Tag Archives: change

The Power of Dreams

My aunty forwarded one of those inspiring videos about life and happiness. One particular message struck me. It said something about having a dream then making it happen. Of course, it is easier said than done. It is not quite that easy to turn a dream into reality but those people who are the happiest are those who had a dream then put their all into making it a reality. I have many dreams. Through hard work and luck, many of my dreams are already a reality. I got into medical school, I graduated. I applied and got into speciality training and I am gaining experience as a paediatrician. I met a man with a big heart, fell in love and married him. We bought our lovely first home, a permanent abode after my many years of moving from flat to flat.  I fell pregnant when we were in good place and the baby has been growing well with the easiest pregnancy. I am getting ready to realise one of my biggest dreams – giving birth and being a mother. So yes, my bucket is overflowing.

This is about my professional dream.  I used to think I would be happy to graduate, specialise as a paediatrician, get a consultant post and settle down to a routine. With the recent political shenanigans and the more I work in the NHS, the more I realise I want more. I want more out of my life and I also want to contribute more than the daily grind. Don’t get me wrong, I know in my current role I do make a difference to lives. There is nothing more satisfying that when I have done a good job and I know that parent or child’s life has been changed for the better, no matter how small that change is. However, many days I look back after a busy day and think was that worth it? Those days which are all about paperwork and administrative tick-boxing exercises that contribute nothing except to some faceless manager’s satisfaction.

The part of the world where my life started (Yola) is lovely in a lot of ways but there is a significant poverty. In terms of economics but also in healthcare terms. Nigeria as a whole fails to cater to the healthcare needs of its population unless you have lots of money to go private. The North-East of Nigeria is one of the poorest when you look at health outcomes. In particular, looking at childhood. The statistics (where there are any) are shocking. Nigeria, for all its wealth, regularly features at the bottom of tables for health outcomes. We are in the bottom 5 for most outcomes including maternal and under 5 morbidity and mortality. For the non-medics reading this, morbidity refers to how much ill-health and disease (sickness there is) there is and mortality refers to how many are dying.

Mothers naturally should come in a low-risk group. Most should be healthy young women doing what is most natural – getting pregnant, growing a baby and then delivering the baby. Young children, although fragile because they are not mature yet biologically are despite all of that resilient on the whole and have bodies that are full of strong healthy organs with endless potential for healing. What we are failing to provide is basic care. Basic antenatal care, trained birthing assistants, hospitals to assist in difficult deliveries and facilities for emergency caesarean sections (surgery) for those women who cannot do it naturally. Infections, on the whole preventable and most totally treatable, cause a lot of the morbidity and mortality in Nigeria. Many of the other things we provide here in the NHS is simple supportive care, allowing patients own bodies to heal themselves in a secure environment.

So here is my dream. I would like to set up a women’s and children’s health centre. Big dream I hear you say. Yes, I am aware. It will be a huge task. I worked at the FMC in Yola for 4 months in 2012. I saw how much need there was and the things that were missing. I know a lot of the patients we couldn’t help were those who lived far away from town and did not come to us until their disease was too advanced for us to be able to do anything. Mothers died in childbirth because they did not have adequate antenatal care so predictable problems were not discovered until it was too late. Preterm babies died because they were born out of hospital in environments not hygienic enough and did not get simple breathing and feeding support and early treatment with antibiotics. Term babies were born too small because their mothers were undernourished and unwell with treatable conditions during pregnancy but were not diagnosed and treated. Very few of the patients we couldn’t help needed fancy expensive medicines or surgery. It was simply too little too late.

On the positive side, those that did come to us in time had better outcomes than those suggested by the statistics I read about on WHO and the likes. Those preterm babies born at FMC Yola thrived and majority survived until discharge. Sure, their progress was slower than here in the NHS because of a lack of basic equipment and provisions like oxygen and breathing support, working incubators, labs, fluid pumps, parenteral nutrition for those too young to feed by mouth or through the stomach. But survive they did because they are little fighters.

So what I dream is to provide all those basic things to the mothers, babies and children free of charge if I can manage to raise funds or at the very least at the smallest prices possible to give those with little the chance to quality healthcare. To go with that, I would like to provide an outreach service to those isolated villages. Run clinics, provide immunisations, antenatal vitamins and nutritional support, teach about prevention of infections and when it is vital to seek early medical help. Central to that idea is to train some of the villagers to provide safe simple birthing assistance, supportive care for new-borns and how to diagnose and treat the most common infections and provide first aid. All little things but added up should cut the numbers of mothers and children suffering unnecessarily and prevent the many preventable deaths.

My grandfather listened to me talking about my dream and was (rather unexpectedly) downbeat about it. He pointed out that it wasn’t as easy as I was making out. Actually, I know it will be difficult to do and as I have never done this before, it is a monumental task. There is so much to do to get this off the ground. However, here is my plan. I will start small and do this project in stages. I will deal with the complications as I get to them. A journey of a thousand miles has to start with that first step. I have taken my first step. I have dared to dream and I have written down my dream in black and white. Now onwards and upwards. Watch this space.

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Mind the Gap

I watched a BBC documentary on The Taj Mahal Palace, one of the best hotels in the world located in Mumbai according to the documentary. It certainly looked the part. The opulence and the service was certainly worth the thousands a stay would set you back by. This struck me but what struck me more was the homeless families who made their home outside the walls of the hotel. The poor women who sold recycled flowers to make enough to feed their children. Where were the men who fathered those children I wondered? If the Taj was so successful, couldn’t it be charitable enough to feed its resident poor? How could the guests stand to walk (or more likely drive) in past those poor wretches into such luxury?

