GREECE IS | HEALTH | 2016-2017 by GREECE IS

greece is experience culture, gastronomy & more

HEA L TH

first edition

ISSN: 2459-041X

2016-2017 issue

16 - 42

44 - 81

82 - 107

108 - 175

origins

nat u re â&#x20AC;&#x2122;s bou nty

EX PERIENCES

med ic al tour i s m

In the beginning, health was left in the hands of gods. Then Hippocrates came along and laid the foundations of medical science as we know it.

An introduction to wild endemic herbs with medicinal properties, innovative natural cosmetics and the nutricious products that give Greek cuisine its special flavor.

For some, wellbeing is all about enjoying activities in nature, for others itâ&#x20AC;&#x2122;s about being pampered in world-class spas. Greece provides both.

Meet the Russian cosmonauts who chose Crete for their rehabilitiation, and explore the specialties that give Greece its competitive edge.

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Hippocrates refusing the gifts of Artaxerxes. Engraving by Raphael Massard, 1816, after A.L. Girodet-Trioson, 1792.

Foundations of Medicine BY GIORGOS TSIROS e d i t o r - I N - C H IE F , G REE C E I S

Mythology and history, the natural environment and dietary customs, wellbeing and physical exercise, natural products and medical innovations, all combine to Greece’s profile as a health tourism destination – and comprise the subject matter of this issue of Greece Is. Instead of an introductory note, we have chosen to publish the Hippocratic Oath in its full version. This monumental pledge from 460-370 BC, a symbol of Greece’s golden age of intellectual achievement, set down the fundamental principles according to which the western world has practiced medicine and advanced medical sciences for the past 2,500 years. (This is the classical version of the oath, translated by classical scholar and historian of medicine Ludwig Edelstein.) “I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant: To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him

who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else. I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.”

From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943.

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CONTENTS Greece Is - Health, 2016-2017 Issue, First Edition 6. A Perfect Place to Heal. Greeceâ&#x20AC;&#x2122;s

44. Small Miracle Workers. A close

unique potential as a health tourism

look at ten endemic plants with healing

102. Running Free. 116. Interview. George Patoulis,

destination.

properties.

president of the Athens Medical

16. Gods of Health. Their mythical

54. Brands in Bloom. Modern Greek

Association.

skills and deeds offered solace and hope.

herbalists look outwards.

120. The Pillars of Medical Tourism.

20. The Holistic Approach. How

60. Reviving Ancient Grains.

From IVF treatment to robotic surgery.

ancient Greek philosophy and medicine

Alternative food crops are changing the

130. Opinion. The making of

built the foundations for the modern

agricultural landscape.

a modern Asclepius.

concept of healthcare.

66. Greek Superfoods. From olive oil

132. Lifesaver. The amazing story of

28. Snakes, Dogs and Dreams.

to dried figs and Chios mastic.

Dr Georgios Papanikolaou,

Asclepieia, the sacred sanctuaries of

74. Eat Greek. An introduction to the

the inventor of the Pap Test.

antiquity.

countryâ&#x20AC;&#x2122;s healthy and delicious cuisine.

136. Genius Minds. Greek research

34. Healing Melodies. Sound as

82. Fountains of Life. From ancient

teams at the forefront of biomedical

therapy in the ancient Greek world.

water worship to the recent natural spa

technology.

38. Train Like an Ancient Greek. For

revival.

144. Medical Services Brief.

those sculpture-perfect abs and glutes.

92. The Spa Treatment. The magnificent seven of pampering, assembled from around Greece.

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82 greece is - health 2016-2017 issue, first edition

Published by: Exerevnitis - Explorer SA, Ethnarchou Makariou & 2 Falireos St, Athens, 18547, Greece ISSN: 2459-041X Editor-in-chief: Giorgos Tsiros (editor@greece-is.com) Commercial director: Natasha Bouterakou (sales@greece-is.com) Creative director: Thodoris Lalangas / www.youandi.gr Creative consultant: Costas Coutayar Deputy editor: Natasha Blatsiou Art director: Ria Staveri Editorial consultants: Dimitris Tsoumplekas, Vassilis Minakakis Translations/Editing: Don Domonkos, John Leonard, Damian Mac Con Uladh, Georgia Nakou, Vasiliki Prestidge, Stephen Stafford, Danae Seemann, Christine Sturmey Proof-reading: Don Domonkos, Omaira Gill Photo editors: Maria Konstantopoulou, Marika Tsouderou Pagination: Asimina Mitrothanasi Photoshop: Christos Maritsas, Michalis Tzannetakis, Stelios Vazourakis Advertising: Sophia Tsepa (stsepa@kathimerini.gr) Advertising department: Tel. (+30) 210.480.82.27 Head of public relations: Lefki Vardikou GREECE IS - HEALTH is a yearly publication, distributed free of charge. Contact us: welcome@greece-is.com

It is illegal to reproduce any part of this publication without the written permission of the publisher.

ON THE C OVER Hippocrates of Kos; illustration by Philippos Avramides.

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The Cradle of Health Greeceâ&#x20AC;&#x2122;s unique potential as a medical and wellness tourism destination. BY GIORGOS TSIROS

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EDESSA WATERFALLS, CENTRAL MACEDONIA

This Greek version of paradise on earth, some 90km west of Thessaloniki, features steep slopes, dense vegetation, water curtains up to 70 meters high and amazing views of the fertile Macedonian plain.

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Â© CLAIRY MOUSTAFELLOU

LOUSIOS RIVER, ARCADIA, PELOPONNESE Arcadia in the Peloponnese is the mythical land of Pan, the satyr-like god of the wild, and represents mountainous Greece at its best. The 19th-century Atsicholos single-arch stone bridge is a popular starting point for white-water rafting.

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ARVI GORGE, HERAKLION, CRETE

One of Crete’s most spectacular gorges is 2.5km long, 2-3m wide and has vertical sides as high as 400m. It features impressive waterfalls and passages, as well as a whirlpool formed by an underwater cave 150 meters deep. A must-see for experienced canyoneers.

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SFAKTIRIA ISLAND, MESSENIA, PELOPONNESE

The Costa Navarino resorts have put southwest Messenia on the global tourism map and Navarino Bay, where the most crucial naval battle of the Greek War of Independence took place, is one of the area’s landmarks. Seen here are the impressive rock formations of the island of Sfaktiria, a giant breakwater for the bay’s inner lagoon.

hen you need to spend four hours a day on dialysis during your vacation, you want to make sure that the other 20 will be perfect. This is exactly what 45-year-old Edinburgh patient D.S. was looking for after suffering acute kidney failure that had nearly cost him his life during a trip to France with his wife. After researching the medical facilities available at various destinations where they could combine a holiday with his treatment, the couple chose to spend 10 days in sunny Greece, splitting their time between Athens and Crete. The friend who told me their story assures me they had a wonderful time. On the island, a member of staff from a local clinic would pick up the patient from his hotel at 6.30 am sharp, take him for treatment and bring him back at 10.30 am, after which he was free to enjoy the charms of Crete for rest of the day. He also used his European Health Insurance Card, so that cost was not a serious concern. This story is but one among thousands and demonstrates just one of the many categories of medical services offered in Greece. It also illustrates something that most Greeks and visitors do not know: that the country which attracts more 10

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than 25 million visitors a year from around the world, mainly for its sun, sea and antiquities, is also equipped with all the facilities and services needed to have a dynamic presence in the rather “closed” global health and wellness tourism market. The worldwide value of this market is hard to pinpoint, but international estimates put it at anything between $5 billion and $440 billion. The facts are simple: Greece is a safe European country, very accessible, with state-of-the-art private medical facilities and highly skilled healthcare professionals. Its natural environment is extremely diverse and, in many parts of the country, pristine: from high mountains with crisp, clean air, to ancient forests and a lacework of sandy beaches with crystalline bathing waters. Its mild Mediterranean climate is ranked among the best in the world (see P.14), without violent fluctuations in temperature or weather phenomena. The bounty of its land and sea, moreover, has shaped its quintessentially Mediterranean cuisine, which experts agree has multiple health benefits: its emphasis on extra-virgin olive oil, honey, wine, nutrient rich seafood, fresh vegetables and pulses is a quality

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DIAPOROS, HALKIDIKI, CENTRAL MACEDONIA

Sithonia, the middle outcrop of the Halkidiki peninsula, boasts a mild climate, pine forests and Caribbean-like sandy beaches with waters to die for, as well as a smattering of lovely islets just off the coast, making it particularly popular with outdoorsy types.

that has distinguished it since ancient times. Its rich cultural heritage, local habits and customs, the laidback lifestyle and the hospitality of its people are assets cherished by visitors from far and wide. In many senses, Greece is the epitome of joie de vivre. The country is blessed with natural springs that rejuvenate body and mind, and mountain trails that inject fresh life into every cell of the body. It has award-winning luxury spa resorts that combine ancient healing practices, natural local ingredients and modern scientific methods, and a philosophy towards health and wellness services that dates all the way back to ancient times. For its many doctors (Greece has the highest ratio in terms of population of any member state of the Organization for Economic Cooperation and Development) it’s an added honor and a responsibility to practice their medicine in the country where the first medical principles were set down by Hippocrates. Their skill and quality is evidenced by the fact that they continue to prop up a national healthcare system that is being stretched to an unprecedented degree by the economic crisis; they maintain the highest standards at

private hospitals, diagnostic centers and clinics; and, in the past few years, have been sought after in highly developed nations that are experiencing shortages in expert medical staff, such as the UK and Germany. A quick scan of the media and medical journals on pioneering procedures and accomplishments attributed to Greek doctors yields the following: a novel surgical approach to a complex penile urethra stenosis; successful, free-of-charge cardiothoracic surgery on a 13-month-old infant with severe cyanotic congenital heart disease; the first live-streamed global interactive rhinology and endoscopic skull base surgery; the successful excision of tumor in an inaccessible and sensitive area of the brain of a five-month-old infant; the first transcatheter closure of a patent ductus arteriosus (PDA) successfully completed on a low birth-weight preterm neonate; transcatheter techniques for aortic valve insertion; laser prostatectomy with the latest generation XPS GreenLight Laser; total hip arthroplasty using the revolutionary ASI technique causing minimal trauma to the soft tissue; the successful artificial insemination without hormones of a woman with G R E E C E IS

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polycystic ovaries after two unsuccessful IVF attempts abroad… and the list goes on and on. What is not on the official record but is widely recognized by Greeks overseas and foreigners seeking medical treatment in Greece is the personal touch offered by doctors and medical staff here, the confidence inspired by professionals who never lose sight of their humanity: the encouraging pat on the shoulder, the warm smile and being treated as person, not just as a patient. What Greece did not have until a few years ago was a coordinated strategy to promote its image and qualities as a top medical tourism destination. It has been making significant inroads, however, building an ever-more dynamic presence in the sector, an effort being spearheaded by the Greek Medical Tourism Council (ELITOUR), whose members consist of medical and tourism service professionals, air carriers, travel and marketing agents and all the other players in the

health tourism business. These efforts are now being augmented by the newly founded Greek Health Tourism Confederation, the brainchild of pediatrician Dr. Constantine Constantinides, a visionary who is proposing a more “holistic” approach to give Greece a competitive edge by combining cultural, sports, gastronomic, nature and geriatric tourism in tandem with health tourism. With a presence in international conferences and exhibitions, targeted campaigns in key markets and innovative proposals on how the Greek state can embrace and coordinate the effort, the private sector has seized the initiative to give Greece the place it deserves on the global health service map. The time is ripe, and this issue of Greece Is hopes to do its part so that more visitors can discover – and benefit from – the country’s many qualities that contribute to a healthy, happy life.

BLUE CAVE, KASTELLORIZO, SOUTH AEGEAN

It’s 75m long and 35m high, it owes its color to the morning light that reflects on its bottom and it is the most popular stop for day-cruise boat passengers from the easternmost island of Greece. Floating inside it is an out-of-this-world experience.

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The “Greek sun” is a thing F resh sea breezes , mild temperatures and stark topographical contrasts have earned G reece a special place on the global bioclimatic map.

raditionally, the Greek National Tourism Organization adverts featured sun-drenched locations, bright blue skies and seas like glass. But Greece is much more. As environmental scientist Michalis Petrakis, former director of the National Observatory of Athens, explains, it is the bioclimate that makes this country so special on a global level. “By ‘bioclimate,’ we mean all of the climatic factors prevalent in a particular biosphere which affect all living organisms, even humans. They are responsible for our sense of well-being,” he says. So what about the Greek sun? In contrast to other countries, where the sun is hot enough to burn the skin, or where it might also come with unbearable humidity, the climate in Greece is rather dry, particularly in the summer, with a normal humidity of less than 50 percent. Meanwhile, the northerly meltemi winds that blow through the Aegean and the localized sea breezes provide a refreshing respite. Greece lies in the Mediterranean climate zone, with mild winters and relatively hot, dry summers. It enjoys a high rate of sunshine almost all year round – as much as 2,000 hours a year in the northwestern regions and up to 3,000 hours a year in the Dodecanese. Even in winter, the sun shines an average of 70 hours a month (compared to 300-390 hours a month in summer). The critical role of the sun in human

health and well-being has been scientifically proven. For example, the sun helps synthesize vitamin D, which is important for building bone strength and combating osteoporosis. The hottest period in Greece comes in late July and early August, when the average maximum temperature ranges from 29 to 35°C. In winter, minimum temperatures in the plains and in cities are not that low. For example, the low in the Athens district of Nea Filadelfia in winter averages about 5°C. And even in mid-winter, stretches of bad weather are often interrupted by sunny days and milder temperatures during what has been known since antiquity as the “halcyon days,” usually in January. Periods of rain do not last very long, and the Greek sky remains fair, clear blue and without the thick, gray cloud cover that is common in other regions of the world. The variable geomorphology of Greece is of particular significance to the overall Greek bioclimate. The mountains and the sea are often close neighbors. Meanwhile, the changing relief of the landscape throughout the country provides a pleasing diversity for the traveler, and also creates a variety of microclimates within the overall Mediterranean environment. This means that, after relaxing on the beach on a hot summer day, one can easily find refuge in the cooler mountain altitudes just a short distance away. - GIANNIS EL AFROS

KOMMOS, SOUTHERN CRETE

In the Minoan Age, Kommos, located approx. 64km south of Irakleio, was a proper city with its own harbor. Now it is famous for its sandy beach, one of the longest in Crete.

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MEDICAL BRIEF

F I L O K T I T I S P h y sical M edical R e h abilitatio n C e n ter

LE ADERS IN POST-HOSPITALIZ ATION TRE ATMENT

Built in Koropi, a central hub in the Attica region, on 19 acres of green grounds and modeled on the ideal of the ancient Asclepieia (the healing centers of antiquity), Filoktitis is intended for people who require high-level medical rehabilitation services following an accident or illness. It is the largest private unit of its kind in Attica, with 125 beds and all the modern facilities and technology required to undertake post-hospitalization treatment for both inpatients and outpatients. While Filoktitis provides all the necessary, state-of-the-art systems to implement comprehensive rehabilitation programs, its whole concept is based on a highly human-centered philosophy. According to this approach, the person attending a rehabilitation program is an active participant and partner in his or her recovery process.

Diseases Nervous System: Such as strokes, spinal cord injuries, head injuries, multiple sclerosis, neuritis, polyneuritis, polyradiculoneuritis, degenerative nervous system diseases and congenital or familial diseases. Respiratory System: Such as chronic obstructive pulmonary disease, fibrocystic pneumopathy and asthma. Muscoloskeletal System: Such as multitraumatic patients, fractures, spinal cord injuries, amputations, osteoporosis, degenerative arthropathies, rheumatic diseases, postoperative rehabilitation after corrective bone and joints and tendon surgery. Cardiovascular System: Such as post myocardial infarction, after heart and vascular surgery. Multisystem Diseases SPECIFIC DISORDERS Due to Neurological Lesions: Neurogenic bladder, disorders of higher cerebral functions, etc. Specific Congenital Immunological Disorders: Myelomeningocoele, cerebral palsy, myopathy, etc.

The success that Filoktitis has with its patients is the result of the collective efforts of many experts, both medical (physicians, orthopaedics, cardiologists, urologists, otolaryngologists and surgeons) and paramedical (physiotherapists, occupational therapists, hydrotherapists and speech therapists) Filoktitis is equipped with state-of-the-art systems that makes it a leader in Greece in the field of rehabilitation, such as: Lokomat, a technological breakthrough in the field of Robotic Assisted Gait; Erigo, a device for the early rehabilitation phase of neurological patients; and Hydrophysio, an aquatic treadmill that offers calibrated water resistance. Filoktitis follows strict quality management policy regarding its services and is certified by both TUV Nord Services Quality (ISO 9001: 2008) (ISO 22000: 2005) and TEMOS for International Patient Hospitalization.

Pefkon & Peisistratou - Karellas - Koropi, Attica, 19400 Tel. (+30) 210.667.0000, Emergency Phone: (+30) 6970.015.930 • Visit us: www.filoktitis.com.gr, Email: info@filoktitis.com.gr •

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The publishers of the magazine are not responsible for the content of this article

origins

Gods of Health Apollo, Chiron, Asclepius and Heracles were leading healers, teachers or promoters of public health whose mythical skills and deeds offered solace and hope. BY G e r a s i m o s A . R i g at o s *

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vanced years kept him from participating in the Trojan War. Instead, he sent to Troy his sons (also mortals), Machaon and Podalirius, as both military leaders and doctors. The “deification” of Asclepius was brought about several centuries after the fall of Troy, by the distant descendants of those same sons. Ancient myths likewise preserve the names of other healing deities, demigods and deified heroes. Prometheus, described masterfully by Aeschylus, was a Titan, the only one who supported Zeus against the power of Cronus. The rift between them came later. The Titan “philanthropist,” as the myth unfolds in “Prometheus Bound,” taught people how to build healthy, sun-filled houses, how to prepare nutritious food and what plants and other substances could soothe their pain. “All the civilizing arts [were taught] by Prometheus,” writes Aeschylus. Prometheus, moreover, offered this knowledge at his own expense and became “the first saint and martyr of the philosophical calendar.” Among the demigods was the cen-

Asclepius and (behind) his sons, Machaon and Podalirius, and daughters, Iaso, Aceso and Panacea. To their left, a family of worshipers and a maidservant. Marble votive relief of the first half of the 4th c. BC (National Archaeological Museum, Athens).

Diseases of unknown origin or those with dire prognoses created the need for a magical healer to serve as an intermediary between ordinary people and unseen superior forces. MEDICINE in homer Read how the Iliad and the Odyssey serve as the earliest source of information we have about Greek medicine.

* Assistant Professor of Medicine and Honorary Doctor of the Pedagogical Department, University of Athens

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he art of healing emerged as a crucial human need eons ago while our species attempted to survive and adapt within a hostile environment. Early humans – sometimes healing themselves instinctively, at other times through a skilled member of the community – were able to deal with simple health issues, such as removing a thorn from the foot, piercing the skin to relieve a purulent infection or covering open wounds with tree leaves. However, the actual causes of ailments were not always clear. Diseases of unknown origin or those with dire prognoses created the need for a magical healer to serve as an intermediary between ordinary people and unseen superior forces. As human knowledge and thinking became more sophisticated, these higher forces became personified as gods and, eventually, as healing deities. The ancient Greek mythological tradition of healing deities is rich with leading figures. According to the Homeric epics that describe the time of the Trojans (probably the 12th century BC), the god of medicine was Paion or Paieon. He served as physician to his fellow gods, including Hera and Ares, as well as to mortals. He was familiar not only with injuries, but also with many useful plants, both therapeutic and poisonous. For his part, Asclepius had not yet been deified at this time. He was still a common mortal whose ad-

ORIGINS

taur Chiron, a healer and teacher of the therapeutic and other useful arts. His legendary amalgamated form – which combined the upper torso of a man with a horse’s body and legs – perhaps alludes to the totemic symbol of a certain tribe, or to the ubiquitous role of the horse in ancient transport, or to cultic activities with horses. Chiron was a great educator. Common people, kings and gods entrusted to him the education of their children. Apollo himself, patron deity of medicine, tasked Chiron with instructing his son Asclepius, whom for many centuries mythology presented as the succeeding god of medicine. Chiron’s “educational program” included the treatment of wounds; knowledge of the rich pharmaceutical flora of the Greek landscape; and exorcisms (“incantations”), to be offered as psychic support for the in18

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jured and the sick. Heracles was another of the demigods, the scion of the god Zeus and the mortal Alcmene. He too is associated with ancient health, as some of his labors are clearly readable as reflective of major health-promoting projects pursued during the Mycenaean era. The slaying of the Lernaean Hydra, for instance, represents one of those prehistoric efforts. As early as the 6th century BC, the reformer Servius Tullius, sixth king of Rome, believed that the monster with nine heads was actually a swamp fed by multiple underground water sources; when one of these was closed, water sprang from elsewhere through one of the other sources. The exhalations of the Lernaean Hydra/ swamp – that is, the swamp’s malodorous fumes – poisoned the surrounding area. According to Servius,

Apollo, the centaur Chiron and Asclepius. A wall painting from Pompeii, 1st c. AD (National Archaeological Museum of Naples).

Heracles drained the area with fire, then blocked the underground sources. Also health-related was Heracles’ task of exterminating the Stymphalian Birds, interpreted by some as representing mosquitoes that spread malaria. Even clearer is Heracles’ fifth labor that required him to clean out the manure-filled Augean Stables – which he successfully accomplished by diverting two regional rivers. Heracles was also worshiped in Athens as a health deity (Heracles Alexikakos), notably during the years of the Peloponnesian War (431-404 BC).

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thousands of years) gushes from the hot spring into the heart of the spa, an ancient fountain of healing and rejuvenation that has been officially recognized as a medicinal natural resource by the Committee on Natural Thermal Resources Protection*. Our wide range of treatments, therapies and tailor-made programs provide a completely rejuvenating experience for every guest. We share our vibrant vision of holistic treatment with an experienced team of professionals and use only the best products, designed for ease, harmony and beauty.

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LEGACY

The Holistic Approach By establishing the connection between body, soul and environment, ancient Greek philosophy and medicine laid the foundations for the modern concept of healthcare. B Y Ya n n i s T o u n ta s M . D . , M . P H . , P h . D . *

he idea of “health promotion,” according to the WHO’s 1986 Ottawa Charter, is a health strategy that aims to incorporate skills and community development and to create supportive environments for health. The theoretical framework for such a strategy stems from the development of the new “biopsychosocial” model for health and disease, which questions the dominance of the biomedical model, by putting emphasis on the role of the environment and of human behavior and on the biological, psychological and social dimensions of both positive and negative health. However, despite the commonly held assumption that such basic concepts are recent in origin, they actually have their roots in ancient civilizations, particularly in classical Greece. The ancient Greeks understood that good health was tied to physical and social environments as well as to human behavior. They defined health as a state of dynamic equilibrium between the internal and external environment. In addition, they considered the physi20

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cal and social determinants of health, they empowered individuals and communities through new democratic and participatory institutions and placed emphasis on health education and skill development. They also recognized the importance of supportive environments and healthy public policy and reoriented medicine towards a more naturalistic and humanistic perspective.

A portrait of Hippocrates (ca. 460-370 BC), a Greek physician, known as the “father of medicine,” who developed the belief that four fluids (or humors) of the body (blood, phlegm, yellow and black bile) are the primary seats of disease.

New Ideas in an Ancient World The Greeks were the first to break with the metaphysical/supernatural conceptions of health and disease that had previously dominated human societies, seeking out answers in the physical world rather than in the actions of invisible forces. Aristotle (384–322 BC), the son of a physician, questioning Plato’s transcendental ideas, called for the systematic observation of nature. The mythical world was replaced by one forged through the power of independent human intellect, a world which demanded that reality be explained through natural causes.

* Yannis Tountas is Professor of Social and Preventive Medicine in the Medical School University of Athens.

The Greek word “hygieia” describes a condition of completeness and contentment. A healthy body is a well-balanced body – one that exists in harmony with cosmic laws and order.

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LEGACY

Early Explanations for Health and Disease: Pythagoras, Socrates and Plato The ancient Greeks’ understanding of health and disease was based on the theory of the four “humors” or fluids (blood, phlegm, yellow bile, black bile), which in turn is premised on the theory of the four elements (fire, earth, water, air) and their four corresponding qualities (hot, dry, humid, cold). The Pythagoreans maintained that health is a condition of harmony and the perfect equilibrium of the fluids. Illness results when this balance is upset; thus, the important thing for maintaining health is to practice a way of life that allows for minimum disturbances to occur in the body. Since this balance can easily be disrupted by external factors, efforts are concentrated on regulating the human body’s physical and nutritional conditions. The Greek word “hygieia” describes a condition of completeness and contentment. A healthy body is a well-balanced body – one that exists in harmony with cosmic laws and order.

The Teachings of Hippocrates

Hippocrates and Galen; fresco in the Crypt of St Mary Cathedral, Anagni, Italy, 13th century (De Agostini Picture Library/A. Dagli Orti).

Health theories were elaborated in greater detail in the work of the ancient physician Hippocrates (ca. 460–370 BC). Unfortunately, little biographical information can be confirmed about this important figure. The 60 or so works comprising his corpus were probably written by a variety of authors, including both Hippocrates himself and his disciples, who together developed the starting point of medical science. According to the text entitled “On Airs, Waters and Places,” a groundbreaking achievement and the Hippocratic school’s most important contribution to medical science, health is similarly defined on the basis of an equilibrium, achieved between environmental forces on the one hand (wind, temperature, water, ground, food) and individual habits on the other (diet, alcohol, sexual behavior, work and leisure). The “in-

ternal” equilibrium of the four bodily fluids depends on the “external” equilibrium between a person and his/her environment. The pathogenic process, according to the Hippocratics, results from the overturning of equilibrium and the predominance of one of the four fluids, thus leading to disease. The Hippocratic physician who came to attend to a town’s population had to consider not only the season, the winds, the water people used and the geography of the place, but also the way people lived: did they drink a lot of wine, eat well, exercise, get adequate rest and work hard? The ancients stressed that good diet was crucial to health. The Greek word diaita, however, meant more than food and drink: diatetica (dietetics), the cornerstone of the healing art, involved an entire lifestyle. The Hippocratics posited a natural theory for the cause of illness. In the case of male impotence among the Scythians, for example, Hippocrates made certain observations that were connected to factors such as horse riding, rheumatism, physical tiredness, weather conditions, ground conditions, and dietary practices.

Empowerment and Education for Better Health Today’s Ottawa Charter proclaims that a key factor for the achievement of skills and community development is the empowerment of people – both as individuals and in communities – which is achieved mainly through health education and supportive environments. Although the term “empowerment” is not mentioned in ancient Greek philosophy and medicine, the Greek intellect in general was very much centered around the individual’s emancipation from the clutches of ignorance and superstition, leading people towards “self-sufficiency” – which, as a concept, is very close to contemporary ideas of empowerment. G R E E C E IS

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The philosopher Protagoras (ca. 490–420 BC) defined “self-sufficiency” as a state of being in which one is not dependent on others. Pythagoras’ followers likewise placed an emphasis on self-maintained hygiene – the well-known “Pythagorean way of life.” Health was a condition of perfect equilibrium achieved by practicing self-control, moderation and calmness. The use of diet, gymnastics and even music were directed to the goal of restoring health when it had been “upset.” Thus, for someone to live “as he should,” systematic preparatory education was needed. Later, Aristippus (ca. 435–356 BC), a student of Socrates, drawing on the principle of self-sufficiency, advanced a theory and practice of life according to which our single aim is to enjoy life as much as possible – provided, however, that we are in control of both ourselves and circumstance at all times. It was only in this broad 5th–4th-century BC philosophical context that ancient “health education” could emerge.

Health Effects of Physical, Social and Political Environments The Hippocratics recognized “endemic” diseases – those always present in a given population – and “epidemic” diseases – those not always present but occurring in greater frequency at certain times. Both terms are still widely used today. (The text “On Airs, Waters and Places” attempts to identify the factors behind local endemicity by addressing climate as well as the quality of the soil, water, way of life and nutrition.) Hippocratic physicians also paid attention to the location of an individual’s dwelling, the winds to which it was exposed and how near it was to rivers, swamps or the seashore. Winds and their influence on health held particular interest for the Hippocratics: “Cities which are faced towards the sunrise are healthier than those which are faced towards the North and … warm winds.” Hippocratic writings 24

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Isonomy (equality of rights) positively affects not only citizens’ health but also democracy. In contrast, monarchy, a system of governance based on the rule of one, gives birth to disease.

go even further, recognizing the importance of the social and political environment as well, and often referring to the “health” of the polis. With the birth of democracy in ancient Greece came a departure from the heteronomous status quo and a movement towards autonomy. Athenians reformed their political system to increase the possibility of real participation of the people in the exercise of power, in a state of autonomy in which the political community created its own laws. Autonomy precludes the idea of an extra-social source of laws and institutions. This is the highest kratos (strength) that exists in a society: the giving of ourselves to the laws and institutions under which we live and the government that determines our direction. Society is never just a simple synthesis or summation of persons, since people are to some extent created by their society. Therefore, an autonomous society means ipso facto autonomous persons, which in turn means an empowered society and empowered persons. The notion of empowerment is thus related not only to self-sufficiency, but also to autonomy. Even before the flourishing of Greek democracy, however, social conditions had already been considered to affect health. The philosopher and medical theorist Alcmaeon (born ca. 510 BC) does not hesitate to define health in terms borrowed from the political vocabulary of his time. He asserts health is isonomy, the equality of rights, the total balance of forces – “fluids, dry, bitter and sweet” – active in the human body. Isonomy positively affects not

only citizens’ health but also democracy. In contrast, monarchy, a system of governance based on the rule of one, gives birth to disease. It destroys the polis (city) by imposing the rule of a single element on the others, thus destroying isonomy.

The Rise of Naturalistic and Humanistic Medicine Little is known of Greek medicine before the testimony of written texts in the 5th century BC, but it can be assumed that Ancient Greece, like many other places in prehistory, possessed folk healers, priest healers and chief tribunes employing divination and drugs. In Homer’s Iliad, Apollo appears as the god of healing. Various other gods and heroes were also identified with health and disease, the most predominant being Asclepius, whom Homer portrays simply as a tribal chief and a skilled healer of wounds. Physicians were apparently little appreciated in Homeric times, perceived merely as lowly craftsmen of inferior standing. Physicians are classed in Homeric epic with other itinerant laborers while Asclepius is not even recognized as a son of Apollo. Only with Hesiod and other authors does Asclepius become the son of divine Apollo and thus a semi-god. This upgrading of his position signified an upgrading of medicine and, at the same time, a reorientation of medical care. Scholars attribute Asclepius’ rapid ascendancy, after ca. 700 BC, to his popularity among the poor and lower classes, who saw him as a god particularly

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Hippocrates in the center of an artistic composite image, depicting: Achilles tending to Patroclus’ wounded arm, Attic kylix by the painter Sosias, circa 500 BC, Berlin, Museum of Ancient Art; surgical instruments, 4th-7th c. AD; wild blackberries described and illustrated in a publication of Dioskourides’ De Materia Medica, AD 512, Vienna, National Library of Austria. Published courtesy of Kapon Editions.

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interested in their welfare, a lover of all people regardless of station. Physicians who followed Asclepius as the god of health and medicine had a clear obligation to treat the rich and the poor alike. The ensuing rise of Hippocratic teachings represented a decisive step in refounding medicine on a quite different basis: as a healing system independent of the supernatural and built on natural philosophy. This separation of medicine from religion is indicative of the openness of ancient Greek intellectual activity. Hippocratic medicine was not only an appeal to reason, however, and thus an early scientific endeavor; it was also a patient-centered rather than disease-oriented approach, concerned more with observation and experience than with abstractions. Ancient medicine shared close ties with ethics – the philosophical study of morality. Today, biomedical ethics include four key principles – autonomy, beneficence, nonmaleficence and justice – considered to be of equal weight or priority in any particular situation. Autonomy and justice were also key principles in ancient Greek medicine. In healthcare, autonomy involves respect for clients’ rights to make decisions about and for themselves and their care. Beneficence and nonmaleficence are age-old requirements of the Hippocratic Oath, stipulating that health professionals to “do good” and “do no harm.” Hippocratic doctors took care to consider their patients’ social circumstances and potential limitations when administering advice and guidance. To care for the poor and for wounded warriors, the institution of “public doctors” was established in ancient Greece. In Athens, such doctors were selected by the popular assembly. The city paid for their salaries and medicines through a special public taxation. Plato, the earliest writer to mention Hippocrates and his theories in his dialogue Timaeus, taught that morality was not simply a matter of edu26

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cation. Since the mind is influenced by the body, the doctor has a part to play in teaching virtue. Plato’s Timaeus went on to become a highly influential text, linking medicine and philosophy, health and politics. Nowadays, it also reminds us of the contemporary conception of sociopolitical determinants in health.

A Medical Revolution The innovative ideas of the ancient Greeks, from the 7th to 4th centuries BC, laid the foundations for later Western thought and achievement in many areas of learning including medicine. Pioneering Greek philosophers fashioned the basic concepts underlying philosophical and scientific inquiry. Since these pursuits were originally interwoven, the discursive framework in which they developed fostered the emergence of core natural science concepts, out of which European philosophy and science later evolved. The Hippocratic tradition in particular, with its definition of health as a state of balance between internal and external environment, brought a revolution in the concepts of health and disease and in medical practices. The naturalistic approach of the Hippocratics, today held up as a precious heritage, can be characterized by its spontaneity, scientific value and humanistic attitude. In the end, Hippocrates and his followers have transformed medical thought. In Western civilization, health continues to be considered a state of perfect balance. The difference between ancient and modern concepts has more to do with what the human body is comprised of. As Henry Sigerist writes, “we know today that the human organism is made of cells and intercellular substances that are kept alive and function because of chemical and physical forces in a state of dynamic equilibrium defined by the internal and external environment.” Ancient Greek medicine’s naturalistic foundations are of fundamental importance to the development

of modern health science. Aristotle put forward very influential views on the constitution of life and health, and his discussions of physiology have long intrigued doctors and philosophers alike. Today, health promotion and educational approaches that emphasize correct diet and physical exercise can clearly be traced back to the ancient Greeks, whose health education, based on a holistic perception of health, incorporated ideas regarding both the physical and social environment and laid the foundations for the concept of health promotion in the modern era. The institution of ancient Athenian democracy, despite its tolerance of slavery and discrimination against women, reflected a supportive social environment for health and the promotion of healthy attitudes and behaviors. In large part based on the health-related legacy and principles of ancient Greece, medicine today is undergoing a reorientation as it seeks to provide more humane, fair and efficient health services. “Public doctors” to care for the poor, the Hippocratic oath’s humanitarian approach towards patients and the development of patient-friendly, easily accessible healthcare units all fall within the basic values and goals of any contemporary healthcare system that strives to restore a more humanitarian and equalitarian spirit in contemporary medicine.

Hippocratic doctors took care to consider their patients’ social circumstances and potential limitations when administering advice and guidance.

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snakes, dogs and dreams Dedicated to the healing god, the Asclepieia functioned as sacred hospitals, nursing homes, centers of religious worship and of popular entertainment, as well as gathering places for teachers and students of medicine. BY John Leonard

In ancient Greece and Rome, an asclepieion (Latin aesculapÄŤum) was a healing sanctuary sacred to Asclepius, the Greek god of medicine, where patients could come to be healed through spiritual or physical treatments.

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A More Human Face of Healing

With the emergence of the divine healer Asclepius, first mentioned in the 7th/6th c. BC texts of Homer and Hesiod, the infirm found a new champion, a figure usually depicted as bearded, ma-

ture and fatherly, like Zeus, and highly knowledgeable in medicine – like his own reported father Apollo – but more ordinarily human, more approachable and seemingly more genuinely concerned with the human condition. He usually carried a staff or walking stick and kept around him a snake and a dog as companions or sacred symbols. Where deities including Eileithyia (the Cretan/Minoan goddess of childbirth and midwifery), Apollo and his sister Artemis, or mythical creatures such as the centaur Chiron (Apollo’s foster son, Asclepius’ teacher) had previously been main mythical sources of medical skill and solace, Asclepius came to represent the new generation, at a time in Classical Greek history when knowledge of medicine and the practice of health care were becoming more scientific endeavors. It was

ealthcare represented a primary concern for people of the ancient world, just as it still does today, but until the 6th and 5th centuries BC healing was rooted mostly in religion and magic. When people became ill or suffered injuries, they did not visit hospitals or clinics, but often sought out treatment and comfort from priests, offered sacrifices and prayers to certain gods, or consulted learned practitioners who might prescribe the use of medicinal herbs or the following of other, sometimes more mysterious, traditional rituals.

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The Asclepieion of Kos: a Corinthian-style temple of the 2nd c. AD, likely dedicated to Apollo, father of Asclepius.

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only with Asclepius that more formal “hospitals” were established. As his cult spread, sanctuaries dedicated to the healing god sprang up throughout many areas of the known Mediterranean world.

