;There&#8217;s been a huge leap forward in many prisons across Europe to develop videoconferencing systems,&#8221; Martufi says. &#8220;That was absolutely unthinkable in many member states before the pandemic. So that was a positive development.&#8221; </p>
<p>Martufi says one possible risk of this is that prisons could attempt to use video calls as a replacement for in-person visits in the long term. &#8220;We have indication that some prison administrations said: &#8216;Well, now you have Skype, you can live with that — there&#8217;s no real need for you to be allowed to meet your family or your lawyers anymore,’&#8221; Martufi says.</p>
<p>&#8220;We don’t know yet how systemic this change is, but the risk is that this might stay with us even after the pandemic is gone.&#8221;</p>
<p>Apart from video calls, Catherine Heard does not see much effort being made to mitigate the effects of restrictions. &#8220;I cannot off the top of my head think of anything really meaningful that was done,&#8221; she says.</p>
<p>&#8220;There was a huge missed opportunity, for example, to provide reading material, recorded information or access to online courses. There were a lot of things that could have been done, should have been done, but weren&#8217;t done.&#8221;</p>
<p>The Netherlands was one of the countries that managed to restart prison activities relatively quickly through measures such as rotational schemes or smaller, fixed groups, Heard says. But most countries didn’t implement such measures.</p></div>
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				<div class="et_pb_text_inner"><h3>Structural problems exacerbate situation</h3>
<p>As in so many other areas of society, the situation has been exacerbated by structural problems that existed long before the pandemic.</p>
<p>&#8220;Some of the most severe and prolonged restrictions were seen in the countries with the worst prison overcrowding,&#8221; Heard says. A lack of space makes distancing measures impossible to implement, and alternative measures are hindered by staff shortages. &#8220;If there aren&#8217;t staff to move people around the prison,&#8221; she says, &#8220;there is no option but to keep them locked up in their cells for most of the day and night.&#8221;</p>
<p>Researchers, NGOs and incarcerated people alike repeatedly mention overcrowding as key to the problem. One in three European countries operate their prisons above official capacity. </p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="507" height="1080" src="https://miir.gr/wp-content/uploads/2021/12/59985285_7.png" alt="" title="59985285_7" srcset="https://miir.gr/wp-content/uploads/2021/12/59985285_7.png 507w, https://miir.gr/wp-content/uploads/2021/12/59985285_7-480x1022.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 507px, 100vw" class="wp-image-12028" /></span>
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				<div class="et_pb_text_inner"><p>In many individual prisons, the situation is much worse than the country average suggests. &#8220;I am in a cell that is intended for five people — now there are eight of us. It is impossible to maintain distance,&#8221; a person on hunger strike <a class="icon external" href="https://slobodnadalmacija-hr.translate.goog/vijesti/hrvatska/u-splitskom-zatvoru-poceo-strajk-gladu-zbog-straha-od-koronavirusa-zivimo-u-nehumanim-uvjetima-osjecamo-se-kao-osudenici-na-smrt-1011886?_x_tr_sl=auto&amp;_x_tr_tl=en&amp;_x_tr_hl=de&amp;_x_tr_pto=nui" target="_blank" rel="nofollow noopener noreferrer">told a Croatian news outlet</a> at the start of the pandemic in March 2020. &#8220;We are unable to see our wives and children, and, God forbid, maybe some of us never see them again. We practically feel like death row inmates, waiting for the coronavirus to break into prison.&#8221;</p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="940" height="529" src="https://miir.gr/wp-content/uploads/2021/12/60006092_403.png" alt="" title="60006092_403" srcset="https://miir.gr/wp-content/uploads/2021/12/60006092_403.png 940w, https://miir.gr/wp-content/uploads/2021/12/60006092_403-480x270.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 940px, 100vw" class="wp-image-12030" /></span>
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				<div class="et_pb_text_inner"><p>French chief prisons inspector Dominique Simonnot: &#8220;Imagine three people crammed 10 hours a day into a 9-square-meter cell, which is only 4.5 square meters with the bunk bed, the table and the toilet area.&#8221;</p></div>
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				<div class="et_pb_text_inner"><p>During the first wave, many countries throughout Europe released people in unprecedented numbers in order to ease the pressure on prisons. &#8220;It&#8217;s what the experts have been telling them to do for years, but it was too politically scary,&#8221; Heard says. &#8220;I think COVID gave many countries an excuse to quietly reduce their prisoner numbers.&#8221;</p>
<p>Heard calculated that the incarcerated population may have been reduced by as much as half a million people globally between March 2020 and June 2021. Countries such as Slovenia, Belgium, France and Italy, all of which had been operating over capacity to begin with, <a class="icon external" href="https://www.europeandatajournalism.eu/eng/News/Data-news/Pandemic-has-opened-prisons-across-Europe" target="_blank" rel="nofollow noopener noreferrer">reduced their incarcerated populations</a> by up to 25%, bringing them down to at or below official capacity.</p>
<p>&#8220;One lesson countries will have learned is that they&#8217;ve reduced their incarceration numbers without the sky falling in,&#8221; Heard says. With the pandemic offering a public health reason for reducing prison populations, she says it is vital that countries now sustain the trend.</p></div>
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				<div class="et_pb_text_inner"><h3>Prison populations are rising again</h3>
<p>But many countries seem to be reversing the progress made since spring 2020. After the initial drop, incarcerated populations are now rising again in about half of the European countries studied — in some cases even surpassing their original levels. </p>
<p>French and Slovenian prisons, for example, are now back to being overcrowded at the national level, with individual prisons worse off still.</p></div>
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				<div class="et_pb_text_inner"><h3>Vaccinations delayed</h3>
<p>With these structural problems exacerbating an already complicated situation, a &#8220;return to normal&#8221; in prisons hinges on the same thing it does for the rest of society: vaccination.</p>
<p>&#8220;When it was announced that there would be a vaccine, people became much calmer,&#8221; Vass says. &#8220;To the best of my knowledge, almost all inmates here took it. I received my first dose in May, the second in June, and, like many, I took the third in September.&#8221;</p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="504" height="1080" src="https://miir.gr/wp-content/uploads/2021/12/59985157_7.png" alt="" title="59985157_7" srcset="https://miir.gr/wp-content/uploads/2021/12/59985157_7.png 504w, https://miir.gr/wp-content/uploads/2021/12/59985157_7-480x1029.png 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 504px, 100vw" class="wp-image-12036" /></span>
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				<div class="et_pb_text_inner"><p>But not everyone has gotten their jab yet. One big reason for the delay is the fact that, even with the high risk to inmates, staff and the general population, most European countries did not include incarcerated people as a priority group in their vaccination plans. Many didn’t mention them at all. </p>
<p>In Germany, for example, people in communal living arrangements such as elderly care homes were prioritized explicitly, but prisoners were still vaccinated in parallel with the rest of the population.</p>
<p>&#8220;There has been consistent indication from independent supranational organizations that prisoners should be prioritized,&#8221; Martufi says. &#8220;It&#8217;s a good example of the absolute discrepancy between the policy indications on the one hand and the reality on the ground.&#8221;</p>
<p>Many attribute this to a lack of political will. In some cases, Martufi says, politics even actively hindered early access to vaccination. &#8220;In Belgium, prisoners’ being prioritized became a political discussion,&#8221; he says, &#8220;and, as a result, prisoners just stayed out of the vaccination campaign until the very end.&#8221; In Italy on the other end, he says, the decision to give incarcerated people priority access to vaccinations was an administrative decision, made without much public discussion.</p>
<p>This has meant that the start of vaccinations in prisons was significantly delayed, with some countries not distributing a single shot in prisons before June, while others reported starting as early as the end of March.</p></div>
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				<div class="et_pb_text_inner"><h3>Facing the second pandemic winter</h3>
<p>With vaccination rates in European prisons finally reaching the level of the general population in many countries and with infections low during the summer, incarcerated people caught a breath of fresh air as visits and activities resumed under hygiene requirements.</p>
<p>But, with winter and the next wave arriving in most European countries, the pandemic isn&#8217;t over for anyone — and certainly not for people in prisons. &#8220;We will not get our old life, our benefits, back soon,&#8221; Csaba Vass in Hungary says. In Italy, weekly <a class="icon external" href="https://www.giustizia.it/giustizia/it/mg_2_27.page" target="_blank" rel="nofollow noopener noreferrer">data</a> show active cases among staff and inmates rising. And Croatia&#8217;s Justice Ministry recently confirmed that more than 20% of incarcerated people have by now been infected with the coronavirus — that is roughly 1.5 times the rate of the population in general.</p></div>
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				<div class="et_pb_text_inner"><h3>Lessons for the future</h3>
<p>Experts say countries need to reduce their prison populations drastically in order to better prepare for such situations in the future. &#8220;We cannot face another health crisis with these numbers of people incarcerated throughout Europe,&#8221; Martufi says. &#8220;That needs to go down.&#8221; </p>
<p>But observers also see reason for optimism. &#8220;COVID should have been a wake-up call to invest in better prison conditions and to reduce the use of incarceration,&#8221; Catherine Heard says. </p>
<p>For that wake-up call to be heard, public interest and political will are crucial. &#8220;It’s time to rethink our perception of prisoners as second-class citizens,&#8221; Martufi says. &#8220;We cannot allow anyone to be left behind. It will be worse for everyone.&#8221;</p>
<p><em>The project is a collaboration within the <a class="icon external" href="https://www.europeandatajournalism.eu/" target="_blank" rel="nofollow noopener noreferrer">European Data Journalism Network</a></em></p>
<p><em>Project lead: <a class="icon intern" href="https://dw.com/data" target="_blank" rel="noopener noreferrer">Deutsche Welle</a></em></p>
<p><em>Collaborators: <a class="icon external" href="https://www.alternatives-economiques.fr/" target="_blank" rel="nofollow noopener noreferrer">Alternatives Economiques,</a> <a class="icon external" href="https://civio.es/" target="_blank" rel="nofollow noopener noreferrer">Civio,</a> <a class="icon external" href="https://www.elconfidencial.com/" target="_blank" rel="nofollow noopener noreferrer">El Confidencial,</a> <a class="icon external" href="https://hvg.hu/eurologus" target="_blank" rel="nofollow noopener noreferrer">EUrologus,</a> <a class="icon external" href="https://www.ilsole24ore.com/" target="_blank" rel="nofollow noopener noreferrer">Il Sole24Ore,</a> <a class="icon external" href="https://www.imedd.org/" target="_blank" rel="nofollow noopener noreferrer">iMEdD,</a> <a class="icon external" href="https://miir.gr/" target="_blank" rel="nofollow noopener noreferrer">MIIR,</a> <a class="icon external" href="https://www.balcanicaucaso.org/eng" target="_blank" rel="nofollow noopener noreferrer">OBC Transeuropa,</a> <a class="icon external" href="https://www.openpolis.it/" target="_blank" rel="nofollow noopener noreferrer">Openpolis,</a> <a class="icon external" href="https://podcrto.si/" target="_blank" rel="nofollow noopener noreferrer">Pod črto,</a> <a class="icon external" href="https://voxeurop.eu/en/" target="_blank" rel="nofollow noopener noreferrer">VoxEurop</a></em></p>
