If you ask people about care work in Portugal, you'll probably be told that Portuguese families take care of their own. It's a traditional society and a Catholic country, so they value their elders and provide for those in need.
Of course, I've also been told that people in Portugal are entitled to subsidized or free home care, yet the wages paid to personal care attendants are so low that it's a struggle to actually hire anyone. Portugal provides subsidized care at home while the US provides it in residential facilities -- and both make it difficult to get. The US, Canada, and Portugal have very different systems for providing home care, so I was surprised to discover I hear the same complaints in all three countries.
The other day I visited the home of Fernando Bissaya Barreto, now a museum commemorating the life and work of a man who established residential care facilities for people with chronic medical conditions and the frail elderly. Bissaya Barreto was a surgeon and a politician during Portugal's dictatorship. He died four years after his buddy, António de Oliveira Salazar.
His philanthropic work has outlived him. The guide I spoke with mentioned that he'd gone to a nursery school founded by Bissaya Barreto. Bissaya Barreto's name is still attached to a number of programs for children, single mothers, and elders.
I had been told that Salazar's regime was patriarchal and hierarchical. There was an educated elite that ran things. Then there was everyone else. Everyone else was a rural population that lived along the poverty line and had Europe's lowest literacy rate. Censorship was used to shelter people from consumerism and the desire for democracy. The goal was for them to be content with the role Salazar had chosen for them.
It was one thing to have a general idea of this and have people reference it. It was another to stand in Bissaya Barreto's house looking at his art collection. One piece after another depicted selfless mothers breastfeeding children and scenes of a simple country life that's equal parts dignity and deprivation.
Inspiration porn didn't start with the internet. It's been with us a long time.
Salazar studied to be a priest before he went into law. His deep faith, decision to remain single, and relative frugality (compared to other to dictators) seems less like a personal trait now that I’ve seen Bissaya Barreto's home. The walls of the house and garden are decorated with tiles from convents and monasteries, many of which were closed and demolished when the monarchy fell. His bedroom, the guide explained, is designed to match the bedroom of the bishop. This included giant matching crucifixes. There is an astounding amount of religious iconography throughout the house, beyond just the tiles.
The celebration of collective life for other people has blurred them into broad categories — idealized types, rather than unique individuals. This makes sense after I read about corporatism. The people depicted in the art throughout the house are the noble poor. The happy poor who understand that life is all about family and faith. The helpless poor. The deserving poor. The paintings strive to conjure up our pity and compassion, while highlighting their purity.
Salazar's goal was stability. He constructed financial policies that allowed people to have a better version of the life they were living when he took power. He kept Portugal out of WW2 in order to maintain Portugal’s empire and its civilizing mission. He didn't push to industrialize the country along with the rest of Europe because he found their version of capitalism immoral.
Salazar was hardly the only politician to foster a nation of quiet farmers. Thomas Jefferson dreamt of a nation of yeoman farmers, an ideal that persisted through the antebellum years. Then the US's desire for capitalist growth surpassed its dedication to the family, the community, and the roots that held us together in one place. The vision of family farms and small towns we still have so much nostalgia for was less important than the demand for factory labor.
I'm trying to make sense of this economist and the men he ran the country with. He is widely criticized for a stagnant economy, lack of development, and low literacy rates, yet the data I find shows that he grew the economy, built massive infrastructure projects, and dramatically increased literacy rates. Are his critics truly concerned about the fate of the poor in Portugal or Angola? Were his concentration camps and special police forces different from the ones in the US? Why is he faulted for holding onto overseas territories when French and British lands still dot the globe? Young Portuguese men fled the draft by going to France while young American men fled the draft by going to Canada. How does one even compare these things? The pot is not wrong when he calls the kettle black.
I keep reminding myself that I’m here to understand care work in Portugal. It’s so much easier to find information on the men who oversaw atrocities than anything about the lives of the people who lived under them.
The Bissaya Barreto Foundation, like so many organizations, cautiously celebrates Bissaya Barreto's spirit of charity while acknowledging his role in Salazar's regime. Bissaya Barreto and Salazar both felt their role was to enact the social doctrine of the Catholic Church, an institution which has survived plenty of scandals bigger than PIDE and intentional poverty. Dead philanthropists continue to sculpt the world to their vision through the foundations they funded and the strings that come attached to their money.
What does it mean when social services are provided out of pity and idealism?
What does it mean that dead colonizers, patriarchs, and dictators decide who is deserving?
A huge factor in inter-generational living is housing affordability. Like in New York, Lisbon has laws protecting people from rent increases that have resulted in a dramatic range of rents. When someone said that several of her grandmother’s tenants in Lisbon paid €17 a month, I assumed it was an exaggeration. Then I realized it’s not. Market rate for a 1-bedroom is around €1,000. These housing laws designed to protect existing tenants fail to protect their kids who’d like to stay near their families. In New York we all know someone who’s moved in with an elderly relative in order to benefit from their incredibly low rent and then inherit their rent controlled apartment. I’m curious to know if things work similarly in Lisbon.
People in Portugal are very conscious about their poverty rate. Like how Canadians imagine they’d earn far more if only they lived in the US, the Portuguese generally believe that by staying in Portugal they’re giving up on a lot of potential income. I was interested to learn that Portugal has a poverty rate lower than that of the US. I guess I shouldn’t have been surprised, since 73 million Americans have a low enough income and such meager assets that they qualify for Medicaid.
Here's an idea: navigating the health care system, but it's a video game.
You know who I don’t want as my doctor? Someone who’s working 80 hour weeks. We know that lack of sleep and burnout are awful for human reasoning capabilities.
The effectiveness of sham surgery compared to standard treatment leaves me wondering just how scientific scientific medicine is. I found this tale of a sham surgery thought provoking.
Black women are especially likely to be supporting family and friends through chronic illnesses, while earning less throughout their lifetime.
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