Saturday, September 23, 2017

The Week in Review - A Few Stories

Better Than The Dog Ate My Homework

"Only in Guyana?"   A student in my class told me that he was not able to complete his research requirement for the whole weekend... "Okay, lay it on me." (This will be good, I thought.)
Friday, he was riding home from school on his motorcycle when he got stopped by a traffic police officer on a routine stop.   After showing the officer his id's, the officer told him that he needed to accompany him to the local police station.   Once there he was informed that he looked like one of the escaped criminals from the jail.    They needed to hold him till they could verify his claim... He said that he wasn't released till late Sunday night.. and that is why he didn't do the assignment.

I love a good story and would have granted him a pass even if it was all a fabrication, but I thought I should inquire a bit more.
"So you were held all weekend and you were never charged with anything?"
He nods affirmatively.
"Did you get your one phone call?"
"Yes, I called my mother."
"And.."
"She said there was nothing she could do. I just had to sit there till they figured it out."
There goes her Mother of the Year Award.  My look of disbelief encouraged him to continue.
"Yes; the last time it happened ......"

Stop!  This can't be true ..... "The last time"!??!   And then I remembered:  I am in Guyana.
He continued, "She came down to the police station and explained to the police who I was and everything.   They said that they had to conduct their investigation all the same even though they realized I was not the escaped criminal."
"Did you think of calling a lawyer?"
"It wouldn't have helped. They were doing their job."
Ugh, he wasn't angry at the whole thing.   He went on to describe the cell he was in .... and I'll spare you the squalid details.

I am overwhelmed by the passivity and hopeless acceptance of so much here, from simple things like someone receiving a traffic ticket for stopping at a red light but across the stop line (while the whole concept of stop signs and red lights are usually considered optional here) to this serious kind of detention.

Of course, I gave him a pass on his assignment... and I got myself a beer.  (Later that evening!)  I raised a toast with a can of Stag:  "Thanks to any god available that O'Connor lives in Canada."  Pretty selfish, eh?

Kim - Trump -- and Me in the Middle
On Thursday night, I went to a University of Guyana public debate on Constitutional Reform.  I was interested in how the human rights of  minorities were to be better protected... I think that technically any same-sex behaviours are illegal.  Cross-dressing even on Halloween is going to get you locked up.  If I lived in Guyana, I could have been arrested many times .....

The Debate on Reform started on time, but the introductions before the introductions were about 40 minutes long.  The event was not very academic and it certainly wasn't a debate; it was more a parade of people who wanted the audience to know how much they are already doing .....   such as the woman who addressed us on women's situation and stated often how they had the same rights as men ..... I wonder where she lived in Guyana?   It is not a right if you are not able to exercise it .....   And the woman who spoke on children's rights .....   more of the same.

I left and since I was at the Pegasus Hotel, I thought I'd have a beer.   Unfortunately, the tv was tuned to CNN ..... and there was the tragedy of earthquake deaths in Mexico and Kim calling Trump "mentally deranged".....  Does not the world have enough suffering without two boys still playing who has the biggest willie?  I was upset.

From the Worst to the Least Worse
The next morning, I was scheduled to teach Psychiatry Residents, as I did last week.  I attended morning rounds where there were four male patients:  a strong-looking patient (acutely psychotic) who thought that I was his father and who had not responded to treatment; a calm older man who was somewhat delusional; a sixteen year old gay youth who had left a lot of shelter placements and finally was brought in by the police as he was in someone else's house watching tv.  (He was described as demon-possessed since he was eleven and had survived a rat poison suicide attempt.)  And finally a man in his twenties who was described as schizophrenic and who said nothing but walked away to a corner of the room.  They all had family who had been exhausted by years of trying to help them.   And there was no shelter willing to accept them.

So the decisions about these four people was about trying to figure out the least bad option ..... and there seemed to be none!

And while I was thinking that what I had to teach was irrelevant to the Psych. Residents' world,  an even bigger black man (handcuffed and dragging Security with him) came into the Residents' office proclaiming his own particular gospel for all to hear.
"I smell a white man here."
"Wow, you are quite observant."
He looked me in the eye up close:  "I want to kill white men."  Security escorted him out.

And then it got worse.  Friday is not an Outpatient Clinic day and yet there were maybe thirty patients sitting and waiting to be seen.   So the residents would have to see them because "Everyone gets seen!"  The residents were already exhausted before this .....

