As I turned corners, there were more of these grey-clad workers spilling out of every doorway. I still haven’t quite worked it all out, but possibly they were going to collect their wages at the end of the week before being bused home. I still don’t know where the women come from. These migrant workers, including many nursing staff, are very poorly paid and viewed with disdain by the locals.
Wages might be low yet are much better than those in their home countries. When I arrived at work on Sunday, I was told that Honeylet had gone back to the Philippines because of a family matter, but no one knew for how long. Relating this to a colleague, the immediate response was, “So she’s been deported”.
Who knows?
When I need to visit the hospital in the north, about an hour’s drive away, I am not keen to drive myself across the desert so, following guidance, I request a car. However, I’m informed that because I have been lent a car by the corporation, I must use it for this journey, though a driver will be provided. This is duly arranged, memos sent (the memo is an important bit of organisational currency) and on Sunday morning, Yasser (tea-boy, stationery dispenser and general gofer) takes me over to Transport. There are several men milling about outside the offices, which resemble a concrete cell block, and while Yasser negotiates in Arabic, I hang about outdoors as I am not invited in out of the sun and heat.
They claim to know nothing but eventually a driver is found for me and we go to my loan car, having assured them that it is full of petrol. My driver is straight out of Lawrence of Arabia with long flowing robes, head-dress with tassels down his back, worry beads, bad teeth and an aroma which is a mixture of male sweat and Arabian perfume. He speaks no English and off we go.
At this juncture, forget David Lean films with vistas of romantic sand dunes and dashing Arab princes riding their thoroughbred stallions over horizons. This landscape is completely flat, very dusty and there is the occasional dead bush. There is nothing else apart from the occasional building site, but at least the road is good and inevitably we drive very fast. Eventually we encounter some habitation and my driver turns to me gesticulating wildly, clearly asking me where to go. I have no idea and nor does he.
We turn into a small health centre and he stops the car, so I tell him to wait. I go in, where I find a man in a white coat with a label saying ‘Doctor’. He is charming, speaks English and happily responds to my request to speak to my driver in Arabic. It takes about five minutes of intensive voluble chat - plus gesticulations - to tell him to turn right, then straight on until we reach the hospital. Having arrived there, we stop somewhat randomly outside the Haemodialysis Unit, so once again, in I go and find a very helpful pharmacist and an Indian porter who offers to take me through the hospital to the office of the Medical Director.
This strikes me as a dangerous ploy since I may never see my car and driver again, so I herd porter and driver, who has by now appeared, and insist that the porter comes in the car with us to the main reception. Amazingly I am on time for my appointment and am treated like a queen. It is a good meeting, with coffee and a tour of the hospital, including an explanation of the isolation rooms designated for infectious diseases.
Before coming here, Lionel and I had to provide a certificate stating that we had never had tuberculosis, yet there is a high incidence of TB in the migrant workers working in the industrial city in the north. They come mainly from the Indian sub-continent, without their families and are housed in dormitory-like accommodation.
They work in this industrial city that covers over thirty square kilometres and is a conglomeration of refinery, tanker port and pipelines. It abuts the huge natural gas field which projects out into the Gulf towards Iran. Unless I had looked it up on the internet I would have never known of its existence, yet it is the source of the country’s wealth. To be fair, I am new here so I do not presume any conspiracy or cover-up.
The episode with the enraged Arab driver made me realise that a decent car is a necessity. Given the state of the driving, traffic and roads, it is clearly important that we have our own cars which are well built, safe and with reliable acceleration in order to get out of trouble. I choose a good European make, a Volvo four-wheel drive and Lionel goes for an American tank, namely a 5.3 litre Chevrolet Tahoe.
I choose the lease-purchase option and he elects to take a personal bank loan (because only then would we be allowed, inexplicably, to take the car out of the country, should we feel the need to escape across the desert). It all sounds astoundingly simple - if only.
For the deposit on the car, which has to be in cash, I have to transfer some money from the UK. So, trotting off to the garage with my thirty thousand riyals (about five thousand pounds), I count it out and expect to drive the car away. Wrong. This is the first process in registering the car and so it goes on, with trips back and forth until eventually I can drive my new Volvo away ... except it isn’t exactly my car. I am still waiting for a resident’s permit, so the garage helpfully arrange for it to be in their name in the interim. It is all very simple.
“You just have to sign a paper in Arabic then you can have the car,” says my Egyptian car salesman.
Frankly by this stage I would have signed anything but Lionel is more cautious.
“Well, OK,” he responds, “But at least can we see my wife’s name at the top of the document?”
Carefully my salesman places his pen at the top right hand side of the document.
“But of course,” he says and, you’ve guessed it, writes something completely unintelligible in Arabic.
Well it all works out in the end, but not before I pledge the hire purchase payments, not with a direct debit but by writing twenty-two post-dated personal cheques, which I leave in the custody of the garage to cash at monthly intervals.
