MarySmith’sPlace ~ The Celebration

We will be celebrating Marys life.

The public memorial celebration for Mary will be held at the Ernespie House Hotel, Castle Douglas on January 14th 2022 at 1.30pm, following a short private cremation.

Kindly email us at maryscelebration@stewartry.co.uk as soon as possible if you are able attend to help us ensure a safe event. On Mary’s request, there is no formal dress code.

We hope you will be able join us for a celebration of Marys life, in person or watch the live stream online at: https://www.stewartry.co.uk/mmc.html

Jon and David

MarySmith’sPlace ~ #CancerDiary#46 #TheLastPost

The post that no one wanted to read. I have to tell you that Mary died at the back of 7am on Christmas Day.

She started her next journey peacefully, without pain or breathlessness and being lovingly cared for.

Despite Mary preparing us we are still in shock as I expect you will be. The support and love she received from you all was as amazing as her care for everyone she reached.

The DH

Notification of the time of the memorial celebration will be posted here along with a link to stream it when it is arranged.

MarySmith’sPlace ~ #CancerDiary#45 #FinishingLineinSight

Well, I’m on the home stretch now; the finishing line very much in sight.

Nothing is quite as expected, though. From early on I had made my wish to die at home be known but here I am in a bed in the Alexandra Unit, which provides palliative care and is the nearest thing we have in Dumfries & Galloway region to hospice provision.

Anyway, the change of plans was my choice. At home, although they would take every possible care to have the drugs I would need when the pain became more severe, I wasn’t going to have someone 24/7 with the key to the locked cabinet. I didn’t want to behave all undignified if I couldn’t get my drugs!

I was mentally preparing some funny stories to share with you (like the woman who wanted a cleaning job but not when she was a bit busy near Christmas) but it’s late and I need to take  my ‘breakthrough’ morphine dose (learning the lingo!) which I’ve delayed to get this wee post out there. I’ll try to remember them – not that I’ll be seeing my house again, dirty or otherwise.

My son is home. He came down after my weekend flight and decorated the Christmas tree and made such a lovely job I realised I should have had him doing it every year! I think I issued a challenge to him and his partner to a game of Rummy. And my sister’s dog is wondering why she’s never been invited on hospital visits before now. Patients have treats hidden all over the place!

Wishing each and every one of you a happy festival time and many thanks for all your support and love.

MarySmith’sPlace ~ #CancerDiary44 – up, up & away – #palliative care

After my last post recording my decision not to go for further cancer treatment I really did intend to post an update a bit sooner than this. I should have remembered the unpredictability of cancer and not made assumptions things would tick over just the same.

The couple of weeks before my last post were busy seeing friends, doctors and the dentist (another emergency – broken filling)! I had an online consultation with the palliative consultant and she changed some of my medication. I’d been on a combination of codeine and paracetamol to try to suppress the constant cough and it was making me feel nauseous most of the time which rather put me off eating.

The consultant prescribed morphine instead, both a tablet and a liquid form. The tablet creates a slow release background dose to provide pain relief, help the breathlessness and suppress the cough and I could take the liquid stuff when required. The pain is something fairly new; a difficult to describe sharp pain along my right shoulder.

Then, the weekend after friends we met in Pakistan thirty years ago came to visit. Usually, they would stay with us and we would never go to bed the same day we got up. This time they booked into a hotel which, although not how I wanted it to be, was incredibly thoughtful. I could come home in the afternoon to have a nap before meeting again in the evening – but my goodness did it not make me feel horribly old to be the person who needed to nap!

Other friends had, unbeknownst to me, had been plotting to arrange a flight for me in a two-seater Piper Pup plane – something I didn’t know was on my bucket list.

Wow! Despite the less than elegant scramble getting in and out of the aircraft, it was absolutely amazing. The sun shone, the flight was stunning and, at the risk of upsetting my friend Beetley Pete, I think it really was awesome. I am so, so glad I went and it happened when it did. I seriously doubt if I’d manage to get in the plane now.

Things went downhill after the weekend. I thought at first it was a result of doing too much and a few days of rest would put me right again. Deciding to have a bit of quiet time, I cancelled engagements, apart from my appointment with the palliative consultant – this time, a face to face consultation. We also cancelled our planned trip to Aberdeen to visit our son at the weekend. That was a good call as it was the weekend of Storm Arwen so travelling would have been a mistake.

Concerned about how breathless I’d become in case there were blood clots in my lungs the consultant organised a CT scan for the next day (the next day!) and upped my morphine.

No blood clots to be seen, which was a relief but nothing else pointed to a cause of the breathlessness. In case it was a return of the pneumonitis, I was put on steroids. Remembering how fast they took effect before I was looking forward to feeling much better after the first couple of doses over the weekend. Unfortunately, I wasn’t.

The GP called me on Monday evening after seeing the scan results and suggested an antibiotic as there was a suggestion there could be an infection. I’m over half way through the course now without any improvement.

I had my first home visit from a Macmillan nurse this week. She further increased the morphine medication, assuring me I am still on a very low dose. We discussed the difficult topics of putting in place DNR (do not resuscitate), which actually isn’t so difficult when you understand your heart stopped because we’re all done here and breaking ribs to re-start it – possibly very briefly – isn’t a great idea.

I have an appointment with the consultant at the beginning of the coming week. I have to say I am very impressed and very glad of the support network which has, seemingly seamlessly, appeared in place.

I’m tired in a way I’ve never been tired before. Chemotherapy made me tired, radiotherapy wearied me deep in my bones but this – this is something else again. In the morning I make and eat my breakfast then go back to bed with a cup of tea. It’s stone cold when I wake up. Talking makes me cough. A short chat on the phone leaves me breathless, coughing and exhausted. I’m a talker – this is hard. I’m hoping further tweaking of the meds will help to relieve some of these symptoms, at least for a while.