<p>&nbsp;</p>
<p><em>This piece was edited by DW&#8217;s Milan Gagnon, Gianna-Carina Grün and Peter Hille.</em></p></div>
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		<title>More than half of European countries prohibit access to assisted reproduction for lesbians and almost a third do so for single women</title>
		<link>https://miir.gr/en/assisted-repro/</link>
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		<dc:creator><![CDATA[ilias]]></dc:creator>
		<pubDate>Sat, 18 Dec 2021 02:05:47 +0000</pubDate>
				<category><![CDATA[Our Network]]></category>
		<category><![CDATA[INVESTIGATIONS]]></category>
		<category><![CDATA[lgbtq+]]></category>
		<category><![CDATA[Gay rights]]></category>
		<category><![CDATA[Lesbian]]></category>
		<category><![CDATA[Assisted Reproduction]]></category>
		<category><![CDATA[EDJNET]]></category>
		<category><![CDATA[EE]]></category>
		<category><![CDATA[Δημοσιογραφία δεδομένων]]></category>
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										<content:encoded><![CDATA[<p><div class="et_pb_section et_pb_section_9 et_pb_fullwidth_section et_section_regular" >
				
				
				
				
				
				
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						<h1 class="et_pb_module_header">More than half of European countries prohibit access to assisted reproduction for lesbians and almost a third do so for single women</h1>
						
						<div class="et_pb_header_content_wrapper" data-et-multi-view="{&quot;schema&quot;:{&quot;content&quot;:{&quot;desktop&quot;:&quot;&lt;p&gt;The situation is much more difficult for trans and intersex people. In addition to the legal barriers, they face economic stumbling blocks: most public health systems cover only part of the costs or have very long wait lists or narrow access criteria.&lt;\/p&gt;\n&lt;p&gt;&nbsp;&lt;\/p&gt;\n&lt;p&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;Eva Belmonte, Mar\u00eda \u00c1lvarez del Vayo, \u00c1ngela Bernardo, Carmen Torrecillas, Antonio Hern\u00e1ndez, Lucas Laursen&lt;\/span&gt;&lt;\/p&gt;\n&lt;p style=\&quot;text-align: center;\&quot;&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;11\/12\/2021&lt;\/span&gt;&lt;\/p&gt;&quot;,&quot;tablet&quot;:&quot;&lt;p&gt;The situation is much more difficult for trans and intersex people. In addition to the legal barriers, they face economic stumbling blocks: most public health systems cover only part of the costs or have very long wait lists or narrow access criteria.&lt;\/p&gt;\n\n&lt;p&gt;&lt;span style=\&quot;font-weight: 400;\&quot;&gt;Eva Belmonte, Mar\u00eda \u00c1lvarez del Vayo, \u00c1ngela Bernardo, Carmen Torrecillas, Antonio Hern\u00e1ndez, Lucas Laursen&lt;\/span&gt;&lt;\/p&gt;&quot;}},&quot;slug&quot;:&quot;et_pb_fullwidth_header&quot;}" data-et-multi-view-load-tablet-hidden="true"><p>The situation is much more difficult for trans and intersex people. In addition to the legal barriers, they face economic stumbling blocks: most public health systems cover only part of the costs or have very long wait lists or narrow access criteria.</p>
<p>&nbsp;</p>
<p><span style="font-weight: 400;">Eva Belmonte, María Álvarez del Vayo, Ángela Bernardo, Carmen Torrecillas, Antonio Hernández, Lucas Laursen</span></p>
<p style="text-align: center;"><span style="font-weight: 400;">11/12/2021</span></p></div>
						
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				<div class="et_pb_text_inner"><p>Heterosexual couples in Europe can undergo assisted reproductive treatment, either through their national health services or by paying out of pocket. It’s legal. In just a few places national services hit the brakes if the couple needs donated eggs or embryos.</p>
<p>Things are harder for <strong>female-female couples or single women</strong>, and even more so for <strong>trans or intersex people</strong>. A lot harder. Even in countries where you might think there would be no discrimination. In fact, it wasn’t until June of this year that <strong>France</strong> <a href="https://www.dw.com/en/france-legalizes-ivf-for-single-women-lesbian-couples/a-58101438" target="_blank" rel="noopener noreferrer">allowed access</a> to assisted reproductive technology (ART) for these groups. <strong>Norway</strong> gave <a href="https://lovdata.no/dokument/LTI/lov/2020-06-19-78" target="_blank" rel="noopener noreferrer">single women access in 2020</a>, just a short time ago.</p></div>
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						<div class="et_pb_blurb_description"><p style="text-align: center;"><strong>Artificial insemination</strong>, or intrauterine, is a technique based on the introduction of semen in the uterus through a cannula. <strong>In vitro fertilisation</strong>, on the other hand, is a technique that consists in extracting the egg and introducing the spermatozoon in it outside the uterus, in a laboratory. And then reintroducing the embryo back in the uterus.</p></div>
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				<div class="et_pb_text_inner"><p>Of the 43 countries analysed for this investigation, <strong>12 do not allow single women to access <em>in vitro</em> fertilisation</strong>. Even more countries, <strong>16, also prevent single women from getting assisted insemination</strong>. The list of countries that prevent single women from getting a donated egg is even longer.</p>
<p>The situation is worse for <strong>female couples: 24 countries ban their access to ART outright</strong>. For the LGTBIQ+ community, having children via ART is not an easy path in Europe. “The places where it’s most difficult for LGTBIQ+ people to get a job or to be out or to get married or to undergo legal gender recognition are also the places where it’s most difficult to have access to assisted reproductive technologies,” says Cianan Russell, from <a href="https://www.ilga-europe.org/" target="_blank" rel="noopener noreferrer">ILGA Europe</a>, a federation of European lesbian, gay, bisexual, trans and intersex rights groups. They say <strong>Hungary and Poland</strong> are the countries where the situation is the worst, but the problem is widespread in Europe. Even where people can obtain reproductive assistance legally on paper, reality sometimes brings “discrimination, harassment or even violence” to the process, Russell says. Those who are <strong>suffering the most problems are trans and intersex people</strong>, they add.</p></div>
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				<div class="et_pb_text_inner"><p>People facing these forms of discrimination grapple with difficult alternatives. In the case of the LGTBIQ+ collective, says Russell, there are three. The first is <strong>misrepresenting one’s identity</strong>, such as female couples who lie by saying that just one of them is seeking treatment as a single woman, if that is allowed, or non-binary people or trans men who say they are women. The second alternative is <strong>crossing borders to seek access in another country</strong>. The third is <strong>conceiving with friends or trusted people</strong> even if they are not attracted to them.</p>
<p>Although this is not common, it is a path that many people who want to have children <strong>may take if the barriers seem otherwise insurmountable</strong>. In the case of single women, Izaskun Gamen, spokesperson for the association Single Mothers By Choice (MSPE), says that, during her years-long process to try to have children, <strong>some people suggested that she get pregnant by a stranger</strong> after a one-night stand and not tell the father. That seems unthinkable to her, she says: “How do you explain that to your child later? How do you explain that he or she was born of a deception?”</p></div>
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				<div class="et_pb_text_inner"><h3 id="older-and-older-mothers">Older and older mothers</h3>
<p>The only legal barrier for heterosexual couples, in most cases, <strong>is age</strong>. The women seeking ART are getting older. In the last decade, the <strong>average age of mothers at the birth of their first child</strong> , whether natural or assisted, <strong>has increased in most of Europe</strong>. In <strong>Spain and Ireland</strong> the average age was over 32 years old in 2019.</p></div>
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				<div class="et_pb_text_inner"><p>That’s average, which means that many women access ART later, when, <strong>because of their age, conceiving naturally becomes more difficult</strong>. Most countries put the legal ceiling for assisted reproduction around <strong>50 years</strong>. This is the maximum age in Greece, for example, but in response to COVID-19 pandemic-related treatment delays the government extended the age to 52 years until June 30, 2023.</p>
<p>Juana Crespo, director of an eponymous fertility clinic in Spain specialised in difficult cases, says the main problem for her patients is old age: “We get old and, when our reproductive system becomes old, the whole orchestra is old.” She calls this a “new disease”: “<strong>The history of delayed motherhood is unwritten</strong>.”</p>
<p>Although women’s ages are a common source of reproductive difficulties, Carlos Calhaz-Jorge, a fertility doctor and researcher at the Universidade de Lisboa in Portugal and president of the European Society of Human Reproduction and Embryology (<a href="https://www.eshre.eu/" target="_blank" rel="noopener noreferrer">ESHRE</a>), says that <strong>half of the problems of couples who seek ART are from the male partner</strong>.</p>
<p>Yet age <strong>is not a factor of legal exclusion for men</strong> and, in general, there are no limits in European countries. Only three of the 43 countries have maximums: France, 59 years; Finland, 60 years; and Switzerland, 56 years, although in these last two cases they are recommendations, not legal prohibitions. In fact, in Switzerland the recommendation is that <strong>the father can be alive until the child turns 18</strong>, a more sociological than medical recommendation.</p></div>
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				<div class="et_pb_text_inner"><h3 id="the-most-common-obstacle-lack-of-financial-resources">The most common obstacle: lack of financial resources</h3>
<p>Once the legal obstacles are overcome, the economic ones rear their heads. According to Calhaz-Jorge, “the problem for most of the population is the <strong>lack of public funding</strong>. Even in countries where heterosexual couples are allowed to have ART it depends a lot on the public financial support.” Another discrimination, to add to the previous ones, is the economic one: <strong>not all countries cover these techniques</strong> (six do not cover it at all), and those who do <strong>sometimes only pay part of it, or the waiting lists are years-long</strong>, in a matter in which every delay works against you.</p>
<p>For example, in Switzerland and Poland, only insemination is funded, not <em>in vitro</em> fertilisation, which is much more expensive. In Greece, the public healthcare system only covers very specific cases, such as people living in faraway islands.</p>
<p>In fact, there are <strong>gaping differences</strong> between European countries. There are even differences between regions of the same country, such as in <strong>the United Kingdom, Italy and Spain</strong>. In Spain, for example, single women can access artificial insemination in Navarra, but not <em>in vitro</em> fertilisation, even if they have medical problems that prevent them from becoming pregnant through insemination. Spain’s other regions do permit that. <strong>Germany</strong>, meanwhile, <strong>does not cover <em>in vitro</em> fertilisation for lesbians and single women</strong>.</p>
<p><strong>Age limits</strong>, already an important legal barrier for those seeking private ART access, <strong>are lower for people seeking ART through national health services</strong>. Once again, in the case of heterosexual couples, very few countries put a ceiling on the age of men. Portugal sets it at 60 years and Austria, 49. For women there are limits: from <strong>38 in Latvia</strong> to <strong>46 in Italy</strong> or 48 in Malta, to the most common figure in Europe, <strong>40</strong>.</p>
<p>In other countries, publicly funded assisted reproduction has additional barriers, such as <strong>not exceeding a certain weight</strong> (in Serbia, Romania and some Spanish regions) or <strong>not having previous children</strong>, as in Denmark, Malta, Portugal, Romania, Spain, Sweden and Turkey.</p>