Origins of Asclepius

Asclepius originally appeared in ancient Greece at ancient Trikka (modern Trikala) in Thessaly. Trikka was considered his birthplace, from which, according to Homer, his sons Machaon and Podalirius traveled with the Greek army to fight at Troy. The Roman geographer Strabo reports that Trikka was the site of Asclepius’ oldest, most famous sanctuary. Two other major centers were Epidaurus and the island of Kos. The cult of Asclepius may have reached Epidaurus by ca. 500 BC and a later local tradition suggested that he had been born there, rather than at Trikka. Epidaurus became the main, highly influential base from which numerous other Asclepieia were founded — usually through a ritual in which a statue of the god or one of his sacred snakes was ceremonially transported to the prospective site and bequeathed to the new sanctuary during its dedication rites. Kos, too, became known for Asclepius in the 5th c. BC. His famous multi-tiered sanctuary there began to rise after the mid-4th c. BC.

Expansion

The 5th and especially 4th centuries BC were a time of great expansion for Asclepius, as his sanctuaries also appeared at sites including Athens, Corinth, Sicyon, Tegea, Megalopolis, Argos, Sparta and Messene. Asclepie-

ia were also founded on the islands of Paros, Aegina and Crete (at Leben, a port of Gortyn); at Pergamum in Asia Minor, Alexandria in Egypt and Cyrene in Libya; as well as in the West at Rome — where the god occupied Tiber Island and was called Aesculapius. Altogether, hundreds of large and small Asclepieia were established in ancient Greek and Roman times, with almost every big town seeking to provide what was essentially a health-care facility for its residents and neighbors. Asclepius’ cult spread usually thanks to the well-intending actions of individuals and became increasingly popular because it appealed to individuals and reflected a growing interest in more reasoned, humanistic approaches to medicine. Asclepieia functioned as sacred hospitals, nursing-homes, centers of religious worship and of popular entertainment, as well as gathering places for teachers and students, especially those interested in becoming doctors. Followers of the pioneering physician Hippocrates (ca. 460-ca. 370 BC) taught medicine at Kos, while the Roman doctor Galen (AD 129-ca. AD 200) received training at Pergamum before assuming his duties as personal physician to the emperor Marcus Aurelius.

Epidaurus

Sanctuaries of Asclepius shared many common characteristics. In addition to Asclepius, other health-related deities were also regularly worshiped in or near these places, including his father Apollo; his “aunt” Artemis, his sons Machaon and Podalirius; and his daughter Hygieia — the personification of health, cleanliness and hygiene. The

Hundreds of large and small Asclepieia were established in ancient Greek and Roman times, with almost every big town seeking to provide what was essentially a health-care facility for its residents and neighbors.

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2nd c. AD traveler Pausanias records that, as a child, Asclepius was nurtured by a goat and protected by a dog — thus explaining why no goat sacrifices were allowed at Epidaurus, but dogs were a common sight generally in Asclepieia. Besides altars and temples, another distinctive, colonnaded building of central importance (the Abaton) was provided, in which patients arriving at the sanctuary would undergo enkoimesis (incubation), spending the night there and waiting for the god to come to them in their dreams with a proposed course of therapy. At the exemplary site of Epidaurus, visitors also had access to bath complexes, a large dormitory-like hostel (Katagogion), ceremonial dining rooms, a stadium, a palaestra, a large gymnasium and a theater that would eventually seat more than 12,000 spectators. A distinctive circular structure (Tholos or Thymele) near the colonnaded Abaton and the Temple of Asclepius may have housed the god’s sacred snakes, which embodied ideas of rebirth and rejuvenation. In some Asclepieia, non-venomous snakes were allowed to slither about freely on the floors of the visitors’ accommodations, while at Epidaurus the serpents, including a peculiar yellowish variety, 32

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were tame, according to Pausanias. The snakes in the Asclepieion at Alexandria were said by Aelian (ca. AD 175-ca. 235) to be gigantic, some reaching 6-14 cubits (about 3-6m) in length. Springs, wells and reservoirs were also common features in Asclepieia. A sacred well inside the Abaton at Epidaurus served in the visitors’ purification process, prior to incubation. Following these two initial stages of treatment, actual medical therapies were often provided. Testimonials describing the frequent miraculous cures achieved at Epidaurus were inscribed on a series of stone slabs publicly displayed in the sanctuary. These fascinating accounts, which record the names of specific patients, their illnesses and the method of their cure, were read some 1,800 years ago by Pausanias and can still be examined by visitors today in the archaeological site’s museum. One such inscription reads: “Arata, a Spartan, suffering from dropsy (oedema, the retention of water in the body). On her behalf, her mother slept in the sanctuary while she stayed in Sparta. It seemed to her that the god cut off her daughter’s head and hung her body with the neck downwards. After a considerable amount of water had flowed

Asclepius, bending forward and extending his arms as he offers therapy to a woman lying on a couch. Behind him is Hygieia, goddess of health, while, opposite, the patient’s relatives plead for her recovery. A votive relief of Classical date, from the Asclepieion in Piraeus (Piraeus Archaeological Museum).

out, he released the body and put the head back on her neck. After she saw this dream, she returned to Sparta and found that her daughter had recovered and had seen the same dream.” In more recent times, Jungian scholars have suggested the dream healing therapy practiced at Epidaurus and elsewhere represents the early forerunner of modern psychoanalysis and psychotherapy.

Kos

Concerning Kos and other major Asclepieia, it was not accidental that they were located in the open countryside, among beautiful, clean surroundings, where the climate was healthy and the water pure. Indeed, these sanctuaries provided a holistic, innovative approach to health and the prerequisites for physical, psychological, social and spiritual well-being.

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During its heyday in Hellenistic and Roman times, Kos’ elaborate Asclepieion must have been a stunning sight, set 100m above sea level on the eastern slopes of Mt. Dikeos, about 4km outside the town of Kos. Rising in three artificial terraces above the ground, the sanctuary was adorned with monumental gateways and staircases; U-shaped stoas (colonnaded, roofed walkways/ shelters); Doric, Ionic and Corinthian temples; altars; fountains; statues displayed in wall niches; and eventually a large Roman bath complex (3rd c. AD). Kos was a headquarters for the close-knit priestly order of the Asklepiadai, supposed descendants of Asclepius, who guarded their secrets of medicine and advocated the treatment of patients not through dreams, but in accordance with the teachings of Hippocrates.

Athens

On the South Slope of the Athenian Acropolis, a small Asclepieion was established in 420/419 BC, during the Peloponnesian War, when Athens’ inhabitants were largely penned inside their defensive city walls and disease was rampant. Plague had broken out in 430 BC and claimed as one of its first victims Pericles, the city’s great leader. To stem the rising tide of illness, a private citizen, Telemachos of Arch-

Artistic reconstruction of the Asclepieion at Epidaurus (drawing: Marina Roussou).

anes, took the initiative of having a sacred serpent representing Asclepius brought across the Saronic Gulf by boat to Piraeus, then up to the Acropolis. A diminutive sanctuary was established that included the main components of the mother site at Epidaurus: a sacred spring, altar, temple dedicated to Asclepius and Hygieia, two-storied Doric stoa/abaton, ceremonial dining room and a monumental gateway (propylon). Pausanias (1.21.4) writes that the Athenian Asclepieion “is worth seeing both for its paintings and for the statues of the god and his children.” He also describes an unusual votive offering displayed in the sanctuary: a military/hunting breastplate produced by Sauromatae craftsmen (from western Scythia, north of the Black and Caspian Seas), consisting of a linen garment covered with snake-like scales made from horses’ hooves. Marble “Kouros” statues were also brought to Asclepieia as dedications to the healing god, a large example of which, from the sanctuary in Paros, is now in the Louvre Museum. In the 1st c. AD, the Roman emperor Domitian sent locks of his hair, a mirror and a jeweled box as votive gifts to Asclepius at Pergamum. The practice of transferring the power and cult of Asclepius through the conveyance of sacred serpents was not unique to Athens, but also reported at sites including Sikyon, where, according to Pausanias (2.20.2), “the god was carried to them from Epidauros on a carriage drawn by two mules…in the likeness of a serpent.”

Jungian scholars have suggested the dream healing therapy practiced at Epidaurus and elsewhere represents the early forerunner of modern psychoanalysis and psychotherapy.

The establishment of the Asclepieion at Rome was also triggered by an onset of plague (293 BC), although the cult of Asclepius/Aesculapius had previously begun spreading into the Italian peninsula during the 5th c. BC. In the face of rising illness in the city, a delegation was dispatched to bring a serpent from Epidaurus – which, upon its arrival at Rome, legend holds, slithered off the ship and swam onto the small island in the midst of the Tiber river. There, the Romans founded an Asclepieion safely removed from the crowded city. Later, the island’s Travertine seawalls were configured to resemble the bow and stern of a Roman ship – a tribute to the original vessel that had arrived from Epidaurus. Today, the water-worn traces of a relief carved on the island’s downstream “bow” still depict Aesculapius’ snake-entwined staff.

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Apollo is shown offering a libation; Attic white-ground kylix, 480-470 BC (Archaeological Museum of Delphi).

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music

Healing Melodies Sound as therapy in the ancient Greek world BY At h a n a s i o s D r i t s a s *

ccording to Damon, a music theorist of the 5th c. BC and teacher of Socrates and Pericles, music is powerful because it imitates the movements of the soul. Music, in the ancient Greek understanding, has two faces. On the one hand, it can suppress human passions and desires, making it a powerful moral and educational tool. On the other hand, it can influence the “animal” part of the soul when that is disturbed, and act as a calming, therapeutic influence. Accordingly, the Greeks of the Classical period attributed the gift of music both to Apollo, for its educational value, and to Dionysus, for its cathartic and therapeutic power. It is this second aspect of music that we will focus on here. According to the Platonic view, while Apollo and the Muses use music to civilize mortals through the gift of education, Dionysus is responsible for mania (a kind of frenzy). Mania is a liberating force, which, when channeled through appropriate rituals, can lead to what the ancient Greeks called catharsis, a purging of the soul. In the Platonic cosmology, mania is a sickness, and the rituals that accompany it, centering on music and dance, are aimed at curing it. According to this worldview, many mental dysfunctions are due to disharmonious movements of the soul, and can be cured with the aid of harmony and musical rhythm. As Plato writes in his dialogue Timaeus, “...harmony, which has motions akin to the revolutions of the Soul within us, was given by the Muses… as an auxiliary to the inner revolution of the Soul, when it has lost

* MD, FESC, Consultant Cardiologist (Onassis Cardiac Surgery Center, Athens), Composer and Member of the International Society of Music in Medicine

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its harmony, to assist in restoring it to order and concord with itself.” In the case of ritual mania, a specific instrument and a particular musical mode are prescribed as the only ways to manage passion and achieve catharsis: the sound of a flute playing Phrygian music. The Phrygian sound was seen as best-suited to the sonic range of the flute, and was perceived to have “orgiastic” qualities which excite the senses. According to Aristotle, the flute, as well as certain sacred songs, awaken passions such as pity, fear and enthusiasm. In those who are susceptible to such passions, flute music and sacred melodies can heal the soul and bring ca36

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tharsis mixed with pleasure. For this reason, Aristotle proclaims, this type of music is suitable for the theater. The idea that certain types of melodies and sounds have a purgative effect on disturbed souls is also expounded by Plato. In his work Ion, he describes how Corybants (ecstatic revelers “who when they dance are not in their right mind”) can only perceive one kind of music: that of the god who possesses them. In order to harmonize with it, they reflexively dance to its rhythm and sing the words that go with it. This is where we begin to see the notion of music – and dance – as a means of diagnosis and therapy.

1. Orpheus enchanting animals, birds and reptiles with his music; mosaic, 4th c. AD (Shahba Museum, Syria). 2. A music lesson; Attic red-figure hydria painted by Phintias, 510 BC (State Collection of Antiquities, Munich).

The Pythagoreans employed a daily routine of music therapy. Music enjoyed prior to retiring at the end of the day helped them to calm down and gave them a good night’s sleep with pleasant dreams.

Greeks from the plague inflicted by the arrows of Apollo. Similarly, it was the peaeans sung by the lyric poet Thaletas in Sparta that were credited with ridding the city of plague. The Pythagoreans employed a daily routine of music therapy. Music enjoyed prior to retiring at the end of the day helped them to calm down and gave them a good night’s sleep with pleasant dreams. Immediately on waking, they performed special compositions on the lyre, which helped them to shake off the reveries from the night before and prepare for the intense rhythms of the day. It seems that the Pythagoreans had studied the relationship between musical rhythm and temperament, and applied musical “prescriptions” according to the circumstances.

“Magical” songs

healing powers of Music The therapeutic role of music was also important to the followers of the Orphic cult and the Pythagorean philosophers. The Pythagoreans shared with the Orphists the belief that life is a punishment for previous sins. For them, music was a technique which, combined with an ascetic lifestyle, aids the therapeutic catharsis of the soul. The Orphists and the Pythagoreans used two main types of purifying choral songs: paeans and epodes. The use of therapeutic paeans is already evident in Homer’s epics. In the first book of the Iliad, it was the day-long performance of hymns and paeans that saved the

Epodes, the second type of curative songs, were more like magical spells. The therapeutic use of epodes is mentioned in the Odyssey, when the sons of Autolycus cure Odysseus’ wound with the use of a compress and a spellsong. Spells found many uses; in addition to being used as medical cures, they healed hear tbreak, tamed the forces of nature and dispelled demonic elements. The mythical figure of the sorcerer, bard and prophet Orpheus is the embodiment of the power of music, and specifically of the potency of the epode. Orpheus himself was able to move all types of objects

just with epodes, from a lit torch to the ship Argo.

From antiquity to today We can see very striking analogies between modern music or drama therapy and Dionysiac rituals or even the carnival. Today, the myths and beliefs of the ancient world about the therapeutic powers of music find their place in the science of music therapy, be it the practice of interactive music therapy or the use of music medicine as a complement to conventional medical treatment. Music is prescribed for adults and newborns suffering from anxiety, pain and sleep disorders, as therapy on intensive care wards and for a variety of other clinical uses. Modern practitioners of music therapy are trained in methods that can be traced directly to the Apollonian and Dionysiac approaches, as conveyed through Platonic theory. It also appears that the ancient Greeks had grasped through empirical observation what we now can see through the use of PET scans and functional MRI; namely that music learning aids in the development of other skills 2 aside from purely musical ability. Children who play in orchestras or sing in choirs learn how to work alongside other children and develop their communication skills. The ancient Greeks realised that musical education enhanced mental ability and produced better-educated and skilled citizens. It is no accident that they rated music not only as a curative tool, but as part of their core education. G R E E C E IS

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The Diadoumenos (Diadem bearer), a sculpture portraying the ancient Greek athletic ideal and the perfect anatomical proportions of a nude male body; a copy (ca. 100 BC) of a famous bronze original (450-425 BC) by Polykleitos (National Archeological Museum, Athens).

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Train Like an Ancient Greek Would you like abs like Polykleitos’ diadem-bearer, or glutes like Myron’s discus thrower? Sports training in ancient Greece was a very different experience from the modern workout... or was it? BY GEORGIA NAKOU

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The Discobolus (Discus thrower); a copy (1st c. BC) of a famous statue (460-450 BC) by Myron (Vatican Museums, Rome).

he first thing you should know about sports training in ancient Greece is that it wasn’t for gym bunnies. The Greeks of the Classical era believed that physical fitness and mental clarity were two sides of the same coin. A good citizen was virtuous in mind and in body; training was a civic duty, rather than a lifestyle choice. Training facilities and professional trainers were provided by the city – for ordinary citizens as well as for champion athletes. The biggest names in philosophy devoted extensive passages of their works to laying out the rules for proper training and healthy eating. Athletic training, what we now know as “sports science,” was considered equal in status to medicine, while the “locker-room talk” of 5th c. BC Athens laid the foundations for Western political thought. Nevertheless, there was little interest in fancy sporting gear or branded accessories. The gymnasium, now shortened to “gym,” derives its name from the word gymnos, meaning naked. But if you are put off by the idea of your wobbly bits being scrutinized by the opposite sex, fear not. In most places, physical exercise, like politics, was a male-only affair. The one notable exception was the city of Sparta, where both boys and girls were put through a militaristic boot camp from an early age. G R E E C E IS

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Most ancient writers attribute the development of systematic training to the establishment of the Olympic Games in the 8th c. BC, which made the pursuit of sporting excellence one of the ties that bound the Greek world together. Plato mentions several famous champions-turned-coaches and medics who pioneered the notion of a rulesbased training regime as the foundation for sporting success. Hippocrates and Galen, best known for their contributions to medicine, observed athletes while they trained, in order to understand the human body, and developed anatomical and nutritional guides to improve performance. Aristotle wrote detailed coaching manuals that were embedded in his philosophical works. By the 2nd c. AD, Philostratus was writing treatises de-

voted entirely to professional training regimes. The exchange between sport and science went both ways: Galen suggested that doctors must train like athletes to achieve excellence in their practice. Philostratus wrote that systematic training evolved out of the more empirical methods that early Olympic athletes devised to improve their fitness. He describes (Gymnasticus, 44), somewhat imaginatively, how “they lifted weights, raced horses and hares, bent or straightened metal bars, pulled ploughs or carts, lifted bulls and wrestled lions, or swam in the sea so as to exercise their arms and their entire body. Their diet was natural, with whole grain bread and meat from oxen, bulls, goats and deer. They slept on hides or straw mattresses, and anointed themselves with plenty of olive oil.

They were healthy and did not get sick easily. They stayed youthful into old age, and competed in many Olympics, some in eight and others in nine.” As sports pundits of any age always seem to maintain, he felt that no athlete of his day could hold a candle to the real champions of yore. Part of the job of a professional trainer was to design a training regime, taking into account weather conditions, the psychological condition of the athlete, and any pre-existing injuries. There were then, as today, conflicting ideas on the best methods, rival coaching “schools” and sports fads. Galen expends a fair amount of time trashing, on medical grounds, the ideas of popular contemporary trainers. A structured training regime in ancient Greece included three stages: warm-up, training and cool-down

A long jumper performing his event, depicted alongside a musician playing the diaulos (double-flute), judges and other athletes; Attic red-figure kylix, 480 BC (Antikenmuseum Basel und Sammlung Ludwig, Basel).

– much in line with current advice from the American Heart Association. However, there were also some extra elements which have not made it into present-day exercise routines. The warm-up started with a massage, followed by gentle movements to boost blood flow and prepare the muscles for more intense exercise. What followed will be unfamiliar to modern exercisers: a rubdown with olive oil by a professional aleiptes. Oiling was an art because it played a critical role in sports such as wrestling, where a deft application could make it almost impossible for an opponent to perform a hold. To counteract the oiling, the athletes applied dust or sand. A wrestler would throw sand on their opponent tactically, with a view to covering those critical parts of the body that would receive their grip. In the main workout, a range of options were available: total-body workout, zone workouts, or training geared toward competitive sport. Training could follow the same routine daily or rotate from day to day. There were specialized exercises for boxing, wrestling and the pankration – an ancient mix of martial arts that combined boxing and wrestling. Punching bags were used, as well as shadow-boxing techniques. Bends were used to strengthen the upper body. Various running exercises, including high-resistance running in sand, were employed to improve lower body fitness and aerobic performance. A variety of jumps are also described, while upper body strength was cultivated using rope climbing and other instruments. In ad-

A youthful jumper in training; Attic red-figure lekythos, by the Bowdoin Painter, 475-470 BC (National Archaeological Museum, Athens).

Most impressive is that training was a total discipline, combining elements of biology, physiology, ergometry and sports medicine, and was fully integrated with philosophy and politics.

dition to repetitive exercises, training also encompassed daily physical activities believed to enhance conditioning, such as digging, horse riding, walking, hunting and fishing. Galen rated most highly those activities that work a variety of muscle groups, including riding and swimming. He distinguished between high-impact and low-impact exercise, also mentioning the principle of circuits or interval training — where bursts of exercise alternate with short rest periods. He differentiated between general exercise and specialized training for professional athletes. The duration of training sessions was at the discretion of the trainer and determined by the athlete’s physical condition. It continued for as long as the athlete retained a lively color, was able to move steadily and rhythmically, and kept “growing in bulk.” It was time to call it a day when the athlete became more sluggish and started falling to his knees to rest. Different forms of exercise were expected to yield different results on the athlete’s body. Running slimmed the body and inflated the muscles, due to its emphasis on breathing. Wrestling increased body heat, as well as the density and mass of muscles. The pankration was thought to dry out the flesh because it was more intense and shorter in duration. Lifting exercises and running were believed to cleanse the body from toxins through sweating. The cool-down, or apotherapeia, was considered necessary for the body to return to its natural condition. It started with breathing exercises, which were said to relieve the heart. Next

EXERCISE & HEALTH Ergophysiology professor Vassilis Kleisouras on a link dating back to Greek antiquity. G R E E C E IS

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came the cleansing of the body from oil, sand and sweat. A metal strigil was used to scrape the skin; these special implements are found in excavations and depicted in vase paintings and sculptures. A post-workout massage followed, at the hands of a professional who used a variety of techniques described in some detail by Galen. Medical writers also praised the benefits of various types of baths − not only for cleaning but also for soothing tired muscles and inducing euphoria in the athlete: a kind of rejuvenating spa. Athletes took dips in natural springs and rivers, but also bathed in purpose-built facilities adjacent to the gymnasium. Baths could be hot or cold, and steam baths were also popular. When athletes were not training,

they rested, as this was part of a total regime also calling for repose and sleep. Sunbathing was similarly recommended – not only to build endurance against the sun, and thus be able to perform in outdoor competitions, but also because solar rays were seen as beneficial to health. An enormous body of knowledge went into sports training in Classical Greece, much of which remains in use today, or is being rediscovered. Most impressive is that training was a total discipline, combining elements of biology, physiology, ergometry and sports medicine, and was fully integrated with philosophy and politics. The results can be seen in the impressive physiques of ancient statues. Before getting too idealistic, however, it is worth remember-

ing one more thing: if you look at Greek statues and think, “maintaining those abs must have been a full-time job,” you are not far off. Many citizens in ancient Athens were not expected to hold down jobs in the modern sense, as most labor was done by slaves and commerce carried out by resident aliens. When he was not at war or politicking in the agora, an Athenian man had all day to do pull-ups with Plato and sculpt his abs with Aristotle − he did not have to fit his workout into his lunch hour.

Source: “Sports training of the Ancient Greeks” (in Greek) by Dimitris Komitoudis and Thomas Giannakis, Department of Physical Education and Athletics, University of Athens.

Athletes in a running race approaching the finish line; Panathenaic amphora, by the Berlin Painter, 480-460 BC (Vatican Museums, Rome).

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Small Miracle Workers The country is endowed with dozens of endemic plants that have significant medicinal properties and aromatic qualities â&#x20AC;&#x201C; and are in need of protection. BY O R E S T E S DAV I A S * I L L U S T R A T IO N s : G E O R G E S F I K A S

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wander around any of nature’s gardens in Greece is a journey back to a land of legend and symbolism, a magical place where men are heroes and where gods give shape to every plant. This is where nymphs elude their pursuers by transforming themselves into fragrant shrubs and where god-sent herbs bring us comfort and succor in abundance. Greece’s natural environment is known for its diverse landscape and myriad microclimates; this variety creates ideal conditions under which certain herbs and medicinal plants can thrive. Dwarf oregano, thyme from the Aegean archipelago, Greek sage and dozens of other herbs that grow here are all endowed with aromatic qualities and medicinal properties more powerful than those found in other countries. What’s more, Greece’s wild plants seem quite happy to flourish in the rugged mountain fields which far outnumber lush irrigated farms. At the same time, we must not overlook the important presence of Greece’s endemic plants, those that can only be found within the country’s borders, many of which have exceptional qualities. Some of these constitute remnants of older geological periods, though most appeared more recently as a result of the particular conditions prevailing in a part of the world where three continents converge. Intense phenomena such as the birth of new islands and mountain ranges, sinkholes and volcanic eruptions have reshaped the landscape again and again through the eons, forcing some species into isolation. Naturally, only a handful of these have survived and can still be found in the wild; they are nature’s acrobats, successful experiments of evolution, because they managed to adapt to and survive the harshest of conditions.

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The parts of Greece considered “hot houses” of endemic plants are Central Greece, the Peloponnese and the islands of the Aegean, including Crete. To put it in numbers, of the 6,500 species and subspecies that constitute Greek flora, some 1,300, or one in five, are endemic. Imagine that Crete alone has 165 native plants when Germany – roughly 45 times the size of the Greek island – has just 42. The bad news is that 25 percent of Greek endemic plants are considered endangered or at risk of extinction. Those that appear only in a restricted geographical area in particular are at risk from factors as mundane as the opening of a new mountain road, the installation of a wind farm, forest fires, prevalent over-grazing and the aggressive development of our coastlines. Another foe that has been around for at least three centuries now is the collector: sundry botanists, nature lovers and hunters of rare plants are scouring the Greek countryside in search of treasures to complete their collections. This means that visitors to botanical gardens across Europe can admire some 300 native Greek plants, while about 100 are even available for purchase abroad. But for every plant that survives the process of being uprooted and transplanted to foreign lands, several dozen are destroyed, thus putting the survival of the species under even more strain. The last of these plants find shelter in remote, inaccessible parts of

the country, often high up on its mountains. It is estimated, in fact, that onethird of the country’s native species live at an altitude of over 1,000 meters. Measures are desperately needed to ensure the survival of Greece’s endemic plants, as we have seen time and again that domestic legislation and international agreements have little if any effect. Efforts should initially focus on highlighting their importance and then on utilizing them to their best possible advantage, in cooperation, of course, with local communities. I am certain that, of the millions of visitors who come to Greece every year, many would be happy to go on nature walks acquainting them with the rare and native plants of each region. I have no objection to ongoing efforts to ensure their survival through seed banks, though to date these efforts can be described, at best, as being rather lackluster. The most promising way forward, however, is for these plants – or at least those which could be used in cosmetic and pharmaceutical products or as edible or ornamental plants – to be cultivated organically at protected farms near their natural habitat. A significant part of the proceeds from their sale could then go towards protecting the wild population so that it can continue to act as a living treasury of their valuable genetic secrets. * Orestes Davias is a biologist and writer.

For every plant that survives the process of being uprooted and transplanted, several dozen are destroyed, thus putting the survival of the species under even more strain.

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Portraits 10 e x c e p t i o n a l e n d e m i c s p e c i e s

Cretan dittany

Origanum dictamnus

Since ancient times, Cretan dittany has been the absolute panacea of folk healing on the southern Aegean island. Its reputation was greatly helped by a reference by Aristotle suggesting that when wild goats were hit by poison-tipped hunting arrows, the animals would eat dittany to counteract the venom and heal the wound. In its wild form, this low-lying bush is found in rugged craggy terrain,

but it is also cultivated in the valley of Embaros near Irakleio, which has taken some of the pressure generated by its traditional collectors off wild dittany. The Cretans drink dittany as a tisane to ward off colds and headaches, to ease rheumatic and stomach pain, and as a general tonic. In older times, it was also used in poultices to heal wounds, chewed to soothe toothache and swollen

gums, and added to baths to preserve youth and increase virility. A plethora of scientific studies have attributed its efficacy in these uses to antibacterial, expectorant, astringent and antispasmodic properties. Studies are still being conducted into its potential but it is certain that Cretan dittanyâ&#x20AC;&#x2122;s age-old reputation will survive for centuries to come. G R E E C E IS

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Laconian thyme

Thymus laconicus

Its similarity to the prolific conehead thyme (Coridothymus capitatus) that is found all over southern Greece and its own rarity have kept this species practically unknown until recently. However, if you know what youâ&#x20AC;&#x2122;re looking for, it can be found in the fallow fields and rocky shrub land of the southeastern tip of the Peloponnese at Cape Maleas. It prefers 48

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areas that are cooled by the sea breeze, though it also has a remarkable tolerance for drought, and can be found at altitudes of up to 900 meters. It has multiple branches, a woody stem and an incredible heady aroma, which explains the frenzy of bees seeking the nectar of its rosy blooms at the start of summer. There have been no com-

prehensive studies of this plant so far, but this is certainly about to change, as there is little doubt that it has significant antimicrobial and expectorant properties as well as digestive uses. This, combined with the fact that it is rare yet grows with relative ease, suggests that Laconian thyme has a bright commercial future.

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Taygetus mountain tea

Mount Juktas St John’s wort

Sideritis clandestina subsp. clandestina

Hypericum jovis

This is one of seven endemic species of the Sideritis genus – also known as ironwort or shepherd’s tea – that is native to the rocky terrain of Greece’s mountains. I had the good fortune to observe a magical harvest just last June. The collectors’ scythes became a blur of slashing blades as soon as we arrived at the spot, and our bounty soon piled up. The intense, heady aroma of freshly-cut mountain tea is said to evoke a sense of euphoria, and I observed this firsthand in my fellow collectors’ broad smiles and in the wild bees diving deep into the yellow blossoms to suck up their stimulating nectar. However, decades of unregulated harvesting in combination with over-grazing have placed this particular subspecies and the genus in general at risk. There are a lot of reasons to introduce controlled cultivation, especially now as the international community is becoming aware of the great potential of Greek mountain tea. Scientists have proven that its infusion acts as a tonic without causing restlessness, helps digestion, softens a cough and does marvelous things against colds. It also has a bright future ahead in the food and cosmetics industries, as its extract has anti-inflammatory, antioxidant and antimicrobial properties.

Only found on the cliffs and crags of the mountains of Central Crete, this plant grows at altitudes ranging from 500-1,500 meters and only in rocky, calcareous soil; as such, it is extremely difficult to cultivate in different territories. It has tiny leaves speckled with numerous glands that look like dark spots, and produces bright yellow blooms in the spring. It is not endangered, as it is not collected locally, but it is considered vulnerable. The plant belongs to the same genus as Hypericum perforatum – renowned mainly for healing wounds and acting as an antidepressant – while its epithet, jovis, is derived from Jupiter, after the ancient Roman name for the king of the Olympian gods. The reason it was given this epithet was that the Cretan believe Zeus’s tomb to be on one of the mountains on which it grows, Juktas. In ancient Crete, the gods died and were reborn in spring. It is a funny coincidence, therefore, that the isolation of two new derivatives – hyperjovinols A and B – found from the plant demonstrated powerful antioxidant and anti-aging properties, which will almost certainly attract the interest of the pharmaceutical and cosmetics industries in the future.

The intense, heady aroma of freshly-cut mountain tea is said to evoke a sense of euphoria, and I observed this firsthand in my fellow collectors’ broad smiles...

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Olympus yarrow

Achillea ambrosiaca

This is a small plant found only on the ancient world’s holiest mountain, Olympus. It grows from the mountain peak where Zeus launched his fearsome thunderbolts – at an altitude of 2,900 meters – down the rocky slopes, across the alpine meadows and along rocky crags, and only rarely at altitudes below 2,000 meters. Collecting its fragrant feathery leaves and the snow-white flower clusters that emerge in the summer is strictly forbidden, as the area is protected. This also means that it cannot be cultivated in the area either, while at lower altitudes, the plant is vulnerable to diseases. Nevertheless, its unusual fragrance, the usefulness it almost certainly has in the production of cosmetics and its association with the mountain of the gods – a great marketing attribute – dictate measures to overcome these obstacles. With coordinated efforts in the laboratory and out in the field, it is certain that the day is not too far away when, thanks to its anti-aging effect on skin, this plant justifies its specific epithet (ambrosia being the food of the immortal gods).

Wild saffron crocus

Crocus cartwrightianus

One of the splendid frescoes found in the prehistoric settlement of Akrotiri in Santorini (and dating from around the mid-second millennium BC) depicts two women in colorful robes filling their baskets with wild crocuses growing in abundance in a rocky landscape. Even today, the women of Santorini continue to collect the bloom every November, bending down again and again to snip out every gram of pure saffron. This arduous work is followed by the equally challenging task of separating the stigmas and stamens from the blooms, then drying and storing them so they can be used a few months later to add color and 50

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fragrance to traditional Easter cookies. Some locals claim that Santorini’s wild saffron has stimulative and aphrodisiac properties, echoing the views of ancient Greek healers. This bloom – the progenitor of the more familiar domesticated species cultivated in different parts of the world – still grows wild in parts of the Cycladic islands, western Crete and Attica. Like the tame species, it has antioxidant, expectorant, anti-inflammatory and anticoagulant properties, just to name a few of its characteristics, so maybe it is time to “rediscover” this wonderful plant and give it back some of its ancient glory.

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botanical medicine Natural remedies based on the best of natureâ&#x20AC;&#x2122;s bounty.

Greek peony

Paeonia parnassica

With large, dark-purple petals that come out in May, this native plant gives us one of Greeceâ&#x20AC;&#x2122;s most beautiful flowers. It is a relatively small plant (usually no taller than 70cm) that is endemic to Mount Parnassus and nearby Mount Helicon. It is found in the clearings of conifer forests, in humid meadows and in ravines, usually tucked away between rocks, and at altitudes of up to 1,500 meters. It

grows in small populations and is considered vulnerable because it is collected intensively for its decorative attributes, despite European Union regulations for its protection. The genus Paeonia is named after Paean, a healer of the ancient gods who, according to legend, first discovered the powers of these plants. From Hippocrates to Galen, ancient physicians

had no doubt that its roots and seeds cure spasms, nightmares, epilepsy and numerous female ailments. The ancients actually thought it a magical plant and would collect it according to a ritual that ensured it would not be harmful. Modern science has so far discovered that its roots have useful antimicrobial properties, but it is certain that it will reveal many more secrets in the future. G R E E C E IS

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Apple-bearing sage

Salvia pomifera subsp. pomifera

Greek knapweed

Centaurea raphanina subsp. mixta

That this endemic Greek plant has more names in the Greek language than any other is indicative of the huge culinary interest it engenders in the Peloponnese, Central Greece and many Aegean islands. Fortunately, it is extremely adaptable and grows at high altitudes, on rocky slopes, in olive groves and brush land, so that there is still plenty to be found, despite intensive harvesting. It stands out for its rosettes of dark-green and deeply lobed leaves and particularly for the purple blooms that emerge in later spring on a short stem. Its leaves are gathered when theyâ&#x20AC;&#x2122;re still sweet and tender, and they are eaten boiled, sautĂŠed or even pickled, as a delightful meze to go with ouzo. However, it also has many promising pharmaceutical properties (both fungicidal and antioxidant), making it very likely that it will soon be cultivated systematically for its extracts.

This species of wild sage that is endemic to southern Greece is not cultivated yet, but it is collected from the pine forests and rocky mountainsides where it thrives, often in large numbers. It is a low-lying bush that does not exceed one meter in height, and stands out among several native Greek sage species for its beautiful and relatively large red-blue spring blooms. Its hairy leaves give off a strong and pleasant fragrance, and just a few are needed to prepare a delightful beverage that acts as a tonic and aids digestion, while also helping combat the effects of a cold. It has quite a high concentration of essential oils, which are further activated during the warmer summer months. Even though this species has not been adequately studied, we do know that it has antiseptic, anti-inflammatory, antispasmodic and antiperspirant qualities. The essential oils are said to boost concentration when inhaled and to relieve headaches and swollen gums when applied locally. Apple-bearing sage is also very promising as an additive in cosmetics, as it helps cleanse oily skin and prevent acne.

Mount Athos immortelle

Helichrysum sibthorpii

Despite strict regulations banning its collection and its own ability to hide at altitudes of 2,000 meters in inaccessible crags on sacred Mt Athos in northern Greece, this rare species of immortelle could, until a few years ago, be purchased in pots online. Any plant at risk of extinction inevitably stirs the interest of collectors hunting down rare floral treasures. Part of this plantâ&#x20AC;&#x2122;s popularity, and one of the reasons why it struggles to survive, is its impressive appearance when in bloom during the summer months; it exemplifies alpine beauty. When carefully dried, the plant keeps for a long time and maintains its delicate fragrance, a trait that reminds us of all the wonderful properties and rare powers contained in its blooms. Judging by close relatives of the same genus, we can surmise that its exceptionally fragrant essential oils are beneficial to the skin, and particularly older skin, protecting and healing it from the ravages of time. It seems a good idea to cultivate this wonderful shrub near its native lands, not only to ensure its survival but also to tap into its rejuvenating powers. 52

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BRANDS IN BLOOM Dynamic Greek companies combine the countryâ&#x20AC;&#x2122;s unique botanical resources with its rich traditions and strong science base to produce luxury cosmetics and nutritional supplements. BY GEORGIA NAKOU

Vials and tubes on parade, in the Korres Natural Products lab.

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n the quiet of the mid-afternoon, on a steep hillside overlooking the deep blue sea, honey bees stir the wild sage, oregano and thyme, releasing the fragile woody aroma of the Greek scrubland, or phrygana. In a state-of-the-art laboratory just outside Athens known as the “hive,” teams of researchers – pharmacologists, cosmetologists, biochemists and chemical engineers – work to extract and test natural ingredients from Greek plants for a new generation of natural products. Greece has a rich natural herbarium and a long tradition of extracting value from it, making, as the food writer Patience Gray put it, “honey from a weed.” Today, a small ecosystem of dynamic Greek companies has emerged whose strength and identity comes from com-

bining the country’s unique botanical resources with its rich traditions and strong science base to produce luxury cosmetics and nutritional supplements. Cosmetics brands such as Apivita and Korres have leveraged their knowledge of traditional herbal remedies to create globally recognized personal care brands. At the same time, companies such as Power Health are becoming known for their natural dietary supplements and over-the-counter remedies based on plant extracts. A whole host of smaller Greek startups are emerging in the natural products sector, both in production and in e-commerce, benefiting from the natural advantages offered by Greece. As modern as these companies are in their approach, they are in fact the

From the age of the sail to the age of the internet, Greece’s unique herbarium has been one of its most distinctive exports.