The four Residents: Stephan, Veneta, Shonnette and Elizabeth.
And then my "I want to kill white men" patient came strolling back into the office... He had given Security the slip...    He smiled at me, so I guess I didn't look white anymore.  And then, a woman came in who was going to need to be admitted, but there were no female beds.. So a quick decision was made to send four men to the National Psychiatric Hospital in New Amsterdam...  It would free up a room for the woman.  And no one believed it would do much for the four -- but it was the best of the bad options.

There were no beds or spaces, no good treatment options, not nearly enough professionals ..... just not the resources for those in dire need.  And there's Trump, with unlimited resources, and Kim, depriving his people of everything, and CNN covers their tantrums as if they were more important, more spectacular than the world's real problems and appeases the soap opera addicts.    It is a sad state of affairs that mercy and compassion seem to have no place.

And there were still the thirty patients in the clinic, waiting .....  and a woman was brought in by her sister; she had not eaten, not talked, not slept for three days .....  And the Residents did not stop working.  I said to them, "I don't know what I taught you today, but you have taught me much. Thanks."   And I left  (maybe fled is a better word) knowing that in a small corner of the universe there is compassion and mercy.

Oh yeah... forgot the Nursing Students


I seem to have overlooked my brilliant class of students ..... I needed to exaggerate, as I yelled at them this week that their research was junk .....  and when I checked research from previous years they were at about the same level of junky-ness.   Anyhow, we had a field trip this week to a show of Amerindian crafts, dancing and stories.   A field trip is even better for teachers than for students! We arrived almost a half hour before the time we were told two weeks ago that the programme  would start ..... and that was only about ten minutes before it ended!  However, they did get to see the crafts and meet Michael Khan a marvelous storyteller.   And there was a free lunch of Pepperpot, cassava and soft drinks .....    

 




Some Pics from the week, including the Girls



Disappointed
My photography exhibit at the Ayr Public Library will be ending this week.   I was pleased with the display.  However, it is hard for me to hide my dismay that the Art Gallery of Ontario hasn't called me -- yet.

Saturday, September 16, 2017

How Long Have I Been Here?

Suicide Prevention Day - March and Speech 


No sooner were we leaving the airport two weeks ago than Bhiro told me that I was doing the keynote talk for the March in Better Hope on last Sunday.   I said, "No way.  You know I don't like to speak at public gatherings."  This is not because I don't like to speak; it is because I try to live by the fact that the Guyanese have a parade of "whites" proclaiming truths.   "I'll write your speech and you give it,"  I said.

After a period of hard negotiation, I lost and was told to give just a 10 minute speech in the middle of the speakers' list. Uh oh, now I knew it was the familiar barrage of important people talking to the assembled who were hoping that there would be food afterwards.   Fortunately, no matter what I said, it couldn't cause too much damage ..... kind of like preaching.

The March was to begin at 3:00 and walk  a mile to raise public awareness of doing something about the high rate of suicide in Guyana.  There is actually some good news: Guyana is no longer Number 1 at 44 per 100,000; We have dropped to 30 per 100,000.   This is quite significant and something to be proud of for the mental health system in Guyana and the numerous NGO's who have provided counseling and educational sessions throughout the country.

About 3:30, one of the organizers thought that maybe there should be some water as it was a scorcher, even by Guyana's standards.   So off we went to the nearest store to get water for 100 marchers ..... At this time, there were about 10 people - three of whom were driving.   And someone had to pay for it.  It is a good thing Bhiro was there ..... and he wasn't even one of the organizers.
Now it was 4pm and the crowd had come close to 20, with 5 of them driving... And we were still waiting ..... for what? We weren't going to get anymore people.  We were waiting for the police to arrive to guide us along the busy Public Road.   They too had been given a three o'clock time...  
But we were off -- after a fierce debate about whether we should walk in 3's or 2's.  The 2's won out because it was decided that we would look like more people.     We were raising awareness alright ..... The traffic driving west with us was stopped for us to walk the mile .....  

I took this pic from the end of the marchers!
When we arrived at the community centre field, there was already a cricket match that had been scheduled for this time. We had not!   However, the cricketers were gentlemen and sat down to listen to the brief speeches as we were already late.    The microphone was set-up to be at the backs of the audience as it was the only power outlet ..... interesting but the Guyanese took it as normal. To be honest, it wasn't a big crowd, with half the crowd being the cricketers, but at least the crowd outnumbered the speakers.

The MC reiterated many times in his opening (not so brief) remarks that this was a short programme. The first speaker from the Ministry of Public Health went 25 minutes.  Mercifully the other half dozen speakers and pray-ers were shorter but by no means brief.

