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.

He says, "25 lashes..."

Yesterday I went to the police station. Again. 

Many of you will know I have had ongoing run ins here with the local government officals. I think it must be my convict origins. I don't take kindly to being told what to do, especially when you decide to lock me in a room and yell at me for half an hour about how my organisation and I are "bad" because we have failed to respect the culture and values of Siberia.

That really ticked me off. 

I am "bad" because I choose to follow the laws of Siberia. It might also be that I have an excellent lawyer who is feared and respected by all. This is because he is able to distinguish between that which is politics and that which is the law. In his words, "the law is our friend, we should use it." 

I am seeing more and more that the law is my friend. It is the enemy of those who like to see themselves as being the law or above the law. In my situation, I am not sure who is going to win, but it has been an interesting experience, although not without some nervous moments.  Being arrested is not something I want to make a habit of.

Because of my situation, I have spent quite a few hours at the police station talking with my lawyer. She is a quiet, considered  lady in her mid forties or early fifties I would guess.  She was educated here in Siberia and works as the second partner in probably the most respected law firm in the country.  Most of her extended family have immigrated. Her husband works in London and they have two older children studying there. She is here alone with her youngest daughter. It cannot be an easy task juggling the demands of being a single parent and having to prevent people like myself from being arrested!

We often talk about mundane issues like the weather or my travels to Dubai. Most times we say nothing, fearing that our conversations can be overheard and used against us by the many people loitering around the station, whose job it is to collect information...

But sometimes we talk about what it's like to be a lawyer. Not only a lawyer but a female lawyer in a context where where the evidence of a woman is only worth half of that of a man.

Justice in this country is certainly not always pleasant or even just.

Yesterday we spent a good two hours, sitting on an old wooden bench, waiting for a judge to come and determine my fate. It was a matter of protocol as the arresting officer had already withdrawn the charge. 

While we sat on the wooden bench,  we watched together as groups of men and women were bought to the police.

First there was a group of South Siberians, who since the separation of the southern part of the country are now consider to be illegal immigrants. They are treated worse than animals. They are rounded up like dogs. They sat or crouched on the dusty ground under the intense heat of the midday sun. The fear in their eyes said it all. They have no hope if they go home and little hope if they stay here. They are arrested and then deported. But still they return and continue to return. Life here in this city offers more than their life back home. That they would be subject to such a life, with little to hope for, leaves me incredibly sad. Many have turned to alcohol to deal with the pain and that in turn leads them to more trouble. It is a vicious cycle.

Then a young Ethiopian man, wearing a Manchester United shirt, was hauled in by a rather portly looking policeman. The young man is cocky and still sports a smile as he is led, in handcuffs, before the judge. The lawyer tells me he has been charged with the possession of illicit drugs. Apparently the fine is 20,000 local currency ($4,000 USD) or several years in prision. I wonder if his family and friends are able to raise such funds? He is not so cocky when he is led away to a prison cell following the decision of the judge.

Then a group of 5-10 men and a similar number of women are bought into the station on a pick-up truck. Some of them have suitcases and other luggage. The men are wearing thick winter coats and sweatshirts which makes little sense to me in the intense 40 degree heat. The lawyer tells me they are Libyan. They have been arrested for drunk and disorderly conduct. The penalty for their crime is 40 lashes. I cannot begin to fathom that kind of punishment, when the first of the men appear from the room that serves as a court.

I am expecting  that he will be led away to a cell to await  his punishment at a later date. Instead, I am shocked to see the man standing spreadeagled, with his back to me, against the wall of the building directly opposite me. A youthful and muscular policeman suddenly appears and begins to meter out the punishment with what looks to be a hollow plastic pipe.

Each of the men at follow receive 25 lashes each. The lawyer tells me that either they have some "friends" or the judge has gone easy on them. The police evenly distributes the lashes between the neck, the back, the buttocks and below the knees.  I understand now why the men are wearing thick heavy jackets. One of the beatings is stopped half way, because the man being punished had cleverly put his wallet in his back pocket. Not so clever, because when the policeman discovers this he restarts his count at one and again dishes out the full punishment...

Two of the men are taken inside for their punishment. Again, the lawyer says that someone has intervened on their behalf. In a culture that avoids loss of face at all costs, being beaten in  the public domain is the ultimate punishment.

The women are sent inside a room. I ask the lawyer if they will be spared the punishment. She says no. I do not see what happens to them, but we hear the dull thud of the plastic pipe echo through the mid day stillness, Even the women are not spared.

