Despite their largely European origins, the Uruguayan people greet you with a kiss on a single cheek (the right one). So each time our group of 12 has arrived at one of our many meetings over the last three days, our entrance has taken time but has been smoothly effected, as each person skims past the cheek of our hosts. The exception to this was the British Embassy, where seven of us were greeted with firm handshakes in a cool large white mansion (with swimming pool) decorated with picture of the Queen and ‘I love London’ stickers. Our Glasgow colleagues were tempted to ask where the rest of Britain was.
We have been fortunate to have had meetings at the European Union Delegation, the British Embassy and the Anglo-Uruguayan Cultural Institute, as well as at the Centro Atención Pulmonar (the Pulmonary Care Centre). At the embassies and at the ‘Anglo’ we and the young people of W-West have explained the purpose of our visit and had enthusiastic responses from our hosts. Brian Pringle, one of the Directors of Ash-Scotland (and a member of our team) has tried to extend this enthusiasm to discussions on funding. This is more tricky but we are very grateful that we can make use of these contacts to raise the profile of this project when we get home and emphasise the possible fruitful links between our two countries.
The Pulmonary Care Centre was a fascinating venue for a visit. One thing we have realised here is that the health system is skewed towards the high tech end of medicine. It is easy to get to see a cardiologist, or respiratory physician, but if you need primary care to support your asthma, COPD, or to help sort out your smoking habit, this is more difficult. This is where the Centre comes in. It is the initiative of Dr Grisel Gold, who works for Haymann Pharmaceuticals in marketing and sales. She is a real enthusiast for corporate social responsibility and set up this clinic with support from her company six years ago. It sees 1000 patients a year, about half for pulmonary training and rehabilitation, the rest for smoking cessation groups. Staff from the clinic also support hospital chest clinics using a special machine to test inhaler technique with them, the only one of its kind in Uruguay. As well as this, they do weekly smoking cessation workshops in some of the larger companies in Montevideo. They are busy but effective! Follow-up phone calls suggest a quit rate at one year of around 40%. The clinic had a wonderfully welcoming and comfortable, non-judgemental feel to it. As a clinician from the UK I am naturally cautious about pharmaceutical companies funding this kind of work: Andrew Russell asked Dr Gold if they only use her company’s inhalers. ‘No’ she answered, ‘but patients do use them’. They are considered good products and they don’t do much marketing. Certainly the clinic did not display big Haymann ads, rather lots of information about ‘Asma’ and ‘EPOC’ (COPD).
This morning we had a final visit to the ‘Respira Uruguay’ exhibition. We had some fun putting our expedition leader on a bed of nails and visiting Antartica (a welcome relief to the upper 30’s temperatures outside). We spoke to three young guides about their experience of taking young people round. This led to some good discussion about what would work in Scotland and what would not, and about the needs and responses of different age groups. What has impressed me about these guides and about the approach of W-West is that they emphasise the need to deliver information about smoking in a completely non-judgemental way.
As W-West member, Michael Caine said, ‘it’s not like your parents saying “don’t smoke”. We just give them information and let them make up their minds. The decision to smoke or not to smoke is theirs.’ There is a subtle difference here between pressure from elders, and peers suggesting that it is up to you – you take responsibility. But if you go ahead, here’s what is likely to happen….The general feeling of our five W-West members (and honorary member Euan) is that the exhibition is ‘brilliant’. There’s lots they want to do with it, to adapt and extend it for the Scottish context, but they are now turning attention to fund raising to get it here.
We will be on the plane back home on Sunday (19th) with a reunion of our team on 31st March to discuss next steps. It has been a fabulous trip, we’ve met some wonderful people, but best of all, we have formed a strong team and all got on well. I think this bodes well for the future and for the prospect of seeing a ‘Breathe Scotland’ exhibit opening in Glasgow very soon!
Andrew Russell, Durham University
Jane Macnaughton, Durham University
Sue Lewis, Durham University
Megan Wainwright, Durham University (and our indispensible guide)
Brian Pringle, Director of Projects and Service Development at Ash-Scotland
Melanie Owens, W-West Lead, Greater Glasgow and Clyde Health Board
Michael Caine, W-West
Nick Carr, W-West
Nicola McFadyen, W- West
Catey Caine, W-West
Emma McFadyen, W-West
Euan Russell, Honorary W-West