Sunday, 17 July 2011
My mom.....well.....what should I say but say that she forgets. And that she is not quite the person she used to be.
It started in her early 50s....maybe earlier......but that is my earliest memory of it.
She would keep her keys and forget where she kept them every day, besides other stuff.
Sometimes when I forget stuff expectedly as a result of juggling too many things in my mind perhaps, my daughter gives me a worried and intense look. She fears for me that I may have inherited the condition from my mother and my grandmother. Me and my siblings all secretly fear it for ourselves, we confess to each other in our "blood meetings" (where we hang out, once every six months at least, sans spouses or anyone else).
It's funny how we don't really fear inheriting my dad's heart condition or my mother's arthritis. What we fear most is inheriting her forgetfulness, which basically became full-blown and stared at us in the face after we lost our father and her companion of more than 5 decades. It accelerated at an unbelievable pace after my father left us. It seemed my mother had held back letting her memory slide downhill. She did not recognize life without him I guess. He was her friend, guide, confidante, the love of her life, the pivot of her existence. Two people, almost antonyms of each other, had one of the most beautiful companionships I have witnessed in my life. Once he was gone, she perhaps felt letting go of her memory was the best option......this would leave her in the long-gone past......retrograde amnesia. The present or recent past she was not so interested in.
Does she have simple dementia, as she is now 70 plus? Is it an effect of "mini-strokes" as her geriatric doctor suspects? Or is it Alzheimer's? And if it is Alzheimer's, is it SDAT (Senile Dementia - Alzheimer's Type). I don't really know the exact answer, because by the time it was discovered, the doctors felt there was hardly anything that could be done about it, and so invasive testing was avoided.
Causes could have been one or more of many. Psychological trauma, inheritance, nutritional deficiencies. Psychogenic amnesia or psychogenic fugue, if it is that, often occurs due to a traumatic situation that individuals wish to consciously or unconsciously avoid.
Fancy terms don't really matter to us. All we know is that it has not been easy. It has not been easy to see my vivacious, extroverted, friendly mother stare at an object for hours. It has been one of the toughest things to see my mother struggling for words that define simple objects……my mother who remembered Urdu and Farsi (Persian) poetry with a passion and would quote the greats often. Whenever I write well, if I do, I know it is because she emphasized so much on my reading habits and writing style. Ammi had the most beautiful handwriting. Today, when for any emergent documentation she has to sign, it takes her 10 minutes for a single signature. She labours over it and I feel helpless seeing that. When my beautiful mother who had an elegant wardrobe and was known for her sense of style cannot recall when she last changed her clothes. When she who organized dinners for and cooked for scores of people forgets whether she has had breakfast an hour back or not. My sister, who lives abroad and comes every few months, shared that she fears that the next time she comes, ammi may not remember her name.
Luckily, the dementia has not been able to take away the most important things. Like the way my mom’s face lights up when she sees her children and grandchildren. Like her insistence on saying her prayers on time, even though she has forgotten the exact Arabic verses. Like her basic nature of always staying thankful and saying “Shukar Allah ka (Thanks to Allah)” whenever someone asks her how she is. Like her sense of humour and her unexpected witty jokes which are always on spot and still make us laugh. Like how she still knows, without my saying, that I am upset or unwell. Like how her inherent calmness and sweetness of nature still remains intact, untouched, unaltered.
We are fortunate that her memory loss has not been very bad. It could’ve been worse. She has good days and bad days. And over time, we have somewhat learnt how to handle it.
But do people remember the important stuff? Or is their forgetfulness more serious than my mother’s dementia?
Have they forgotten that one does not choose to have amnesia or dementia, just like one does not choose to have other illnesses like heart disease or cancer or a hemorrhage? Why is then the acceptability of other illnesses more than neurological or mental illness, may it be Alzheimer’s or Schizophrenia or dementia or chronic depression? Perhaps because these illnesses alter behaviour. And alternate behaviour threatens us because we do not understand it. And when we do not understand something or find it different, we marginalize it.
My mother may have dementia but she remembers and knows enough to know when someone is warm to her and when not. She knows when people talk in front of her about her as if she is not there…..When they just exchange pleasantries with her but do not have the time, patience or inclination to sit with her and make conversation. When their faces have weird reactions when she says something a little off centre simply because her brain has weakened just like someone’s heart or lungs may weaken.
This is not just true for her. This is generally true for how we treat elderly people. We marginalize them instead of including them in everyday activities and get-togethers. Add to it dementia and people have even lesser understanding unless someone close to them has had it. They also do not know what the caretakers and the family are going through.
The mind is as much a part of our body as is any other…..it is time we took time to understand the illnesses of the mind. Only understanding can develop empathy.
Friday, 8 July 2011
Confession of a hard-core, biased Karachiite - I love my city, no matter what! That doesn't mean I'm not hating what's happening to it
I love Karachi. Period!
I was born here. This, to me, is home. This is where I belong.
Karachi is where the heart is.