I ask the lawyer if the punishment will have any affect on the men and the women? She laughs."They will get drunk again tonight". I suspect she is right.  

I am finally called before the judge. My appearance lasts less than 30 seconds.The policeman withdraws the charge. There are smiles and handshakes all round. The arresting officer is my new best friend.

Sitting on that wooden bench,  I've had plenty of time to think about justice. I am thankful for a good lawyer who has done most of the legwork and the talking to get the charges against me dropped. I know how much we pay her/them and know it is well beyond what most Siberians could ever afford. 

When I arrived in this country I was told by a contact to get myself a good lawyer, as they're all mother*******. Turns out he was probably right.

Justice in this country, and many others, is the privilege of the wealthy and the educated. It is not always whether you are innocent or guilty but whether you know the right people and whether you can afford a good lawyer. Being educated and knowing your rights also helps. 

 

If my lawyer had been willing or able to intervene on behalf of the Ethiopian, the South Siberians or the  Libyans, their punishment could have been reduced, or even prevented. Such is the world we live.

I am told I no longer need to return to the police station. As much as I will not miss spending countless hours waiting for police to come and go, watching them smoking cigarettes at their desks in between shuffling piles of paper and yelling at helpless South Siberians, it has been good to have a sobering reminder of how privileged and fortunate I am as a westerner living in this country compared to the experiences of most other people who are visitors (legally or otherwise).

I suspect that in my case,  I have won the battle but may ultimately lose the war. Let's see just how good my lawyer is and whether she/they are able to deal with those that consider themselves to be the law or above the law. It's going to be an interesting story either way.

 

She says...28 days, 1,000 CVs and 'The Cave'

After completing a couple of short contracts for the Yemen program of the Disaster Response Unit last year, I was still surprised to get a call 3 weeks ago offering me a 4 week contract in northern Iraq.  Excited to be going, humbled to be offered work in a field very foreign to my experience, sad to be leaving him and Rhodes behind, I packed my bag and flew via Qatar to Erbil, the capital of the Kurdistan region of Iraq.

He and I had done some Google-based research before my departure and learned that Erbil is predicted to be the new Dubai. Great wealth, fast cars and heavy investment were hallmarks of a place that I was enthusiastic about exploring. In reality, Erbil might become the new Dubai by 2070, if very, very lucky and a certain OAG* is displaced, or preferably defeated. I have been describing the city as a very run-down version of Amman. I've found quite a few nice cafes, and two even served coffee worthy of a repeat visit. My favourite serves good coffee, pizza and pasta, and has a wonderful view of an enormous tank (one one day I visited), an artillery-pick up (on another visit) uniformed men carrying large and heavy guns, and a lot of army-camouflage fabric. I asked the waiter what they were guarding and was informed that it is the US consulate. Every time a vehicle slowed down in front of the cafe, I felt my muscles tensing, as if perhaps, I would have time to run.

The weather in Erbil has been reasonably nice outside, generally 12-20 degrees during the day, but in the house/office, it’s almost always freezing. We usually only have a few hours of power a day, and then generator power for 4 or 5 hours if we're lucky, so I spend a lot of the time feeling cold and sorry for myself. It’s nothing compared to what most IDPs / Refugees are dealing with, of course. My colleague and I have affectionately dubbed the house/office ‘The Cave’. It’s dark, cold and really not that pleasant. But what joy upon discovering a hot water bottle in the bathroom (wonderful when the power has been on long enough to warm the water!).

My role here is basically ensuring we’ve got everything we need to run the head office including:
1. Functioning utilities (ha! No power or generator today for 8h so I nearly froze and my computer battery drained so I couldn’t do any work)
2. ADSL (none of the 20 companies we’ve contacted can provide it here)
3. Transport (taxis are currently deemed an abduction risk for expats, but it’s the only mode of transport we have)
4. Staff and interviews. I advertised 4 positions here for national staff and 5 in Duhok, and I received almost 1,000 applications.  About 10% of the applicants applied for at least 2 and sometimes all 9 positions. The Translator needs to be female (culturally, and women tend to be more accurate at translation), and despite it saying so in the job requirements, 90% of the applicants are male, and many don’t speak English. 
5. An established relationship with all key stakeholders. This one is actually going ok, but it seems so crazy to be getting known when I’m leaving in 2 weeks. Hopefully people are connecting with the organisation and not me.