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inheritors of a millennia-old tradition. In Classical Greece, the natural environmental diversity came under scrutiny by the first philosophers, resulting in the earliest systematic studies of plants and their properties. In the 5th c. BC, Hippocrates and his students laid the foundations for scientific medicine, while Theophrastus, a student of Plato and Aristotle, pioneered the field of botany with the first-ever classification of plants. While working for the Roman army, a Greek doctor named Pedanius Dioscorides compiled the definitive “pharmacopeia,” De Materia Medica, which became the primary medical reference book through the Middle Ages. In the 18th c., John Sibthorp, a professor of botany at Oxford, set out with a copy of De Materia Medica in his luggage to catalogue Europe’s “last unexplored plants.” The resulting work, a luxuriously illustrated work titled Flora Graeca, was recently exhibited in the Gennadius Library in Athens. It recorded 2,500 medicinal plants, of which 700 were classified for the first time. Throughout this time, nameless traditional herbalists (many of them undoubtedly women) developed and passed down home remedies using the wild plants around them. The new generation of Greek herbalists gives credit to both these traditions, the formal and the informal, in shaping their methods and ingredients.

Beauty outside Apivita, whose name means “life of the bee,” was founded in 1979 by two young pharmacists with a passion for beekeeping, Greek nature and the Hippocratic holistic approach to health and healing. Their product range, which started with natural soaps, now includes face, hair and body care products, combining ingredients such as red wine, royal jelly and propolis, or bee glue, with herbal extracts. “When we decided to expand from the pharmacy business, it was a time when no one believed in natural cosmetics, and no one bought Greek products, let alone Greek cosmetics, but in the craziness of our youth we saw an opportunity,” says Niki Koutsiana, Apivita’s President and co-founder. “In reality, we have never

Cosmetics brands such as Apivita and Korres have leveraged their knowledge of traditional herbal remedies to create globally recognized personal care brands. 1

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1. At the source: a lavender field ringed with beehives that together supply Apivita Natural Cosmetics with pure ingredients. 2. Korres Natural Products takes pride in its modern design and branding, an approach that extends to its facilities as well. 3. George Korres started his company in 1996, using his deep understanding and knowledge of natural ingredients and their application in over 3,000 herbal remedies. 4. Chemists at work in the state-of-the-art Apivita labs.

sold the products themselves, but the vision, the ideas; our mission was to spread the teachings of Hippocrates, to ‘pollinate’ the world with his ideas like bees.” Indeed, one of the company’s flagship initiatives has been the Hippocrates botanical garden, an homage to the “father of medicine” on his ancestral island of Kos. Apivita sources its ingredients from small producers across the country. Their distinctive logo, a modern graphical representation of the “Mallia bees,” a Minoan pendant depicting a pair of facing bees, reflects the combination of ancient and modern in their approach. The bee provides a discreet motif around their headquarters, itself housed in a purpose-built bioclimatic “hive” complex. In their research and development laboratories, Apivita’s team have used state-of-the-art techniques to develop over a hundred proprietary extracts and oils from a few dozen plants and beekeeping products. Their biochemical lab holds a library of over 200 genes associated with skin conditions in order to study the efficacy of their raw materials. In addition to selling from its own stores and pharmacies in Greece, Apivita has chosen to pursue an outward-facing strategy, with activities in 15 countries across Europe and Asia. Today, the overseas markets account for up to a third of their sales. G R E E C E IS

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1. Lilly Perganta, Power Health founder & Managing Director. 2. Power Health’s modern headquarters in the suburb of Metamorfosi, northern Athens. 3. A look into the research department of the company.

It seems that the world is indeed coming around to the Hippocratic approach. As consumers worldwide become more conscious of the ingredients in their cosmetics, they are seeking out greener and safer choices. A growing segment of the market is demanding natural and sustainable materials with organic certification, and avoiding synthetic substances and petroleum-based products. It is a desire that marries health-consciousness with a concern for the natural environment. According to a recent study, this trend is driving growth in the global market for organic personal care products at a projected rate of 10 percent every year, meaning it should reach almost $16 billion in value by 2020. In this market, small specialist independent brands are able to play a major part based on their ability to develop innovative, market-leading products. Another pioneer of the “green” philosophy in Greece has also been riding this global tide to great acclaim. The seeds of the Korres brand were sown when its founder, a pharmacology graduate, went to work in Athens’s first homeopathic pharmacy in 1989. Combining the scientific method and the homeopathic approach, he ended up taking over the business and launching the Korres brand in 1996. Korres has a simple philosophy: high-quality natural and/or organic ingredients, clinically tested for efficacy, at affordable prices. The products are sold in airports, Korres stores, and luxury outlets and pharmacies worldwide. Their branding is instantly recognizable (they have won awards for their packaging as well as for their products): bold modern typeface, combined with retro imag58

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“For 33 years, our vision has remained steadfast and focused on making consumers’ lives healthier and happier through the unique benefits that Greek nature provides us” . LILLY PERGANTA, POWER HEALTH FOUNDER & managing director

es in striking color-coded blocks. The original Korres pharmacy had over 3,000 herbal remedies in its stock, and the company continues to research unusual ingredients. Their fig-scented body-care range and wild rose facial products are perennial favorites, while their latest lines of anti-ageing creams, based on Black Pine and Castanea Arcadia (Arcadian Chestnut), were produced in collaboration with the University of Athens and a number of research centers worldwide. What’s more, their business practices are as “green” as their products; sourcing raw materials from local producers and cooperatives, banning animal testing throughout the development chain, avoiding mineral oils, minimizing waste and conserving resources are all integral parts of the Korres philosophy. “During our 20-year journey, we

HIPPOPHAES

have been focusing on Greek herbs, on our cooperation with farmers around Greece, on promoting scientific research in relation to skin biochemistry, on producing brand-owned premium organic extracts and on developing innovative products,” says the company’s founder and president George Korres.

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More Greek companies are seeing their competitive advantage and seizing the opportunity. A dynamic new entrant to the natural supplements market is SUPERFOODSTM, which has been active since 2003 but only began developing its own proprietary products in 2008. It is best known for a suite of supplements based on sea buckthorn (hippophae), a berry noted for its beneficial properties since Classical times, and whose revival the company has been encouraging in Greece. Having established a firm footing in the domestic market, they are planning to take the brand global in the next year. This is not small-time. Both natural cosmetics and supplements manufacturers benefit from strong synergies with more established business sectors

“The network of ethical cooperation we have developed with farmers supports around 5,000 families; the choice not to cultivate ourselves the herbs that we need is a conscious one. Our aim isn’t to compete, but to support the farmers and their unions, as well as the local communities. This is an essential part of our effort to take valuable Greek herbs around the world through outstanding new products of unique quality that hopefully inspire and make people happy.” Korres has a presence in 30 countries; the brand has established a strong footprint in the USA and Europe, and is now expanding in Latin America through a strategic agreement with Avon. Health inside Athens-based Power Health started manufacturing natural supplements in 1984, with the twin goals of encouraging preventative healthcare and offering a more natural alternative to prescription medications for treating mild health complaints. Power Health founder and Managing Director Lilly Perganta, who describes herself as a “romantic chemist,” is effusive about the potential of Greek herbal supplements: “For 33 years, our vision has remained steadfast and focused on making consumers’

lives healthier and happier through the unique benefits that Greek nature provides us. We believe that a ‘green’, or environmental, logic is more timely today, and more necessary for our body and soul, than ever. We are constantly raising the bar for health food supplements ahead of consumer trends, creating added value through innovation, professionalism and quality.” The company has a strong presence in Cyprus and the Balkans; it exports throughout Europe (where it has won numerous awards) and sees the Gulf countries as its next area of growth. The same concerns that lead people to seek out natural cosmetics are also driving an increase in the demand for natural food supplements and herbal remedies. Consumers around the world are becoming more aware of the beneficial effects of a healthy diet, and are searching for ways to boost their intake of micronutrients and vitamins. They are also increasingly conscious of the dangers of over-medication for long-term health. According to market research, the global market for supplements, valued at $108 million in 2013, is expected to grow by 7.4 percent annually and reach almost $180 million by 2020.

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in Greece. The conventional pharmaceutical industry is the unsung hero of the Greek manufacturing sector. The industry anchors a skilled workforce numbering several thousand employed in R&D and manufacturing. There’s a further, very modern, trend that has been helping Greek manufacturers of natural products to expand: the growth of e-commerce. With more consumers buying personal care products on the internet, online pharmacies such as www.greekpharma.com and www.olivegarden.gr are offering a digital shop window to the world for Greek products. G R E E C E IS

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y late grandmother, a farmer’s wife in the agricultural heartland of Thessaly, had a generic term for wholemeal bread: skylopsomo, which translates as “dog bread.” In her household, as in most households at the time, bread for humans was made from refined white wheat flour. The bran from processing the grain was baked into loaves and fed to the farm dogs. I can picture my grandmother crossing herself and chuckling wryly at the thought of what is sold as bread for human consumption these days, and the premium that consumers are prepared to pay for it. Over the past decade, the seeds of a small revolution have been sown: Greece has seen the revival of ancient food crops as modern “superfoods.” Plants once derided as famine food or relegated to animal feed now line the shelves of health-food stores and upmarket delicatessens, to meet an increasing demand for special diets, nutritional supplements and more adventurous gastronomic experiences. Dotted all around our ancestral village, across the Thessalian plain and up into the surrounding hills are clearly visible mounds, which the locals call magoules (cheeks). They are the layered remains of generations of habitation by the very first Greek farmers, dating back as early as 9,000 years ago in the Neolithic period. These early farmers cultivated the ancient varieties of today’s grains; crops that were first domesticated in the Near East from wild grasses, 2,000 years earlier. Emmer wheat, whose scientific name is Triticum dicoccum, is one of the oldest domesticated grains, together with einkorn wheat (Triticum monococcum) and barley. To this family was later added spelt wheat, Triticum spelta; together they formed the backbone of the early farmers’ diet. Neolithic cereals yielded meager volumes by today’s standards, producing smaller seeds encased in a hard husk, which re-

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Demeter, with her daughter Persephone, offers ears of wheat to Triptolemos. The Eleusinian hero sits in a winged chariot, which he will use to traverse the world teaching people the art of cereal cultivation; an artistic interpretation of an original scene on an Attic red-figure skyphos of ca. 500-480 BC (British Museum, London).

As Greeks turn to their native soil and traditions to restore their national pride, and a new generation of producers look with fresh eyes on neglected opportunities, alternative food crops may be among the few economic sectors benefiting from the crisis. BY Georgia Nakou

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Dimitris Yoldassis, Harvest, 1963 (Municipal Art Gallery of Larissa, G. I. Katsigras Museum).

quired hours of extra labor to remove after threshing, and even further effort to grind. But the grains were also hardier, more resistant to pests and weather, and more nutritionally complex than their modern descendants. In classical Greek literature, we find references to a grain called zea or zeia (as distinct from the more common sitos for wheat) which may hark back to these earlier wheat varieties. For Homer, zea was a byword for fertility: the epithet zeidoros, meaning “zea-gifting”, is used in the Iliad to describe fertile land. However, it is not entirely clear whether zea was grown for human or animal consumption. Certainly Herodotus thought it worth mentioning in his Histories that the exotic Egyptians preferred zea to wheat or barley. It is also suggested, based on medieval texts, that the grain gave its name to the Piraeus harbor of Zea; however, more recent investigations have shown that in classical times, Zea was a naval base for Athens’s fearsome fleet of trireme warships, rather than a grain port. Despite the ambiguities of language, the name zea with its classical connotations has become widely adopted in modern times. By the classical period, the archaeological evidence suggests that the ancestral wheat varieties had been mostly displaced by barley, and eventually by durum and bread wheat. By modern times, zea was all but un-

Zea grains have a very distinctive nutty flavor, while bread and pasta produced from them have a pleasantly chewy consistency but are lighter and more elegant in texture than whole wheat alternatives.

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Geografica Protetta) since 1996. The name farro is used in Italy colloquially to refer to einkorn and spelt as well as emmer, often causing confusion among grain purists. Like zea, it is a useful shorthand for rustic grain varieties that have more in common with one another than with modern hybrids. Within the last decade, just a few kilometers along the highway in both directions from our ancestral village, on land overlooked by the Neolithic magoules, a small group of entrepreneurial farmers have decided to reject modern high-yield wheat varieties and cash crops such as cotton and sugar-beet, which dominate the fertile plains, in

favor of these ancestral grains. While some producers have opted to use certified Italian farro seed, marketed in Greece as Dikokko Sitari, at least one farmer claims to be using old grain curated by his family in Thessaly, marketed as zea. Their products can now be found quite widely in health food stores and Greek specialty delis, and are making their way into supermarkets and neighborhood bakeries as well. The whole grains can be used in soups, stews and risottos instead of rice or pasta, while the flour can be baked into bread and cookies, and dried pasta made from the flour is proving particularly popular. Zea grains have a very

ÂŠ STYLING: TINA WEBB, PHOTO: GEORGE DRAKOPOULOS

known in Greece. An urban myth holds that its cultivation was banned in the 1930s, for fear of undercutting the price of grain imports, or, in a more lurid version, in a bid to keep the Greeks docile by depriving them of key nutrients. The reality is probably more pedestrian. Modern wheat varieties are much better suited to meeting modern mass demand, as they have been hybridized over the centuries to produce high yields, and are much easier to process by mechanical means. The main holdout for emmer wheat in modern times is Italy, where it is known as farro; the canny Tuscans have protected the grain as a regional specialty (Indicazione

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distinctive nutty flavor, while bread and pasta produced from them have a pleasantly chewy consistency but are lighter and more elegant in texture than wholewheat alternatives. In addition to providing a more adventurous gastronomic experience, proponents of emmer in particular note that it is low in gluten (though not gluten-free), twice as rich in dietary fiber as ordinary wheat, and high in the amino acid lysine, which improves digestibility. It is therefore suitable for diabetics, as well as people with mild digestive disorders (though not for sufferers from severe wheat allergies). It is also rich in vitamins A, B, C and E and magnesium. “I would say that it’s like eating a dietary supplement,” says Vincenzo, an Italian transplant who, together with his Greek wife, has spent the last 20 years running Aloe, a local health food store in the residential Athenian neighborhood of Ilissia. “People these days are being more careful about what they eat, even though there is less in their pocket. I have new customers coming to us and asking for these products all the time, particularly young mothers.” The revival of ancient grains is part of a global phenomenon, spurred by a growing recognition of the health contribution of dietary fiber, the enduring popularity of the Mediterranean diet and the search for new gastronomic experiences. There is also a burgeoning demand for gluten-free, whole foods and other alternatives to processed wheat, initially to cater to sufferers from medical conditions such as celiac disease, but increasingly to meet demand for alternative diets as a lifestyle choice (the global market for gluten-free food alone was valued in 2011 at $1.6 billion). In Greece itself, greater health-consciousness and a return to traditional ingredients and recipes and locally-grown crops has created a flourishing domestic market in the teeth of the recession. Indeed, as Greeks turn to their native soil and traditions to restore their national pride, and a new generation of producers look with fresh eyes on neglected opportunities, alter-

native food crops may be among the few economic sectors benefiting from the crisis. There is clearly room for growth in the home market, as German spelt – marketed as Dinkel – still takes up considerable shelf space alongside the native products, while global demand might eventually provide an export market. Gusto di Grecia, a delicatessen specializing in traditional Greek foods from small producers in the upmarket neighborhood of Kolonaki, carries several lines of zea and Dikokko products. “We see lots of demand for whole grains from people with special dietary requirements, but our mission with all our products since starting out has been to identify small producers across Greece,” says sales manager Katerina. “There’s a lot of activity in the countryside, often by young people, reviving traditional foodstuffs and bringing them to market.” For the farmers, this growing appetite for ancient grains presents a clear opportunity. Emmer and its sisters are likely to remain a specialty or “premium” product, as the prices are considerably higher than for ordinary wheat products: according to the producers, grains fetch up to two and a half times the price of wheat in wholesale terms, and the gap widens for processed products. Much of the price differential is due to the lower yields, greater wastage (those tough hulls) and higher processing costs compared to industrially grown wheat, so not all of it goes to the farmers as profit. However, the ancestral wheat varieties can grow in poorer quality rocky soil, thrive in hilly terrain up to 1,500m elevation, do not need irrigation and require fewer fertilizers and pesticides because of their naturally higher resistance to pests and common diseases. Thanks to their rugged, undemanding character, they allow farmers to cultivate land that would otherwise lie fallow. I’m sure my grandmother, who by all accounts held the purse strings in the household, would see the benefit in that.

More ancient superfoods Other traditional crops are finding a new lease of life as modern “superfoods,” too. For modern metropolitan Greeks, eating acorns has long been a metaphor for desperation or backwardness, but on the Aegean island of Kea, a resident American used the Kickstarter online crowd-funding platform to fund a revival of the local wild acorn harvest. The acorns are used to produce nutrient-rich gluten-free flour and baked goods which are exported worldwide. The harvest itself forms the focus of a growing agritourism trade, for visitors looking for something more than a beach holiday. (Read more: www. iloveacorns.com) • Stamnagathi, a wild spiny chicory rich in fiber, vitamins and antioxidants, traditionally popular in Crete for both raw and cooked salads, is now systematically cultivated for the Greek market and is also exported to France. • Sea-buckthorn (Hippophae L.) is a berry which was mentioned by Dioscurides, the “father of pharmacology,” and other ancient authors as a medicinal plant. Its scientific name, derived from ancient Greek, translates as “shiny horse” - it is credited with keeping the horses in Alexander the Great’s cavalry healthy and bright-coated. Over the last decade, it began being systematically cultivated in Greece, with support from the government. The berries are made into premium fruit juice for the Northern European market; it is also used in a variety of food supplements, skin treatments and cosmetics. •

Bread made from zea wheat is making a culinary comeback for nutritional reasons, as well as for its special taste.

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GREEK SUPERFOODS They can be found everywhere, from delis to pharmacies, conveniently packed and easy to carry back home. And theyâ&#x20AC;&#x2122;re the most beneficial gifts from Greece you can offer yourself and those you love. BY Ta s s o u l a E p ta k i l i F OO D S T Y L I N G : T I N A W E B B P H O T OS : G E O R G E D R AKOPOULOS

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regano adds the familiar fragrance to a Greek salad, but it also provides relief for a sore throat. Olive oil is an essential component of Greek cuisine, but it is also medicinal. Honey is a sweetener that also contains more than 180 nutrients. Ancient Greek gastronomy, the ancestor of the food culture of Rome, is the source from which many features of European diet and cuisine are derived. But that’s not all. Ever since antiquity, the Greeks have not only sought to satisfy their hunger or to find enjoyment in foods. Many foods were used to prevent or treat a number of health conditions.

Olives and olive oil A plant native to Greece, the olive tree was being cultivated in the Aegean as far back as 2000 BC. The olive and its precious oil have been omnipresent components of Greek life ever since: in the diet, in religion, in mythology, in medicine, in literature and in art. Olive oil was particularly important at the palaces of Knossos, Mycenae and Nestor (Pylos). It was a key ingredient in most cooking, used in bread-making and even eaten with bread for a light meal. However, it also had important uses beyond cooking; it served as a fuel, as a cosmetic and as a medicine (60 medicinal uses are referenced in the Hippocratic Corpus). The olive tree was endowed with rich symbolism as well: it was the sacred tree of the goddess Athena, and its branches were used to make the kotinos, a crown given as a trophy to Olympic champions. The mainstay of the Mediterranean diet to

Sage Its official botanical name is in fact Salvia officinalis, which is partly derived from the Latin verb salvare, meaning “save,” and alludes to its therapeutic properties. The ancient Greeks used its fresh leaves to treat wounds and snake bites, and as a drink to enhance female fertility. As a beverage, sage-infused “Greek tea,” as the French call it, or “Greek sprout” for the Chinese, remains popular to this day, either on its own or combined with other aromatic herbs. Sage is also associated with some less scientific benefits. In Syros, for example, they say it exorcises gossip. You will often find little bunches of it hanging outside homes. A beneficial herb, sage has anti-catarrhal properties (for asthma, bronchitis and coughs), as well as anti-fungal and anti-infective action (for flu, gingivitis and insect bites). It is an effective antispasmodic (in cases of dysmenorrhea) and healing agent. Its broader effects include stimulating the nervous system, improving memory and boosting blood circulation, while its antioxidants act against free radicals.

Trahana According to gastronomic history, modern-day trahana has evolved from a porridge-like mixture of milk and wheat eaten by the ancient Greeks and Romans. The noted gourmet and recipe collector Apicius (1st c. AD) refers to this food substance as tractae. In Byzantium, it was popular as tragos or traganos. Until a few decades ago, when the refrigerator was still largely unknown in most Greek households, it was a practical method for using up leftover milk and was critical to a family’s survival – trahana could be stored for more than a year in a cool place. Trahana is made with fresh cow’s, sheep’s or goat’s milk that has soured, to which wheat is added. The wheat can range from coarse to fine – Cretan xinohontros, for example, uses coarse wheat. Trahana is rich in carbohydrates and is a good source of energy. It’s also a source of fiber, which aids intestinal health. The lactobacilli in the sour milk have a beneficial effect on the digestive tract, too. Trahana contains protein, magnesium, iron, phosphorus and calcium in a form which the body can easily absorb. It also has carotenoids, such as lutein, a powerful antioxidant that works to prevent the harmful effects of free radicals, thus helping to maintain healthy eyes, skin and heart. Trahana can be made into a thin or thick soup, and is low in calories (100 calories/100g). In recent years, many chefs have enriched the classic trahana soup recipe with bits of meat and vegetables or fish. It can be added to savory pie fillings or used in stuffed vegetables or grape-leaf dolmades instead of rice.

this day, olive oil is critical to good health. It is ideal for the heart and prevents blood clots. Its polyphenols reduce bad LDL cholesterol and increase good HDL cholesterol. Its cancer-fighting and anti-aging actions derive from its valuable antioxidants (flavonoids), vitamin E, provitamin A, minerals and trace elements. It helps to regulate glucose levels in diabetes, plays a key role in central nervous system development, and also aids in the normal function of the digestive system, decreasing the possibility of ulcers and improving intestinal tract motility. “But why Greek olive oil?” you may ask. Well, first of all, because of its unique flavor. Secondly, because more and more research is confirming that olive oil produced in Greece is higher in polyphenol content – polyphenols are the precious chemical compounds that promise to rid us of many health problems – than those produced in other parts of Europe.

More and more research is confirming that olive oil produced in Greece is higher in polyphenol content – polyphenols are the precious chemical compounds that promise to rid us of many health problems.

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Anthotyro According to Greek mythology, knowledge of cheese-making was gifted to humans by the gods of Olympus through Aristeas, son of Apollo. There are references to cheese products in the writings of Aristotle and in the comedies of Aristophanes, while Homer famously referred to them in the Odyssey as well, citing the production of cheese from goat’s and sheep’s milk by the one-eyed Cyclops Polyphemus who was eventually blinded by Odysseus. Could this cheese have been anthotyro? It is quite possible. Soft, white and rind-less, anthotyro is made in most regions of Greece from whey (left over from making another type of cheese) and the addition of sheep’s or goat’s milk, or a combination of the two. Lightly salted, it combines a pleasant rich flavor with high nutritional value. It provides all of the substances that dairy products offer (protein, calcium, potassium, phosphorus), but contains less fat (it is not high in cholesterol content) and is just 200 calories/100g Compare that to 470/100g calories for graviera cheese, 420/100g calories for kefalotyri, and 350 calories/100g for feta. Anthotyro is served as a side dish with meals, used in savory pies and salads or as a spread on bread. It pairs deliciously with fresh fruit and nuts, and makes an excellent dessert when topped with honey.

Stamnagathi These greens are a variety of wild chicory (Cichorium spinosum), and have a bitter flavor. They are a key element of Cretan cuisine. The Greek name originates from an old habit the Cretans had of placing these greens over the mouth of the water jars to keep bugs out of the water. The Stamnagathi plant is a source of dietary fiber, antioxidants, iron, calcium, potassium and vitamins A, C and E, and beta-carotene. It is an excellent tonic and diuretic; it helps to detoxify the liver and has slightly cathartic properties. The ancient Greeks considered it medicinal. The greens can eaten raw with a lemon or vinegar and olive oil dressing, boiled on their own, or cooked together with lamb or goat. They can also be pickled after parboiling.

Barley rusks The ancient name for rusks was dipyritis artos, meaning “twice-baked bread.” Rusks have been a staple of the Greek diet since before refrigeration or preservatives, when a way of keeping bread for as long as possible was needed. Rusks, particularly those made with barley (which thrives better in the Greek climate than wheat), are considered a key ingredient of a healthy and balanced diet. They are a good source of vitamin B complex, selenium, potassium, calcium, phosphorus, silicon (which helps to rebuild and protect bones), chromium (for better

Rusks, particularly those made with barley (which thrives better in the Greek climate than wheat), are considered a key ingredient of a healthy and balanced diet.

Dried figs The ancient Greeks considered figs a luxury, with a quantifiable economic value that lent prestige to those who could consume them. But they were also a special delicacy. There was a word – sykoskopos – that referred to someone who brought news of where syka (figs) were to be found; there was also the term sykofantis, used for the person who revealed their illegal trafficking. It was not uncommon in Attic comedies to see the impoverished protagonists dreaming of buying wine and dried figs as soon as they could find a little money. In classical times, figs were eaten fresh as an appetizer, and were usually salted. In dried form, they accompanied the wine served at symposia. The leaves of the fig tree were soaked in brine to remove the bitterness and were then 68

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control of glucose levels in diabetes) and dietary fiber (especially beta-glucan, linked to lower cholesterol). They also aid in better intestinal and liver function and help reduce cellulitis. It should also be noted that barley contains less gluten than wheat. So, why not try replacing your breakfast toast with barley rusks? Alternatively, you can also replace commercial breakfast cereals, which contain a high level of hidden sugars, with boiled barley, honey and cold milk. And remember that, because their low moisture content eliminates the risk of microbial spoilage, rusks do not contain preservatives, either.

used to prepare foods similar to modern-day dolmades. The nutritional value of figs, particularly dried ones, is indisputable. Rich in natural fiber (which stimulates intestinal motility), they help in weight control because they enhance the feeling of satiety. They are one of the best sources of potassium, which regulates blood pressure and boosts ligament health: just half a cup provides 300mg. They also contain magnesium, which is important for the function of the nervous system, for metabolism and for bone health. Surprisingly, they contain more calcium than milk does. You can add chopped dried figs to milk or yogurt along with your favorite breakfast cereal, eat them together with white cheeses, or try them on their own as a snack.

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1. Extra virgin olive oil 2. Anthotyro 3. Anchovies 4. Stamnagathi 5. Dried figs 6. Barley rusks

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Honey The history of apiculture, or beekeeping, in Greece goes back thousands of years. Excavations at Phaistos uncovered ceramic beehives from the Minoan era (3400 BC). Hippocrates, the father of medicine, recommended honey to all his patients. Honey, eaten with bread, was the main food for Pythagoras and his followers. Frequently, the libations to the gods included honey with wine and milk, while ambrosia, the food of the immortals, was said to contain royal jelly. In classical times, desserts with honey were very popular, including honey pies called melitoutta to plakountes, which also had sesame seeds and spices. With more than 180 nutrients, honey is a food of high nutritional value. It is an excellent source of carbohydrates, antioxidants, vitamin B complex, trace elements and minerals (calcium, magnesium, zinc, iron, copper) essential for keeping the body in balance and contributing to everything from bone strength to metabolism. It has a lower glycemic index than sugar. In other words, in small quantities, it is even suitable for people with diabetes. The great biodiversity of the Greek land – 1,300 endemic plants and an exceptional variety of flowers, herbs and trees – also affects the quality of the honey produced in Greece: it is far superior in flavor, aroma and density than honey from other countries.

With more than 180 nutrients, honey is a food of high nutritional value. It is an excellent source of carbohydrates, antioxidants, vitamin B complex, trace elements and minerals.

Tahini Closely tied to Christian fasting, tahini, the paste made from roasted sesame seeds, re-entered the Greeks’ diet through migrants from Asia Minor who carried with them the knowledge of how to make it and its cousin, halva, from their lost homelands. It has the delicious essence of roasted nuts and the rich flavor of its precious oil. One spoonful of tahini, particularly whole grain, is the perfect dietary supplement. First, the fatty acids it contains are mainly monounsaturated and polyunsaturated: these are fatty acids which raise the level of good cholesterol (HDL) that protects the heart. It is rich in high-quality proteins, vitamin B complex

(which regulates the synthesis of several hormones, among other things), calcium (acts against osteoporosis), iron (for physical and mental well-being), potassium, zinc (fortifies the immune system), phosphorus, magnesium (relieves stress and migraines), manganese and copper (reduces joint pain). It also contains selenium, which is one of the weapons in the body’s defensive arsenal against oxidative stress. Tahini is the ideal topping for breakfast (try bread with tahini and honey). It goes well with sweet flavors (honey or chocolate), with tangy lemon and with garlic, pepper, pulses and salads (it makes a great dressing). It can also be used in soups, pies, cookies and hummus.

Moustalevria In the days when there was no sugar, or it was hard to come by, homemakers made full use of everything the Greek soil gave them to expand their cooking repertoire. This is how moustalevria was born. The exact date of that birth is not known. We do know it is a dessert that dates back to antiquity; during the Byzantine period, it was called moustopita and was made with flour and boiled grape must. That is more or less the recipe that survives today, though it is now embellished with nuts and cinnamon. Moustalevria is a highly nutritious food, thanks to the raw material – grape must – which provides a large quantity of antioxidants. With the addition of walnuts, almonds, cinnamon and sesame seeds, it is enriched even further, not only in flavor but also in nutrients. Sesame seeds are rich in amino acids, minerals, trace elements and calcium. Cinnamon improves glucose levels in the blood, while walnuts and almonds provide valuable omega-3 fatty acids, antioxidants and phytosterols. What’s more, all this comes with zero fat.

Traditional yoghurt Yoghurt has always held a special place on the Greek table, although it is in fact widely consumed throughout the southeastern Mediterranean. The ancient Greeks called it oxygala, and they had a particular liking for it. French explorer Pierre Belon (1517-1564) wrote, “The Greeks and Turks have oxygala, a type of sour milk which they carry in fabric bags hanging off the side of their animals. Though it is quite watery, it stays in the bag without spilling.” There’s been a lot of milk under the bridge since then. Nowadays, as the food industry endeavors to offer products with long shelf lives, most yoghurt is processed at temperatures high enough to prevent the growth of unwanted microorgan-

isms. However, this means that beneficial live bacteria are also eliminated and yoghurt loses a large part of its nutritional value. Traditional Greek yoghurt, the one with the skin on the surface, it made from cow’s or sheep’s milk and contains valuable bacteria which have a positive effect on the entire digestive tract. These bacteria include the Lactobaccilus, which research has shown to have cancer-fighting properties. In addition, yoghurt enhances digestion, provides all of the nutrients of milk (protein, carbohydrates, fats, calcium, phosphorus, vitamin B complex and others), and can often be consumed by people who are lactose-intolerant. It is, indeed, an all-round superfood! G R E E C E IS

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Oregano The ancient Greeks held it to be a symbol of joy: it was used to make wedding crowns. But they also knew of its therapeutic value and used it as a drink to treat poisoning, diarrhea and colic, or externally to relieve skin inflammation. Arcadia and Tenedos are famous for producing oregano. Until a few decades ago, Cretan folk medicine used oregano leaves fried in olive oil to make a poultice for back pain, and oregano oil offered relief for toothache. Oregano grows practically everywhere in Greece. Fresh or dried, it adds beneficial properties along with its characteristic fragrance to many dishes. Rich in vitamin C, it also contains calcium, magnesium, zinc, iron, potassium, copper, boron, manganese and vitamin A. The essential oil of Greek oregano is considered the best in the world, as recent studies have shown it to have the highest content in carvacrol and thymol, both of which have powerful antioxidant and cancer-fighting properties. It has antibiotic and antiseptic properties as well. Oregano can relieve intestinal upsets and abdominal pain; it exhibits stimulatory, sudorific and anti-asthmatic effects; it is used to treat flu, colds, gingivitis and sore throat (in a gargling solution). Amazingly, oregano demonstrates 42 times greater antioxidant action than apples, 30 times greater than potatoes and 12 times greater than oranges.

Kozani Crocus ...or saffron, is probably the result of efforts to tame the wild Crocus cartwrightianus in ancient Greece, as the plant appears frequently in Crete’s Minoan-era frescoes and pottery, as well as in a fresco from the prehistoric settlement of Akrotiri in Santorini depicting a woman collecting the flowers. Saffron was widely used in medicine – the ancient Greeks drank it in a tisane to cure sleeplessness and hangovers. Today, Kozani’s saffron is one of the most expensive spices in the world (it takes more than 150,000 flowers to produce one kilogram of the stuff) and is very sought-after for its subtle aroma and flavor, its properties as a coloring agent and its health benefits.

Kozani Crocus is good for the digestive tract, boosts the metabolism and improves memory and overall brain function.

Santorini fava Traces of stored crops and seeds found at Akrotiri indicate that a local species of vetchling, Lathyrus clymenum, was cultivated exclusively on Santorini for more than 3,500 years. Dioscorides, a famed 1st c. AD physician and botanist, distinguished the plant that provided the specific fava from its relatives in other regions. The particularities of the Santorini soil, the climatic conditions and, strangely enough, the lack of water combine to create a unique product with a velvety texture and sweet flavor. Rich in protein (20 percent) and carbohydrates (65 percent), the local fava is an excellent source of vitamin B1, iron, copper, phosphorus, potassium and magnesium. Its high fiber content makes it ideal for maintaining normal levels of glucose and cholesterol in the blood, for promoting the proper function of the digestive system and for preventing cancer of the large intestine. And it’s just 85 calories/100g. The fava is served in pureed form with lemon juice, oregano and olive oil, and sometimes with chopped onion and capers or with tomatoes and olives. You might also see it in salads, made into patties or even served with seafood such as octopus or anchovies.

Mastic from Chios The mastic tree was particularly popular with the ancient Greeks: its shoots were pickled and considered a fine appetizer, while its “tears,” the well-known mastic resin, were chewed to clean the teeth and freshen the breath. These tears were also used to flavor wine. The aromatic resin of the lentisc plant, of the Pistacia lentiscus Chia variety, is not produced anywhere in Greece but Chios, and even there, it only grows in the south of the island. Prescriptions based on mastic can be found in medical texts dating from late antiquity, when it was already considered beneficial. Modern-day studies have confirmed this. Its antioxidant extracts prevent the formation of atherosclerotic plaque on artery walls, thus protecting against heart problems. Its polyphenols 72

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Saffron contains vitamins A, C and B complex, as well as iron, calcium, magnesium, potassium and lycopene, which is known to help prevent cancer. It also has powerful antioxidant and anti-aging properties, as its carotenoids protect cells from free radicals. It is good for the digestive tract, boosts the metabolism and improves memory and overall brain function. In addition, it helps fight anxiety and acts as a mood elevator. A mere pinch is enough to give food a rich yellow color, a subtle tang and plenty of aroma. It goes particularly well with rice, pasta, white meat and fish; it is used in salads and soups; and it is also used in sweets. It can be found in powder or thread form and as a tea.

reduce glucose and cholesterol levels in the blood. Regular use of mastic limits the formation of dental plaque. It plays a critical role in preventing and treating diseases of the digestive system. It exhibits powerful anti-inflammatory action, and acts as an analgesic, a cough suppressant, an appetite stimulant, an aphrodisiac, an astringent and a diuretic. It is an amazing multi-purpose medicine! Nowadays, mastic has many uses: as a spice in cooking, mainly for meat and fish, and for ice cream, loukoums, spoon sweets and cookies; in beverages (in mastic liqueur and ouzo, drunk as an aperitif or added to foods while simmering); and in cosmetics. Commonly seen in the form of chewing gum, the resin can be also found in a variety of other forms, including as powders and crystals, as mastic water or as an essential oil.

products

Information courtesy of Antonis Kafatos, Professor Emeritus of Preventive Medicine and Nutrition at the Univeristy of Crete.