This sort of wealth inequity is replicated all over the world of course. The less industrialised the nation, the more likely you are to see scenes like these replicated. In Yola where I come from, this is very much in evidence. It is not unusual to see a huge mansion complete with high surrounding walls, an impressive iron gate manned by gatemen and perfectly manicured hedges sitting next to a hut, little more than a lean-to with dry barren land surrounding it and the inhabitant(s) unable to afford 3 square meals and clean drinking water.

When I was little, we would have bouts of feeling charitable and go visit one of those poor homes. Most of them are inhabited by single old women. Some were called witches because of their social isolation or maybe because of their disdain for some of our archaic cultural norms. Many are just poor and alone, without a benefactor to lift them out of abject poverty. A good proportion were quite old and really did need a hand. My friend and I would go in and give their hut a spring clean, refill their water pots (their lounde) and clear out accumulated rubbish. We would leave with their prayers for us and our mothers ringing in our ears. These women managed because they had neighbours like us who would go in periodically and help out.

That is one thing I love about Yola. By Yola I mean Yola town. Not the metropolis that is Jimeta which has lost most of its old school community (or maybe being ‘new’ never got a chance to form the same bonds). No one can deny that poverty is pervasive in the society there but actually, so is charity. It is imbedded in our culture to look after our neighbours. No one in Yola that I know of has ever died of starvation (malnourishment is a different kettle of fish). If your neighbour struggles to find a meal, they could simply turn up at meal times and they would get fed.

I remember one of our dear matriarchs who had little herself always fed more than just herself and her dependents. We always had food to eat at hers even though she was poor herself. When we went to see her before we went off to boarding school, she would ask for forgiveness (in case she died before we came back) and forgive us any infractions then she would rummage under her mat and give us some of her precious savings so we could buy something. We would demure unfailingly but we also knew we had to take it. Because not to take it would be seen as disrespectful and a sign we did not value her loving gesture.

This was 2 decades ago. Things are changing but charity is still very much alive. I am not sure whether the local children are still doing what we did back then but I sincerely hope so. Especially because as religion and politics become more and more of an issue and many of those in our communities claim to be religious. Well then. If that is true, true poverty should never be an issue. Islamically, Zakat is part of our core duties, one of the 5 pillars of Islam.

“Be steadfast in prayer and regular in charity: And whatever good ye send forth for your souls before you, ye shall find it with Allah”                                        Qur’an Chapter 2 Verse 110

For any Muslim who can afford to support their living themselves and have something left over, they should donate 2.5% of their wealth to those who are in need. This is Zakat. Imagine if in a society like Nigeria where an estimated 50% of the population (87 million) are Muslims. Now imagine that about half of them can afford to pay Zakat. If even half of those (20 million) contributed 2.5% of their wealth to a community fund that was well-managed, things would be so different. So I challenge the practising Muslims who preach all things good to sit up and remember this core duty of ours. More than a billion Muslims across the globe, a good proportion with enough wealth to alleviate poverty all around them. Let’s do it people!

The Expiry Date

This morning I read drkategranger’s blog regarding her expiry date (she is a doctor with terminal cancer who talks about death so candidly, it inspires. I would absolutely recommend!!!). The blog and some of the responses to it got me to thinking about death. I have already written about dying and the fact that I fear it not so much. As a Muslim, I tend to see death as just one of those certainties of life so I treat it quite matter-of-factly. This blog is will be further musings about my experiences of death. I will start with a quote from Hadith (Islamic teachings) which summarises how I generally see life and death:

Al-Hasan Al-Basrî said:
‘The life of this world is made up of three days: yesterday has gone with all that was done; tomorrow, you may never reach; but today is for you so do what you should do today.’ Al-Bayhaqî, Al-Zuhd Al-Kabîr p197

I am generally an optimist or more accurately an optimistic realist so I try not to be morbid and I am generally not one to dwell on death. However, I have had times in my life where the thought of dying has crossed my mind. Last winter was a pretty bad time for me. I was working in the hospital that inspired me to become a paediatrician (which still inspires me) but I was in a job with a particularly toxic individual who succeeded in poisoning the atmosphere. I became depressed after 6 weeks of this. So much so that I hated waking up every morning I was scheduled to work. It got to a point that I would lie in bed, sleepless and think ‘would it be that bad if I didn’t wake up in the morning?’ As soon as the thought came to my mind, I would feel guilty and terrible. Guilty because I knew that my life really wasn’t that bad and that there was so much for me to be grateful for. Terrible because I knew my death, although insignificant in the grand scheme of things, would be horrible for my nearest and dearest. My mama especially. I got through those 4 months because my husband was there and would not let me sink into the depths of depression that kept pulling at me. Thank you George!

I am now back to my normal sunny self despite some current work horrors. As a newly-qualified doctor back in 2009, I dealt with death day in, day out especially on my first job on gastroenterology at a busy inner-city hospital. After the initial shock, I got used to it. Not that I didn’t care or it didn’t bother me but I dealt ok with it. There are 2 patient deaths from those days that have stayed with me. Both died of alcoholic liver disease. Both men in their 40s.

The first patient died slowly from hepatorenal syndrome (HRS). Basically with chronic liver failure, if your kidneys too fail, you will die soon because that means 2 of your 4 vital organs are dead or dying, unless you get brand new organs (i.e. transplants). As things currently stand, you cannot be put on the transplant list for a new liver if you are still abusing alcohol because the new liver will get damaged just the same and it is considered a waste of an organ that is in high demand but short in supply. So with my first patient, who I will call Patient A, when his kidney function tests declined rapidly and nothing we could do medically fixed it, we diagnosed HRS and my registrars and consultants had a meeting with his wife to inform her of the diagnosis and what that meant for the patient. He too was told in due time but because of his liver failure, he was confused and did not fully grasp the fact that his condition was terminal.

