While the question of whether cities can change the world feeds passionate debates and initiatives around the world, the challenge for Greece’s capital city is rather less ambitious. How can Athens cope with the social impact of the economic crisis in a sustainable way? Indeed, this is a crucial question when one bears in mind the severity of the crisis, on the one hand, and, on the other, the metropolitan size of Athens, which gathers approximately 660,000 registered residents. The fact is that Athens, Greece’s administrative and economic center, has symmetrically suffered from the socioeconomic decline. All these happen in a country where, admittedly, family solidarity can smoothen the crisis’ social impact in rural areas, but not so much in big urban centers, like Athens.
How did austerity lead to an outburst of poverty and extreme poverty in Athens? And how does the City of Athens respond to the constantly increasing needs created by the crisis? This note attempts to address these questions by focusing in particular on three (the list here not being exhaustive) areas of social policy, namely food aid, primary health care and housing. The note also discusses social policy engineering and how could the experience of the economic crisis impact on the protection of social rights.
I am dealing with these questions based on policy at the local level and my analysis is informed by statistical and empirical data that I acquired from the Social Services Department and the City of Athens Solidarity Center. I am thankful to these institutions. Finally, the usual disclaimer applies: the opinions expressed in this note are exclusively mine and shall not be attributed to the City of Athens.
From Austerity to Recession and Poverty – Impact on Athens
The Greek crisis officially began in 2009, when the newly elected government announced that earlier fiscal data was inaccurate, raising considerably the 2009 deficit and debt figures. Yet, the socioeconomic impact of the crisis was not apparent until 2010, when the first programme of austerity measures -being followed by two more similar programmes- started. The implementation of the first two memoranda (as they are called) included VAT and personal income tax increases, emergency taxes, along with severe cuts in public sector pays, pensions, minimum wage and other social benefits.
These austerity measures brought an unprecedented recession. Cuts in the income of civil servants and pensioners led to lower demand for goods and services provided by private firms, many of which went bankrupt or relocated. As a result, private sector wages and self-employment earnings declined, while unemployment rose sharply from 9,5%, in 2009, to 27,3%, in 2013 –with a sad record of 58,3% in youth unemployment. This recession spiral, together with the fact that market prices did not fully adjust to wage cuts and the rise of unemployment, resulted in a very big number of people facing poverty and extreme poverty. These are the two groups I discuss here as the core beneficiaries of food, health and housing services.
Regarding poverty, the picture changes depending on the indicator used. The first indicator is that of relative poverty. This concerns the proportion of the population with an income lower than 60% of the median disposable income. According to this indicator, the poverty rate appears to have risen moderately from 20%, in 2009, to 23%, in 2013. However -and this is particularly useful in times of rapid change in living conditions- there is a second indicator that raises poverty to 60% -increasing, accordingly, considerably the population considered to be poor. That indicator relies on a comparison between median income in 2013 and 2009. Poor are those whose income dropped below 60% of the median disposable income they had before the criris. According to that second indicator, poverty rates have drastically increased from 20%, in 2009, to 44,3%, in 2013.
Among the population affected by poverty there is a particular group of people who suffer from extreme poverty, that is, people who are deprived of access to a basic set of goods that are deemed necessary to live in dignity. This percentage has been constantly rising from 2,2%, in 2009, to 14%, that is, to approximately 1,500,000 individuals, in 2013.
In Athens, the increase in poverty rates follows the national trend with a raise from 16%, in 2009, to 40,4%, in 2013. On the contrary, extreme poverty rates, which where already significantly high in 2009 (16,5%, that is, 8 times the national average) increased further to 20,6%, in 2013, leaving far behind the equivalent rate in other cities and rural regions. To put it plainly, approximately 268,000 residents of Athens live below the poverty line, half of them lacking the basic means for dissent living, such as appropriate housing, sufficient clothing and/or medicine.
Unemployed are the mostly affected ones. This clearly associates unemployment with the rise in poverty and extreme poverty. Families with children, private sector employees and students are also substantially affected. In urban environment, one may also add that the crisis mostly affects young households. These are among the several target groups of the action taken by the City of Athens to tackle hunger, absence of medical care and homelessness.
