The Italian Healthcare System

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1428853231351Living in a foreign country, one doesn’t become familiar with the healthcare system unless the need arises. Unfortunately, the need arose and I’ve found more about healthcare in Italy in the past month than I really wanted to know.

1428853577252Italy ranks 2nd after France in the WHO 2000 ranking of healthcare systems in the world. Canada incidentally ranks 30th, the US 37th and the UK 18th. I haven’t actually read the report so I’m not quite sure what it’s based on and it is somewhat out of date I’m sure. In Italy, healthcare is provided to all citizens and residents through a mixed public/private system. Emergency care is free to all including tourists I believe. However, there’s wide regional variation in th quality of care. Hospitals in the north are generally highly efficient while those in the south tend to be less so. Rome falls somewhere inbetween. Here, there are very good, modern, ‘state of the art’ hospitals like the one on the left and then there are others which date back to the Xth century like the one above, but which have been renovated, rebuilt or had new buildings added over the years.

Family doctors are assigned based on the area in which one lives. If a family doctor requests a particular test, one can go to a public facility, pay a fee and go on a short waiting list. One can also go to a private facility, make a small co-payment, and have the test done immediately. A test can be done even if it hasn’t been requested by a family or other doctor but the payment in this case will be in full. A visit to a specialist can be done through the public system with a possible waiting time and sometimes a fee which can be claimed back depending on one’s income bracket, or privately for a much higher fee. If hospitalization is involved, one can use the public system which is free, or opt for a private hospital which is quite expensive. Usually, the same doctors work in both systems so there is no difference in medical expertise. From what we’ve seen so far, the doctors here are highly trained and very capable. However, there’s a big difference in waiting time for tests and in the level of patient comfort. Where in a private hospital, everything is well-coordinated and geared towards the optimum well-being of patients, public hospitals can vary considerably in this regard. Some are no doubt highly efficient. Others can be disorganized with lack of communication between the different departments and a shortage of good nursing care.

1428853853760I wouldn’t want to be sick and in need of medical care in any country but from what I’ve seen, there are worse countries to be sick in than Italy. One thing I found amusing was a cafe/bar in one of the hospitals we were in. Notice the bottles of champagne on the shelf in the picture on the right. I guess one might either be celebrating a cure or drowning one’s sorrows. Hopefully, friends and family of the patients and not the medical staff!

 

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Auguri di Buona Pasqua

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Casiatello

Casiatello

Easter or Pasqua is a big festival in Italy. It marks the end of Lent which consists of 40 days of prayer, fasting and abstinence. Not that too many lay people take that seriously but the celebration of the end of Lent is a given. It occurs on the first Sunday after the first full moon following the spring equinox and also celebrates the arrival of spring.

1428183333970Food as always plays a big part and eggs are a big feature with different regions having their own specialties. The eggs are a symbol of fertility, life and renewal. The Easter bread above, Casiatello, comes from Naples. It has bits of cheese and prosciutto through it and the shape symbolizes the crown of thorns placed on the head of Jesus when he was crucified. Only in Italy! Pizza Pasquale is another light bread with bits of cheese and prosciutto that one only sees at Easter. Colomba (dove) is a very light cake in the shape of a dove with candied peel within and almonds on top. Specialty shops have different types some with chocolate or exotic fruitsall beautifully wrapped to be given as Easter presents. Lamb is traditional on Easter Sunday and here in Rome, it is usually abbachio which is cooked with a garlic and anchovy paste. Lunch features dishes with eggs or lamb. I’m looking forward to seeing what will be served tomorrow for lunch at a Roman friend’s house.

Via Crucis at the Colosseum

Via Crucis at the Colosseum

Anyhow, before getting to the Easter Sunday celebration which commemorates the resurrection of Christ, there’s Good Friday which marks his crucifixion. Many churches have a Via Crucis, a procession re-enacting the Stations of the Cross. The biggest one in Rome is presided over by the Pope. It starts at the Colosseum at 9.15pm and goes to the Palatine hill a short distance away. It’s not a procession as such, since there are thousands of pilgrims and only the people involved in the carrying of the cross can actually make their way along the path. I went to it last night and though I couldn’t see much from where I was, it was quite a sight to see so many people gathered in prayer in front of the Colosseum with the full moon rising above and the Pope on a covered podium with a giant cross behind him lit with flaming torches.