<p>Another of the most common limits is to cover only <strong>a maximum number of attempts</strong>. Few countries are clear on insemination, or do not establish limits, although if they do, it is usually six or three cycles. Countries are clearer about <em>in vitro</em> fertilisation: almost all limit the number of funded attempts. <strong>Belgium, Slovenia and Italy fund six attempts</strong>. <strong>15 other countries fund three attempts</strong>. Romania, Moldova, and Kazakhstan fund <strong>only one</strong>. There, either you get pregnant the first time, or if you want to keep trying you have to pay for it out of pocket.</p>
<p>Irene Cuevas, director of the embryology laboratory of the public General Hospital of Valencia (Spain), says that after a certain number of attempts the probability of success drops a lot. “We have very limited resources and we have to try to optimise them in some way. It is a very logical number,” she argues.</p>
<p>Then there are the <strong>copays</strong>, which mean that access is not free in practice. The most common are those for medicines, and they are significant. Each round of hormonal treatment for <em>in vitro</em> fertilisation in Spain, for example, <strong><a href="https://www.reproduccionasistida.org/prices-medication-assisted-reproduction/" target="_blank" rel="noopener noreferrer">can cost more than a thousand euros</a></strong>.</p>
<p>There are also the <strong>long waiting lists</strong>. Cuevas calls them, “the fundamental problem.” Long waits are also common, for example, in <strong>Hungary</strong>. At one point Hungary did not permit sperm donors that were not Hungarian. Even after they removed that obstacle, things did not improve, Sandor says. Last summer, Hungary <strong>nationalised all fertility clinics</strong>. “Everyone knows that this means that they’re going to be five- to 10-years-long waiting lists for those who don’t have any money,” Sándor says.</p>
<p>Calhaz-Jorge says this is not only a problem of rights: “I’d like to have more support in my country, Portugal, because there are too-long waiting lists and as in the rest of Europe. <strong>Our fertility is declining</strong>. More support could help slow the decline. We have an intention of providing reproductive assistance to up to 5% of all babies born in Portugal. This is realistic but for that <strong>we need more money</strong>.”</p></div>
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				<div class="et_pb_text_inner"><p><strong>Spain</strong> is the country in Europe, together with Greece, in which <strong>more children are born thanks to assisted reproduction procedures</strong>, reaching 7.9% of the total number of children born in 2017 (last year with comparable data, but in 2019 this number <a href="https://www.registrosef.com/public/docs/sef2019_IAFIVm.pdf" target="_blank" rel="noopener noreferrer">grown to 9,5%</a>). In <strong>Italy, the UK, and Portugal</strong>, the rate is around 3%.</p>
<p>Faced with all these difficulties, is a <strong>common European regulation</strong> possible that guarantees equal access for all? Russell, the LGBTIQ+ spokesperson, says that would be difficult. European countries, not the EU, have jurisdiction over this matter, so the only alternative when it comes to defending LGTBIQ+ rights are <strong>the courts</strong>.</p>
<p>Calhaz-Jorge, chairman of the ESHRE, says: “I’m convinced that it is not possible to have similar rules. If in one country it is not legal to treat single women, which kind of regulation will they have if going abroad? <strong>The political views and the cultural sensitivities are very different</strong>.” Indeed.</p></div>
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<p>The post <a href="https://miir.gr/en/assisted-repro/">More than half of European countries prohibit access to assisted reproduction for lesbians and almost a third do so for single women</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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		<title>No appointments for mental health patients during the COVID-19 pandemic</title>
		<link>https://miir.gr/en/no-appointments-for-mental-health-patients-during-the-covid-19-pandemic/</link>
					<comments>https://miir.gr/en/no-appointments-for-mental-health-patients-during-the-covid-19-pandemic/#respond</comments>
		
		<dc:creator><![CDATA[ilias]]></dc:creator>
		<pubDate>Tue, 05 Jan 2021 10:48:04 +0000</pubDate>
				<category><![CDATA[Our Network]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[patients]]></category>
		<category><![CDATA[pandemic]]></category>
		<category><![CDATA[COVID-19]]></category>
		<guid isPermaLink="false">https://miir.gr/?p=11118</guid>

					<description><![CDATA[<p>The post <a href="https://miir.gr/en/no-appointments-for-mental-health-patients-during-the-covid-19-pandemic/">No appointments for mental health patients during the COVID-19 pandemic</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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<li>Remote therapy brings little healing for the mentally ill.</li>
<li>COVID-19 has paralysed mental health care, already weak in several  European countries.</li>
<li>During the first wave, 75% of psychiatry services were via telemedicine, but it doesn’t work for everybody.</li>
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<p>Reporting: <a href="https://civio.es/equipo/angela-bernardo/">Ángela Bernardo,</a><a href="https://civio.es/equipo/maria-alvarez-del-vayo/">Maria Álvarez Del Vayo</a><br />Interviews: Ollala Tunas, Monica Georgescu <br />Data visualization: <a href="https://civio.es/equipo/carmen-torrecillas/">Carmen Torrecillas,<br /></a>English editing: Lucas Laursen</p>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="1120" height="747" src="https://miir.gr/wp-content/uploads/2020/12/ANDRES_COLAO_001-grad4-civio.jpg" alt="" title="" srcset="https://miir.gr/wp-content/uploads/2020/12/ANDRES_COLAO_001-grad4-civio.jpg 1120w, https://miir.gr/wp-content/uploads/2020/12/ANDRES_COLAO_001-grad4-civio-980x654.jpg 980w, https://miir.gr/wp-content/uploads/2020/12/ANDRES_COLAO_001-grad4-civio-480x320.jpg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1120px, 100vw" class="wp-image-11086" /></span>
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				<div class="et_pb_text_inner"><p>&#8220;<em>Before the pandemic, there were already many people confined to their home, their sofa, their bed, their room, and their minds</em>&#8220;</p>
<p>Andrés Colao, spokesperson for a Spanish charity related to mental health, stares through a window | Marta Martín Heres</p></div>
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				<div class="et_pb_text_inner"><p><a href="https://consaludmental.org/sala-prensa/actualidad/vivir-sin-miedo/"><span style="font-weight: 400;">Andrés Colao</span></a><span style="font-weight: 400;"> speaks from his own experience as a patient who has seen the </span><a href="https://civio.es/coronavirus"><span style="font-weight: 400;">COVID-19</span></a><span style="font-weight: 400;"> pandemic cripple an already weak healthcare system. He is the spokesperson for </span><a href="https://www.afesasturias.org/"><span style="font-weight: 400;">AFESA</span></a><span style="font-weight: 400;">, a Spanish charity of people with mental illness and their relatives. For those who had a disorder diagnosed before the COVID-19 pandemic, the crisis has left them in limbo.</span></p>
<p><a href="http://www.clubsociallamuralla.com/"><span style="font-weight: 400;">Jorge Daniel Castilla</span></a><span style="font-weight: 400;">, who was undergoing treatment for a mental health condition, says “I have had a couple of calls since March, the last one was in June to ask how I was doing. My therapy has been left up in the air.”</span></p>
<p><span style="font-weight: 400;">The crisis has been especially difficult for people seeking psychiatric and psychological services. “There are patients who </span><a href="https://www.salutmental.org/5e-informe-covid-salut-mental"><span style="font-weight: 400;">have suffered</span></a><span style="font-weight: 400;"> a lot,” Colao says.</span></p>
<p><span style="font-weight: 400;">COVID-19 has caused a tsunami in mental health. During the first wave, 93% of countries </span><a href="https://www.who.int/publications/i/item/978924012455"><span style="font-weight: 400;">surveyed</span></a><span style="font-weight: 400;"> by the World Health Organization (WHO) suffered paralysis in one or more services for patients with mental, neurological and substance abuse problems. Almost 40% of participating European countries reported worse conditions: they had stopped three out of four health services. “The stricter the lockdown, the more severe the impact,” says Marcin Rodzinka, spokesperson for </span><a href="https://www.mhe-sme.org/"><span style="font-weight: 400;">Mental Health Europe</span></a><span style="font-weight: 400;">, a network of mental health service users and professionals. This happened in Spain, for example, which shut its mental health outpatient centres.</span></p>
<p><span style="font-weight: 400;">In the most serious cases, people admitted to hospital have had an even more dramatic experience, according to Montse Aguilera, who works for the rights of people who, like her, have a mental health diagnosis. Those with severe mental disorders are generally more isolated and vulnerable, so confinement and social isolation can have a significant negative impact, says psychiatrist </span><a href="https://www.unimi.it/en/ugov/person/armando-dagostino"><span style="font-weight: 400;">Armando D’Agostino</span></a><span style="font-weight: 400;"> of ASST Santi Paolo e Carlo hospital in Milan, Italy.</span></p></div>
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						<h4 class="et_pb_module_header"><span>The unequal impact of lockdown</span></h4>
						<div class="et_pb_blurb_description"><p><span style="font-weight: 400;">Staying at home has not been a great difficulty for </span><a href="http://www.clubsociallamuralla.com/"><span style="font-weight: 400;">Lurdes Lourenço</span></a><span style="font-weight: 400;">, because her disorder is related to going outside. Her experience is not unique: many patients were not distressed by confinement. “Many of them were already partially confined. Some patients found their anxiety alleviated by confinement”, says psychiatrist </span><a href="https://www.docenti.unina.it/#!/professor/46454c49434549415345564f4c4953564c464c433736453135493037334e/riferimenti"><span style="font-weight: 400;">Felice Iasevoli</span></a><span style="font-weight: 400;">. However, other people, such as those affected by autism spectrum disorder, did experience intense stress due to the loss of their daily routines and the inability to go to specialised rehabilitation centres.</span></p></div>
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				<span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="1120" height="747" src="https://miir.gr/wp-content/uploads/2020/12/MontseAguilera-12-grad4-civio.jpg" alt="" title="" srcset="https://miir.gr/wp-content/uploads/2020/12/MontseAguilera-12-grad4-civio.jpg 1120w, https://miir.gr/wp-content/uploads/2020/12/MontseAguilera-12-grad4-civio-980x654.jpg 980w, https://miir.gr/wp-content/uploads/2020/12/MontseAguilera-12-grad4-civio-480x320.jpg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1120px, 100vw" class="wp-image-11099" /></span>
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				<div class="et_pb_text_inner"><p><i><span style="font-weight: 400;">&#8220;It broke my heart when a friend was hospitalised </span></i><i><span style="font-weight: 400;">and went through this double confinement, </span></i><i><span style="font-weight: 400;">without visitors, without being able to call&#8221;</span></i></p>
<p><span style="font-weight: 400;">Montse Aguilera poses at the headquarters of </span><a href="https://www.salutmentalblln.org/contacte/"><span style="font-weight: 400;">Associació per la Salut Mental del Baix Llobregat Nord</span></a><span style="font-weight: 400;">, the charity where she collaborates | Hugo Fernández Alcaraz</span></p></div>
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				<div class="et_pb_text_inner"><h4><b>Distance and intermittent mental health care</b></h4>
<p>&nbsp;</p>
