He says, "Life on the outside..."

Everyday is much the same. I wake at 7:30am and open the curtains. Outside the weather is cold, grey and uninviting. People wearing brightly coloured jackets pass by on bicycles (no one wears helmets) on their way to work or school.

I make my way from room 221 down to the breakfast bar. The coffee is weak. I have to make a cafe latte and then an additional jug of espresso to reach the required strength. For a country so obsessed with coffee, they make a lousy brew. Someone really needs to make a visit to Melbourne or Wellington to learn how to make a decent flat white. I am proud to be an antipodean coffee snob.

After breakfast, a mix of cold scrambled egg and soggy bacon, I make my way to work. It is a 3.7km walk through beautiful gardens and rows of antique homes straight out of Home and Garden Magazine. The daily walk to and from the hotel has become the highlight of my day. A time of good physical exercise but also time to think and survey the situation.

To be honest, from where I stand, things look pretty ordinary. That's ordinary in the Australian sense. In other words, things look pretty bleak, just like the weather.

I have come the office each day this week except for Monday which was a public holiday. Something called Easter, apparently. I am not sure why I bother as there's no real work to be done? I think it is the free lunch, coffee and unlimited Wi-Fi.

I have been told that for the good of the organisation, I should take a step back from my role as Country Director for Siberia.
 
After we left for South Africa, the good people at HAC (the Humanitarian Aid Commission) put the clappers on my colleagues. Scared them into the naughty corner and told them to behave or face the wooden spoon. The thing about HAC is that they are more bluff than bite. Lots of smoke and mirrors but very little fire.

Unfortunately my colleagues aren't regular poker players and fell for the bluff; far too easily in my  personal opinion. They're a little raw, a little immature and without good leadership looking like a herd of lost sheep heading for the proverbial cliff face. I'd be a little worried, but it's not my problem anymore.

In effect, HAC and some of my senior colleagues staged a coup in my absence. They decided that the organisation would be better off without me. Sad, disappointing and left  feeling a little betrayed. Still these are good people and I wish them no ill. They've got caught like a kangaroo in the headlights and didn't know which way to hop.

So, I am a Country Director without a country. Like being a teacher without a class of ratty kids or a Doctor without any sick patients. It's kind of boring and unsatisfying..

She is back in Siberia sorting out our four legged friends and making final preparations for our move to Nairobi. It's not nice being apart, with crappy internet and some friends/colleagues making their displeasure at her being back in Siberia rather obvious. They somehow think our very presence will spur HAC into action. A little paranoid in my opinion.

Next stop, on the Siberian Express, is Nairobi....

After Siberia, life in Nairobi will feel like paradise. Good coffee, nice restaurants and cafes, alcohol. bacon and the promise of regular camping trips to Lake Naivasha, weekend safaris and trips to the Indian Ocean at Mombassa and Diani. Hopefully a garden for the boys to run around in and take a dump. Some weather cold enough to justify an open fire... All good things to look forward to

I have no concrete plans workwise as yet, but there is the  possibility of some consultancy work with a few private companies and the establishment of my own small consultancy business. It would be nice to have a guaranteed role and job, but for now it's not a bad thing to have some space to look at some different opportunities. I'd also like to write a book, but as I'm finding, it's easier said than done...

She will continue to nail the study (so far straight High Distinctions) and look for meaningful work. We will not be flash with cash, but hope to have some time to settle down as a family and push forward with the adoption process.

Things might look pretty bleak right now, but as the saying goes, the darkest hour is before the dawn. I hope they're bloody right. It can only get better, can't it?

















 

He & She say..."You can't stay in Sudan but we won't let you leave".

*before you all send panicked messages about declaring our location, we have deliberately exposed it. We are not at risk of physical harm, and we certainly don't mean to belittle the more severe trials of others in any way...but no country should be able to act invisibly against expatriate residents as is described below.

Most of you will know that He is the Country Director (hereafter CD) of an international non-government organisation (hereafter NGO) with European headquarters. He is working for this organisation here in Sudan*, and we have been here for just over 2 years. It is well known that there is significant friction between international NGOs and the Sudanese government, but perhaps it is perhaps less well known how this affects the expatriates working for those NGOs.

