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Thursday, July 30, 2015

The last six weeks of my stay in Saudi Arabia have begun

Yes, friends, I am leaving this job very soon. My final exit is approximately due in the last week of August or early days of September. As such, the last 5-6 weeks of my life here in Saudi Arabia have begun. I am definitely not going to be emotional about it, as my future beckons me strongly. The last three months have been filled with work, but outside work hours, I have had time to relax, to read, to watch movies and TV serials, to chat with friends and family, and to continue some element of study here and there. 

My acceptance of exit from this country was approved by the Ministry of Health, Directorate of Health Affairs in Taif a couple of weeks ago. Once that paper came, I became sure that I would leave as per my end of contract. I worked during the Eid period, thereby entitling me to an additional 4 days of holidays. To this, I added a further 26 days of holidays that lie in my balance for the current year. I have therefore obtained a vacation of a month (26 + 4 days). As my contract ends on the 3rd of October, I will be able to leave around the 3rd of September. 

I am not openly disclosing my plans for what I will do once I return to India. Perhaps I will try for a new job in another country, perhaps either the UAE or the UK. Let's see what happens. 

In the meantime, my family is doing fine, as is my mom, who, however, is now confined to her house, barring some social outings to her sons' (either my place or my brother's place) homes. I am growing impatient to meet them.

Back here, I keep experimenting with food. I made goat's legs (trotters) - once about 3 weeks ago, and then again, yesterday. I seem to have mastered the method of making them, as they turned out just fabulous on both occasions. Today, one of our ER residents, a Sudanese by the name of Dr. Asiya, brought a Sudanese preparation of fish curry. It was absolutely delicious. I had it with brown bread (khubz burr) in the afternoon. Life goes on ...

Friday, July 24, 2015

An unusual experience concerning medical care delivery

In the past few weeks, I had to accompany preterm, extremely small babies to transfer them to the Children's Hospital in Taif. The first such incident was event-free as the baby reached the hospital in reasonably good health and was handed over to the NICU in the proper way. 

The second such incident occurred a few nights back. This was a 28-week male child who was gasping at birth and needed active resuscitation for nearly 3 hours before the baby stabilised a bit to transfer to Taif. During these 3 hours, the baby needed to be given artificial breathing. The insertion of a tube into his airways needed the expertise of an anesthetist not once, not twice but up to 4 times. 

When we were en route to Taif, the child gradually deteriorated. By the time we reached the destination, unfortunately, we had almost lost the baby. The final end came after another hour when the resuscitating team at the Children's Hospital announced that the baby had died - about half an hour after the child had been received by them.

The incident was definitely very unfortunate and may depress the readers of this otherwise positive blog. The reason why I am actually including this incident in my blog is to make readers understand why working in a peripheral area with lack of facilities can cause such unfortunate outcomes. The distance from Al Muwayh to the Children's Hospital is nearly 200 km. The risk to an extremely sick child is indeed very high and even if the ambulance driver drives very fast at speeds of 160 kmph or more, it still takes nearly 2 hours to reach the NICU, because of city traffic. 

There are no easy answers to this, and the medical establishment all over the world is worried about such problems. In some rare circumstances, developed countries do transfer patients by air ... but this requires an infrastructure that is highly expensive to develop and very difficult to secure for a normal patient who is not a VIP or well-connected. 

I welcome comments. 

Sunday, July 19, 2015

After Ramadan

Ramadan Eid was celebrated some days ago, and it was a relief to see the month pass. This is not just about the rigours of fasting. It is also about the changed duty timings, the unavailability of things in the market during several hours of the day, and also between Maghrib and Tarawi prayers, and some other minor inconveniences. 

During the days surrounding the Eid, we have what is known as the "murabta" - which is the compulsory duty period if you wish to get compensation in the form of either extra pay or extra days of vacation (you can choose one of the two). During these days, every staff member attends duties. In the ER it is not unusual to see 4, or even 5 doctors in one duty shift! Nurses are always available - except for the Saudi brothers, who disappear during the Eid days. It is a good time to socialise, to meet your friends in the hospital and to reflect. At the same time, the overcrowding with the absence of patients makes one realise that this is a system that does not work in the correct way. Why enforce attendance at a time when there are hardly any patients? I am still trying to get an answer to this question. 

