800 Days in Doha

by Penelope Gordon

  Why am I so bothered? I have always been clear that patients are my first concern and the last thing I would sanction would be poorly qualified doctors giving poor care. Of course it isn’t like that: many of these non-Qatari doctors have been in post for years. Highly experienced, they’ve taught their junior staff who have then been promoted above them. It isn’t that they are lazy but they often are not allowed to sit the examinations for the Arab boards.

  Sometimes these doctors have unique skills, such as the Iraqi General who was working in the morgue. Post mortems are not forbidden in Muslim societies, but local customs mean they are very infrequently undertaken. So suspicious or unexpected deaths become very difficult to assess. The Iraqi pathologist had much experience and was the only person in the country who could deal with unexpected deaths. Not only the hospital staff but the Ministry of the Interior wondered how they would manage without him.

  I like to think that we could have dealt with this problem in a managed way. Further training perhaps? But in Qatar? For foreign nationals? Apparently not. They are to be dismissed. The end result is all that matters, never mind the human fall-out.

  But it is not just the humanitarian aspects that concern me and many of my Qatari colleagues. There is a pragmatic element. How will the country appear in the eyes of the world if swathes of doctors are suddenly sacked for no good reason? Many of these doctors are Palestinian, technically refugees. They have no passports, many have lived in the Gulf for decades, have children in school and literally have nowhere else to go. Imagine the diplomatic furore if these people are summarily dismissed and ejected from the country?

  We can’t appoint doctors and nurses fast enough to cope with demand. The population is increasing exponentially, mainly with construction workers preparing the buildings and infrastructure for the World Cup. Families are also arriving and the pressure on maternity and paediatric services is immense. Yet the government refuses to discuss a reasonable way forward with us in the hospital sector.

  I put forward action plans that are rejected, or at least accepted then rejected for unfathomable reasons. Qatari consultants lobby me vociferously about individual doctors at risk. “The minister doesn’t understand,” they say. “You must not let this happen!” I feel powerless.

  Nevertheless I look into every case, about hundred and fifty. I meet them all to discuss the realities of their situation. There is a lot of denial, then pleading; grown men in tears in my office, worried for their families.

  We try to emphasise the point about Qatar’s status on the world stage. Yet no one can reach the MD. She is always away or meetings are cancelled. The chiefs are as powerless as me. Questions are already being asked about the World Cup processes and the football association, FIFA. We are trying to save face on behalf of the minister, yet inexplicably no one is allowed near him.

  It is exasperating and frankly heart-breaking. This is not why I went into medicine and it is certainly not in the interests of the patients. I try to make sense of it all: I can’t stop the process but I could limit the damage. If people have to go, then at least make it like a redundancy process, with final salaries and other benefits.

  In the end Middle Eastern procrastination allows many people to buy time. Some manage to do their exams and become eligible to stay, some get jobs elsewhere, some retire and some stay in complete denial. Their letters of termination of contract are distributed not long before I leave the corporation.

  Building teams and encouraging high morale in such a milieu is difficult but not impossible. Rising to the challenge was actually quite fun and we both managed it. Nevertheless, things are not going to improve and our initial enthusiasm is starting to flag. More to the point there are personal things at home that sharpen the mind - the birth of our grandchildren plus a sick mother-in-law - and clinch the decision to return early.

  We return to Qatar from our UK annual leave in September of 2014 with a plan to hand in our resignations and be home by Christmas.

  This is easier said than done. Lionel goes first. He has completed the job he was given as CEO of the Heart Hospital. The management team are in good shape. Prior to his arrival there was no team, no meetings to discuss policy, simply a collection of disparate Arabs getting things done by the age-old method of he who shouts loudest achieves the result he wants. Now, the American-based external regulators, Joint Commission International, inspects the hospital and pronounced it the best-run they have ever assessed in the country. Praise indeed.

  But the plan was always to appoint a CEO who was also a Cardiologist. Lionel is a doctor but not that specialty and although the hospital staff (including the Cardiology ex-minister) pleads for him to be kept on, it is to no avail. Face-saving is paramount in this culture.

  So Lionel is to be moved. No shame there, but no one will tell him where he is going. So he resigns. And all hell breaks loose.

  Mohammed, his deputy, interrupts him one morning.

  “Dr Lionel, the MD wants to see you.”

  “OK, when?”

  “Now!” he retorts.

  “Fine,” says Lionel, “I’ll get one of the drivers to take me over to her office in corporate headquarters.”

  Mohammed looks astonished “But you don’t understand,” he says. “She is here. She has come specially to see you.”

  This is unheard of: she never goes to see people on their territory, apart from the ex-minister.

  She spends a long time with Lionel, telling him how much she values his work. How she wants him to be her trouble-shooter, how she doesn’t want him to leave. But she doesn’t offer him a specific job and anyway, the die has been cast.

  The knock-on effect, quickly apparent to her and others, is that I will be going too. I dread telling my team. They are now settled in their new offices and I have circumvented a crazy plan to move them again. Meanwhile they have organised a teaching session for all the medical secretaries from the country’s hospitals. Suddenly they all have pride in their work and they believe that I am their protector.