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EAT REAL The cuisine of Greece is rooted in simple, traditional foodstuffs bursting with flavor and nutrition. BY Diane Kochilas*

t was warm and the color of seduction itself, pure red. When my Aunt Mary cut it open with her small, dull, serrated knife, on the stone slab of a table right outside her kitchen door, goats gently bleating nearby, I could smell its perfect scent, light as the breeze. My first real tomato. I was reluctant to eat it but, goaded on, I did, at first a little frightened by the thin juice and sticky seeds on my lips and by its thick leathery skin and fleshy pulp. I was forever transformed. Ikaria. Summer of â&#x20AC;&#x2122;72. My love affair with this country and its cuisine began then and there, unbeknownst to my 12-year-old psyche. That was the summer I discovered food. Real food. Cut from vines, picked from trees, plucked off straw in coops, snapped from stalks. Comforting food placidly swimming in olive oil, punctuated with sharp oregano and crunchy salt. That was the summer I discovered the Greek diet although, back then, the term was not yet in use. Goats were everywhere, and we ate them. It was, however, years later before I dared milk one; to this day I am awed by the process, such a yin

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1. Diane Kochilas, a Greek food guru and writer, buys fresh vegetables and fruit from a farmer’s market. 2. When making a pie, sprinkling the dough with flour is necessary. 1 5

3. Portrait of an elderly couple in Ikaria, a Blue Zone island, known for the highest percentage of 90-year-olds on the planet. 4. Delectable shrimp stew cooked by the monks on Mt Athos. 5. Xinomavro is northern Greece’s unrivaled wine variety (Boutaris Estate, Yiannakohori, Naoussa). 6. Rustic bread, feta cheese and olives make up the most common and delicious of Greek snacks. 7. Fresh Greek ingredients ready for use in making the classic chicken in wine sauce. 6

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and yang. How, from this cranky mammal’s soft, grey wrinkled teats, using just the right kind of pressure, which takes time to hone, you get that hard stream of warm white milk. Soft-hard, feminine-masculine, ancient-modern. This is Greece eternal, my life lesson in contrasts and the untold but palpable balance that is in evidence all over this country’s stunning natural landscape. More than four decades later, battered by a crisis of Herculean proportions, beaten but breathing, Greece and its food still seduce. The land is giving and many people have returned to it to revive their lives and livelihoods. Many, of course, have also left in droves for distant shores, moving in free markets to work but just as likely fettered by what in Greek is called nostos, a yearning to return home, the root of our English word nostalgia and, tellingly, the root of the Greek word for delicious. Delicious home. That is always how I think of Greece – the vantage point of my perspective is forever the Greek table, and all that happens around it. REGIONAL CUISINES The more one delves into the origins of Greek food and lore, the more one becomes entangled in the web of this country’s long, complex history. Greece has always been a crossroads between East and West. It has endured conquests and has absorbed whole populations from neighboring lands. Much of its history is one of migrations and resettlements. Most migrations, of course, were forced upon the Greeks, whether by outside threats, from pirates, earthquakes, Ottoman Turks and others, or by economic

hardship, a recurring catalyst and one we are seeing today. Greece’s sinuous history has played itself out on her table. The cuisine is a rich amalgam of ancient, Byzantine, Balkan, Turkish, English and other influences, all fused into the terrain of the country itself. Geography and climate, more than anything else, have dictated what people in different regions of Greece cultivated and consumed throughout history. For the most part, even the modern Greek table overflows with ancient foods; the same basic ingredients have sustained Greeks since prehistoric times. Among them are the olive and its oil, of course, but there are also grains, such as barley and wheat; pulses, such as lentils, peas, chickpeas and broad beans; wild herbs and greens; game, such as wild birds and rabbits; snails; sesame, honey, nuts, and certain fruits. Goats and sheep have long provided milk, cheese, festive meats, and various household necessities such as wool or the goatskin bags still made on Ikaria, called filaki. Pork, a meat that divides the Mediterranean between Christian and Judeo-Muslim culinary traditions, has always been an important meat in Greece. Indeed, even today on the Aegean islands, the hoirosfagia, or “pig-slaughtering” custom, is alive and well. Taking place around the holidays, the family ritual is reason for a feast, and showcases the skills necessary for butchering the animal so that every last scrap is used. It has always been my belief that the regional cooking of Greece can be divided into three main “arteries”: mountain cooking (shepherd traditions), island cuisine (born from the thrifty

Greece’s sinuous history has played itself out on her table. The cuisine is a rich amalgam of ancient, Byzantine, Balkan, Turkish, English and other influences, all fused into the terrain of the country itself.

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1. A cook from Epirus is making filo for a pie – the trademark dish of the region.   2. The Tsantalis vineyard on the “Holy Mountain” of Athos in Halkidiki.   3. Cretan pies with greens accompanied by traditional tsikoudia, a grape-based pomace brandy.   4. Returning from grazing at the end of the day (Trifylia, Kyparissia).   5. Picking olives the old-fashioned way, by hand (Argolis).

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cooking of the Aegean), and the urbane, fragrant cuisines of the Greeks of Asia Minor (as well as of the Italian aristocracy whose historic presence in parts of the Aegean and Ionian left a most aromatic mark on local tables). One could argue that Crete, almost a country unto itself, naturally blessed with a fecund landscape and host over the centuries to Venetian and Turkish invaders as well as to Greeks fleeing Asia Minor, is in a category all its own. As one moves from one corner of Greece to another, distinct regional cuisines emerge. The Peloponnese, for example, thanks to the copious amount of excellent olive oil that is produced throughout the region, is home to some of the best and simplest one-pot vegetable and bean stews in Greece. Oranges, lemons, and olives flavor the local cuisine. Pork is a local passion, so much so that on weekends all over Messinia one can find roast pork, or gourounopoula, sold even at roadside stands. There are commonalities between the cooking of the Peloponnese and some of the culinary traditions of the Ionian, on the western coast of Greece, but the cooking of the Ionian Islands has also been shaped by hundreds of years of Venetian presence. Some foods have Italian names to this day. Heading north through Roumeli (central Greece) and Epirus, the land is so imposing, mountainous and dense, that the local cuisine is greatly defined by it. This is shepherds’ domain, where wild greens, meats, dairy and savory pies make up the mainstay of local food traditions. Thessaly, the great plain and wheat belt of Greece, is a kind of bridge for all the cooking traditions of the mainland, combining Macedonian traditions with shepherds’ ways, and both of those with the region’s unique geography of coastline, flat open expanses and lush mountains. In Macedonia and Thrace to the north, the cooking is spicier than elsewhere in Greece. All manner of peppers define the flavor palette. Cabbage and leeks are the most important vegetables. The kitchen is a reflection of the land, of 78

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local and Balkan influences, and of the rich, fragrant foods that Greece’s Asia Minor refugees brought with them en masse in 1922, when hundreds of thousands resettled in the area. The Aegean is a different story. For the most part, Greek island cooking is sparse and simple, and all of Aegean cuisine culminates in the great traditions of the Cretan table – one of the best examples of a unified, perfect, seasonal and varied Mediterranean cuisine.

1. The old traditional Greek café is still a meeting place, especially in the villages (Mani).   2. Sage grows everywhere in Greece and is a popular herbal tea during the winter months. 3. Eggs with smoked ham preserved in fat.

4. A traditional bakery in Aeropoli (Mani). 5. Sotiris Lymberopoulos, a modern-day forager, supplies gourmet restaurants with wild greens through his successful company Radiki. 6. Snails have been a part of Crete’s food history for millennia.

COMMON THREADS Regardless of the region, however, connections run deep throughout all of Greek cuisine. To this day, our culinary traditions are living traditions, something reinforced, at least to my mind, every time I visit a laiki (farmers’ market) in my Athens neighborhood. Here, one sees the Mediterranean Diet and the Greek Diet in practice. The markets are a potpourri of all that is in season at any given time of year, and this adherence to seasonality, to the laws of nature, so to speak, is probably the one defining value of all of Greek cooking. These street markets are a living example of something else as well, equally important and often overlooked: the importance of plant-based foods in the Greek tradition. Long before it became fashionable to think about vegetarianism, Greeks had been practicing a kind of selective vegetarian-based cooking rooted in the fasting traditions of the Greek Orthodox Church. To follow the fast – and many people, including myself, still do – one basically goes off all animal products for almost half the year. It’s the ultimate detox diet, time-tested, healthy and delicious. IKARIA Plant-based cooking, seemingly anathema to contemporary Greeks, who do, indeed, love their animal protein, is one of the secrets to what just might be the perfect living example of the traditional Mediterranean diet in action, that of the island of Ikaria. Ikaria was catapulted to fame a few years ago as a Blue Zone, one of a G R E E C E IS

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handful of places on the planet where people live an extraordinarily long time. One main factor for this must be their diet, along with a lifestyle that includes strong communal ties and a resistance to the pressures of the clock. For my most recent book, “Ikaria: Lessons on Food, Life and Longevity from the Greek Island Where People Forget to Die”, I talked to many old people on the island (my ancestral home, too) about what they ate growing up. What I discovered was that it wasn’t so much what people ate a generation or two ago, but what they didn’t eat. Food was not nearly as plentiful then as it is now and they didn’t eat very much at all. It was a dearth of food, rather than the types of foods, which seems to have defined their diet. Equally important, of course, is the quality of food. On Ikaria, and I dare say in many parts of Greece, people consume very little processed food. Most people on the island grow at least some of their own food and many still forage for wild foods, such as seasonal greens, herbs, and mushrooms. Farm animals are either grazed or eat the family leftovers, not a diet of processed animal feed. Olive oil flows in copious amounts (as it does all over Greece, which has the highest per capita consumption in the world). The food people consume is very fresh; it’s packed with nutrients and free of pesticides. Herbs, not only as flavoring agents but also dried for tea, are a major part of the Ikarian diet. Indeed, the folk pharmacopoeia on the island is alive and well. “Why do you need penicillin when you have sage, garlic and honey?” an 85-year-old friend asked, referencing the cold medicine of yore. Pulses, whole grains, garden vegetables (fresh in season but also dried – and known as tsifia), foraged wild foods, fish, some game and some meat were the mainstays of the diet. Meat was scarce, so much so that to this day there is a tradition in the villages of Raches called mnimosyno. That’s the word for memorial service in Greek. On Ikaria, it refers to the communal Easter 80

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“Why do you need penicillin when you have sage, garlic and honey?” an 85-yearold friend from Ikaria asked, referencing the cold medicine of yore.

meal to which everyone who can contribute, and anyone who wants to can partake in. It was a way to ensure that even the poorest islanders got a little meat at least once a year. Ikaria is still a place where life is simple, and slow. People there have an appreciation for the kinds of things money can’t buy – good company, friends, family, and shared meals. Most people make their own wine and it flows freely, enabling islanders to also live uninhibitedly, loosened up and unstressed. It is a place where the Mediterranean Diet of 50 years ago still flourishes, as does a culture that frowns upon material wealth and its stressful pursuit. Maybe these long-living islanders are onto something all Greeks knew instinctively a generation or two ago: that eating fresh seasonal food (mostly plants) prepared simply, consumed with wine and shared with friends and family is what a healthy diet is all about. I can still taste that first real tomato, savored more than 40 years ago in what was then one of the most remote places in Europe. It changed my life.

* Diane Kochilas is a chef and award-winning cookbook author. She is the host of the forthcoming cooking/travel series My Greek Kitchen, airing across the USA on PBS in September 2017. Together with her husband, Vassilis Stenos, she runs the Glorious Greek Kitchen cooking school every spring and summer on their native island, Ikaria.

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1. The “flower of salt” (fleur de sel) is handpicked from rocky cavities by the coast. (East Mani).   2. A vendor stacks his tomatoes at a stall in an open air market in Athens.   3. Cooking food in olive oilbased sauces is very common in Greek cuisine. This is okra with tomatoes and mizithra.

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4. Traditional festivals are a beautiful expression of Greek culture (Ikaria).   5. A beekeeper sells his thyme honey in the village of Anopoli on Crete.   6. Fishermen on the islands sell their catch of the day early every morning. (Mykonos).

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Fountains of Life A short narrative on a long healing tradition, from ancient water worship to the most recent natural spa revival. BY Maria Coveou

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Surrounded by breathtaking scenery, Pozar Hot Springs in Pella, Northern Greece, features a variety of pools both private and public.

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ith about 800 locations of natural curative resources, most of which are water-related, Greece could be described as a paradise of healing spas. Still, most remain undeveloped: only 34 springs have been officially recognized so far, while recognition of another 60 is pending. Meanwhile, few of them have onsite lodgings. Over the last few years, as holistic medicine has once again become a topic of discussion for the scientific

ers to it. Early Greek texts and myths confirm this: Achilles, for instance, was invincible because his mother, Thetis, dipped him as a baby in the magical waters of the River Styx. As she held him by his heel, it remained the one vulnerable spot – his Achilles heel – which became the target of Paris’ arrow in the Trojan War. Heracles, another legendary hero, regained his strength after completing each feat by bathing in the hot springs at Thermopylae, which the god Hephaes-

community, there has been rekindled interest in developing these springs by creating high-end hydrotherapy facilities and hotels that focus on balneotherapy, not only as a treatment for specific ailments, illnesses and injuries, but also to promote general wellbeing. The Greeks were among the first to discover the beneficial properties of water. They used it not only for cleanliness and therapy, but also for relaxation. At first, unable to understand the actual curative capability of water, they (like other ancient people, such as the Egyptians, Babylonians, Persians and Indians) simply worshiped it as a deity and ascribed supernatural and magical pow-

tus had created for him at the behest of the goddess Athena. As we learn from Homer’s epics, Greeks of this period also used water for personal hygiene. They welcomed visitors by serving them water as a gesture of hospitality, and by inviting them to wash in their home’s tub, called the asaminthos. Their love of water was passed down over the centuries to their descendants, who created the first public baths. The balaneia, so-called because of their acorn-shaped dome (balanos in ancient Greek means “acorn”), were available for warm or cold bathing, or for steam baths in the special chamber called the pyriaterio. This was

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The Greeks were among the first to discover the beneficial properties of water. They used it not only for cleanliness and therapy, but also for relaxation.

Thermae Sylla Spa and Wellness Hotel, in Edipsos, uses thermal spring water that gushes up from depths reaching 3,000 meters.

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heated either by a furnace or by steam coming through the floor. Most balaneia were built near the gymnasiums and wrestling schools where athletes trained, but they also attracted citizens who wished to meet and discuss philosophy while relaxing in the waters. And, during Greek winters, there were more than a few of the less well-off who frequented the baths for warmth. For the Athenians, both hot and cold baths were an indicator of civilization and a part of everyday life. On the other hand, the Spartans and Macedonians, both fierce warrior tribes, preferred cold waters and avoided the balaneia, where they believed the heat just made one soft. The Spartans made an exception for the pyriaterio, which they used 86

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to work up a sweat before diving into the ice-cold waters of the River Eurotas to toughen themselves up. During the 6th and 5th centuries BC, the ancient Greeks used healing water for the first time in medicine, as practiced then, at the Asclepieia. These were both places of worship and healing centers dedicated to the god Asclepius. Treatment included washing, hot or cold baths, diet, exercise and entertainment. Most Asclepieia were conveniently located next to water sources (thermal springs, rivers or the sea) and in areas of particular natural beauty. Since nature was associated with the divine and was therefore miraculous, it was considered to be an essential component of treatment.Â

For the Athenians, both hot and cold baths were an indicator of civilization and a part of everyday life. On the other hand, the Spartans and Macedonians, both fierce warrior tribes, believed hot water made one soft.

The foundation of holistic medicine had been laid, but it was Hippocrates (460-370 BC) who established its scientific basis. He separated treatment from religion and instead linked it to ecology, rationally propounding that the environment and climate could have a beneficial effect in the treatment of patients. He was the first to study the sources of water and to classify it as potable, saline or sea water, where the “saline” water was actually mineral spring water. He spoke of the effect of cold and hot baths on the human body and investigated conditions for which curative waters might be indicated. The Romans inherited Hippocrates’ knowledge of hydrotherapy and applied it to the treatment of many diseases.

The Greek physician Galen, who lived in Rome in the 2nd c. AD, contributed greatly to continuing the Hippocratic hydrotherapy tradition. Among other things, he classified springs according to the temperature and the chemical content of their water, while also documenting numerous therapeutic indications. As great fans of Greek baths, the Romans copied the idea and named them “balnea,” from the Greek balaneia. With advancements in plumbing systems and a greater abundance of water, the Roman baths surpassed the Greek ones and evolved into impressive bathing facilities, the so-called thermae. They reached their peak initially as recreational centers and led to the establishment of the early spa towns,

before becoming identified with opulence and debauchery, then ultimately declining after the fall of the empire. In the Byzantine period, the clergy initially fought against the baths, as the Christian ethic was diametrically opposed to the orgies that were supposedly taking place in the spa towns. However, the bath tradition was so deeply rooted in the lives of most citizens that the church ultimately had to accept it. A visit to the baths then became an im-

Vouliagmeni Lake, a year-round natural thermal spa of particular beauty, is located just 25km south of the center of Athens.

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portant social event for the Byzantines, particularly those of the upper classes. In Greece, hydrotherapy essentially disappeared after the end of the Byzantine era, though the Turkish conquerors in turn made good use of the existing Byzantine baths. They turned them into the “Byzantine hammami,” and thus the “hamam” came to be known – wrongly, some may argue – as Turkish. By the mid-19th c., as thermalism was gaining popularity in Europe, the springs in Greece, which had just been liberated from the Turks, began to get attention as well. The first to take an

Popular for almost a century, the coastal town of Loutraki boasts modern facilities which complement its natural springs.

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interest in them was Ioannis Kapodistrias, the governor of the newly formed Greek nation. He formed a scientific committee to analyze and assess the thermal springs, particularly those in Ypati, Edipsos and Kythnos. In 1835, a Bavarian scientist named Xavier Landerer, the personal pharmacist of King Otto of Greece, published the first positive findings. Queen Amalia made Kythnos popular with her visits for balneotherapy, and in 1845 the first modern Greek public bathing facility was built there. By 1935, many of the areas with springs that were also near

the sea had grown into important spa destinations, achieving European standards. The towns of Loutraki and Edipsos, among others, were at their peak in the interwar period, as they began to attract members of the upper middle class. By the 1950s, many spa towns would come to feature well-marketed hotels and resorts with restaurants and even casinos, thus creating a tourism product that the recently established Greek National Tourism Organization (GNTO) could now export. In the meantime, however, growing faith in conventional medicine and pharma-

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ceuticals had impinged upon the popularity of spas. The Greek spa towns enjoyed one last period of glory in the 1960s and 70s, as the new middle class began to vacation there, taking advantage of their proximity to the sea. Naturally, spas were no longer a high-priority treatment option and were only used incidentally by those preferring cosmopolitan beaches. Thus, they gradually came to be used only by the elderly, and their use came to be associated primarily with cures for illnesses. In this way, spas came to be regarded as destina-

tions for the old and the ill. In fact, no matter where in Greece you travel, you’ll come across thermal springs, often with only basic facilities but with fanatic grey-haired supporters as well; you shouldn’t hesitate to join these enthusiastic individuals in the ancient practice of balneotherapy. If, on the other hand, you are more interested in higher-end facilities, there are now a number of luxurious hydrotherapy resorts supplied by the same thermal springs that have long invited visitors to experience the healing aspect of Greece.

MIRAGGIO THERMAL SPA RESORT

KRINIDES MUD BATHS

scientific background One of the steps taken during the process of officially recognizing a thermal spring is an analysis of the chemical composition of the water. Springs are characterized by what they contain: sodium chloride; hydrogen sulfide; carbon; iron; radon; or any combination of the above. They are also classified on the basis of temperature: cold (<20°C), tepid (20°-35°C), medium-warm (35°-50°C) and hot (>50°C). For different medical conditions, different mineral contents are indicated. Medical conditions may include disorders of the musculoskeletal, nervous, respiratory, cardiovascular, hematopoietic, gastro-intestinal and urinary systems, as well as dermatological, gynecological, endocrinological, otolaryngological and periodontal conditions. Hydrotherapy is used in thermal medicine as an adjunct to conventional medical treatment and is distinguished as either external (balneotherapy, mud treatments), internal (inhalation and water-drinking therapies) or thalassotherapy (using seawater). Treatment is applied under a doctor’s supervision, with an established time duration per session and a prescribed overall length of treatment period to achieve the maximum therapeutic result.

* The scientific details used for this article originate from the Greek-language publication Medical Tourism-Thermal Spa TourismThermalism (2014) by Konstantinos Kouskoukis, Dermatology Professor, President of the Hellenic Academy of Thermal Medicine – Lawyer; and from the Institute of Geology & Mineral Exploration (IGME).

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Best spots for a soak N AT U R A L S P R I N G S W I T H E X C E L L E N T H E A L I N G P R O P E R T I E S A N D F A C I L I T I E S T O M AT C H

KRINIDES MUD BATHS

Originally a Byzantine-era spa, Krinides became deserted after the 1923 Greek-Turkish population exchange and were left to flood, creating a mudflat. It is said that a sick buffalo was left by its owner in the mud for the wolves to devour, only to be spotted ten days later fully recovered and grazing the fields; this was how the thermal properties of the mud were discovered. Nowadays, the Krinides Mud Baths, located 3km west of the village, ranks as Greece’s most popular mud therapy spa. Guests here first visit the center’s doctor, take a five-minute thermal shower to clean the skin and immerse in the mud for 20 minutes. The cycle concludes with a second thermal shower, the only thing capable of washing off the Krinides mud.

THERMAE PLATYSTOMOU RESORT & SPA The spa at Platystomo, in the prefecture of Fthiotida, is located close to the village of Makrakomi, at the southern foot of Mount Othrys. Construction work initiated in 1929 to develop the spa (which opened in 1933) led to the discovery of the ruins of ancient baths dating back to the Roman era, confirming the use of the region’s two thermo-metallic springs in ancient times. The four-star hotel Thermae Platystomou Resort and Spa, located amid a richly vegetated and privately owned 78-hectare expanse, utilizes the thermal waters in its two indoor swimming pools.

VOULIAGMENI LAKE Vouliagmeni Lake, located in the heart of the Athens Riviera, is a spot of particular natural beauty. It features water stemming from sources between 50 and 100 meters deep at temperatures ranging between 22°-29°C, which makes the spot a year-round thermal spa. From a distance, the lake’s water looks black; this is the result of dark-colored seaweed and a layer of mud that has formed on the lake bottom. The lake flows into the sea, which means the lake water has a brackish taste. Small Garra rufa (or doctor fish), native to the lake’s waters, promise visitors a unique exfoliation experience by ridding the skin’s outermost surface of dead skin cells.

MIRAGGIO THERMAL SPA RESORT The thermal waters from the spring in Kanistro, on the Kassandra peninsula of Halkidiki, supply the Myrthia Thermal Spa at the brand new Miraggio Thermal Spa Resort, an ultra-luxury facility. Located amid a rich green landscape in front of a 500m-long beach, the ultra-modern, two-level, 3,000sq.m. wellness center offers both thermal and sea water for reinvigorating and cosmetic purposes in four different pools, each maintaining a different water temperature. This spa operates from April until the end of October.

water type

Cool, metallic, alkaline, calcareous, magnesiumbearing, acidic, carbonated.

Cool, high alkaline, medium sulfur presence.

Cool, metallic, alkaline, chlorinated.

HELPS WITH

Cool, metallic, chlorinated, brominated and highly carbonated.

HELPS WITH

Musculoskeletal, respiratory and nervous system disorders, skin conditions, gynecological conditions.

Musculoskeletal system disorders, skin conditions.

Musculoskeletal and nervous system disorders, gynecological conditions, skin conditions, cosmetic mud therapy. INFO

Krinides, Kavala (160km west of Thessaloniki) • Tel. (+30) 2510.516.162 • Open JuneOct. • www.pilotherapia.gr 90

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INFO

Loutra Platystomou (246km north-west of Athens) • Tel. (+30) 2236.022.510 • www.platystomo.gr

INFO

Vouliagmeni (25km south of central Athens) • Tel. (+30) 210.896.2237 • www.limnivouliagmenis.gr

HELPS WITH

Musculoskeletal and nervous system disorders, peripheral vascular conditions, skin conditions. INFO

Kanistro, Paliouri, Halkidiki (103km south of Thessaloniki) • Tel. (+30) 2374.440.000 • www.miraggio.gr

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POZAR SPA Located in the prefecture of Pella, northern Greece, at the foot of Mount Voras (Kaimaktsalan), 500m above sea level. Thermal waters here were being used during the era of Alexander the Great through the Roman and Byzantine periods. The spa was named Pozar (“fire” in Serbian) during the First Balkan War (1912-1913), when a Serbian officer, excited at having discovered hot running water, built a basin (still functional) to contain it. The verdant area around the spa features an impressive ravine. The Toplitsa River, a thermal river formed by hot water springs that gush out at elevations of 360-390m above sea level, flows through the ravine. At the site, there is an old hydrotherapy center featuring 48 private baths, two indoor pools and two small hamam facilities, as well as a modern hydrotherapy center with eight 6-person pools. A 50m swimming pool is located on a specially designed plateau and visitors may also enjoy the small thermal waterfalls along the river. water type

LOUTRAKI THERMAL SPA

THERMAE SYLLA SPA & WELLNESS HOTEL

GALINI WELLNESS SPA & RESORT

The ancient Greek historian Xenophon has written that Spartan soldiers would use the thermal springs of the ancient city of Thermes, believed to be today’s Loutraki in the prefecture of Corinth, for relaxation and reinvigoration following their battles. The first organized spa here was launched in 1855, and in the early 20th century, Loutraki became Greece’s first spa destination. This seaside town, which also features a casino and is linked to Athens by train, is still regarded as the country’s main spa therapy destination, while many prominent figures have visited the facilities known today as the Loutraki Thermal Spa. The complex was renovated in 2009, at which time the original 1934 building was joined to a new, larger structure housing modern facilities for spa therapy and thalassotherapy.

Edipsos is one of the most renowned spa resort towns of modern Greece. Its thermal springs gush up from depths of as much as 3,000 meters at temperatures reaching 75°-85 °C. The best-known of these springs, the Thermae Sylla, was named after the Roman general Sylla (AKA Sulla), who, according to the historian Plutarch, suffered from a case of gout while in Athens in 84 BC and traveled here for relief. Nowadays, this spring’s waters (35°-50°C) are channeled to the five-star Thermae Sylla Spa and Wellness Hotel. Established in 1897 and revamped in 1999, the hotel is equipped with a spa that was further upgraded in 2012 to feature facilities for thermal therapy and thalassotherapy. Additional water (the temperature of which can be as high as 85°C) from the EOT (Greek National Tourism Organization) Springs is also used here.

Back in the early 20th century, Kamena Vourla in the prefecture of Fthiotida, was home to nothing more than swampland. However, the area possessed many thermal springs which prompted its development as a spa town. Today, the spa at the five-star Galini Wellness Spa and Resort hotel, a facility covering 3,000sq.m., offers visitors both indoor and outdoor swimming pools, filled with thermal waters from the region, and a separate indoor swimming pool filled with sea water for thalassotherapy, as well as specialized therapies based on the use of its thermal waters. These are thought to be among the few in Greece that, thanks to the presence of radon, exhibit radioactive properties. This spa is open from April until the end of October.

Medium temperature, metallic, acidic.

water type

Cool, metallic, alkaline, chlorinated, hydrosulfuric.

Medium warm, metallic, alkaline, chlorinated.

HELPS WITH

Musculoskeletal and nervous system disorders, skin conditions, gynecological conditions.

Musculoskeletal and nervous system disorders, skin conditions, gynecological conditions, as well as cosmetic use.

Medium warm, metallic, acidic, chlorinated, mildly carbonated, mildly hydrosulfuric, medium radon presence.

INFO

24 G. Lekka, Loutraki (80km west of Athens) • Tel. (+30) 2744.062.186 • www.loutrakispa.gr

2 Posidonos, Edipsos, Northern Evia (190km from Athens) • Tel. (+30) 2226.060.100 • www.thermasylla.gr

Musculoskeletal and nervous system disorders, gynecological conditions, skin conditions. INFO

Loutraki, Aridea, Pella (110km from Thessaloniki) • Tel. (+30) 2384.091.300 • www.loutrapozar.com.gr

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HELPS WITH

Musculoskeletal, nervous system disorders, skin conditions, gynecological conditions. INFO

5 G. Vasiliadi, Kamena Vourla (177km from Athens) • Tel. (+30) 2235.080.501-6 • www.galini.mitsishotels.com •

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WE LLNE S S

The Spa Treatment The best in luxurious, sophisticated, cutting-edge and pleasingly personalized pampering around the country. BY Alexia Amvrazi

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WE LLNE S S

Anazoe Spa Costa Navarino in Messenia, Peloponnese, has received more than a dozen international distinctions including “Best Hotel Spa” at the Hotel & Spa Awards 2016. Ιts signature Oleotherapy© treatments are based on ancient local practices inscribed on clay tablets discovered at the nearby Palace of Nestor.

pa therapy is certainly not new to Greece. Thousands of years ago, Greeks were already well acquainted with the many pleasures and vital benefits of curative hot springs and mineral springs, of seawater rich in ozone, salt and iodine and of therapies involving the inhalation, imbibing or bodily application of herbal and flower essences. They were aware of oil massages, medicinal diets, healing music, and the role of physical exercise in health. Today, spa and thalassotherapy centers operating around the country have taken wellness to a new level by using high-tech equipment, new-age practices and radical new scientific products that offer guests highly sophisticated, tailor-made wellness services. Although most of the best spas in Greece today include a delightful range of therapies from other

ancient cultures such as India, Japan and China, the enduring reliability of the health principles of Classical Greece, inspired by the likes of the physician Hippocrates and the god Asclepius, continue to be the prevalent foundations for even the most progressive treatments, thus holistically and harmoniously bridging the old with the new. To all of this, you can add the attractive prospect of relaxing in either majestic interiors with peaceful lighting and décor carefully designed to enhance the serenity of your surroundings or outdoor locations where the air is ozone-rich, the sun is bright and the sea embraces the landscape in dazzling blues. Finally, throw in fresh local seasonal food divinely prepared, and it’s guaranteed the experience will leave you “sparkling” inside and out. G R E E C E IS

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Anazoe Spa, Costa Navarino Ancient Greek healing philosophies and cutting-edge techniques embrace guests in a curative, restorative and relaxing experience at Anazoe, a spa whose name comes from the Greek word for rejuvenation. A broad and beautiful variety of therapies, using products from around the world and natural ingredients sourced in the flourishing Messenian countryside, is accompanied by the soothing musical elements of ancient Greek modes and scales. The 4,000m2 spa is in the competent hands of certified physiotherapists. When it comes to physical wellbeing, 94

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Anazoe centers on the holistic approach of osteopathy, offering what the director of the spa Dora Koromila describes as “structural diagnosis and manipulative therapy” that helps to realign and relax the musculoskeletal system, meanwhile treating the guest holistically, based on Hippocratic doctrine. As for their emotional wellbeing, guests are encouraged to unwind by enjoying the various Thalassotherapy treatments. Further options at Anazoe Spa include kinisiotherapy, hydrotherapy and floating pools, and indoor and outdoor treatment areas, as well as an extensive range of

light therapies and heat treatments, including the use of ice-grotto rooms, mist showers and herbal saunas. The most in-demand therapies to date are Anazoe’s Oleotherapy® Signature Treatments. These involve pure olive oil and are based on ancient local practices inscribed on clay tablets discovered at the nearby Palace of Nestor.

Ana zoe Spa Navarino Dunes, Costa Navarino Tel. (+30) 2723.095.000 www.costanavarino.com/anazoe-spa

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Six Senses Spa, Porto Elounda The Immot Detox Program at Six Senses Spa (a chain with outstanding branches around the world) was recognized as the most progressive of its kind in the world in 2015 by Conde Nast Traveler. Leading a dynamic staff of healers, occupational therapists, fitness and wellness instructors, estheticians and physiotherapists, Porto Elounda Spa Manager Elli Soumaki says that “our vision, now more than ever is to help people reconnect with themselves and others in the world around them.” How does Six Senses Spa achieve this daunting challenge? “We combine treatments that benefit the mind, body and soul of our guests, using both ancient and cutting-edge techniques,” she says.

“One of our diagnostic tools for 2017 will be Fusionetics, a system that monitors and analyzes movement and fitness levels, while physiotherapy, body alignment, respiratory techniques, fascia and Bowen therapies are all elements of our programs as well.” The spa has even created a preventive healthcare package called Olous, to be launched in 2017, which will include check-ups and pain-free diagnostics based on the latest in health technology. Meanwhile, yoga aficionados can enjoy a yoga detox program that combines physical exercise with meditation, breath regulation (pranayama) and a balanced Ayurvedic diet. If guests simply wish to relax and be pampered, Soumaki recommends the most popular therapies – from signature massages and Subtle

Energies Aromatherapy to the Abhyang Fusion and the Apivita Queen Bee Facial. All this pampering magic takes place in a gorgeous space that has won several awards for its Zen-like esthetics that manages both to reflect the local surroundings (via the use of wood, stone and glass), and to offer profound serenity. Make sure to spend time relaxing in the tepidarium area, where the water element rules so completely that you can even enjoy its presence in the quasi-skylight water pond overhead.

Six Senses Spa Porto Elounda Golf & Spa Resort, Crete Tel. (+30) 2841.068.000 www.portoelounda.com/en/six-senses-spa G R E E C E IS

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luxury wellness spas

Divani Apollon Spa & Thalasso Center The new program named #DivineYou reveals a great deal about the philosophy of this spa and thalassotherapy center, which provides its guests with tailor-made treatments that holistically address their every need. Cutting-edge technology (with machines such as the Hypoxi, the Vacunaut and the i-Lipo) is used to enhance programs such as body sculpting and weight loss. This is done in combination with the use of a range of Symmetria products created by Dr Nikos Metaxotos. The suite of massage therapies include those based on Eastern 96

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health philosophies, with treatments such as Thai massage, reflexology and head massage, and there’s also an extensive range of meditation and yoga classes, especially idyllic in summer when they are held on the hotel’s private beach at sunset or sunrise. Housed in a space with warm earth tones and marble-covered walls, with individual cabins featuring natural wood elements, the spa prides itself on its well-trained staff (they attend Thalgo and St Barth seminars every year) and their ability to provide tailored care for each guest. One of the most attractive wellness features at the spa is the Thalassotherapy Pool,

which Spa Manager George Notopoulos describes as unique: “At 270m2, it is the largest of its kind in Greece, with 16 different areas with water jets.” Guests are offered fresh homemade lemonade, green tea and antioxidant “vitamin water” with cucumber, lemon and blueberries as they receive therapies and savor the tranquil environment and opulent atmosphere.

D i v a n i A p o l l o n S p a & T h a l ass o C e n t e r 10 Aghiou Nikolaou, Vouliagmeni Tel. (+30) 210.891.1100 www.divaniapollonhotel.com

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Thalaspa Chenot, Grand Resort Lagonissi Relying entirely on the “multidisciplinary therapeutic approach” of the Chenot Method, Grand Lagonissi Resort’s Thalaspa is one of the handful of exclusive Chenot Wellness Centers located around the world in locations as far-flung as Tanzania, Italy and Morocco. Catalan-born Henri Chenot was the first to create a series of high-quality phytocosmetics and focused a great deal of his studies on Chinese medicine and on bio-energetic psychology and naturopathy. His plantbased products, together with noteworthy global research into wellness practices,

are used to offer guests a boost to their physical, esthetic and psychological wellbeing. Traditional Chinese medicine is in fact the basis for the one of the spa’s most dynamic treatments, the Chenot Detox Therapy: the therapist uses cupping glasses to dissolve energy blocks as well as to speed up the wave rhythm of liquids, stimulating cell regeneration and the elimination of waste. It provides powerful detoxification results, especially in those suffering from water retention or a lethargic metabolism. The spa offers a plethora of first-rate treatments designed to detoxify the body (including cellulite treatment, detox therapy and purifying

detox facial) as well as the highly innovative Anti-Ageing Regenerating Treatment, which uses electrical stimulation massage to regenerate the skin’s tissue. Last but not least, a nutritionally rich, “biolight” menu is offered in combination with Chenot treatments in order to optimize the spa-goer’s wellbeing experience.

T h a l as p a C h e n o t Grand Resort Lagonissi 40th km Athens-Sounion Tel. (+30) 2291.076.000 www.lagonissiresort.gr

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GB Spa, Grande Bretagne Hotel When the luxurious GB Spa first opened its doors to hotel guests and the wider public in 2003, it gained an immediate reputation as the capital’s most luxurious wellness paradise, and it has retained its standing as one of the most impressive spas in Greece, with absolutely flawless standards, stunning facilities and unparalleled treatments. “Following the true meaning of the word ‘spa,’ which 98

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derives from the Italian ‘salute per aqua’ meaning ‘health with water’, our ozone and oxygen-rich swimming pool with thick sea salt that’s brimming with mineral elements immediately whisks guests away from the intense stress of urban life,” says Spa Manager Anne Speck. Guests are encouraged to enjoy steam and water experiences one hour before treatments, and to spend at least 5-15 minutes in the various steam rooms, such as the Amethystos Grotto, which has walls covered in

amethyst crystal mosaics and air infused with the pungent aroma of eucalyptus, or the Herbal Suite, in which local, seasonal herbs are steamed to release their curative aromatic essences. “Basing our therapies on the use of top-quality ESPA products, we have created a series of treatments for all tastes and conditions,” says Speck, adding that their most popular therapy is the Balinese massage, which focuses on the back, shoulders, face and scalp, areas of the body commonly knot-

wellness

ted with tension among high-flying hotel guests and stressed-out city folk alike. GB Spa’s two Ayurvedic therapies, each two hours long, encourage a profound rebalancing and regeneration of the mind and the spirit. These therapies use exotic sensual floral essences infused into coldpressed sesame oil, and massage on the marma points (mini chakras as defined in ancient Indian medicine). For instant beautification results, Speck suggests the Signature GB facial, based on the use of

Japanese Kobido massage and innovative prickly pear products, as well as the Regenerating Mask Treatment by Valmont, which offers a “biological lift” using a 100% collagen mask.