He deteriorated slowly over a few weeks but in the meantime, he would ask me daily when he could go home and travel to India to be blessed in the Ganges River. I would mutter something non-committal and beat a hasty retreat out of his side room. Initially, it was clear that his wife knew his death was near. But even she began to belief he would miraculously recover from his liver and kidney failure. Every week, she would say something that made us worry we hadn’t prepared her for the inevitable. Every week we would remind her gently that although she couldn’t see it, he was in actual fact deteriorating judging from his biochemistry lab results and worsening oliguria (he was weeing less and less).

In the week of his death, he suddenly looked well again. If I wasn’t the doctor patiently doing bloods on alternate days and chasing those results and noting the relentless rise in his urea and creatinine, I too would have started to believe in miracles. His wife upon seeing the light return to his eyes and his demeanour brighten plunged headlong into denial and joined him in planning their trip to India to the Holy Ganges River. Less than 24 hours before his eventual expiry date, it was devastating for me to watch her grief as the light in his eyes faded rapidly and he shrunk back into himself. Within 12 hours of his final illness beginning, his strength was gone and his mind with it. His utterings became incomprehensible and he became completely disorientated. The look on her face said it all when we came in to see him on our ward round that morning. We returned the look and she ran out of the room to sob in the corner. He was anuric by then (had stopped weeing completely) with a creatinine of over 400 (in other words, his kidneys had packed up). His liver function tests painted an equally damning picture. We completed his end of life paperwork that morning and when we left work that evening, he was hanging on by the tips of his fingers. We came in the next morning to the news that he had died before the end of the day before. The side room he had occupied for many weeks stood empty, awaiting its deep clean before the next customer.

Patient B was a young alcoholic who had developed liver cirrhosis in the months before I started the job. He had just turned 40 and I don’t think had any idea how serious the consequences of regular alcohol binges could be. Reality hit when another patient who was his ‘neighbour’ on our ward developed HRS and died rather quickly. All of our words of warning had somehow not sunk but with this other patient’s death, his mortality was clear to him. He called me over urgently that afternoon and said ‘Doc, I am ready to change’. I was pleased and felt a sense of accomplishment when I referred him to the rehabilitation programme. His wife found me the next day before they were discharged home to thank me for getting through to him. I was honest to say it wasn’t anything I did.

Unfortunately, he came in a few weeks later unwell with an infection which caused his liver function to deteriorate badly. I was encouraged to hear that he had no touched a drop of alcohol since his last admission. He developed litres of fluid in his tummy and I had to put in a tube into the side of his tummy to drain out all that fluid. He was in a lot of discomfort and fearful for his life and he asked me ‘Doc, am I going to die?’ I hesitated over the words I used but in the end I made no promises. Just that I would do everything I could to help him get through this. At first, it looked like the drain and intravenous antibiotics were effectively doing the job and the next day, the fear was gone from his eyes. I was encouraged by his blood results and left having ordered some more routine bloods for the next morning. Coincidentally, at I was securing his abdominal drain, I carelessly dropped the needle I was using to suture and when I went to retrieve it, gave myself a needle-stick injury. I had to get a co-doctor to inform him and take blood samples off him to check that he didn’t have any blood borne infections I could catch. He apologised every day after the event like it was his fault I had stuck myself with a contaminated needle. He asked me about those results daily – he seemed genuinely to care for my welfare. This went on for over 2 weeks as he slowly improved.

I was doing the ward round alone one morning when I was called urgently to his side. He was in a great deal of pain and was writhing in his bed with his abdomen larger than before we drained him. He was pale and clammy and his eyes looked like a man staring down the barrel of a gun. I could barely make sense of his words and as I changed his prescriptions, called the blood bank for blood products and prepared to get a new drain inserted. I could see the life begin to ebb out of his eyes. In a panic, I called my registrars and told them I needed them on the ward ASAP because patient B had taken a turn for worse and nothing I was doing was making a difference. The registrar told me to leave the drain for the meantime and focus on reassuring the patient. After I asked the nurses to call his wife in, I went to him and I held his cold hand. I looked into those eyes and I knew in that instant that he was not long for this world. I remember saying a mental prayer that he could hang on for his wife to be by his side.

‘Doc!’ he cried. I squeezed his hand and responded ‘Yes B?’

‘I am dying aren’t I?’ he asked. I looked down and swallowed the lump in my throat. ‘I am here for you B and I will do everything I can to help you. Your Mrs is on her way in.’

‘Stay with me,’ he entreated fearfully. I nodded and again I had to look away because the fear in his eyes was too powerful for me to take in. The rest of it was a blur. His wife made it in before he died but not in time for him to know she was there. He was delirious by the time she got to the ward and as he was slipping away before our very eyes, there was little time to have ‘that conversation’ with his wife. The consultant whisked her away and broke the news to her. She could see that treatment was futile by then and knew that he was on maximal available medical treatment. We had no more to offer. She signed the DNAR (do not attempt resuscitation) forms and we set about making him less agitated. When we finally called it a day, he was less distressed, still mumbling incoherently and his eyes had started to take on that distant look I now associate with death. I came in the next morning to a request to come to the morgue to complete his death certificate and Crem forms so that his wife could lay him to rest. I got a call 3 days after his death to say his blood tests for blood borne infections had come back negative so I was in the clear. I cried in the staff toilets. He would have been relieved not to have put me at risk I think.