He replaced a CD who was given persona non grata status in this country for a personal connection with an international church (nothing to do with his work or the organisation). We came here with an understanding that the situation between NGOs and the government is fragile, and that we, as part of an organisation who had suffered the expulsion of a CD,  would be under even more tension and scrutiny. There has been a constant level of tension, stress and threat since our arrival two years ago, about which we have written on other occasions. The purpose of this blog however relates to our current visa-less status here, the corruption within the government, and the personal impact it is having on us.

Our annual residence permits and His work permit expired at the end of October 2015. We began the process of renewal formally in early October, and as of 8 February 2016, we have not received a response to the request, ether negative or positive. 

Along with our residence and work permits, our multiple exit/re-entry visas also expired, therefore we have been and remain unable to leave the country since the end of October, and He has been unable to travel domestically for work.  In effect, we are being held hostage in Khartoum, with the freedom to remain in our home and move around the city. A fine of 50SDG per person per day is accruing for over-staying our previous visas, now at more than SDG12,000 (approx. USD2,100)…yet we cannot legally leave the country.

Over the course of the 4 months since our permits expired, we have petitioned for a response many times to both the Humanitarian Affairs Commission (hereafter HAC), and National Security (hereafter NIS). There has been a clear indication by the Labour department representative who sits within HAC  (hereafter HAC-LR) that a “cooperative off-the-books payment" would hasten the decision. The HAC-LR filed a petition letter to NIS to have my husband expelled. Following an investigation by NIS in January 2016 (including a lengthy interview), He was cleared and a letter sent to HAC explaining that there were no grounds for expulsion and that our permit should be issued until October 2016. There has been no response despite NIS calling for a meeting to push the recommendation. 

Excuses we have received for the failure to issue our permits include:

1) The HAC-LR  claimed multiple times that the paperwork requesting the permit renewals was never received, yet the paperwork has been re-submitted in full 3 times by the organisation's liaison officer. At one stage, this excuse was because HAC-LR had locked it in a cupboard and then went on holiday for 10 days. As soon as he was back at work, he went on sick leave. Obviously HAC have never heard of leave cover, and no one person being indispensable.

2) There is allegedly a letter (on the organisation's letterhead), signed by Him, reporting that He was fired as CD by headquarters. Yes, as ridiculous as it sounds.

3) Organisational labour issues. The issues faced in the past year or so have all been won by the organisation so Mr HAC-LR has not got his cut. He is less than happy about that. The one unresolved issue has been thrown out of court twice due to lack of evidence.

4) Allegedly poor communication between the organisation and both HAC and NIS about projects. The requested information has been provided, but has not resulted in an outcome for us.

5) They don’t want to issue the permits but refuse to expel us, so they are hoping we will leave “voluntarily” through the attrition of our patience and sanity. 

This is just a single example of the systemic corruption existing within HAC, of which even NIS are aware since they questioned Him about it, in great detail. The Sudanese government has been attempting to re-engage with the international community recently, including pushing the US to remove existing sanctions. Despite this, they are systematically removing iNGOs from the country. After broad condemnation of the proposed expulsion of Tearfund UK in late 2015, their offices were closed down by the Sudanese government and all assets frozen. The expatriate employees of Tearfund UK are, like us, stuck in the country, despite having requested their final exit visas (the formal means of closing their files as expatriate employees in Sudan and leaving the country). The final exit process should take a few days, or a week at most to complete. In late 2015, another CD was also kept waiting for 5 weeks before his final exit visa was issued. A third CD was in a similar situation to us, pushed hard to be permitted to leave for a Christmas break and was then unexpectedly expelled. 