GB Spa Grande Bretagne Hotel Syntagma Square, Athens Tel. (+30) 210.333.0799/772 www.gbspa.gr

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Aldemar Royal Mare Thalasso Greece’s first Thalasso/Spa Center, this 4000m2 wellness paradise, which opened in 1997, welcomes up to 200 guests per day and is rated as one of the top 10 of its kind worldwide. “Our key focus is to be innovative at all times, rather than imitating others,” says Spa Manager Apostolos Rizos. “Some of our most advanced treatments are the Innovzen Breath Concept, our Ritual Detox, the Affusion Watermass and the Four-finger Lifting Massage.” A luminous and luxurious environment that instantly seduces guests into letting go of all their tensions, the spa has 50 individual treatment rooms, four swimming pools and a 100

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large beauty center. It is decorated with mosaics and offers a dream-like atmosphere set against a “Big Blue” backdrop. At Aldemar Royal Mare, the sea theme reigns supreme, with many treatments involving hydro-jet pressure and curative seaweed or mud wraps. There is also a focus on bolstering the immune system. “With treatments like Vein Tone Vitality Program and Elixir Vertebral Program, combined with our hydrotherapy rituals, we effectively address physical problems and the discomfort they cause,” Rizos says. For emotional and mental wellbeing, the spa/thalasso center pampers its guests with sensual and pacifying aromatherapy and Ayurvedic therapies and programs that help guests recon-

nect with their inner self, including the Breath Revive program and the two-day Absolute Serenity treatment. The center, which offered highly customized care to cosmonauts Anton Shkaperlov (2015) and Yuri Malenchenko (2016), prides itself on the multitude of medical benefits that its waters and specialized treatments can offer to treat a whole host of conditions, from rheumatism, arthritis and blood circulation to insomnia, backache and cellulite.

A l d e m a r R o ya l Ma r e T h a l ass o R e s o r t Limenas Hersonissou, Crete Tel. (+30) 2897.027.200 www.aldemar-resorts.gr

wellness

Elounda Spa, Blue Palace The ingredients used at this spa could be sourced from the kitchen cabinet of any Greek household: honey, extra virgin olive oil, Cretan raki, wild herbs and sugar. Blue Palace, however, manages to work wonders, using these simple local products in a highly sophisticated way, adding pure essential oils to create their effective and enjoyable signature treatments. The spa’s environment, too, plays its part: your senses are stimulated by streams of sunlight, the sound of running water and textures and shades that reflect the natural landscapes of Crete. Here, there is something for everyone: a couple’s suite where

privacy-lovers can enjoy luxurious, synchronous respite; the late-night spa pampering program, for those who need to relax after a demanding day; one-day rituals that rejuvenate guests completely; and weekly classes such as water watsu, prenatal yoga, basic pilates and even boxing. Apart from offering beautifying treats such as the Ariadne Beauty Ritual (named after the daughter of King Minos and based on ancient health and beauty practices), the spa also helps guests suffering from chronic or ordinary aches and pains by offering them its Medical Massage, an intense rub-down during which pressure is applied to muscles and bones, releasing metabolic waste and boosting

circulation, and which concludes with the application of a special analgesic ointment. “Most of our clients suffer from back, neck and shoulder muscular pain or stress, and all the treatments from our Ultimate Massage Collection are ideal for releasing tension and restoring vitality to the body,” says Spa Manager Babis Egglezakis. “For weight loss and muscle or joint healing, we recommend any of our pleasurable and remedial Thalassotherapy Collection treatments.”

E l o u n da S p a a n d t h a l ass o t h e r a p y Blue Palace, Elounda, Crete Tel. (+30) 2841.065.500 www.bluepalace.gr

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ACTIVIT Y

Running Free

In the land that gave the world the Olympic ideal of excellence through athleticism, people are rediscovering a sport that brings strangers together and helps its participants appreciate the nature around them. BY F r a n k D e M i ta

shake hands with Thomas Daskagiannis outside his home in the Zografou neighborhood of Athens early on a bright Sunday morning. It is only five days before Christmas, but the mild temperatures and blinding sunshine are a tonic to this sun-deprived northern Europe-dwelling runner, more accustomed to rain, mud and darkness in December. Daskagiannis is to be my guide today as I join him and the “Thomas Group” for the Run the Lake 10km race at Lake Vouliagmeni, some 20km south of the city center. Situated on the coast, the lake is fed in part by thermal springs that maintain a constant temperature of 24°C. A spa, yacht basin and resort are all to be found on its shores, but none of this is of any interest today to Daskagiannis, a trim civil engineer whose 63 years are belied only by his gray hair. After the briefest of introductions, we’re in the car and on our way. “We must leave now because parking will be difficult!” Now in its fifth year, Run the Lake has grown rapidly in popularity and attracts more than 1,800 runners. This level of participation in a “local” event stands as a testament to the explosion of interest in recreational and competitive running across all of Greece, where on any given weekend several race events are taking place in every corner of the country. We arrive at the lake in plenty of time for the 9AM start, but parking, as predicted, is scarce. He successfully negotiates his car into an impossibly small space on a road close to the lake, and once outside we strip off our outer warm-up layers to get ready. As we make our

Rodopi 100-mile Advendurun, a tough adventure footrace for experienced runners through the amazing scenery of the Rodopi Mountains National Park in Northern Greece, will take place on 20-21 October 2017.

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way to the starting area, Daskagiannis darts across the road to greet a strikingly athletic woman. Returning a few minutes later, he tells me that he just wanted to say hello to Maria Polyzou, “the Greek women’s record holder in the marathon.” I am speechless until I notice Polyzou chatting casually with any number of runners heading to the starting line. It is a striking image to someone more accustomed to the hyper-competitiveness of events in many major cities, where elites remain walled off from recreational runners. We finally meet up with the rest of our team in time for the start of the race. The group expands and contracts depending upon members’ time commitments; age and ability is no barrier, and the only requirement is the desire to run, to be healthy, and to have fun. This morning, there are nine in total from a wide range of backgrounds: along with us are civil engineer Hara, mathematics teacher Fotis, electrical engineer Yiannis, insurance broker Dimitris, mechanical engineers Thanasis and Thodoris and architect Praxiteles. Thomas gets everyone’s attention and issues a stern command: “Remember – we run for fun!” We nod solemnly and pair off into groups of three, based on age and running experience. Hara explains, “Thomas doesn’t want anyone to get left behind, so we run in groups to keep morale up when we get tired.”

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This, I come to see, is a common theme of running in Greece: you are not just partaking in a sport; you are a member of a community, a brotherand-sisterhood of fellow runners that come in all shapes, sizes, ages and abilities. Running training laps around the secluded, Aleppo pine-scented campus of the National Technical University of Athens in Zografou, I had already been struck by the number of nameless “friendships” I’d struck up; fellow runners who took to the course at the same time every evening. With each lap, there would be smiles, nods, thumbs up and briefly uttered words of encouragement. I shouldn’t have been surprised that a recreational runner like Daskagiannis would think nothing of approaching a national champion and celebrity. What connected them was not first place finishes and split times, but simply that they were both runners. That was enough. The race ends too soon, with sunshine glinting off the lake. Some runners jump into the water for a soothing soak in the warm thermal spring adjoining the finishers’ area. As all runners know, the individual reasons for putting one foot in front of another are as numerous as the steps taken in completing a marathon. The benefits of running have been well-documented. A 2014 study of 55,000 adults in the Journal of the American College

of Cardiology found that running even a mere 50 minutes a week resulted in a 30 percent drop in mortality rates. But as any committed runner will tell you, running isn’t simply about physical well-being. The real reason running becomes an addiction is the psychological changes that occur while you run. You literally get a kind of “high” from the mere activity of putting one foot in front of another. One shortcut to the “runner’s high” is to do your running somewhere beautiful. At Lake Vouliagmeni on this sundrenched Sunday morning, my fellow 1,800 runners only have to glance over their shoulders at the shimmering blue water a few meters from our path. It is easy to forget the pain of the gentle uphill stretches when surrounded by such natural beauty. It is also astonishing to find such unspoilt nature on the doorstep of the congested center of Athens. Interest in running among Greeks has been growing at an almost exponential rate. In 2005, there were only 800 Greek entrants in what is known as the Athens Marathon – The Authentic. By 2015, that number had grown ten-fold. The Spetses Mini Marathon had a mere 700 entrants – all Greek – when it was first run in 2010; today, that number has grown to more than 10,000, with 40 percent coming from abroad. Petros Bouchoris came late to running, but has now completed five mar-

athons to date, qualifying to compete in the Greek Marathon Championships at the age of 40. With a background in consumer research and a love for travel, Bouchoris saw a business opportunity and founded Running Greece (www. runningreece.com) three years ago as a specialist travel agency serving international visitors passionate about running and fitness. In those three years, Bouchoris has seen a year-on-year doubling of bookings. He found that foreign visitors’ needs were not well-served by traditional travel agencies. The absence of fitness-related travel services was compounded by the simple fact that information about the vast majority of running events only existed in Greek. Something as basic as providing a comprehensive English-language race calendar suddenly opened up a world of possibilities for exercise-minded travelers. The value-added component to Running Greece is its expertise, being able to guide visitors to running events in out-of-the-way corners far from the well-beaten tourist path, augmented with bespoke touring and travel arrangements. The opportunities for running in Greece are almost limitless in their variety of distance, difficulty and setting. Among Bouchoris’ personal favourites: the 21km Meteora Trail Run, for the otherworldly beauty of the towering rock formations dotted with monaster-

ies clinging to the sheer rock faces; the Ioannina Lake Run, for revealing the lesser-known alpine beauty of northwestern Greece; and lastly, the Chios Half Marathon, because the island and the course together encapsulate the most iconic elements of Greece’s beaches, hills, villages and culture. For novice runners, Bouchoris recommends the Athens 10km in November. For those looking for a first attempt at a longer distance (perhaps with their eye on eventually running a full marathon), he recommends the Nafplio Half Marathon held in March. The early spring weather is ideal in this jewel of a Venetian port that makes an optimal base from which to explore the Peloponnese and the nearby ancient sites of Mycenae, as well as the perfectly preserved theater at Epidavros. Daskagiannis, too, lists the Napflio Half Marathon as one of his favorite events, as it was his first attempt at such a long distance. He ran with several others from the Thomas Group, each providing moral support for one another along the course, something which he credits for his finding the will to complete the 21km distance. “The cheer from the crowd as I crossed the finish line was unforgettable!” Like Running Greece’s Bouchoris, Daskagiannis agrees that the iconic Athens Marathon (and its related 5km and 10km events) is a must-do for any

Ready, Set, Go: At the starting line of the 34th Athens Marathon - The Authentic, which attracted more participants than ever, with some 18,000 running the full 42,195m distance.

You are not just partaking in a sport; you are a member of a community, a brotherand-sisterhood of fellow runners that come in all shapes, sizes, ages and abilities.

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serious runner visiting Greece, combining as it does the majesty of history with the fantastic atmosphere bursting with Greek pride for the event’s dual origins, one in a battle fought 2,500 years ago and one in the first modern Olympics held right here. Asked which race he would recommend to a first-time visitor looking to run in Greece, he replies, “Without question, Thessaloniki.” After a pause he reconsiders, “No, definitely Spetses. It was stunning.” Another pause. “But Run the Lake at Vouliagmeni is beautiful, too!” Clearly his answer will change with each new race, and that’s high praise indeed for what Greece has to offer the visiting running enthusiast.

Recommended events Athens 10Km & Athens Marathon The Authentic

www.athensauthenticmarathon.gr Held in early November, the race attracts more than 50,000 participants to run the 5km, 10km and the full 42,195m distance. The Athens Marathon was established at the first modern Olympics in 1896 to commemorate the feat of Greek soldier Phidippides, who in AD 490 ran from Marathon to Athens to bring news of the victory over the Persians.

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Chios Half Marathon

www.chiosrunning.gr Scheduled for the last Sunday in August, the race takes place in the Campos District of Chios, its route passing alongside fragrant citrus orchards and historic mansions.

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Navarino Challenge

www.navarinochallenge.com September. Half marathon, 10km, 5km, 1km swimming and Stand Up Paddle Boarding. Endorsed by legendary GreekAmerican ultramarathon runner Dean Karnazes, and with the goal of raising awareness about the benefits of healthy living, the Mediterranean diet and childhood obesity, the Navarino Challenge is set amidst one of the most breathtak-

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Passing by the iconic Athenian Trilogy of neoclassical buildings, on Panepistimiou, during one of the parallel races of the Authentic Marathon.

ing and historically-rich landscapes in Greece and accessible to athletes of all abilities.

and 5km runs, youth races and 5km/3km cross-channel swimming events. Running course takes in beautiful coastal vistas and pine forests.

Napflio Half Marathon

www.nafpliomarathon.gr Early March. Expect perfect weather and a course that combines both the historic city and the coast road.

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Lefkada Green Half Marathon

www.greenhalfmarathon.gr Early May. Half marathon, 10km and 5km races take place on this scenic island along routes incorporating regions of international ecological significance, including the Lagoon of Lefkada.

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Thessaloniki Night Half Marathon

www.thessalonikihalfmarathon.org Early October. Join more than 20,000 runners who take to the streets of this historic city, cheered on by the festival atmosphere. A 5km event is also available.

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Spetses Mini Marathon

www.spetsesmarathon.com Early October. There are 25km, 10km

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Meteora Trail Run

www.runningreece.com Late October. Offering both a half marathon and a 6.6km distance, the Trail Run is set amidst the rock peaks and monasteries of this UNESCO World Heritage Site, with participation capped at 500 entrants. •

Ioannina Lake Run

www.ioanninalakerun.gr 16 - 17 September 2017. A 30km paved course around Lake Pamvotis, ringed by mountains, combined with the vibrant university city of Ioannina, makes this event irresistible.

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Andros Trail Race

www.androstrailrace.gr Early October. Choose between 22km and 10km distances run along ancient Venetian mountain trails of outstanding natural beauty.

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Hydra Trail Race 2

www.hydrastrail.gr Early April. Set on the tranquil, carfree island, this competition offers five different events, ranging from the iconic 25.6km, 1,100m altitude-gain trail race to the unique “downhill” mountain race, the fastest of its kind in Greece.

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Olympus Marathon

www.olympus-marathon.com Late June. This marathon is held on the historical and UNESCO World Natural Heritage Monument of Mount Olympus. •

North Face Zagori Mountain Race

www.zagorirace.gr July. 80km Ultra, 42km, 21km and 10km mountain trail events cater to everyone, from elite pro runners to first timers. The course traverses Vikos Gorge – one of the deepest canyons in the world – as well as ancient villages and the extraordinary ancient stone bridges for which the Zagori region is famous.

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1. October 2016 saw the fifth edition of the Thessaloniki Night Half-Marathon. 2. Vouliagmeni Lake Run has grown rapidly in popularity and now attacts more than 1,800 runners.

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Â© KATERINA TSAGARAKI

From Space to Crete

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The islandâ&#x20AC;&#x2122;s temperate climate, legendary hospitality, diet and culture are just what the doctor ordered for the rehabilitation of Russian cosmonauts. BY N ATA S H A B L AT S I O U

After months spent in space, there is no better way to reconnect with Mother Earth than standing barefoot on a beach with your loved ones. Oleg Skripochka and Alexey Ovchinin did exactly that.

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t’s mid-October, a month and a half after their return to Earth, when I meet up with Russian cosmonauts Oleg Skripochka and Alexey Ovchinin as they reach the end of their rehabilitation program on the island of Crete. They are enjoying their breakfast in the sun-washed courtyard of the Aldemar Royal Mare Thalasso Resort in Hersonissos, along with their families, their coach Alexandr Serdyuk, from the Gagarin Research and Test Cosmonaut Training Center, and their Greek liaison, journalist Thanassis Avgerinos. Dressed in shorts and t-shirts, they seem to be in fine fettle, showing no sign of the ordeal they have been

Α rejuvenating plunge in a thalassotherapy pool is one of the things that can’t be enjoyed in space.

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through prior to arriving here. Our discussion begins with life in space. Ovchinin describes how, within 24 hours, you’ll see the sun rise or set 14 or 15 times and joked about how the Earth is actually perfectly round, while Skripochka speaks about how it feels to return. One of his most striking observations is how his sense of smell came rushing back; upon landing, his nose was filled with the natural aromas of flowers and grass. Beyond happy discoveries like this, however, the experience of “re-entry” is a tough one. “Life on Earth is no walk in the park when you’ve spent six months on the International Space Station,” says

Skripochka. “From the moment you land, when you’re overcome by a sense of discomfort and overall weakness, to the first painful physical therapy sessions to work on lost muscle mass and to regulate your biorhythms again, it’s a lengthy process.” To Earth-bound folk such as myself, the things Skripochka is describing seem incredible. To put it simply, once the cosmonauts boarded the spaceship to be shot up to the space station, they became superheroes who could fly, carry the weight of their 100kg suits and even lift an entire refrigerator with their little finger, thanks to the lack of gravity. When they returned to Earth

Gym workout sessions, to rebuild lost muscle mass, are an essential part of the rehabilitation program.

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“Sunny days, a temperate climate, the sea, physical therapy, the gym, the spa, the sauna and massages – we found everything we needed and a lot more we didn’t expect.” - ALEXEY OVCHININ

six months later, they were “patients,” weak as kittens and in need of medical attention and a grueling rehabilitation regimen that would allow them to regain the basic functions needed to survive. It can take days to learn how to stand again after six months of floating; a lot of physical therapy is required to deal with the muscle pain, and it’s hard work to learn from scratch simple things, like doing the spatial math to 112

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walk through a door. “The effects on the organism are caused by the natural adjustment to the conditions of space flight,” explains Mikhail Potapov, Head of the Cosmonauts’ Rehabilitation Department at the State Institute of Medic0-Biological Problems of the Russian Academy of Sciences. “We have the effects of zero gravity, the strain of takeoff and leaving the Earth’s atmosphere – the sheer force of it – and then living in a restricted space, the effects of radiation and high-stress situations. The most typical “adaptation syndromes” are a “lazy” cardiovascular system, resulting in orthostatic intolerance and physical strain, loss of balance and effects on the autonomic nervous system, damage to the spinal column and to the systems regulating voluntary movement, metabolic pathways and, more than anything, the effects on the regulation of the water-salt metabolism.” All of these rather ominous symptoms, however, disappear within six

months of returning to Earth. The cosmonauts return to fighting form, primed for their next mission – on the condition that they follow an intense two-month rehabilitation program. The first phase takes place at the Yuri Gagarin Cosmonaut Training Center in Russia. It lasts two to three weeks and the emphasis is on regaining balance, improving the function of the spinal column and restoring blood flow and cardiovascular function. The second phase of rehabilitation is equally important. So that cosmonauts can return to regular life in Earth, it focuses on reuniting them with their families, honing social skills and overall rejuvenation. This part lasts 21 days and takes place at a resort with spa and physical therapy facilities. This is the third time that Russian cosmonauts are holding this part of their rehabilitation program in Crete. “Prior to this, the Russian space service would choose someplace like a resort in Karlovy Vary in the Czech Republic or a

1. Crew members of Expedition 47/48 shortly before the launch, at the Baikonur Cosmodrome. In the white jacket, Dr Alexander Vasin - medical officer for the crew. 2, 3. The Russian cosmonauts with their DSLR gear on the International Space Station

Attending a traditional Cretan feast in the village of Episkopi at Hersonissos.

Russian hotels in Sochi or the Crimea,” says Avgerinos, who works at the Moscow-based public relations firm Agora and is one of the pioneers of the Crete rehabilitation program, which began in 2015. “The idea of coming here started with Dr Potapov expressing an interest in Greece. He got in touch with Greek-Russian cosmonaut Fyodor Yurchikhin; they contacted me, and we started working on the program.” The selection of Crete was somewhat random to begin with. “It has plenty of tourism infrastructure and flexible businessmen who understood the concept immediately and embraced the program,” explains Avgerinos. The medical report compiled by Cosmonauts Training Center after the first rehabilitation program showed impressive results. In his summary on cosmonaut Anton Shkaplerov’s progress, Potapov noted that, from the 15th to 17th day on the Greek island, all the cosmonaut’s basic function indexes

had returned to pre-flight levels. In a self-assessment he gave upon completing the Crete program, Shkaplerov described his own physical condition as excellent. “The success rests with the fact that, contrary to the past, the program combined physical rehabilitation with a vacation and social activities,” Avgerinos points out. “The cosmonauts didn’t just come here to be isolated in some luxurious resort with all the necessary services and athletic activities, they got to enjoy the island as well.” “Sunny days, the temperate climate, the sea, physical therapy, the gym, the spa, the sauna and massages – we found everything we needed and a lot more we didn’t expect,” says Ovchinin. “It was important to us that the trip was culturally interesting, that we had a lot of social interaction and that we met some very interesting people. What I will remember most is a visit to a school, where we got so much joy from the children and answered their ques-

tions. This made us feel that our work matters to regular people as well.” The aim now is to develop the program further and expand it to other parts of Greece. “We’ve got a lot of ideas and we’re designing a package that includes a stop in Athens, as well as visits to religious sites, which are really interesting to Russians,” says Avgerinos. “The important thing for us is that cosmonauts seem to be lining up to come to Greece. Both medical specialists and the cosmonauts themselves are so pleased with the rehabilitation that they have become ambassadors for the program. Some have even called us from the space station to discuss the Crete experience and the possibility of coming to Greece. That’s how it happened with Oleg and Alexey,” adds Avgerinos, looking at the Russian cosmonauts as they play with their children and splash around in the surf – just like regular tourists and not the awe-inspiring supermen they really are.

The rehabilitation program in Crete was organized for the engineers of the International Space Station Expedition 47/48 Oleg Skripochka and Alexey Ovchinin, from September 29 to October 19, 2016 at the Anemos Luxury Grand Resort and Aldemar Royal Mare Thalasso Resort Hotels.

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INTE RVIEW

“Greece is only beginning to show its potential” Dr. George Patoulis, president of the Athens Medical Association, describes the country’s advantages in the medical tourism market. BY A L E X A N D R A T Z AV E L L A

s president of both the Athens Medical Association (ISA) and the Central Union of Municipalities of Greece (KEDE), George Patoulis has contributed significantly to the growing medical tourism market in Greece. Just recently, he co-organized a trip for medical services providers to the US, to promote his country as a top health destination to the Greek-American community. A distinguished orthopedic surgeon, Patoulis also holds a degree in Health Economics from the National School of Public Health. For the past 30 years, he has been involved with medical representative bodies. For him, the future of Greece as an international destination for medical tourism looks bright – and he explains the reasons why.

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What is Greece’s most significant advantage in the medical tourism market? Greece’s profile in the medical tourism market presents many dynamic characteristics. The country’s good climate, its healthy diet – responsible for Crete and Ikaria ranking high in the longevity tables – its historical and cultural inheritance and its advanced tourism services make Greece a top travel destination. All of these factors can be combined with the country’s excellent medical services and the highly trained scientists. Besides, Greece is the home of Hippocrates, the father of modern medicine, who inspires the international medical community to this day. The healing god Asclepius was also born here. Since antiquity, therapeutic herbs and remedies that later became part of treatments for illnesses have been growing under the Greek sun. Today, with its medical expertise, modern hospital infrastructure and pioneering, internationally recognized doctors, the country has the potential to become a strong player in the medical tourism market.

So why do you think, given the advantages you’ve just mentioned, that Greece hasn’t yet managed to establish itself among the top medical tourism destinations like Costa Rica and Singapore? Let’s not go that far. Our neighboring country, Turkey, receives five 118

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The estimates relating to incoming medical tourists in Greece vary. Some people talk about attracting 50,000 patients annually, others 400,000 within a decade if certain steps are taken. What’s your view?

Visits are expected to rise from January, when a EU directive comes into force that allows citizens to choose the health services in any EU country they wish and obliges their insurers to cover the expenses.

million tourists from all around the world, just for hair transplants. They are visiting Turkey, having secured very cheap flights as part of travel packages. Recent Greek governments haven’t made serious efforts to develop medical tourism. They haven’t tried to promote the clear advantage of our country in this rapidly growing market. On

our own initiative, we are now making coordinated efforts. The ISA and KEDE have realized the huge potential of this market. Its development will not only benefit our economy; it will also help people in many countries around the world who suffer from underfunded national health systems, long waiting lists and exorbitant medical costs.

Greece might not be able yet to compete in terms of numbers with the large medical tourism markets. However, what is important is that Greece has already proven that it can succeed internationally in difficult medical cases. The most recent example is that of a woman from Melbourne, who, after two liver transplant operations, decided to become a mother. She tried IVF in eight different countries without luck before finally fulfilling her wish in Greece. We were tremendously happy when we found out some time ago that she gave birth to her child. I believe that medical tourism has a bright future in Greece and that it will develop quickly. Of course, the Greek ministries have to champion the ISA’s efforts to include medical tourism in the country’s promotion strategy.

In which medical services areas does our country offer better value for money? Normally, patients who come to Greece seek IVF services, plastic surgery – mainly cosmetic – dental care, ophthalmology services, robotic surgery and therapeutic thermal springs. In all of these areas of specialization,

INTE RVIEW

the private medical institutions and doctors respond quickly, offering high-quality services at lower prices compared to other countries. Unfortunately, we are not good at marketing and we haven’t communicated that to the world.

ing hotels and some of the most notable hospitals in the world. The aim is to ensure that patients feel at home, from the moment they land in Greece to the moment they return home after having recovered. This is the ultimate goal.

facilities with such highly qualified specialists in so many departments covering so many fields. The country offers small units too, which cover the full range of specializations, such as pioneering ophthalmological and dental centers.

Which countries do you think will come to see Greece as a more attractive option for medical tourism?

How do you evaluate what’s average and how do you ensure that Greek doctors are highly skilled?

Where should a potential medical tourist look for information about Greece?

All the European Union countries will. Visits are expected to rise from January, when a EU directive comes into force that allows citizens to choose the health services in any EU country they wish and obliges their insurers to cover the expenses. But medical tourism goes beyond the EU, as Greece is already attracting visitors from the Middle East (United Arab Emirates and Israel) and from countries where a lot of Greeks live, such as the US and Australia.

What comes first in choosing where to go as a health tourist? Is it the destination or the healthcare service provider? The choice is driven by a combination of the two. Health tourists look for high-quality healthcare services and, at the same time, they want to have a nice time in a country that’s a top tourism destination. Greece offers expertise, excellent facilities and doctors, while the warm climate helps with the recovery process. Furthermore, it offers islands, places of immense beauty, outstand-

The qualifications and titles doctors receive and the positions they hold in national health systems in countries such as the UK, Germany, Denmark and Sweden proves their high level of expertise and knowledge. Greek doctors with very competitive profiles hold top positions in European and American private medical institutions. The fact that there are already patients coming from abroad, despite the current lack of an organized approach to medical tourism, proves that autonomous teams, consisting of very competent doctors, have already set strong foundations that will support growth.

Similarly, how high does Greece rank in terms of hospitals? The big private hospitals and diagnostic centers in Athens, such as Hygeia, Mitera, Iaso and the Athens Medical Group, as well as the European Interbalkan Medical Center in Thessaloniki, are extremly wellstaffed and well-equipped and have received their international certifications. In no other country I’ve visited have I seen healthcare

hotels and airlines, thus reducing the cost. Some of them cover the travel and accommodation expenses of chaperones, too. We are hoping that within the next few months there will be a more coordinated framework within which each medical visitor will be able to choose what suits them, finding the best and most competitive medical and tourism services for them.

The internet seems to be the predominant means for all those looking for information in relation to health issues. In fact, an online hub is currently being created.

What is your message to our international readers as the president of the Athens Medical Association? When they visit Greece for a health issue, they will feel like human beings, and not like numbers on a list. They will be provided with the best medical services at the most competitive prices and will enjoy the beauty of a country that will boost their physical well-being and lift their spirits.

What other initiatives have you planned to promote “Destination Greece”? We have already started executing a coordinated action plan to promote medical tourism internationally. We have visited New York, where we’ve established contacts. The ISA, in collaboration with KEDE, organized a two-day event to raise awareness of medical tourism in Greece. Within the same framework, we are also planning to visit Chicago, Toronto and Melbourne. The conference on health tourism, taking place next May on the island of Ithaca, will be the highlight of these activities.

In no other country I’ve visited have I seen healthcare facilities with such highly qualified specialists in so many departments covering so many different fields.

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THE SEVEN PILLARS OF MEDICAL TOURISM Greece is making its mark on the medical tourism map by offering innovative, high-quality services at competitive costs. BY A L E X A N D R A T Z AV E L L A , M ar i a C o ve o u and N ata s h a b lat s i o u

THE “DA VINCI” REVOLUTION As soon as the patient is asleep on the surgical table, robot “fingers” enter the body through a tiny incision and, with very precise moves, locate and remove the diseased gallbladder.

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GREECE BOASTS ONE OF THE TOP ROBOTIC SURGERY TEAMS IN THE WORLD

The revolution of robotic surgery has one of its strongest frontlines in Greece and its achievements here are being recognized by the international medical community. Doctors from Europe and the Middle East who want to learn the specialization of the future, as well as patients from many countries, are buying tickets to Greece. As soon as the patient is asleep on the surgical table, the robot awakens. The super-fine ends, or “fingers”, of its articulated arms enter the body through a tiny incision and, with very

precise moves, they locate and remove the diseased gallbladder. Obviously, the robot doesn’t have a mind of its own. It serves the surgeon, seated in front of a computer console and looking at an enlarged, 3D version of the surgical site. The commands (given by the surgeon by means of control levers) are executed by the robot. The cholecystectomy can be completed within 40 minutes, almost bloodlessly. The patient recovers quickly with minimum discomfort, no pain, often without any complications and with only the tiniest scar just

a few millimeters long. This isn’t a scene from a sci-fi film, but everyday practice in some of the most modern hospitals in the world. Back in 2006, Greece became the first southeast European country to acquire Da Vinci Si HD, the first FDA-approved robotic surgery system. Da Vinci is still used by the top 50 hospitals in America and is employed by five major hospitals in Athens and one in Thessaloniki. In Greece, it is mostly used in urological operations, particularly prostate, kidney and cyst procedures. HowevG R E E C E IS

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er, when we speak about the Greek revolution in robotic surgery, we are referring specifically to general surgery, a medical specialty in which the country excels at an international level. In 2011, Intuitive Surgical, which designs and builds Da Vinci Si HD, chose a Greek hospital and the team of an internationally acclaimed surgeon to start applying single-site robotic surgery in operations that have only recently started taking place in Spain, Italy and Germany. The doctor was the “father” of robotic surgery in Greece, Konstantinos M. Konstantinidis. He is Adjunct Professor of Surgery at Ohio State University, President of the South Eastern European Robotic Surgery Society, and heads the Department of General, Laparoscopic, Bariatric and Robotic Surgery at Athens Medical Centre. The hospital specializes in robotic surgery and he is one of only a few doctors in the world whose experience covers such a broad spectrum of the field. “Robotic surgery is the successor of laparoscopy and my team applies it, having performed 15,000 laparoscopic surgeries,” Konstantinidis notes. “Imagine what this number really means, taking into account that a surgeon is considered experienced once they’ve carried out 200 operations,” he adds. By means of 3D video streaming, the international scientific community watches operations taking place at the ultra-modern facilities of Athens Medical Center. Some of these are unprecedented in medical history: single-site robotic cholecystectomy in pregnant women, robotic pancreatectomy (Whipple procedure and distal pancreatectomy), robotic nephrectomy in a seven-year-old child with malignant hypertension, robotic spleen cyst removal in a nine-year-old child. “We have reached the point where, for the first time internationally, we can operate on pregnant women during their 27th, 28th and 31st weeks. With an incision just 1.5 centimeters long, we carry out hernia operations on pregnant women and they are discharged the following day,” the Greek surgeon says. Twenty-five years ago, he was the first to establish a department of laparoscopic surgery and laser applications in Greece, even though he had only just returned from his studies in America. His team was the first to operate using the Da Vinci robotic surgery system. Today, the team uses an advanced 4th generation model. After receiving numerous accolades, they now attend leading national and

international scientific meetings, such as the International Robotic Surgery Conference and the European Association of Urology Meeting, where their advanced techniques spark scientific debate. Among the honors and awards they have received is the Award for Successful Organization of International Robotic Surgery Meeting “MIRA”. Many of Konstantinidis’ operations have become case studies; one of them being the robotic removal of a scalpel that had broken inside a patient’s body during diaphragmatic hernia repair surgery. “We are the most experienced in Europe in the Whipple procedure, specifically in cases of pancreatic cancer,” he mentions. “They are the most difficult, dangerous and lengthy surgeries. They take 8-12 hours because we remove a large part of the stomach.” Greek doctors who learned about robotic surgery by participating in his team, first as observers and then as active members, are now on successful career paths at leading hospitals in Athens. In his role as Proctor for Intuitive Surgical, Konstantinidis supervises doctors from all across Europe, guiding them in their first steps in robotic surgery. “Some of them visit Greece to observe operations. Recently, we were visited by 20 professors of medicine from Russia. We receive doctors from all around the world.” Very often, surgeries are broadcast live to 5060 countries. “If I operate on a woman during her eighth month of pregnancy, removing the gallbladder through an incision, my colleagues from all around the world want to see it. This is why I share it with them. Difficult operations are followed by clarifications and telementoring.” Spearheaded by Konstantinidis’ team, the Athens Medical Center is now leading efforts to conquer markets such as China and the Arab world, with the aim of developing medical tourism in Greece. Hundreds of patients from places such as Israel, Libya, Qatar, Dubai, the UK and Russia are coming to Greece to undergo robotic surgery. Some of the most common robotic surgeries are gynecological, gastroesophageal reflux syndrome, diaphragmatic hernia, colon cancer, stomach cancer, cholecystectomy and hernia. “Our experience is vast, and the future is bright,” says Dr Konstantinidis. “We are being spurred on by technology! We are part of a huge scientific experience. Greece has both the scientific training and suitable facilities to become the leader in robotic surgery on an international level.”

“Robotic surgery is the successor of laparoscopy and my team applies it, having performed 15,000 laparoscopic surgeries. Imagine what this number really means, taking into account that a surgeon is considered experienced once they’ve carried out 200 operations.” KONSTANTINOS KONSTANTINIDIS

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By means of 3D video streaming, the international scientific community watches Dr Konstantinos Konstantinidis perform his operations in Greece. Some of these are unprecedented in medical history.

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Ophthalmology NE W A DVA NCED SURGICA L TECHNIQUES Ophthalmology is the field of medicine that deals with the anatomy, physiology and diseases of the eye. It is one of the major specialties on offer in the context of medical tourism. Technological progress in this field along with new advanced surgical techniques have made it possible for almost all surgical procedures in ophthalmology (approx. 90 percent) to be performed without the need for hospitalization. This means it is even easier nowadays for patients to seek medical services in countries other than their own and to combine an opthalmological procedure with a vacation. Medical centers and clinics in Greece typically include an ophthalmology department, but most medical tourists seeking out ophthalmic procedures are likely to opt for one of the country’s day clinics, established under new laws in 2014. They boast cutting-edge equipment alongside expert ophthalmologists, opticians, optometrists and nurses, and can perform surgical procedures that require only a few hours of

post-operative hospitalization. Their rates are quite competitive compared to those in other countries, making Greece one of the top destinations for ophthalmic treatments. Among the standard procedures on offer in Greek day clinics are excimer laser refractive surgery for the correction of myopia, hyperopia and astigmatism; cataract and glaucoma surgery; as well as treatment for age-related macular degeneration and for diabetic retinopathy. Some medical tourists may also seek out oculoplastic interventions, performed to correct an injury or done simply for esthetic purposes. According to a recent study, Greece could attract about 100,000 medical tourists, in particular from the EU, southeastern Europe, Russia, the Middle East, the US and China within the next 2-3 years, and up to 400,000 patients within a decade. Greece’s high-standard services in ophthalmology could play an important role in shaping the country’s future as a medical destination.

Information courtesy of Andreas Tourmouzis, ophthalmic surgeon and medical director at Athens Ophthalmic Day Clinic.

