I'm not sure if I'll post this, but I want to write down a few thoughts I've been having lately...
It's a little strange living here in Zambia, watching the rest of the world through BBC news and social media. I'm sure it's a fairly distorted view of what's going on back home, but a few things keep cropping up at the turn of the year, so they must hold some truth about how the nation is feeling. The main theme on social media at the moment seems to be "Thank **** 2016 is over" and "what can I take for myself in 2017" or "how can I make 2017 better for me than 2016?"
I know 2016 has brought us some serious curveballs, and I was among the sorely disappointed at the results of Brexit and the US election, but I suppose I want to challenge all of us, myself included, to take a step back and appreciate what privileged, stable lives we live. We may not be pleased with the outcome of these votes, but we mustn't forget how incredibly lucky we are that we have a democratic political system that is not based on corruption, where as a nation we are able to change the course our country takes.
It's also interesting watching the responses to the many celebrities who have died this year. I don't mean to undermine the grief that their families are going through, but living here does bring a different perspective to death. Working in obs and gynae, back home you ask patients how many pregnancies they've had, including have they had any miscarriages? Here I ask my patients how many pregnancies they've had and how many of their children are alive. A typical history will look like this:
2001 - stillborn at 9 months
2002 - spontaneous vaginal delivery, alive
2004 - spontaneous vaginal delivery, died at 3 months
2005 - spontaneous vaginal delivery, alive
2006 - spontaneous vaginal delivery, died at 5 years
2008 - c-section, neonatal death
2009 - c-section, alive
2010 - miscarriage at 3 months
2011 - c-section, alive
and so it goes on... Back home we use an abbreviation system to denote how many pregnancies a women has had (gravidity) and how many she has carried to 24 weeks (parity), so someone might be G3P2 if they've had 3 pregnancies and carried 2 to 24 weeks. Here we have a third abbreviation - alive. The above woman would be G9P8A4.
The idea that we can live in a nation where people are genuinely upset that actors/pop-stars - people we don't know personally - die in their 50s and 60s, over here seems a little ludicrous. I don't say this in any way to criticise people who are grieving loved ones. I just want to remind us what a privilege it is to live in a country where we have a very high standard of healthcare, free at the point of access, so we don't frequently have to experience the natural course that life often takes. It's so easy to complain about waiting 30 minutes to see the GP, and to forget how lucky we are to have a GP to see in the first place. At home we don't have to decide whether we can afford to sell the last cow to pay for our 10 year olds chemotherapy or whether actually the rest of the family won't be able to survive if we do that. We don't find ourselves in the position of being transferred from one hospital with a live, but threatened pregnancy, because they don't have enough equipment left to do any more c-sections, only to find that by the time you arrive at a hospital that can, that the baby has died. These may not be easy things to think about, but this is a daily reality for many of my patients, who have done nothing "wrong" to be born into such different circumstances.
The second half of this little ramble is to challenge how easy it is to get caught up in self-serving and to think that perhaps there are some better things we can focus our efforts on in 2017 than just "getting really fit so people will find me more attractive" or "earning more money this year". I feel challenged as we enter the new year, not to be seeking what can I take for myself, but to look at how I can live more generously. I haven't quite figured out how I plan on doing that but here are a few thoughts.
There are a few of people who wander round the hospital compound begging or looking for work. There's a man named Andrew Phiri who comes to my house asking for bottles of water, blankets, anything he can sell/knows the English word for. He's a sweet guy, but is an alcoholic and doesn't inspire a huge amount of confidence that anything you give him will benefit him beyond buying himself more booze. Because of this and because I didn't want to encourage him to keep hassling me I've not given him anything more than the odd bottle of water. I justified this by the (not unreasonable) argument that giving people hand outs isn't a sustainable form of charity and is of little long term value.
And yet there's a lot of irony in this situation... I think I've mentioned before we have a number of animals living on the hospital compound who have a fairly communal ownership. There are 2 dogs in particular who have wormed their way into our group - Tiger and Danger. They're a bit of a nuisance, but are sweet enough and everyone has a bit of a soft spot for Tiger. Every evening they let themselves into the mess where we have dinner and if there's any food left on our plates often we feed it to them. They're pretty skinny and despite the complaints we make about them smelling bad, we're all mildly concerned about them going hungry. One of my colleagues even went as far as buying dog food for Tiger in Chipata.
I've been challenged lately - why am I concerned about the dogs going hungry and yet I allow myself not to be concerned about the humans? This hit home the other day. For Christmas, among other things, I made a trifle using some stale cake that Kars and Marloes gave me. There was more cake than could fit in the pudding and since it was already stale and we had so much better food on offer, I didn't particularly want to eat it. It sat on my table for a day getting more stale, then I put it in my kitchen bin where it sat for a few more days, until I took the bin out. As I was emptying the bin I remember thinking how gross it had become - there were rotten mangoes that had started to go mouldy! (Don't judge, it's hot and I'm busy :P)
Later that day I saw Andrew Phiri and we had our usual nonsensical chitchat (his English is poor and his brain pickled), when suddenly I noticed him holding the piece of discarded cake. I know what was in that bin - he must have been seriously hungry to think that this cake was a good meal! I was talking to Alex about how this bothered me and he pointed out the unsustainability of feeding Andrew Phiri. In many ways I entirely agree. But then why do we feed the dogs?! Surely the same argument applies.
I'm not really sure what the solution to this is, but I just feel a bit sick that I allowed myself to be more concerned about the dogs welfare than the humans. I'm still working on the practicalities of how that will change my actions. So I suppose the point of this ramble is to encourage us to be a little more grateful and a little less self-absorbed as we enter 2017!