1428183447071And then of course there are the Easter eggs. I have never seen people buying so many Easter eggs as they do here and apparently everyone buys an egg for their dearest and closest. I myself prefer the little mini-eggs but I’m told that the larger ones contain a surprise inside which varies dependig on how high-end the egg is. The largest egg on the left was Eur 88 and though I would love to know what’s inside, I won’t be buying one! So, on that note, Happy Easter to all my readers and I hope you all get an Easter egg tomorrow.

 

 

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Rome’s 21st Marathon

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1427660496722It’s a bit late to be talking about the marathon as it happened a week ago on Sunday March 22nd but it was interesting and I thought that those of my readers who are runners might like to know more about it.

Photo from 'Corriere della Sera'

Photo from ‘Corriere della Sera’

The weather was a little on the cool side for Rome which the runners likely welcomed, and the day started out with rain. For some reason, Rome combines the marathon with a 5k run/walk for anyone who is interested, and this starts about 15 minutes after the marathon begins. This year, the there were about 19,000 marathon runners and 80,000 or so participants in the 5k run. As you can see from the picture on the left, the rain did not deter the less serious runners.

1427660338298The route is spectacular and takes in most of the historic sites. It starts at the Foro Romano close to the Colosseum, and passes the Trevi fountain, the Spanish Steps, Piazza del Popolo and St. Peter’s Basilica to mention a few. A lot of the route goes through narrow cobbled streets so making headway with the crowds involved, is a challenge and it can be hard on the feet. It didn’t slow down the first person to finish, Ethopian runner, Ngewo Abebe Degefa who did it in 2h 12′.

The centre of the city more or less grinds to a halt as neither buses nor cars can traverse the city. I’m ashamed to say that we forgot about the marathon until after lunch. We had to walk to the finish line since there were no buses and we got there for the end of the race, 6 hours after the start. There were still people going past the finish line but they definitely weren’t the cream of the crop though I guess 42 km in 6 hours is still an achievement. Maybe I’ll do the 5k next time around, I know I could do that in 6 hours!

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Lasagna Al Ragu’ Bolognese

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1426964042805A couple of weeks ago, I went to a concert with a friend after which we went for dinner. The restaurant was one where I had eaten before, and where the food is generally quite good. We both ordered lasagna but to my disappointment, it was awful. When I related this to Fidz later, he said “You should know better than to order lasagna in Rome, they don’t know how to make it properly here”. Fidz is from Emilia-Romagna where lasagna originally comes from. The meat sauce or ragu’, as it is called, hails from Bologna. Hence the description ‘ragu’ al Bolognese’ and the derivation of the Italian-American Spaghetti Bolognese, though in Emilia, this ragu’ would not be served with spaghetti but with fettucine or pappardelle.

1426964597226Anyhow, I wanted to invite one of the women in my choir over for lunch. She’s very kind and insists on dropping me home after practice even though she lives around the corner from where we meet and has to cross the city to bring me home. I couldn’t think of what to make. My friend is a Roman nonna (grandmother) and likely a very good cook and I wanted to ‘fare una bella figura’ (make a good impression). I decided to make lasagna as I make the traditional Emilian one using a recipe by Marcella Hazan who came from there, and even Fidz agrees that it’s good.  It turned out well and everyone enjoyed it so I was quite pleased with myself! And what have the flowers above got to do with anything? My friend brought them over as a present (she wanted to fare una bella figura as well!) and even though my lasagna tasted good, the flowers looked a lot better so I couldn’t resist showing them.

Ingredients

Ragu':

Simple to make but needs to simmer for 3 hours so I make three or four times the amount and freeze it

3/4 lb (300g) minced beef

2 tabspns olive oil and 2 tabspn butter

1 small onion,  1 small carrot, 1 stick of celery all very finely chopped to give about 2 tabspns of each

1/2 cup milk (110 mL), whole milk is best,

1 cup white wine (225 mL)

2 cups canned whole tomatoes

1 tsp salt, 1/8 tsp nutmeg

1426963957078Melt the butter and oil on a low heat. Add the finely chopped onion, saute for a couple of minutes and then add the carrot and celery. Saute gently for a few minutes until the vegetables soften. Add the beef and salt and saute until the meat browns. Add the wine, increase heat to medium and cook until the wine evaporates. Add the milk and nutmeg, reduce the heat and cook until the milk is evaporated. Add the chopped tomatoes and simmer for 3 hours or more if you have the time.