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Physical Medicine & Rehabilitation

A WIDE R ANGE OF SERVICES IN AN IDEAL ENVIRONMENT Physical Medicine and Rehabilitation is that field of medicine which aims to restore and enhance the functional ability and quality of life of those who have suffered strokes, traumatic injuries and acute illness, or are suffering from various chronic diseases, disorders, or post-operative conditions. Such rehabilitation entails interdisciplinary care to achieve improved health and deliver the higher quality of life that comes with that improvement. Thanks to state subsidies, Greece has experienced a surge of growth in this field since 2000, with many private rehabilitation and recovery centers being established around the country, most of them in the regions of Macedonia and Thessaly. They offer top-notch facilities staffed with highly competent and experienced doctors, therapists and nurses, implementing well-established techniques, as well as new clinical innovations, all supported by cutting-edge medical and rehabilitation equipment. Greek rehabilitation centers also stand out for their competitive prices. For a 30-day neu-

ro-rehabilitation all-inclusive package, for example, an in-patient should, according to the Union of Rehabilitation Centers of Greece (EKAE), expect to spend around €9,900. This price includes use of the center’s facilities and rehabilitation services, full-board accommodation, transfers to and from the airport, special diet menus, laundry and ironing services, and much more. There are currently 19 major private rehabilitation centers in Greece, all following internationally recognized protocols. Their rehabilitation programs take into account patients’ individual needs and combine a wide range of services from the different specialties available: physiotherapy, hydrotherapy, occupational therapy, speech therapy, psychological support, nutrition and dietetics. State-of the art facilities, exceptional services and outstanding medical experience, powered by great prices and assisted by the Mediterranean climate and diet as well as the famed Greek hospitality, make Greece an ideal recovery spot for natives and foreigners alike.

Information courtesy of the Union of Rehabilitation Centers Greece (EKAE) and Dr. Christos Goumas, Physiatrist and Scientific Director of the physical rehabilitation center Euromedica-Arogi of Thessaloniki.

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Dental Tourism E x ceptional standards at lower costs

In recent years, a number of Greek dental clinics have become part of a dynamic branch of medical tourism, attracting not only Greeks living overseas who return for treatment but also patients from other countries, chiefly the UK, Belgium and Russia. The largest dental centers in this category are private and operate in Athens and Thessaloniki; there are less than a dozen of them, and they offer high-quality services at costs up to 50 percent lower than similar clinics in Europe and the US. Equipped with the very latest infrastructure (including advanced laser technology, robotic dentistry devices and dental microscopes) and enjoying both international recognition and quality-of-service certification to ISO standards, these centers offer the highest quality dental care at an affordable cost. There’s even a clinic for children with special needs, which has earned a fine international reputation by successfully undertaking even the most difficult dental cases.

In addition to the actual treatment, the cost package that you are offered by these clinics may include transfers to and from the airport, accommodation at a good hotel, special arrangements for accompanying persons, and provisions for covering additional expenses in cases where more days are needed than those originally scheduled. And, of course, there will also be time for sightseeing and excursions. Treatment is generally of short duration, thanks to the simultaneous provision of care to the patient by a number of specialists. The clinics are manned by dental practitioners representing up to 10 different fields, including oral and maxillofacial surgeons, cosmetic dentists, implantologists and periodontists. Most of the dentists and other specialists at these centers have completed post-graduate training abroad, often in Scandinavia, North America or Australia, and many are dental care “veterans”, with experience spanning four decades, who also collaborate with medical schools in Greece.

Information courtesy of the Athens Dental Tourism Cluster.

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In Vitro Fertilization (IVF) M A N Y O P T I O N S , H I G H S U C C E S S R AT E S

Year after year, more and more couples from Europe, the USA, Canada and Australia are placing their trust in medical professionals in Greece to help them realize their dream of childbearing. Greece’s IVF legislation, one of the most progressive, is one of the main reasons why couples choose Greece as a destination. Greek legislation allows anonymous and voluntary egg donation; the transfer of more than one embryo – depending on the age of the woman who’s going to bear the pregnancy; embryo, egg and sperm freezing; prenatal checks; and surrogacy. The fact that, in Greece, women up to the age of 50 are given the chance to become mothers is another factor in the development of IVF-related medical tourism. Greek IVF units operate under license from the Greek National Authority of Assisted Reproduction which monitors whether legal requirements are being met and whether they are in accordance with the Greek and European regulatory frameworks. Recently, the authority launched a program of strict checks to reassure IVF candidates that they will receive secure and reliable service and to get a clearer picture of the current situation in the field of assisted reproduction in Greece. To date, 10 of the 45 units that applied for a license have met the requirements. These 10 units apply best practices

and are staffed with trained specialist doctors and excellent personnel. They offer advanced services at a cost for couples many times lower than in the rest of Europe. Each one of these units has developed a “full-package” offer and is ready to assist couples with the financial aspects of the process. While most clinics are located in Athens and Thessaloniki, there are pioneering units on islands and in smaller cities like Larissa. A large unit in Crete for example, has received roughly 200 couples from European, African and North American countries, as well as from places as distant as Australia and Sri Lanka. The couples remain on the island from 7 to 45 days in order to complete their treatment, combining their stay with a holiday. “The high percentages of pregnancies achieved in Greece, a country that ranks first internationally in many different areas relating to IVF, are also due to a reason that’s not medical: the country’s bioclimate. The sun and the quality of life on the islands, where the couples stay, improve well-being and boost positivity,” said Dr Konstantinos Pantos, secretary-general of the Hellenic Society for Reproductive Medicine and a member of the Medical Tourism Committee of Athens Medical Association, during his speech on IVF at the Medical Tourism Conference in New York on October 29-30, 2016.

Information courtesy of Dr Aristidis Antsaklis, professor of Obstetrics and Gynecology at the University of Athens and president of the Greek National Authority of Assisted Reproduction.

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PLASTIC SURGERY W orld - class standards of beauty augmentation

In 2015, ISAPS, the International Society of Aesthetic Plastic Surgery, rated Greece second in the world after South Korea for esthetic plastic surgery performance. This is because most Greek plastic surgeons have been trained at internationally accredited centers worldwide and have acquired the valuable experience needed for excellent performance in the medical tourism field. Some of the Greek plastic surgery clinics have ISO and TEMOS accreditation and are already renowned for both their international clientele and the high levels of after-treatment patient satisfaction they achieve. Safety, lower costs, spectacular esthetic results, a great environment enhanced by the well-known pleasant climate of Greece, the possibility of short vacations in the Greek islands and the vibrant culture found in today’s Greece are only some of the compelling reasons someone should come to Greece to beautify him/herself and to look younger. The most popular esthetic plastic surgery operation in southern Europe is breast augmentation, followed by facial fillers and botox, liposuction and gluteoplasty, and other esthetic treatments. For every procedure, there are specific mandatory pre-op-

erative and the post-operative steps. Before any surgical operation or beautifying procedure is performed, a thorough discussion takes place with the patient. All details are reviewed, a medical history is taken and full preoperative clinical-laboratory tests are carried out to ensure the patient’s good health. All surgical operations take place in a fully equipped medical clinic in the presence of an experienced anesthesiologist. That way, the patient is taken to the operating room in complete tranquility. Post-operative instructions (and medication, when necessary) are given after each treatment. Depending on the procedure/operation, the patient remains in Greece from one to 15 days. Office procedures do not require post-operative follow-up. For one-day clinic procedures like liposuction, breast augmentation (2+1 triple-plane or 2+2 quadru-plane), the patient will usually be able to travel on the second or the third post-operative day. With more complex surgical operations, such as facelifts, the doctors will probably need at least 10 days for post-operative treatment. One of the best ways one can find out about esthetic plastic surgery in Greece is through social media, where many doctors have a significant professional presence.

Information courtesy of Ioannis Lyras MD, Director, Clinic for Plastic Surgery, Athens, Honorary Consul of Brazil in Greece.

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SPECIALTIE S

DIALYSIS A H A S S L E - F R E E D E S T I N AT I O N F O R K I D N E Y P AT I E N T S Every other year, kidney patients undergoing blood dialysis at Liège University Hospital take their vacation in Irakleio. They don’t choose it just because of the beautiful beaches, the amazing sights and the Mediterranean cuisine. After all, they couldn’t enjoy any of these if a hemodialysis unit didn’t operate there. Every two days, these tourists visit the local unit for blood dialysis, a process necessary to keep them alive. In Greece, hemodialysis tourists began appearing a few years after the first private Greek hemodialysis unit opened in a Cretan hospital in 2000. Nowadays, there are 55 active private units in the country. With specifications meeting European standards, they are ISO 9000 and 9001 certified, which ensures quality. Over the past 15 years, these units have attracted more than 20,000 foreign kidney patients; English, Germans, Danes, Swedes, Dutch, Italians and Belgians as well as a few Americans and Australians. They prefer the Greek sun and the cheaper prices that Greece offers them over its main competitors, Spain and Turkey. Some come for a few days, others arrive during the off-season and remain for roughly five to six months. They often stay in popular tourist cities and islands, within or near the hemodialysis units. Using their accommodation as a base, they take short cruises and trips. Crete, Santorini, Rhodes, Kalamata and Meteora have all invested heavily in hemodialysis units, becoming key players in the medical tourism industry. “What did you do to her that improved her condition so

much?” asks a Swiss doctor about his patient who returned home in much better shape after her trip to Irakleio. “The difference wasn’t in the dialysis method; the standards are the same as those followed elsewhere in Europe. It was the Greek climate, the good food, the sun and the sea that changed the mental well-being of this kidney patient,” says Nick Stathoglou, General Manager of Mesogeios Dialysis Centers, a medical group that, apart from its facilities in Crete, also has units in Athens, Kalamata, Halkida and Serres. In just 16 years, these centers have received more than 9,000 patients, most of them traveling with their chaperones. For the most part, these private Greek hemodialysis units offer advanced medical services and, in addition to nephrologists, are also staffed with specialists, such as cardiologists, pulmonologists and urologists; many also collaborate with social workers, psychologists and nutritionists. The units are usually linked to large public hospitals and are equipped with modern medical facilities in attractive surroundings. Some of them remind you more of hotels than clinics, with libraries as well as dialysis suites. On the other hand, if patients ask about sightseeing tours or other organized activities, they might be disappointed in the options on offer. There’s still a lot of room for improvement in creating medical tourism packages. However, most units are happy to handle matters of bureaucracy such as the transfer and accommodation of foreign patients. They also offer friendly prices to their patients’ chaperones.

Information courtesy of Nick Stathoglou, General Manager of Mesogeios Dialysis Centers, Crete.

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OPINION

The Making Of A Modern Asclepius Greek doctors distinguish themselves at home and abroad. What is it that makes them such good scientists? BY Dimitrios Linos e d i t I N G : E le n a K i o u r k t s i

ILLUSTRATION: PHILIPPOS AVRAMIDES

reek doctors are not only a match for their colleagues in the most scientifically advanced countries in the world, but many are emerging as leaders in their fields. This did not happen by magic. Behind their success lies a demanding system of medical training led by world-renowned teachers and a continuous assessment and filtering process which starts with the entry exams to the country’s medical schools. Only a small percentage of applicants (somewhere in the region of 9 percent) are accepted into university to study medicine. The need for up-to-date training in specialties leads the best Greek medical graduates to pursue ad-

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vanced studies in centers of excellence abroad, where only those who meet the highest international standards succeed. In the United States, where I have several years’ first-hand experience of the system, I know that the bar for studying at the top training hospitals is set very high indeed. Distinguished Greek doctors have trained and taught at the world’s most prestigious medical establishments. Some have remained abroad, but others have returned to Greece. In either case, these “doctors of the diaspora” are able to use their knowledge to help patients and to offer their support to young doctors who wish to follow their footsteps.

In my personal capacity as a Governor of the American College of Surgeons, I can testify to the great interest from our doctors to train abroad, and to the genuine desire of experienced colleagues abroad to support medical training in Greece, as well as an eagerness to be present whenever medical challenges here at home require their assistance. Both individually and collectively, Greek doctors continue to work through their professional bodies to maintain their standards of training and practice at the highest international levels. In many medical specialties and sub-specialties, Greek doctors are internationally acclaimed. They are invited as keynote speakers to international conferences, they are active participants in peer review for the most authoritative international medical journals, and they author influential medical publications. They are elected presidents of international medical societies. This is certainly the case in my own field of endocrinology, particularly in the area of diseases of the adrenal glands (among the most frequent causes of the modern “epidemics” of obesity, high blood pressure, metabolic syndrome and diabetes). These conditions, which afflict thousands of people worldwide, require specialist knowledge, proper diagnostic procedures and advanced surgical techniques for their treatment. Often the

patients are not even aware that their condition is treatable. For example, a certain percentage of high blood-pressure sufferers have tumors in their adrenal glands, the removal of which alleviates the problem. In other cases, obesity and diabetes can be traced to adrenal tumors causing an over-production of cortisol; prompt diagnosis and treatment can prevent health complications in the patient and improve quality of life for them and their families. The leading Greek endocrinologist, Fotis Pavlatos, has given his name to the standard diagnostic test that can distinguish between malignant and benign adrenal tumors, allowing doctors to remove malignant tumors and monitor benign ones. Pavlatos first published his discovery in 1965, as a medical researcher at the University of California; since then, this test has been used by pathologists, endocrinologists and specialist surgeons around the world. Recently, the European Society of Endocrinology and the European Hormone Society award-

ed him an annual prize for his contribution to medicine. Pavlatos, who taught pathology and endocrinology at Athens University for several years, continues to honor Greek medicine with his presence at international conferences. In the same field of adrenal gland disorders, in the sub-field of obesity due to cortisol over-production (or Cushing’s Syndrome) and in the etiology of stress, the leading specialist is also a Greek doctor: Professor George Chrousos graduated from Athens University Medical School and completed his postgraduate training in the United States, where he served for many years as Chief of the Pediatric and Reproductive Endocrinology Branch of the National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), before returning to Greece to take the post of Professor at Athens University Medical School. According to Google Scholar Citations, he is the 65th most frequently cited scientist worldwide.

Thanks to the high caliber of their training and education, Greek doctors specializing in the surgical treatment of adrenal gland disorders are achieving some of the best outcomes worldwide; the surgical treatment of adrenal tumors in Greece uses pioneering endoscopic methods, which are minimally invasive, and deliver better results than those published in North America and Europe. It is no accident, then, that the President of the International Association of Endocrine Surgeons is also Greek. Endocrinology is not the only area of focus: Greece also plays host to centers of excellence in oncology, rheumatology, orthopedics, ophthalmology and gynecology (including reproductive medicine), as well as surgery and robotic surgery. There are internationally renowned clinicians, academics and medical researchers in a wide range of specialties, and hospitals equipped to perform the most challenging diagnostic and therapeutic treatments. This means that a Greek patient has no need to seek diagnosis and treatment abroad, as used to be the case for many medical issues, particularly for heart conditions. In fact, it’s the other way around now, and patients from abroad are increasingly trusting the healthcare services of a country that has not stopped producing outstanding scientists and healers, from antiquity to the present day.

* M.D., Ph.D., Professor of Surgery, National and Kapodistrian University, Athens Medical School President, International Association of Endocrine Surgeons Governor, American College of Surgeons/Greek Chapter

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LIFESAVER

Georgios Papanikolaou, seen where he nearly always was: by his microscope, examining a slide. New York City, 1958.

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Georgios Papanikolaou, the inventor of the unsurpassed method for the prevention of cervical cancer, is rightly regarded as one of the most brilliant scientific minds of the 20th century.

BY Elena Kiourktsi

f we wanted to trace Georgios Papanikolaou’s life on a map, we’d start our line at his birthplace, Kymi in Evia, and then run it through Athens, the German cities of Jena, Freiburg and Munich, and then down to sunny Monaco. It would briefly pause during the Balkan Wars, during which Papanikolaou fought, only to move on to New York before finally stopping at Miami. This geographical exercise would prove that for Papanikolaou the researcher, the world had no borders. Millions of women are grateful to him for the test he discovered and presented for the first time in 1928. He was 45 years old at the time, and the medical community was initially skeptical about him and his work. Nearly a century has now passed, and there is still no sign of a better, more modern method for the prevention of cervical cancer. And yet, Georgios Papanikolaou almost didn’t become a doctor. He was born May 13, 1883, the second son and third child of the Nikolaos Papanikolaou a doctor popular enough to be elected Mayor and subsequently a Member of the Parliament. According to the tradition of those times, the firstborn son had to follow his father’s career. But as his older brother chose law, Georgios, who was already showing a particular inclination towards medicine, took up the responsibility instead. After primary school, Georgios left for Athens where he started learning French, a language considered a necessary skill for young Greek gentlemen. Leaning towards music, he also studied violin for eight years at the Laut-

When Papanikolaou and his wife first arrived in New York, he sold carpets and, in the evenings, played the violin in various restaurants, while she sewed buttons for five dollars a week.

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To this day, the Pap Test is used worldwide for the diagnosis of cervical cancer, precancerous dysplasia and other cytological diseases of the female reproductive system.

Machi Papanikolaou spent half a century in the laboratory, by her husband’s side.

ner School of Music. In 1898, aged only 15, he managed to get into the School of Medicine of the National and Kapodistrian University of Athens. During his university years, he formed strong friendships with other students, including Dimitris Glinos and Alexandros Delmouzos from the School of Philosophy. They were dedicated to the demotic movement, an attempt to make the demotic, colloquial Greek the predominant language in place of the cultivated imitation of Ancient Greek known as katharevousa. In these matters and others, Glinos and Delmouzos influenced Papanikolaou. philosophical thought Having finished school, Papanikolaou returned to Kymi under the influence of the new ideological movements and philosophical theories of the early 20th century and withdrew to his birthplace to cultivate the land, read philosophy and biology and occupy himself with language and demoti134

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cism. He was influenced by the theories of Kant, Nietzsche, Schopenhauer and Goethe, and by Ernst Haeckel’s book “The Riddle of the Universe.” Nevertheless, scientific research still fascinated him. Knowing this, his father sent Georgios to Germany for further studies in 1907. For three years, he studied Biology and Zoology, first in Jena, then Freiburg and finally Munich, from where he acquired his PhD. This “German period” of his life was full of explorations and discoveries, and it was during this time that Papanikolaou decided that research and biology would be the twin purposes of his life. He wrote to his father: “I am no longer a dreamer. Science snatched me out of Nietzsche’s hands. I’ve got my feet on the ground.”

Scientific Odyssey When he returned to Greece in 1910, Papanikolaou realized that the conditions were not favorable to his plans for the future. He married the educated and open-minded Andromachi – or Machi, as he called her – Mavrogenous (a descendant of the Mavrogenous family who made history fighting against the Ottomans in the Greek War Of Independence). Right after their marriage, he decided to leave Greece again. He clari-

fied his position to his parents, explaining that his “ideal in life was neither to become rich, nor to live happily, but to work, act, create and do something worthy of a man who’s moral and strong.” The young married man’s first stop was at the Oceanographic Institute of Monaco. In 1911, he took part in a scientific expedition in Prince Albert’s oceanographic vessel L’Hirodelle. A year later, during the Balkan Wars (1912-1913), he was conscripted into the army as an Assistant Medical Reserve and returned to Greece. During this time, he met a number of compatriots who had previously migrated to America and were now back in Greece voluntarily, to fight. From conversations with them, he began to form the opinion that the New World was the place where the conditions for scientific research were at their best. On October 19, 1913, Georgios Papanikolaou, together with his wife, disembarked in New York. The couple initially faced serious financial difficulties. At the beginning, they lived in a single room on 116th Street and both worked at Gimbels Department Store. He sold carpets and, in the evenings, played the violin in various restaurants, while she sewed buttons for five dollars a week. However, although poor and seemingly

the pap te s t

unknown, Papanikolaou overcame the difficulties quickly. He found work as a journalist for the Greek paper Atlantis and was later recruited by the New York Hospital, having been recommended by Professor Thomas Hunt Morgan of Columbia University. Dr Morgan knew Papanikolaou from Germany and appreciated his work. Finally, in October 1914, he started working at Cornell University where he would remain for the next 47 years. Two months later, his wife Machi joined him as his technician. the Pap test The 1920s were the most productive but also the most difficult years of his efforts. The experimental stage of his research began with vaginal smears from actual guinea pigs. The results were encouraging. Shortly afterwards, Papanikolaou began to experiment on vaginal smears from his own wife and, eventually, female patients at a hospital affiliated with Cornell. When he identified cancerous cells in a sample from a woman with cervical cancer, he confessed that it was one of the most staggering experiences of his scientific career. The first clinical trials proved the diagnostic value of cytological examination of smears. This work became the cornerstone that established his method for the timely diagnosis of cervical cancer. In 1928, he made his first announcement titled “New Diagnosis of Cancer.” It was first received with doubt by the American medical community. He, however, was absolutely confident about its value and continued his research with greater zeal. Thanks to his perseverance, Dr Pap’s pioneering cytodiagnostic method became both accepted and internationally known under the medical abbreviation Pap test. To this day, it is used worldwide for the diagnosis of cervical cancer, precancerous dysplasia and other cytological diseases of the female reproductive system. The epilog in Miami Papanikolaou worked relentlessly for almost half a century at Cornell.

He didn’t take any vacations, apart from one short scientific trip to Europe where he slipped in his hometown Kymi as the final stop. In 1961, despite the fact that he was 78 years old, he decided to leave New York and settle in Miami. He planned to undertake the organization and management of the Miami Cancer Institute. However, he did not have the chance to inaugurate the Institute himself; he died suddenly of a heart attack on February 19, 1962. The Institute was renamed Papanicolaou Cancer Research Institute. Throughout his career, the great researcher and scientist kept unbreakable bonds with Greece and maintained his interest in Greek politics and the various intellectual and social movements in the country. His wife continued his work in Miami until her death in 1982. She believed that one is born a scientist and that research comes to fruition only inside labs. For this reason, she said, “There was no other option for me but to follow him inside the lab, making his way of life mine.” She was so devoted to him that she decided not to have children in order to always be by him. She said that she never regretted it.

The Nobel Prize that wasn’t Papanikolaou’s bibliography consists of 158 articles and five scientific books. The most prominent of them is the famous Atlas of Exfoliative Cytology. The book is a milestone not only in the science of cytology, but also in the medical bibliography of the 20th century as a whole. Even though he never received a Nobel Prize (although he was nominated twice), he was awarded many medical prizes, both during his life and posthumously.

Sons of Hippocrates Eight Greek scientists who changed the course of modern medicine

With his beloved wife, Machi, and a group of students.

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Innovation

genius minds Greek research teams on the forefront of biomedical technology. BY Ko s ta s D e l i g i a n n i s

Greek start-up helps global pharmaceutical giants test new active substances in a reliable and cost-effective way. A University of Patras spin-off is getting ready to run clinical trials of a very promising medicine developed for multiple sclerosis. Scientists from the University Hospital of Ioannina have designed a pioneering scalpel which lets the doctor know, during the operation, whether they’ve removed the whole tumor, i.e., if the operation has been successfully completed. These are just a few examples of the revolutionary biomedical technologies being developed in Greece which promise improved treatment and a better daily life for millions of people around the globe. It’s thanks to breakthroughs like these that Greece is boosting its presence on the world map of biomedical innovation and continuing to contribute significantly to the efforts of the worldwide scientific community to fight the most serious illnesses. 136

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Micrel

Telemedicine in drug infusion pumps

In 2006, Micrel became the first company in the world to launch a drug infusion pump that could be connected to the internet via a mobile phone network. As with all other pumps, Micrel’s device also releases drugs in small doses into the patient’s body. However, thanks to its online connectivity, doctors can control its operation at any time and even modify the treatment from miles away. Another Micrel invention, a parenteral nutrition pump for patients receiving food intravenously, lets a doctor see remotely if a patient’s catheter is about to occlude, helping to avoid unnecessary complications. Both devices have conquered the European market. “99 percent of our clients come from foreign markets and we have two operating subsidiaries in Germany and Sweden,” says Alexandros Tsoukalis, co-founder and Managing Director of Micrel. “Our aim is to develop our products even further, having already patented disruptive new technologies in both EU and US that are going to transform the infusion landscape.”

EMBIO Diagnostics

Fast, cost-effective detection of pesticides

ens but registered in Cyprus, because Greek law at the time did not allow academic institutions to establish spin-off companies. “The US, Australia, UK and France have expressed interest in the detector,” notes the professor, “and by altering the same technology slightly, we’re currently developing a medical device that will be able to assess how tumors are responding to chemotherapy. This way, the doctor will be able to choose the best course of treatment for each patient.” The company is currently run by Mr. Konstantinos Loizou, an electronics engineer from the Technical University of Crete.

The portable device from EMBIO Diagnostics that detects traces of pesticides in agricultural products was commercialized first in Germany. The device is based on cellular biosensor technology developed by a team led by Prof. Spiros Kintzios, co-founder of EMBIO Diagnostics, at the Agricultural University of Athens. Each test lasts just 3 minutes and costs €4-5, while the only other alternative method is chemical analysis, which takes 30 minutes and costs €150-300 per sample. EMBIO Diagnostics was “born” at the Agricultural University of Ath-

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Innovation

ProtATonce

A pioneering approach in checking active substances in medicines

Over the past few years, ProtATonce has been increasing its clientele and establishing new collaborations with pharmaceuticals and research centers. This Greek start-up has developed a faster and more reliable preliminary analysis of chemical substances considered to be potential candidates for medicines. This is achieved by looking at the substances’ effects on cells and tissues related to a given disease. “Our advantage is that we have developed one of the top technologies for measuring multiple proteins, improving the speed, quality and systematic analysis of the data,” says Dr Leonidas Alexopoulos, Assistant Professor at the National Technical 138

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University of Athens and co-founder of ProtATonce. The company is internationally acclaimed, thanks to its specialized bio-information analysis and its pioneering technology for manufacturing high-quality reagents. “Apart from our facilities at Lefkippos, the Technology and Science park of Attica, we have opened an office in London. Furthermore, we recently launched a new service finding new biomarkers for diagnostic and prognostic use. Most importantly, we are working with Harvard Medical School and Washington University in St. Louis to apply this new technology on chronic kidney disease,” Alexopoulos adds.

Innovation

PCC Hellas

Improving out-patients’ medication adherence

In collaboration with Evangelismos Hospital in Athens and after completing a pilot run in November, PCC Hellas now has tangible evidence that the platform they’ve built has accomplished its mission: it encourages patients to follow their treatment consistently and punctually. “The trial took place with patients suffering from hypertension. In the middle of the trial, after a 6-month period, it indicated that the percentage of medication compliance for those patients with access to the platform was 88 percent, significantly higher than the 64 percent recorded in the control group that didn’t have such access,” says Managing Director George Mazarakis. The platform consists of four interacting systems: the company’s central management information system (MIS) and one each for the nurse, the patient and the doctor or pharmacist. In each system, treatment-related data such as medicine intake and nutrition is recorded, using any mobile device. This way, the doctor/health professional can have real-time, valid information regarding their patients, giving them a powerful tool to assist them in decision-making.

Locus Medicus

Childbearing hopes for thousands of couples

The diagnostic method developed by the Greek company Locus Medicus has revealed an important cause of male infertility, which prevents many couples from having children. The pioneering method examines the specimen for infectious microorganisms which are likely to either prevent conception or infect the fetus, resulting in miscarriage. However, both of these possibilities can be prevented by appropriate treatment, if the infection is detected. “Couples who used IVF several

times and suffered many early miscarriages, were able to have children, naturally immediately after having received the treatment,” says one of the two inventors, Vassilis Tsilivakos, histopathologist-perinatal immunologist and co-founder of Locus Medicus SA. The examination is becoming increasingly popular abroad, particularly in the United Kingdom, and Locus Medicus is about to announce a partnership with another European company to promote it further around the world. G R E E C E IS

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Innovation

SinusMedii

qCELL

Thanks to a new device developed by SinusMedii, ophthalmologists will soon have, for the first time, quantitative data which they can use to decide whether a cataract operation is needed or not. They will also be able to evaluate the performance of various treatments used in fighting corneal disease. A European company has acquired the technology to commercially exploit the invention, which is expected to make its market debut mid-next year. The device is highly innovative because it measures the light scattering inside the eye, providing the doctor with an objective index of vision quality, without the patients having to subjectively describe their symptoms. “For several eye conditions, even today, diagnosis can be subjective: for example, in the case of cataracts, the doctor examines the lens of the eye and decides based on their experience whether surgery is indicated or not. Now, with this innovation, the doctor will be able to measure the severity of the symptoms and decide based on objective criteria if an operation is needed,” says Harilaos Ginis, the scientist behind the invention.

A radical advancement of optical diagnostic imaging called spectral hyper-vision has opened new horizons in non-invasive diagnosis. The technology has been created and patented by Costas Balas, Professor at the Technical University of Crete (TUC). Early iterations of this technology are already in the mass-production phase, with a FDA-approved product being launched in the global market. Known as DySIS colposcope, this product has been the subject of international trials involving thousands of women and has proved capable of detecting high-grade cervical neoplasia approximately 80 percent more accurately than traditional methods. Early and accurate detection means that many lives can be saved – more than 40,000 women have been examined so far. Capitalizing on his past experience, Professor Balas has recently developed the “real-time spectral hyper-vision,” a technology with incomparable diagnostic capabilities that won top prize in the 2nd edition of the “Greece Innovates” competition, organized by Eurobank and the Hellenic Federation of Enterprises. The miniaturization of such high-end technology, currently in progress, could open new horizons in medical imaging, since the equipment will be easier to use and cheaper (by roughly 95 percent) to make. The end product is also expected to create a new international market and to perform particularly well in low-resource countries. In Q3 2016, Professor Balas founded a new technology company (QCell) to commercially exploit this technology, after attracting seed funding from Jeremie Open Fund II.

A new reality in eye tests

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Hyper-vision: advanced diagnostics in mobile platforms

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Innovation

Biosensors Lab Professor Electra Gizeli

Cost-effective DNA analyses

Scientists at the Institute of Molecular Biology and Biotechnology of the Foundation for Research and Technology-Hella, led by Dr Electra Gizeli, Professor at the Department of Biology, University of Crete, have developed a new concept in healthcare which employs an autonomous system for genetic analysis operated through a smartphone. The method is fast, simple and cost-effective, while the use of a smartphone and miniaturized electronics allows for future development of on-site measurement devices and applications in developing countries. The system has been shown to detect infectious diseases in human blood, tumor biomarkers, and pathogenic microorganisms in food samples, by analyzing genetic material. “The method is based on the fact that, with suitable preparation, every DNA molecule gives out a distinct signal (its acoustic signature) when subjected to ultrasound waves,” says Gizeli. The team has patented the method in the USA and Europe, and is currently setting up a spin-off company to commercialize it.

Treating multiple sclerosis: a potential candidate for clinical trials ELMog is, according to Professor John Matsoukas of the Chemistry Department of the University of Patras, a strong candidate for potential use in the immunotherapy of multiple sclerosis, given that it has already shown properties of therapeutic vaccine in animal models. Over the last decade, the research team has worked extensively under Matsoukas’ supervision in the design, synthesis and biological evaluation of biomolecules (peptide and semi-mimetic peptide analogues), epitopes of the protein myelin, which is associated with MS. This work has led to the development of the new candidate “ELMog”. The research team is targeting the initiation of Phase I Clinical Trials in Australia by the mid of 2017. Professor Matsoukas started researching the illness during the 1990s when a relative was diagnosed with MS. “This experience brought me face-to-face with multiple sclerosis, a serious autoimmune disease with exhausting and difficult symptoms that appears most often in young people,” he says. The professor and his collaborators are hoping for an improved treatment for the disease. 142

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Innovation

GV/GA Sarissa-Lancet

Innovative scalpel for tumor removal

Studies indicate that the full surgical removal of a tumor increases the patient’s life expectancy. However, to this day, there is no subjective way for surgeons to know whether they have removed all of the neoplasm. GV/GA Sarissa-Lancet, an advanced scalpel developed by scientists at the University Hospital of Ioannina, promises to solve this problem. The innovation lies in the biological material being examined inside the operating theater as soon as the tumor is removed so that, within five minutes, the surgeons know when they have reached the healthy tissue surrounding the tumor, and therefore when the surgery has been suc-

cessfully completed. Other techniques, developed for the same purpose, are less reliable or cost more. This explains why scientists found private funding to produce the scalpel. “We are confident that, in early 2017, the final version of GV/GA Sarissa-Lancet will be completed and that it will be used in Phase III clinical trials (surgical operations on humans). If the results are positive, then it will be patented and thereafter commercialized,” say the inventors of the device, Dr Georgios Vartholomatos, Scientific Director of the Molecular Biology Unit of the Hematology Lab of the Hospital of Ioannina, and Dr Georgios Alexiou, neurosurgeon.

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O P A P C O R P O R AT E S O C I A L R E S P O N S I B I L I T Y

Supporting Greek Societ y and the New Gener ation Health, Sport and Employment are the three pillars of the company’s Corporate Social Responsibility strategy.

For decades, OPAP has been a constant supporter of Greek society and the economy. Focusing on the young generation, the company’s corporate social responsibility strategy rests on the pillars of health, sport and employment, serving essential needs and making effective interventions. Health: Upgrading Children’s Care With the improvement of living conditions for children as one of its priorities, over

the past two years OPAP has renovated the children’s hospitals of Aghia Sofia and Panagioti & Aglaia Kyriakou, the most important pediatric institutions in Greece that serve the needs of children from all over the country. To date, OPAP has delivered eight hospital units, covering a total of 5,330 square meters and with a capacity of 191 beds. Thanks to their design and esthetics, these modern units create a pleasant environment for children, their parents, nurses and medical staff.

OPAP’S CONTRIBUTION significantly upgraded the most important pediatric hospitals in Greece, by providing a safe, comfortable and pleasant environment for both children and adults.

MEDICAL BRIEF

Sport: Building the Future OPAP is an integral part of Greek sports and, through its innovative Sports Academies program, has invested in a creative way in the future of sports with the aim of making great athletes out of great people. Within two years, the program has achieved impressive results. It has supported 10,400 young athletes in 48 prefectures and 125 amateur academies, providing training equipment and full insurance coverage for sporting activity. Furthermore, it has organized seminars upskilling the expertise of 450 coaches, making them better able to support children in terms of technique and psychology. In addition, the programâ&#x20AC;&#x2122;s team of experts provides 20,000 parents with guidance on psychological, pediatric and nutritional issues.

Founded in 1958, OPAP, the Greek Organization of Football Prognostics S.A., is Europeâ&#x20AC;&#x2122;s biggest betting firm. To find out more about their CSR initiatives, visit www.opap.gr

Employment: A Fresh Boost for the ECONOMY The OPAP Business Growth program was designed to offer a unique perspective to developing small- and medium-sized enterprises so that they can broaden their business horizons, thus helping to boost the economy and employment in Greece. Businesses participating in the program will have access to valuable information, as well as an important business network that will help them not only to overcome obstacles and difficulties but also to innovate and develop their export activity. Specifically, the program aims to give businesses access to markets, investment and credit as well as advice on financial management, human resources, branding and communication.

OPAPâ&#x20AC;&#x2122;S innovative Sports Academies program aims to make great athletes out of great people

The publishers of the magazine are not responsible for the content of this article

n e w era , n e w s t rat e g y

The Henry Dunant Hospital CENTER President Christos Sorotos talks about plans to overhaul this important Athenian medical center. From the eighth floor of the HENRY DUNANT Hospital Center’s administrative offices, the horizon appears to stretch infinitely. Perhaps it is this expansive view that explains why the president of the medical facility, Christos Sorotos, would rather talk about the hospital’s present image and future plans than dwell on its past: “There is an unfortunate chapter behind us, but the Piraeus Bank Group deemed that it could not allow this medical center to close.” This is the only statement Sorotos has made regarding the events triggering the banking group’s involve-

ment. From his comment, it should not be interpreted that a sense of obligation towards society motivated Piraeus Bank; rather, it was solid financial reasons that compelled the bank’s decision to invest in tertiary healthcare, spearheaded by the investment in the Henry Dunant Hospital. In the two years Sorotos has been at the helm, it is not only the hospital’s ownership status and corporate identity that have undergone transformation. As a subsidiary of Piraeus Bank, the hospital’s management, operational, and de-

107 Mesogion, 115 26 Athens Greece Tel. (+30) 210.697.2000 Fax. (+30) 210.697.2160

velopmental models are also different. Over the course of his lengthy career serving multiple leadership roles in banking, this was not the first time Sorotos was asked to bring an enterprise back on track and to rationalize its management. The top-flight executives who have followed him from the Group confirm the robustness of both the strategic hospital plan and the operational safeguards that have been put into place – a robustness that is understandable in such a particularly difficult period and under such unfavorable economic conditions. Sorotos himself does not perceive his undertaking as a “rescue mission,” nor does he believe that managing a hospital needs to be any different than managing any other business. “There is no difference in crisis management; basically, businesses collapse because of mismanagement. Henry Dunant had and still has first-rate medical and nursing personnel and excellent facilities that were, from the onset, created for a medical center.” It wasn’t, Sorotos stresses, an apartment block that suddenly became a hospital – a factor seen as one of its biggest advantages by Piraeus Bank. The task at hand, therefore, was mostly about rebooting the hospital and improving its image and prospects on an ongoing basis. Sorotos admits that one of the critical steps in the transition’s first phase was to rally a skeptical staff, but certain actions that were implemented from the start, particularly safeguarding jobs, soon shifted the climate. “The aim was to stabilize Henry Dunant Hospital, and this has now been achieved,” says Sorotos. Operational costs were rationalized within two years and overall financial results are on the path towards stabilization - an impressive improvement on figures and projections from October 2014. The key to upgrading operations lies in implementing a series of new approaches, including a five-year financial plan drafted by a specialized overseas firm; the structural readjustment of the internal organizational chart on the basis of the latest international standards; and a new management model for medical staff management. It has been determined that, like all major top-end medical facilities, Henry Dunant should offer services in the following eight areas: internal medicine, surgery, cardiology, oncology, gynecology, neurology, musculoskeletal treatment, and

We are promoting autonomous management for every department, an autonomy which is not restricted to their scientific and medical activities but will also pertain to their financial performance.

clinical services. In the domestic private tertiary healthcare system, the emergency care unit needs to operate on a 24hour basis, while out-patient clinics and radiology/diagnostic labs must be located in purpose-designed areas that have ample room for future expansion. Another important step in revamping the hospital’s image is strengthening its staff profile by attracting acclaimed and gifted doctors. At the same time, the new operational model needs to redefine the role of management department wide. “We are promoting autonomous management for every department, an autonomy which is not restricted to their scientific and medical activities but will also pertain to their financial performance,” says Sorotos. Where the medical center will go next depends on the Piraeus Bank Group’s overall plans. The president of the HENRY DUNANT Hospital Center does not rule out selected collaborations that will further strengthen the hospital but repeats his comment about “apartment buildings turned into clinics” in order to stress that future collaborations will be defined by a strict framework. Given all the changes which have taken place, it seemed reasonable to ask why the hospital decided to keep the same name. A smile indicates that Sorotos was expecting this question. “It is indisputably a strong brand name in the health sector, one in which hospitals abroad are also prepared to invest. Furthermore, it was deemed that moving forward and putting the past behind us did not mean that we had to write off Henry Dunant or his legacy.”

