Dr Philip Murray recounts the recent trip of the County Sligo GP Society to Portugal’s second city, Porto, where despite the food, friendliness and fado, the economic outlook remains uncertain for the population and their doctors.
At the end of September, fourteen members of the County Sligo GP Society travelled to Porto to attend a medical conference.
This meeting had been pre-arranged by Sligo/ Leitrim CME Tutor Dr Frank Hayes in conjunction with Dr Jaime Correia De Sousa, Head of Department of Community Health, and Teacher at the School of Health Sciences.
Our group – led by Dr Donal Smyth, Secretary of the Sligo GP Society — flew RyanAir from Dublin, the flight time being just two hours.
For most of us, it was our first time to visit Porto, and some were already thinking that with such a short flight time, Porto would be an ideal destination for a weekend break some time in the future.
Eurostars Das Artes Hotel was our headquarters, and was about half an hour’s drive from the airport. It was ideally situated for our needs, as it was close to the historic Museum District of the city, and everywhere was within walking distance.
Beatrice Periera was our guide for the walking tour, which took three hours in total. The city centre is quiet compact, and she brought us to the principle sights, including Torre Dos Clerigos, a 75-metre high baroque tower that dominates the city skyline.
There are 240 steps to the top but none of us ventured upwards; the Cathedral Se; Igreja de Sao Francisco, a Gothic church; the city’s most important museum, Museu Nacional Soares Dos Reis; and the Palácio Da Bolsa – The Stock Exchange. This has also been converted into a museum, and the country’s main Stock Exchange has been relocated to Lisbon.
Despite this, it was an amazing building and we were greatly impressed, as none of us had been to a stock exchange before.
She also brought us to Livraria Lello e Irmao, one of the most famous bookshops in the world. It is stacked from floor-to-ceiling with new, second-hand and antique books and is more like a museum than a bookshop.
Livaria Lello is a major tourist attraction, with coach tours pulling up outside and a continuous stream of people filing through.
Every few minutes the owner could be heard saying: “No photographs please.” The cameras continued to click, however.
We learnt that there were two defining times in Portugal’s history. One was the 48-year dictatorship of Salazaar, and the other was the revolution in 1974. The country has only recently begun to emerge from these shadows.
Beatrice also told us that the area around Lisbon and the Algarve coastline is regarded as the trendy and most opulent part of the country, whereas the northern end around Porto is regarded as the more conservative and religious.
They have a saying in Portugal:“Lisbon shows off, and Porto works.”
As most of our group had been to Lisbon and the Algarve on previous occasions, there was an awareness of this discrepancy.
It was still disturbing for us to pass so many derelict buildings, and to see the huge number of ‘For Sale’ signs everywhere, as well as being continually harassed by beggars — on a much greater scale than would be seen in Ireland.
Apart from the fact that our two countries lie at the westernmost edge of Europe, it is obvious that there are a lot of similarities between us. We are both descended from peasant stock, and have traditionally been two of Europe’s poorest nations.
The Portuguese do, however, have many of our characteristics of friendliness and an unhurried approach to life. On top of that, Catholicism is the dominant religion, with over 90 per cent of the population registered as Catholics.
There is one major difference between our countries, and that is in education. Their education system is pretty appalling, and apparently the Salazaar regime is mostly to blame for this, because for four decades it invested as little as possible in education.
Emigration is a huge issue. Where our emigrants go to England, North America, and Australia, theirs go to South America, particularly to Brazil. Even today, there are more than three million Portuguese living abroad, and in many instances their monthly cheques home are their families’ main source of income — shades of old Ireland!
It is difficult now to realise that centuries ago, Portugal was one of the great maritime and exploratory nations of the world. They had many African colonies, including Angola, Cape Verde, Guinea-Bissau, Mozambique, and Sau Tomé e Príncipe before they all got their independence in 1974-75.
They even claim to have discovered Australia in the 16th Century, some two-and-a-half centuries before the arrival of Captain James Cook. Vasco Da Gama was their most famous explorer and is best known for leading the expedition that discovered the route to India around the Cape of Good Hope in 1497.
The clinical meeting was chaired by Dr Roddy Quinn, current Programme Director of the Sligo GP training scheme. The first speaker was Dr Bernie O’Connor, the title of whose talk was ‘Osteoporosis: An Update’. This was a well-researched paper, and gave a comprehensive overview of the subject.
She was followed by Dr Jaime Correia De Sousa, who spoke on ‘Portuguese Family Medicine’, and then Dr Rui Meldon, who spoke on ‘Primary Health Care: Postgraduate Reform’. The final paper was a case presentation on ‘Prostatic Disease’, and was delivered by myself.
28 per cent cut in pay
There was much discussion about the current situation regarding our respective GP systems, as well as the financial situation of same. Our Portuguese colleagues have had their incomes cut by about 28 per cent, just like in Ireland. Again, like us, they have had their workload dramatically increased without any additional funding, and they are finding it increasingly difficult to cope. They are equally apprehensive about the future of general practice.
We were told that unemployment and emigration are rampant in the country, and that there are more antiausterity protests in the offing. People who have a job regard themselves as lucky. One young taxi driver told us that he was one of the lucky ones, even though he worked 12 hours a day, seven days a week. He also told us that many young couples are not now having children, as they cannot afford to bring them up. A lot of young couples are also moving back to live with parents.
For fish-eaters, Porto and its environs is a paradise. Along with tourism, fishing is the country’s main industry. The variety of fish on offer was amazing, and as well as being fresh, it was extremely cheap. We ate almost entirely at local restaurants, and were greatly honoured on one occasion when the proprietress sang fado.
Our free time was limited, but we did manage a 60-minute cruise on the Duoro, one of Portugal’s three main rivers. Barcos Rebelos are the cruise boats, and they were originally used for carrying port wine down from the vineyards.
The five bridges crossing the Duoro are some of the city’s most distinctive landmarks, the most distinguished of them being the Gustave Eiffel, designed Ponte De Maria Pia. As the name suggests, Gustave Eiffel also designed the Eiffel Tower in Paris, as well as the framework of the Statue of Liberty in New York.
The other main landmarks that we could see from the cruise boat were the port wine lodges in the Vila Nova De Gaia region overlooking the city. All the international names in the port wine business, including Taylors, Ferreira, Grants, Messias, Sandeman, Rozes, Fonseca etc, had huge signs advertising their products and at the same time dominating the skyline.
Apparently they have organised tours and tasting on weekends. We were told that most of Portugal’s port wine is made exclusively from grapes grown in the Douro Valley.
The highlight of the entire trip was our visit to Guimaraes. Known as ‘The Cradle of the Portuguese Nation’, it lies about 40 minutes by road from Porto. It is a university town, and is a finely preserved enclave of medieval monuments, including two convents, both of which house museums.
It is now a UNESCO World Heritage Site. Unfortunately, we didn’t have enough time to do it justice.
Our visit to Porto was very successful, both from an educational and a social perspective. We were in general very positive about the city of Porto, but most importantly, we were very taken with the Portuguese people.