III
Earthquake; Green onions and the street vendor; It is getting cold but no heat; Staff illnesses, teeth; Critical report; Buttons; Clinics, Buildings, Steps, Doctors and Medicine; Snow
I felt it and looked and saw the wall in my apartment moving back and forth and the curtains sway. I was on the phone with Sharon at about nine-thirty at night here, when it happened. I said, “There was a tremor.” It was a bit disconcerting but I was aware that this is an earthquake prone area. I had not felt any before here or anywhere. It was the next day that I learned of the large 7.0 on the Richter scale quake south of here in the Osh area. That is on the south side of the mountains several hundred miles from Bishkek. Over seventy people died.
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I was on my way to the ATM and I noticed a man on the corner selling apples and bunches of green onions. He had a cardboard box with apples and bunches of green onions spread across an overturned box. I had not found good green onions anywhere and his looked good. On my way back I stopped and picked out a nice bunch. He got a plastic bag and put the bunch in it. Then he put two more and said “three.” I was thinking they must have been three for something and I asked that. He, of course, could not speak English beyond a few numbers. Then he put another bunch in and said four. Again I asked, “four for what?” He then put a fifth bunch in the bag, far more than I would eat in a month. He said “five.” I said how much and he said “five.” I knew it was not five som, since five som is about – well at thirty-seven som to the dollar, not much. I pulled a five som note out of my pocket and showed it to him saying, “five.” He said “Net.” He then pulled out a fifty som note and showed it to me. I said, “That’s fifty; how much for one bunch?” He pulled out a ten som note and showed me. “Give me one bunch,” I said. He said “net.” Then he placed the ten som note over the fifty som note and as he pulled the ten som note away from the fifty som note, he said, “five.” I had to capitulate at this point and paid the man forty som (just over a dollar) for five bunches of green onions when I needed one. Best I could do back at the office was to convince Julia that she needed one bunch, I still had four.
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Chui Street October 31
Nearly all buildings in Bishkek are heated by the central heating authority. Hot water and hot water heat are piped from the facility at the base of the large stack under the plume of smoke on the eastern edge of town. Hot water runs year around; well except for one month around April when it is down for servicing each year. Hot water heaters in apartments are therefore necessary if you want continuous hot water. I have one in my kitchen and one in my main bathroom. They are not turned on now, but will be when the government hot water stops.
The heat is another matter November 15 to April 15 whether it is needed before or after those dates or not. It is needed this year before November 15. Our weather has cooled considerably to the high fifties in the day time and forties at night, and damp. In our office we have several air conditioners in most offices which are the split unit variety so common in all parts of the world outside of the US, however we just installed one in our new cottage in Key West. These units can be reversed to provide heat in colder weather. The air conditioners and a few space heaters served us well for a couple of days at the office until we smelled something burning. Of course it was an electrical wire. I had already noticed that the electrical cabling here seems to me to be on the lighter side of safe and this was an example. We called the electricians who came relatively quickly. When they discovered that they could not get in to the basement to run a new wire, they left and we made arrangements with the landlady for the following day, Friday. As you can guess from my bothering to write this detail, there was miscommunication and the landlady did not come; the electricians did and sat around for a time then left. We re-scheduled for Monday. We spent another day in the cold. The landlady unlocked the basement door, but on Monday the electricians thought it was still locked because it was so tightly closed they could not open it or there was another door and they had the wrong one, I am still not clear. Tuesday they were busy most of the day but by Wednesday they had it fixed and we have had heat since. I am reminded how difficult things in these environments can be. Things we struggle with in the US, like getting mechanics to service problems, are magnified several times with results generally more adverse.
The municipal heat is on now. It did not come on in my apartment for a week after everyone else ad it. I had Jyldyz call my landlady. The landlady told Jyldyz that a tenant on the sixth floor was remodeling his apartment and had the heat cut somehow for some reason. In any event, the heat in the entire building was cut off and all tenants were waiting for the remodeling to get to a point where he heat could be turned on. That has finally happened.
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And so this was another experience in the developing world. Of course we then had several staff persons out with a variety of illnesses. Olga had some sort of kidney problem, Meergul had pneumonia, Jamilya had an infected tooth extraction, Denis’ wife was hospitalized with an unknown something or other and I began having dizzy spells. Not all can be attributed to a cold office, but it does not help when people are struggling to maintain an appropriate body temperature. Most are also having their electricity cut for several hours a day at their homes which can only contribute to maintaining conditions which stress the immune systems.