Bechamel Sauce

The quantity depends on the size of your pan. I use a 12″x 9″ (30cm x 22cm) pan.

4 cups milk

4 tabspns butter

4 tabspns flour

1/2 tsp salt and 1/2 tsp nutmeg

1426965167619Heat the milk to just under boiling point and set aside. Melt the butter on a low heat, add the flour and cook until golden. Add a little milk and mix to a smooth paste (I find it easier to get a smooth sauce if I remove the pan from the heat). Continue adding the milk and mixing well until all the milk has been added. Return to the heat, add salt and stir continuously until the sauce thickens and just starts to bubble.  Remove from the heat, add the nutmeg and cover with a lid to prevent a skin from forming. Best to use it immediately.

Pasta

I buy readymade fresh pasta but if you can’t find this, I’ve also used the dried variety which does not require boiling before assembling the lasagne and it works fine. You will need enough for 4 layers.

Parmesan cheese

1426967486516Freshly grated parmesan is best. If you do a lot of Italian cooking, it’s well worth investing in a micrograter as nothing else gives you fluffy, light parmesan. You will need enough to sprinkle lightly over each layer.

The grater is also great for lemon or orange zest!

Assembling the lasagne

1426964901681Spread a thin layer of bechamel on the bottom of the pan and cover with pasta.

1426964235402Then add a layer of meat, a layer of bechamel, followed by a sprinkling of parmesan. Make 2 more layers in this way. Marcella mixes the bechamel with the meat sauce but I haven’t tried it that way yet.

1426964316731Finish with a layer of pasta, a layer of bechamel and a sprinkling of parmesan. Bake at 180C for 30 minutes. Raise the temperature to 200C and bake for another 10 minutes until the top is bubbling and golden. Remove from the oven and allow to rest for 10 – 15′ before serving.

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Pasta Rules

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1426431849492Until I met Fidz, my idea of eating pasta was to make a sauce and to simply open my kitchen cupboard and choose whichever pasta might be on the shelf to go with it.  Wrong. It wasn’t until I started living in Italy that I came to realize how carefully people match pasta with sauce. Choosing the right pasta to go with a particular sauce has rules and Italians  actually follow them!

1426431962156First of all, there are two types of pasta, egg-based (non-durum wheat) and water-based (durum wheat). The egg-based pastas traditionally come from the north where originally, wheat grown here had less gluten (the component in wheat that affects elasticity and stretching). Hence the pasta could not be rolled in long sheets and cut in long thin strips to make spaghetti but was better suited to pasta that is rolled out in smaller sheets and cut in ribbons to make fettucine, lasagna, tortellini, ravioli etc.

1426432140294Water-based pasta on the other hand, originates from the south and historically, being of a higher gluten content, was sturdier and could be extruded into shapes like maccheroni and penne. By the way if you order penne in Italy, make very sure that you pronounce the double ‘n’. A single ‘n’ as in pene, means penis! But I digress……………Pasta existed in Italy long before Marco Polo, contrary to the belief that he introduced it here from China. However, it was the Arabs in Sicily in the 8th century who introduced dried pasta which allowed it to be stored, carried on long journeys and prepared quickly thus turning it into a staple food.

1426432409689As for the marriage of pasta and sauce, it’s very confusing especially as there are hundreds of pasta shapes, many with charming names, which vary from region to region. All I can tell you is that mini shapes like orzo, farfallette (mini butterfly bows), annelli (rings) go in broths and soups. Egg-based pasta is generally used for butter or cream sauces. Stuffed pasta like tortellini or ravioli is served with very light butter based sauces which do not take away flavour from the stuffing within the pasta. Medium weight strands like spaghetti, go with a sauce which sticks and slips along the strand like simple olive oil with chili and/or garlic, or sea-food sauces based on olive oil and tomato paste. Heavy chunky sauces go with tubular shapes like penne (quills) so that the sauce can get inside the tubes. Scooped shapes like orecchiette (ears), are good with drier sauces which can be trapped within the scoop. Twisted shapes go with pesto or heavier cheese sauces which can get caught within the twist. There are endless and particular combinations but basically, think about how the pasta will catch the sauce and whether the pasta is egg- or water-based.