To someone visiting Karachi for the first time, it would seem like a gigantic, unruly, chaotic, overgrown, terribly overpopulated metropolis with anger and impatience in it's people's traffic sense and a visible cloud of pollution over it when you land at Jinnah International. The pollution chokes you, literally, in certain areas. The load-shedding and electrical breakdowns are legendary. The compartmentalization and social disparity in Karachi is horrendous.........we divide people into burgers and bun kababs, for God's sake! We talk of people in terms of this side of the bridge and that side. People here are so busy and their lives are (no jokes ) so fast-paced that you gotta take appointments even to say hello! It's a combination of a myriad of ghettos. And the ghettos are very guarded!! It has too many cultures in one city.....or rather, it has a culture all it's own. It hardly ever rains in Karachi. The weather is often despicable. Half of the population has allergic rhinitis, allergic asthma (me included), and paan stains on walls and roads
are a norm.
And yet, Karachi is where the heart is. And if I could make a million emoticons of the heart right now, I would.
This huge, gigantic city welcomes everyone from all over the country and provides livelihood to millions. The multi-ethnicity culture gives a Karachiite so much exposure that he or she can usually speak Urdu, a bit of Gujrati, understand some Sindhi, laugh at jokes in Punjabi, have had friends from many religious backgrounds, and fit with ease in the hoity toity crowd as well as the average fellow-Karachiite. A Karachiite's life is crazily fast-paced, yes, but the advantage is we are least pushed about peering into the neighbour's house to check who their daughter is seeing........we are more worried about our own lives.....whether this "we" is a maid or a bus driver or a corporate executive or a teacher. We are a little more streetsmart, a little more savvy, a little more resilient, and a little less laid-back than our counterparts from other cities.
My city boasts of Frere Hall, Empress Market, Mohatta Palace, the Baaradari, and the whole heritage museum.....mile upon mile....which we call Saddar. My city is the home of Waheed's dhaaga kabab, Burns Road ki Rabri, Noorani ki Karahi and BBQ Tonite. My city has amazing cafes and the most upscale eateries, a great night life, and it throbs with art and culture. My city has beaches and parks and bridges that are our pride. We go crabbing here and love scuba-diving here. We get the freshest seafood and our city has the best evening breeze in the entire world. And on a positive note that may border on irrational here, Karachi is the home of the best paans in the world (can anyone beat Ami's Raja Saab?)!
All's ALMOST perfect in Karachi. To Karachiites, it's the best place on earth. We take pride in it with arrogant defiance.
But every now and then, a part of me wants to run away. Escape.
Just go somewhere else and shut my eyes and pretend Karachi is like it was when I was growing up........when I could cycle alone on the street and go for a walk every night, me and my mother alone, after dinner. When I could have smaller walls and no alarm systems in my home. When my school had no bomb threats. When I didn't have to pray for my loved ones every few weeks when fresh surges of violence erupt that they make it home safe. When I could give lift to someone in my car and help someone I didn't know without fear of being mugged.
When I did not have to read a headline on the 8th of July, 2011, that today is the fourth consecutive day of senseless violence and 80 people so far have lost their lives. 80 people.....mere statistics for me, but 80 homes in my city shattered and bleeding and in darkness. And this is not stopping any times soon, they say. It's like a terminal illness. Dormant for a while, and raising it's head again and again.
Karachi - How I love you, only I know.
But there are times I want to leave you. Give up on you. Run away.
I don't.......but I do fantasize about doing so. I confess, my beloved, I confess.
Monday, 4 July 2011
As I sit down to write down my blog for that last, eventful day in Ethiopia, I am getting all “EMO”. Emo, short for emotional, is a term my daughter Iqra has introduced me to, and my friend and mentor Zofeen has labeled me with – an apt label, and one I quite like :). Emo because of nostalgia. I miss those wonderful days. Writing this travelogue makes me re-visit all those days, one at a time.
I started writing this basically for myself, trying to experience an iota of what my favourite travelogue-writers and “earlier” bloggers experienced when they wrote memoirs – writers like the Mughal kings who each wrote a “Tuzk”, like Ghalib whose letters are forever fresh, like our own Mustansar Hussain Tarar whose travelogues have given me the inspiration to travel Pakistan from Karachi to Azad Kashmir by road. And then the women travel writers like Freya Stark and the more recent Elizabeth Gibert who stole my heart with “Eat, Pray, Love”!
I have enjoyed this journey of writing this. Many of you have accompanied me on this journey. Thank you for reading it through, from the beginning till the end, and for the encouragement you have given an amateur traveloguer.
Thanks to Women’s Edition, in a few months, I hope and pray another travel-blog will soon be written by me. Another country. Another experience. InshAllah :).
Debbie and Charlotte have warned us the day before that the last day will be back-to-back, full of lots of activities on the agenda. And the day begins with our visit to the office of Pathfinder International, an organization said to be a global leader in reproductive health.
