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Medical and Dental Care |
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Religion
The
Churches
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Medical Care
Now,
there are major hospitals in both Vila Real and Chaves and a system
of health centers in all the small communities.
Granted that this health system is filled with problems and
is not capable of attending to the large number of beneficiaries of
the social security system—with waiting lists for some operations
as much as five years—but we can say that where there were once
only hospitals run by the Church—Hospitals of Mercy—with
coverage of a very small part of the population, there has been
marked improvement. In
the public health system, treatment is free, as are all essential
medicines. Discounts of
at least 50 per cent are given on prescriptions for non-essential
medication. But the
worst feature of the public system is the waiting.
It is not uncommon for the hospital to send a letter to a
patient notifying him that his appointment is on such and such a day,
only to discover that the patient has long since died.
Recently the Minister of Health called the system a
“national shame”. Basic
operations that could improve quality of life—cataract removal for
example—can require a wait of as much as five years. Everyone can tell you a shocking story about medical blunders and disregard for the most basic rules of doctor-patient care. With the slowness of the judicial system it is virtually impossible to sue a hospital or doctor for malpractice. Often, when the case is finally heard, the case has been prescribed for lapse of time, or the doctor will stall by not appearing for dates in court, suffering no punishment for this attitude. Few people are able to pay lawyers for such a long-drawn out process.
Hospital
personnel are not trained to counsel the family when one of their
members is gravely ill or has died.
In Chaves there is a well-known case of a man who fell off
the roof of his apartment breaking his neck in the process and
suffering immediate death. The
wife was out at the time, and when she arrived at the scene she was
told by a fireman that her husband had been taken to hospital, but
not that he was dead. No
one had the courage. Up
to this point it is understandable.
Upon arriving at the emergency room, she rushed inside asking
about her husband, expecting the worse, but not even imagining that
he could be dead. The
nurse called the doctor in charge, who walked up to the wife and
pressed a piece of paper into her hands, a hospital report.
The woman, in her anguish, couldn’t read properly and asked,
“Is he in a coma Doctor?” The
answer accompanied by a cynical laugh was, “You wish!
He was dead on arrival.”
In Portuguese the words were much harsher, literally, “he
arrived as a corpse!” Late
the family members wanted to do something about this total lack of
professionalism and lack of basic human kindness, but they gave up
when they saw the obstacles before them.
For another true story from a recent Público article
click
here.
The
problem with the medical system is that in this area there is no
alternative to the public hospital. Rich
and poor have to go to the same place.
There are no private hospitals
in Chaves or in all the district of Vila Real.
There is also a tendency for the population to rush to the
emergency room for the slightest complaint—a common cold for
example—thereby overburdening the system.
The postos de saude—health clinics—have been
trying to diminish the numbers who use the hospitals, but they are
not open at night and do not have specialists to attend to the
population. A lot of
people do not believe the doctors there know much and prefer to take
their chances in the emergency room. Most of the time spent by the general practice doctor at these public clinics is putting the results of patients' exams and medicines prescribed into the computer. A physical examination is rarely done. When making a recent request (December 2007) for an appointment with a specialist at the hospital the writer of this article was told that in the Chaves hospital it would take six months, but if done through Vila Real might be done in four months. The doctor at the health center recommended a private doctor, who charges from 70 to 80 Euros for a visit. What private patients pay for—often from private insurance—is individual attention. A visit to a private doctor can be made a few days before the date and there is usually only a short waiting period in the waiting room. The doctor might spend as much as half an hour with each patient. The same appointment in the public hospital might take six months to get, and a day could be spent at the hospital for a ten-minute rush job. Often the appointment will not be kept because the doctor is out of town.
Dental
Care
In a region where almost no dentists even existed twenty years ago, there are now enough to attend to the population, at least in the larger towns. In a city like Chaves, which has 13,000 people, but serves an area of around 50,000, there are at least 20 dentists. All of them are private and not cheap. In
Chaves there are also so-called "mecânicos", dentists who have never
finished university, or in some cases not even secundary school.
For some bizarre reason the government allows these non-qualified
dentists to operate legally. In a
controversial decision the National Assembly actually passed a law legalizing
all the dentists ("mechanics") without diplomas to carry on their
practice, with the dubious obligation to do a certain number of
courses in a determined number of years.
No one thinks that these so called dentists will ever do any
courses. Many of them
are semi-illiterate and some are too old to set foot in a classroom.
The
population with fewer financial means prefers these “dentists” because
they are cheaper. In Chaves there are about six of these
dentists, the number varying as they move to different locations. The public health system has no dental care whatsoever. Not surprisingly, many people never go to the dentist until it is too late, and gum problems are prevalent, causing loss of teeth. The use of braces is becoming popular among the upper middle class and it is not uncommon now to see teenagers wearing them.
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