Impact
The project aims at improving the preventive health care and social services and focus to the effective out-of-hospital management of cardiac arrest victims, as well as incidents requiring provision of first aid, within the urban area

Project idea
The overall project objective is to increase the number of effectively managed out-of-hospital cardiac arrest incidents and save patients' lifes.
The Heart Safe Cities project approaches the cardiovascular diseases, cardiac arrests and the provision of preventive health care in a special way, by trying to create multipliers addressing directly to the general public and confronting the occurrence of heart arrests immediately and effectively. In this way, a large part of the population acquires a rounded and general knowledge about heart matters, eg how it works and how it can be protected, what needs to be done in case of a heart attack etc, while at the same time people are engaged in social life, which enhances their lost sense of usefulness. At the same time, people at high risk of a heart arrest, most of who do not even know they belong to a high risk group because of their lack to health care access, gain higher possibilities of surviving such an incident, and they obtain access to cardiac examination, monitoring and information on how to prevent such incidents.
The project idea is consistent with the "Heart Safe Communities" Program, in a systematic effort to manage directly the relevant incidents, not only by health professionals but mainly by suitably trained citizens.
Project Background
Over the past years public investment in health and social welfare systems fell rapidly in Greece due to economic crisis. Increasing disparities and the risk of poverty are tightened.
As a result the personnel in public health and social welfare has decreased and consequently the quality of health services provided has fallen, setting in some cases, people’s lives at risk. In Republic of North Macedonia the situation is worse, as 21% of the population live below absolute poverty line while many of them (54%) live in households with five or more members.

As such access to basic health care treatment is almost absent, resulting in fatal incidents that could be saved easily if they were identified and treated in time such as heart arrests and cardiovascular diseases. Also, high poverty rates and low educational level result, among others, to lower food quality consumed, which in turn is worsening the heart diseases and their symptoms, along with the ageing of population, thus creating more demands on the healthcare system which is gradually burdened. Despite the ageing population, the average age of patients with cardiovascular diseases is decreasing.
In other words sudden cardiac arrests occur now in younger people too, due to low access to doctors because of poverty, due to lack of systematic monitoring of heart as a matter of access and health culture, due to decrease in quality of food consumed, and increase of stress, anxiety and sadness. Regarding heart, one of human’s most vital organs, the frequency of cardiac arrests is estimated between 0,4 and 1 for every 1.000 citizens annually (800 - 2,000 people daily), within a total population of ca. 730M people in Europe. In Greece and Republic of North Macedonia the situation is consistent with the EU statistics, with a slight ascending tendency over the last years, due to the causes mentioned above, resulting to serious losses of human life.
A crucial factor in limiting those losses is the immediate provision of first aid and basic life support from trained individuals, within the very first minutes until advanced emergency care arrives to the spot. It is argued that the majority of the incidents would have been effectively addressed, if: (a) they had been early identified; (b) first aid and basic life support had been provided immediately; (c) early defibrillation had been available and (d) proper post-resuscitation care had been provided afterwards.
This sequence, referred to as “The Chain of Survival”, has been accepted by the European Resuscitation Council and American Heart Association, while convincing scientific evidence has been produced that emphasise the importance of early identification and provision of basic life support, which, even without defibrillators, can “buy” valuable time for the victim, until advanced emergency assistance arrives. Moreover, the monitoring of the current situation regarding cardio vascular diseases through population screening and timely diagnosis of potential threats are considered as the most important preventive factors of future health diseases. Given this situation it is clear that the problem is complicated and requires long-term and multi-faceted approach.
Project Scope
• Raise awareness on the seriousness of cardiac arrest incidents and inform for ways that they can be prevented and/ or effectively managed.
• Improve early response readiness through mass training of citizens, as well as training of trainers (medical/ paramedical staff).
• Improve capacities for effective management through the provision of AEDs (Automated External Defibrillators) in selected city spots.
• Improve the life support services provided by local and regional health care units.
• Increase the overall capacity for life support and first aid provision on city level & reduce the losses of human lives.
• Enhance cooperation in life support issues & issues related to cardiovascular diseases.
• Improve quality of life in the cross-border area.
• Upgrading of the medical services provided in 9 health units in the cross-border area thanks to the supply of new medical equipment
• Increased use of IT applications in the health care sector both by the potential beneficiaries as well as by medical staff (doctors & nurses).
• Raising awareness on preventive health care with particular focus on cardiovascular diseases prevention and early diagnosis through a series of open information events and other promotional activities ending in an average number 8.000 informed citizens and relevant stakeholders.
WP1 Project Management & Coordination
WP2 Communication & Dissemination
WP3 Life support and Training equipment Procurement
WP4 Training of citizens and trainers
WP5 Piloting Heart Safe Communities