One of the minor inconveniences is the unavailability of things in the markets for several days after the Eid. This is because suppliers send their stuff in trucks; and these truck drivers are on holiday! When I visited a supermarket today, I found the vegetable and fruit racks empty. The bakery shops are closed, as are the small snack bars (the buffiyas). There is no one to open the shop that sells water by the can for drinking and cooking purposes. In short, there is a pseudo-shortage of several items, because the locals have already hoarded up on these things before the Eid. And also because the workers are just not around. 

I expect that things will begin to improve by tomorrow, which is the 4th day after Eid. Ameen to that.

In other news, I am continuing my efforts to write a book on my MRCPCH journey. It would be my attempt to help future students to take these exams. My efforts are also on to search for a job either in the Emirates or in the UK - this must happen soon, as I am due to exit the Kingdom within the next few months. I have signed up for writing job tasks on a few web-sites - an attempt to test myself to do constructive work in my spare time. (Do check out http://www.freelancer.com if you are also interested - and not just for writing jobs.)

That's it for now. Thank you for reading. I will await your comments and constructive feedback. Eid Mubarak to my Muslim and non-Muslim friends. May your coming months be prosperous and peaceful. 

Tuesday, July 14, 2015

Enjoying a few days' leave

The truth of the matter is that although I am entitled to get more than 35 days of leave (leave that I am legally entitled to, and which I have earned with hard work and performing duties outside Al Muwayh over the last 3 years), there is a severe shortage of doctors of all specialities in the Taif directorate-governed hospitals. The situation for Paediatricians is extremely dire. There is just one Paediatrician in almost all the hospitals in the region, except for a few; even there, one of the doctors is on annual leave - in most cases. Thus, when I applied for 7 days' leave, the Muderiya was able to grant me only two. They arranged for one doctor from Turabah - one Dr. Mahmood. He requested me to adjust his leave in such a way that he would arrive to replace me on Sunday evening, and would like me to relieve him on Tuesday evening. I agreed.

Accordingly, I was relieved of my duties for two days. Yesterday evening, the good doctor arrived at five p.m., as he had promised. I arranged with one of the brothers working in the hospital to take me to Taif when he went there after his night duty. His name is Rakan and he is a Saudi. He picked me up around half past twelve, his brother actually the driver. 

The journey was completed within an hour and a half - at an average speed of 150 km/hour, the range being between 130 and 172 kmph. These Saudi guys can really drive! At one point, he did not get the right of way, and he forcibly stopped the car driver whose car was blocking his way, and shouted a string of bad words at the poor Egyptian who seemed to be at a loss for words. While he drove at 160+ speeds, my heart was in my mouth, and I kept praying silently for him to reach safely to Taif.

In the event, we had a safe but eventful journey. These guys live about 30 km before Taif in a city called Hawiya. They dropped me at a desolate junction before going their own way, I finally got a Pakistani guy to drive me to another junction on the way to Taif. From there, a Saudi fellow, driving his private car unofficially as a taxi, took me to my destination to the hotel where I would stay for the night.

I have stayed at Ahle Saif hotel so many times I cannot remember! I reached the hotel at a little after 2 a.,m. I spent the next hour settling into my room, then going down to purchase a few things, and then I retired to my room, where I finally fell asleep at about 5 a.m. 

Waking up at a half past ten, I continued my work from where I had left it earlier. I went to the Bab-al-Rea market to buy trotters and some vegetables, to the Indian market to buy stuff like curry leaves, salted cashew, "garam masala", a few bulbs of garlic, snacky stuff and a few other things. I had completed my purchases by half past two. I slept for a few hours in my room, then went back down a little after the Maghrib prayer and, after buying a few more things, I returned to my room and packed my things. By 7:15 p/m., I checked out and went straight to the bus stand (SAPTCO) in a hired car. I returned to Al Muwayh by half past eleven in the night, and here I am, completing this entry at mid-night. 

Post-script: The Saudi taxi driver who took me to Taif had a harrowing story to tell. Apparently, his siblings are almost all affected with some complex disorder. His one brother is fine, like him. His two other brothers are in the Taif Psychiatric Hospital since many years for a chronic psychiatric disorder; his three sisters, all adults, are physically disabled and at home. His father is no more. He earns money through his taxi driving in Taif, although his family lives in Riyadh. When I expressed my regrets, he simply said "Alhamdolillah" That was something. My salute to him.

That's it for now. Thank you for reading this post!