Everyone began having dental problems and one by one they were taking half days off to have teeth fixed or extracted. It started with Julia. She had a toothache and went to the dentist. She had to make several trips before she was finished resulting in several half days off work. Then Jyldyz A. had the same issues starting the day that Julia finished her last dental appointment. Jyldyz’ issues took two days of her work. Denis then left with a toothache after begging a dentist to take him immediately. He had his tooth yanked and came back the following day. Jamilya then had her teeth fixed. She had a tooth extracted and came to work with a sore and swollen jaw. Next day she did not come in and took three days to control that infection. And I have not even mentioned Ermek’s periodic hospital trips for his asthma; he smokes as well.
Two things are clear from these experiences; first, we have excellent health care for those who can still access it in the US. Second, the value of preventative measures is readily apparent. I have never understood insurance companies’ reluctance to fund preventative health programs and activities. I think their actuaries should spend some time in my office as I struggle to move work forward with half of my staff out sick and filling in where possible with expensive replacement temporary staff. Productivity is crippled here as a result of a combination of bad health care and a lack of preventative medicine.
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Blind man playing at the Osh Bizaar
All of these issues; the cold office, the beginnings of staff illnesses and dental problems, came when were finalizing one of our most important reports. This report has been talked about since I arrived in country. It really marks the beginning of our work but to listen to those waiting for it, it sounded like it marked the end. Regardless, it was much anticipated and was due October 21. We had scheduled a meeting to review a final draft of the document on Friday the 24th of October. The date had been agreed to by USAID and the Millennium Challenge Corporation people as well as the local Kyrgyz counterparts. The report was an assessment of the entire Kyrgyzstan judiciary and included a number of recommendations for improvement. It was a major piece of work and necessitated our staff and consultants doing a large amount of research. The research and data collection had been going on since July. It continued until Friday morning before our afternoon presentation. We had already done closed and pending case surveys, interviews with counterparts and review of legislation; we were now waiting on the questionnaires that were still drifting in from courts. Erkinbek was assessing those results and writing a report to give to Dick who had come to assemble the entire document and help with certain of the recommendations. Dick and I had worked together in Bangladesh and Kosovo and keep in touch through e-mail. He was the perfect person for this monumental job. Joe was finalizing the piece on commercial courts and enforcement of judgment issues.Just when everything was set, and the translators were working on the last of the document – English to Russian and Russian to English so that we have one complete document in each language – Erkinbek said to me. “I think it should all be under the Supreme Court.” A dramatic departure from our recommendation. He then proceeded to articulate his opinion, through a translator of course. If his comment had not referenced the one recommendation we had made which could be most controversial I would not have cared, but it went to the core of what we had done on judicial governance in the report which was ready to be printed. I immediately called a staff meeting in the conference room. We rehashed things we had been discussing for months and I drew diagrams on the white board. We discussed more, heard arguments and reasoning, and after about a half hour or so we had actually better articulated our original position and gotten the agreement of all staff members and consultants.
We met with our counterparts in the judiciary together with USAID overseers and presented our work. The final pages of Joe’s work were delivered by the translators mid-way through his presentation and in time to distribute before the discussion took place.
The Judicial counterparts were satisfied with our report and we had only to make minor revisions before a final presentation to the public generally the following Wednesday. I bought Champagne and called a late afternoon staff meeting. We all deserved it.
The following week started slowly with Dick, Erkinbek and others refining the document for the Wednesday presentation. The international consultants had been called to the Embassy to meet with the USAID country director. When we arrived, the meeting took a turn for the worse when the country director expressed dissatisfaction with the part of the document Joe had done. This was the beginning of a nightmarish two days. We returned to the office by late afternoon and Joe began a re-write of five or six pages of findings and recommendations. The translators were working on revisions but the several people doing them were working on separate documents and they were having fits trying to integrate all revisions into the same document, same two documents, one English and one Russian. Meantime, Joe did not finish his revision until Tuesday morning. Tuesday was not better. I got called to a lunch and following meetings with the Department of Justice advisor who was working with prosecutors. I didn’t get back until late afternoon and found that the staff had just finished working as a group to reconcile all the versions to get one each of an English and Russian version. We had originally planned to deliver the document, some ninety pages, to the printer on Tuesday morning or afternoon at latest. The revised Wednesday plan was to deliver it to two printers by noon. The presentation was at two in the afternoon. We had already decided to produce a black and white photo copy of what we had produced in house to save time at the printers. By noon the plan was again revised to use three printers each producing twenty copies of the document. The English version had been copied by noon.