Alongside the personal and work-related stress of being stuck here indefinitely, my chronic health issues cannot be sufficiently assessed or managed within Sudan. Some of you will remember that I was medivacced to Nairobi in mid 2015 following a back injury. In November 2015 we submitted a request for an emergency exit/re-entry visa to attend a specialist review of my back (with a supporting written recommendation) and this was not granted. We also both have broken teeth for which we wish to seek treatment abroad. #fallingapartattheseams

As foreigners, the concept that a government could want us to leave their country and yet not allow us to leave is simply outrageous. That they have the power to prevent us leaving Sudan when we have done nothing wrong, let alone illegal, is mind-boggling. So where to from here? This blog is part of our campaign to force them to make a decision either way. We may still end up leaving "voluntarily" if our patience runs any thinner. And whilst He is working well and hard, there is only so long that He can persevere with his work while facing the travel restrictions. We don't know that if we choose to leave "voluntarily" if they will be happy to get rid of us and issue our final exit visas straight away, or if they'll choose to prolong it and cause us even more frustration. 'Not knowing' is also a good reason to try and avoid that course...let alone us not wanting to let them "win".

She says...Is hostage too strong?

Today is the day we are booked to travel to Dubai for the rugby 7s competition, to relax, shop for food for Christmas, and to replace my wedding rings. We planned this trip a year ago and have been really looking forward to it.

We are not traveling because we have not yet been granted our residence visa or a travel visa (dependent on the first). We cannot legally leave Siberia without an exit visa. Although we are free to move around our city, we cannot travel domestically or internationally. So, if we wanted to leave Siberia "voluntarily" without one, we would have to grease a palm at immigration. Rather ironically, and conscience-tugging, this is exactly what we have refused to do in the process of seeking our residence visa. If we did leave this way, it would also cause significant issues for His replacement when he/she seeks a work permit.

As time has gone by and we have continued online sessions with a counselor, my anxiety and panic about being stuck here and threatened with expulsion has reduced. For this, we are very grateful. The increased stability of emotions has also strengthened my resolve to want to stay here for another year. In the last 4-6 weeks, we have expanded our group of friends and social adventures with many nationals. The thought of leaving "voluntarily" now fills me with sadness and disappointment.

In His ever-optimistic view that the visas are resolved later in the week, but too late to get to Dubai, He has decided that the Capetown 7s on the 10th would be a suitable substitution...so we're daydreaming about that. His favourite city in the world and somewhere I haven't yet had the pleasure to visit.

He says, "Mexican standoff."

I am killing two birds with one stone.

She and I have started a conversation with someone in Netherlands to try and help us process our situation in a more positive and constructive way. Not an easy task.

As she mentioned in her last post our visas expired on the 30th of October. We have not been told if they are going to be renewed. We are able to stay as we have submitted the paperwork to the authorities, more than three months ago. However, we cannot legally leave as that would require a final exit visa. Basically if we leave, you can be guaranteed we will not get back in through the same channels. 

What is the issue?  As She says, it started with my arrest at the start of this year. However It's more than that. When my boss visited in May they told him I was too opinionated, too outspoken and that I lacked respect for them. On all three fronts I would agree with them. 

My problem is that I have an opinion and I am happy to push back. I'm not afraid to shout (when they start shouting) and I have become very good at preempting what they might do next. I frustrate them, incredibly so, because I haven't stopped the shouting, the pushing back, the saying no and then bringing in a lawyer when I knew they were going to ask me to pay them a "facilitation fee." to fast track the renewal of our visas/stay permits.

My biggest problem is that there are too many Country Directors here in Siberia that are not like me. They give a little, then a little bit more, then quite a bit more after that. It's only then that they realise that they're on a very slippery slope and it's very hard to stop the momentum. Still if you have deep pockets, maybe it works?

To quote her again, "We want to stay. We have good friends here, a nice house and garden, and access to a lovely gym and pool, and we live next-door to the place we’re hoping to adopt from. His work is challenging but mostly rewarding. We want to complete the [three year] stint and get our [three months] of paid holiday at the end of it. I want to stay for practical reasons, and I want to go for emotional ones. I’m tired of the uncertainty.

My natural inclination would be to go and demand the permit for us to stay. I'd dare them, and have done so on a few occasions, to kick us out. However, this is what they want.

If Siberia has taught me anything, it's that often the best thing is to do nothing. 