Food Aid, Health Services and Housing: A Brief Overview
A. Food aid
Hunger is one of the toughest aspects of the economic crisis, affecting those who live in extreme poverty and most of those who live in poverty (in a situation between malnutrition and hunger). The City of Athens provides on daily basis hot meals and other basics (i.e. groceries) to 20,000 individuals.
In more detail:
· The Solidarity Center -acting in co-operation with the orthodox church- offers a soup meal –access is free from administrative proof burdens.
· Families are supported through the Social Grocery and the Solidarity for Families programmes, which provide free food, personal hygiene products, but also psychological support. Both programs are sponsored by the private sector, under corporations’ social responsibility budget.
· Families and individuals receive food supplies, clothing and personal hygiene products at the “Solidarity Garrison” building, which operates thanks to donations by corporations and other individuals.
· At the same building runs the EEA Grants program too, which provides food vouchers to 3,600 households, covering over 8,700 individuals.
· Last, but certainly not least, 5,500 meals are prepared by the Municipal Nursery for children up to 5 years old at municipal nurseries.
B. Primary Health Care
According to the Centre for Health Management and Evaluation at the University of Athens, overall, public health expenditure in Greece fell from €16.1 billion, in 2009, to €12.4 billion, in 2012. Moreover, the public health system became increasingly inaccessible, in particular for poorer citizens and marginalized groups. This owes to increased fees, to the participation of patients to healthcare costs, to the closure of hospitals and health care centres, but also to the fact that more and more people are losing public health insurance cover, mainly because of their unemployment status.
In such an environment, it is obvious why the network of 6 Municipal Health Centres (a 7th one being under reconstruction) is of crucial importance. It provides free primary healthcare to those in need, including uninsured, unregistered migrants and other vulnerable social groups. Medical staff is authorised to subscribe drugs that are accessible for free (among other places) at the Social Pharmacy. The later runs thanks to private sponsorships (both corporate and non-corporate). Approximately 1000 people benefit from these services yearly.
From 2009 to 2013, there has been an estimated 25% increase in the country’s homeless population. Their total number is estimated to be at least 20,000, 15,000 of which are living in Attica. This 25% increase includes new homeless people. According to reports by NGOs' street workers, in the past, most of the homeless people they approached were single, most of which with addiction problems and/or mental health issues. The profile of a “new” homeless person is that s/he has higher qualifications and work experience. S/he often has a family, the sole reason why s/he is homeless being housing costs. More importantly, by living in the streets without support, “new” homeless rapidly grow addiction and/or mental health issues.
In view of this experience, the City of Athens provides two forms of provisional housing:
· Shelter accommodation: Five shelters of a total capacity of 275 beds are accommodating mostly vulnerable groups, providing them with psychological and medical support by specialised staff. Three of these shelters offer short-term accommodation and the other two specialise in elder people and domestic violence victims.
Through participation at the Ministry of Labour’s “Housing and Reintegration” programme, the City of Athens contributes annually to the rent costs and (partially) to salary/wage income, while providing psychological support and full counselling on professional reintegration to 38 families who have been hosted in our shelters. This helps beneficiaries to make a decisive step towards social reintegration.
· The “Social Housing Network”: This project targets preventively the so-called ‘new homeless’, that is, families facing an imminent risk of eviction or living under inadequate conditions (water supply, electricity and/or heating). It is an innovative program aiming to provide short-term accommodation and support to families through charge-free, specialised and personalised assistance. It helps them avoid social exclusion and reintegrate within 6 to 12 months. Since the beginning of the program in 2013, 2 social buildings along with 10 social apartments are covering the needs of 32 families/111 individuals.
After 5 Years of Crisis: Social Policy and Rights Empowerment
It is a sad but undeniable fact that the crisis will have long-term effects. This is why all the above-mentioned social support projects converge in one capital necessity: transforming the municipal social policies that were designed to address what was initially seen as an emergency situation (i.e. the economic crisis) into a stable and viable, long-term strategy for social protection. I argue that such a strategy shall include at least 4 key elements:
1.Deepening local synergies with private businesses and NGOs as a means to replace the weak welfare state. The use of corporate responsibility budget (CSR) has proven to be a precious tool that allows the involvement of the private sector in the areas of food provision and housing. Simplifying the administrative procedure for private donations, as well as adequately communicating them will facilitate synergies with corporations. Working with NGOs is valuable both for implementing programmes in food and housing and because of their street work teams who direct homeless people to food, health and housing units.