  There are tears when I tell them I am going but they rally and decide that at least they can organise a good leaving party. This is a huge secret and I have to be complicit in pretending I know nothing about it.

  Because of all the changes I have made to contracts, promotion policy and pay, the senior doctors are distraught. “What can we do to make you change your mind?” they ask. One senior Arab physician puts his head in his hands. “This is a disaster,” he says. “You cannot go. What will we do?” To be fair, he is rather given to histrionics and I reassure him that the world will not end if I go home.

  It is all very flattering but needs to be put into perspective. Yes, they like me but they are also used to me. They don’t want change and worry about who might come next. Still, nice to hear from Dr Mustafa who sighed, “The good people always go.”

  My own immediate boss is extremely worried about how he will cope without me, although very understanding, so we make an agreement. I will give four months’ notice instead of the usual three and he will ensure that I’ll be put up in a five-star hotel for the final month when Lionel has already returned to the UK. This latter stipulation is important because of the difficulties of leaving the country: I want no impediment to my easy departure once Lionel has gone.

  18. Farewells

  In spite of the threats of being put on a plane and chucked out of the country at a moment’s notice, the reality of leaving at will, as it were, is very different. The country and the corporation are paranoid that leavers might have unpaid debts. This fear stems from the crash of 2008 when the economy collapsed overnight in Dubai. Expats, in their haste, left with the clothes they stood up in. Porsches, Ferraris and other such expensive cars were abandoned, littering the roadside on the way to the airport; tenancy agreements and credit card arrangements were ignored. The wealth had dried up and there was nothing left to st
ay for.

  So there is a long list of procedures to be completed before we can receive our final salary and be allowed to leave the country. True to form, no one knows the rules exactly and certainly no one is going to tell us. Those who have gone before have left few clues. We reckon they were so relieved to be off that compiling a checklist for others was not their priority. So like everyone else, we muddle through.

  Leaving the house is the most onerous task. Everything has to be left in pristine condition, even to the extent of taking down curtains and blinds.

  “But we have good curtains,” we explain to Mr Khalid from Housing. “The new tenants might wish to keep them.”

  He smiles comfortingly then shakes his head.

  “Housing is in short supply. You must know who will take over. Tell us and we will talk to them.”

  “No, Dr Penelope. Just take everything down. This is all too difficult to arrange.”

  Our house had been completely unfurnished so we had bought white goods, cooker, fridge and so on.

  “Mr Khalid, can we not sell these on to the next person?”

  Again, the head shook.

  “Or even leave them free of charge?”

  No, it would appear this was against all rules and the house must be cleared.

  “Including all the plants,” he adds.

  It is tempting to simply leave everything and pay for any perceived damages, but this is inadvisable. Three inspections are made and if unsatisfactory then final salaries will be docked and the precious exit permit refused. Lionel agrees to sort out the domestic arrangements, leaving me to work and then calmly move into the hotel with him for my final month in post.

  Nothing is ever calm in the Middle East. We set about selling all the furniture. Websites abound, with legends such as Qatar Living. We advertise an item then wait for the offers to come flooding in. We bargain hard with one man, who gets a good deal on a television. He then turns up in a beaten-up van, gives us a toothless grin and says he has no money. Could he have it for free? He doesn’t look like a wealthy man but he is trying to rip us off.

  “Give me the money or you don’t get the goods,” says Lionel sternly.

  Suddenly our buyer remembers the cash under the dashboard, but still tries to bargain us down further. We are not playing his game and he gives up, hands over the money and drives off with the TV in the boot and a cheery wave.

  We sell a large sideboard to a colleague. He turns up one Saturday morning with a lorry driven by an elderly Arab.

  “It’s heavy, Dave,” I warn. “Still, the three of you will cope.”

  “I don’t think my man understands that bit of the deal,” replies Dave. “He’s not shifting from that lorry.”

  Sure enough, the elderly Arab watched while Lionel, Dave and I struggle to load his truck.

  We have some beautiful specimen plants in large tubs. A haughty Syrian lady from along the road buys the lemon tree.

  “I’m going out now,” she informs us, “You can get your men to bring the tree when I return.”

  Except we have no men to move trees. I pop in to see my friend Suman from the garden centre. He’s always had a soft spot for me and happily complies with my request for a few chaps to come and shift plants, for a small fee.

  So at the appointed time we have four men with a large lemon tree in the road in the scorching heat, but no Syrian lady and no reply from the house. I am furious. But Lionel has a plan.

  “I’ll break in and open the garage door from the inside, then we can dump the lemon tree in her courtyard,” he says.

  So he shimmies over the wall and our chaps are positioning the tree when she swans in, not having noticed that we are technically trespassing. We pay the garden centre men who leave, then she has the gall to pop round half an hour later.

  “I don’t like the position of the tree,” she announces. “Tell your men to come and move it.”

