Friday, November 22, 2013

About what is happening in Saudi Arabia since November 1

I write this with a heavy heart. I feel so sorry for the so-called "illegal" expatriates who are now at the receiving end of the full force of the Saudi police and armed forces. To explain this, I would have to go back a few months in time ... nay, try and trace the root of the problem.

To be fair to the Saudis, they have had a steady infiltration of foreigners since the past several decades. Their modus operandi is simple: if possible, "disappear" from the scene when you arrive in the Kingdom for performing the Umrah or the Hajj. However, these disappearing Hajjis form just a small fraction of the problem. The bigger problem is caused when conniving and cunning Saudis sponsor people from the poor countries to come to Saudi Arabia on a free visa, then allow these people to work anywhere they want in exchange of an annual fee (which becomes their business - they don't need to work at all), and then, when a year has passed, declare these people as having "absconded" from their control and make their further stay in the Kingdom illegitimate.This happens because at the end of the year, the residence permits (Iqamas) of these expatriate workers expire. 

The poor workers continue to work wherever they want. If they want to renew their Iqama, they have to go back to their sponsor, who will then "oblige" in return for a hefty fee. Now comes the interesting part: this year, the Ministry of Interior started a "legitimisation" program where they have the right to expel all illegal expatriates, and also they can enforce a new rule whereby the employee can only work in a place that belongs to their original sponsor and not elsewhere. 

The last date of amnesty for this program was on the 3rd of November, and lakhs of illegal expatriates, whose only crime was to trust their Saudi sponsors in the past, had to leave the country. Millions of expats are still here ... and their status is illegal. Effectively, bread-earners have now become criminals in this country. Most have gone into hiding as the MOI has unleashed a huge force of policemen who are empowered to detain, arrest and set into motion all the steps needed to expel whoever they find with an improper residential status or work permit. As a result, many restaurants, convenience shops (bakalas), repair shops, etc. have closed down all over the Kingdom. In Al Muwayh, I personally know that both the Kerala restaurants have shut down, many car-repair shops have closed as well, and many small eateries (known here as "buffiyas") - where talented cooks worked their as@ off, preparing simple snacks for their customers. 

As I write this on the eve of my departure to India for my annual vacations, my heart goes out to these poor men and women who are in a state of despair - and most are, in fact, looking for a way out of the Kingdom.

The last week before the annual vacation: Sunday evening (17th Nov.) to Thursday morning (21st Nov.)

After my return from Turabah on Sunday evening, I started my preparations for the annual vacation coming up this coming week-end. I had expected our liaison officer, Mr. Ali, to bring my passport from the MOH Muderiya on Sunday and hand it over to my colleague Dr. Niaz Qureshi (OB-GY from Pakistan), but Ali did not oblige. However, he had assured me on the phone that he would hand me the passport on the next day if I went to Ta'if. I had no choice but to take permission from our medical director Dr. Shehab and request Dr. Yasser to allow me to go to Ta'if. 

On Monday, I received my passport from the Muderiya directly, as Ali had arranged with one of the employees to hand me the required document without him being present. I was greatly relieved to have my passport with a valid, stamped exit-re-entry visa. This is the exact moment when all my stress dissipated! Now, I was, for the first time, sure that I would, indeed, be going on Friday, the day of my flight to India. 

I then allowed Yasser to proceed on a two days' leave and said I would look after the work.  One of my other friends, Dr. Emaam Sayed, had co-ordinated his ER duties in such a way that he would be free to take me to Ta'if in his car. Things were finally going my way, I thought smugly. Yasser wished to return on Thursday afternoon, and I okayed this, since I was sure Dr. Emaam would not mind taking me in the evening. 

Then things again began to go wrong. Emaam said he would be going in the morning ... and when I tried to re-arrange my understanding with Dr. Yasser, he went into an incognito mode! His official cell number was switched off, and he did not pick up the other number, his personal line, which he has shared with me. As Tuesday turned to Wednesday and morning to night, my panic increased. I had to contact him and request him to join the next morning, or I would be left without any mode of transport to go to Ta'if. 

In the end, he never did pick up my calls, but, to my pleasant surprise, he turned up for duty on Thursday morning. Thus it was that I finally left for Ta'if with Dr. Emaam at ten a.m. on Thursday. 

My vacation had finally begun!

P.S. On Tuesday evening, my car again gave me some trouble. One of the belts that connects the engine and generator to the car battery had probably fallen off and the battery, therefore, was not getting charged. I managed to get the necessary belt replaced and rectified the problem on Wednesday evening.

