I Love a Surprise

I love a surprise, like yesterday when I said “Maragash Altsi” as I put my coat on to leave.  A pair of eyes peered over the top of a mask and just fixed on me.  Maybe I said it wrong so repeated in English “See you tomorrow”.

Mary, not sure it is her real name but close enough for me, turned and fled into the next room, only to be quickly followed out by an English speaking student nurse.  “Aren’t you staying for the party, they are having dinner to celebrate Women’s Day?”  Oh bugger, why didn’t they tell me, well they did, but not when they were having the party and Women’s Day is 2 days away. I had friends coming over for Wooly Grier’s Knitting Night (that is another story) and had to clean the apartment and get ready. So I made my apologies and trudged out of the ward, feeling rather guilty.

Women’s Day is a big thing in Soviet countries. It is sort of like Mother’s Day but you don’t have to have had kids. Your male friends/partner is supposed to smother you with gifts and affection (are you reading this fellas), florists do a roaring trade and womanhood is celebrated. Wonder what Germaine Greer would have thought. But the best thing is….it is a public holiday.

So this morning, to make amends, I bought a pretty pink heart shaped cake with a pink 8 on top (Women’s Day is the 8th of March, score that date into your memory bank guys). We all sat around the table in the staff room and discovered the pink cake was chocolate on the inside. Everyone politely had a slice, served up in anything, cups, bowl or plates. When finished, those lucky enough to have a bowl or cup took my used tea bag and poured hot water on top, sort of doing the dishes and having a drink at the same time. My dear old mum would have been happy to see the tea bag wasn’t being wasted but did 4 cups, really a bit like dish water by the 4th.

I felt pretty good, I had made up for the mistake of the day before, took some photos and everyone was smiling. Then one of the doctors stood, said something to me in Mongolian and beckoned for me to follow. Not wanting to blot my copybook again, I did as requested. A quick stop in the corridor for a two minute consultation with a patient and we headed down stairs.

In the main foyer, a crowd had gathered, but that wasn’t unusual. This area is where patients present to register and get their appointments. Monday mornings in particular are frantic. Patients are allocated an appointment time and from what I understand, it can be any time that day or the following days. They may have to go away and come back, I think a big ask of those who have travelled from the countryside. From there they go to the room where they will see the doctor, just standing around because there are only a few chairs, till it is their turn.

Behind the throng of people at the desks in the main foyer were tables set up in a cleared area. About 6 nurses from our ward sat at two of the tables, taking blood pressures. Don’t know who was doing the blood pressures on the ward. Another table was covered with brochures, I spotted the one I have designed for care givers. In broken English I was told this was Open Day., where they advertise for the ward. Didn’t think Palliative Care needs advertising, but then again I guess it is a new concept here.

A few months ago I had talked with one of the ward doctors about having information leaflets for the patients and families, to educate them a bit about health issues etc and was told that they did have them, but didn’t display them in the rack where patients and care givers have access, because they take them. Mmmmm

But the frenzy that was generated at the table with all this information supports my theory that there is a lack of health education in this country. There was a real crowd crush as they scrambled to reach brochures that I think were related to healthy diet, signs of different cancers and lifestyle causes. There were some on different drugs, like the ones put out by pharmaceutical companies for doctors, not sure how much good they would be, but they were free and just as popular. One good thing the Russians did here was promote great literacy skills, so I just hope that all of the information is read before it is used to start the fire in the ger.

One of our ward doctors sat at the table with me, people would come up with their medical record. Everyone keeps their own medical records here, nothing is kept at the hospital or doctors surgery. So when you go to the doctor, regardless of where, you have your health history with you. It is surprisingly compact, and efficient if seeing different doctors all over the place. So, with presentation of the medical records, Dr M was doing mini consultations, listing suggested medications for treatment which they could buy over the counter at the pharmacy, all within the throng of those grabbing brochures. I had to suppress the giggles when one of the security guards came up and started adjusting his trousers to show off his swollen legs. No such thing as privacy here.

On another table were samples for the tasting. The ward makes its own laxative, a mix of dried fruits, oil and water. This was being spread on morsels of bread for sampling. Fortunately not as popular as the brochures, but still finger licking good and drawing a crowd.  

I wandered around in my white coat and was stopped by a guy who presented his health record to me along with a sheaf of urine and blood results. Obviously the white coat indicated that I knew what I was doing, rather than being part of the costume that had been enforced when I first arrived. I tried to tell him in Mongolian that I really don’t speak the language, gave up and said it in English. Then he spotted my phone with which I had been taking photos, and insisted that I record our meeting for prosperity. I turned it around to show him the product and he was more than pleased with the photo, said something in Mongolian and that was that.

On the big screen TV that is encased behind glass was the promotional video showcasing the surgical unit, a bit of “theatre” to entertain (That was a bad joke wasn’t it?) A few sat on the old fold up wooden chairs, like those old ones you see in country cinemas, taking in the movie of someone’s operation, mammogram and blood taking. But all good education in a country where statistics say that if you are diagnosed with cancer, the average life expectancy after diagnosis is about a year. 

There is a lot of cancer that reflects the lifestyle of the country, fatty meat and dairy eaters who drink vodka and smoke equates to liver, lung and gastric cancers. Ovarian cancer is predominant in the women. The hospital screens all staff once a year with ultrasounds, x-rays and blood testing and a few weeks ago one of the doctors was getting her own treatment. Hepatitis is common among health professionals. I have gotten over the shock of walking into the staff room and seeing one of the staff with an IV line in getting a top up of something. I have seen the proven hangover treatment of a few litres of saline run into a person who is recovering under a doona in the seclusion of the doctor’s office. I guess with such acceptance of sticking needles into veins at the drop of a hat, it is no wonder that infections are so predominant. During winter small bottles of Vit C syrup are a big seller at the supermarket checkout and most of the ladies I work with seem to be big into vitamins.

So, the excitement in the foyer eventually died down and the crowd thinned. All the brochures were gone, well most of them, so there was nothing much to pack up but the cute black sheep scales and the left over laxative. Wonder what is for afternoon tea.