That patience is often the most valuable tool in the bag. 

They want me to beg, to plead for the permit. They will shout at me, probably lock me in a room and then tell me I am too loud mouthed, too young, too inexperienced and most importantly I lack respect for them and for the Country of Siberia. That wouldn't worry me if I thought it would get us the permit. But I am not sure it would. I could go through all of that and they'd still likely leave  us in limbo. 

It's more than two weeks since I last met them. I have not called them and they have not called me. It's a Mexican standoff in Siberia.

Still, time is not on my side. They could leave us waiting, waiting for weeks and months. My Zimbabwean colleague waited four months for an exit visa. He was never the same and left shortly afterwards.

She has made it evidently clear that she wants a decision to be made either way. Rightly so, we can't keep living in limbo like this. To add to the time pressure, we are booked to go to Dubai for the rugby sevens. Something we both have been looking forward to for a whole year. Is it worth giving up on our life in Siberia for a weekend of rugby and time with friends ? I honestly don't know.

I feel weighed down by my own expectations, her expectations and trying to decide what is best for our organisation. There are no simple answers and I have no real plan. Each and every day I think of a different angle, or a different way forward. I operate in a million shades of grey (why just fifty?). That only exacerbates her frustrations and concerns as she pushes me for black and white answers. What are we doing? When are you meeting them? We are leaving on the 30th, right? I simply don't have the concrete responses she is looking for.

At times like these I often think about the book of Ecclesiastes.  This is one of my favourite books. It was written by a bloke, much smarter than me, who  thirsted for wisdom and knowledge. He gave many years of his life, looking for answers.  The sum of all his investigation was that life was basically meaningless. That good and bad happened to all of us and that the only certainly of this life was death. 

Like me, he didn't have the answers either. 

The point is, that we are not always going to have the answers in life that we need. That life is much bigger than you or I or the multitude of decisions that we have to make on a daily basis. The message of Ecclesiastes is that whatever our situation or lot in life, there is a Power that is beyond our knowing and fully understanding. The Power that brings the sun to shine and the rain to fall on good and bad alike. Though we may not fully understand or comprehend we are called to trust, to live and to know even in difficult and shitty situations that His character is constant and unchanging. 

That He knows our situation, far more than we ourselves do. That is our strength. Our Hope.

It's easier to type this than it is to live it out. To continue our normal routine and to keep things going at the office when we could very easily find ourselves out of the country, with all the upheaval this would cause. 

He knows. Thank goodness for that.

She says...Those who have power and those who have none.

It’s been a while since we blogged. Stuff has happened, time has passed, laundry has been done and Rhodes even had a bath. I’m in the last two weeks of my semester, and I’ve written nearly half of my 6,000 word Master’s assignment. I’d tell you the topic but you might fall asleep and fail to read the rest of the blog, so I’ll save it for those who genuinely want to know and ask. Isn’t it funny how I always think of blog topics when I should be writing about other stuff?

We’ve just been through another of our ~3mthly panics that we were about to be expelled and I’m conscious that my resilience is waning. I think it’ll be cathartic to write about it, so here it is. An insight into the complexity that life is working in a country where you are needed by those who have no power, but definitely not wanted by those who do.

These events started happening not long after we arrived in early 2014, and the first was my fault, when I caused mayhem by trying to find a job. Let it be known that the rest of the panic-events can be clearly blamed on Him. Although I am legally entitled to work here, it is one of the many strings of control that can be pulled by the authorities to place pressure on the international aid workers. By preventing me from working, it makes the choker-chain that little bit tighter around Him and his organisation. In order to work here, I would have to surrender my spouse visa and leave the country. There is absolutely no guarantee that I would be granted a work visa, so I could be permanently stuck outside the country while He continues to work in Siberia. Not ideal, and not worth the risk.

