Tag Archives: family

The Malay Experience

In 2008, after a short 4th year of medical school, I caught a flight to Kuala Lumpur. My first trip to Asia. Solo. I cannot remember how I came to choose Malaysia. I think I wanted to go to Asia, wanted an English speaking setting and importantly somewhere warm. Sri Lanka was another option but I didn’t know anyone there so Malaysia was the choice I made.

My mama as a human rights activist worked with an organisation with close links to Malaysia so she had been to visit many times and had made some good friends there. When I asked her for help, she was on it. She contacted her friends and asked whether any of them had medical connections in Malaysia. Fortuitously, one of her friend knew the health minister in Kelantan State. The only question was did I want to go to Kelantan, being the most conservative of states, quite ‘Muslim’ in its ways? Well, being a very modern Muslim I could see why some would question my willingness to be in a community that was rather more conservative than I chose to live my life. But I wanted an experience so I had no hesitation in saying yes.  Then I had to find somewhere to live for the month. Another one of my mama’s friends had a GP husband who was resident in Kota Bharu, the capital city of Kelantan state where the hospital was located. His home was too far to walk to and from the hospital so he organised for me to stay with his sister.

A few days before I was to fly out, he emailed to say that unfortunately his sister had a family emergency so she wouldn’t be in Kota Bharu (KB) for my arrival and he didn’t know when she would be back. Before I could panic, he went on to say I was welcome to stay at his and I would have to catch rides with his grandchildren to and from the hospital. So back to the beginning, I arrived in Kuala Lumpur on a warm afternoon. As I got off the plane after my 12-hour trip, I felt a queer tingle in my feet. I looked down and lo and behold my feet was swollen and my toes resembled little chipolatas. Remember I was only 22 years old so this was rather foreign. I wriggled my little sausage toes and poked both feet. Clearly, I should have mobilised more on the long flight. Noted. I made my way through baggage retrieval, immigration and customs and got to my hotel without incident. One of my sister’s uni friends generously came to find me later and took me out for dinner. The next day, after he kindly took me to get a phone and camera, we went to the Twin towers. What a sight! My jetlag was cured and I was suddenly filled with excitement. My first adult adventure in foreign country! The next day, my mama’s friend who had been instrumental in organising the whole trip took me to the famous Batu caves where we took in the impressive sights and also had one of the best Indian meals I have ever had.

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I think the sister in KB being away was a huge blessing in disguise. My new digs were rather luxurious compared to what I had been expecting. Dr R and his children were excellent hosts and made me feel at home. Bibi, their Indonesian housekeeper, was a godsend. She couldn’t speak a word of English and I couldn’t speak a word of Malay or Indonesian (a variant of Malay). It didn’t matter! She was a lovely lovely woman. She was short (average for the population) and portly for want of a better word. A little like Mrs Potts in Beauty and the Beast – very motherly figure. She always had a smile on her face and fed us beautifully. When I came home, there was always a jug of iced tea waiting to cool me down. It was very hot in the afternoons and the icy drink was like manna from heaven. I would change into my cotton Malay dress and throw myself down on the sofa in the upstairs living room which I made my own and down the cold fluid. That was all the activity I could manage until the sun went down and brought with it some refreshing breeze.42

The only cloud on the sunny Malay sky, apart from the relentless over 30-degree heat, were the mosquitoes. I was told soon after landing in KB that we were in the middle of a Dengue outbreak, spread by pesky mozzies. Now I am one of those who will get bitten wherever I go, regardless of covering or insect repellent. I like to say I have juicy blood. So what were my chances of contracting Dengue. Well, reassuringly (not!) I was informed the virus was only carried by the mosquito with the striped-back. I laughed about this – pray how was I supposed to tell whether a mosquito had stripes on its back? And if I had such keen senses, surely, I could just squash the little terrors before they bit me (whether they were the evil striped ones or not). Also I was helpfully informed that I was more at risk of catching Dengue Haemorrhagic fever in my first episode of the illness (I have since learnt that you are more likely to catch the severe strain on a second episode). Fabulous, I was at risk of catching a deadly disease (risk of death from the haemorrhagic disease was significant, 2-3 per 100). I got a few bites despite precautions but avoided Dengue fever thankfully.

The medical experience was quite opening. Based on the old British system, it was still quite paternalistic and the doctors knew best in most cases. A big population of KB was poorly-educated farmers and fishermen so many of the patients had no interest in being given hard choices. They wanted the doctors to diagnose them and tell them what was to be done. The nurses and healthcare assistants were also very much directed by the doctors and there was a noticeable hierarchy. The respect for doctors was palpable and that extended to us the medical students. To be fair, the doctors I came into contact with were respectful in return.