  Her husband, by contrast, is delightful. An academic who had trained in France and America, he is the patriarch of the family. His niece has arrived from Syria to live with them, and his adult son also lives at home, but his mother sadly died before she was due to leave his beleaguered homeland. Every day he speaks to relatives there. The situation is worsening and I wonder how his Syrian based extended family will cope. Will they join the trail of refugees crossing Turkey?

  We hear that bank accounts need to be closed. This is a worry. How will our salaries be paid? How will we pay our bills? Luckily the rumour is wrong: credit cards are the issue. They have to be relinquished ninety days before we leave the country. Lionel goes first. About three weeks later I follow and give up my card. We check that Lionel is OK as he will be leaving before me.

  “Your card has only just been cancelled, sir,” advises the bank clerk.

  “What!” Lionel exclaims. “But I relinquished it weeks ago.”

  “Sorry sir, but we have only just cancelled it at the bank. There may be a problem with you leaving the country. It is now less than ninety days.”

  We are outraged.

  “But this is the bank’s fault,” insists Lionel.

  The clerk is unfazed, “Don’t worry; we can keep a deposit from your account, in case there are any outstanding debts.”

  “There are no debts,” we say. “Anyway, how much deposit?”

  “Fifty thousand riyals,” he replies and smiles sweetly.

  A mere bagatelle of about ten thousand pounds! This is getting serious and there’s no contrition whatsoever from the bank who had cocked up.

  The whole thing is a nonsense anyway, as the banks do not allow overdrafts and credit cards are automatically paid off each month. Luckily Lionel never has to find his putative deposit and the first exit hurdle is done.

  Utilities, water, electricity, phone and internet all have to be closed down and paid up. Inevitably this is as complicated as it was when we arrived. Timeliness is poorly understood in the Arab world: cancel the electricity too soon and you are cut off the following day, leave it too late and you can’t leave the country because they haven’t received your final bill.

  What to do? Behave like an Arab.

  Our Arab colleagues have no notion of the stress we are under. “Just get a boy to do it,” they advise. So we do. Ayoub, one of Lionel’s hospital’s drivers, goes to the utility companies to sign everything off. He whizzes round the hospital, signing off the meaningless checklist. He passes by my office one afternoon beaming and proudly announcing, “Hello ma’am. You know me. I am Dr Lionel’s boy!”

  My ‘boy’ is Ibrahim, the Chief Aide on my corridor. I slip him some dosh and he spends many hours and days doing irrelevant tasks such as guaranteeing the return to the laundry of white coats (even though I’ve never worn one and have never been allocated any).

  We have to relinquish our passports. This is uncomfortable and the gilded cage metaphor becomes all too real. I want mine returned as soon as possible so I go personally to the hospital immigration department, accompanied by my henchmen, Ibrahim, who speaks several Indian languages, and Aliya, veiled Qatari lady. I figure this duo will be able to cut through the bureaucracy. It starts well.

  We walk into the cramped office, packed with people of all nationalities who part, allowing us to march up to the front. I keep silent but glide in behind them like Lady Bountiful. Can you imagine blatant queue-jumping like that in the UK? I am afraid I have no compunction. This is necessary and expected.

  It is to no avail. Lots of Arabic, Urdu, Hindi and a bit of Pidgin English, eyelash fluttering, arm waving and summoning of supervisors ... but the answer is an emphatic “No”. They will keep my passport as long as necessary, with no explanation whatsoever. We shuffle off, beaten, and I take Aliya for a consolation coffee and cake in the hospital Starbucks.

  The house is nearly empty. The curtains hav
e gone, carpets are rolled up ready for shipping home, and the garden is once more a barren wasteland. Ayoub and his mates come over to tidy up the holes in the walls made by picture hooks and the like. A blob of plaster with a covering of paint is all that is needed. We have already advised Ayoub on which shades of paint to buy in small tester pots.

  Ayoub and the gang fill the holes then proudly demonstrate the painting materials: four pots of paint and one paintbrush. They then proceed to cover one hole and stand back proudly surveying the result.

  “This colour is wrong, Dr Lionel,” pronounces Ayoub.

  “No, it’s still wet, so we can’t be sure yet,” we say.

  Ten minutes later no one has moved. The awful truth dawns: we are paying them to watch paint dry.

  I take the one paintbrush and test a different area. Ayoub is almost apoplectic.

  “No madam, please let me.”

  They then proceed to systematically paint each hole in order while carefully washing and drying the brush in between. It takes four men and four hours. Luckily they are nice chaps and very inexpensive. We have a pile of stuff that we were unable to sell.

  “Take what you want,” we say.

  They take the lot.

  Leaving is a wrench. When I first arrived, I was wary of making eye contact with the Arabs, but my reticence was misplaced. “We like your big smile,” they told me, “and Islam tells us you should smile and be friendly.” I took their advice and started to freely greet people in the corridors, in the lift.

  In the final few weeks, I pass a couple of Paediatricians deeply engrossed in conversation in the main hospital concourse. I know them well and don’t wish to appear rude, so as I walk past I say:

  “As-salaam alaikum.“

  “Wa-alaikum-salaam,” they reply. Then Dr Mohammed looks up. “Oh it’s Dr Penelope. How are you? Is it true you’re leaving?”