The potential-expulsion-events have become more of a routine since early 2015 when He had a ‘meeting’ with some officials who like to carry handcuffs. They sometimes involve a warning when He sees or hears something and tells me to be ready, and sometimes I get no warning. The most recent event was a no-warning occasion and I got an SMS to say that a colleague was coming to collect me immediately, and I was to rush to off-load our passports with our diplomatic mates. They who failed to make the quarter-finals of the RWC2015(!!) are very kind to us in this regard. I can’t provide much detail about the actual event, but it involved a couple of meetings with various kinds of official people. He was right to be concerned, but it seems they backed down at the last minute.

For 36h or so, I was thinking through one-way flights out of here, life in the Netherlands, finishing off my semester of study in a hotel, Christmas in Europe, packaging enough dog food to last a few months, and how to decide what belongings to leave behind. Then as abruptly as it started, it was over. Life was back to normal, and we picked up the laptops and passports and carried on, again. As stressed as He was during it, once it was over, He bounced back like nothing had happened. But this time I felt different and I was sobbing-dreadfully unattractively-upset. Upset not to be expelled. But I want to stay. We want to stay. We have good friends here, a nice house and garden, and access to a lovely gym and pool, and we live next-door to the place we’re hoping to adopt from. His work is challenging but mostly rewarding. We want to complete the 3y stint and get our 3mths of paid holiday at the end of it. I want to stay for practical reasons, and I want to go for emotional ones. I’m tired of the uncertainty.

The uncertainty isn’t over, but things have calmed down. I’m so grateful to the big man that when one of us melts down, it often happens that the other is calm, rational and comforting - one of the many treasures of marriage.  We don’t yet have permission to be here after the end of this month. We may not get permission, as it would be a convenient way to force us to leave without any drama. We wouldn’t be forced to leave immediately - basically, if we don’t get our next visa, the next time we travel, we couldn’t re-enter. That is likely to be early December. But we might get permission.  It’s in the big-man’s hands.

She says...Lions, an unexpected trip to Kenya and doubling the size of our family

It's been far too long since I last wrote a blog...but there are a few excuses. I finished up an extremely busy semester of study, and we then went on an incredible 2 week vacation with my parents in Tanzania. The safari was mind-blowing amazing, and we had a great time relaxing on and exploring Zanzibar.

I then, extremely unglamorously, fell out of the shower and my back landed on the porcelain edge of the toilet. After a couple of excruciating days in Siberia, we were flown in a private jet to Kenya, where I spent 2 weeks in the Nairobi hospital. I'm recovering extremely well, but it's a 2 step forwards, 1 step backwards kind of process, as I constantly re-assess my ability in the gym. Not being a gym-bunny, I've adapted quite quickly to being there 5-6 days a week, and I'm surprised that I'm really enjoying it. Long may it last.

The other thing that has been keeping me busy, is working on the logistics of trying to adopt. It's something we've been thinking about for a long time, but it has required a lot of talking and praying about, for obvious reasons. The idea has also spent considerable time in the too-hard basket. It was virtually impossible for us to adopt in the Antipodes primarily due to lengthy waiting lists, delays of up to 10y before a child is received, and various other limitations. Adopting as an expat is known to be one of the easier ways to do it, and legally, once we have lived overseas for 12mths, we are permitted to adopt and seek citizenship for that child in one of our home countries.  But, naturally, international adoption comes with all kinds of risks and logistical complications.

The first step in the adoption process is to complete a home study, i.e an assessment by a qualified Social Worker or adoption agency, or our suitability to be parents. It doesn't make a lot of sense when most people can get pregnant and have a child whenever they like, but it does when you consider that there are so many stories of adopted children being abused and mistreated.

We were fortunate to find a home study provider that normally works with US expatriates, but agreed to work with us. They recommended that we adopt from the US, based on the ease of the process, the ability to adopt infants (this is surprisingly uncommon nowadays in international adoptions), and the speed of the process. We were surprised that we could do this, as Antipodeans, but eagerly pursued the idea with happiness at avoiding all the risks of African adoptions. We were referred to a man in New York is specialises in expatriate adoptions in the US...and then quoted USD60,000 per child, not including all the travel and in-country expenses involved. I cried.  Sadly, there is a lot of money involved in the process. I had expected 25k, but 60k?!!! As He said, "they should be paying us to adopt a child"! When I mentioned the cost estimate to the home study provider, they were horrified. They had no idea that this gentleman charged such an exorbitant fee, and suggested we re-consider Ethiopia.