I'm due to finish up at the end of next week. He and I have a planned rendezvous in Dubai for relaxing weekend before heading home. I'm really, really looking forward to it. A great opportunity to be here, good for my CV, and good for building relationships in the organisation, but 4 weeks apart is too long. I miss him and I miss Rhodes.

To finish up, I thought I'd share some of the pearls that I've read in the 600-odd CVs I've managed to get through so far. I admit that if I were to apply for a job in Arabic or Kurdish, someone could write a very funny blog about mine:

Regarding language ability:
"Excellent level of extreme Kurdish"

"English: not bad"

"Being bilingual gives me the chance to function efficiently in both English and Arabic and Kurdish."

"I like English language and it is a part of my body."






Motivation statements and Greetings:
"I need Developed, rival, creator, I will give him my experiences to we grow together, Managing in a modern style, Believes that the team perform more than personnel."

"I am pleased to be one the interview that submitting to work in your company if possible I would enjoy to be interviewed"

"I am ready to do my best in work and work hardly"

"if you feel that i am feet for any of this position"

"Hope My Email finds You as well"

"Dear NGO stuff"

"I had other skills and experiences, which I able to describe with you by meeting, because all the time I am going to build my acknowledgment."


General gems:
"Accunted 2003-2005, Accunted 2006-2007, Translator 2008"

"I'm working on Duhok with displaced people who want to get a job Advanced training nudity CV Writing"

"Name: Ahmed Mohammed, Date of Birth 26 September 1991, Sexual: Syrian Kurd"





* OAG = Organised Armed Group. I think I had added at least 30 new acronyms to my brain database since arriving here; 28 belong to various militias and political parties and the other 2 are yet to be identified. To add to the confusion, each group seems to be known by at least 3 different names.

He says, "The bachelor is back!"

Having started the blog on such a positive note for 2015, we need to keep the momentum going!

I am now a bachelor with her having taken an exciting role with my/our organisation in the Kurdish Region of Iraq (KRI). It is an exciting opportunity in a very interesting part of the world. I had no hesitation in letting her go, although the thoughts of her living 40km down the road from an unruly mob of Jihadists, did give me a few restless nights. She is a strong woman though and I am sure she will put them in their place.

We have loved the cooler winter days and nights. Wearing socks and long pants to bed and sleeping under our quilt with no fan or A/C is a real novelty for us.  I'm not sure it will continue much longer though as we are headed back to high thirties later this week.

Rhodes has not been his normal cheerful self. He seems to be unsettled by our constant coming and going. The site of suitcases being packed /unpacked seems to send him into a state of melancholy... I managed to take him for a run at the American School yesterday. He loves the grass and spends more time sniffing and trying to find puddles of water to jump in than fetching the ball.

There is also an eagle that patrols the school oval. It has a massive wing span and very large claws. I know this because it (I should call it Woosha, Summa or Jacko) has taken to trying to swoop down and collect Rhodes. Thankfully he hasn't managed to lay a claw on our little doggy, but yesterday he managed to pick up a plastic bottle and then drop it just near us. We have been warned!

Speaking of melancholy, to be or not to be? That is the question. We were visited this week by the Globe Theatre of London and their worldwide tour of Hamlet. Siberia was destination number sixty-nine. They plan to visit every single country in the world by the end of 2016. This is in celebration of the 450th anniversary of Shakespeare's birth (I think)! I am sure Siberia was one of their more challenging whistle-stops. The performance was held in an outdoor amphitheater next to the river. We started very late (9:15pm) as we had to wait for the Minister and Under Secretary for the Arts) to arrive. The sound was limited and to make matters worse, another concert of local music was being held next door. By half time (10:45pm) we, along with more than half the audience decided to leave as it was getting later and later and we could hardly hear what was being said. Despite all this, the backdrops and acting were fantastic and we'd love to see the performance in full sometime in the future when the quality of the sound can be guaranteed.

On Wednesday night we had dinner with a representative of the Australian Embassy. I think they see us as a bit of a novelty! Every time a staff member travels to Siberia, the Ambassador makes sure that they invite us out for dinner. She was a pleasant young lady and I have been asked to visit them sometime and have breakfast with all the non-resident Ambassadors/representatives for Siberia. I think I will definitely take her up on the offer!

