The role of gynaecologists in the years of demographic, political and economic crisis: the Greek aspect

Introduction It is widely spread that History teaches the next generations, while every single generation contributes significantly to the enrichment of this valuable store of knowledge. Greece is facing the epoch of politicaleconomic declination; a fact with great impact on demographic parameters (mean life-expectancy, Malthusian parameter r of the Exponential Law in population dynamics, entropyreproductive potential of population). The aim of this review was to support the essential role of contemporary gynaecologists against current demographic shrinkage. Materials & Methods We searched the web, looking for articles concerning history of nations and low birth rate. Historical proportionality was our main tool in selecting and distributing our results, as well as in extracting conclusions. Descriptive statistics was applied, followed by sequence analysis, association rules, grouping and forecasting. Results In classical Sparta, the alarming decline of Spartan citizens, as commented by Aristotle (384–322 BC), was one of the The role of gynaecologists in the years of demographic, political and economic crisis: the Greek aspect A Koumousidis1,3*, M Varras2, N Tzoumas1, L Top1, I Boutas1, C Sofoudis1, C Katsetos3, N Salakos1 major factors, which led to the decline of the Polis during the following Hellenistic and Roman Age. In his work on the rise of the Roman Republic and its gradual domination over Greece, Polybius (200–118 BC) cites the phenomenon of low birth rate, population decrease, subsequent agricultural decline and city desertion in Greece, attributing them to Fortune (Tyche). We studied that plagues and low birth rate among Roman citizens led to depopulation in the Empire and in order this to be combated, Barbarian tribes were actually welcomed into the Empire and encouraged to “set up shop” (as famous author and historian Will Durant states, ‘An Empire is not conquered from without, until it has fallen from within’). On the other hand, several modern articles have attributed the EU economic crisis to low birth rate (e.g. an article from the Head of Vatican bank). Conclusion Historical proof of low birth rate leading as a factor to the catastrophe of a state is abundant. We, as gynaecologists, could decelerate and maybe reverse this decline in births by informing properly our population on their fertility options, by combating the unnecessary abortions (by launching campaigns for parents, schools and media) and finally, by cultivating a positive attitude towards immigrants to Greece, as they can contribute significantly to the recovery of our wounded economy. Such actions may protect our nation from the Malthusian Catastrophe, as it was prophetically described by Thomas Malthus and published in the “An Essay on the Principle of Population” in 1798. Introduction In 18th-century Europe, a British scholar, named Thomas Robert Malthus (1766–1834), published his work on political economy and demography and particularly on population dynamics. He introduced a simple exponential growth model, which is an exponential growth based on a constant rate of compound interest (formula: P(t) = P0e, P0 = initial population, r = growth rate or Malthusian parameter, t = time). In his “An Essay on the Principle of Population” he described the demographic expansion and shrinkage in response to various factors, presenting in a very thorough and deterministic way to the world the behaviour of this system1. The Malthusian Catastrophe (or check) was the cornerstone in his studies, dealing with the forced return to subsistencelevel conditions once population growth has outpaced agricultural production2. Of course, those concepts, which Malthus used to describe his theoretical models, have to be interpreted carefully within their concurrent feudalistic reality, originated initially from the medieval years, and can then be proportionally adjusted in our contemporary industrialised and atomic epoch. As nowadays capitalism seems to have replaced entirely the feudalism of Medieval Europe and moreover, the “capital” (like the “land”, in the corresponding medieval prevalent economical model) is actually concentrated in the positive financial balance of various companies, resources have already become rarer and the growing population struggles for its survival, with the latter to be a direct result of the above-mentioned Malthousian calculation. Wars, crisis, *Corresponding author Email: kumusidi@yahoo.gr; kumusidi@ doctors.org.uk 1 Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Aretaieio Hospital – Family Planning Unit, Athens, Greece 2 Third Department of Obstetrics and Gynecology “Helena Venizelou” General, Hospital – Maternity, Athens, Greece 3 “Tzaneio” General Hospital of Piraeus, Piraeus, Greece