Southwest Europe’s Surfing Peaks at Easter
“We can breathe again, so we have found our voice again, but our neighbours are not so lucky yet, but hopefully soon we will all learn that liberty cannot be taken away by a medical intervention that is not based on good medical evidence (clinical evidence)”, medical specialist and medical director. “It is like a wave, some have freedom now, some don’t, it comes and goes, but like the famous song goes, if one of us is in chains, we are all in chains, we need to ask questions, speak up, protect those without a voice, so that this pattern stops”, medical specialist, expert in the field. “I have survived the pandemic only because I surfed and windsurfed most days, so I could have normal, where the world made sense, where truth and beauty lead”, GP.
Further to recently travelling along the south coast of Iberia, travelling west then north along the coast in Portugal, mid Algarve to Ponta de Sagres and then north along the coast to Cabo Ortegal, Spain, and along the northern Spanish coast to San Sebastian then Biarritz in France and finally along the Pyrenees mountains to Banyuls-sur-Mer and the beautiful D914 to the border of Spain, and along the Mediterranean coast in France towards Italy, we observed significant variations in culture, unique beauty and opportunities, along with excellent surf.
One of the reasons for our trip was to meet with colleagues in the south of Iberia to discuss child mental health needs and services. We have worked with interpreters since 2004; for instance, we have seen children in the UK, children with families or unaccompanied minors, from Asia, Africa and Europe, language is never a barrier for doctors. Many of the areas where we have offered services have various local languages and dialects, language cannot prevent children from an effective and user-friendly service. Many of our patients, children or adults, are also non-verbal, however mental health and risk assessments can still be completed, as most communication is non-verbal. Doctors who offer services in different countries and cultures often benefit as much as the communities where they work, because with every patient or local colleague they learn something new.
We share our observations and areas of extraordinary beauty as requested:
Every country or area presents with strengths and weaknesses, which vary, depending on time, seasons, environment, leadership and many other factors.
Some Strengths: We could not spend a significant amount of time in most places, especially northern Spain, but would recommend the trip with a focus on ocean, mountains, nature and camping.
Extraordinary beautiful coast, roaring ocean in too many areas to mention
Around Lagos – snorkel, caves, rock formations as dramatic as in Thailand or Greece
Ponta de Sagres – uniquely beautiful and excellent walking
Zambujeira do Mar – beautiful surf
Odeceixe – beautiful surf
Estoril and Cascais – as above
Praia de Guincho – as above
Supertubos beach south of Peniche – excellent beach and casual dining
Pinhal de Leiria north of Nazare (fire destroyed some of the area north, but the beauty remains)
Cabo Fisterra close to Santiago de Compostela – dramatic and beautiful
Cabo Ortegal (north) – most extraordinary route – arrive very early
Beautiful Petites Pyrenees – take the smaller mountain roads such as the D117 towards St-Martin-Lys
The D914 between Coullioure and the border of Spain (Mediterranean coast) is extraordinary with excellent diving and snorkelling opportunities
Windsurfing between St Cyprien-Plage and Canet-Plage (30C)
Further north of Perpignan – horse riding
Kitesurfing south of Port-la-Nouvelle
Driving east along the coast to Marseille (excellent seafood), Toulon and along the D98 to Cap Camarat (excellent walks) towards Juan-les-Pins (excellent Jazz festival in Summer – our favourite performance was New Orleans’s Preservation Hall Jazz Band in 2014 or 2015) and then to Menton filled with orange blossoms in Spring.
• We arrived from outside of the EU and the first thing we noticed as different compared to many other countries was the opportunities for wonderful and simple fish dishes; most eat fish twice a week at least.
• Salsa is a common theme in Latin America, Florida, Portugal and Spain. We heard salsa music all over Portugal, the Portugese islands and Spain. The only difference is that most people danced in Latin America. We are connected by music and food. This is often the turning point when we meet with refugee children or unaccompanied minors – our joint interest in food and music – how many connect with communities. Food is a wonderful theme. We enjoyed wonderful local cheese and breads from Portugal to Spain and to France and Italy. There is no better way to experience the terroir, the climate, the culture than talking to people, sharing food and music, and often, dancing, or in Portugal, surfing. Culture around food is educational. Most say that they always arrive too early for food in Spain (arriving at 5-6pm, but waiting for dinner served from 8pm often in the areas we visited) and too early in France (lunch often ends at 2pm or 3pm).
• Most of the markets were indoors in Spain and Portugal, but outdoors in sunshine in France during this trip.
• Portugal and Spain provided wonderful shows of blooming flowers, Azaleas, Rhododendron and Magnolias. Portugal was more or less 17-23C along the coast, towards the northern coast in Spain more or less 17C, and in France 25-28C away from the coast with blooming Lilacs. Witnessing the changes in temperatures and subsequent changes in nature, the ocean and blooming flowers is reason enough for this trip in Spring, before the waves calm slightly.