She says...the end of Year 1

As He mentioned, we've just returned from a wonderful, month-long holiday down under with our families. We spent two indulgent weeks with each of our families (in their respective countries) at the beach. A few tidbits for those of you who know one or both of our families:

• He performed a beautiful ballet dance with dear little friends on a giant jumping pillow.
• We left one family with 4 extra legs and a lot more trouble than they had before we arrived.
• We held a My Kitchen Rules competition with one family - 4 couples each spent 3h preparing and cooking a main and dessert for all, which was then judged by the other couples. The scores were out of 90 and all 4 couples scored within 3 points of each other. We were unfortunately at the bottom. Good food. Good company. Good fun.
• One Mother turned 70. An event worthy of much celebration and a headstand by the birthday gal.
• One beach holiday included approximately 10x as much alcohol as the other.
• We swam at the beach in only one of the countries. No prizes for guessing which.
• We met the youngest of our siblings' 13 children for the first time, and missed seeing the eldest as he's away adventuring on his gap year after finishing high school with very impressive scores.

Naturally, every one we met down under wanted to know what life was like here. I'm not sure I shared many positive thoughts about our experience, if any. In that, I'm sure I did this country and her people an injustice. It is much easier to think of and express those things I find difficult, sad. frustrating and infuriating than to talk of those that I've appreciated, enjoyed or celebrated. So, here are a few, in memory of our first year in 'Siberia'.

• The local people are very generous towards one another with their possessions and money, even in their own difficult circumstances. 
• I've had a growing fascination with the items that are sold at intersections in our city. Those I can recall include:

• various kinds of fruit, clothes drying racks, toy tuk tuks
• a coat stand
• a whip (I thought it was for the donkeys, but our house helper reported that they are for household use i.e. wives and children)
• rugs of all sizes, including ones which would cover the majority of the floor space in our house
• children's clothing in every shape, colour and size, and consistently with misspelled English phrases
• an electric iron and kettle
• a machete (I was in a local taxi when I was first offered one. I said a bad word in my shocked exclamatory question about what I would do with a machete, and my taxi driver who, until then, had not said or acknowledged one word of English laughed out loud).
• a Sudanese passport cover (He has been tempted to buy one of these)
• a V slicer for vegetables in multiple brands and colours
• a battery-operated guitar with coloured flashing lights
• wind wipers (they appear every time it rains)
• a fishing rod

• Unlike all other local foods that I have tried, the fish served in many local restaurants is absolutely delicious. It's usually deep fried and prepared as a whole fish or filleted pieces, crumbed. It's served with a plate of raw onion, some green leaves that look like spinach and taste like grass, an extremely hot but addictive chilli paste, lemon wedges and wads of hot bread. It's served on a large platter and everyone eats from the one dish with their right hand. The restaurants are often open air, scented with a local perfumed smoke, complete with mist-spraying fans and local music. Lovely.
• A byproduct of living in the "country that fun forgot" (His term), it has been special to have so much 1:1 time as a couple in our first year or so of marriage. There are parts of the week when nothing can be done other than being at home, enjoying a cup of coffee, our favourite music, our books, or a TV show at our home cinema.
• The many weekend afternoons we've spent at an international hotel swimming pool where we have a membership, chatting with friends, meeting new people in the pool, reading books, drinking litres of cold water, enjoying the 'cool' 32 degrees in the pool.

He says, "Rabbit surveys and the relief of winter..."

Two wonderful examples of Siberian English (Siblish?) that I have seen this week.

The first is from my wonderful WASH (Water and Sanitation) Adviser who is 60+ and suffers from poor eye sight and is deaf as a door nob.  He sent me an email with a  very detailed assessment of the water and sanitation indicators for two localities we are hoping to work in. However,  the document is entitled 'Rabbit Survey'. I am fairly sure he meant rapid.

The second came from a government agency inviting me for a meeting tomorrow to discuss "relief of winter." I am chuffed that they think that my organisation and other INGOs (International Non Government Organisations) control the passing of the seasons. Or, maybe they are concerned that the affects of global warming are yet to sufficiently present themselves in Siberia?  I am thinking of putting them in touch with Tony Abbott.  I suspect that winter relief will not be required. The current cold snap is due to pass in the next few days and we will return to our balmy winter days with highs of 30 degrees. That will be' winter relief' to the many who are not enjoying single digit temperatures during the night.

He says...Did we land in Siberia?

We have returned from the antipodes. We landed back in Siberia at 12:15pm on 8 January 2015, exactly one year to the day of our arrival here. It's good to be back but it's cold! Maybe we are in Siberia? It was 8 degrees yesterday at 11am. I was wearing three layers of clothes. It reached a top of 22 degrees late in the afternoon. Tomorrow is supposed to be 17 degrees... I imagine that all the staff at work will be wearing gloves, beanies and jackets. We will need plenty of hot tea.