Frustration reigns supreme in our project!
We are “hands off” here. We don’t practice our professions with the families referred to us; we are training our Tajik counterparts to do it. This is the way it should be but it can be a lot less satisfying than just jumping in yourself. For instance our young and enthusiastic pediatrician, Christoph, can be quite vocal about this (in the privacy of the office). He shakes his long hands at us in exasperation after a morning at the hospital, asking “what is so hard about ....???” at the realization of yet another gap between his training and that of the doctors here. It would be so much easier to just step in and do it himself.
This country has many difficulties and one of them is in the transfer of knowledge. This gives Christoph a kind of stigma too. He is feared, perhaps even resented, for the power his knowledge lends him. They are finding it hard to give him their trust. It’s going to take time, a lot of communication, and maybe some vodka ...
Meanwhile, I struggle with another frustration - the importance of language for communication. You can only do so much with sounds, facial expressions, gestures and body language. To go deeper, to discover what’s really inside a person, to really hear their thoughts, at some point you need words. I am a therapist at heart. I am curious about how others think, I am fascinated by behavior, I am moved and affected by another’s suffering and I get deep satisfaction anytime I succeed in helping alleviate stress or grief. However, I am a ‘verbal’ therapist - my tools are words.
But I can’t use them. I don’t have enough Tajik or Russian words yet. I train our national counselors through translators. The translators do something to my words, the counsellors interpret those words into interventions, the responses from the family get translated back to me. Or they don’t, as the case may be, for various reasons.
Have you ever drunk a really good smoothie? Where the tang of berries or citrus was softened by banana and made creamy by yogurt; a whole new blended flavor? That’s what good communication feels like to me. But here it feels like I keep ending up with three berries and a glass of milk and no idea where the banana went! Not exactly satisfying.
It’s not that our translators aren’t good, they are. It’s hard work and they sometimes put in long days trekking round the country with us. It was Friday today, end of the day, end of the week, and our nurse Andy came back to the office after spending the better part of the day training national nurses in a certain procedure. I’ll spare you the details, but it involves putting a tube into a child’s lung through the nose. Andy was the guinea pig four times, letting nurses practice on him, so he had quite the day. But it was Nozil, his translator, at whom I took one look and said - you need to go home, you’re exhausted, and he simply nodded and pointed to his neck: I need a massage!
Ioanna, who works down in Kulob with our nurse-practitioner Tina (who can’t practice, another frustration), is our TB doctor, or phthisiatrician (a great new word!). She struggles with a whole mass of frustrations, including how to put into words what working for MSF in Tajikistan means. But her attempt is so poetic: “it’s weird, what we are seeing in Tajikistan, the work we are doing, it is real, but it’s not. You think there is understanding, but then there is not. It’s like the landscape, it looks unreal, it looks like maybe you are on the moon, but you are not.” And then she takes one of her amazing photographs and you see what she means.
Getting back to smoothies though, I have to say we made some amazing ones here in the fall. The grapes were on, the pomegranates ripe, and the persimmons were just turning chocolate-colored inside. Grapes and persimmons grow in our garden, and the pomegranates are sold by the side of the road for 13 somoni a bucket - about two euros. Some kefir from the supermarket - which is a kind of yogurt, but more liquid and tangy - and the blender MSF has conveniently provided in our house did the rest. You had to strain the pulp from the pomegranate seeds through your teeth, but man, the flavor!
Although we have several, it was a sad loss when one of the persimmon trees cracked under the strain of all the snow ...
Can’t wait for spring - I’ve heard they have early cherries ...