My Speech

I had offered to be cut from the programme, as it was going on and on, but a guest is a guest.   I decided that I would be Canadian-brief and cut my 10 minutes to five.   I said that with the reduction of the still-high rate, about one half of the suicides in Guyana are impulsive and spontaneous with the ingestion of a lethal herbicide/ pesticide called Paraquat.   It is used in the fields for many crops; before the cane is harvested it is used to clear out weeds, snakes, etc...  One teaspoon ingested is lethal, so lethal that even if you drank it in an Emergency Room there would be no antidote or treatment. You will die a not-nice death within a few days.   There are in reality no restrictions on its sale ..... It is not unusual for a street vendor to be selling fruits, candy and Paraquat.   Banning Paraquat or at least lessening its easy availability would probably reduce suicides by half!


It is banned in all of Europe and most developed countries, except the US -- no one can explain the US today!   One Syngenta plant is in England where it is illegal to use for anything...  and shipped to -- you guessed it -- poor and less regulated countries.

The theme for the day was "Take Time; Save a Life"  which is almost identical to the previous year's, so I decided to be different.   I suggested that they forget about those contemplating suicide and think only of themselves - Be Selfish.    When they work in the fields and spray crops, did they know that it is absorbed by breathing and through the skin .....  and in 15 minutes you can't wash it off.   Paraquat stays in soil for at last 20 years... and in water some say 300 years...  There are trace amounts in the cereal they had for breakfast .....

Exposure to Paraquat, according to research by independent investigators (but not by Syngenta's researchers) leads to an increase in birth defects, elevated risk for Parkinson's,  trouble with lungs, kidneys, liver and more.   This is because it is a "Hit and Run" chemical:  it immediately attaches, but goes away and returns years later .....

And a line that got the cricketers' attention was this: "Hey guys!  Long term Paraquat absorption decreases testosterone production.  And (with my out-pointed, straight index finger) you want to know what happens?"  I slowly bent my index finger and it went limp... "And those little blue pills don't help with this problem.

"So be selfish:  get rid of this stuff!   Clean it out of your homes ..... tell local merchants to lock it up and label it.  Don't wait for the government -- a recommendation for a ban has been on a minister's desk ever since I came in 2002.   Do it for your wives and your children and yourselves."   (I chickened out of  adding, "You don't want your cricket bat to be the only part of you that's hard!" as the newspaper reporter had stopped writing.)  "And if you look after yourselves we will also reduce the number of impulsive suicides dramatically .....and you will maybe even get a Mother Teresa Award for caring about young people."

Dr. Harry (Bhiro) had a good speech on the theme.   He has become like a Psychiatry Saint ..... or since he is Hindu a Swami.   If you want credibility you invoke his name.  People need to be seen with him and just touch his "cloak" or the hem of his garment.


 You Never Know Whom You'll Meet  


The gentleman on the left kept staring at me throughout the whole programme.  After I had finished he came up to me and wanted to know where he had seen me recently... He knew he had.   We finally figured it out; it was at the Everest Cricket Club where I was writing the speech over a beer and some Banga Mary.  He (Primrad) said he was at the Everest praying!  He had to introduce me to his friends and told me that a custom in Better Hope was to have all guests have a beer....  Okay, I can handle that.   And then when I was leaving, he said,  "Well the first beer was for coming and you need  a second for leaving..." and all the guys agreed with him - so it must have been a real tradition.    I had a great chat with them about their lives and struggles and as I was was about to leave again, they told me about another custom.. "You can't leave on an even number of beers..."  by now I figured they might have been making this up...  Bhiro was leaving after having shaken the hand of everyone there, so I had an excuse to break tradition.

A Festival Dinner



As if  Bhiro had not had enough handshaking,  he had 4 tickets to an Indian Arrivals group dinner that evening.   He had to find two people to go with us, and with a stroke of luck he found two young women and off we went.  It was an Indian [South Asian] celebration to be catered with Chinese food by a Chinese restaurant and some karaoke accompanied by a single steel drummer and his computer who played Reggae most of the night.   It was a good time and good food... and we didn't see Bhiro the whole evening as he was making his rounds.

And I got my picture taken at the arrivals monument which is usually off-limits.  And this was just the first day of the week .....

I'll Let "My" Girls Speak for Themselves

I actually had a full week of PBL Classes and they were good.  Some other stuff like doing psychiatry rounds and teaching at Georgetown Public Hospital.  Those things will have to wait.


Thanks for joining me this week.