Specialized Medical Centers: a new chapter for the HENRY DUNANT Hospital Center Fitted with cutting-edge technology for specialized care and built to the highest-quality standards, the HENRY DUNANT Hospital Center’s progressive new patient-focused medical centers are paving the way towards new enterprise growth and driving change in both general and tertiary health care. The HENRY DUNANT Hospital Center has positioned itself as an innovative leader in the Greek healthcare industry and is already reaping the rewards of its first seven specialist centers. Metabolism & Diabetes Center: This center offers the latest in diagnostic and treatment capabilities for a broad range of metabolic disorders by implementing international best practices in health care. The center’s philosophy is based on a comprehensive approach to metabolic disorders,

including a complete assessment of metabolic risk followed by implementation of preventative measures and/or treatments. Continuous patient monitoring through frequent interactions with medical staff and special consultations is a key component of the center’s practice. The Metabolism & Diabetes Center also places significant emphasis on weight control and adopting a healthy way of life. The center’s advanced technology supports these goals by enabling body composition analysis and close monitoring of basic metabolic rate.

The new Breast Center is equipped with an advanced digital mammograph – the only EUREF-certfied (European Reference Organization) service in Greece.

MEDICAL BRIEF

107 Mesogion, 115 26 Athens Greece Tel. (+30) 210.697.2000 Fax. (+30) 210.697.2160

Βreast Center The new Breast Center is staffed with top-ranking physicians and an expertly trained nursing staff, offering preventative, diagnostic, surgical, and post-surgical care services. It is also equipped with an advanced digital mammograph – the only EUREF-certified (European Reference Organization) service in Greece – which facilitates stereotactic biopsy effectiveness.

Pain & Spine Center The Pain and Spine Center is run by American Board Certified specialists with broadbased experience in pain management and non-surgical spinal injury treatments from US hospital groups. In cases where surgery is considered necessary, the center recommends procedures that are as non-invasive as possible, resulting in less post-surgical pain and a more manageable cost profile compared to conventional surgical methods.

Preventive Cardiology & Heart Disease Center The Center for Preventive Cardiology applies “bloodless” diagnostic methods, including echocardiograms, to cover a broad range of preventive tests and also utilizes methods such as 2D and 3D colored transthoracic echocardiograms, transesophageal ultrasounds, and dobutamine stress echo tests. It also applies modern protocols, such as adenosine stress echo tests and dyssynchrony tests, while comprehensively testing for specific disorders like high arterial pressure, rheumatoid arthritis, psoriasis, diabetes, heart disease, and dilated cardiomyopathy.

The Pain and Spine Center recommends procedures that are as non-invasive as possible, resulting in less postsurgical pain and a more manageable cost profile.

Sleep Studies Center The Department of Pneumonology operates a fully equipped, state-of-the-art sleep study laboratory run by sleep medicine experts and supported by specially trained technicians. Areas of interest include sleep apnea, snoring, and daytime drowsiness testing and diagnosis as well as assessment of other sleep disorders, including narcolepsy and neurological sleep disorders.

Center for the Prevention of Heart Disease in Women (Women’s Heart Center) The Women’s Heart Center, the only one of its kind in Greece, designs tailored heart disease prevention regimens. With highly expert medical staff and advanced medical machinery, it delivers timely prevention, accurate diagnoses, and effective treatments.

The Metabolism & Diabetes Center’s advanced technology supports these goals by enabling body composition analysis and close monitoring of basic metabolic rate.

Vascular Malformation Center The high-tech vascular malformations center operates in collaboration with the world-renowned Lariboisiere Hospital in Paris, facilitating large-scale vascular surgeries and a multidisciplinary approach to dealing with this complex disorder.

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MEDICAL BRIEF

AT H E NS L E A D S I NT E R N AT I O N A L N E U R O S U R G E R Y

Christos Georgopoulos

performs comple x br ain and spinal surgery to standards of world - cl ass e xcellence Knowledge and experience combined with state-of-the-art robotic technology At our facilities, we offer internationally acclaimed expertise in neuro-oncology, vascular neurosurgery and spinal neurosurgery. We take the lead internationally in the emergency treatment of brain-subarachnoid hemorrhage from ruptured aneurysm or arteriovenous malformation, either by utilizing endovascular embolization or by other surgical procedures. Having described and implemented innovative microscopic and endoscopic techniques and revolutionary technology, we offer the most effective surgical treatment of vascular malformations and cavernous hemangiomas of the brain and spinal cord. We are the only neurosurgery department in our country (and one of the few in the world) to have discarded open craniotomy brain mapping with the patient awake – it’s laborious and may be accompanied by patient intolerance and/or intraoperative complications – in favor of non-invasive preoperative brain mapping, which is bloodless, painless and delivers maximum accuracy. To accomplish this, we use the most advanced electronic technology (Navigated Transcranial Magnetic Stimulation of the Brain, or NTMS) for pre-operative planning of surgery, for both tumors and vascular malformations, in eloquent areas of the brain. Radical microsurgical excision of specific abnormalities in extremely sensitive brain regions, such as those controlling movement and speech, is an enormous surgical challenge. In such cases, pre-surgical mapping is transferred to the operating room, where, using the microscope and neuronavigation, radical removal of the tumor or vascular malformation is achieved with the greatest safety, with minimal post-operative complications and hospitalization, and with a significant improvement in disease prognosis and quality of life of patients. During surgery, there is continuous neurophysiological monitoring of the patient.

“I treat my patients as I would treat my own family.”

C h ristos G e orgopou l os , MD, PhD, C C S T- N S ( U K ) Chairman of Department of Neurosurgery “Henry Dunant Hospital Center” • Tel. (+30) 210.270.2800 • Εmail: georgopoulos.ns@gmail.com • YouTube: christos georgopoulos • FB: christos georgopoulos

All neurosurgical procedures are performed with the most modern anesthetic techniques (using either general anesthesia, or local/regional anesthesia with the patient awake, “awake surgery”). Our colleagues, including the neurophysiologists, neuropsychologists and speech and language therapists on our team, have unique expertise and experience both in diagnostic approaches and in the comprehensive treatment of our patients. We work closely with other specialists, including prominent histopathologists, oncologists and radiotherapists, who also have vast experience in their therapeutic techniques, which include stereotactic radiotherapy and radiosurgery (X-knife and CyberKnife). In epilepsy, we are taking the lead internationally in the transition from operational identification of epileptogenic cortical areas to non-invasive, safe and effective neuromodulation of the brain, by the application of approved therapeutic protocols such as NTMS. At present, we are working to establish NTMS therapeutic protocols for treating stroke, higher mental disorders, demyelinating diseases, chronic pain, diseases of the spinal cord and emotional disorders. To ensure the best diagnostic and treatment services for our patients, we have at our disposal up-to-date infrastructure and equipment and cutting-edge technology consistent with the standards of other leading neurosurgical clinics. Specifically: • Neurosurgical microscope, endoscope and stereoscopic 3D, HD, Super Vision camera. • Neuronavigation and stereotactic frame with intraoperative ultra-sound of the brain • Fixed and flexible LASER • CUSA and bone cavitron ultrasonic aspirator • Intraoperative monitoring of brain and spinal cord • Continuous recording of pressure and metabolic markers of the brain.

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At he n s O P H T H A L M I C D ay C L I N I C

SURGICAL INTERVENTIONS WITH state- of-the-art technology AND high standards OF OPER ATION The Athens Ophthalmic Day Clinic, situated in the center of the city, is a modern facility offering complete medical care to patients with vision problems. Athens Ophthalmic Center: Thirty years of operation. The Athens Opthalmic Center has been operating since 1986 and it is the Greek capital’s first private facility of its kind, providing modern medical services for the prevention, diagnosis and treatment of eye conditions. The impeccably trained and specialized doctors and staff as well as the state-of-the-art medical equipment combine to deliver services of the highest quality.

At the Athens Opthalmic Center, specialized teams are in place to deal with: • Cataract •

and Glaucoma

Refractive Surgery and Excimer Laser

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Retinal and Macular Disease

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Child Ophthalmology and Strabismus

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Oculoplastic surgery

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Corrective Glasses and Contact Lenses

•

Ophthalmic Check-up

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Last year, the Athens Opthalmic Center expanded its operations into Day Clinics by setting up an ophthalmic surgical unit which stands out thanks to its progressive infrastructure, innovative technology and high standards of care. Experienced surgeons provide specialized and customized medical treatment to ensure both high-quality treatment and ideal post-surgical results. At the Athens Opthalmic Day Clinic excimer laser treatments are used on a daily basis to correct refractive errors of the eye including myopia, hyperopia and astigmatism. Operations for cataracts, glaucoma, macular and retinal diseases as well as for conditions of the vitreous and the eyelid are also performed daily. The patients who choose to undergo surgery at the Athens Opthalmic Day Clinic enjoy the unique personal care we provide in a comfortable and friendly environment. Their smiles and sincere testimonies relating to the experience they have had and the treatment we have offered them validates our constant endeavors to provide services of the highest quality in the sector of ophthalmology. The operations of the Athens Ophthalmic Center are not limited to medical services. Education is also provided, by coordinating and conducting programs aimed at training ophthalmologists. In the amphitheater of the Athens Ophthalmic Center, from the very first days of its operation, training programs led by both Greek and foreign speakers have helped train new ophthalmologists in recent diagnostic and therapeutic advancements. Alongside these programs, training opportunities are also offered to any doctor wishing to improve their surgical techniques. To further enhance the quality of teaching, the Athens Ophthalmic Center has installed an advanced teleconference system in its amphitheater, providing the opportunity to observe any surgery in real time. At the Athens Ophthalmic Center, we believe that medical practice is an integral part of the society within which it operates. With that in mind, we recognize the corporate and social responsibility we have towards our society and environment. Therefore our doctors, op-

Αt Athens Ophthalmic Day Clinic experienced surgeons provide specialized and customized medical treatment to ensure both high-quality treatment and ideal post-surgical results.

tometrists, nurses and staff take part in actions and initiatives to help people in need and protect the environment. Since November 2012, the Athens Ophthalmic Center has been supporting the philanthropic work of the “Ark of the World” and “SOS Children’s Villages”. It has also been collaborating with the mobile ophthalmological unit of Doctors of the World, conducting medical checkups for people living in remote areas of the Greek mainland and on Greek islands. The Athens Ophthalmic Center has taken every step necessary to operate at its maximum potential whilst being environmentally sustainable at the same time, by taking “green” initiatives and by reducing its environmental footprint. Throughout these past 30 years, the Athens Ophthalmic Center has been operating responsibly and professionally. Our aspiration has always been the complete satisfaction of our patients. Our continuous success in achieving this objective demonstrates that all of us, doctors and staff, are committed to offering innovative and high-quality services in the area of ophthalmology.

w w w . e y e c e n t e r. g r •

64 Vas. Sofias • Tel. (+30) 210.724.7103

A n d r e as T ourmou z is Ophthalmic Surgeon - Medical Director

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E U R O D E NT I C A s peciali z ed de n tal care

EVERY PATIENT IS SPECIAL The private clinic Eurodentica, boasting nearly 40 years of expertise in dental care, is located in downtown Athens. On a daily basis, it accepts dozens of patients from all over Greece and Europe.

International Association for Disability Since its foundation in 1978, Eurodentica and Oral Health. Dr. Kouvelas, who rehas treated more than 10,000 patients ceived his degree in Pediatric Dentistry with disability, including both children from the University of Toronto, Canada, and adults suffering from serious psyhas been at the head of Eurodentica SA chological and mental conditions such since 1978, and has taught at Athens as autism, as well as individuals with ceUniversity from 1980-2013 and at Mosrebral palsy and physical disabilities. cow University from 1997-2000. “We are the one of few dental health centers in Europe that specializes in dentistry for “Only highly skilled and specially trained dentists can fully communicate with disdisabled patients,” says the clinic’s presabled children, provide the proper care ident, Dr. Nicolaos S. Kouvelas, Assisand handle the complex medical issues tant Professor of Pediatric Dentistry at that go beyond dental problems; issues the Dental Department of the University which compound the patient’s condition of Athens and former President of the

In 2016, Eurodentica was shortlisted as one of the top three nominees for the International Dental Clinic of the Year Award at the Medical Tourism IMTJ Awards.

MEDICAL BRIEF

and make it particularly difficult to provide dental treatment. We specialize in treating disabled children as young as two years old. Our doctors show understanding and sensitivity towards patients, ensuring that, when necessary, they are treated under sedation, with the support of an anesthesiologist.” In addition to its work in pediatric dentistry for disabled children, Eurodentica also provides services for adults, calling on a staff that includes orthodontists, cosmetic dentists, endodontists, periodontists, prosthodondists (prosthetic dentists), a maxillofacial surgeon and CAD Cam/ robotic dentistry as well as an otolaryngologist and a plastic surgeon. In total, clinic personnel are working in 12 areas of dental and medical specialization. The team of specialized dentists have trained at universities in North America, Scandinavia, Australia and Athens University. Two or three dentists may work on the same patients during the same day in order to provide faster and more effective treatment. “Cooperation between the cosmetic dentist, the prosthodontist, the orthodontist, the dentist who specializes in LASER dentistry and the plastic surgeon, in cases where such teamwork is found necessary, allows us to achieve the best possible result based on our patients’ choices,” says Dr. Kouvelas. Experience appreciates innovation – Eurodentica makes a point of staying abreast of all the latest developments in dentistry and eagerly adopts innovative applications and methods with proven significant clinical results. One of the most advanced technologies it employs is the dental microscope. It is “an amazing innovation that provides entirely new diagnostic and treatment possibilities in both endodontistry and CAD Cam technology,” says Dr. Kouvelas. “CAD Cam dentistry is a particular field of prostho-

DR. NICOLAOS S. KOUVELAS Assistant Professor of Pediatric Dentistry at the Dental Department of the University of Athens President of ADTC

Athens Dental Tourism Cluster Athens is a particularly attractive destination for patients from all over the world looking to combine medical appointments with a city break or even island excursions. It is even more appealing to dental patients, as it not only has a large number of dentists who have studied, trained and worked abroad, but also because these dentists offer very high quality services at a lower cost than competing destinations. In order to promote the city’s medical tourism status, the Mayor of Athens, Giorgos Kaminis, in cooperation with former European Parliament Member Theodoros Skylakakis, has created the Athens Dental Tourism Cluster – of which Dr. Kouvelas was elected president in 2016. The cluster aims at coordinating private dental practices with a view to promoting dental tourism in the Greek capital and making Athens dental destination.

dontics which uses computer-aided design and manufacturing to improve the design and creation, often in a single appointment, of dental restorations such as crowns, inlays, onlays and porcelain veneers.” Another innovation involves the application of dental lasers, which allow work to be conducted without the use of an anesthetic and with minimal bleeding. This year, Eurodentica was shortlisted as one of the top three nominees for the International Dental Clinic of the Year Award at the Medical Tourism IMTJ Awards. Of the other accolades Eurodentica has received to date, Dr Kouvelas says: “We are proud to rank among the world’s top 150 dental clinics and to be the first clinic of our kind in Greece to receive distinctions from two major international organizations.” Eurodentica is certified by the German-based international certification organization TEMOS, providing a seal of trust regarding patient safety, and by the Diplomatic Council’s Healthcare Forum and Quality Program, which was designed to match patients striving for greater health security and better treatment quality with medical facilities seeking to treat a greater number of international patients. The Global Quality Certificates for medical facilities issued by the Diplomatic Council showcase quality dental care abroad; they have allowed Eurodentica to maintain a dynamic presence on the world dental tourism map over the recent years. With this heightened international presence comes an increased awareness of service requirements; the clinic has recently partnered with an air carrier to facilitate the transfer of special needs children by ensuring free passage for their chaperone, while also covering the cost of travel to and from the airport, as well as accommodation at an Athens hotel.

E U R O DE N T I C A 150 Patision & Aghiou Meletiou Tel./Fax: (+30) 210.825.7050-60 • Mobile: (+30) 6983.672.229 • www.eurodentica.gr • www.dentaltourismgreece.com • •

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2 +2 Q U A D R U P L A N E

NEW PL ASTIC SURGERY TECHNIQUE FOR A BE AUTIFUL FEMALE BRE AST AND BODY

For female patients, the new techniques Dr. Lyras applies consist of the placement of a suitable silicone implant together with the optimal use of the body’s own fatty tissue in a single, painless, composite and holistic operation, to achieve new natural breasts and total body reshaping at the same time. Greece has always been a favorite destination point for people from all over the world. Europeans, Middle Easterners and even North Americans have made the trip here for the wonderful weather, the natural beauty, the breathtaking culture and the sheer enjoyment that a vacation in Greece could offer. Today, many visitors have yet another reason for choosing Greece; they’ve come here to undergo plastic surgery performed at the highest standards of medical competence and innovation. One of the most prominent medical destinations in Greece is “Dr Lyras - Plastic Surgery,” where we provide Health and Beauty care and the highest-quality medical services available. Our patients’ comfort, safety and satisfaction are our utmost concern. What’s more, our services are offered according to an exceptionally competitive pricing policy, particularly in light of our stellar international reputation. With our vast expertise and the support of the latest technology and materials cou-

pled with luxurious accommodation in the finest hospitals in Greece, we can assure you the best treatment possible. Our medical team also includes Pari Rapti, MD, an endocrinologist who specializes in curative care. Dr. Rapti has organized World Congresses on the topic of Curative Medical Tourism, and is a strong advocate for the benefits that this type of tourism can bring to our country. Based on knowledge and skills acquired in both Brazil and Europe, Dr Lyras combines two surgical approaches and the two most popular techniques in use. For female patients, the new techniques consist of the placement of a suitable silicone implant together with the optimal use of the body’s own fatty tissue in a single, painless, composite and holistic operation, to achieve new natural breasts and total body reshaping at the same time. This new method is called “no pain composite holistic breast implant and fat grafting technique for breast augmentation and reconstruction.” It forms part of the “Qua-

MEDICAL BRIEF

druplane 2+2 holistic technique,” which involves a charming buttock lift achieved in the world-famous Brazilian way to complement the equally charming new dropshaped breasts. To accomplish the breast augmentation and reconstruction, Dr Lyras combines the anatomical “dual plane” American approach for the central part of the new breast and the “fat tissue sculpturing” Brazilian approach for the peripheral areas. By doing this, he is better able to create superior, inner and inferior hemispheres, natural cleavage and a beautiful lateral projection, completely avoiding the “stair-step” imperfection that happens with other techniques. For this sculpting, he harvests adipose tissue from aesthetically problematic areas and immediately reinserts it in the host area around the mammary gland and in the chest. Then he inserts the best medical implants available, and proceeds to buttock and body sculpturing. The overall take rate of the fat cells is more than 50 percent with no complications, which means that this is a very safe technique with permanent results. Should localized deformities occur due to fat accumulation in the waist, glutei or abdominal areas, they can be effectively treated at once with the use of this same approach. This combination method leads to a truly beautifying result, fulfilling the eight key characteristics of a beautifully augmented breast: great results in size, shape, position, symmetry, firmness, tissue coverage of the foreign body, harmony and safety, all in one single operation and all leading to a harmonious body silhouette contour. In fact, Dr Lyras’ international patients have reported that, following their one-day in-clinic surgery, their new breasts appear very natural and that their movement flawlessly follows the natural movements of the body. The ground-breaking combination of these painless cosmetic procedures gives patients beautiful new breasts in a beautiful new body with a natural cleavage and a fitter, slimmer shape. This fall, Dr Lyras took part in the 4th World Plastic Surgery Congress in Monte Carlo, Monaco, from 24 to 26 November, once again as a guest speaker and also as president of the session, re-introducing the “Quadruplane 2+2 holistic technique.”

Dr Lyras’ international patients have reported that, following their one-day in-clinic surgery, their new breasts appear very natural and that their movement flawlessly follows the natural movements of the body. I oannis Ly ras M D Director Clinic of Plastic Surgery, Athens, Greece. Honorary Consul of Brazil in Piraeus. Greece. • www.ioannislyras.gr

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MEDICAL BRIEF

D ermat olo g y

THE BENEFITS OF INJECTABLE THRE AD LIF TING When the sagging of the face becomes too obvious but the idea of invasive surgery seems scary, injectable thread lifting is certainly the ideal treatment. Eight Point Non-surgical Facelift Non-surgical facelift goes beyond simply addressing or filling wrinkles in isolated areas of the face. Currently, the aim is to achieve, without a surgical operation, a rested, happy, natural-looking face with no signs of time or gravity. Therefore, a new approach has been developed. The new method uses Hyaluronic Acid Fillers that can be applied through injections in just eight main strategic points of the face. As a result, the face is instantly reconstructed and lifted. The whole process takes place following a series of targeted injection points. These are chosen and adjusted carefully to match the specific needs of each particular face. Experience but also aesthetics determine where exactly these eight injection points will be. Observing where the shadows fall on the face and the downward and ‘sad face’ lines, identifies the areas for improvement. These areas lack volume and shape in terms of both adipose tissue and bone structure. Usually, these areas are found: • Around the eyes and at the lacrimal groove • On the cheeks where the lacrimal groove continues, giving the impression that it splits the cheek • On the nasolabial folds, on the chin and on the lines starting from the corners of the mouth going downwards, also known as “sadness lines” Following this initial diagnosis, the three points from which the treatment begins are usually found in the zygomatic bone and lacrimal groove areas. The aim is to generate support that will push the face upwards and backwards. After that, the nasolabial folds and sadness lines are treated.

Treatment time is short (15-60 minutes); the patient can return immediately to her or his daily activities and expect to witness continuous improvement of the results in the coming months.

V e n e tia B l iampti Dermatologist-Venereologist • FB: dermatologos. bliampti.venetia • Email: venetiagbliampti@gmail.com • www.venetiagbliampti.gr

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Moving towards the chin, the Hyaluronic Acid generates support lifting the sadness lines. The ‘sadness’ look of the face is addressed by injections on the sides of the face and is completed by filling in and supporting the area in front of the ears. The exact injection points, the amount of Hyaluronic Acid infused through them and the application technique, are customized for each client. For example, it is likely that perhaps not all 8 points will be used or that the exact point of each injection might be different and that’s decided on a case by case basis. Therefore, the course of treatment is guided by the initial, careful observation and recording of the individual needs and characteristics of each face. For the vast majority of cases, the results are immediately impressive. Cheekbones are clearly defined, under eye bags are reduced, smile lines are smoothed out and mouth corners are lifted, giving the impression of a continuous happy smile. The cheeks appear smooth and lifted as they hug the beautifully-shaped zygomas. The oval of the face improves and the sadness lines of the chin fade. It is a complete treatment that restructures and supports the face against gravity by replenishing its lost volume. This newly added volume regenerates the missing support. Choosing the suitable Hyaluronic Acid implants is particularly important as their suitability determines the dynamic creation of volume and the desirable and secure behavior of tissue. The eight point face-lifting method has clear advantages as it: • Achieves a natural and youthful appearance • Has a short recovery period, allowing immediate return to social and professional commitments • Is suitable for improving any face regardless the patient case

MEDICAL BRIEF

U P G R A D E y our s mile

VENEERS: One of the most popul ar esthetic dentistry tre atments With 9 out of 10 adults wishing to change something about their smile, veneers can improve texture, color, size and tooth shape, offering a long-lasting, lustrous finish.

upgrade. Esthetic problems like gaps between the teeth, exposed roots due to gum recession, uneven tooth size and chipped edges can be corrected in 2–4 hours. The technique involves detailed tooth sculpting with biomimetic esthetic composite resins to the desired tooth size, position and color. Since they are usually placed without harming teeth, veneers can be removed at any time. Dental visits: one Duration: up to 10 years Cost: from €150 per tooth

Veneers (thin shells of composite resin or porcelain) can help recreate a symmetrical smile, providing the strength and resilience of natural teeth. Individually sculpted to fit each smile, it is impossible to tell the difference between a veneer and a natural tooth. The process It all starts with a digital smile design, in which your face characteristics and overall appearance are matched. The aesthetic dentist will, of course, discuss the planned changes with you. With a process known as the mock-up technique, the designed smile can be transferred to your teeth, allowing for a realistic visualization in less than 30 minutes. It is generally advised to treat at least four front teeth for a symmetrical look, while veneering 6–8 front teeth is regarded as the gold standard for a beautiful smile. Depending on the desired changes, a superficial amount of tooth, less than half a millimeter, may be removed to create room for the placement of the veneer and to avoid a bulky appearance. Alternatively, no-prep minimal veneers require no tooth preparation and are ideal for young patients or healthy teeth. Immediately after placement, veneers can be used like natural teeth. Their maintenance is quite simple: you treat them as you would natural teeth, including brushing with a non-abrasive fluoride toothpaste, flossing and going for professional teeth cleaning once a year at your dentist or hygienist. The options Composite veneers are the best value-for-money choice for an instant smile

“With veneers you can have the smile that lets you feel more confident, attractive and self-assured”

Porcelain veneers are the luxurious alternative for the Hollywood smile you always dreamed of. They can correct crowding, gaps, fractured or worn teeth, abnormal sizes, poor shapes and tooth position for those who don’t wish to undergo orthodontic therapy. They can also mask stained teeth which do not respond positively to bleaching or satisfy the wish for permanently white teeth. Since porcelain veneers are made by specialized dental technicians, a seven-day interval between the dental appointments is required. During that time, temporary glazed veneers are placed on the teeth. Dental visits: two Duration: up to 20 years Cost: from €300 per tooth Are you a good candidate? Although there are no contraindications regarding general health or age, veneers are not recommended for previously crowned teeth, untreated gum disease or heavy teeth-grinding. If you are unsure whether veneers are the best choice for your smile makeover, feel free to contact us for an online consultation.

C h ristina B outsiouki , DD S , M S c , P h d c a n d . Specialist Aesthetic Dentist, Scientific Associate at the University of Giessen, Germany. • www.smilesdentalclinic.eu • FB: odont.smiles

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MEDICAL BRIEF

PEROR AL ENDOSCOPIC MYOTOMY (POEM)

THE THER APY OF CHOICE FOR ESOPHAGE AL ACHAL ASIA Innovative, incisionless, mini-invasive and with excellent results worldwide, Peroral Endoscopic Myotomy (POEM) has emerged as the most effective, long-term treatment for all types of achalasia. Achalasia – a Greek term that means “no relaxation” – is a chronic, benign, esophageal motility disorder, with progressive dysphagia for solids and liquids the most common presenting symptom. Chest pain, weight loss and depression are also common signs of the disease. In advanced stages, there is a risk of aspiration and malignancy. Achalasia is a rare disease, affecting men and women equally and, with one case per 100,000 people every year, may affect any age group, from children to octogenarians. Diagnosis can be delayed due to misinterpretation of symptoms or atypical manifestations. Appropriate examinations are initially gastroscopy (to exclude organic disease), esophagogram and finally esophageal manometry, especially high-resolution manometry (HRM), which is the examination of choice. The most modern, long-term therapy for achalasia is the innovative, incisionless, mini-invasive, Peroral Endoscopic Myotomy (POEM), which, having produced excellent results worldwide, has replaced older and outdated techniques and is now considered the therapy of choice. POEM is performed during the gastroscopy. It is a low-cost, relatively painless and bloodless procedure, involving a short hospitalization (1–3 days). The recovery time is also short; patients regain mobility the same day and return to normal within a few days. The major advantage of POEM is the long myotomy it achieves (up to a length of 25cm), which is practically impossible with any other method. In any case, the older surgical Heller (first performed in 1913) or laparoscopic (LHM) myotomies are so in-

The major advantage of POEM is the long myotomy it achieves, up to a length of 25cm, which is practically impossible with any other method.

vasive and aggressive, necessitating both thoracoscopic and abdominal approaches to access the esophagus, that they are practically prohibitive in terms of safety. In contrast, POEM approaches the circular muscle responsible for achalasia directly and easily, through the submucosal tunnel, enabling a safe and effective long myotomy, while no anti-reflux procedure is necessary. Our team has also applied POEM to compromised elderly patients with contraindications for surgery, in cases of advanced sigmoid achalasia and after the failure of previous therapies, such as failed surgery or LHM or balloon dilation. Bilateral POEM (redo POEM) was also possible in advanced cases. After its first successful use in humans by Professor Haruhiro Inoue in 2008, POEM has spread worldwide. Our team was the first in Greece to successfully perform POEMs routinely as part of the Endoscopy Department standard approach, without exception, even, for instance, on a 92-year-old woman with sigmoid esophagus. Our achalasia patients showed exciting long-term results (three-year follow-up) after POEM. In view of its excellent results and advantages, POEM has become the therapy of choice for all types of achalasia (classical (Ι), vigorous (II), or spastic (ΙΙΙ), according to the Chicago classification), and other esophageal motility disorders (diffuse esophageal spasm, nutcracker and jackhammer esophagus). I would like to thank Prof Inoue, the “father” of POEM, for my training in this procedure. Our website contains authorized testimonials from our many POEM patients.

Dr N iko l as E l e ft h e ria d is Interventional Gastroenterologist, Aristotle University of Thessaloniki Scientific Associate Gastroenterology Unit, Endoscopy Department, Metropolitan Hospital, Athens Greeece • www.nikoseleftheriadis.gr • Email: nikoseleftheriadis@yahoo.com

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MEDICAL BRIEF

E mbr y olab F er t ili t y C li n ic

“Your dre am of becoming a parent is our driving force”

Alexia Chatziparasidou

Nikos Christoforidis

MSc, Senior Clinical Embryologist, Lab Director at Embryolab

MD, MRCOG, DFFP, Reproductive Gynecologist, Clinical Director at Embryolab

Over the last decade, there have been significant advances in assisted reproduction. Which of them do you consider most important? Without a doubt, oocyte cryopreservation is a huge breakthrough. Thanks to this new development, fertility preservation for women is now possible. Any woman who has been diagnosed with a malignant disease or who needs to postpone motherhood for later in life can safely store their oocytes for future use. Furthermore, over the last decade, our labs have acquired the latest generation incubators that provide a stable culture environment, allowing real-time monitoring of embryo development. All the recent advances have changed our everyday work and have maximized efficiency by increasing our overall pregnancy rates. Is it true that the lab plays a key role in the success rates of an IVF unit? Undoubtedly, the embryology lab plays a critical role in the outcome a couple may have. However, the medical team is also very important for a successful outcome. I would say that IVF is mostly teamwork, where everybody’s goal is to deliver high-quality service, with high success rates being the ultimate goal.

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How do you select the best theatment plan for each couple? The cornerstone of our approach is a thorough investigation of prior treatment. We follow a holistic approach in which all important parameters are assessed and optimized. This way, we can identify the unique characteristics of each couple and design a treatment plan that best meets their needs. All our couples are considered unique and are treated as such. When should preimplantation genetic diagnosis be considered? This method is applied to couples who are carriers of certain genetic diseases, such as thalassemia or cystic fibrosis, as well as to couples who have increased chances in producing embryos with chromosome abnormalities, as in cases of couples with a medical history of repeated miscarriages or of women of advanced maternal age. Embryolab has long and significant experience in the application of the latest preimplantation genetic diagnosis techniques, and has offered many couples the possibility of fulfilling a life’s dream. Embryolab has client couples from all over the world. What makes Embryolab a better option? Just some of the reasons are our top success rates, favorable Greek legislation, lower costs compared to other units and the excellent service we provide in combination with our dedication to our couples and our devotion to Embryolab’s three basic founding values of transparency, innovation and quality.

• 173–175 Ethnikis Antistaseos, 551 34 Kalamaria, Thessaloniki, Greece Tel. (+30) 2310.474.747, (+30) 2310.473.000 (for international callers) • Fax (+30) 2310.475.718 • www.embryolab.eu • Email: info@embryolab.eu

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MEDICAL BRIEF

T H E V ATS A P P R O A C H

Minimally Invasive Techniques in Thor acic Surgery Less postoperative pain, a shorter hospital stay, faster recovery and a quicker return to normal activity are among the benefits of Video Assisted Thoracic Surgery. In the last 30 years, minimally invasive surgery (also known as Video-Assisted-Thoracic-Surgery or VATS) has dramatically changed the surgical landscape by providing the same surgical results without the large incisions and more complicated maneuvering around internal structures typical of traditional surgery. Today, minimally invasive surgery performed through VATS offers several advantages for patients, particularly in early-stage lung cancer treatment. The VATS approach allows the surgeon to access the problem area by using an endoscope and other small endoscopic instruments. These instruments can be inserted into the chest through small 2–4cm “keyhole” incisions made between the ribs. The scope allows the surgeon to view the tissue under high magnification, and manipulate the instruments to effectively transect and remove it. The VATS approach does not require any rib spreading. The benefits for the patient includes less postoperative pain, a shorter hospital stay, faster recovery and a quicker return to normal activity. Some of the most common uses for VATS include treatment of pneumothorax and lung emphysema and lung biopsies for solitary nodules or interstitial lung disease and for lung, esophageal and mediastinal tumors. HYGEIA HOSPITAL thoracic surgery unit treats a large variety of thoracic diseases, from pneumothorax to very aggressive tumors of the lung and the mediastinum. Like most of the thoracic surgery centers in the West, we perform most of the procedures using minimally invasive approaches. It should be stressed that VATS procedures and thoracotomies are the same operations using different approaches. We offer our patients the minimally invasive approach as a default procedure. Almost 60 percent of the procedures performed in our department are minimally invasive, and this

K osmas I l ia d is Thoracic Surgeon, PhD, FECTS, • Email: k.iliadis@hygeia.gr

Dimitrios M a l l ios Thoracic Surgeon, MD, Msc, FECTS, • Email: djmallios71@gmail.com

At h a N A sios K rassas Thoracic Surgeon, MD, FECTS, • Email: akrasas@hygeia.gr

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corresponds with other thoracic surgery centers around the world. In addition, our center is currently running a VATS lobectomy program. Indeed, in 2011 our hospital performed the first VATS lobectomy in Greece, on a 17-month baby suffering from a benign pulmonary disease. HYGEIA HOSPITAL was also the first to perform minimally invasive procedures for the resection of mediastinal tumors. We are currently using VATS for the treatment of the tumors of the anterior mediastinum (thymus) in order to perform more complete resections and to protect the vital structures of the mediastinum. The robotic approach (RATS) enables the surgeon to be more precise, as it uses articulated instruments that perform the same movements as the human wrist. Our department was the first in Greece to use robotic technology for the resection of mediastinal tumors.

Some of the most common uses for VATS include treatment of pneumothorax and lung emphysema and lung biopsies for solitary nodules or interstitial lung disease and for lung, esophageal and mediastinal tumors. Thoracic surgery unit also deals with obstructions of the main airways. With the use of a rigid bronchoscope, we provide palliative care to these patients (desobstruction and stent placement to maintain a patent airway). This instrument helped us to perform, for the first time in Europe, an endoscopic suture of the tracheal wall without using the conventional right thoracotomy.