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I was with a group of female medical students, most of whom were indigenous Kelantanese girls coming home from KL for their elective. They were lovely girls. Very welcoming. They were my unofficial translators with the patients and did the job without minding how much of a drag it was.  They were all quite petite. I think the tallest was 2-3 inches shorter than I was. At 5 foot 6, I never thought of myself as tall but there I was being referred to as the tall foreigner. It felt rather nice. The girls all wore the hijab (hair covering with their traditional Malay dress) and were all shocked to learn that I was  Muslim as I wore the lightest formal clothes I could find and no head covering. However, they didn’t judge me. If anything, they seemed to be impressed by my independence. One of them, Nurul became quite close to me and I got to visit a more traditional Malay family and eat with them. Again, her family was so welcoming and humble that I wanted to adopt them all. Nurul had a small car which she generously used to take me and the girls to the markets, museums, cultural centre and even the seaside. Their culture was beautiful as was their food, music and natural environment.

Back in Dr R’s home, I made friends with the loveliest little girl called Ayin. His granddaughter, the youngest of his 3 grandchildren who I shared the school runs with. She was a tiny little thing. I think she was 4 or 5 years old and either she didn’t understand that I understood not a word of Malay or she didn’t care. She would come to my room after work and tell me all about her day (in Malay). She would share jokes and laugh. She would admire my little knick-knacks and tell me how much she loved my things. I would laugh with her, reply in English and invite her to look closer at my things and show her what new things did. She particularly loved my Malay silver butterfly earrings which I got there in KB and I would let her borrow them. One afternoon, me and my little friend were hanging out and chatting when Dr R came home early from his GP practice. As he walked past my room, he heard us conversing and was amazed. At dinner, he asked what it was we were talking about. It amused him to hear that I had no idea what Ayin was talking about but that we had these conversations. I was her ‘aunty’ and she was my little niece. Didn’t matter one bit that we spoke completely different languages but we were great friends which was all that mattered.

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The month in Malaysia flew by and although I was off on holiday to Thailand for 10 days, I was quite sad to leave my new family. I had an absolutely amazing elective in KB, met the most wonderful people and experienced healthcare with different levels of expectations and resources. I haven’t been back since then but I definitely want to take my husband and baby there so they can experience the great country that is Malaysia.

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The Taboo of Domestic Violence

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Here are some facts and statistics from Women’s Aid (http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220041&sectionTitle=Domestic+violence+%28general%29) by way of introduction:

  • Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.
  • The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.
  • Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle.  Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.
  • The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.
  • Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.
  • The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.
  • The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.
  • Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

  • Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)
  • 60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).
  • The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).
  • 76% of separated women reported suffering post-separation violence (Humphreys & Thiara, 2002). Of these women:

– 76% were subjected to continued verbal and emotional abuse.

– 41% were subjected to serious threats towards themselves or their children.

– 23% were subjected to physical violence.

– 6% were subjected to sexual violence.

– 36% stated that this violence was ongoing.

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.

My Very Own UN

My sister is (or should that be was) a social butterfly. She always had more than friends than she knew what to do with and she never had issues making new ones. A classic extrovert. I considered myself an introvert for most of my youth. Now with more self-awareness, I know I am more of an extrovert than an introvert but I am pickier than my sister, the true extrovert. Because I have been so picky, I think I have ended up with the best friends in the world.

Some of the people I am talking about might not realise how much I value their friendship or indeed that I am talking about them but I hope when I describe how fabulous they are, they will realise how great and valued their friendship is to me. When I was little and my mama was my only role model, one of the things I thought was absolutely amazing about her and her life was her array of friends. They were young and old, some local, many from far afield (and being in Yola that is quite something I tell you). Some Muslim, some Christians. Some skinny, some fat. Some beautiful, some not so beautiful. Some quiet, some loud. Many feminists like my mama. All sorts. The one unifying thing about them was that they were kind and caring, they spoke to me like I mattered and they were passionate. If she ever needed anything around the world, all she had to do was pick up the phone or send an email and the cavalry would arrive. Subconsciously, as I grew up, I think I looked for all those things in my would-be friends. I think I succeeded in developing my very own passionate, kind, caring, loving, helpful and loyal circle of friends. The inner circle is a small one compared to my mother’s but I happen to believe the best things come in small packages. I will talk about my current inner circle in no particular order as I value them all fairly equally. I won’t mention my mama and my sister but they are my best friends and are the core circle.