It's a little strange living here in Zambia, watching the rest of the world through BBC news and social media. I'm sure it's a fairly distorted view of what's going on back home, but a few things keep cropping up at the turn of the year, so they must hold some truth about how the nation is feeling. The main theme on social media at the moment seems to be "Thank **** 2016 is over" and "what can I take for myself in 2017" or "how can I make 2017 better for me than 2016?"
I know 2016 has brought us some serious curveballs, and I was among the sorely disappointed at the results of Brexit and the US election, but I suppose I want to challenge all of us, myself included, to take a step back and appreciate what privileged, stable lives we live. We may not be pleased with the outcome of these votes, but we mustn't forget how incredibly lucky we are that we have a democratic political system that is not based on corruption, where as a nation we are able to change the course our country takes.
It's also interesting watching the responses to the many celebrities who have died this year. I don't mean to undermine the grief that their families are going through, but living here does bring a different perspective to death. Working in obs and gynae, back home you ask patients how many pregnancies they've had, including have they had any miscarriages? Here I ask my patients how many pregnancies they've had and how many of their children are alive. A typical history will look like this:
2001 - stillborn at 9 months
2002 - spontaneous vaginal delivery, alive
2004 - spontaneous vaginal delivery, died at 3 months
2005 - spontaneous vaginal delivery, alive
2006 - spontaneous vaginal delivery, died at 5 years
2008 - c-section, neonatal death
2009 - c-section, alive
2010 - miscarriage at 3 months
2011 - c-section, alive
and so it goes on... Back home we use an abbreviation system to denote how many pregnancies a women has had (gravidity) and how many she has carried to 24 weeks (parity), so someone might be G3P2 if they've had 3 pregnancies and carried 2 to 24 weeks. Here we have a third abbreviation - alive. The above woman would be G9P8A4.
The idea that we can live in a nation where people are genuinely upset that actors/pop-stars - people we don't know personally - die in their 50s and 60s, over here seems a little ludicrous. I don't say this in any way to criticise people who are grieving loved ones. I just want to remind us what a privilege it is to live in a country where we have a very high standard of healthcare, free at the point of access, so we don't frequently have to experience the natural course that life often takes. It's so easy to complain about waiting 30 minutes to see the GP, and to forget how lucky we are to have a GP to see in the first place. At home we don't have to decide whether we can afford to sell the last cow to pay for our 10 year olds chemotherapy or whether actually the rest of the family won't be able to survive if we do that. We don't find ourselves in the position of being transferred from one hospital with a live, but threatened pregnancy, because they don't have enough equipment left to do any more c-sections, only to find that by the time you arrive at a hospital that can, that the baby has died. These may not be easy things to think about, but this is a daily reality for many of my patients, who have done nothing "wrong" to be born into such different circumstances.
The second half of this little ramble is to challenge how easy it is to get caught up in self-serving and to think that perhaps there are some better things we can focus our efforts on in 2017 than just "getting really fit so people will find me more attractive" or "earning more money this year". I feel challenged as we enter the new year, not to be seeking what can I take for myself, but to look at how I can live more generously. I haven't quite figured out how I plan on doing that but here are a few thoughts.
There are a few of people who wander round the hospital compound begging or looking for work. There's a man named Andrew Phiri who comes to my house asking for bottles of water, blankets, anything he can sell/knows the English word for. He's a sweet guy, but is an alcoholic and doesn't inspire a huge amount of confidence that anything you give him will benefit him beyond buying himself more booze. Because of this and because I didn't want to encourage him to keep hassling me I've not given him anything more than the odd bottle of water. I justified this by the (not unreasonable) argument that giving people hand outs isn't a sustainable form of charity and is of little long term value.
And yet there's a lot of irony in this situation... I think I've mentioned before we have a number of animals living on the hospital compound who have a fairly communal ownership. There are 2 dogs in particular who have wormed their way into our group - Tiger and Danger. They're a bit of a nuisance, but are sweet enough and everyone has a bit of a soft spot for Tiger. Every evening they let themselves into the mess where we have dinner and if there's any food left on our plates often we feed it to them. They're pretty skinny and despite the complaints we make about them smelling bad, we're all mildly concerned about them going hungry. One of my colleagues even went as far as buying dog food for Tiger in Chipata.
Tiger looking very pleased with himself having just dug up half of my sunflower seedlings!
I've been challenged lately - why am I concerned about the dogs going hungry and yet I allow myself not to be concerned about the humans? This hit home the other day. For Christmas, among other things, I made a trifle using some stale cake that Kars and Marloes gave me. There was more cake than could fit in the pudding and since it was already stale and we had so much better food on offer, I didn't particularly want to eat it. It sat on my table for a day getting more stale, then I put it in my kitchen bin where it sat for a few more days, until I took the bin out. As I was emptying the bin I remember thinking how gross it had become - there were rotten mangoes that had started to go mouldy! (Don't judge, it's hot and I'm busy :P)
Later that day I saw Andrew Phiri and we had our usual nonsensical chitchat (his English is poor and his brain pickled), when suddenly I noticed him holding the piece of discarded cake. I know what was in that bin - he must have been seriously hungry to think that this cake was a good meal! I was talking to Alex about how this bothered me and he pointed out the unsustainability of feeding Andrew Phiri. In many ways I entirely agree. But then why do we feed the dogs?! Surely the same argument applies.
I'm not really sure what the solution to this is, but I just feel a bit sick that I allowed myself to be more concerned about the dogs welfare than the humans. I'm still working on the practicalities of how that will change my actions. So I suppose the point of this ramble is to encourage us to be a little more grateful and a little less self-absorbed as we enter 2017!
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