At the site of the presentation, I got a call from Jyldz A. who told me that the copies would be ready by three. I needed to stall. Guests were arriving including the high ranking judges. The media was present and was delighting in interviewing several of the people there including me and my staff. The interviews took several minutes. By two-fifteen no additional people were arriving and we had to start. I introduced the report and presenters and told the participants that we would distribute copies of the report after the power point presentation. The presentation went fine; Dick took his time explaining things. Joe presented last, starting at about three. As he started, the copies arrived and were passed out to the participants. It looked like we were totally organized.
Vendor at the Osh Bizaar
We had a meeting on Thursday to discuss why things got chaotic and how to avoid that situation in the future. I had to confess to the staff that in spite of all the chaos, no one cried (close for a couple of our staff), no one yelled at each other, everyone worked together, alternatives were identified when original plans failed, and the whole event came off looking like a professional operation, which it was. There were no weak links in the chain. I am blessed with a first rate professional group of people.Finally, for those of you who have asked what it is I do, I think this is an indication, but I will summarize: I deal with strange landladies, I make sure the cleaning lady has a stick on the end of her broom (her husband ended up putting one on it) so she doesn’t have to stoop so far with the typical stick-less straw brooms they use here, I have meetings with the Chairperson (Chief Justice) of the Supreme Court and Chairperson of the Judicial Council, I make sure the electricians fix the burned wire so we can have heat, I deal with the USAID people who oversee the project, I deal with the home office bosses, I listen to all the problems our staff members encounter at work and in life, I write reports, I make sure we have translators when we need them, I make sure things get copied, I speak publicly for the project. I make sure the consultants get picked up at the airport and have a hotel to go to, and lastly, I take blame for all that goes wrong. Thankfully, so far, with this group of people that has happened very infrequently, and they deserve the credit for that.
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It has been so cold lately that I dragged out my leather overcoat that I bought in Athens a few years ago. It is a beautiful coat and keeps me warm but two of the four buttons were missing. They are just simple black medium sized buttons with small backer buttons. Julia said she knew of a place to buy buttons. I went with her and Vladimir to the bank and Julia and I went around the corner to a store. We walked in and there were bolts of cloth everywhere, standing on end, laying on shelves. There were glass shelves showing all manner of buckle, ring and other metal clasps, there was thread of all colors and ribbons and rolls and rolls of frilly fringe and there were buttons. In the far back corner, a woman stood behind a counter in the button section. There were trays of buttons on the wall behind her, there were stacks of small plastic drawers standing about five feet tall and lined in a row of five or so; hundreds of little drawers. There were buttons displayed on the wall to the right. There were maybe a trillion buttons in all or if not that many, then for sure something more than I could count.
We approached and Julia asked in Russian if she had a button like the one on my coat, she pointed. “Net.” The woman said without hesitation. I was awestruck. How could this woman know that she did not have a button like the one on my coat or even anything that would be a suitable substitute? Julia and the woman had a few more words and the woman turned and walked to the back of the area and pulled a drawer out and retrieved some buttons. They, as she already knew, were not suitable, wrong design, wrong color, or wrong size. None would work. Julia and I went to the wall to the right and looked at the various buttons on display. None were what we were looking for. In another shop we found a button which worked fine. We bought four with four backer buttons and some thread. I could not, however, get the woman at the first store out of my mind. She was not just a clerk in the button section of the store, she was the button woman and she knew every button in the hundreds of trays, drawers and displays in her charge. She knew her job well, I respect and appreciate that.
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It occurred to me while I was suffering with dizziness particularly while I lay in bed, that it may be an ear infection. I had Jyldyz A. contact a clinic and Ermek and I went to see an ear, nose and throat doctor.
