The young doctors who 50 years ago started a revolution in Portugal. The Health

“They called me urgently to deliver a baby in Ferreira do Alentejo and I went there, of course, wanting to show confidence. There were some nuns from Misericórdia there, used to delivering babies, and everything ended up going well. In the end, they went to get a little bottle of bitter almonds to drink behind the screen to celebrate life in an accomplice peccadillo, everyone laughing and happy that everything went well. But I didn’t know if everything would go well. I had attended some births at Magalhães Coutinho [maternidade de Lisboa inaugurada em 1931] and I tried to do the same. But if it were something complicated…”

“The births were our biggest puzzle”, remembers Ana Jorge. “Whenever a woman in labor arrived, the first thing was to try to figure out if it was possible to get to Setúbal. If she couldn’t do it, we had to do it ourselves.”

The man pecked by chickens

António Leuschner was the same age as Ana Jorge when he completed the SMP in Vila Real, Trás-os-Montes, also in 1976. He speaks of a “kind of antechamber of the SNS” because, despite the right to health having been written into the Constitution drafted and approved that year, two years after the 25th of April, the diploma that would constitute the SNS would only be approved later, in 1979. “We went in March and the Constitution was approved in April, so we had an unprecedented experience at the time – we were the first SNS employees ahead of time”, recalls the psychiatrist.

“Before there was the SNS, there were already doctors and medical services on the periphery that were, in some way, the advance guard of the SNS.” And it was with some of these professionals, the oldest, with private practices, that young people faced one of the first and few obstacles to the unprecedented experience, which democratized access to healthcare and which in three decades helped to catapult Portugal from the tail of the Europe to the 12th best healthcare system in the world.

With 13 other doctors, Leuschner’s group was the second to arrive in Vila Real to fulfill the SMP, so there was already a certain structure installed on the ground by the smaller group they were replacing. “But the previous group had mainly been active in the hospital and didn’t stay there for a year, because it was in July and they left at the end of February. We worked in Vila Real, Santa Marta de Penaguião, Vila Pouca de Aguiar, Ribeira de Pena, Murça, Alijó and Sabrosa”, he lists from memory.

Everyone spent hours at the hospital in Vila Real and then, “every day, we went in groups of two to do consultations, domiciles and other services at one of these places – and the access was not like today, there were no roads, there were not even jeeps or of these vehicles to travel some of those paths. There were situations, for example in Ribeira de Pena, where we could only get to people’s houses by donkey.”

At first, relations with some of the local doctors, who were “older” and who looked at the young newcomers “with some suspicion”, were difficult, recalls Leuschner. Leonor Duarte de Almeida also remembers “a certain initial retraction” of the local doctors, “who had been installed for many years and who suddenly saw a bunch of kids appear there, all fun and friendly and happy and motivated to work”.

“They thought that we were, after all, agents of the 25th of April and, therefore, that we were going to call it into question… Note that doctors were traditionally people well established in society, owners too, some tried to create doubts among the population, who then told us…” , adds José Manuel Boavida, current president of the Association for the Protection of Diabetics of Portugal, who completed the SMP in Reguengos de Monsaraz and later in the eastern Algarve, between 1978 and 1979.