What did patients A and B teach me about death and dying? Firstly that when it is your time to go, it is your time to go. Life unfortunately doesn’t usually give you a clearly labelled package with an expiry date on it. Secondly, although death is scary for the person dying, it is actually worse for the person who loves them who has to watch them lose their battle to live and battle their fear of the unknown. Who has to go home and face life without them and rebuild their lives around the hole left by the dead loved one. Who for a very long time will think about their dear departed every morning when they wake up and every night before they fall asleep. Lastly, every human is unique. Despite having the same disease and modifying your risk factors, your body will do its own thing. We doctors can try to influence outcome but whether we succeed or not is not within our power to control. That is beyond science and medicine. That is life. That is God. That is reality. May we all depart this world in the easiest swiftest way possible. Amen

Is the UK really a democracy or is it a dictatorship in cloaks?

no to war

Do you all remember when Tony Blair announced that Afghanistan was a direct threat to us UK citizens and that we would be sending in troops with America to fight the Taliban? That was in 2001. I was only 16 years old. Yet I saw straight through that lie. What a whopper! America was out for blood after September 11th and wanted one man in particular Osama Bin Laden. Majority of the UK population knew this. The marches in protest against sending in troops were the biggest ever in British history. Numbers quoted for those marches were around the 30,000 mark (police say 20,000, some sources say up to twice that number). I was one of those thousands of face. I might have been once of the few ‘children’ there but I can tell you, there were people from all works of life. Some poor, many middle class, few clearly wealthy. Some young adults, some elderly with walking aids, even the odd scooter here or there. There were Caucasians, Asians, middle Easteners and Africans like me. There were atheists, agnostics, muslims, christians, hindus, buddhists and more. Many came from all corners of the UK to join those of us who lived in London. We all marched for hours across London. We made it clear that we did not agree with the premise of the war and did not want our taxes paying for the illegal invasion of a foreign land. We signed petitions. The media talked about it for weeks on end.

The outcome? Tony Blair and his Government went ahead to approve the war and committed us to over 10 years of conflict. Our taxes paid for more than an estimated £37 billion. 454 of our armed forces died in that war. An estimated 21,000 innocent civilians living in Afghanistan, already terrorised by their Government and the Taliban, lost their lives. All because America lost 2996 people in the September 11 twin towers bombings. Sure that is a big number but what does it have to do with the UK really? Is the US not big enough to fight its own battles? Where is the proof that it was actually Bin Laden that carried out the bombings? Or maybe it was the Taliban. If there had been proof, the Afghanistan Government was willing to extradite those responsible. No such proof was forthcoming. Instead, the innocent were slaughtered.

Now their blood is on our hands. Despite the fact we stood up and said no. So I ask you: how is this a democracy when a significant proportion of your electorate says  we do not want it and you don’t even dignify them with a proper answer. No appropriate justification or apology for the cost of the war which we all could predict but not the government that is supposed to be looking after us. Can you imagine what we could have done with that £37 billion pounds instead? That is over £2.8 billion a year. That could have paid for 95,000 junior doctors, 113,000 band 5 nurses or 98, 000 high school teachers. We could have paid for most of the proposed high speed rail project (estimated £46 billion) or paid for an upgrade of our main railways and motorways. Which would you rather invest your money in?

Personally, as a taxpayer I would have been happy for the money to be spent on any of the aforementioned worthy projects which would improve our lives. I resent that I involuntarily paid for the slaughter of thousands of innocent Afghanis. Similarly, we invaded Iraq and the costs are still adding up. Because our murdering politicians (Tony Blair and his parliament) decided like a bunch of dictators to pursue an agenda not in the interest if their population. Not only are we still paying the financial cost, we now face bigger threats from groups like Islamic State who have evolved directly from the Afghani/Iraq conflict and our role in it. So shame on you Tony Blair and whoever was in a position to stop this and chose not to. Shame on you, You murderers of innocent children and women and unarmed men. Shame on you politicians pretending to be democratic when clearly you are the worst kind of dictators. Who else wants to declare war on these criminals and invade them, capture them and extradite them to Afghanistan and Iraq so that they can be punished for their war crimes? Anyone?

Should anyone accept blatant injustice and a distinct lack of appreciation?

Question I often get asked: would you push your children down the route to become a doctor?

Answer before graduating medical school: yes if they expressed interest in medicine, I would encourage it.

Answer now: Not unless medicine was the only thing they want to do (like me) but I would encourage them to look at other career pathways and think about the quality of life they might be signing up for. I would tell my child (and indeed any other child that asks) that there are plenty of ways of helping people, not just medicine. I would say that unless they have spoken to many doctors, read blogs/articles written by a wide variety of doctors and done a good period of shadowing of a full time NHS junior doctor, maybe consider something like law or better yet engineering if they want a profession or even become a journalist, photographer or best of all a human rights activist. Other healthcare roles are available and evolving with incentives and support to train in those pathways. A physician’s assistant is better off than the physician, not just in terms if salary but expectations and quality of life. Nurse Practitioners (specialist or advanced) certainly have a better work life balance and earn more for their hours.

Maybe in the 20th century, doctors’ pay and the respect they got compensated for the gruelling backbreaking hours of hard work and sweat and not getting to see daylight for days on end. But not now. Not in the NHS in England

Government threatens the NHS in England
Government threatens the NHS in England

anyway. I dread to think what the state of affairs will be in 2022 when a baby being born today would be making that career decision 😐

P.s my answer in short: no save yourself, do something else

If Music be the Food of Love

…Then I am glutton and I want it all. I look at my little nephew loving music and it melts my heart. Where it not for music, I would not be where I am today. Music of all kinds. Music that is live or recorded. Current or retro. Played through headphones or on speakers. Walkman, discman to iPod. Music punctuates the story of my life.