Three days in Turabah: Thursday, 14th November to Saturday, 16th November, 2013

These substitute duties are the biggest problem when one is working as a specialist doctor in the Kingdom. The reason is that the Ministry appoints the bare minimum required doctors in their region, and sometimes, matters become so difficult for them that even THAT is not possible as they are unable to find enough specialists to fill up the vacancies. Add to this the fact that most doctors in peripheral areas work for 3-5 years and then exit (unless they are Arabs, who tend to stay for more years), the fact that every doctor goes for their annual holidays for 45-60 days, and the fact that core specialities MUST have attending doctors - it is easy to see why we are asked to go to other places to cover for other doctors. 

Arriving in Turabah

This chart explains the Arabic alphabet

A road corner installation with the word "Turabah"

A roundabout with a huge installation

A new kind of service introduced by the Ministry recently
Just outside the ,main gate of the OPD

Another aspect of the floral bed outside the OPD

Turabah is about 220 km from Al Muwayh, and is a medium-sized village with over 20000 residents. However, their general hospital is much the same as my own in Al Muwayh. The patient load is greater and they have a more busy ER and OPD as well. It was my colleague's turn to go for substitution duty this time, as I had done the last one in Missan a few months ago. However, he requested me to go, and so I agreed. One of our drivers, a genial guy by the name of "Bandar" took me to Turabah on Thursday morning. The doctor I would be relieving for a few days is Dr. Mahmoud, an Egyptian Pediatrician. He wished to go to Makkah for Umrah in addition to other work, and he was currently alone as his colleague has gone for vacation too.

The work over the next approximately three days was not very hectic. There were a few new-born calls and less than 10 ER calls. A very relaxed atmosphere prevailed. The room I was given was well-appointed, but had a peculiar problem of running out of water each evening and through the night. I was able to partially rectify the situation on the second night, but otherwise, I had to leave the room and go to a bathroom inside the hospital to, well, er ...

The staff nurses here were amicable, but I spent too short a time to really know them; the one thing I did observe was that there are nearly 15-18 Indian nurses here. The doctors were mostly Egyptian, but I heard they had one Indian specialist looking after the dialysis unit. The hospital here has a functioning level II nursery and CT scan in addition to the dialysis unit - all these three are absent at Al Muwayh, though we do have the equipment to start a level II nursery (we just don't have the nursing manpower) ... and the CT scanner is due in the next few months, inshallah. (As Al Muwayh is located on the main Riyadh highway, we get a lot of cases of vehicular accidents, and a CT scan is imperative in most such patients. They have already started the creation of the CT scan department by breaking down two adjacent rooms in the male word.)

Turabah relieved me when Dr. Mahmoud returned on Sunday afternoon and I was back at Al Muwayh by the early evening.

Sunday, November 10, 2013

Studying for Part 3 of MRCPCH examinations; watching TV

We have formed a group on Facebook and on Skype with doctors who have, like me, passed part 2 of the MRCPCH earlier. As of now, we have about 14 members on the FB group, of whom about 7-8 are regularly with me on Skype each day evening. We discuss 2-3 case scenarios every day from 6:00 p.m. to half past seven. The usual suspects are my friends Dr. Ahmed Sallam (Egyptian doctor working in Madinah), Dr. Hala (Egyptian doctor working in a private hospital in Riyadh), Dr. Makram Nagy (also Egyptian, working in Egypt), Dr. Marwan Hegazy (Egyptian)  and Dr. Sanjay Shukla (from Jaipur, India). Sometimes, we are joined by others from the study group. 

We have been doing these scenarios since almost a month now, and I must say that the discussions are now prompting me to read about the cases under discussion and slowly, but surely, I am getting into a mood to study. Evenings have become very busy indeed, what with the group study, my daily walks, other work in the house, watching interesting TV shows, taking a nap, surfing the net, playing games on FB and what not! 

However, the upside of this is that I have successfully driven away boredom and am enjoying myself. I just hope that I am able to clear the exams next year and get the certificate of Membership of the Royal College of Paediatrics and Child Health, U. K.

In other news, I keep watching Kaun Banega Crorepati (the Indian version of the famous TV show "Who Wants To Be A Millionaire") on Sony International Television (SET India) on week-ends (Fridays through Sundays evenings 7.30-9.00 p.m.) The organisers are really inventive! This weekend, even as I am watching the Sunday episode, they invited senior school children to play as this weekend precedes the Children's Day in India. They even invited the final four contestants of Indian Idol Junior yesterday, and it was a pleasure to watch them perform once again, especially my favourites, Debanjana and Anjana. Of course, there was Amol and there was Nirvesh too. 

The other shows that I watch on TV are the news on Times Now, the series Bade Achche Lagte Hai on SET and a few others. In between, I keep watching movies and serials that I download from the net. Yesterday, I watched one episode of the 10th season of Grey's Anatomy (currently ongoing). A day before that, I watched the new movie Shuddh Desi Romance ... and was greatly entertained by the fresh acting of both the main protagonists (Sushant and Parineeti) and the eminently emotive Rishi Kapoor in a very engaging role. 