What about Lionel? His salesman is a pale, skinny Lebanese girl with fiercely plucked and painted eyebrows. Her hair is scraped back in a Croydon facelift and the answer to any question is, “Yes, of course,” delivered in the abrasive clipped tones worthy of any Bond villain.
“Can I drive my car away tomorrow?” Lionel asks.
And the answer is, “Yes, of course.”
This is pure fiction and he goes through similar convoluted procedures as I have, even though he has waited for his Residence Permit. There were some good things, such as the personal bank loan that was granted, no question, that very day. The money was simply transferred into his account. However when he suggests transferring it over to the garage’s account (same bank) this suggestion is met with astonishment.
No, cash is preferred. So off he goes across town with roughly forty thousand pounds in Qatari Riyals in a brown paper bag. On arrival at the garage they calmly put it through their on-site cash counter and all is well.
“Yes, of course,” is only one of several stock answers to any query. Others include, “No problem” and “In the next five minutes.”
In fact, any answer but “No” is given. How to judge the truth? Depending on the ethnicity of the person, there are often some non-verbal clues, the commonest being a barely perceptible head motion that manages to be simultaneously a nod and a shake, culminating in a subtle figure of eight. The more vigorous the movement, the more likely that he is talking complete bullshit. But most importantly, I learn to watch the eyes. Dodgy and evasive translates as “not a hope in hell,” despite the promise of “yes, sir, immediately!”
I fill up my new Volvo with petrol for the princely sum of thirty-two-and-a half-riyals, which is about six quid. The guide books recommend rounding up the bill in order to give the petrol pump attendant a tip, so I give him thirty-five riyals and with great largesse tell him to keep the change. He gives me a strange look and points out that the QR5 note is in fact a QR500 note - and I was priding myself on being able to read numbers written in Arabic script. Of course, had I turned the note over, it was all written in English anyway!
Throughout all the HMC hospitals are signs in English and Arabic and one of the most notable reproduced below, advises relatives how to behave when visiting patients.
Etiquette of visiting patient (published by the Religious guidance and Da’wa department.)
Select a suitable time for the visit
Avoid staying with the patient for a long time
Respect patient’s condition, do not raise your voice in his presence and do not disclose information which would upset him
Pray for the patient sincerely
Console the patient using an optimistic approach and give hope of recovery
Remind the patient about the rewards of patience
Do not make the patient doubtful regarding the doctor or the treatment plan
Avoid mentioning non-suitable suggestions to the patient
Imagine such exhortations in a British hospital! I did hear people volunteering to pray for patients when I was in America, but we British tend to be much more subtle regarding religious matters and even the chaplains do their praying discreetly. The sub-text of protecting the patient from unwelcome news is interesting and very much part of the culture here.
Relatives will go to great lengths to keep a diagnosis of cancer from the patient and I hear of one case where a daughter was proud that even on his deathbed, her father thought he was suffering from anaemia, not the prostate cancer that finally killed him. It would seem that openness is not embraced as a concept and questioning the doctor appears to be actively discouraged. Yet complaints are numerous and patients and their families are very demanding.
Expectations are high, but there are few attempts to manage them. An out-patient booking system has recently been installed, which is having some effect. Previously patients would simply turn up and demand to see the doctor of their choice, usually because they had seen that particular doctor before or because there was a family connection. If you are not from a local family then the Emergency Department is the only place, as there are very few GP surgeries.
Relatives from local Qatari families are unwilling to take their turn in the Emergency Department and stories abound of doctors being physically dragged away from treating a migrant worker in order to see a local patient first. This has resulted in a kind of local apartheid where Qataris are treated in separate bays, in order to diminish the acts of violence and aggression. And I thought the Emergency Department on a Saturday night in Portsmouth was bad.
Yet overall, people are generally warm and friendly. I make formal appointments to see prominent Arab doctors in order to discuss policy and strategy and am made very welcome. I’m given their delicious Arabic coffee, flavoured with cardamom and saffron and I’m offered sticky pastries with chopped pistachios or occasionally fresh dates, which look revolting yet taste sublime. There is much small talk and people are amazed when I say that we had a good laugh. I may not be getting the business done but at least we can share a joke and I suspect this relationship-building is crucial.
It is particularly important as a westerner to show that you have some understanding of these cultural mores. An abrasive let’s get straight down to business approach does not work in the Arab world.
Exactly how well I am doing is hard to judge. Lionel, needless to say, is flying in those terms but he needs to be. The prestigious new Heart Hospital has no governance, failing leadership and a need to meet external regulation. The place is in relationship meltdown with various warring factions, interventions by the Royal family and an expectation that Lionel will sort it out. Never frightened of confronting the issues, he asks directly whether a consultant attended his out-patient clinic and the reply is strongly affirmative, whereas the out-patient manager is perfectly clear that the consultant has seen no one in out-patients for months, but leaves it up to his junior staff.