1426436756182A few tips about cooking pasta. Use plenty of boiling salted water and for most pasta, cooking time will be between 8 to 10 minutes (usually indicated on the package). Never over-cook pasta, it should always be ‘al dente’ (basically its core should remain a bit harder than the outside). Always keep a little of the water when you drain the pasta as this can be added after the pasta and sauce are mixed if the combination ends up being too dry. If parmesan is added at the end, it will become even drier and the best way to moisten is with the cooking water.

Finally, if you come to Italy and see ‘Spaghetti Bolognese’ on a menu, walk out of the restaurant as it is most certainly geared towards tourists. This dish is an American-Italian invention and does not exist here as such. Incidentally, neither does Caesar’s salad!

 

 

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The Pipes are Piping

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St. Stephen's Church (The Pepper Canister)

St. Stephen’s Church (The Pepper Canister)

I do not need a lot of encouragement to visit Dublin so when I got an invitation to a retirement event in honour of a friend and ex-colleague, I was only too happy to have an excuse to go there last weekend.

Dublin is a lovely city as I described in a previous post, but what stands out is the warmth and humour of the people. 1425732537227The retirement event was held in Trinity College where one of the buildings is connected by a covered walkway above street level to the adjacent Pearse St. train station. The walkway has glass sides and one can see people walking across it from the street below. The locals refer to it as ‘The Bridge of Thighs’. Only in Dublin………………..! St. Stephen’s Church above is referred to as the Pepper Canister or the Pepperpot Church and you can see why.

Gay McEown

Gay McKeon

One of the highlights of our visit (and there were many!) was getting a chance to see how the Uilleann (prounced ill-uhn) pipes (Irish bagpipes) work. We went to Hughes Pub, where traditional music is played every Sunday, at a time when the musicians had just arrived and before the pub had filled up. Our friend Renee who took us there knows the musicians and introduced us to the Uilleann Pipe player, Gay McKeon. He kindly showed us how the pipes are constructed and played. The word ‘uilleann’ means elbow in Gaelic and refers to the fact that the pipes are played by pressing air out of a bag using the elbow. It is a much more complicated instrument than Scottish bagpies or the Italian zampogna and in addition to the bag, it has bellows to blow air into the bag, a melody pipe or chanter which has a range of two octaves, three drones which provide the underlying sound and three regulators or closed pipes which give a rhythmic or melodic accompaniment to the melody. The pipes and drones produce their sound through the use of reeds. Gay was leaving the next day for Mexico city and had to get a special set of spruce reeds from the US as the air in Mexico city is so dry and different from the moist air of Ireland that the sound of the reeds would be affected. As you can imagine, playing the pipes requires a lot of co-ordination, a good ear and years of practice. Gay told us that he had started learning the pipes at the age of 9! Making the pipes is also an art and a full set of Uilleann pipes can cost around Eur 10,000 though there are simpler practice sets which are cheaper.

Cobblestones Pub

Cobblestones Pub

Irish music is played by ear and is improvised, so the tradition is handed down from teacher to student. Naturally, a lot of musicians come from musical families. In Cobblestones and Hughes Pubs on a Sunday, musicians gather randomly to play together. I was pleased to see a number of accomplished women musicians as well as a number of young musicians. Its good to know that the tradition carries on. Interestingly, Gay told us that the Uilleann pipes are popular in a number of countries and he gives lessons through Skype to people in Cuba, Mexico and even in Italy.

Guinness is Good For You

Guinness is Good For You

Finally, I have to add that listening to Irish music in a pub calls for a good pint of Guinness and there was no shortage of that!

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Urban Birdwatching

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1424717752392Every few days there’s a raucous squawking outside our window and we see these green parakeets picking berries or bursting open pomegranates on the trees outside. It still takes me by surprise as seeing parrots in the wild is something I associate more with India or Africa than with Rome. I first saw parrots here on the Via Appia Antica where there’s a flock of them close to the Catacombs. I assumed that someone had once let loose pet parrots and that they had survived and multiplied. I’ve heard that one can also see them in the gardens of the Villa Pamphili and the Villa Borghese but to see them so close to buildings is surprising. I’m not sure if there’s a shortage of food or if they’ve just adapted to urban life and are spreading.