All Soviet era buildings are the same. They were the same in Kosovo and they are the same here. There are entrances at each end and in the middle. Inside there is a long hallway that runs the length of the building. On each side are doors to various rooms and offices. They are all the same. The courthouses are like that. The courthouses in Kosovo were like that. The courthouses here that were converted from schools are also like that. And the clinic was like that. We stopped in a room that Ermek must have known (or perhaps he read the Cyrillic Russian on the door) was a reception or check-in room. We paid a fee of 300 som and were told to go to third floor room 9. We climbed the uneven stairs to the third floor and walked down the hallway until we came to room 9.
Old Soviet Building, American University
As standard and predictable as the building designs are, so are the stairways. This was something I found in Kosovo and in Bangladesh. The steps of the stairways are not uniform in height. Some will be the same but then there will be one higher or one shorter. Westerners stumble a lot on these types of stairways, anticipating uniformity as we walk. I do not know why this is. I have offered to share the formula used in the West for stairs, but have not found an architect interested. In the meantime, I know that the steps of stairways are not uniform.
Another example is my apartment building. I live on the third floor. I go up two flights to the second floor. One flight is ten steps, the second nine. Go figure. Then I go up to the third floor using two flights of stairs. The first is ten steps and the second ten, but the final step on the second flight is about three inches high. It simply does not make sense, but is as common as the uniform building design.
Inside room nine Ermek gave the woman the slip we obtained from paying on the first floor. She directed us into the adjoining room. There sat a doctor (by his white coat) and a nurse (by her tall cylindrical white hat) each on a stool. They directed me to sit as well. The room was stark. There was a sink hung on the wall, a cart on which the freshly sterilized instruments of the doctor were neatly laid on the top rack. Underneath were the used instruments in a pan for washing later. There was a cupboard and another cart, but not much else. The walls may have had a notice or chart of some sort but otherwise were clean and painted.
The doctor asked appropriate questions and checked my ears, nose and throat. Ermek translated. He scheduled an appointment for us to go to a specialist of some sort; I am generally calling her an audiologist. He also ordered blood tests. We arranged that appointment before we left. The tests were fasting tests, so I would come the following morning, a Saturday.
Vladimir had driven us and was waiting outside. We drove to the second doctor’s office and, after paying another 300 som or so, were seen by the doctor. Again, she asked appropriate questions and looked into my ears. Then she gave me a hearing test. I already know that I have a certain amount of hearing loss. I also have ringing in my ears. After the test, the doctor said I had hearing loss – high tones – and that the loss and ringing were the result of nerve damage. She said it was due to inadequate blood flow. It could not be cured but could be contained. She then proceeded to describe a regimen of intravenous drips she said I should have twice a year. These are mostly B vitamins. I needed to couple these with regular exercise for the muscles in my upper back, and with massages. She spent an abnormal amount of time with me based on the several knocks on her door, but I attributed it to the fact that I was an American and she wanted to make sure I was satisfied with the treatment.
I had the blood tests, they were fine. Again, the cost was around 300 som. I have not had the therapy she prescribed. I talked to my doctor in Key West. He seems to think the dizziness is something that will pass eventually. It is always difficult to get medical treatment in these places. I do have a certain amount of confidence in the Russian doctors, but I am uncertain whether these doctors are Russian trained. I believe so but am not sure. It is also readily apparent that doctors outside the US practice medicine differently than US doctors. Knowing when to rely on alternate medical treatment is difficult. The total cost – less than thirty US dollars, two doctors’ visits and lab work.
I should also mention drugs. Prescription drugs here are bought at pharmacies but generally without a prescription. My blood pressure medicine is purchased that way. I purchased twenty tablets of my blood pressure medicine made by Russian companies for, 15 som for twenty of the 10 mg tablets, and 12 som for twenty of the 5 mg. tablets. At 37 som to the dollar, this was pennies. I did pay 90 som for Slovenian made tablets from the same company who made the tablets I bought in Kosovo. These Slovenian blood pressure tablets were .50 Euros in Kosovo. At the best sale of the generic version of this medicine I cannot come close to these prices, especially the Russian made tablets. We need a time for serious reflection and discussion regarding health care in the US.
Out my Apartment window
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It snowed November 9, 2008. I think winter will
be long.
Until Next Connection,
Dan