First one is my Ethiopian friend who I met in 2001 who I shall call Lizzie. We were in the same tutor group in Gladesmore Community School (10AH massive) and we both joined in year 10 so we had common group but our big unifier was where lived and that we had to get 2 buses to get to school. So, earlier than the other pupils, we were up and out, dragging sleepy bodies onto the 144 which I caught at the first stop in Muswell Hill and Lizzie would hop on 4 or 5 stops later in Hornsey. We were normally quiet in the 144 but by the time we got on the 41, we were awake enough to chat. It was on the 41 that I got to know Lizzie’s life story and about her very grown up relationships. At this stage, I had never had a proper boyfriend and despite having a crush at school, I wasn’t really interested in a relationship. So I lived vicariously through her. We also bonded over our love of heels (low enough to wear to school and get away from censure) and long braids. Also I have been mistaken for Ethiopian so we had a similar slim innocent look. We have remained friends over the years, closer after school than in school, through her babies and marriage, through my medical school. Lizzie was a bridesmaid at my wedding and she regularly makes the drive up to Birmingham from London to visit. Even though we had periods were we got too busy with our lives, she has remained a constant. We may drift (although not so much now) through complacency but we never fight and we are there to listen. So here is to my yummy mummy Landan friend. For being constant and loyal and inspiring me to be more glamorous and feminine.

Next is my Northern Nigerian friend who I shall call Halima. We met in 1996 in Queen’s College, Yaba Lagos and we were friends from the very beginning. It was the Hausa lessons that cemented the friendship and as we were both boarders, prep times and dinner times were there for us to foster the relationships. In another blog, I have mentioned Na’ima and I was close to a couple of other girls, 2 of whom were boarders. Halima was in a ‘House’ located all the way across the quadrangle which thinking about now wasn’t so far but during those years was enough to make visiting her during weekends a significant event. She was responsible for the one and only time I had periwinkles (the hairstyle) for Sports day in JSS2 (see blog on that). Those periwinkles make an appearance on my first ever British passport and my husband loves the photo so much he keeps it by his bedside. She was one of the only girls whose homes I would visit outside school too and I knew her family so that made her more special than many others. Post-QC, she is certainly the one who would always make an effort to come and see me whenever I went to Nigeria. I knew about her wedding as soon as she had a date in mind because she wanted me to be able to jiggle my doctor on-call to make it there.  I am so glad I did. We shared her pregnancy from across the distance too. In all these years, I do not remember ever fighting with Halima. She is probably one of the gentlest and sweetest women I know and her son and husband are so lucky she is theirs. Despite being many thousands of miles apart and despite our other friends from that era being on social media and living in close vicinity to her, Halima is the one of all that I would be able to count on today if I needed a friend in Abuja. What a sweetheart!

Then there is my Southern Nigerian friend, let’s call her Tolu. I met her through NLI which is a (NGO) Nigerian initiative to promote young accomplished Nigerians living at home and abroad to be the champions that make Nigeria great once again. NLI was in 2010, or was it 2009? I came from here and she came from the US. We bonded over our passionate pitches and speeches. Never before had I met a young woman who seemed so like me. She exuded integrity and honesty and passion. When I told my husband about her, the words I used were ‘Tolu motivates me to be a better person. I wish she lived nearby so I could be in her presence regularly’. Being next to her or chatting with her on the phone or on social media never fails to give me a positive boost. Tolu to me is everything a young Nigerian should be and she makes me so proud to be in the same circle as hers. If I could choose anyone for my baby to be like, it would be Tolu. She went through a very harrowing time a couple of years ago and being so positive and so strong, she didn’t say anything for a long time because she is that type of a person who will be everyone’s shoulder but have no shoulder to lean on herself. She has come through all of that in a way that is no less than heroic. She is generous and kind. She is a wonderful listener. She is passionate about life and justice and selfless in her outlook. Maybe I don’t want my baby girl to be like her, maybe I want to be like Tolu. Anyway, if you are reading this my love, I might not have said in so many words but your strength, honesty, passion and selflessness makes you wonder woman in my eyes and I could not be prouder of you. I hope your dreams for Nigeria and the world come through because this world is so much better for having you in it.