<p><span style="font-weight: 400;">The COVID-19 pandemic has transformed health care, including mental health care, and continues to cause problems. “Even from June on, the number of appointments was largely reduced,” says </span><a href="https://www.docenti.unina.it/#!/professor/46454c49434549415345564f4c4953564c464c433736453135493037334e/riferimenti"><span style="font-weight: 400;">Felice Iasevoli</span></a><span style="font-weight: 400;">, a psychiatrist at the Federico II University Hospital in Naples, Italy.</span></p>
<p><span style="font-weight: 400;">In addition to the cuts in available mental health services, demand for care has dropped among people with mental health problems.</span></p>
<p><span style="font-weight: 400;">“This demand decrease is because of the lockdown and the people’s fear: they did not want to come to the hospital, or they could not come because of travel restrictions or the lockdown,” says Croatian psychiatrist </span><a href="https://scholar.google.com/citations?user=ikuqT3UAAAAJ&amp;hl=en"><span style="font-weight: 400;">Martina Rojnic</span></a><span style="font-weight: 400;">, spokesperson for the </span><a href="https://www.europsy.net/"><span style="font-weight: 400;">European Psychiatric Association</span></a><span style="font-weight: 400;">, a professional society.</span></p>
<p><span style="font-weight: 400;">This has been the case for Maria, a woman from Bucharest, Romania, who prefers not to give her real name due to stigma. When the confinement began, she continued consultations to treat her depression online. When her therapist suggested that she return to face-to-face appointments due to the decrease in cases over the summer, Maria says, “I was very anxious even then and very afraid to get out and get infected.” After the arrival of the second wave of the coronavirus, Maria returned to online therapy in order to minimise the risks of contagion.</span></p>
<p><span style="font-weight: 400;">“There is a necessity to organise continuous care because if care is disrupted, it means that a large number of patients might relapse,” Rojnic says.</span></p>
<p><span style="font-weight: 400;">In some places, the options were phone calls and, in some cases, video calls. According to internal data from the European Psychiatric Association, more than 75% of the psychiatric care provided by caregivers was online during the first wave, although there were big differences between countries.</span></p>
<p><span style="font-weight: 400;">“There are some countries where online psychiatry was not used at all,” Rojnic says, so the services were completely disrupted. Moreover, “in some other countries like the Balkans or south eastern countries, the switch to online was up to 50%. In those countries that have already implemented it for 30 years, like Scandinavian countries, they easily switched to online therapy in these circumstances,” Rojnic says. According to a </span><a href="https://www.who.int/goe/publications/atlas/2015/en"><span style="font-weight: 400;">survey</span></a><span style="font-weight: 400;"> conducted in 2015 by the WHO Global Observatory for eHealth, only </span><a href="https://www.who.int/goe/publications/atlas/2015/fin.pdf?ua=1"><span style="font-weight: 400;">Finland</span></a><span style="font-weight: 400;">, the </span><a href="https://www.who.int/goe/publications/atlas/2015/nld.pdf?ua=1"><span style="font-weight: 400;">Netherlands</span></a><span style="font-weight: 400;"> and </span><a href="https://www.who.int/goe/publications/atlas/2015/swe.pdf?ua=1"><span style="font-weight: 400;">Sweden</span></a><span style="font-weight: 400;"> had operational telepsychiatry programmes at the national level at the time.</span></p></div>
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				<div class="et_pb_text_inner"><p><span style="font-weight: 400;">Other countries, such as </span><a href="https://www.who.int/goe/publications/atlas/2015/grc.pdf?ua=1"><span style="font-weight: 400;">Greece</span></a><span style="font-weight: 400;"> and </span><a href="https://www.who.int/goe/publications/atlas/2015/esp.pdf?ua=1"><span style="font-weight: 400;">Spain</span></a><span style="font-weight: 400;">, had launched pilot programmes for remote psychiatric care, while </span><a href="https://www.who.int/goe/publications/atlas/2015/hrv.pdf?ua=1"><span style="font-weight: 400;">Croatia</span></a><span style="font-weight: 400;">, </span><a href="https://www.who.int/goe/publications/atlas/2015/ita.pdf?ua=1"><span style="font-weight: 400;">Italy</span></a><span style="font-weight: 400;"> and </span><a href="https://www.who.int/goe/publications/atlas/2015/ltu.pdf?ua=1"><span style="font-weight: 400;">Lithuania</span></a><span style="font-weight: 400;"> had more informal initiatives at the time. “Digital consultations had never truly been a focus of healthcare policies before the pandemic,” D’Agostino says. Confinement changed it from being one among many options to the only option for some people.</span></p>
<p><span style="font-weight: 400;">Although telephone and video follow-up can help, mental health specialists call for “continuous support” for people who have more serious problems. In fact, the problem already existed before the arrival of COVID-19: the lack of resources limited mental health care. According to </span><a href="https://ec.europa.eu/eurostat/databrowser/view/HLTH_RS_SPEC__custom_109378/default/table?lang=en"><span style="font-weight: 400;">2018 Eurostat data</span></a><span style="font-weight: 400;">, the countries with the most psychiatrists per 100,000 inhabitants were Germany (27.45 psychiatrists per 100,000), Greece (25.79) and the Netherlands (24.15). Poland (9.23 psychiatrists per 100,000 inhabitants), Bulgaria (10.31) and Spain (10.93) had the fewest psychiatrists in proportion to their populations.</span></p></div>
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				<div class="et_pb_text_inner"><h4><b>Remote care is not a panacea</b></h4>
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<p><span style="font-weight: 400;">Mental health resources were scarce before the pandemic. Today access is even more difficult. While remote care has emerged as an option, patient opinions on it vary. For some people, face-to-face meetings are very important because of the eye contact and the trust they can build between the healthcare providers and the people they are treating. “If you have no other choice, you do it, but it is not the same,” says Aguilera, the mental health patient and activist.</span></p>
<p><span style="font-weight: 400;">Other people say remote care is more comfortable for them than a face-to-face consultation, says Jorge Daniel Castilla, a patient who works at </span><a href="http://www.clubsociallamuralla.com/"><span style="font-weight: 400;">La Muralla</span></a><span style="font-weight: 400;">, a charity linked to mental health.</span></p></div>
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				<div class="et_pb_text_inner"><p><i><span style="font-weight: 400;">&#8220;I opened up a lot because I noticed that </span></i><i><span style="font-weight: 400;">on the phone you could open up more than </span></i><i><span style="font-weight: 400;">when you have the professional in front of you&#8221;</span></i></p>
<p><span style="font-weight: 400;">Jorge Daniel Castilla, standing in Tarragona (Spain) | Hugo Fernández Alcaraz</span></p></div>
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				<div class="et_pb_text_inner"><p><span style="font-weight: 400;">For the psychologist Marta Poll, director of the charity </span><a href="https://www.salutmental.org/"><span style="font-weight: 400;">Salut Mental Catalunya</span></a><span style="font-weight: 400;">, experiences such as Castilla’s show that remote care can help people with mobility difficulties or who have a hard time building trusting relationships face to face. However, there are other barriers to access that can make it difficult to care for some patients, especially in the cases of older people or those who cannot use technology, whether for economic or other reasons.</span></p></div>
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				<div class="et_pb_text_inner"><p><span style="font-weight: 400;">Swedish patient Jimmie Trevett | Riksförbundet för Social och Menta</span></p></div>
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				<div class="et_pb_text_inner"><p><span style="font-weight: 400;">“For some of the patients there was no contact at all because they couldn’t handle the digital meetings and they couldn’t go out, so they felt worse,” explains patient Jimmie Trevett, spokesperson for the Swedish Association for Social and Mental Health (</span><a href="https://rsmh.se/"><span style="font-weight: 400;">RSMH</span></a><span style="font-weight: 400;">), a charity.</span></p>
<p><span style="font-weight: 400;">Health professionals say calls and video calls can be useful to keep tabs on patients already in treatment. However, they are not always effective. “[They] can become tricky for novel users in which a therapeutic alliance still has to be built,” says D’Agostino. According to various studies published in recent months, remote examination of patients is </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177054/pdf/main.pdf"><span style="font-weight: 400;">more limited</span></a><span style="font-weight: 400;">, although several countries have opted for </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164869/pdf/main.pdf"><span style="font-weight: 400;">remote care</span></a><span style="font-weight: 400;"> during the pandemic.</span></p>
<p><span style="font-weight: 400;">Mental health services in some places, such as Utrecht, the Netherlands, have come up with more imaginative solutions. “Even when the lockdown was in place, they introduced the concept of ‘coffee to go’. The mental health professionals will meet people outside keeping the distance and will do counselling and therapy while walking,” says Rodzinka, the Mental Health Europe spokesperson.</span></p></div>
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				<div class="et_pb_text_inner"><h4><b>Worry for the future</b></h4>
<p>&nbsp;</p>
<p><span style="font-weight: 400;">The problem for the mental health sector is not only how to care for people with existing diagnoses, but also how to deal with new cases.</span></p>
<p><span style="font-weight: 400;">“The consequences [of the pandemic] are going to be devastating for many people, who will be ruined, unemployed, without horizons,” says Nel Zapico, a relative of a person with a mental health disorder and president of the </span><a href="https://consaludmental.org/"><span style="font-weight: 400;">Confederación Salud Mental España</span></a><span style="font-weight: 400;">, a charity. </span></p>
<p><span style="font-weight: 400;">In fact, Tedros Adhanom Ghebreyesus, director-general of WHO, </span><a href="https://www.who.int/news/item/14-05-2020-substantial-investment-needed-to-avert-mental-health-crisis"><span style="font-weight: 400;">has already warned</span></a><span style="font-weight: 400;"> of this danger. A </span><a href="https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930460-8"><span style="font-weight: 400;">review</span></a><span style="font-weight: 400;"> of the psychological impact of past quarantines, such as during the SARS, MERS, and Ebola epidemics, showed higher levels of anxiety and stress among people who underwent quarantine. In several European countries there seem to be more </span><a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30308-4/fulltext"><span style="font-weight: 400;">mental distress</span></a><span style="font-weight: 400;"> and </span><a href="https://www.eurofound.europa.eu/publications/report/2020/living-working-and-covid-19"><span style="font-weight: 400;">concern</span></a><span style="font-weight: 400;"> about the COVID-19 pandemic.</span></p>
<p><span style="font-weight: 400;">Mental health experts fear a wave of mental health problems. “I will expect anxiety disorders as a consequence of the stress and the tension that every one of us is facing at the moment: depressive disorders as the consequence of confinement, family loss, economic loss; traumatic disorders as the consequence of severely shocking situations, such as having been hospitalised for COVID-19 or having had a close relative hospitalised,” says Iasevoli, the psychiatrist. Iasevoli also predicts a recurrence of “substance use disorder and the re-exacerbation of psychotic symptoms in the most vulnerable populations”. The list does not end there: “High rates of Post-Traumatic Stress Disorder (PTSD) are also predicted in COVID-19 survivors with prolonged hospitalisation or lack of adequate assistance at home,” D’Agostino says.</span></p>