1424718755673There are lots of birds in Rome. We see swallows swooping down in the mornings which is a real pleasure when its warm enough to have breakfast on the balcony. Starlings cover the trees near Termini Station in the Fall filling the air with their chirping at dusk (and leaving a helluva mess below for the city to clean up!). It’s very pleasant hearing birdsong and seeing birds flying about but the seagulls have become a problem. No longer do you have to go to the seaside to see gulls skimming for fish along a lonely coastline. They’ve all come into the city. Rome has a communal garbage system and I guess they have easy pickings in the large bins on every street. You see them atop the statues and monuments making a mess and quite unafraid of people walking by.

1424716409097Every year, towards the end of January, the Pope would release a couple of doves in Piazza San Pietro as a sign of peace. Last year, no sooner had two white doves been released when a seagull attacked one and a crow set upon the other. People watched with horrified fascination as the poor doves were viciously attacked. Animal Rights activists pleaded for the practice to be stopped so it didn’t happen this year. However, it’s not only gentle, peaceful doves who get brutalized. Last week we were in front of the Palazzo Montecittorio (Parliament building) when all of a sudden we heard a party of American schoolgirls screaming and shrieking. We went over to see what had happened and saw two seagulls viciously tearing a pigeon apart and fighting for the choicest pieces. Luckily, it was well dead and mostly consumed by the time we saw it as it was not a pretty sight. Interesting that we should have come upon this outside the Parliament building and perhaps an apt metaphor for what must go on inside!

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A Festive Weekend

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Chinese New Year Performance, Piazza del Popolo

Chinese New Year Performance, Piazza del Popolo

Not only was it Valentine’s day on Saturday, but there were also celebrations for the Chinese New Year. Valentine’s day is not a big deal here except that the flower shops hang a few red hearts outside and some restaurants have started offering Valentine’s Day dinners.

1424008218178It was a beautiful day with sunshine and blue skies so we went to Ostia on the coast for lunch where seafood was the order of the day.  We haven’t been eating desserts since Christmas but being Valentine’s day, we made an exception and indulged.

 

 

Piazza del Popolo

Piazza del Popolo

Back in the city, there was a Chinese festival at the Piazza del Popolo. The name of the Piazza translates as the ‘People’s Piazza’ but in actual fact it takes its name from the church of Santa Maria del Popolo which was built on top of the tomb of the Roman emperor Nero  over which grew a poplar tree. Or so the legend goes anyway. It was the site of public executions until 1826 but is now a pleasant spot for public celebrations and gatherings. A huge stage had been set up and we were entertained by various types of Chinese performances from music and dance to gymnasts.

1424105198729Carnival celebrations were going on all over the city and the streets are littered with coriandoli (what in English we call confetti) which is being sold in little packets by street vendors and newsagents. Children dressed in costume were running around throwing it on each other. There were a few adults in costume as well and for us, it was a bit reminiscent of the Halloween weekend.  Of course, all celebrating stops after Martedi Grasso or ‘Fat Tuesday’ but more about that when it actually happens.

1424105501418

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Habemus Presidente

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1423491020468With the appointment of our new President Sergio Materella, the weeks of political speculation have ended. He was inaugurated a week ago following the resignation of Giorgio Napoletano in mid-January.

1423513091044It was strange to see the Presidential Palace (Palazzo del Quirinale) only flying the flags of Italy and the EU during the time that there was no President. Normally, the Presidential Flag flanks the Italian flag at the Quirinale. Hopefully, we will not see the flag staff bare again for some time. The President mostly plays a ceremonial role, meeting visiting dignitaries and such, but he can play a vital role in time of political crisis which seems to be the norm in Italian politics for the past few years. He is responsible for guaranteeing that Italian politics complies with the constitution and he appoints the Prime Minister.

www.quirinale.it

www.quirinale.it

Sergio Matarella is a Sicilian constitutional court judge closely associated with the fight against organized crime. He entered politics after his elder brother, who was the President of the region of Sicily, was murdered by the Mafia in 1980. Favoured by the Prime Minister, Matteo Renzi, his appointment will hopefully help to bring about the political reforms that Italy so badly needs.