Ethiopia: second largest country in sub-Saharan Africa with a growing population that is currently at 82 million people—more than half of whom are under the age of 25. 84% of Ethiopians live in rural areas where access to modern health care is often limited and harmful traditional practices, such as early marriage and female circumcision, are prevalent. Organizations like Pathfinder are fighting the odds with programs like the Integrated Family Health Program, HIV and AIDS care, Family and Reproductive health support, Fistula repair services, Family Planning services and many others.
So much work being done. But never enough. Work in the development sector always has a catch phrase: It’s never enough, yet you gotta do what you gotta do.
With Dr Adnew as our guide, we head St Paul’s Hospital, to visit the Cervical Cancer Prevention Unit working under Pathfinder. St Pauls is a typical general hospital. People queuing up, waiting for their turn to be seen by the messiahs. Nothing fancy. The typical smell of disinfectants. Clean, surprisingly. An old building. Flooring that has been smoothened out by the thousands of feet that have tread on it, as they entered the premises in search of healing.
Going around in labyrinth like hallways, we reach our destination….a tiny 3 room unit with the simple most equipment, and an old steel bed for patients. A very welcoming and warm-faced woman is there in a white lab coat, waiting for us. Haragewoine Garedew, Senior Nurse Professional, answers our curious and excited questions gently, as we stand around her, 15 of us cramped in a tiny room….a room that smells of disinfectants, is highly non-fancy, and yet to me seemed to be emanating some kind of symbolic light. This is the room where early detection of the earliest signs of cervical cancer of so many women has taken place, and has in turned saved their lives.
Cervical Cancer is one of those rare forms of cancer the cause of which can be contracting (refer to blog about Day 3 on this site). Early detection is key, because by the time the patient starts showing signs, it has already progressed considerably.
Pap Smears can detect it, but Pap Smears are expensive. And people in Ethiopia or Pakistan are generally not only unaware but also poor. At St Paul’s, they are using a far less expensive method to screen women for signs of cervical cancer. The method is one of direct visualization with acetic acid and has gained popularity and proven itself as an adequate alternative to PAP smears in developing countries. In visual inspection with acetic acid (VIA), 5% acetic acid is applied to the cervix with a large cotton swab and left for 30-60 seconds, after which the cervix is visually examined with the naked eye and a lamp. Pre-cancerous lesions, with a higher ratio of intracellular proteins, turn white when combined with acetic acid. Normal cervices without any precancerous lesions, do not change colour. It is low-cost, requires fewer visits to the physician and the efficacy is about 5 years. Women with pre-cancerous lesions are treated with cryotherapy. Women suspected with cervical cancer are referred for advanced care. Haragewoine and her team are performing this test on 10 women or more on an average at this unit in St Paul’s…….Potentially, saving ten lives a day!
My mind, expectedly, applies the knowledge I am gaining to my own country, my home, Pakistan. As it can be sexually transmitted, my observation and gut instinct leads me to the thought that the incidence of Cervical cancer in Pakistan is much more than we like to believe. The taboos linked with screening for STDs (sexually transmitted diseases) and the lack of awareness even among educated, urban women that a simple Pap Smear test can be a life saver….yes, Pakistan needs more awareness on this issue, like most developing countries.
On return from St Paul’s, we join a group of Ethiopian female journalists for a meeting and a lunch. They have what I sense in all African female journalists I have met – an inner strength and an inherent defiance that comes from having fought many battles.
Our last session together is interesting. We talk excitedly about the upcoming session in the Fall season. Suggestions are taken about which countries would be value-adding experience, and some of these are short-listed. Debbie and Charlotte gently remind us that we have to be “intrepid women” to be able to enjoy Women’s Edition and all it has to offer. We also discuss the work we all plan to do and issues we need to advocate through our writing or any other form of media in the months to come.
Habasha 2000. We are told that this is the name of the traditional restaurant where our farewell dinner will be held. Dressed to kill, all of us start gathering in the hotel lobby. We shriek excitedly upon seeing each other looking nice in formal clothes, and compliment each other. Kounila, Rose, Tetee and Montessori look beautiful in traditional Ethiopian clothes they have bought on their shopping sprees in Addis. We click away endlessly from our cameras, and have to be reminded that we must leave for the restaurant for the grand finale.
The restaurant is indeed a tour into traditional, cultural Ethiopia. The perfect ending. Great company. Amazing food. A cultural show that was a treat. Rich Ethiopian coffee. Laughter. Conversation. Nostalgia. Anticipation for the next conference. Hugs. Good byes. Promises to email each other the photographs, and stay in touch. And hugs and good byes again.
Back in my room, I pack frantically. There is a knock on the door. I know who it is. Shai, all pragmatic and practical on the surface, is already missing Addis, the team and me. We relish our last few cups of tea in Addis Ababa, in the chilly weather on my tenth floor balcony. Once the good bye is over, I am enjoying that last bit of time on my own in Ethiopia. Ethiopia – what a beautiful country. And how much it has taught me. Will I visit it again, ever? I wonder. I hope.