Following on neatly is my only fellow Iro-Nigerian, who I call Irish anyway. She is Irish in all the best ways possible except she lacks an accent being southern England-bred (sadly but she can put on a pretty good one). We went to medical school together and once again it was fate that brought us together because we met in student halls in 2004. Being the only two medics in the flat of 6, naturally we became close pretty quickly as we were together pretty much all day every day for the first 2 years of our medical school. We were up ridiculously early and gone all day. We couldn’t party any night of the week like a certain somebody we lived with. We had plenty of work and exams to keep us busy. The first thing about Irish is that she is a morning person. I am most definitely not. She would wake up at dawn even on weekends and whistle cheerfully. She had these dryer sheets that smelled of fresh laundry…even today, that lovely fresh scent equates to Irish to me. She has tremendous boobs (sorry Irish but I feel they need to be celebrated) and the loveliest bouncy hair which is NOT mousy brown as she used to claim. She is one of those friends I have never fallen out with. It’s strange to think but we don’t have fights at all. Perhaps it is because she doesn’t tend to get dragged into one of my deep philosophical conversations because she is quite squeamish with deep emotional stuff and would rather the happier topics. That is not to say that she won’t indulge me if I need to offload. She makes the best butter icing cupcakes and has managed to teach me to bake a couple of things. She loves sunflowers. That is in a nutshell Irish to me. She is little Ms Sunshine with a spine of steel underneath all the Gaelic charm. She will stand up for what she believes in and will call you out if you do something wrong but all with the sweetness of honey. She has dealt with family issues that would faze many but she remains unfazed and strong. She also has lovely blue eyes and dimples which I would give my little toes for. Oh and she gives the best hugs ever! If Tolu is the girl I want my daughter to grown up to be, Irish is the woman I want to be for my children. I want to be all sunshine and sweetness and quiet strength and I want to be charming just like her when I grow up.

Then there is my Indian friend who around birth was inadvertently called One on some documentation and that is my name for her which I shall stick to. She is the only one of my friends who is younger than I am. We met whilst I was out doing clinical experience in SEWA rural, Jhagadia – a village in Gujarat State, India. She was out there too doing field research and being the only other single girl resident in the flats on hospital grounds, we instantly gravitated to each other and became fast friends. She is a biomedical scientist. We quickly found common love in tea and laughter and feminism. We quickly fell into a routine. She would come over after ‘work’ to put her water in my fridge and we would go over to hers for tea. I would usually drape myself all over her bed and even occasionally on the cool floor for it was pregnant with heat during my 3 months there. My friendship with her is very similar to the one I have with Safa except the age difference and my having a bit more life experience. And our life stories seem to mirror each other down to meeting the ‘wrong’ boy as defined culturally but actually believing them to be our Mr Right. Unlike Safa though, she is the only one of my friends who is shorter than I am so I feel refreshing normal size next to her. One is rather fearless I think and having lived in remote Jhagadia for a whole year, she then applied for a post-graduate course in the US and off she went to live in NY. Now she is in Malawi, again independently sourced job and seems to be flourishing. What makes her so special goes beyond her fabulous tea, her wicked sense of humour and independent spirit. She is also very honest and open, kind and supportive, generous and when she loves, she gives it her all. One is going to be great someday soon. Mark my words!

Last but not least is my youngest adopted mama, Farah for today. I met her in 2009 as a lowly FY1 doctor in the crazy world of City Hospital (Birmingham). She was soon to be medical registrar and had a reputation for being brutally honest and fierce. Did that put me off? No! I love my women fierce and fearless so we became friends in the mess when I was on surgery and actually had time to go to the mess every day. I loved her unconventional ways and I think she liked me because though small and ‘quiet’ on the face of it, I gave as good as she gave and never seemed to take it personally when that sharp tongue was pointed my way. Despite the difference in years, in the hierarchical world of medicine, we remained friends over the years and have grown closer since we stopped working together. She is another one from a Muslim background who was born into the religion and though respects me for practicing, is not of the same opinions about it. I respect that despite being from a middle-eastern background, she is honest enough to say this is how ‘I’ feel about religion and all that comes with it. I love that despite that prickly first impression she gives out, she is a big old softie with a heart that is good as gold. She is loyal and supportive and she is always there for me if I need her. She wore a polka dot dress to my wedding – if for nothing else, I will love her forever. What a woman! Farah I salute you. You are one of my heroes.

There you are dear readers, my wonderful array of close companions without whom I would be less of the woman I am today. I will take this opportunity to say that for the reasons I have mentioned above and for many more that I cannot put into words, I feel privileged to have met and befriended you all. Thank you for all the love and support. I love you all.

Can You Miss What You Don’t Know or Have?