<p><span style="font-weight: 400;">Healthcare professionals working on the front lines, such as </span><a href="https://civio.es/medicamentalia/2020/07/01/coronavirus-covid-19-especialidades-medicas-hospitales/"><span style="font-weight: 400;">medical</span></a><span style="font-weight: 400;"> and </span><a href="https://civio.es/medicamentalia/2020/06/23/covid-19-pandemic-exposes-southern-europes-nursing-shortage/"><span style="font-weight: 400;">nursing</span></a><span style="font-weight: 400;"> staff, can also suffer from mental health problems. “There is a higher level of burnout and maybe post-traumatic stress disorder later on,” says Rojnic, the European Psychiatric Association spokesperson. This is not just a prediction. Previous epidemics, such as SARS and MERS, affected the mental health of the healthcare professionals involved. Studies on the impact of the first wave of COVID-19 in countries like Spain report that the majority of workers on the front line have not received </span><a href="https://www.mdpi.com/1660-4601/17/21/8149"><span style="font-weight: 400;">the psychological and psychiatric help they need</span></a><span style="font-weight: 400;">.</span></p>
<p><span style="font-weight: 400;">Those who have lost loved ones also carry the pain of not being able to properly part or farewell, says psychiatrist </span><a href="https://www.researchgate.net/profile/Roberto_Mezzina"><span style="font-weight: 400;">Roberto Mezzina</span></a><span style="font-weight: 400;">, who directed a mental health referral centre in Trieste, Italy before retiring. He warns: “This amount of grief is still floating in the air, just suspended and in any moment it can heavily impact society.”</span></p></div>
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				<h5 class="et_pb_toggle_title">Methodology</h5>
				<div class="et_pb_toggle_content clearfix"><p><span style="font-weight: 400;">Data linked to psychiatrists in the European Union from this article is available for download </span><a href="https://datos.civio.es/dataset/psiquiatras-en-la-union-europea/"><span style="font-weight: 400;">here</span></a><span style="font-weight: 400;">, while information on telepsychiatry can be downloaded </span><a href="https://datos.civio.es/dataset/telepsiquiatria-en-la-union-europea/"><span style="font-weight: 400;">here</span></a><span style="font-weight: 400;">. The United Kingdom is included since the information corresponds to data obtained before the Brexit.</span></p>
<p><span style="font-weight: 400;">Information on the availability of telepsychiatric services comes from a </span><a href="https://www.who.int/goe/publications/atlas/2015/en/"><span style="font-weight: 400;">global survey</span></a><span style="font-weight: 400;"> conducted in 2015 by the World Health Organization. In the case of Estonia, remote psychiatry had both international and national coverage, while in Finland it had national and regional coverage. According to WHO data, in Spain, the geographical scope of telepsychiatry was regional, intermediate and local, while there were pilot and established programmes. In Sweden, coverage was national and intermediate and there were also pilot and established programmes. No information is available for Austria, Hungary, Ireland, Latvia, Luxembourg, Malta, Poland, Portugal, Romania, Slovenia and Slovakia.</span></p>
<p><span style="font-weight: 400;">Psychiatrists per capita data is from </span><a href="https://ec.europa.eu/eurostat/databrowser/view/HLTH_RS_SPEC__custom_109378/default/table?lang=en"><span style="font-weight: 400;">Eurostat</span></a><span style="font-weight: 400;">: in most cases, the figures are from 2018, although in Poland, Luxembourg and Sweden, the numbers go back to 2017. Finland and Slovakia are not included for these reasons: in the first case, the data was outdated and, in the second case, there is no information in Eurostat linked to the Slovak Republic.</span></p>
<p><span style="font-weight: 400;">Data on the disruption of mental health services published by the WHO comes from a </span><a href="https://www.who.int/publications/i/item/978924012455"><span style="font-weight: 400;">2020 report</span></a><span style="font-weight: 400;">. Finally, data on psychiatric care in Europe during the first COVID-19 wave is from an internal survey conducted by the European Psychiatric Association, which has not yet been officially published.</span></p></div>
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				<div class="et_pb_text_inner"><div>Source: <a href="https://civio.es/medicamentalia/2020/12/03/mental-health-coronavirus-covid-19/">CIVIO</a> | European Data Journalism Network</div>
<p>Licence <a href="https://creativecommons.org/licenses/by/4.0/">CC BY 4.0</a></p></div>
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<p>The post <a href="https://miir.gr/en/no-appointments-for-mental-health-patients-during-the-covid-19-pandemic/">No appointments for mental health patients during the COVID-19 pandemic</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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		<title>COVID-19 pandemic exposes southern Europe’s nursing shortage</title>
		<link>https://miir.gr/en/covid-19-pandemic-exposes-southern-europe-s-nursing-shortage/</link>
					<comments>https://miir.gr/en/covid-19-pandemic-exposes-southern-europe-s-nursing-shortage/#respond</comments>
		
		<dc:creator><![CDATA[ilias]]></dc:creator>
		<pubDate>Tue, 17 Nov 2020 21:36:38 +0000</pubDate>
				<category><![CDATA[Our Network]]></category>
		<category><![CDATA[nurses]]></category>
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		<category><![CDATA[pandemic]]></category>
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					<description><![CDATA[<p>The post <a href="https://miir.gr/en/covid-19-pandemic-exposes-southern-europe-s-nursing-shortage/">COVID-19 pandemic exposes southern Europe’s nursing shortage</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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				<div class="et_pb_text_inner"><h3>For weeks, Spain and Italy were epicentres of the COVID-19 pandemic. Their health defences had an important gap: large staffing shortages and low ratios of nurses to doctors. At the same time, nurses had higher infection rates than the general population, mainly because of the lack of personal protective equipment.</h3></div>
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				<div class="et_pb_text_inner"><p>Every evening this spring, when the clocks struck eight, thousands of people <a title="Link a across Europe" href="https://www.washingtonpost.com/world/europe/clap-for-carers/2020/03/26/3d05eb9c-6f66-11ea-a156-0048b62cdb51_story.html" target="_blank" rel="noopener noreferrer">across Europe <i class="fa fa-external-link"></i> </a>came out to applaud from their balconies. They did this to recognise the immense effort of healthcare workers who are still fighting to save the lives of thousands of patients. Since the crisis began, Europe <a title="Link a has recorded" href="https://qap.ecdc.europa.eu/public/extensions/COVID-19/COVID-19.html" target="_blank" rel="noopener noreferrer">has recorded <i class="fa fa-external-link"></i> </a>over 1.5 million cases. COVID-19 has killed at least 174,000 Europeans. “These have been very hard months. What health centres have experienced is appalling,” says María José García, spokesperson for <a title="Link a SATSE" href="https://www.satse.es/" target="_blank" rel="noopener noreferrer">SATSE <i class="fa fa-external-link"></i> </a>, the main Spanish nursing union. García, who works in Madrid, has been one of thousands of healthcare workers who have been on the front line against the virus. As in other European countries, they have made a titanic effort despite the lack of resources.</p>
<p>However, there is an invisible line across Europe. Before COVID-19 hit, the Nordic and Central European countries had the best prepared health staff. Although the number of doctors per capita was similar to southern Europe, another important link in the chain differed: nursing. The northern and central European countries had many more nurses than did southern European countries. According to <a title="Link a Eurostat" href="https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_rs_prsns&amp;lang=en" target="_blank" rel="noopener noreferrer">Eurostat <i class="fa fa-external-link"></i> </a>data, Germany had almost 13 nurses per thousand inhabitants, similar to Luxembourg (11.72), Belgium (10.96), Sweden (10.90), the Netherlands (10.88) or Denmark (9.95).</p>
<p>At the other extreme, Greece had 3.31 nurses per thousand inhabitants in 2017, the lowest number. According to Eurostat data, other southern countries also had large staffing shortages. Spain, with 5.74 nursing specialists per thousand inhabitants, and Italy, with 5.80, were far more short-handed than their northern neighbours. During the height of the pandemic, both Spain and Italy became epicentres of the health crisis. The COVID-19 emergency has revealed, more clearly than ever, one of the historical weaknesses of those countries’ health systems: the nursing shortage. The fewer the nurses per patient the worse the health outcomes, according to a <a title="Link a study" href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62631-8/fulltext" target="_blank" rel="noopener noreferrer">study <i class="fa fa-external-link"></i> </a>of 300 hospitals in nine European countries.</p>
<p>Italy and Spain also have lower than average ratios of nurses to doctors. In general, the Nordic and Central European countries have close to the Organisation for Economic Cooperation and Development (OECD) <a title="Link a average" href="https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2019_4dd50c09-en;jsessionid=-Wai4D9Z6WqSogh1B9tJww5i.ip-10-240-5-25" target="_blank" rel="noopener noreferrer">average <i class="fa fa-external-link"></i> </a>of three nurses for each doctor. In contrast, Italy had 1.45 and in Spain the ratio was similar: 1.48. This is because the number of doctors in both countries are similar to the European average, unlike the number of nurses, of whom there are far fewer in southern European countries. “Our healthcare system focuses more on curing than caring for people or preventing disease,” explains Mar Rocha, spokesperson for the Official College of Nursing of Madrid (<a title="Link a CODEM" href="https://www.codem.es/inicio" target="_blank" rel="noopener noreferrer">CODEM <i class="fa fa-external-link"></i> </a>, in Spanish).</p>
<p>The situation is even worse in care homes. “Care homes for dependent people, not just for the elderly, have always had a very poor ratio,” Rocha says. “If historically in the health field there are few nurses, in the social health field we are practically alone. This pandemic has made that lack of healthcare visible and has wreaked havoc on residents,” she says. As of June 10, about <a title="Link a 20,000 residents" href="https://www.rtve.es/noticias/20200611/radiografia-del-coronavirus-residencias-ancianos-espana/2011609.shtml" target="_blank" rel="noopener noreferrer">20,000 residents <i class="fa fa-external-link"></i> </a>of Spanish nursing homes had died of COVID-19 or with its symptoms.</p></div>
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				<div class="et_pb_text_inner"><p>“There is an endemic lack of nurses,” says García, the Spanish nursing union spokesperson. Barbara Mangiacavalli, president of the National Federation of Nursing Professionals (<a title="Link a FNOPI" href="https://www.fnopi.it/en/" target="_blank" rel="noopener noreferrer">FNOPI <i class="fa fa-external-link"></i> </a>) says it is the same in Italy. The <a title="Link a Italian Court of Auditors" href="https://www.corteconti.it/Home/Organizzazione/UfficiCentraliRegionali/UffSezRiuniteSedeControllo/RappCoord/RappCoord2020" target="_blank" rel="noopener noreferrer">Italian Court of Auditors <i class="fa fa-external-link"></i> </a>wrote in a <a title="Link a recent report" href="https://www.corteconti.it/Download?id=f900afd4-5f07-4a4b-81a1-273e14a4456a" target="_blank" rel="noopener noreferrer">recent report <i class="fa fa-external-link"></i> </a>that lower public spending on Italian healthcare has led to fewer healthcare personnel working the country, especially nurses. Italy would need to add between 53,000 and 54,000 nurses to reach the European average proportion of nurses in the population, according to <a title="Link a FNOPI" href="https://www.fnopi.it/2018/09/17/la-carenza-di-infermieri-regione-per-regione-nel-ssn-fnopi-correre-ai-ripari/" target="_blank" rel="noopener noreferrer">FNOPI <i class="fa fa-external-link"></i> </a>. In Spain, the shortage is between 88,000 and 125,000 nurses, according to the Spanish nursing union, SATSE, and Madrid official college of nursing, CODEM. The OECD has also <a title="Link a highlighted" href="http://www.oecd.org/coronavirus/en/#policy-responses" target="_blank" rel="noopener noreferrer">highlighted <i class="fa fa-external-link"></i> </a>the nursing shortage in both countries.</p>