I have 2 cousins in the US of A. The older of the two, the girl who shares my grandmother’s name with me, plays the violin to a good standard. She probably isn’t Vanessa Mae standard but the effect her music had on me was electric. She played a piece of music I wasn’t familiar with in my room in London and it changed that room for me forever. As she coaxed the strings into song, the tune struck a chord deep within me. It was as if everything came alive. My senses turbo-charged. I wanted to lie down and close my eyes and for it never to end. I must have had a very foolish smile on my face by the time she played the last note. It was the first time I had seen her in over a decade and I didn’t know her all that well. All it took for me to love her was a piece of music that she insisted wasn’t very good. All the shyness, the reserve, the uncertainty of my relationship with her was wiped away and in its place, I felt love, kinship and trust.

I will never forget the first time I heard the flute being played live. I was in JSS2 (equivalent of year 8) in QC Lagos when one of the senior girls was called on stage to play some music. There must have been nearly 4000 girls crammed into the Hall and despite all effort throughout the rest of the special assembly, there was steady background chatter. She came on stage and as she assembled her flute, the silence began to wash across the room. She played the theme song to Disney’s Pocahontas. Have you ever listened to the score on that song? It is so beautiful. And the words amazing in their simplicity. As she played, I could feel the tears gather in the back of my throat. All the other girls must have felt the same because the silence was absolute halfway through and at the end of it all, there was a stunned silence before we all erupted into applause and hooting. From then on every time I saw her, it felt like there was a magical halo around her for me. She glowed blue to me. And although I have forgotten the names of some of the girls I sat with for years, I remember her name as clear as daylight. Talking about Disney music – I get a similar awe when I listen to ‘When you believe’ from Prince of Egypt and ‘The cycle of life’ from Lion King. Spell binding.

I had a friend in QC who used to be just a classmate. Then one day, she opened her mouth and sang in class and we were all in awe. I guess you could call me the original fan. Although I have since forgotten what the first song Esther sang in public was, I will never forget how I felt about her from that day forward. Of course it helped that she was a lovely girl anyway but in my appreciation for her talent, we became fast friends. The song I will associate with Esther for the rest of my days is ‘I love you Mummy’ which was a hit in Nigeria in the 1990s. Every time she sang that song, all the hairs on my body would stand up and all my worries and stress and unhappiness and negative thoughts would simply disappear. There was once a special assembly only a select few attended and Esther sang that song there. Apparently, there wasn’t a dry eye in the house. Even our Principal had tears in her eyes. I saw her as an angel. She had a golden yellow halo. She was quiet, unassuming and her smile could light up a stadium full of people. Little did I know that when I left QC in 2000, it would be the last time I would see her. She was diagnosed with cancer shortly after I left and she died a couple of years later. Like they say, the best of us die young. R.I.P Esther. What a loss to the world and especially to those who never got to experience the magical voice Esther had.

I love musicals and I have the utmost respect for the incredible talent of theatre actors and actresses who sing their hearts out night after night. My favourite musical is Catz but my absolute ever performance was back in 2001 when I went to see ‘Notre dame de Paris’ in London. The narrator man with his long blond hair and colourful blue coat looked just like all the other stars but he overshadowed them all so that by the end of the show, I was more focused on his bits than on the lead actor and actress. What made it more amazing was that his voice outshone all the female vocalists on stage and I think that is a rare quality. The tone in his voice was pure. It was like crystal in its clarity and every word resonated in my soul. The power was like no other I have seen in theatre and I literally cannot comprehend how he could work his vocal cords so hard for so long and retain its beauty. When the show was over, I did not want to leave. I felt like if I didn’t move, I could remain wrapped up in the magic of his voice forever.

Last year, my then fiancé and I went to the Stephen Lawrence memorial concert at the O2 arena and the line-up was epic. I was mostly looking forward to Emile Sande but there were numerous others I was excited about. The revelation of the night for me was the lovely Beverly Knight from Wolverhampton (which is down the road from me). I have always liked her songs and loved her personality but when she sang ‘Fallen Soldier’ on stage, I fell in love with her. It is by far the best live performance I have ever heard. I have heard the song before and thought it was ok but when dear old Bev sang it, she elevated it to new heights. Every word struck chord in my soul and I felt the tears come as I remembered all my fallen soldiers. The pitch was perfect. The sentiment suited so well to the theme of the evening. She sang her heart out and she won a fan for life. I now realise that she is probably one of the most underrated British stars. It must be because she is so understated in her manner, so personable and so approachable. She is the ultimate girl-next-door except she is more than that. She has been blessed with the most gorgeous voice. What a star!

I know some Muslims believe that modern music is on the scale of evil but I honestly could not disagree more. How could I not appreciate beauty that I believe is a gift from God? How could music which inspires me to be pure and to be kind be bad in any way? How can music which erases my sadness and stress be anything but good? How can music which promotes happiness and positivity be anything but encouraged? Life is hard enough I think so I simply cannot accept that something that makes it all better can be a bad thing. I love music and I celebrate its existence. And most of all, I thank God for music because it has been life’s saving grace more times than I can count.

Corazon Por Corazon

I speak very little Spanish but being a salsa fan, I have heard enough Spanish lyrics to know the Corazon means heart and the Spanish-speaking world is always ‘Corazon this’ and ‘Corazon that’. The title is a nod to the video I just watched on Facebook which has inspired this piece. It was posted by Andre Gayle who has stuck English subtitles on a Spanish video entitled Corazon por Corazon (heart by heart…changing the world). Basically, the video is about the loss of our humanity, the very essence that is supposed to make us superior to other animals and plants. It highlights what cruelty and sadness there is in the world and how a lot of us are desensitised to the sight of another human in need. So much so that when we witness suffering, many a times our response now is to take out our smartphones and take a video instead of offering our help.