This one is a hard topic for me. If you have been following my posts, you will know by now that my mama was a single mother for a large part of my life. I also had a step-dad for a good chunk of my childhood. I do not know if I have mentioned my biological father at all. I probably haven’t because there isn’t much to say. I can summarise what there is to say about him. He was my mother’s boyfriend in University and despite a lot of reservation from third parties, my mother married him soon after graduation. He is from Malumfashi in Katsina State (Nigeria) and is academically gifted. His family has royal links (small fry I understand). He is still alive and working in Katsina. He is tall and considered good-looking. He is married with several children.

That last point is the one thing of all that does bother me a little. Because of the way I was brought up and my closeness with my immediate family, I sometimes feel sad that I have siblings that I could be supporting but do not. I have siblings (majority female I hear) who I could be a role model to. I could make a difference to their lives but I am unable to because I do not exist to them. I do wonder if they even know about my sister and me. If they do, do they care?

My mama got a divorce when she was 5 months pregnant with me so I was born outside of that relationship. I have no strong feelings over him. I have met him. Twice in my life. First when I was 4 or 5 and then again when I was 7 years old. I also met a couple of his brothers when I was 8 or 9 years old. To be honest, I remember more what we ate when we had lunch with him and where that meeting took place. I remember feeling somewhat conflicted and wondering how I was meant to feel. I also worried that if I liked him, would I be disloyal to my mama who was the love of my life? My mama, amazing woman that she is, hid her upset quite well but with hindsight, I know she was upset that it took him so long to turn up and that he was putting us through emotional turmoil. I recall her sitting my sister and me down after he had turned up unannounced the first time and confirming that he was indeed our biological father. She gave us a choice about going to spend the afternoon with him and said we could decide to go or not.

My sister had a vague recollection of him and was excited to see him so I didn’t object. Off we trundled to Yola International Hotel to his suite. We each had a chapman (love that drink, bright red fizzy non-alcoholic cocktail still popular in Nigeria) and I think I had a meat-pie because they made them nice and I was a fan. He must have tried to talk to us but I really don’t remember what was said. I remember saying that ‘everyone at home calls me Diya not Aisha’ when he kept calling me Aisha. I think he felt rebuffed. My sister and I soon got bored and we went off to play with the lifts and got up to mischief. He left the next day and life returned to normal. The only evidence was that he gave us some money which we promptly deposited into our savings accounts and forgot about.

The second visit was only slightly less awkward and I remember thinking ‘what does this all mean anyway?’ I mean, after the first visit, he made no effort to promote any kind of relationship. I firmly believe he would never have visited again if he had no business bringing him to Yola. Since then, I have not seen or heard from him. My sister got a couple more visits to her boarding school and then nothing since. It has been over 20 years since I have heard a peep out of him. I do not think I ever met my grandmother but we did hear that she was still alive about a decade ago. A friend of my sister’s sister-in-law last week got word to my sister through the sister-in-law to say that our grandmother had died. Our reaction was lackadaisical to say the least. First, we thought ‘erm yes our grandma died about 12 years ago in two days’ (October 6th). Then we clarified that this was our paternal grandma. We mentioned it to each other in passing and no more was said. We went to sleep that night without a second thought and honestly, I can’t say I feel like I have lost anything.

This brings me to the question I wanted to address here. When we were little, and some people still say this, we were told that despite not knowing our father and his relatives, we would regret it if we let him die without trying to get to know him. Apparently (somewhat mystically) we would feel his death and be deeply saddened. Well, my grandma has just died and it made not a dent on my life. I felt the same as I would for any of my patient’s relatives dying. Sad for a moment then life goes on.

So will I be sad if my father dies today and I have no relationship with him? I suspect not. Would I be sad if my siblings died and I know nothing of them? Probably a little. Would I be sad if I found out that they are oppressed and in need of assistance I could provide? Yes quite sad. Would I be sad if I could save them from some desperate need like donate bone marrow or a kidney to save a life and I did not because no one thought to approach me? Yes definitely. Of course I wish I could be a sister to my sisters and brother. I wish things had worked out differently and that my mama’s love had not been misplaced. I wish she had seen through her loyalty and love and chosen a different man who would have treated her and her child better. I wish she had never fallen in love with this particular man but she did. It would be a waste of my time to dwell on what ifs on behalf of my mama. She has moved on. So will I. Such is life.