Saturday, July 11, 2015

An unfolding future

Even as I write this post, I am wondering how and what my future is going to pan out/ turn out to be. I am an eternal optimist. When my family received the original MRCPCH certificate by post in India, I urged my daughter to scan it and send me a soft copy. I tweaked it a bit, removing unnecessary blank portions from the scan, then converted the scan into a picture. When I posted this on FB, I received a deluge of likes and comments. I received more than 10 new friend requests from people who are keen to complete their MRCPCH qualifications. I received congratulatory comments even off Facebook ... on Whatsapp, by calls, and through SMS messages on my Saudi phone. 

When the hullabaloo over this had subsided, I decided to introspect. I have read elsewhere that people who post about their own achievements and activities are not liked much They are perceived at best to be narcissistic and at worst to be egotist. However, sharing good news of this kind is what social media are all about, aren't they? So. I carry on in this way.

I also received my much-awaited  (delayed) salary this week. I believe this will be one of the last few salaries I will take from the Kingdom, as my exit papers have already arrived, and, as I write this, I have less than 2 months to go for my return flight to India. I am regularly applying for jobs in the Emirates, and recently, also in the UK. I hope something or the other materializes soon in some direction. 

Now to some tit-bits: 

  • Yesterday, I met a few Malayali nurses in one of the small stores in Al Muwayh. They had come to our village in their dispensary-sponsored vehicle to make local purchases from a village called "Rukna". This village is 140 km from Al Muwayh! There is no other place where they can go to do their weekly shopping.
  • Ramzan duties are going on as usual.
  • I will be able to take a few days off from Sunday evening onwards until Tuesday evening, as a doctor from Turabah is going to come to work in my place.
  • I spent a few hours yesterday night with my namesake Dr. Tahir (the ER resident from Srinagar), and we had a good discussion on various issues. He is planning to study for USMLE and wants to emigrate to the US in some years from now. 
  • Like every year, the shrubs and trees are decorated with blinking lights in preparation for Eid. This festival is most likely going to be on the coming Friday, 

Thursday, July 02, 2015

Over half of Ramadan over

Yes, more than half of the holy month of Ramadan is over. Not much has been happening in Al Muwayh. Roads are nearly empty through the day. Activity picks up only after the evening prayers. A couple of small eateries bring out pakodas, chana chaat and samosas to sell to fasting devotees; department stores of all shapes and sizes open for brisk pre-iftaar business; cars appear on the wide promenade and roads; women appear in their ubiquitous abayas, walking to eateries and "bakalas"; young men and boys are seen ambling down the road. By half past six o'clock, cars begin to collect outside mosques, the roads again start emptying themselves. Fasting men and boys start collecting in groups with fruit and other stuff piled on a plastic sheet in front of them as they wait for the sound of the Maghrib azaan.

As the sun goes down, a hush falls on the town. Women who have made their purchases run home to cook hot meals for their men-folk; cars dwindle, children go back home, and expats, too. Non-Muslim people have to go back to their homes as well. Bakalas and shops start closing, with their managers urging shoppers to leave soon as the prayer time draws near. Through all the stillness, the sounds of azaans break out all over the town, tens of mosques blaring out the pious prayer over the megaphones. Devotees break the fast, their eyes on the clock, as they must complete the food piled up in front of them before rushing to the mosque to join the rows of devotees who are awaiting the call of the muezzin to begin the Maghrib prayer. 

Once the maghrib salat is over, people spill out again into the streets. Activity picks up from where it died down before the prayers, More people emerge out of their homes to take advantage of the fading daylight to purchase food and other necessities. Business is brisk in the next one and a half hours before it will be time for the next prayers - the Isha prayer and the Taraawi

My duties in the hospital during the working week are in two shifts. The first shift is from ten a,m, to 1 p.m. During the morning shift, there is no work at all, as fasting people do not venture out for routine OPD visits. Only road accident victims and emergency patients continue to come - mostly in the ER. The medical OPD does see some patients, as do the others. My own OPD (Pediatric) hardly sees one or two routine cases in the morning shift. Our second shift begins at 10 p.m. and continues until 1 a.m. During this shift, it is work as usual. The out-patients are full of patients and care-takers. Doctors and nurses are busy inside their cubicles. There are a limited number of patients in the ER as all routine cases are diverted to the OPD. By half past twelve, most of the work is done, and we slow down, awaiting the end of duty. The work day is then over.

I reach home within five minutes. Usually, I have slept most afternoons, so sleep does not come easily. I sit on my laptop, updating my games and checking my email. I usually watch an episode of two of the LOST series (currently I am on season 2) before retiring for the night at half past two or so. I take my suhur before sleeping, but I do not observe all my fasts owing to my diabetes. 

And Ramadan goes on.