It made me cry, especially the scenes of animals and children being abused. It made me ask ‘why’ again. I am the half full glass type of a girl but occasionally, I become despondent when I watch the news and it is full of pictures of little children being bombed by Israel or another old pensioner being abused by a carer. It makes me question what I am doing spending so much of my time doing NHS/eportfolio paperwork when there is suffering out there and I have the medical training to perhaps make a difference to so many, in Nigeria for example. It makes me question whether having children is a good idea because what legacy are we leaving behind for them to inherit?

The environment is a huge worry for me. I drive a Nissan Leaf in an attempt to be greener and I recycle and try to minimise waste. I know my efforts mean something but are probably insignificant in the grand scheme of things but at least having made the effort, I go to bed with a clearer conscience. For every person who drives a ‘green’ car or cycles or walks, there’ll be 10 people who drive cars with ridiculous amount of emissions, who waste more than half the food they buy and who never do any recycling. As the ozone layer thickens and the greenhouse effect is compounded, global warming intensifies. Formerly temperate climates develop extremes of weather. Flooding, draughts, tsunamis, tornadoes, forest fires and earthquakes occur with greater frequency than ever before. Large populations of the world who are dependent entirely on subsistent farming are living in famine conditions year after year. Ironically, in Europe and the US more and more of the population are buying excess food and every week are binning it as they buy too much and let it all go to waste. Too much of land is taken up by refuse which no one knows how to get rid of properly. Mountains of waste piling up as we become more and more wasteful. Turns out that even our recycling is not all recycled. Because our Governments have not invested enough into recycling plants so only a fraction of the potential recyclables are being  recycled.

Kindness is becoming short in supply too. As the video highlights, it is now commonplace to watch a person being beaten, robbed or even stabbed and no one wants to step in because it is all about protecting the self. Every year, there is someone on the regional news who has been stabbed or mugged in a bus or at a bus stop or somewhere similarly public where everyone has just stood by and watched. Yet some of these people have the audacity to whip out their phones and video the event and then post it on YouTube. I always wonder how these onlookers would feel if the victim was not a stranger but their mother, father, brother, sister, daughter, son or best friend?

As for the violent offenders, many of them are children who are old enough to know between right or wrong but even at that early age, they seem hardened and lacking in the most basic of human kindness. I know this lack of kindness and empathy is multifactorial but I am convinced one of the main reasons is poor parenting that comes with the modern time. As a paediatrician, I am in a privileged position to be able to closely observe the intimate relationship between parents and their children. There are many things we see that cause us to raise our eyebrows and a few that send us running to Social Services. But what I find most disappointing is when a young child aged 3 or 4 does or says something cruel and the parents, instead of taking the opportunity to point out what is right or wrong and explain why, turn their faces away and throw away the chance to shape their child into a decent person. A couple of weeks ago, I was on-call and went to see a 10 year old boy who was in pain with my registrar (senior to me) and an ST1 (junior to me). The registrar examined him and decided we needed to investigate by taking a blood sample. The boy’s reaction was to shout ‘You are not f*****g touching me. I will bash your f******g head if you come near me’. What did his father do? He bowed his head and my registrar shot the top of the dad’s head a look. As more swearing came forth, I stepped closer to the boy and said firmly ‘I’m sorry you are scared of having a needle but you are not allowed to speak to us like that. We are here to help you.’ That stopped him in his tracks and he resorted to sobbing. His red-faced dad followed us out of the cubicle to apologise and all I could think was ‘don’t apologise to us, teach him to have a bit more respect.’

Speaking about respect, I think that has run off with the kindness. As doctors, we are at the receiving end of a lot of disrespect but we put up with it because we understand when people come in contact with us, it tends to be the most stressful, frustrating, unhappiest time in their life. I think a little respect goes a long way. It is in the small things like saying sorry when you barge into somebody, holding open a heavy door for the person a few paces behind, picking up an item someone (especially frail, old or pregnant) has dropped right in front of you or even smiling at a stranger who makes eye contact. It is about saying please and thank you to anyone helping you out even if it is their job to do it. It is about acknowledging your work colleague who does a little extra work so you don’t have to do it or staying longer at work to finish a task so they don’t have to hand it over to you. It is about realising your loved one is sad and giving them a hug. It is about saying the occasional thank you to your spouse for all the little considerations they give you daily that make your life better without you even realising they’re doing it.

I will say that I am lucky to be surrounded by lovely people who I am proud to call my family and friends. I know I did not get to choose my family but I certainly chose the family I keep close and the friends I surround myself with. These people are generous. They are donating to charity and taking part in fundraising for charities. They are courteous to strangers and helpful where they can be. They smile easily and are generous with their hugs, kind words and cups of tea. They recycle. They reclaim furniture. They treat their pets with love and tenderness. They are there when you get bad news. They hold your hand and sit beside you when there are no words that can ease the pain and hurt. They pray for you to succeed and celebrate whole-heartedly when you do succeed. They turn up when you need them the most. They laugh with you and not generally at you (but sometimes they laugh at you too if they know you can take it). They care about their neighbours and it is not always about them. They are diamonds…beautiful bling with surprising strength. They inspire me every day to be a better person and whenever I reflect on the people in my life, I feel blessed.

Allah (swt) is Al-Jabbar: The Mender of broken hearts

The words that follow were written by a lady called Asmaa Hussein who lost her love and reflects on how her relationship with God is helping her through it all. It struck a cord with me because this is the Allah I believe in and worship. The loving, merciful incredible God who promotes peace and love, not war and violence.