<p>“Historically, nurses have had very little visibility,” says Rocha, the spokesperson for the Madrid official college of nursing, which “translates into a lack of social recognition.” “Most people think of us as staff under the orders of doctors in hospitals and health centres, but that is not the case,” García says. Nurses lead patient care and are in direct contact with them on an ongoing basis, Rocha says. Their work during the COVID-19 pandemic has multiplied exponentially. “Beyond healthcare, our role was to never leave any patient alone,” Mangiacavalli says.</p></div>
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				<div class="et_pb_text_inner"><h3>Healthcare workers in the breach</h3>
<p>That explains why nurses, like other healthcare workers, had higher infection rates than the general population. In early April, the World Health Organization <a title="Link a warned" href="https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/statements/statement-older-people-are-at-highest-risk-from-covid-19,-but-all-must-act-to-prevent-community-spread" target="_blank" rel="noopener noreferrer">warned <i class="fa fa-external-link"></i> </a>that 10% of all infections in the European region were healthcare workers. Soon after, in late April, the European Centres for Disease Prevention and Control (ECDC) <a title="Link a published" href="https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-rapid-risk-assessment-coronavirus-disease-2019-ninth-update-23-april-2020.pdf" target="_blank" rel="noopener noreferrer">published <i class="fa fa-external-link"></i> </a>some revealing figures: 20% of people with COVID-19 in Spain were healthcare workers. In Italy the percentage was 10%, although in some of the most affected areas, such as Lombardy, the proportion of infected healthcare workers reached 20%.</p>
<p>Because healthcare workers are overwhelmingly women, women are suffering <a title="Link a higher rates" href="https://data.unwomen.org/resources/covid-19-emerging-gender-data-and-why-it-matters" target="_blank" rel="noopener noreferrer">higher rates <i class="fa fa-external-link"></i> </a>of COVID-19 than they otherwise would. At the beginning of June, <a title="Link a 70% of Italian healthcare workers" href="https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_3-giugno-2020.pdf" target="_blank" rel="noopener noreferrer">70% of Italian healthcare workers <i class="fa fa-external-link"></i> </a>with COVID-19, were women, the <a title="Link a Istituto Superiore di Sanità" href="https://www.epicentro.iss.it/en/coronavirus/sars-cov-2-gender-differences-importance-sex-disaggregated-data" target="_blank" rel="noopener noreferrer">Istituto Superiore di Sanità <i class="fa fa-external-link"></i> </a>reports. Similarly, <a title="Link a 76% of Spanish healthcare workers" href="https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/Documents/INFORMES/Informes%20COVID-19/COVID-19%20en%20personal%20sanitario%2029%20de%20mayo%20de%202020.pdf" target="_blank" rel="noopener noreferrer">76% of Spanish healthcare workers <i class="fa fa-external-link"></i> </a>with COVID-19 were women. But only 56% of the <a title="Link a general population" href="https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/Documents/INFORMES/Informes%20COVID-19/Informe%20n%C2%BA%2033.%20An%C3%A1lisis%20de%20los%20casos%20de%20COVID-19%20hasta%20el%2010%20de%20mayo%20en%20Espa%C3%B1a%20a%2029%20de%20mayo%20de%202020.pdf" target="_blank" rel="noopener noreferrer">general population <i class="fa fa-external-link"></i> </a>in Spain with COVID-19, were women. Why the difference? According to <a title="Link a Eurostat" href="https://ec.europa.eu/eurostat/web/products-eurostat-news/-/DDN-20200409-2" target="_blank" rel="noopener noreferrer">Eurostat <i class="fa fa-external-link"></i> </a>, 78% of all healthcare workers are women, and the ratio is even higher in nursing. “It has been a highly feminised profession since its origin,” Rocha says.</p>
<p>Policymakers have offered several explanations for the higher rate of infection among healthcare workers. In Spain, for example, the Health Ministry <a title="Link a attributed it" href="https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/ITCoronavirus.pdf" target="_blank" rel="noopener noreferrer">attributed it <i class="fa fa-external-link"></i> </a>to the higher diagnostic testing rates among healthcare workers, greater exposure to the virus at work and the initial ignorance about asymptomatic transmission. However, they do not mention the problem that professional organisations claim caused the infections: the lack of personal protective equipment.</p>
<p>“We are not heroes, we do not wear capes nor do we have superpowers. That is why we have the infection rate that we have,” García says. According to a recent study in Spain, during the first weeks of the epidemic, healthcare workers especially noted the lack of availability of filter masks, for example, to protect themselves, both in hospitals and in primary care. “I have never known a fireman who goes into a burning house without protection, but the governments asked nurses to go into the COVID units without any protection and to risk their lives. This is unacceptable,” says Paul De Raeve, secretary general of the European Federation of Nursing Associations (<a title="Link a EFN" href="http://www.efn.be/" target="_blank" rel="noopener noreferrer">EFN <i class="fa fa-external-link"></i> </a>).</p>
<p>As of <a title="Link a May 29" href="https://www.youtube.com/watch?v=k2Bfq-umUfU&amp;feature=youtu.be&amp;t=360" target="_blank" rel="noopener noreferrer">May 29 <i class="fa fa-external-link"></i> </a>, 51,482 Spanish healthcare professionals had been infected with coronavirus. The same thing happened in Italy. According to FNOPI data, some 13,000 Italian nurses were infected with COVID-19, <a title="Link a almost half" href="https://www.sanita24.ilsole24ore.com/art/dal-governo/2020-04-30/coronavirus-inail-piu-28mila-contagi-lavoro-45percento-infermieri-e-14percento-medici-093700.php?uuid=ADcmEdN" target="_blank" rel="noopener noreferrer">almost half <i class="fa fa-external-link"></i> </a>of the 30,000 healthcare workers infected in this country. “<a title="Link a Forty" href="https://www1.ordinemediciroma.it/newsletter-dire/25808-speranza-riunisce-consulta-professioni-fnomceo-grazie-a-ministro-riconosciuto-valore-operatori.html" target="_blank" rel="noopener noreferrer">Forty <i class="fa fa-external-link"></i> </a>died of COVID-19, and this despite the fact that the nursing population is young enough to better withstand the effects of the virus,” says Mangiacavalli, the Italian nursing association president. But what happened with COVID-19, as de Raeve says, is nothing new.</p>
<p>When Ebola first came to Europe in 2014, a health worker <a title="Link a caught" href="https://www.rtve.es/alacarta/videos/telediario/telediario-21-horas-21-10-14/2821636/?t=00h00m28s" target="_blank" rel="noopener noreferrer">caught <i class="fa fa-external-link"></i> </a>the dangerous virus in a Madrid hospital. Back then, healthcare professional associations and unions focused on the need for personal protective equipment. “Nobody paid any attention,” de Raeve recalls. Now, the International Council of Nursing (<a title="Link a ICN" href="https://www.icn.ch/" target="_blank" rel="noopener noreferrer">ICN <i class="fa fa-external-link"></i> </a>), calls the situation a “global emergency.” As of May 18, according to an <a title="Link a ICN letter" href="https://www.icn.ch/sites/default/files/inline-files/WHA73%20COVID-19%20ICN%20statement_0.pdf" target="_blank" rel="noopener noreferrer">ICN letter <i class="fa fa-external-link"></i> </a>to the World Health Organization, at least 360 nurses worldwide had died of COVID-19. However, many countries, including Spain, do not break down data by professional categories, so this figure could just be the tip of the iceberg. “We need to make sure that we take care of those who care for us,” de Raeve says.</p></div>
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				<div class="et_pb_text_inner"><h3>The invisible footprint</h3>
<p>The impact of COVID-19 worldwide has been and will continue to be enormous. But for frontline staff, it may be even greater. The emotional overload and the feeling of lack of protection soon added to the enormous amount of pandemic-related work. Garcia says, “You go to work afraid of infecting your family, of becoming a vector for the disease.”</p>
<p>“When you have thirty years of professional experience, many people have died throughout your life and you get used to it. But you know how to deal with it because it only happens from time to time,” García adds. But COVID-19 crisis became an unmanageable nightmare overnight. Patients died almost continuously, in most cases alone and far from their families. “We are continually exposed to people’s pain and illness, but this crisis has been an emotional and psychological tsunami,” Rocha says. In fact, <a title="Link a preliminary research" href="https://www.agenciasinc.es/Noticias/El-80-de-los-sanitarios-tiene-sintomas-de-ansiedad-por-su-trabajo-ante-la-COVID-19" target="_blank" rel="noopener noreferrer">preliminary research <i class="fa fa-external-link"></i> </a> from the Complutense University of Madrid shows how almost 80% of the healthcare workers interviewed had symptoms of anxiety and 51% suffered signs related to depression. Rocha and García both told Civio of endless hours of work, of hundreds of patients to look after, of the urgency and of the distressing number of dead they saw every day. Despite the physical and mental fatigue, their commitment was unequivocal: “Never leave anyone alone,” Mangiacavalli says.</p>
<p>For De Raeve, that mission and the will to complete it reflects the commitment of the nursing profesion, which is commemorating <a title="Link a its international year" href="https://www.who.int/campaigns/year-of-the-nurse-and-the-midwife-2020" target="_blank" rel="noopener noreferrer">its international year <i class="fa fa-external-link"></i> </a> in 2020. Few imagined at the start of this year that it would take place in the midst of a global pandemic that would shine a light on the value of nursing. Yet nurses suffer high levels of job insecurity, he says: in Spain, work contracts sometimes last just weeks or even days. In Italy, salaries are far below the European average. According to De Raeve, these conditions exist despite the high academic level of southern European nurses. In Portugal and Spain, there is a high training standard, so “you have a good and strong workforce and that is key,” he says. In contrast, Germany, which has more nurses, requires fewer qualifications of its nurses.</p>
<p>These differences may also explain why many southern European nurses packed their bags years ago to work in other regions. According to data published in the <a title="Link a United Kingdom" href="https://commonslibrary.parliament.uk/research-briefings/cbp-7783/?doing_wp_cron=1591630374.1319429874420166015625" target="_blank" rel="noopener noreferrer">United Kingdom <i class="fa fa-external-link"></i> </a>, almost 6% of the nurses in its national health system, some 19,325 nurses, come from other European countries. 60% of those come from Ireland, Portugal, Spain and Italy. The SATSE union points out that, according to estimates from years ago, more than 5,000 Spanish nurses may have gone to work in other regions, while, in the case of Italy, FNOPI estimates the number may be 20,000. Nurses now face the fear of outbreaks and the return of the virus. “A resurgence would be much worse. There is so much physical and mental exhaustion that we could not give the same effort no matter how much we wanted to,” García says.</p>
