The UN Secretary General was in Nukus yesterday. That's why there were so many police, flags, and fresh paint on the road to the bazaar. He came to see the Aral Sea, or what's left of it. After seeing the graveyard of ships, the Secretary General was "shocked" and has urged "all the leaders...to sit down together and try to find the solutions." How does one say "too late" in UN-speak? The Aral Sea is a complicated situation. The Amu Darya River used to flow into it, but this river has been diverted to irrigate cotton fields, a major source of revenue for the country. Meanwhile the environmental ramifications of this ecological disaster include the highest rates of respiratory infections in the region. MSF was also shocked by this environmental disaster, and came here to assist in improving the health of people who have been affected. Now, over 10 years later, our organization is focused on treating tuberculosis.
Would it have been helpful for the Secretary General to walk the last 10 years with MSF and end up at one of the TB hospitals in Nukus? We could have told him about the problems of paying for food for patients who are hospitalized for months before they are discharged to ambulatory care. We could have discussed the difficulties in rebuilding facilities for adequate infection control. We could have engaged in conversation about ensuring an uninterrupted drug supply, because though we work hard to convince patients to take a handful of drugs with difficult side effects daily, sometimes those drugs aren't there. But I know, it's hard to understand these things when you are only in Nukus for a day, and have spent so much time in a helicopter flying over the "largest manmade environmental disaster in the world" (UN words, not mine). Perhaps the flying visit of the Secretary General will bring a little more attention to the region; perhaps a few more people will read about it in an article on the international page and be shocked as well, perhaps people will take a moment from their busy lives and wonder what has been done to help these people who are less fortunate than them. I believe 90% of the world is good, and is willing to help. But it takes time to really understand the context of a community in need.
I've been in Nukus for nearly 2 months now, and I still feel like a foreigner. I started Russian classes, and have learned the alphabet. I can now read Russian, though I don't know what the words mean. I have learned that there's a cell phone service called "Beeline," which means their ads in black and yellow stripes now makes sense to me. I feel like a filter has been lifted, that all those Greek-looking letters are no longer a mystery, but instead a puzzle to be figured out. I'm hoping to speak soon, it would clear up some of the misunderstandings I have. One weekend I went to a colleague's house for a late lunch, she's an assistant to one of our doctors and greets me each morning with stories of her son or cooking Indian food. Her husband was happy to host and kept pouring vodka in my glass, and I kept drinking. I was wondering when/if he would stop pouring and he was wondering when/if I would stop drinking. By the time the bottle was empty, we had figured out our misunderstanding. Sometimes stumbling through can be more fun. Last weekend I went to a couple of weddings. There were some ceremonial gestures, but weddings seem to be mostly about food, drink and dancing, a universal concept. Although the differences in cultures are often intriguing, the similarities are comforting.