 

It has been a year since I got that most-hated phone call, a year since I stood over Amr’s body at the morgue and tried to memorize every feature of his face before I would have to let him go, a year since we were attacked in the graveyard by people who hated the truth and righteousness that Amr stood for.

People wonder how I was able to hold myself together. They wonder why I haven’t collapsed or given up hope in Allah or in the goodness of people.

I don’t have an explanation from myself, but the answer can be found in the story of Prophet Musa’s mother in the Quran. She was instructed to place him in the water if she feared for his life at the hands of Pharaoh’s army:

“And We inspired to the mother of Moses, ‘Suckle him; but when you fear for him, cast him into the river and do not fear and do not grieve. Indeed, We will return him to you and will make him [one] of the messengers'” (28:7).

I often wonder about what kind of strength she must have possessed when she placed her infant child into a basket, and pushed him into the water without knowing where he would end up, or whether she would see him again. She did one of the most difficult things a mother could do. But she held herself together with the help and guidance of her Lord, and watched him drift away.

Musa was accepted into the house of Aasiya, but he refused to breastfeed from any woman and his sister who had been following him, led them to take the baby back to his mother.

What was the purpose of Allah (swt) returning Musa to his mother? Musa could have breastfed from any woman without returning to his mother and still grown up to be the messenger of Allah, not decreasing anything from his righteousness or his remarkable journey and story.

But there was a reason Musa had to come home to his mother:

“So We restored him to his mother that she might be content and not grieve and that she would know that the promise of Allah is true. But most of the people do not know” (28:13).

Allah caused Musa to return to his mother simply so that she wouldn’t grieve, so that her heart would be at ease and that her faith would not waiver.

Allah (swt) cared about this woman. He mended her heart, not so that the course of history could change or some big momentous event could take place. He mended it because He is Merciful and Loving to the believers. And so that when we read her story, we can know the extent of His Love and Mercy. That is all. And that is enough of a reason.

Allah (swt) doesn’t wish for the believers to grieve, and He wants them to know that His promise is true. I’ve lived it this past year. Every time I was about to reach a breaking point in my despair, or to fall into the darkness of losing hope, I would receive some news that would lift my heart. Someone would have a beautiful dream of Amr, someone would perform ummrah on his behalf, or establish some charity on his behalf. I would receive words of support from people I love and respect, or encounter some verses in the Quran that would take me by the hand and hold me steady.

I remember a few months ago sitting one day after I had prayed Asr. Tears were streaming down my cheeks, my heart was aching and I didn’t know how to rid myself of the immense pain. I raised my hands to ask Allah (swt) to help me be able to somehow visit His sacred house to come closer to Him and for that to be a part of my healing. Before I was able to even make the dua, my phone rang. It was Amr’s parents calling me to tell me they were just at the Ka’bah making dua for me to be able to visit it. And I thought – how strange that this dua has yet to come from my lips, and Allah (swt) has put the same dua on the lips of people beloved to me in such a blessed place.

My heart was lifted so much in that moment that the tears of sadness turned into tears of joy.

None of these things are coincidences. And none of these things happened because I am particularly good or worthy. They happen because Allah (swt) cares about the hearts of His slaves. I know that He cares about me and about my daughter because I’ve lived in the realm of this immense Mercy this past year…every ounce of pain was met with some inexplicable beauty and serenity that no human effort could produce. And it was from Him. All of it.

If you believe in Allah alone with no partners or intermediaries, and you worship Him alone, and you sacrifice that which you love in order to come closer to Him alone, you will see wonders in your life. Your difficulties will become blessings. Your heartaches will become healing. Your duas will be answered in ways that you could have never imagined. He doesn’t want you to grieve, and He wants you to know that His promise to the believers is true.

It’s not any more complicated than that. It happened to me, and it’s still happening.

Alhamdulillah.

Straight Up Nigerian

Nigeria is a humongous country so I will not even attempt to write about it all in one little blog. It would take a whole book to make a dint in the story that is Nigeria. This blog will focus on my memories of growing up in Yola.

Yola City. 2 words. Enough said but just in case you have not sampled the delights of my hometown, I shall expand on the 2 words. Why do I love Yola so? Biggest reason is because my mother is the happiest there and whatever makes my mama happy, I love. Yola like me is full of contradictions. It is still small enough in Yola town (different from Jimeta a.k.a Yola North) that most residents either know me or my mama and will definitely know who my granddad is. So I cannot go round being naughty willy-nilly because they will come round to my house and make me feel like I am 3 years old again.

Knowing so many people is a great advantage. When I visit Yola, I get lots of food brought round and somehow these people know all my favourite foods, all the food I spend many hours daydreaming about back in Birmingham. Every morning is like a lottery and throughout the day, I intermittently check on the little dining table by the fridge to see if there have been any food deliveries. This time, I got at different times: Dan-wake, waina, masa, sinasir, dakuwa, kosai, gari basise, okro soup, this tapioca-type grain which I had with yoghurt, zogale (a.k.a moringa) seeds which were awful, a traditional kanuri drink made up of milk with bits of chewy yumminess in it, dambun nama, zobo and more. I was in food heaven. I ate small portions often in an attempt to get through a bit of everything. I didn’t remember half of those who sent the goodies to thank them but you know what? They probably got report that I stuffed my face with all of it and are satisfied they have done their bit to feed me.