<p>For now, nurses remain in the breach, carrying out their usual duties and, in many regions, also taking charge of taking samples for testing or contact tracing, says Rocha, the CODEM spokesperson. Meanwhile, they are asking to work with more protection, better working conditions and the support of psychology specialists who can help them and other health workers to recover physically and emotionally from what happened. “Since we have had this unfortunate situation, we ask that it not be forgotten and that we succeed in getting a strengthened healthcare system that revolves around the needs of patients,” García says. That would convert the eight o’ clock applause into a new bulwark against future pandemics.</p></div>
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<h4><strong>Methodology</strong></h4>
<p>Doctors and nurses per capita data are from <a title="Link a Eurostat" href="https://ec.europa.eu/eurostat/web/health/data/database" target="_blank" rel="noopener noreferrer">Eurostat <i class="fa fa-external-link"></i> </a>: in most cases, the figures are from 2017, although in Belgium, Denmark and Sweden, the numbers go back to 2016, and in Finland to 2014. In all cases, we compared the categories of <a title="Link a practicing doctors" href="https://ec.europa.eu/eurostat/databrowser/view/tps00044/default/table?lang=en" target="_blank" rel="noopener noreferrer">practicing doctors <i class="fa fa-external-link"></i> </a>and <a title="Link a practicing nurses" href="https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_rs_prsns&amp;lang=en" target="_blank" rel="noopener noreferrer">practicing nurses <i class="fa fa-external-link"></i> </a>in each country.</p>
<p>In some countries, the figures for <a title="Link a practicing nurses" href="https://ec.europa.eu/eurostat/cache/metadata/Annexes/hlth_res_esms_an3.pdf" target="_blank" rel="noopener noreferrer">practicing nurses <i class="fa fa-external-link"></i> </a>are overestimated: Austria and Latvia include nursing assistants, while Cyprus and Spain count midwives. Despite the fact midwives in <a title="Link a Cyprus" href="https://www.moh.gov.cy/moh/moh.nsf/page24_en/page24_en?OpenDocument" target="_blank" rel="noopener noreferrer">Cyprus <i class="fa fa-external-link"></i> </a>and <a title="Link a Spain" href="https://www.boe.es/buscar/act.php?id=BOE-A-2005-7354#boen" target="_blank" rel="noopener noreferrer">Spain <i class="fa fa-external-link"></i> </a>earn nursing degrees before specialising in obstetric and gynaecological care, the vast majority of European countries <a title="Link a publish separate figures" href="https://ec.europa.eu/eurostat/cache/metadata/Annexes/hlth_res_esms_an3.pdf" target="_blank" rel="noopener noreferrer">publish separate figures <i class="fa fa-external-link"></i> </a>for midwives. Other countries could be reporting artificially low figures. For example, Czechia and Hungary do not count nurses working in care homes, Estonia does not include nurses specialised in radiology, Malta does not count self-employed nurses, Poland does not include prison nurses and the UK only reports public sector data.</p>
<p>In the case of <a title="Link a doctors" href="https://ec.europa.eu/eurostat/cache/metadata/Annexes/hlth_res_esms_an1.pdf" target="_blank" rel="noopener noreferrer">doctors <i class="fa fa-external-link"></i> </a>, some countries exclude certain specialities. Luxembourg, for example, excludes haematologists, microbiologists and pathologists, Germany excludes maxillofacial surgeons and Belgium excludes internal medicine doctors.</p>
<p>In addition, Italy estimates the number of practicing nurses using the register of professionals who have completed mandatory recurrent training in recent years. Finland’s estimate is based on a survey conducted in 2014 so their data may no longer be accurate. Finally, we have not included <a title="Link a France" href="http://www.data.drees.sante.gouv.fr/TableViewer/tableView.aspx?ReportId=3704" target="_blank" rel="noopener noreferrer">France <i class="fa fa-external-link"></i> </a>, <a title="Link a Portugal" href="https://www.ine.pt/xportal/xmain?xpid=INE&amp;xpgid=ine_publicacoes&amp;PUBLICACOESpub_boui=257793024&amp;PUBLICACOESmodo=2" target="_blank" rel="noopener noreferrer">Portugal <i class="fa fa-external-link"></i> </a>, <a title="Link a Ireland" href="https://assets.gov.ie/9441/e5c5417ee4c544b384c262f99da77122.pdf" target="_blank" rel="noopener noreferrer">Ireland <i class="fa fa-external-link"></i> </a>and <a title="Link a Slovakia" href="http://www.nczisk.sk/Documents/rocenky/2018/Zdravotnicka_rocenka_Slovenskej_republiky_2018_en.pdf" target="_blank" rel="noopener noreferrer">Slovakia <i class="fa fa-external-link"></i> </a>since they do not publish their updated figures in Eurostat and the numbers that they report at national level and to the OECD do not correspond to the OECD category of practicing professionals, for <a title="Link a doctors" href="https://data.oecd.org/healthres/doctors.htm" target="_blank" rel="noopener noreferrer">doctors <i class="fa fa-external-link"></i> </a>and <a title="Link a nurses" href="https://data.oecd.org/healthres/nurses.htm#indicator-chart" target="_blank" rel="noopener noreferrer">nurses <i class="fa fa-external-link"></i> </a>. We have also decided to exclude Romania, given that its numbers for nurses include workers such as laboratory assistants and forensic assistants, among others.</p>
<p>To calculate the ratio of nurses to doctors, we used the total <a title="Link a doctors" href="https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_rs_prs1&amp;lang=en" target="_blank" rel="noopener noreferrer">doctors <i class="fa fa-external-link"></i> </a>and <a title="Link a nurses" href="https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_rs_prsns&amp;lang=en" target="_blank" rel="noopener noreferrer">nurses <i class="fa fa-external-link"></i> </a>by country data published by Eurostat, not the per capita figures. We did not include Greece and the Czechia in the ratio calculation since their medical personnel data are inconsistent.</p>
<p>&nbsp;</p>
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<div class="source">Original Source: <a title="apri il link in una pagina esterna (si lascerà il sito)" href="https://civio.es/medicamentalia/2020/06/23/coronavirus-covid-19-espana-italia-enfermeria/#nota-collapse-1" target="_blank" rel="noopener noreferrer">https://civio.es/medicamentalia/2020/06/23/coronavirus-covid-19-espana-italia-enfermeria/#nota-collapse-1</a></div>
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<div>Credit: CIVIO | <a href="https://www.europeandatajournalism.eu/eng/News/Data-news/COVID-19-pandemic-exposes-southern-Europe-s-nursing-shortage">European Data Journalism Network, 6/2020</a></div>
<div>Licence: <a href="https://creativecommons.org/licenses/by/4.0/">CC BY 4.0</a></div></div>
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<p>The post <a href="https://miir.gr/en/covid-19-pandemic-exposes-southern-europe-s-nursing-shortage/">COVID-19 pandemic exposes southern Europe’s nursing shortage</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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		<title>Undress or fail: Instagram&#8217;s algorithm strong-arms users into showing skin</title>
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		<dc:creator><![CDATA[ilias]]></dc:creator>
		<pubDate>Wed, 04 Nov 2020 17:41:18 +0000</pubDate>
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					<description><![CDATA[<p>The post <a href="https://miir.gr/en/undress-or-fail-instagram-s-algorithm-strong-arms-users-into-showing-skin/">Undress or fail: Instagram&#8217;s algorithm strong-arms users into showing skin</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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				<div class="et_pb_text_inner"><h3>An exclusive investigation reveals that Instagram prioritizes photos of scantily-clad men and women, shaping the behavior of content creators and the worldview of 140 millions Europeans in what remains a blind spot of EU regulations.</h3></div>
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Sarah is a food entrepreneur in a large European city (the name was changed). The company she created helps women feel at ease with their food intake and advocates “intuitive eating”. Like many small-business owners, Sarah relies on social media to attract clients. Instagram, Europe’s second-largest social network after Facebook, is a marketing channel she could not do without, she said.</p>
<p>But on Instagram, which is heavily oriented towards photos and videos, she felt that her pictures did not reach many of her 53,000 followers unless she posed in swimwear. Indeed, four of her seven most-liked posts of the last few months showed her in a bikini. Ely Killeuse, a book author with 132,000 followers on Instagram who agreed to speak on the record, said that “almost all” of her most liked pictures showed her in underwear or bathing suits.</p>
<p>It could be the case that their audiences massively prefer to see Sarah and Ely in bathing suits. But since early 2016, Instagram arranges the pictures in a user’s newsfeed so that the photos a user “cares about most will appear towards the top of the feed”. If the other pictures Sarah and Ely post are less popular, it could be that they are not shown to their followers as much.</p>
<p>Which photos are shown and which are not is not just a matter of taste. Entrepreneurs who rely on Instagram to acquire clients must adopt the norms the service encourages to reach their followers. Even if these norms do not reflect the values they built their businesses on, or those of their core audience and clients.</p></div>
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				<div class="et_pb_text_inner"><h3>2,400 photos analyzed</h3>
<p>To understand what pictures Instagram prioritized, the European Data Journalism Network and AlgorithmWatch asked 26 volunteers to install a browser add-on and follow a selection of professional content creators. We selected 37 professionals from 12 countries (14 of them men) who use Instagram to advertise brands or to acquire new clients for their businesses, mostly in the food, travel, fitness, fashion or beauty sectors.</p>
<p>The add-on automatically opens the Instagram homepage at regular intervals and notes which posts appear on top of the volunteers’ newsfeeds, providing an overview of what the platforms considers most relevant to each volunteer.</p>
<p>If Instagram were not mingling with the algorithm, the diversity of posts in the newsfeed of users should match the diversity of the posts by the content creators they follow. And if Instagram personalized the newsfeed of each user according to their personal tastes, the diversity of posts in their newsfeeds should be skewed in a different way for each user. This is not what we found.</p>
<p>Between February and May, 1,737 posts published by the content creators we monitor, containing 2,400 photos, were analyzed. Of these posts, 362, or 21%, were recognized by a computer program as containing pictures showing women in bikinis or underwear, or bare chested men. In the newsfeeds of our volunteers, however, posts with such pictures made up 30% of all posts shown from the same accounts (some posts were shown more than once).</p></div>
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				<div class="et_pb_text_inner"><p>Posts that contained pictures of women in undergarment or bikini were 54% more likely to appear in the newsfeed of our volunteers. Posts containing pictures of bare chested men were 28% more likely to be shown. By contrast, posts showing pictures of food or landscape were about 60% less likely to be shown in the newsfeed.</p>
<p>These results, which can be read in detail <a title="Link a on a dedicated page" href="https://docs.google.com/document/d/1L7A5hmskm3Y3huSXHNtIIoiVijHD3dkDqubff4Yvkg8/edit" target="_blank" rel="noopener noreferrer">on a dedicated page <i class="fa fa-external-link"></i> </a>, pass standard tests of statistical significance.</p></div>
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<p>The skew towards nudity might not apply to all Instagram users. While it was consistent and apparent for most volunteers, a small minority were served posts that better reflected the diversity published by content creators. It is likely that Instagram’s algorithm favors nudity in general, but that personalization, or other factors, limits this effect for some users.</p>
<p>Our results fall short of a comprehensive audit of Instagram’s newsfeed algorithm. They only document what happened in the newsfeeds of our volunteers. (You can help us improve the results by <a title="Link a installing the add-on" href="https://algorithmwatch.org/en/instagram-algorithm/" target="_blank" rel="noopener noreferrer">installing the add-on <i class="fa fa-external-link"></i> </a>, we will publish updates as more data comes in.) Without access to Facebook’s internal data and production servers, it will always be impossible to draw definitive conclusions.</p>