This is my on-call week, and I am now less than a fortnight away from going to India on my annual holiday ... thanks for reading!

A photo gallery - unusual snaps from inside the desert country

Over the last few months, I have clicked some interesting pictures of things happening around Al Muwayh and also within it. I may have already shared some of the following pictures earlier; if so, I beg your indulgence to check them out again as they make an interesting comment on how things are in this area of Saudi Arabia.

So, here goes:
New shop: sweets on display
Each of these hampers costs between SR 20-25 ... and it makes for a great treat.
It's a watch? A Samsung Gear? No ... it's a medical device
This watch-like device can activate an instrument within the body of a child with repeated fits; the instrument was implanted under the skin of this 5-year old's chest and would stop a fit when this watch-like device is brought next to it and passed across it. This is called a Vagal stimulation device. The implantation is not available in India yet.

A lovely fruit-salad created for a party by the Filipino nurses in our 
This is an aerial view of a small traffic island park in the center of Ta'if
A new football ground and race-track has been built in Al Muwayh.
This ground is being used very sparsely for football alone; no one has ever used the track laid alongside it. The ground can't be used after sunset as there are no lights and it is located in a remote area.
The Ministry of Health's new Operating Room dress
... and the drapes on a patient under anaesthesia.
The new materials are ALL DISPOSABLE - including the patient drapes, the doctor's and nurses' uniforms, etc. Makes for a sky-blue atmosphere, but where the chances of infection, I presume, would be reduced as all the material is thrown away for safe disposal after one-time use.

A picture of a petrol pump in Riyadh.
Another photo of some offerings from the sweet shop
... and this is the last one
A lovely candle used by the Filipinos at a party to celebrate a friend's birthday.
Potato bhaji made by me
A custard with choco-chips packed separately

Bridal gowns available in a Ta'if mall

These steel bars provided some fun for these locals

A nice toy that was kept on the table
The occasion was the Saudi National Day and this was kept, along with the next item, on the lunch table as an attraction.

I adorned my computer table with these green takeaways from the hospital
 This was also on the Saudi National Day ... green is their national colour.

How a juice shop ought to be decorated

This is the inside of a special tent of a rich local Al Muwayhian

He is the "king" of this house!

That, on the right, is the hearth ... for lighting a fire in winter

This cat is cute, but also intrusive and curious.
 He/she stays in the local garden where I go for my daily walks. His/her intrusiveness is awkward when we sometimes gather to eat food or cook chicken at a barbeque.

Locals posing for me with their ... ah ... moustaches.

Sunday, November 03, 2013

Looking back at Two Years in S.A. - some thoughts.

I have now completed two years in the Kingdom as per the Arabic dates; if one wishes to follow the Gregorian calendar, then, well, I have about a fortnight to go before I cross the two-year milestone. I have seen a fair bit of this side of the world, and a lot more remains to be seen. I do not yet know if it will be possible for me to visit all the places in the kingdom. It has been a roller-coaster ride, and the big highs have been the steady, high income, the freedom to live in the way you want, the relatively easy work and the pilgrimages to Mecca and Madina. How can I forget that it was after coming here that I got more time at hand to study, to brood, to walk, to travel, to cook, to make new friends, etc. 

I had big lows too: staying away from a very charming family has taken its toll on both sides; while I miss them completely, the daughters have tasted a father-free life and my wife, a husband-less one; it is up to her, and not me, to comment if that has been a boon or not; regardless, their freedom has created some tensions, as the 100% female family there has no male control - I firmly believe that males can defuse the mental stresses that occur between females much more effectively than other females can; on the contrary, other females may even INCREASE that stress to higher levels! The other big low has been the loss of my father. Of course, nothing can stop Death, and I know that, but even so, I hold my absence responsible to some extent for his very acute deterioration over the last four months of his existence on Earth. If I had been there (and he really missed me, for he kept beckoning me to come back when I chatted with him on Skype), perhaps ... but who knows what Fate has destined for anyone?