On Death and Dying

My best friend confessed early in our friendship her fear of death and I remember being curious about why she was scared. Now looking back, maybe the question should have been why I did not feel the same? I mean of course death is not a welcome or happy thought but I don’t dwell on death and I certainly don’t actively fear it. I am very much of the school that there are 2 certainties in life: we are all born and we will all die. And since death is inevitable, I don’t think about it much.

Death is the final release.  Whatever one believes in, I think most of us believe that once you are dead, you don’t feel pain anymore. I know some people believe in reincarnation, some like me believe in the Hereafter and some think that whilst your body dies, your spirit never does and it still retains the memory of pain/anger/hurt/happiness. Although I believe in the Hereafter being Muslim, I do think that when I die, my soul leaves my physical shell and returns to its source (God). Then at some point, our lives are all assessed and we are rewarded (or not) for all our good deeds.

I wonder sometimes about what it feels like when your soul detaches from your body. I wonder if it is like a physical break, painful but transient or if it is more like an emotional separation where the after effects are long felt. I then wonder what the soul feels if it feels anything at all once it is separate from the vessel that conducts and interprets pain. Beyond that, I think death is more fearful if you are not the one dying. I mean, I would imagine that if I was in a terrible car accident, I would either die instantly with no time to think or become scared of what was happening. Or I would be in pain or feel myself getting weaker and weaker and it would be so unbearable that death would be a welcome reprieve. Same as if I had a chronic illness which was not curable but I was steadily deteriorating then dying would probably be a mercy for me.

When I think about dying properly, I realise that although I am not afraid of the dying itself, I am scared of some of the ways that I could potentially die. I am afraid after all. Being a medic, I have seen many people die so I have spent time thinking about the way I would not like to die. I guess one of the scary things about dying is that most of us do not have any idea when we are going to die. It is different for those who are diagnosed with ‘predictable’ illness but even there, giving patients a prognosis (i.e. a number of days/weeks/months/years they are expected to survive) is not an exact science.

In the past 6 months, I have come across patients who were not expected to survive being born and the first few days of life yet despite all odds, they are still with us many months later. I have also come across patients who were predicted more time only to deteriorate much quicker than anyone has experienced, giving no time for their loved ones to be prepared. The only people whose time of death can be predicted with any accuracy are those who are already brainstem dead but on life-support and when the machines are switched off, we can be fairly sure they will die within a certain time period. Even so, we have all heard of the ‘miracle’ stories where patients defy the odds and remain alive far beyond the expected time of death.

My ideal death would be the one most people wish for. I would like to die in my own bed, in my sleep. I would like for it to be when I am old but young enough that I am still completely independent. I would like for it to be after a family reunion where my nearest and dearest are all sitting around a table and reminiscing about the good old days. I would like for it to be after my mother has gone to her grave because I can’t think of anything worse for a mother than to bury her own child. I would like for my children (if I have them) to be old enough that losing their mother does not scar them too badly.

If I am unfortunate enough to have a catastrophic trauma and needed life support, I have told my closest family that I would prefer not to be kept alive for many days. I would like to be given a chance to recover (if there is one) but when it gets to the time where my chances of waking or recovering are much less that 50% then I would prefer for the machines to be switched off. I would like to be an organ donor although in my donor card, I have not ticked the skin donor thing because I am a bit squeamish when it comes to being buried with bits of my skin harvested. I don’t yet have a will but I have told my husband of my wishes verbally if I don’t get around to writing a will before the day comes.

I would like to be buried according to Islamic rites. I think the simplicity of an Islamic burial suits me perfectly. Washed and wrapped in a cotton shroud and buried within a day. If I am in my bed, the closest Muslim graveyard would be perfect but if I happen to be abroad in a strange land then I would like to be taken back to Kaduna, the town of my birth because that symmetry also appeals to me. Also my great grandmother and grandmother are both buried there so it would feel right to lie next to them.

When my grandmother died, there were a lot of tears and prayers and silence but there was remembrance every evening after the crowds dispersed and I found that uplifting. I think the sitting around the dining table and talking about Mammie’s life helped lift the gloom that surrounded us all. The fact that we could all remember and share our memories of Mammie reminded us all that although she was gone, a part of her was alive in us all. And that she had had a good life and her quick death was merciful. Those evenings also reminded us that life is transient. It is unpredictable and death can pick any of us at any time. In remembering our dead, we embraced life and were thankful for all we had been gifted with. I really hope those I leave behind can do that instead of it being all sad and tearful. May we all die a pain-free dignified death and may those we live behind be able to accept it is our time to go and may they have the strength to celebrate a life well-lived (hopefully).

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.