<p>Facebook did not answer our precise questions but sent a statement: “This research is flawed in a number of ways and shows a misunderstanding of how Instagram works. We rank posts in your feed based on content and accounts you have shown an interest in, not on arbitrary factors like the presence of swimwear.”</p>
<p>We nevertheless have reasons to believe that our findings are representative of how Instagram generally operates.</p></div>
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<p>In a <a title="Link a patent" href="http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&amp;Sect2=HITOFF&amp;p=1&amp;u=/netahtml/PTO/srchnum.html&amp;r=1&amp;f=G&amp;l=50&amp;d=PALL&amp;s1=8929615.PN." target="_blank" rel="noopener noreferrer">patent <i class="fa fa-external-link"></i> </a>published in 2015, engineers at Facebook, the company that runs Instagram, explained how the newsfeed could select which pictures to prioritize. When a user posts a picture, it is analyzed automatically on the spot, according to the patent. Pictures are given an “engagement metric”, which is used to decide whether or not to show an image in the user’s newsfeed.</p>
<p>The engagement metric is partly based on past user behavior. If a user liked a specific brand and a photo shows a product of the same brand, the engagement metric increases. But the engagement metric can also be computed based on past behavior from all users of the service. The patent specifically states that the gender, ethnicity and “state of undress” of people in a photo could be used to compute the engagement metric.</p>
<p>While Instagram claims that the newsfeed is organized according to what a given user “cares about most”, the company’s patent explains that it could actually be ranked according to what it thinks all users care about. Whether or not users see the pictures posted by the accounts they follow depends not only on their past behavior, but also on what Instagram believes is most engaging for other users of the platform.</p></div>
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<p>Facebook automatically analyzes pictures with a software, known as computer vision, before its algorithm decides which ones to show in a user’s newsfeed. Such software draws automated inferences from a training data set, made of thousands of manually annotated images. Its limitations could impact how Instagram prioritizes pictures in newsfeeds.</p>
<p>Computer scientists have known for years that such systems replicate and amplify the biases of their training data, leading to spurious, or fallacious, correlations. For instance, a program tasked with identifying wolves and dogs based on pictures of the canines found online will not recognize the animals in the human sense of the word. Instead, it will give the label “wolf” to any animal on a snowy background.</p>
<p>Training data for computer vision is usually produced by poorly-paid workers with an incentive to work quickly and provide results that fit the expectations of their employers. This leads them to uncritically adopt the categories offered to them and to overlook the subtleties a photo might contain, wrote Agathe Balayn, a PhD candidate at the Delft University of Technology on the topic of bias in automated systems.</p>
<p>The consequences can be severe. In December, a Brazilian artist tried to advertise one of his Instagram posts. The request was denied on the grounds that the post contained violent content. It only depicted a boy and Formula One racer Lewis Hamilton. Both were dark-skinned. In April, a yoga teacher was denied an advertisement on the ground that the picture showed profanity, even though she was only doing the side crane pose. She is Asian-American.</p>
<p>(In our experimental setup, we also used a computer vision system, Google Vision. While its results are egregious – the label “beauty”, for instance, was only returned for females – it is very likely that its biases are similar to Facebook’s computer vision engine, were it only because it was built in part by the same people.)</p></div>
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				<div class="et_pb_text_inner"><h3>A fine line to thread</h3>
<p>Instagram’s guidelines state that nudity is “not allowed” on the service, but favors posts that show skin. The subtle difference between what is encouraged and what is forbidden is decided by unaudited, and likely biased, computer vision algorithms. Every time they post a picture, content creators must thread this very fine line between revealing enough to reach their followers but not revealing so much that they get booted off the platform.</p>
<p>A 2019 <a title="Link a survey" href="https://saltyworld.net/algorithmicbiasreport-2/" target="_blank" rel="noopener noreferrer">survey <i class="fa fa-external-link"></i> </a>of 128 Instagram users by the US magazine Salty showed that abusive removal of content was common. Just how common such occurrences are, and whether People of Color and women are disproportionately affected, is impossible to say as long as Instagram’s algorithms remain unaudited. </p>
<p>However, a review of 238 patents filed by Facebook containing the phrase “computer vision” showed that, out of 340 persons listed as inventors, only 27 were female. Male-dominated environments usually lead to outcomes that are detrimental to women. Seat-belts in cars, for instance, are only tested on male dummies, leading to higher rates of injuries for women. Our research shows that Facebook’s algorithms could follow this pattern.</p></div>
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<p>Sarah and other entrepreneurs who rely on Instagram were terrified to speak to the press. Most professional Instagram content creators fear retaliation from Facebook, in the form of account deletion or shadow-bans (a practice where a user’s posts are shown to none or very few of their followers, without the user’s knowledge) – a death sentence for their business.</p>
<p>A young entrepreneur with about 70,000 followers, who said that Instagram was “very important” for her business, specifically told AlgorithmWatch that she did not want to be named for fear of a shadow-ban. Ely Killeuse, who talked on the record, said that having another source of income was the “number one condition” for her. Too much dependence on Instagram would mean losing her freedom and her sanity, she added. </p>
<p>The General Data Protection Regulation (GDPR), which came into force in 2018, and the Platforms to Business (P2B) regulation, which will be applicable from 12 July 2020, already provide many guarantees for users and professionals. In particular, GDPR states that users have a “right to explanation” regarding automated decisions, and the P2B regulation shall force online intermediation services to disclose the “main parameters determining [algorithmic] ranking”.</p>
<p>This new measure should not force platforms to disclose the inner workings of their algorithms, according to Petra de Sutter, who chairs the Committee on the Internal Market and Consumer Protection at the European Parliament. Preventing Instagram from sorting its users’ newsfeeds would not be legally feasible, she wrote in an email to AlgorithmWatch. Instead, the transparency P2B will bring should allow for well-informed policy decisions at a later point, she added. As for fears of shadow-bans, Ms de Sutter considers them overblown. “A question never brought retaliation”, she wrote. </p>
<p>P2B might be different, but two years after GDPR came into force, several experts deplore a very lacunary implementation. One problem is that the Irish data protection authority, who is responsible for regulating Facebook’s Dublin-based European subsidiary, appears to be woefully understaffed and “does not seem to understand GDPR”, as a specialist in platform work put it to AlgorithmWatch. Another issue lies in the lack of policing. No authority, at the European level or within Member States, has the power or the tools needed to audit any of the giant platforms, including Instagram, leaving many of GDPR’s provisions unenforced.</p></div>
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<p>While our results show that male and female content creators are forced to show skin in similar ways if they want to reach their audience, the effect could be larger for females, and be considered a discrimination of female entrepreneurs. However, although discrimination based on gender is prohibited by the Charter of Fundamental Rights of the European Union, no legal avenues exist for an Instagram user to start legal proceedings. The specifics of social media entrepreneurship are not taken into account in legislation.</p>
<p>Miriam Kullmann, an assistant professor at WU Vienna University of Economics and Business, wrote to AlgorithmWatch that European anti-discrimination legislation deals almost exclusively with employment relationships. Self-employed persons, such as the professionals we monitored, are not protected.</p>
<p>Some groups do fight for the rights of independent creators on social media. IG Metall, Europe’s largest union, supports a collective action of YouTubers, demanding more fairness and transparency from Google (which owns YouTube) when a video was demonetized. They do not plan to extend their program to content creators on Instagram or other platforms.</p></div>
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<p>With the number of European entrepreneurs creating content from Instagram likely ranging in the thousands, the impact of their posts is massive, as they routinely boast hundreds of thousands of followers. Facebook claims that close to 140 million residents of the European Union, or one in three, used Instagram in April. </p>
<p>Among the 18-to-24-year-olds, Instagram penetration is about 100% in every EU country. The stay-at-home orders linked to the Covid-19 pandemic increased the time spent on Instagram by staggering amounts. In one week in locked-down Italy, Instagram views doubled over normal, Facebook reported to investors.</p></div>
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<h3>A roll of one’s own</h3>
<p>Almost a century ago, famed British author Virginia Woolf said that women needed “a room of one’s own” to allow for their creativity to flourish. Deferring to the opinion of external authorities, she wrote, was like inviting rot to develop at the heart of one’s work.</p>
<p>On Instagram, deferring to the opinion of the authorities that built the newsfeed algorithm is not a choice. Refusing to show body parts dramatically curtails one’s audience. Male and female entrepreneurs must abide by the rules set by Facebook’s engineers if they want to stand a chance of making a living.</p>
<p><em>This investigation was the result of a collaboration between EDJNet and Algorithm Watch, coordinated by Nicolas Kayser-Bril.</em></p>
<p> </p>
<p>Original Source: <a title="apri il link in una pagina esterna (si lascerà il sito)" href="https://algorithmwatch.org/en/story/instagram-algorithm-nudity/" target="_blank" rel="noopener noreferrer">https://algorithmwatch.org/en/story/instagram-algorithm-nudity/</a></p>
<p>Credit: Algorithm Watch | EDJN</p>
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<div>Licence: <a href="https://creativecommons.org/licenses/by/4.0/">CC BY 4.0</a></div>
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						<h4 class="et_pb_module_header"><span>Get in touch</span></h4>
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<h3 class="panel-title"><span style="color: #666666; font-size: 14px;">Do you use Instagram professionally? Have you seen your posts or your account suspended, disabled or shadow-banned? We’d love to hear from you. Contact Nicolas Kayser-Bril securely at </span><a style="font-size: 14px;" title="Link a kayserbril@protonmail.com" href="mailto:kayserbril@protonmail.com">kayserbril@protonmail.com</a><span style="color: #666666; font-size: 14px;"> or Signal +491702875332.</span></h3>
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<p>The post <a href="https://miir.gr/en/undress-or-fail-instagram-s-algorithm-strong-arms-users-into-showing-skin/">Undress or fail: Instagram&#8217;s algorithm strong-arms users into showing skin</a> appeared first on <a href="https://miir.gr/en/">MIIR</a>.</p>
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