2.Interconnecting food, health and housing networks and making them more visible through a bottom-up specialised approach. To explain that point, let me please give an example: Yannis and Maria are unemployed, parents of three underage children and unable to pay their rent for the past 5 months. They should be informed that their family can move to one of the Social Housing Network’s apartments, that they can weekly shop from the Social Grocery, receive clothing and personal hygiene products from the Solidarity Centre, and that their elder child can be examined for bronchitis in one of the municipal Medical Centres and receive, if need be, free drugs from the Social Pharmacy. Targeting possible beneficiaries requires the full digitalisation of the social services databases and their interconnection so that every single case can be monitored and followed up from first registration to any kind of municipal support programme.
3.Securing “before” and “after” to avoid further regression and prevent institutionalisation. To break the vicious circle/chain of people who fall into poverty and then extreme poverty, prevention is required. A good example to give is that of applicants who fulfil the eligibility criteria but who cannot benefit from the social housing network because of the lack of available apartments. A successful social policy should aim at helping and preparing people who benefit from welfare benefits to stop depend on support. This requires a step-by-step approach that will be adapted to the specific needs of each target group and -ultimately but necessarily- will also include professional reintegration support. These policies are the responsibility/competence of the central state (i.e. a ministerial responsibility). Yet, donations by corporations might enable local governance/administration to be proactively engaged.
While Yannis and Maria wait for a social apartment to empty, they should receive food, psychological and medical support by professionals who can help them become again autonomous and step out of the waiting line for free shelter. If they are sheltered, realistic professional training programs that will be designed with a practical focus will enable Maria to look for an accountant job and Yannis to start his Social Co-operative Enterprise in building maintenance –hopefully getting his first contract from the City of Athens itself.
4.Enhancing the involvement of local stakeholders in law-making and decision-making. I firmly believe that access to a threefold social safety net that will include food, primary medical care and housing, should be guaranteed as a law enforceable social right that will reflect the minimum content of human dignity in times of crisis. Beneficiaries would be those living under extreme poverty, including undocumented migrants. Such a right would be a remedy to recent legislation that excludes undocumented migrants from the official definition of homelessness. Should such a social right be actionable and legally enforceable? This is probably the toughest question to answer. I am of the opinion that, should such a justiciable right be carefully designed, it could provide clear legal status for those affected by extreme poverty, empower their registration and follow-up action, and enhance local accountability. On the other hand, at least two concerns should be addressed regarding the feasibility of such a legal entitlement. First, justice delays rendering judicial protection of the kind ineffective. The establishment of alternative dispute resolution procedures could remedy that problem. Second, the absence of the necessary political will. This is probably the toughest problem. Overall, Greek governments have shown a rather poor record regarding (the justiciability of) socioeconomic rights, with the recent inaction concerning the signature and ratification by Greece of the 2013 Optional Protocol to the UN International Covenant on Economic, Social and Cultural Rights being quite telling.
V.Arapoglou, K.Gounis, “Poverty and Homelessness in Athens: Governance and the Rise of an Emergency Model of Social Crisis Management”, Hellenic Observatory European Institute, GreeSE Paper no 90, 2015, available at http://eprints.lse.ac.uk/61319/
D.Katsikas, A.Karakitsios, K.Filinis, A.Petralias, “Social Profile Report on Poverty and Social Exclusion and Inequality before and after the Crisis in Greece”, ELIAMEP Fragmex Report, 2014, available at http://crisisobs.gr/
FIDH, “Downgrading Rights: The Cost of Austerity in Greece”, 2014, available at http://www.fidh.org/
M.Matsaganis, Ch.Leventi, “Distributional Implications of the Crisis in Greece in 2009-2012”, Euromod WP no14/13, available at https://www.iser.essex.ac.uk/research/publications/working-papers/euromod/em14-13.pdf
M.Matsaganis, Ch.Leventi, “The Anatomy of Poverty in Greece 2013”, available at http://www.paru.gr/files/newsletters/NewsLetter_05.pdf.
Dr Theodora Papadimitriou, Advisor on Social Issues to the Mayor of Athens