MEDICAL BRIEF

A V A NTG A R D E U R O L O GY C E NT E R

GreenLight ™ YOUR PROSTATE RELIEF The use of high-energy lasers for the treatment of benign prostatic hyperplasia is a totally bloodless and transfusion-free method of treatment that will allow you to carry on with your holidays. What is BPH? The gradual enlargement of the prostate is a non-cancerous disease common amongst older men. The enlarged prostate can intrude into the urethra, causing partial or complete obstruction of urine flow. This condition is known as benign prostatic hyperplasia (BPH). While BPH is usually not life-threatening, it could cause considerable discomfort, with complete obstruction leading to emergency surgery for resolution. Over half men over 50 have BPH symptoms, with the percentage growing to 80% of men over the age of 80. Due to overall increase in longevity, the number of men seeking treatment over the next 20 years is expected to increase. New, stateof-the-art procedures that use LASER technology can be performed on an outpatient or overnight-stay basis. GreenLight™ photoselective vaporization of the prostate (PVP): PVP uses a high-energy LASER to vaporize prostate tissue and seal the treated area. Its advantages over transurethral resection of the prostate (TURP) with monopolar or bipolar diathermy, are total lack of bleeding, a much shorter catheterization time and a shorter hospital stay. The procedure is performed via an endoscopic instrument inserted into the urethra under a spinal or general anesthetic. Advantages of GreenLight™ ablation of prostate tissue: • Immediate urine flow improvement • Quick return to normal activities • Virtually bloodless procedure • Less than 1% reported cases of erectile dysfunction • Short to sometimes no catheterization at all • Outpatient or overnight stay procedure • Long-lasting symptom relief. Worldwide, this is considered the surgical treatment of choice for travelers who happen to have

Many tourists have been already been treated while on vacation in Athens without losing more than one day from their sightseeing and travelling schedule. Depending on your travel plans, we would recommend it as a treatment of choice during the last 1-2 days of your stay.

acute urinary retention while abroad; many tourists have been already been treated while on vacation in Athens without losing more than one day from their sightseeing and travelling schedule. Depending on your travel plans, we would recommend it as a scheduled treatment of choice during the last 1-2 days of your Athens stay. Your recovery after surgery: The amount of time you will need to stay in the hospital depends on how quickly you recover. At the end of surgery, a special catheter is inserted through the urethra of the penis to drain urine from the bladder into a collection bag. This catheter is usually left in place overnight or until you feel able to walk (after the anesthetic is completely out of your system). Some mild bleeding (pink urine) might occur; it should clear up by the time you leave the hospital. During your recovery, it is important to drink a lot of water (up to 8 cups a day) to help flush out the bladder and speed healing. Getting back to normal life: Even though you’ll probably feel much better by the time you leave the hospital, and be able to play golf the day after, it may take a couple of months for you to heal completely. During the recovery period, the following are some common problems that can occur: Blood in the urine (pinkish). Burning sensation at the end of urination – this is a common symptom that is avoided by the prescription of painkillers. Difficulty in refraining from urinating – this can occur as the urethra is healing – that improves daily. We can always avoid that or decrease it at a level that is not appreciated as significant one, with the prescription of a medication for a few days. Scheduled procedures could be fixed before your arrival with full consultation service provided by exchange of medical records and teleconference service.

Dr Dimitrios K . K aramano l akis M D , F H U A , F E B u , p h d Surgeon in Urology Avantgarde Urology Center of Minimally Invasive Surgery • www.avantgardeurology.com

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MEDICAL BRIEF

F er t ili t y s ervice s i n Greece

AN IDE AL DESTINATION FOR IVF TRE ATMEN T Top medical personnel, short waiting times, a liberal legal framework and competitive prices for top quality services, attract more and more couples with fertility problems.

Apart from being a unique pole of attraction for international visitors and an ideal destination for vacations, Greece has become one of the top countries for medical tourism in recent years. Combining both medical treatment and holidays, international visitors come to Greece, where medical science was born, for its integrated healthcare services. Although Greece is a newcomer to the medical tourism market, the country has become an ideal destination for orthopedic treatments and rehabilitation, hemodialysis, aesthetic surgery, eye surgery, dental services as well as reproductive medicine. With their state-of-the-art equipment, medical centers in Greece offer high-level medical services and top-quality care. They are staffed with experienced scientific personnel, with most of their doctors having trained at universities or hospitals in the United Kingdom or the United States. Reproductive tourism is a specialized, rapidly developing area of medicine in Greece. Couples with fertility problems from neighboring and other European countries avail themselves of Greeceâ&#x20AC;&#x2122;s experienced clinics for evaluation, diagnosis and treatment for infertility. There are four good reasons to choose Greece for IVF treatment: 1. Safety and high quality of treatment Greek doctors have internationally recognized qualifications. In addition, most doctors are fluent in English, making communication easier. Accredited scientists, gynecologists, embryologists, psychologists and urologists as well as ISO-ac-

credited contemporary labs, comparable to those in any other developed country and run according to good laboratory practice, ensure the high rates of success, as confirmed by the European Society of Human Reproduction and Embryology (ESHRE).

The Greek National Authority of Assisted Reproduction provides a common scientific, legal and ethical framework for the operation of assisted reproduction centers, ensuring safe and reliable services for candidate parents.

2. Very affordable prices The cost is approximately a quarter of that in the USA and only half of that in many other European countries. Patients usually need to remain here for about 10 to 14 days for their treatment, so the cost of travel, accommodation and food must be calculated for that period. 3. A liberal legal framework Greek legislation for assisted reproduction is considered one of the most liberal, progressive and patient-friendly in Europe. IVF is permitted for women up to 50 years of age. Furthermore, Greek law permits anonymous egg and sperm donation as well as surrogate pregnancy. In addition, there are licensed clinics in Greece offering IVF with preimplantation genetic diagnosis (PGD). The Greek National Authority of Assisted Reproduction provides a common scientific, legal and ethical framework for the operation of assisted reproduction centers, ensuring safe and reliable services for candidate parents. 4. Short waiting times for treatment There are no waiting lists for treatment in Greece. Undeniably, Greece has plenty of potential and the required infrastructure to become a European medical tourism superpower in the coming years. In an ideal environment that provides excellent services reliably and professionally, international visitors to fertility centers can expect a high level of treatment.

B asi l K e l l aris , M D , P h D ( U niv e rsit y of At h e ns ) , M S c Obstetrician Gynecologist Research Fellow at Genesis Athens Clinic â&#x20AC;˘ www.vasiliskellaris.gr

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MEDICAL BRIEF

O T O L A R YNG O L O GY

DEVIATED NASAL SEP TUM AND ITS COMPLICATIONS Αn estimated 80% of people have a crooked septum, which blocks either one or both respiratory tracks. Now, a simple procedure that doesn’t involve external incisions can provide relief. What is the nasal septum? It is the bone and cartilage separating the nasal cavity into two nostrils. The cartilage is located mainly in the front and middle part of the nose. Towards the back of the nose, the septum becomes a bone. 80% of people have a crooked septum. This either blocks one of the respiratory tracks or, in the case of an S-shaped septum, both of them. What are the symptoms caused by deviated nasal septum? It causes shortness of breath and discomfort and it decreases endurance during exercise. It also causes heavy breathing and snoring during sleep. Furthermore, it is partially responsible for obstructive sleep apnea syndrome. Often nosebleeds, nasal mucosa dryness, rhinitis and sinusitis are caused because the air flow and the movement of the naturally created mucus are obstructed. When the nose is blocked, a sense of air pressure is felt on the ears as fluid gathers behind their drums. How can deviated septum be corrected? A simple procedure can be performed inside the nostrils without external incisions. The operation involves the removal of the bony protrusions and the reshaping of the cartilage deviations, resulting in a strong new aligned septum. This kind of operation should not rely on excessive removal, as it used to, because if big parts of the cartilage are removed in order to free up space, there is a danger that the upper and middle parts of the nose might drop postsurgically. It is very important that the crooked and broken cartilage parts are reshaped and repositioned inside the nose so that they connect with each other. In serious cases, a thin absorbable implant (PDS foil) is used as the base onto which broken cartilage

Nasal septum surgery does not cause bruising and it is painless. There are no dressings needed inside the nose. Silicone sheets are used instead to enable the patient to breathe easily from day one of recovery.

pieces are stitched. Nasal septum surgery does not cause bruising and it is painless. There are no dressings needed inside the nose. Silicone sheets are used instead to enable easy breathing easily from day one. What are the nasal valves and why do they obstruct our breathing? They are narrow areas found inside and towards the upper part of the nose and they block the airflow. They can be observed from the outside because they look like indentations on the sides of the nose. When we inhale, the side nasal walls retreat towards the septum, something that’s known as collapsus. Recent studies indicate that 50% of the nasal breathing discomfort problems are caused by nasal valve insufficiency, 30% by deviated nasal septum and 20% by hypertrophic nasal turbinates. Nasal valves can be corrected by placing alar batten graft on the nasal side walls. In addition, new rhinoplasty techniques provide support for the nasal valve areas. With which other surgeries would you combine nasal septum surgery? Very often it can be combined with rhinoplasty surgery because both these surgeries interact and an appropriately supported septum, constitutes the basis of a successful rhinoplasty. Furthermore, cartilage grafts from suitable areas of the cartilage septum are used in rhinoplasty, especially for correcting a crooked asymmetric nose, during posttraumatic and corrective reconstructive rhinoplasties. Endoscopic sinus surgery can also be combined with septum realignment to open the airway and create airflow from the nose towards the sinuses.

Dr A rgiro K y praiou , M D ΕΝΤ-Rhinoplasty surgeon, Head of Functional and Reconstructive Rhinoplasty Department of “Mitera” Hospital, Hygeia Group • Member of the European Academy of Facial Plastic Surgery • www.faceanatomy.gr • FB: kypraiou.Faceanatomy

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MEDICAL BRIEF

I V F T R E AT M E NT I N G R E E C E

Debunking Fertilit y Tourism My ths There has never been a better time to consider Greece for your IVF treatment. The Gennima IVF team is passionate about helping you create your family. Myth No. 2: “The quality of healthcare abroad is lower than at home” In Greece, recent legislation has made it mandatory for all IVF clinics to apply accredited and internationally certified quality management systems specifically developed for the healthcare sector. In addition, new, stricter rules from the Greek National Authority of Assisted Reproduction regarding the facilities, medical staff and equipment ensure the safety of all patients.

Fertility tourism involves traveling abroad for fertility treatment. In vitro fertilization (IVF), donor sperm insemination, surrogacy and egg donation are the most commonly sought treatments. People may do this for several reasons, such as: • Some fertility treatments might not be available to them at home due to factors such as legal prohibitions or regulation. • Shorter waiting lists. • Lower costs, even when flights and accommodation costs are taken into consideration. Getting fertility treatment in another country might seem complicated because of the distance from home and the differences in culture and language involved. But it doesn’t have to be this way. Myth No. 1: “It’s IVF; it’s not tourism” The term “tourism” is commonly used alongside the word “medical,” partly because of the need to travel, but mostly because fertility treatments are minimally invasive, thus allowing patients to enjoy the destination while receiving their treatment. Greece is an ideal “IVF vacation” destination for many reasons: • Most Greek fertility experts trained with IVF pioneers (in the UK or US), are very experienced and have sterling reputations; • Greek legislation allows for all fertility treatments, including donor sperm insemination, egg donation, surrogacy and fertility preservation through egg freezing; • Prices are low and the benefit-cost ratio is very attractive, considering the high success rates. Moreover, Greece is a great destination! Athens is ideal for a city break; it has a mild climate and offers a variety of museums, archaeological sites and other sightseeing opportunities, short excursions, shopping and gastronomic possibilities.

Getting fertility treatment in another country might seem complicated because of the distance from home and the differences in culture and language involved. But it doesn’t have to be this way.

Myth No. 3: “It’s impossible to build a relationship with my doctor” Building a relationship with your fertility expert and his or her team is a crucial part of your treatment – at least most patients believe so. Distance is no longer an obstacle to communicating with and getting to know your doctor prior to and during your treatment. Social media and communication applications (such as Skype) make it easy to reach out and get in touch, even if you are thousands of miles away. Here are some tips to consider: • Be proactive and actively seek to build a relationship with your fertility clinic; • Make sure your doctor and their team are comfortable communicating with you in your preferred language; • Explain any specific differences in your culture. This way, it’s going to be easier for your fertility clinic to respect them. We look forward to welcoming you to Gennima IVF, where we are passionate about helping you create your family. Attention to detail and hard work are key factors of our high success rates and patient satisfaction levels. Contact us for a free telephone or Skype consultation.

Dr Evripi d is M antou d is , F R C O G Reproduction Gynaecologist Obstetrician - Medical Director and fertility expert at Gennima IVF, Athens, Greece • 346 Kifisias, Halandri 15233, Athens • Tel. (+30) 210.681.6100 • www.gennima.com • Email: info@gennima.gr

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MEDICAL BRIEF

P H YS I O T H E R A P Y

A PATENTed DEVICE THAT RELIEVES FROM PAIN Tecar Med exploits the interaction between radio frequencies and biological tissue, to activate the biological mechanisms of the cells, speeding up self-healing and anti-inflammatory activities in the body. “At Physiof we respond with consistency, responsibility and credibility to the ever-increasing therapeutic needs of our patients and their referring doctors, adjusting quickly to the continuously evolving techniques of rehabilitation physiotherapy,” says Physiotherapist Theofanis Th. Mountzouris, talking sbout his private physiotherapy center. A graduate of the Technological Institute of Athens and an active member of the Panhellenic Association of Physiotherapists, he has attended a significant number of workshops on specific techniques relating to physiotherapy and rehabilitation after orthopedic neurological ailment and sports injuries. His extensive experience includes working for major Greek hospitals (Tzaneio Prefecture General Hospital of Piraeus – Intensive Care Unit; General Hospital Asklipieio of Voula – Neurology & Orthopedics Department; and Onassis Cardiac Surgery Center – specialization in the Intensive Care Unit) while he is currently a physiotherapist at the Open Center for the Protection of the Elderly (KAPI) in the prefecture of Keratsini.

“We respond with consistency, responsibility and credibility to the ever-increasing therapeutic needs of our patients and their referring doctors, adjusting quickly to the continuously evolving techniques of rehabilitation physiotherapy.”

TECAR Med Therapy Tecar Med is a device created for the purpose of treating injuries and delivering pain relief. It is the result of research conducted by TSEM Med Swiss S.A. over several years. By exploiting the interaction between radio frequencies and biological tissue, Tecar

Med Therapy activates the biological mechanisms of the cells, speeding up self-healing and anti-inflammatory activities in the body. It stimulates tissue from the deeper layers, addressing the pain and its causes. At the same time, it reduces treatment time and accelerates functional recovery. A self-adjusting system which provides energy selectively to each tissue, Tecar Med also has a real-time function which monitors how tissue is responding to the therapy. What’s more, it can help carry out diagnoses. Tecar Med uses TSEM Med Swiss’ global patent for Adaptable Energy Transfer (WO/2006/109109). The system automatically controls the ammounts of energy being supplied by detecting tissue impedance in real time. Energy is automatically adjusted based on tissue impedance behavioral changes during treatment. In this way, the tissue receives only the amount of energy needed and at the same time, energy isn’t wasted. What’s more, the device monitors each session in order to measure the effectiveness and the benefits of the treatment. The frequencies generated by the device, 215, 430, 645, 300 and 600 kHz, have immediate effects on the tissue, achieving rapid rehabilitation. Thw lowest of these frequencies, 215 kHz, is used in the NRV program, which is able to reach the nerve endings and, as a result, can tackle both pain and its causes.

T h e ofanis T h . M ount z ouris , P h y siot h e rapist Physiotherapy Center Physiof 62 Salaminos Av., Keratsini, Piraeus • Tel: (+30) 210.400.9621, Mob: (+30) 6934.010.713 • www.physiof.gr •

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MEDICAL BRIEF

P R E V E NT I V E H E A LT H

You’ve checked in, but have you had a check-up? It’s been a while since your last check-up — right? We don’t mean a last-minute visit to your doctor because of a cold. We’re talking about a real face-to-face, head-to-toe evaluation of what is, after all, the most important thing in your life: your health! Yeah, we thought so. You probably haven’t had one for a while. It’s OK. We can help. Let’s look a little closer At Orthobiotiki, we believe in strong foundations, and a solid foundation for your health can be built in one day and in one place. Not being ill doesn’t necessarily mean that you’re 100% healthy. A human being cannot survive for decades on low energy levels. Many symptoms, things that we often neglect or ignore (i.e., chronic fatigue, headaches, insomnia, increase in body weight, high cholesterol, bloating after a meal, constipation, low libido, hair loss or morning stiffness) could be the result of cognitive disorders or cellular malfunction. These signs tend to appear long before an illness does. We know that when our body no longer performs at its best, like it used to when we were younger — remember that old age occurs because time reduces our ability to regenerate cells to replace those that have been destroyed — it’s due to an imbalance of chemical elements, such as proteins, necessary fatty acids, vitamins, minerals, micronutrients and antioxidants. In addition, there are molecules such as hormones and neurotransmitters that control our metabolism. Hormones act as messengers, giving cells orders to perform at peak levels; to heal better and faster, to revitalize tissue, to improve blood flow, to moisturize the skin, to burn fat or cellulite and to produce hair. If the

hormonal balance is disrupted, this can slow down our body’s performance. Give us one day and we’ll take care of everything. We offer an approach that is innovative on an international level. You won’t have to waste your time in a waiting room. Our solution bypasses such obstacles to deliver results effectively and efficiently. We strongly encourage you to invest just a little of your precious time so that we can ensure that you become active and healthy and remain so, not only tomorrow but for a long time to come. ELEANA PAPACHARALAMBOUS, CEO - Healthcare and Ageing Well Specialist Orthobiotiki Preventive and Executive Health Center

“We offer an approach that is innovative on an international level. You won’t have to waste your time in a waiting room. Our solution bypasses such obstacles to deliver results effectively and efficiently.”

Let’s start your health journey You begin your day by meeting with a doctor specializing in preventive medicine who will examine you and highlight your general medical needs and potential issues. From then on, as you continue with tests and examinations, a personalized health plan and solutions is being put together for you. In the background, your doctor is working together with a specialized team of medical professionals, including nurses, consultants, nutritionists and sports doctors. As the day progresses, your medical information is carefully pieced together to create a full picture of your health status. This allows the medical team to draw up a complete medical care plan, customized to your individual needs.

O R T H O B I O T I K I P R E V E N T I V E A N D EXE C U T I V E HE A LT H C E N T E R •

• 3-5 Sorou, Marousi, Athens Tel: (+30) 210.323.0000 • Email: info@orthobiotiki.com

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MEDICAL BRIEF

L a s er H emorrhoidopla s t y

A modern method for tre ating hemorrhoids Thanks to medical advances, the surgical removal of hemorrhoids is now considered outdated. LHP is the only technique that is truly non-invasive, painless and effective, without any complications.

The treatment of hemorrhoids has progressed to an advanced level with a technique that maintains the physiology and the structure of the area. The purpose is no longer to remove them; instead, the aim is to treat them through the least invasive operation possible. In hemorrhoids, as in other conditions of the anus, surgical removal is not indicated; on the contrary, it is almost prohibited. To this end, the extensive removal operations for hemorrhoids, as well as surgical intervention regarding the sphincter or fistulas are now considered outdated. The reason for this is that the hemorrhoidal plexus constitutes a normal structure in our body; it is not a useless genetic residue. Its presence in our body serves a purpose, and in this case, certain important functions, such as maintaining continence with the anal sphincter mechanism. In addition, removing hemorrhoids is a torment for the patient, leaving him or her in pain for weeks. This pain is the worst that one can possibly have in the area. Furthermore, operating in or near the anus risks side effects that are hard or impossible to correct, such as incontinence of gases and/or feces. The treatment of hemorrhoids began to change in a revolutionary manner from the mid-1990s, when incision was replaced by ultrasonic litigation of the hemorrhoid arteries, later supplemented by lifting the mucus mem-

The operation takes just 15 minutes; no hospitalization or even painkillers are required. The patient will return home on the same day. From the following day, he or she will be completely functional.

brane, leading to significantly improved results. Today, this is identified as the Hemorrhoidal Artery Ligation–Recto Anal Repair (HAL-RAR) or THD or TRILOGY. About a decade ago, a major breakthrough occurred in the treatment of hemorrhoids, through the use of a special laser optic fiber. This was a watershed, after which we could speak of the healing of hemorrhoids without the need for surgery. Laser Hemorrhoidoplasty (LHP), as it is called, is the most modern method that medical technology and scientific specialization has for treating hemorrhoids. It is the only technique that is truly non-invasive, painless and effective, without any complications. This operation, which can be performed safely on patients taking anticoagulant medications such as Sintrom or Plavix, does not touch the intestine, just the hemorrhoidal plexus. This means no stiches are required, no metal clips need to be installed and the result is permanent, without any side effects. The operation takes just 15 minutes; no hospitalization or even painkillers are required. The patient will return home on the same day. From the following day, he or she will be completely functional. Please consider the above and don’t hesitate to improve your quality of life, freeing your body from hemorrhoidopathy once and for all.

Dr A l kivia d is Pappas Surgeon Proctologist Tel: (+30) 210.282.0470 • Fax: (+30) 210.283.2001 • www.proctoclinic.gr • Εmail: info@proctoclinic.gr

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MEDICAL BRIEF

o t orhi n olar y n g olo g y

Recent advances in Ear, Nose and Throat (ENT ) Surgery New surgical techniques involving atraumatic dissections mean less bleeding, less pain, shorter surgeries and faster postoperative healing.

The most important contribution of medicine to humanity is the relief from pain, disease and fear, as Hippocrates said centuries ago. Nonetheless, despite the developments in modern medicine, patients often put off surgery, mainly due to the fear of postoperative pain and discomfort. For this reason, all surgical specialties seek to achieve the same therapeutic effect with minimally invasive surgery (MIS). The advantage of MIS over classic open-surgery methods is that the suffering organ and the surrounding healthy tissues are affected to the least extent possible. Head and neck surgery in particular has made great progress recently with the application of modern endoscopic techniques. Requiring no external incisions, endoscopic surgery of the nose and paranasal sinuses represents a much more desirable treatment of diseases such as sinusitis (chronic or acute), nasal polyps, benign and some malignant tumors and deviated nasal septum. Using magnification and illumination in association with powered instruments and navigational system, the surgeon has the ability to treat disease more accurately and with less risk of complications. This is very important, especially in surgery on children. In adenoidectomy and tonsillectomy it also ensures full removal of the tissue in question. Other common ENT problems in children that can be

In recent years, the use of threedimensional cameras in transoral robotic surgery in otorhinolaryngology has enabled a more precise estimation of the depth of the surgical site and the anatomical structure.

A nato l i Patari d ou ENT, Î&#x2014;ead and Î?eck Surgeon â&#x20AC;˘ www.pataridou.gr

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treated with the new endoscopic techniques are choanal atresia and chronic rhinosinusitis. Transoral endoscopic laser surgery in the throat area has radically changed the treatment of benign diseases as well as cancer in early stages. This new technique has two main advantages for the patient: it is an alternative to a tracheostomy and it can be repeated in cases of local recurrence, particularly in patients with glottic cancer. In recent years, the use of three-dimensional cameras in transoral robotic surgery in otorhinolaryngology had enabled a more precise estimation of the depth of the surgical site and the anatomical structure. Also, wristed instruments and robotic surgery offer better access to hidden points of the upper airway. This surgery is now recommended for benign diseases such as obstructive sleep apnea and for early stages of pharynx and larynx cancer. It has also begun to play a very important role in exploring head and neck cancer with unknown primary sites. The major advantage of robotic surgery for the patient is that is involves less postoperative edema, pain, bleeding or difficulty in swallowing. I would highly recommend new surgical techniques involving atraumatic dissections, which mean less bleeding, pain and surgical time and faster postoperative healing for the patient.

MEDICAL BRIEF

AT H E NS E U R O C L I N I C H O S P I TA L

ONE-STOP BRE AST CLINIC IN THE CENTER OF ATHENS Early diagnosis and tailored treatment of breast lesions are the keys to better outcomes

Breast cancer is the most common malignant disease in Greece. An estimated 4,500 new breast cancer cases occur annually in our country, while 1,500 Greek women die from the disease every year. According to European Union data, one in nine women will develop breast cancer during their lifetime. Early detection, therapy and follow-ups should be performed by a multidisciplinary team of breast health care professionals, in a highly specialized breast unit. Our breast unit is located on the 6th floor of the Athens Euroclinic Hospital, in the center of the capital. Equipped, technology-wise, in accordance with European care standards, the unit treats a large number of women every day, for screening and assessing palpable lesions or abnormal findings from breast imaging (mammography, ultrasound, magnetic resonance). The unit was recently accredited as a full member of the Breast Centers Network, an international network of over 200 breast units for the diagnosis and treatment of breast cancer. The network is under the auspices of European School of Oncology (ESO), the most eminent institution for surgical oncology worldwide. The core of our unit comprises a breast surgeon, breast radiologists, a breast care nurse, a breast pathologist, a medical oncologist, an onco-psychol-

During one visit, a patient can access all the breast imaging needed, a physical examination, histological/ cytological evaluation and surgical consultation.

ogist, a plastic surgeon specialized in the breast, and breast imaging technicians. After a diagnosis, the breast surgery department can offer the full range of modern surgical treatments, combined with adjuvant (or preoperative) chemotherapy, genetic counseling, follow-up and full psychological support from the onco-psychologist. The advantages for patients who are diagnosed and treated in an accredited breast unit are very clear in terms of early diagnosis and high-quality treatment. Trials have proved that modern breast units ensure better therapeutic results, greater patient satisfaction rates and increased overall survival rates. There is a 16 percent difference in the survival rates for breast cancer patients in the European Union member states, depending on the access women have to organized breast units (Eurocare trial). Other trials suggest a decrease in morbidity from breast cancer by 18 percent when the patient is treated by multidisciplinary teams. We aspire to be a one-stop breast clinic, where, during one visit, a patient can access all the breast imaging needed, a breast physical examination, histological/cytological evaluation and surgical consultation. Early diagnosis and tailored treatment are the keys for better outcomes, increased survival and better quality of life for women with the disease.

fiorita pou l akaki M D , P h D , F E B S ( br e ast surg e r y ) Head of Breast Surgery Department, Athens Euroclinic Hospital • www.poulakaki.gr • Email: poulakakifiorita@yahoo.com • Tel. (+30) 6944.530.710

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MEDICAL BRIEF

R e t h y m n o M edical A s s i s ta n ce

Your Trusted Doctors in Crete Having treated more than 40,000 patients over the past 12 years, RMA offers personalized, high-quality, hassle-free medical services for all types of emergencies, from sunburn to heart attack.

A tourist destination ought to provide a variety of services, including international patient management, a complex but necessary service. Tourism is growing rapidly despite the crisis and, as a dynamic industry, it continues to make a significant contribution to the economy. Statistics indicate not only a general increase in arrivals, but also a significant increase in the average age of those traveling the world: in particular vacationers over 55 have increased by at least 23%. This means that the medical care system needs to be ready to face potential incidents ranging from potentially life-threatening heart attacks, strokes, allergic shocks and accidents to more common holiday emergencies such as food poisoning, asthma attacks, colds and sunburn. Providing medical care to tourists requires strong organization skills due to the patients’ high expectations, expectations which the Public Health System cannot meet. Access to both primary and secondary healthcare isn’t easy, especially during a crisis where staff shortages and technical limitations are evident even in tourist areas. Τhis, in short, is the situation, and all of us who work in the first line of response to emergencies on islands and tourist areas

of the country during high season must be ready to deal with it. Rethymno Medical Assistance is staffed with experienced healthcare professionals in both the medical and paramedical fields. They provide primary healthcare and medical tourism services to the wider area of Rethymno. Our facility is certified by the German Organization, ΤEMOS, which ensures that services are secure and sufficient and meet quality standards. Tourists expect quick and effective services in a comfortable environment which they trust, preferably in their place of residence. RMA treats more than 4,000 patients per season (April to October) and has been in operation for more than 12 years.

Rethymno Medical Assistance is staffed with experienced healthcare professionals in both the medical and paramedical fields.

We offer • 24/7 services in the patient’s place of residence by multilingual staff • Medical diagnostic devices and trained personnel • High-quality secretarial services in a digital environment • Links to secondary care • Collaboration with all international travel insurance and medical assistance companies • A network of colleagues throughout Crete.

Dr . Emmanoui l T z agarakis General Practitioner (GP), Family Doctor 75 Adelianos Kampos, 74110, Rethymno, Crete • Tel. (+30) 2831.071.300 • www.rethymnomedicalassistance.com • Email: info@rma.gr •

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MEDICAL BRIEF

H I G H -T E C H O R T H O P E D I C S

Computer-assisted hip and knee repl acement surgery The evolution of technology and surgical techniques continues to improve the effectiveness of hip and knee replacement procedures. Procedure The general premise of digital-assisted surgery is that the computer software generates a virtual model of the patient’s knee and hip anatomy, which serves as a draft for the surgeon to follow. The navigation camera monitors the position of the implant and the surgical instruments during the process and transmits this information to the computer. Special software then displays in real time on the virtual model the exact position of the instruments and the implant in relation to the patient’s anatomy.

Several factors can influence the success of a surgical total knee and hip replacement, including the proper alignment of the implants to the patient’s unique anatomy. This is one important reason why orthopedic surgeons choose to utilize digital guidance in surgery. Hip Hip replacement surgery involves replacing the femur and acetabulum with an artificial prosthesis consisting of three parts: a cup that replaces the hip socket, a metal stem which replaces the support of the femur and a metal or ceramic ball that replaces the damaged head of the femur. Knee During a total knee replacement, the distal femur and proximal tibia are resurfaced. The knee implant consists of metal and polyethylene. The femoral and tibial components are used together to reproduce the knee joint. The surfaces of the distal femur and the proximal tibia are cut to match the corresponding surfaces of the implant. Computer-assisted surgery helps surgeons make these cuts, allowing for more precise alignment of the implant, customized to the unique anatomy of the patient.

The surgeon can make precise movements to ensure the optimal application of an implant, the range of motion and the stability of the joint.

Benefits Computer assisted arthroplasty surgery cannot replace the surgeon, but it provides him or her with a comprehensive understanding of the anatomy of the patient’s knee and hip that conventional mechanical means cannot provide. The surgeon can make precise movements to ensure the optimal application of an implant, the range of motion and the stability of the joint. This can help to minimize damage and prolong the survivorship of the implants. It also means less postoperative physical rehabilitation, smaller incisions and less blood loss than with traditional knee or hip surgery recovery.

D R V A S I LE I O S I . S A K ELL A R I O U M D , M S c , P h D Attending Orthopedic Surgeon Head of the Hip and Knee Unit at Mediterraneo Hospital, Athens PhD, Medical School, University of Athens Scientific Associate, University of Athens Specialized in hip and knee surgery at the Mayo Clinic, Minnesota, and at the Hospital for Special Surgery, New York

C ontact information : •

Office: 46 Omirou Str., Nea Smyrni, Athens 171 21 • Tel: (+30) 2130.299.117, (+30) 6944.838.101 • www.sakellariou-ortho.gr • www.athensorthoexperts.gr • Email: bsakellariou@gmail.com

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MEDICAL BRIEF

M edical Touri s m

Investing in long -term rel ationships Thanks to a state-of-the-art clinic offering hemodialysis treatment, Santorini and its romantic sunsets are now accessible to renal patients.

Situated in the clifftop village of Pyrgos, on the famous Aegean island of Santorini, the Santorini Renal Nephrology and Dialysis Center is a dream come true for the island’s residents who suffer from renal failure and need to get treatment three times per week. The clinic was designed for patients’ comfort and safety on a 0.4 hectare site with breathtaking views of Fira (Santorini’s capital) and the neighboring islands of Ios and Sikinos. It also offers its services to international patients visiting the island. Fully satisfied with our high-quality services and comfortable environment, many of these visiting patients keep coming back to our clinic, the existence of which means renal patients can visit Santorini all-year-round secure in the knowledge that their needs will be looked after. The Santorini Renal Center is housed in a new, easily accessible 770m2 building with ample parking. The clinic, in operation since July 2010, comprises three large air-conditioned rooms, a separate unit for people with Hepatitis C, a patient’s reception, medical rooms and technical support. The clinic has 17 modern dialysis machines and uses the latest hemodialysis methods in up to three daily shifts all year around. A nephrologist is always on duty, along with specialized nursing personnel.

Our customers are guaranteed a high level of service in terms of medical care and quality in the doctor–patient relationship. During your stay, our extensive list of services will satisfy all your needs. Our services • Most modern dialysis treatments • Application of the highest standards • Dialysis room & suites • High and low flux filters and on-line hemodialysis • Intensive Care Unit • Private ambulance • Wide parking spaces • Free internet (Wi-Fi) service • All insurances, including European Health Insurance Card (EHIC), accepted • All-inclusive packages upon request plus transportation free of charge • We also offer services to patients wishing to visit nearby islands: Ios, Naxos, Paros, Folegandros, Anafi and Sikinos. Imagine a positive working environment that enhances the patients’ experience on a dreamy island with crystalline waters, geological and archaeological monuments steeped in ancient history, authentic flavors, smiling faces, a picture perfect sunset... We know how to deliver the best. For your holidays choose the magnificent island of Santorini!

Fully satisfied with our highquality services and comfortable environment, many visiting patients keep coming back to our clinic, the existence of which means renal patients can visit Santorini all-year-round secure in the knowledge that their needs will be looked after.

S antorini R e na l N e p h ro l ogy an d Dia ly sis C e nt e r •

Pyrgos, Santorini • Tel. (+30) 2286.027.107 • www.santorinirenal.gr

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MEDICAL BRIEF

Smile D e s i g n er s

The Number One Cosmetic Dentistry Provider in Athens Smile Designers has nearly 20 years of experience in providing outstanding treatment for every kind of dental problem.

In operation since 1998, Smile Designers is a generalist boutique dental clinic with a focus on cosmetic dentistry. The two owners – Dr Elisabeth Koukopoulou, DDS, MSc, and Dr Olga Efstratopoulou DDS, MSc – are both US-trained and have master’s degrees in their specializations of Restorative and Cosmetic Dentistry. The rest of the team consists of five handpicked dentists who have done postgraduate studies in the best internationally accredited universities in the US and Europe. This highly specialized, skilled and experienced team is proud to offer dental treatments of the highest quality at an affordable cost. At Smile Designers, effective and efficient communication with patients and the delivery of personalized dental care are top priorities. Over the last two decades, the dental team has helped thousands of patients to improve and brighten their smiles. Already well known within the Attica region for its high-quality standards, the clinic provides comprehensive dental care with a team fluent in English, French, German, and Italian, offering patients a comfortable, calm and hassle-free experience. Dental specialties include family dentistry, restorative dentistry prosthodontics, implant dentistry, oral surgery, endodontics, periodontics, pediatric dentistry and orthodontics. Smile Designers, expert at handling dental phobia, focuses on cosmetic dentistry, and offers state-of-the-art solutions with the aid of the most modern dental equipment and technology. The solutions offered are based on experience and on scientifically documented clinical methods and procedures that create really ATTRACTIVE BRIGHT smiles. The clinic specializes in improving people’s smiles with the aid of ultrathin prepless porcelain veneers. Its high-tech laboratory allows dentists and patients to design a new smile with the aid of a dental technician, minimizing any risk of error while speeding up the procedure. For those who want to change the shape or color of their teeth and achieve a new dazzling smile,

Smile Designers’ highly specialized, skilled and experienced team is proud to offer dental treatments of the highest quality at an affordable cost.

Dr E l isab e t h K oukopou l ou DDS, MSc Specialist Cosmetic and Restorative Dentist University of Michigan USA

Dr O l G a Efstratopou l ou DDS, MSc Specialist Cosmetic and Restorative Dentist University of Michigan USA

•

• www.smiledesigners.gr Email: info@smiledesigners.gr • Τel. (+30) 210.672.7310

ultra-thin veneers, made with porcelain material just .04mm thick, are used in place of traditional 1.0mm-thick veneers. This new material is incredibly tough and resistant. Its unique characteristics make the production of ultra-thin layers possible, necessitating little or no preparation (i.e., drilling) of the tooth surface. With proper care and regular check-ups, ultrathin veneers can withstand chips and cracks and last for a period of fifteen to twenty years. What’s more, for the past four years Dr Elisabeth Koukopoulou is a doctor, DHA-licensed in Dubai and HAAD-licensed in Abu Dhabi, offering her services as a specialist prosthodontist and restorative cosmetic dentist in first-class clinics in the United Arab Emirates. The Smile Designers Dental Clinic is located in the quiet, upscale area of Psychiko in the northern suburbs, an elegant neighborhood which also hosts most of the international embassies. The tranquil green streets are a world away from the noise and traffic of downtown Athens, yet the area is easily accessible from the center, either by car/taxi (a 15-minute drive) or by public transportation (bus or metro). The Smile Designers Dental Clinic is member of the Athens Dental Tourism Cluster (ADTC), a non-profit organization that, under the auspices of the Municipality of Athens, promotes dental tourism in the wider Athens area. ADTC is an alliance of some of the best dental clinics in Athens. All of its members are committed to certified services, highly specialized dental teams and top-quality dental services, in order to establish Athens as an international center for dental care. As part of its Dental Tourism package, Smile Designers offers: a free online smile design pre-consultation, complimentary transportation to and from the airport and hotel, special prices for 4- and 5-star hotels, 24hour VIP concierge service for reservations or other help, a free annual check-up, and a three-year guarantee for every dental procedure.

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