The most significant risks in Africa are getting fooled into adopting a child that is not an orphan, or who has been sold or trafficked into adoption, or at least 'led' by persuasion. One of the ways to reduce this risk is to adopt from a Hague-accredited country*. There are a lot of them, >30.

Unfortunately, Ethiopia was accredited but then stripped of it a few years ago due to reports of recruitment of children from birth parents by adoption service providers or their employees.  There are rumours that it won't be long before it's reaccredited. Once they were stripped of their accredita

tion, the Australian and NZ governments rightly ceased formal arrangements for adoption with them. However, we can still adopt privately from Ethiopia, and I soon learned that there are a lot of expatriates doing so. Most of them seem to live in Singapore or the UAE. Unsurprisingly, none of them are in our country of residence (!)...but it has been encouraging and extremely informative to talk with them, especially the Antipodeans who've been through it and successfully obtained home-country citizenship for their adopted children.

Ethiopia is a good choice for us for a number of reasons; it was our first choice due to friends who've had good experiences adopting from there, it's one of our neighbouring countries, thus convenient for traveling in and out, it's a country that allows adoptions by people of our faith, and it is one of the few foreign countries that still offers the opportunity to adopt infants. 'Siberia' does not allow adoption by people of our faith, which is very sad, particularly because there are more than 10,000 children in need of homes from one region of this country.

Navigating the adoption is tricky. Naturally we want to do the best we can to avoid corruption, adopting a child who shouldn't be available for adoption, or unintentionally greasing the palms of dodgy providers. This is also where the expat group is helpful for their experience and advice. The number of people involved in the process is huge. The home study providers, lawyers in Ethiopia and our home countries, adoption facilitators, the Ethiopian Ministry of Women, Children and Youth Affairs, the Ethiopian courts, etc.

So, what now? It's a little astonishing that after months of paperwork and correspondence, we are really only at the first stage. The home study required a 5,000 question survey that we had to complete together. Slight exaggeration on the number of questions there, but it must have been close. It took us months. It was extremely intensive, personal and confronting, addressing our childhood histories, our marriage history, our schooling, studies, careers, faith beliefs, why we want to adopt, why we love each other, how we plan to raise children, how we would discipline,  and a number of other extremely personal questions.

The organisation wisely asked us to determine numerous things to ensure that we can definitely obtain citizenship for the children once they're adopted. This was really difficult, as the Antipodean governments don't want anything to do with the adoption until the children are legally ours, so are unwilling to provide anything in writing in advance. But, this is where the expatriate group was helpful again, as there are many couples from down under who have successfully done it recently. So after 3mths of back-and-forth enquiries and discussion, the Social Worker agreed to proceed. We then had to get a visa for her to enter Sudan, which we thought would be very problematic, mostly due to her being American (she lives in Ethiopia). But, all praise to the big man, we got it in a week!

She will visit our home, assess it for suitability for children (we need smoke detectors and childproof locks for cupboards now...try finding those in 'Siberia'!), assess us as a couple, and go through all the answers we gave on the questionnaire. She then has a month to write up the report recommending us (or not...), and once we have that report, we can start the process of finding children, with the help of a facilitator in Ethiopia, who we've already connected with. We have requested two children under the age of three, no gender preferences. They might be siblings or twins, but they could also be unrelated. Adopting two at once is naturally more expensive, and this, at least in Ethiopia, appears to speed up the process. So we expect that we may complete the adoption in the first half of next year. There are no guarantees though, and plenty of opportunities for major hiccups along the way, including not ever getting children. It's hard to imagine how that would feel, but we do keep reminding ourselves that it might not happen at all.

We have decided to be open about it, and update you along the way so that it isn't such a shock if we suddenly have two children who look nothing like us :). Also, for those of you who pray, we'd appreciate your prayers through the lengthy process ahead. We'll update you as things proceed, but be aware that it is likely to be months between any significant news. And don't fear we are going to be all about adoption talk...there's always enough going on (or not going on) in Siberia to share.