Meanwhile there are votes of no confidence, disreputable memos signed by members of the same family discrediting other staff members, and only this week, Lionel has had several grown men and women in tears in his office.
Nevertheless the standard of clinical practice here can be high. I attend a Mortality and Morbidity meeting in the Heart Hospital where two cases are discussed in detail. The debate is scholarly and heated at times but there are some very wise voices among the assembled senior clinicians. I experience the same commitment to good medical practice at a Grand Round in the education centre. These usually take the format of a junior doctor presenting a recent interesting case followed by a discussion about the treatment plans, the outcomes and how this all fits with the recent academic literature. It is a good forum for the juniors to hone their public speaking skills and for the senior doctors to guide (and in some cases to show off) their knowledge. Everyone learns so ultimately the patients also benefit.
There is a pecking order among the staff. Lionel’s senior physician (and former minister of health) chairs the proceedings, asks the pithy questions and when he alone has decided that the meeting is over (regardless of any guidance on the timetable), he announces that the meeting is closed ... then sweeps out with a flamboyant swish of his robes. There is no question of a cosy chat afterwards.
3. Hot but not bothered
It’s difficult to believe that this is just the annual hospital awards beano. The venue is massive, shaped like an enormous tent with a high central dome, a stage at one edge and seating for eight hundred people around white linen-draped tables, each seating ten. The VVIPs with gold tickets are in the front two rows of tables, the VIPs slightly further back and the rest take their chances. The whole place is bathed in a silvery light with lasers flashing across the room and stilt dancers, clad in fantastic white glittering costumes, parade around. A dancer in a bubble moves around the tables and the whole scene is reminiscent of a winter wonderland. The temperature outside is thirty-seven degrees Celsius, but inside the air conditioning is working overtime.
We are treated to an amazing light show depicting images of the hospital as it seemingly emerged from the desert and our guide for this is an eagle who appears to be flying with us. Beautiful and extravagantly done, though the ensuing awards are somewhat lacklustre. Maybe such things always are, but it occurred to us that some champagne would have fizzed up the proceedings more than lemonade or mango juice.
Traditional sword dancers bumble around on the stage accompanied by drummers. Swords are being waved about with abandon and not for the first time, it occurs to us that ensuring our necks are well out of the way of such dancing was a judicious plan.
Frothy and superficial with entertainment galore for the glitterati - but where are the ordinary workers? Have they been invited to this extravaganza? Sadly no. A few representatives from the winning teams are hauled onto the stage from their tables at the back of the room. Most of the hospital staff can only dream about attending such an event.
Meanwhile there is day-to-day work to do. And it all seems very normal. There is a chairman, a secretary taking minutes, an agenda and the usual accompanying paperwork. We sit around the boardroom table and the meeting starts. Anarchy could not begin to describe the ensuing scene. Admittedly people stay in their chairs but the dialogue is vivid, people talk across each other, the chairman is completely ineffectual and at one stage I spot the lawyer adjacent to me reading his papers backwards, because they are, not unreasonably, in Arabic.
The problem starts when he quotes from those papers (in English) provoking a vociferous challenge from another Arab. “Read it in Arabic,” he demands, “then we will trans
late”, the sub-text being that he clearly does not trust his lawyer colleague.
The body language is florid, with hands waving, worry beads jangling and the men constantly fiddling with their headgear. The ghuttra is the long flowing white, or red-and-white chequered, headdress which is held in place by a black aghal or rope ring. There are numerous ways to wear this and the most traditional is in the style of little boys playing shepherds in the school nativity play.
However there are many alternative styles with asymmetric coiling of the ghuttra, with maybe one edge hanging nonchalantly over a shoulder; sometimes the aghal rope is covered by multiple pleats and the men constantly fiddle, in the manner of teenage girls tossing their flowing hair, as they readjust their look.
Overall the look is so uniform that individuality is reached through such variations plus differences in beards and cufflinks. A friend who teaches English to young Qatari men reveals that their conversation revolves around three Cs: cars, camels and cufflinks.
The meeting ends in disarray as everyone simply stands and leaves and the poor Filipina secretary has no idea what to record. Frankly, I cannot help. I confess that I probably added to the confusion, by also talking at loud volume and waving my arms around. It is the only way to get a point across, even if there are no decisions ultimately made. Maybe I am settling in more than I realise.
It might be expected that relocating to a new country would involve a certain amount of personal admin and although it seems excessive here, we have to keep reminding ourselves that foreigners moving to Britain might share our sentiments. The first hurdle is the Residence Permit, without which nothing can happen. We are fortunate because we receive this within four weeks along with a multi-exit visa, as hoped for.
This latter piece of documentation is particularly important as without it, permission needs to be sought from your employer for every trip out of the country. Also, should we go abroad without our Residence Permit then on our return it would mean starting the whole process again from scratch, assuming we were let back in.
800 Days in Doha Page 3