• Sailing, snorkelling, diving, surfing, kayaking, biking, camping, walking, hiking, running opportunities everywhere along the coast.
We are frequently asked, since early 2020, by patients, their families and colleagues what we suggest in terms of “travel opportunities to recover health” or “travel opportunities to keep health up”.
We usually recommend areas where:
1. Good clinical evidence is followed at all times.
2. Clinical thinking or approaches, based on clinical (medical) training, clinical experience and good clinical evidence is adhered to, along with laws relating to capacity, confidentiality, liberty and autonomy.
3. Protective factors for general and mental health, based on good clinical evidence, are adhered to, such as normalcy and prioritising education relating to health and safety for children and adults. Areas where education is prioritised in the context of the pandemic are usually associated with calm and positive individuals within the general public and medical profession. Calm and positive mental states usually lead to good health and mental health and reduced risk.
We arrived in Iberia from the abroad and no passengers were asked about recent symptoms, recent positive tests or recent contact with individuals with symptoms or positive tests on our 7-14 day journey to Europe. We were however informed that “masks have to be worn everywhere” in Iberia.
In Portugal and Spain every shop or business owner asked individuals who have medical exemption for face masks why they are not wearing masks and then for proof of medical exemption (a GP letter). This is not a pattern we observed in any other European country or country where face mask exemption was accepted. Most were not aware that medical exemption was possible and needed to see the government web page, which was shown. Shop or business owners informed us of how “stressful” it was to “have to enforce masks”. It was reported that “many became aggressive when masks are not worn, some faint, some run to the corner of the shop, people call each other murderer, it is a nightmare, people tattle on each other like it is war”, shop owner. Most agreed that “we know that masks are not backed by good research (good clinical evidence) and that the things that have good research behind it like education is not done”, shop owner. Many reported that they did not know that they could get medical exemption for face masks, and said that they avoided shops or anywhere where they have to wear a mask, and sometimes ask friends for favours, many said “it has disabled us”, veteran.
We observed that most individuals did not cover their mouths when sneezing or coughing, and that most restaurants served individuals with significant symptoms of colds and flu (the culture is not to remain at home if significant symptoms from our observations during this trip). Many reported that they were “extremely sad to see what has happened to this world with everyone in masks, and no one any wiser on how to keep healthy”, GP.
We observed a significant sense of fear in the areas were travelled in Portugal and Spain, less so in the south of Portugal, but much more so compared to France or other areas in Europe where masks are not compulsory. “For some, if you wear a mask or see a mask your emergency signals go off, you know something is really wrong, and you go in stress mode, you know nothing is normal, so when masks stop, people relax and become hopeful sometimes, and that helps more to keep you healthy than a mask, and people also leave their homes, because they have avoided life with masks – I say this because I see people in clinic every week who hate themselves, because they cannot cope with masks, and if people know it is ok and many feel this way, that it doesn’t make them abnormal, this protects many people, so we need to be honest with what we see in clinic, this is how we protect people and our jobs as doctors are to protect people’s health – I know doctors would never have gotten ethical approval to masks people for a research study, so it is interesting that this happened so fast and so vast, even though it has no good evidence backing it”, GP.
Colleagues avoided hotels or shops and remained in areas or engaged in activities where masks were not mandatory, such as camping, biking, walking or surfing.
Colleagues reported “extreme joy to reach France where we can breathe again”, medical specialist. “I can breathe again” is a phrase we hear very often from patients and colleagues. It is interesting to observe the noticeable change in anxiety crossing into France; face masks are not mandatory, are worn by less than 5% from our observation, most are calm and positive, laughing with friends and making jokes.
As we have mentioned before, statistics support the approach regarding masks taken by countries in Asia in early 2020, such as Singapore, and countries who have subsequently taken steps to prioritise good clinical evidence, education, liberty, autonomy and normalcy.
“I hope this wave that we are seeing where countries are dropping restrictions and returning to normal reaches us too, because we need it, having no normal, no choice, no freedom (“we have no freedom or choice to wear masks, this now year 3″, GP) for going onto 3 years now is wrong on so many levels, and it hurts people’s health, mental health and safety, but people remain quiet, doctors remain quiet, courts remain quiet, is it too much to ask to follow good clinical evidence and to respect laws relating to liberty, autonomy, confidentiality, capacity, protecting adults and children taking a systemic view – we need people who care and understand these things, with training and experience, to stand up, speak up, make their voices heard, medical opinions clear, this is an international problem, we need to work together”, medical specialist and medical director.
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