1423506656202Giorgio Napolitano resigned at the age of 89, claiming fatigue. He looks remarkably fit as you can see in the photo above but its no wonder that he’s tired. He tried to leave after his first term of office which lasted from 2006 to 2013 but no agreement could be reached on electing his successor, so he reluctantly agreed to continue for a second term. Last week, we were at a concert at Rome’s concert hall built by Renzo Piano. All of a sudden, spontaneous applause broke out on the main floor. We craned our necks to see what was happening and saw Napolitano walking down the central aisle to take his seat. Word must have spread because when the conductor Antonio Pappano came to the stage, he made a short impromptu speech thanking Napolitano for supporting the Arts during his term of office. It was very sweet and a nice way for Napolitano to start enjoying his well-earned retirement.

 

 

 

 

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Beyond the Walls

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Vatican State (Partial View)

Vatican State (Partial View)

The Vatican State encompasses a huge area (about 110 acres) just east of the Tiber in the city of Rome. It is completely surrounded by walls over 30 ft high, except for the part in front of St Peter’s Basilica. I walked around it once and it took me an hour at a fast pace.

Vatican Walls

Vatican Walls

Since we live close by, anytime we want to get to the neighbourhood north of it, we have to make a huge detour as one can’t go across it. I’ve always wondered what its like inside the walls so when a friend who is a nun and who has access to the Vatican Farmacia asked me if I wanted to join her on an excursion to the Farmacia, I jumped at the chance.

 The Vatican State is all that remains of the once extensive Papal States which were secularized during the unification of Italy between 1860 to 1870.  So called because the land on which it sits used to be called Ager Vaticanus, it was created in 1929 through the Lateran Treaty between Pope Pius XI and King Vittorio Emmanuele III of the Kingdom of Italy. It was actually Mussolini who signed the treaty on behalf of the King.

communiostblogs.org

communiostblogs.org

It is an independent entity which can issue its own passports, stamps and currency. Its currency is the Euro even though it is not part of the EU. With a population of about 850, it has its own newspaper, Post Office, bank, radio station and even a railway station. Most countries including Canada have two embassies in Rome, one for Italy and one for the Vatican. The embassies to the Vatican are not situated within the walls.

There are three gates into the Vatican which are normally accessible from the city of Rome, all manned by Swiss Guards.

Porta Sant'Anna

Porta Sant’Anna

We entered through Porta Sant’Anna which is the busiest gate and allows access to cars as well as pedestrians. Interestingly, the Guards posted here don’t wear the typical colourful robes of the Swiss Guards but a blue uniform (covered with a cape during winter). The pink building you see just inside the gate to the left are the quarters of the Swiss Guards. Once inside, we made our way to the Farmacia past a supermarket and the Post Office.

Farmacia

Farmacia

There is no tax payable within the Vatican which is why people who have access to the Farmacia prefer to buy their medicines there. I was expecting a sort of basic dispensary but to my surprise, it was like any other pharmacy in the city. Larger and better stocked if anything and to my amazement, with a fine collection of perfumes and cosmetics by Gucci, Dior, Chanel etc. I didn’t need anything but I did buy a tube of toothpaste which was indeed cheaper than in our local cut-price supermarket.

Vatican Bank

Vatican Bank

To my disappointment, it was not possible to freely wander about as there are more walls inside and lots of buildings with high locked gates. The gardens occupy a large part of the land but these are kept locked and are only accessible to the public if you pre-book a guided tour. The bank is within a fortress-like tower. When the Lateran Treaty was signed, the Vatican received a financial settlement from the Italian State for the loss of the Papal States. This consisted of 750 million lire in cash and 1 billion lire in the form of government bonds. This was used as seed money for Vatican investments and the less said about the Vatican’s present assets, its property empire and financial scandals the better! Incidentally, the Lateran Pact stipulates a 5 year prison sentence for an Italian citizen who makes a public joke against the Pope ‘whether by means of speeches, acts or writings’. No wonder the media don’t make jokes about the Pope.

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