Born in
Lisbon on 24 February 1912, Maria Palmira de Macedo Tito de Morais was the daughter of Carolina de Antas de Loureiro de Macedo and Tito Augusto de Morais. Her father was a naval officer and an active member of the
Portuguese Republican Party, who played a leading role in the
5 October 1910 revolution that overthrew the monarchy in Portugal, taking command of the warship
São Rafael, which bombarded the
Necessidades Palace, residence of the king. He would eventually become an admiral and also served as governor of
Portuguese India. Her elder brother was the socialist leader
Manuel Tito de Morais, one of the founders of Portugal's
Socialist Party and its Secretary-General between 1986 and 1988. Tito de Morais did not attend school beyond elementary level, being schooled at home. In 1935, at the age of 23, she completed a course in singing at the
National Conservatory of Lisbon. Deciding to continue her studies, she chose to pursue nursing. However, the male tradition in nursing and the low level of female education in Portugal generally prevented the access of women to the nursing profession at that time and there were virtually no facilities for nurses' training in Portugal. She took advantage of a fellowship provided by the
Rockefeller Foundation to study in the US. At the same time, two others were selected to study in the medical field: Jaime Pereira, for sanitary engineering and Maria Angélica Lima Basto for nursing. Her younger brother, Augusto, was also a Rockefeller beneficiary, studying at
Harvard University. Her fellowship was approved for the period of one year, starting on 1 September 1936 and later extended until 1939. In the summer of 1936, she spent time in the wards and surgery rooms of a hospital in Lisbon, visited the Ministry of Health to study its organization, and went to various locations to study the handling of epidemics,
tuberculosis, and infant welfare, with the intention of being able to judge differences between what she saw in Portugal and what she would see in the US. She initially attended the
Case Western Reserve University in
Cleveland,
Ohio but this did not provide the certification that would be accepted in Portugal and so in 1938 she transferred to the
University of Toronto in Canada, where she obtained qualifications in public health nursing. ==Career==