Yola’s geography is awesome. We are in the North-east corner of Nigeria. In the old days, we were definitely in the savannah but now with all the aggressive deforestation by unethical businesses, we are part desert and part savannah. When you drive to Adamawa from Jos/Bauchi sides, you can see the more abundant greenery and exotic plants give way to Neem and baobab trees and green green grass in the rainy season dotted with low shrubs and anthills. I think Adamawa has cleaner crisper air and I can almost taste Yola when I drive into the Adamawa region. The river Benue goes through the state and is an amazing sight to behold in the rainy season. In the dry season, the water level is so low that the river Benue is reduced to a network of streams. In these months, you can see families fetching water, doing their laundry and bathing in those streams. I always want to stop the car and go down into the river bank, feel the sand underneath my bare toes like those families. In the rainy season, it is very different. The banks of the river are full to bursting. In fact more and more these days, we get floods as the effect of global warming is felt. Around Numan if you look carefully enough down at the river from the bridge, you’ll see how there is a clean side of the water and the dirtier muddier side of the water and curiously, the 2 seem separate as the river gushes past. I cannot remember the explanation my mama gave me when I asked decades ago but it doesn’t even matter to me. All I know is that the clean water somehow knows not to mix with the dirty water despite there being no physical barrier separating the 2. Incredible.

I love Yola market especially on ‘market’ day which has always been on a Friday. Back in the day, my mama banned us from going to the market unless in the company of adults. Most of the time, we obeyed that rule but not on Fridays. Every Friday, we would find a way to sneak out of the house with all the pocket money we had managed to save and head to the market. The biggest draw was the snake charmers who would display their trained cobras and even pick on members of the public in the audience to help them out with their tricks. My mama hates snakes so although I was less afraid of them, there was still a healthy dose of fear that I inherited from her. I used to have to look away from time to time during those displays as the excitement crossed the border into fear. However, I never turned down a chance to go there as long as my sister and I were in town on the Friday.

The other act we loved was the monkey owners. These people were less reliable and would turn up randomly. They even went house to house to perform and get given change. I loved the monkeys best and would pray for them to turn up every day during the school holidays. Sadly, my house was never visited. I am not sure whether it is because of our scary dogs or maybe my mum or stepdad were not receptive. Anyway, I was resourceful enough to catch them at the market or neighbours’ house. Another reason for my love of Yola market is the contraband fast food on sale. Contraband in my house meant any cooked food from a kitchen whose owner we didn’t know personally. Naturally I loved everything not cooked ‘at home’ so I was a regular customer and my favourite buys were Dan-wake and allele (bean cakes) cooked in tins with a drop of palm oil to make it glorious. Mmmm, these 2 foods are still my absolute favourite snacks from home.

Other delights I will never forget in Yola market include Amani who had a bad scarring infection on his face once upon a time and his vegetable stall. I loved the exotic fruit sellers sitting in the fruit section who came with their fruits picked fresh from the villages in our state. I loved the goruba sellers right at the back of the market especially because they had sacks of the thing and I always wondered if they ever sold it all and what sort of tree the gorubas came from. I loved the ‘odds’ lane where everything from nails to tree gum for charcoal ink and batteries were sold. I also loved the sweets man near the Fulani ladies with their fresh milk and yoghurt. I was a regular at his stall and especially loved it when he went to Cameroun and came back with the little pink mint balls with green stripes called bon-bon. On the rare occasion we needed to buy yoghurt, I would speak to the Fulani ladies and be amazed they spoke my language because these were the nomadic Fulanis (the bororos) and they were so pretty and different from us. I would watch in fascination as they tipped a ceramic dish of yoghurt into the one I bought without disturbing the smooth set of the yoghurt. I was so happy then. Le sigh.

I will finish on one final point about Yola. I loved the neighbourly spirit in the community when I was little. I rarely ate a proper meal at home in those days. I was always round one neighbour’s house or the other eating their meals because it was different from the meals at home. You know as a child, the grass is greener on every other side. There was always food in these homes and I was always welcome to it. I ate to my fill and said thank you then off I went. Mango and guava trees were abundant in those days (and I guess still are) and when those fruits were in season, I would forget about meals and just gorge myself on those fruits, sitting high up in the trees. So much so that I was constipated half the time because in my impatience, I would eat the fruits half raw particularly the guavas. I, of course, kept my medical problems to myself because I knew fully well it was self-induced and that actually my mama was clear on the rule that we should not be eating unripe fruit. One year, we discovered the delight of climbing up date trees and we were round Amadi’s home daily, eating so many dates that I still cannot handle more than 1 date at a time these days. I had a whale of a time growing up in Yola despite all the naughtiness. I have no regrets fortunately.

Every Little Helps

Dedicated to Zainab ABM who has just said to me ‘please write more’. She is a fellow doctor, blogger, new wife, northern Nigerian young woman and generally a good egg. Just like me, only a few years younger. Also dedicated to my brother Abdulkhalid with whom I have just had the conversation about hope and inspiration and being the catalyst for change.

 

I am in the process of doing an online course on paediatric palliative care and came across a story that inspired me so I saved it and now will share it. It appeals to my firm belief that no matter how insurmountable the difficulties we face seem, all we can do as mere mortals is to pick a point. Any point relevant that forms part of the fabric of change and start working on it. My hope is that if many of us think like the Star thrower in the story below or like I try to think, then there will be many hands on deck, all making light work of the changes we need to heal our ailing world. And if like me, you like to ask why, I will tell you why. Because I want to be part of the change. Because I want to spread a little love and happiness. Because I want to have children and I want them to have something positive to aspire to.

 

The Starfish Story adapted from The Star Thrower by Loren Eiseley (1907 – 1977)

 

Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out “Good morning! May I ask what it is that you are doing?”

The young man paused, looked up, and replied “Throwing starfish into the ocean.”

“I must ask, then, why are you throwing starfish into the ocean?” asked the somewhat startled wise man.

To this, the young man replied, “The sun is up and the tide is going out. If I don’t throw them in, they’ll die.”

Upon hearing this, the wise man commented, “But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!”

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, “It made a difference for that one.”