*The Hague Convention on Protection of Children and Co-operation in Respect of Intercountry Adoption (or Hague Adoption Convention) is an international convention dealing with international adoption, child laundering, and child trafficking in an effort to protect those involved from the corruption, abuses and exploitation which sometimes accompanies international adoption.

She says...study, death, culture and stigma

I've had the incredible opportunities this week to interview a 'Siberian' Oncologist about her involvement in the establishment of palliative care into her hospital of employment, and to interview an older gentleman who cared for his wife through her battle with breast cancer and eventual death.

My mind and emotions are still reeling in response to what I heard. There is little, if any structure to it right now, so the outlook for my assignments due soon isn't impressive. Yet I feel the need to write about the experience and my learnings anyway, without giving too much thought to the hundreds of articles I've been reading or the need to critically analyse what I heard.

It was somewhat serendipitous that I chose palliative care as my topic of choice. I stumbled across a paper about palliative care for oncology patients in 'Siberia' on the online ANU library. I noted the author's name and google-stalked her email address. Not really expecting a reply, I sent a short email requesting permission to interview her. She replied the same day with a great deal of enthusiasm and agreed to meet me and welcome me into her clinical world.

As I had expected, she has faced and continues to face challenges in her 'mission' to see palliative care become an integrated part of patient care from every angle; her colleagues, the hospital administration, the government and, naturally, her patients and their families have expressed varieties of disinterest, concern and even outrage, and those in authority have actively prevented progress. However, she has prevailed, and now has an active Palliative Care unit at the hospital. Sadly, it isn't yet integrated into the hospital system, and without money and acceptance, it won't become so. This means that patients must be referred by their own Specialists, which is fraught with problems because many of those Physicians consider palliative care to be luxurious. One Oncologist even threatens his patients with being sent to palliative care if they don't behave!

I let the interviews flow with only a cursory glance at my topic guide to ensure we'd covered everything. However, preparing a topic guide allowed some of my preconceptions to blossom. I was surprised to learn that, in general:

• Cultural beliefs are much stronger than religious beliefs with respect to understanding illness and death
• People are much more likely to die in wards rather than the palliative care unit, because they delay seeking treatment until it's so late (due to cost and fear), that they often die before a referral to palliative care is made.
• Traditional healers will often send their 'patient' to the hospital in his/her last days to ensure that the patient's death is not attributed to the traditional methods or 'medicine'.
• There is a serious social stigma associated with cancer in this country.

There is enormous cultural stigma associated with the 'bad disease'. Cancer and HIV fall into this category.  People generally believe that all cancer is contagious and if they learn of someone with it, they will often ostracise and even abandon the person, including their parent, spouse or child.

However, being sick induces compassion, so it is not unusual to see a woman who has had a tumour removed but is perfectly capable of walking and caring for herself, being aided by a relative on each side as she limps along in pretend-discomfort. As long as no one knows that she has a 'bad disease', she maintains her relationships and gains compassion.

In the light of this knowledge, I learned that the gentleman had cared for his wife for 5 years, through two 'bouts' of cancer and therapy, had refused to leave her even when his wife insisted.  He carried her, bathed her, fed her, gave her medications and generally loved on her. He lost contact with all of their friends and many family members due to fear of catching the disease, he spent all of their savings and sold all of their assets whilst traveling to and from our city from their village. He looked at me with tears and said (in Siberian) "Of course I cared for her. She was my wife. My only love. She was my everything." Even yesterday, when I asked, he did not know that cancer is not contagious. He insisted that it didn't matter. He loved his wife.

I was teary and struggled to even speak my gratitude at the end our interview. He was also teary, and I feared that I had unkindly upset him. As I began to apologise, the Dr assisting me with translation corrected me, and said that he was upset because he hadn't known that he would be interviewed by a foreigner. He was upset with the Dr for not informing him in advance, as he felt he had been ungracious and inhospitable by not greeting and hosting me with food and drink at the clinic. What an incredible, inspiring man.