Health, Wealth & Welfare?

We decided to visit an organic farm, as Her Outdoors was trying to find some turmeric to grow in our garden. ‘Organic’ is usually a term added to the description of items for sale in order to charge more. Cynical, I know, but perhaps there is some truth in it. What the term does suggest, is that the items are healthier, or ‘good’ for you.  Not for me though, our visit landed me in the hospital casualty and gave me an unwanted insight into the Portuguese health system.

I’ve not played serious football since1983 when I sustained a serious knee injury. Shoot forward to November 2017 and I started playing football again. Or rather the walking football variety of football; no running, three touches and the ball is not allowed above head height. I strained my calf muscle playing, but hobbled on in goal, so as not to let my teammates down. Silly me! Two days later Her Outdoors and I went for a look round the organic farm. I limped round, but when leaving the farm I tried putting my full weight on my foot. Big mistake! To the sound of a loud ‘pop’ and an excruciating pain in my ankle crumpled. I thought Her Outdoors had kicked me to hurry me up! The pain was serious, so we decided to visit the nearest hospital. This was my second mistake; the Hospital Lusiades is actually a private hospital.

Old codgers playing walking football.

At the Lusiades we got a great reception – wheelchair brought to me immediately, charming receptionist speaking excellent English. But when she realised we didn’t have private health insurance (other than our EHIC), I was kicked out of the wheelchair and directed to the ‘Centro de Saude’. (Actually I jumped out immediately, fearing that she would start charging me for its use. Just trying to evoke some sympathy here.) Why no private health insurance you might ask? It’s a long standing socialist principle with me, I have trouble supporting elitist systems or divisive public services.

‘Her Outdoors’ suggested we went to Faro Hospital. My third mistake of the day was insisting we went to the local Centro de Saude. Once there, I quickly got registered and saw the triage nurse where I was colour coded. Well my arm band was coded, not me personally. I was the second lowest ‘urgencia’ band. One above the “don’t waste our time” category. A notice suggested my colour code would entail up to 2 hours wait. The waiting room was full, so we settled in for a wait. We sat back and I researched the likely diagnosis: rupture or partial rupture of the achilles tendon.

Spanish, but similar!

Two hours later, the waiting room had emptied somewhat and I was hopeful… (mistake number 4!) Unfortunately the next two hours saw no progress. We learned later that there were no Doctors in attendance at that time. When things did start to move again, there was a commotion. A new, greenbanded incomer was immediately seen by a Doctor because she knew him. Docile patients immediately started rebelling and the sacred complaints book, Livro de Reclamações was brought out. We also complained, but it seemed to fall on deaf ears. Clearly there were no doctors in Ear, Nose and Throat either…

Another two hours ensued, at which point Her Outdoors asked the receptionist why I had waited so long and when I would be seen. Very shortly after (!) I was taken in to see the Doctor. I explained the problem in English, with the odd Portuguese word thrown in for effect (It didn’t have one!) and also gave my own diagnosis. The Doctor didn’t seem too impressed with my new found medical expertise but called in the receptionist, not for a second/third opinion as I thought, but to translate. She explained that I needed an ultrasound, but they didn’t have one I was offered an X-ray. I pointed out that I understood it wouldn’t show a ruptured tendon. I needed to go to Faro Hospital, (cue a ‘look’ from Her Outdoors) but it was unlikely to be done that night, as there is usually a two month wait. This all happened without any examination of my ankle at all. We were amazed at either; the Doctor’s skills in diagnosing injuries telepathically, or how convincing I must have been in my diagnosis. Google has a lot to answer for!

I waited a short while to get my ankle ‘immobilised’ (bandaged!), and took the time to stop an older man leaping out of bed while attached to a drip and oxygen mask. I paid the €14 tax for the appointment, which would have been €20 if I’d had an X-ray and we headed home with the instructions to go to Faro Hospital at 8am the following day.

Author, with borrowed crutches.

Faro hospital was a better experience. I only waited two hours to be seen, or rather before asking the nurse why it appeared that nobody was being seen by a Doctor. Two minutes after asking, I was ushered into the consulting room. After a brief examination, but no ultrasound, I was diagnosed with a partially ruptured achilles tendon (well done Google!). I was then plastered, (a cast that is and by the Doctor!) told not to put any weight on my foot, to come back in a week and then wheeled to reception in a decrepit old wheelchair and left to sort myself out. Without crutches as they don’t supply them!

Faro was a better experience, although I was shocked after taking a wrong turn and coming across a basement room with about 50 beds/trolleys, full of old people with drips and breathing masks. No privacy curtains, no windows and standing room only between beds. It looked like a war zone hospital. Not that I’ve ever experienced a war zone hospital…

A week later I returned to Faro Hospital, as directed. I wasn’t given an actual appointment and got the impression that an appointments system is an unknown concept. The reception was full, although I was able to go straight to the reception. Language was a bit difficult, but I gleaned that I had to wait for the triaje nurse, which took about 20 minutes. Once I had explained to the triaje nurse why I was there (I was beginning to wonder…) I was directed to the ‘ortho’ waiting area which was already full of walking, and non walking wounded. (Forgive me another war zone reference.)

THREE hours later I was eventually seen but the Doctor didn’t know why I was asked to return. He told me that the Doctor I’d seen the previous week “would be here in half an hour/an hour” and for me to wait. I did, for a further 90 minutes until he arrived but it was 2 hours until I was seen. The cast was removed (again by Doctor!), my hand was shook (I forgot to wash my hands!) and I was discharged with a smile and a wave. No explaination, no follow up, no fitness regime, no advice other than “be careful”. And he gave me no date to start playing football again. It was all an anti climax.

On leaving the hospital via the triage area, I was again shocked by the sea of bodies (alive!), trolleys, ambulance crews, Bompeiros crews and the faces of people who I am sure had been there before me. It was a scene you would expect to see after a disaster, yet it was relatively calm. The Portuguese are remarkably patient at being patients in a seemingly chaotic system.

Did I tell you we were invited to a breakfast at the Organic Farm we visited? I think I’ll give it a miss…

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Sunshine in the rain

With no significant rain from early May to November, Portugal has had it’s worst drought in over 20 years. Her Outdoors tried pleading, praying and dancing to break the dry spell. See her reaction as the heavens opened.

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