Most of the time I have spent in Saudi Arabia has been one that has given me a lot of pleasure; the expats who live in Al Muwayh are from various countries, and talking with them, breaking bread with them, and going places with them has sensitized me to the lives others live; working closely with these people of different nationalities makes you understand how they live, what their values are, what their culture is all about, how they view BIG issues like religion, morality, Life, Death, etc. To summarise:

Arabs (Egyptians, Syrians, Sudanese, Palestinians, Tunisians, etc.) are very keen about Islam. Over 99% of those I have met are Sunnis and lay a lot of stress on the Qur'an, the Hadiths and the Sunnah of Prophet Mohammad (P.B.U.H.). They pray on time, eat mostly bland food with an overdose of the non-vegetarian stuff, love to drive cars, usually have 3+ kids, and some among them look down upon Asians (read Indians, Pakistanis and Sri Lankans). A large number of them are loyal to their wife (all of them have just one, unlike some Saudis who often marry more than one woman) and enjoy themselves in the Kingdom. They, being Arabs, mould well with Saudi society and customs and do not generally want to leave their jobs unless they have some peripheral problems such as when their children grow to school age and there is no proper schooling in Al Muwayh, for example. They love to chat in their own language and will often ignore me even when I am in the same room with them. Barring a few good doctors, most will not bother to translate the conversation they are having. They take their time to make friends, but when they do, they become very good pals. I must mention here that I have grown very pally with a few of these worthy doctors. 

Filipinas (Philippines), mostly nurses, but also engineers and other skilled and semi-skilled staff, are a totally different breed of people. Caring and nurturance is like second nature to the women staff, be they nurses or cleaners. Short in height but tall in "stature" Filipina nurses are ambitious, hard-working and meticulous; besides, most of them are talented in skills like decorations, craft, cooking and so on. They live a joyous life, spending hard-earned money or frivolous stuff like costume jewellery, cosmetics, hand-bags, shoes, dresses and the like with abandon. It is a surprise to me how they spend so much and save so little, considering that most of them are here to make a future for themselves. I am friends with almost ALL the Filipinas in my hospital. I try to help them when they need my help; in return, they smile a lot, get food sometimes for me, and help me whenever I need it. Most of them are married, with children, though some, especially Muslim Filipina nurses, aren't married. It is a different culture from the one that we see in South Asia. They marry late, only after achieving their financial targets. There is no such thing as an arranged marriage. Females must find their own life-partners through social meetings, dating and the like. In this respect, they resemble the Western culture. The nurses and the helpers live apart, but help each other, and do not differentiate between each other in most respects. 

This leaves me with fellow Indians (from various parts of the country), the lone Pakistani doctor and the few Sri Lankans. There is hardly any cultural divide between the people from India and those from the other two south Asian countries, though clear differences exist in language, cuisine and dress. The lone Pakistani is Dr. Niaz, a gynecologist-obstetrician, and we have shared our living quarters for a part of 2012. Other than him, I have met several Pakistanis, and my relations with them have been in the range of cordial to friendly. Not one of them has had problems with me, or I with them. I eat Pakistani food when I pretend to be eating Indian food, for they are the only ones who have restaurants in my village. 

The Sri Lankans are cleaners too, and a few are technical chaps working in the hospital as electronics technicians, plumbers, etc. My interaction with them has been very pleasant too and I have no regrets when I have called upon them to fix my water leak or set up my TV set, etc. 

This brings me to the end of my brief observations on the expats. In my next post, I will expand further on the indigent people of the Kingdom. Until then, bye.

Do leave your comments. Thank you.

Saturday, November 02, 2013

New month ... and some new thoughts

Before I proceed with the personal stuff, let me wish all my readers a HAPPY DIWALI and a PROSPEROUS NEW SAMWAT YEAR. Also, let me wish my Bohra readers HAPPY THAAL NU VARAS and all my Muslim brethren HAPPY HIJRI/MISRI NEW YEAR.

Okay, so I last posted about 5 days ago, and in the intervening days, I have been on-call. Life is as usual. I continue to walk about 5-6 km daily evening, trying to set a pace of at least 5.7-6.0 km/hr. My friend Emaam Sayyad is my companion, and my rather slower pace is because of the fact that a) he cannot walk faster and b) we chat while walking. Even so, I believe that I am feeling fitter. I don't think I have, as yet, lost any significant weight, but perhaps I have lost an inch off my rather humungous abdomen. I try and eat less at meal times, but it is the mid-meal snacking that is my nemesis. I have set a goal of reducing at least 2-3 kg in the next fortnight or so, but let's see what happens!

In other news, I finally finished my online courses in "Animal Behaviour" and "Vaccines". I "un-enrolled" myself from the course on "Global Warming" due to lack of time. I have begun Week 1 of a course on Diabetes and am waiting to start a course on Nanotechnology later this month.

I was in Ta'if last week and brought back a lot of edible stuff so I haven't really cooked anything substantial; however, yesterday, I tried my hands at making dosai; they weren't really good, but you could eat them and still maintain a smile on your face. A little chatni was what I had them with. With the left-over batter, I made a masala utthappam, which I had for lunch. Thus, I had better success with these things than I had had when I had tried it the first time. One of the reasons for this might be that I used a new large non-stick pan that I have bought from Ta'if last week. I shared the dosai with some leftover sambar that I had from my last experiment.

That's it for now ... see you around. Do leave your comments. Thank you.