I take a plane from Tashkent to Nukus where I will stay for two weeks. My Korean driver is a small man with drawn lines from his eyes giving the impression that he is laughing or squinting, as though he needs glasses. I hope he is not squinting given that he is driving me two hours from the airport to the town of Nukus in Karakalpakstan, Uzbekistan. I think he is laughing, silently, probably at my unfortunate difficulties with the Russian language.
We stop so that he can collect some documents for MSF. I stand outside watching this new world I am suddenly exposed to. It is a curious feeling, being on a side of the world you have preconceived ideas about, but desperately trying to avoid forming uninformed judgments, but the truth is I feel I’m on an adventure and really quite free. The town is active but not in a rush: there is a small girl dodging the hooting cars, getting what looks like milk across the road to her father’s kiosk. The cars arrive at the junction with families in their orange, green, red, light blue, pink ladas, russian cars that are little saloons reminiscent of sleepy days gone by (I love it!). Above the little girl’s father’s shop are posters of perfumes and crystal glasses and coca-cola zero. An old woman, with a white headscarf and long black dress looks up at the poster and pauses. I wonder what she makes of this poster world - is it as alien as it looks to me? She continues with her day and edges slowly towards what is probably daily routine for her. It is a sleepy world with the sights and sounds of everyday life, but without the pressures of ‘targets’, or ‘one year plans’, or ‘life goals.’ My driver returns and we carry on for 2 hours into the desert until Nukus.
The air is dry and the dusty desert does not leave me with much joy although we pass a round brick called ‘Daxma’, pronounced Dakhma, shaped from a distance like a red blood cell. I later find out from the Savitsky museum in Nukus that Dakhma is a tower erected on a hill for the disposal of the dead according to the Zoroastrian rite. So if I have understood correctly, these towers have corpses inside which are exposed to the sun and to the vultures. After vultures have picked the bones clean, they fall into a pit below, thereby fulfilling the belief that a corpse must not suffer contact with either fire or earth, two of the elements important in this religion.
When I arrive at the MSF office, I am greeted with a handshake by everyone who I meet, occasionally by a palm on the hand. I am later told that, when you meet someone for the first time in the day, you always shake their hands, but be careful you do not get too carried away, as if you shake their hands twice you look like an idiot, as the response is usually ‘why are you shaking my hand - do you not remember meeting me’. This etiquette causes me some anxiety in my first few days, but it makes me more attentive to this rather lovely ritual. I am hungry to understand this culture because apart from respect, it will make me better at my job as a doctor.
There are some who notice my dazed expression and fortunately for me, one of the health education officers offers me an explanation of the history and culture. But first, he takes me out of the room and into the sun where I offer my words of wisdom about the benefits of Vitamin D. He is, in my opinion, one of the most important persons as he is the one who will engage with his culture and dampen any fears about TB. He tells me that the patients are ‘hungry for information’ and he helps to dis-spell myths about us, the ‘good’ guys. He talks about women who commit suicide because they will be shunned from their husband’s family if they have TB and can’t hug their children, stories sadly not uncommon all over the world.
I ask him to tell me about the history of this land and the culture of her people. He whispers and reminds me that history is still palpable. “Let’s talk for an hour”, he says, "over a coffee, when we have more time”.