As a Pregnant Indian Tourist Dies in Portugal, What's Behind the Health Crisis?

Explained: What ails Portugal health system that led to the death of a pregnant Indian tourist in the country.

On 30 August, Tuesday, Portugal's Health Minister Marta Temido resigned hours after a 34-year-old pregnant Indian tourist died of cardiac arrest while being transferred from one hospital to another due to the lack of availability of beds.

According to various reports, there has been heavy criticism of the government, and the health minister, for failing to address an increasing medical crisis brought on by the closure of emergency care services, lack of specialist doctors specifically gynaecologists and obstetricians, and an ageing state-led national health service (SNS).

Portuguese Heath Minister Marta Temido took full responsibility for the incident as she put in her papers.

The pregnant tourist, a woman from India, was turned away from a full maternity ward.
She died while being transferred to another hospital.
Her baby survived.

Dr Marta Temido quit because she said she had no way of resolving the crisis in Portugal’s health sector. https://t.co/3bhIw5wYg9

— Ottilia Anna MaSibanda (@MaS1banda) August 30, 2022

The Lack of Specialists and Ageing Doctors

As the crisis in Portugal's health services get even more intense, the emergency gynaecology, obstetrics, and childbirth services at various hospitals are to be shut for another weekend, according to local media reports.

Earlier this summer the director of the country’s Directorate-General of Health (DGS) had said, “the worst thing that can happen to anyone in Portugal is to get sick or have an accident in August."

The scarcity of doctors, especially in the area of obstetrics, happening all over the nation has become a cause of concern.

According to the Doctors' Order, around 50% of Portuguese obstetricians work in the private sector or abroad and nearly half of those working in public hospitals are aged over 55, meaning they can legally refuse emergency services work, reported Reuters in June.

So this crisis has been brewing for a while. The ageing out of doctors who serve in the National Health Service is only going to increase as training of new doctors takes effect. For the service to have adequate doctors, it will require almost all the newly trained specialists in the field to join the SNS, which is unlikely to happen.

Unequal Distribution of Doctors 

Much like India, there is regional disparity in how specialists are distributed. For example, the crisis is bigger in Lisbon, where the young Indian tourist died, Vale Do Tejo and Algrave.

Is the Government Trying to Address the Crisis? 

The government has set up a monitoring commission to oversee the response in gynaecology and obstetrics departments, it has updated information on the health portal where women can look up what services are open in their area, and which are closed, and it has offered better pay to those who work in emergency departments.

It has set up hospital referral networks, which basically means hospitals can refer patients to other hospitals that offer services they can't. But this involves patients having to be transferred long distances, something like what happened with the Indian tourist.

But experts say these measures are just not enough.

While these problems in Portugal are not new, they've progressively gotten worse, leading to the unfortunate death of an Indian woman.

(With inputs from Portugal Resident and Reuters)