I would like to do some writing – there’s still the Goldfish blog to convert into a book and there are poems to be written and edited – but it will depend on my energy levels and focus. I apologise for not reading and commenting on as many of your blog posts as usual. That takes stamina. I will try to respond to as many comments on my blog as possible – it’s always been a cardinal blogging rule for me to engage – but if I don’t please don’t be offended. I’m just a wee bit knackered right now.

The last couple of weeks haven’t been easy, not least getting my head round the fact the increasing amount of medication I’m taking is not going to make me better, but there have been some wonderful highlights which I’ll enjoy remembering.

MarySmith’sPlace ~ Circle of hell: Cancer Diary #28

Saturday, 27 March: After such a gap, this will be a long post so grab a coffee or a glass of wine and some cake. At the end of my last diary entry on March 10 I still, despite antibiotics, had a hacking cough. On Monday 15 I had more bloods taken at the health centre. The practice nurse thought I felt a bit warm, took my temperature and spoke to the GP who was able to see me after the last patient. Stronger antibiotics and a codeine-based cough syrup prescribed.

Just after 6pm the GP called to say my CRP (C-reactive protein, which can be an infection marker, or indicate inflammation such as in pneumonitis, caused by radiation) was, at 128, much higher than before and wanted me to go straight to the CAU (combined assessment unit) at the hospital. Someone there knew I was coming in. Hah! That person must have gone off duty by the time I turned up, rang the buzzer and waited in the cold for ten minutes before someone came to fetch me.

Admitted at 7pm, nursing staff did the basic observations. Fortunately, I’d had experience of being in the unit before when I had the pulmonary embolism so I knew patients’ drinking water must come from a deep well guarded by multi-headed monsters and had brought some with me. I wasn’t offered any. Everyone on the unit is “very busy”. At midnight, a doctor came to examine me. She prescribed intravenous antibiotics, booked me for an x ray – and said I could have a couple of paracetamol to bring my temperature down.

A cannula was fitted for the IV antibiotic, a Covid test was carried out – then nothing happened for a while until just before 2am two people arrived to take me for the x ray – but the nurse wanted to put in the IV antibiotic first and made them wait. I was still waiting for the paracetamol – they had to check the doctor had written up that I could have it. Finally, roughly two hours after seeing the doctor I got paracetamol to bring down my temperature – and, I hoped, so something about the banging headache I had.

TOP TIPS for being admitted to a “very busy” NHS assessment unit – bring in plenty of drinking water; have a packet of paracetamol hidden in your handbag or trouser pocket; and a wee packet of oatcakes to provide sustenance. Unfortunately, I’d only managed to bring water.

The drip was put up. When it gave the two minute warning bleep that it was about to finish, I pressed the buzzer. After a while, I got up, opened the door and stood in full view of every member of staff until someone finally came to see what I wanted. I was told the drip would finish in a couple of minutes. I asked if she would hear it bleeping or should I press the buzzer? She said she’d hear it. If she did, she was ignoring it – and my buzzer. Again, I opened the door and waited until asked what I wanted. I explained the drip was finished (of which she was well aware) and I was desperate to go to the loo – was told to unplug it at the wall and take the drip stand into the loo. Fine, but that does not stop the bleeping.

For another forty minutes I listened to the bleep and the buzzers buzzing all around before a nurse finally removed the drip, though not before letting me know there were patients with more serious issues than waiting for an IV line to be removed – so that was me told. Well, maybe, it was true, but I’d been coughing constantly for days, was breathless on any exertion, had a high temperature and was exhausted, desperate to sleep. I just wanted it all to stop and told her every minute spent here was making a trip to Switzerland and DIGNITAS more and more appealing. She said it wasn’t a nice thing to say. I wondered if she knew how not nice it felt. She offered me a cup of tea. Said she could probably even find a biscuit.

Early in the morning they moved me into a different room. As I was being pushed along the corridor, sitting on my bed heaped with my belongings, a nursing assistant said she’d managed to find me a breakfast. I told her I loved her. She brought a tray which contained not only breakfast, but a jug of fresh water.

The doctor appeared on the morning round, with the doctor from last night and some students. Said the x ray showed a lung infection (didn’t tell me he’d decided it was community acquired pneumonia – that little nugget came from the DH who was told when he called to find out what was happening) and I’d continue with the IV and oral antibiotics. Said he’d seen my tumour on the X ray (really?) Then followed a squirm-making commentary on how I had to face up to some serious decisions about whether or not I would want to be admitted to an ICU, be put on a ventilator, have ribs broken if I didn’t have a signed DNR … It made me query the seriousness of the infection I have. He assured me it would respond to the treatment – he was talking about the future.

I realised I wasn’t going to get home which meant I was going to have to pull out of the Mining Memories creative writing workshop I was to deliver the next day. I felt so bad at letting people down and so disappointed that the one ‘normal’ working activity since my cancer diagnosis wasn’t going to happen. Spent some time ringing the organiser and my friend, writer Margaret Elphinstone, who I hoped could step in. She did, which was a huge weight off my shoulders. The talk on publishing and marketing has been postponed until April 14, by which time I hope to be able to talk for more than five minutes without coughing.

You, know, I’m not going to give a blow by blow account of the rest of my time in the CAU – one of Dante’s circles of hell. This post could become the length of a novella. I queried the pneumonia diagnosis a few times but, hey, I didn’t do any medical training so what do I know about how long it takes for antibiotics to start to treat an infection. They made not one tiny bit of difference – coughing did not ease, breathlessness increased, for the first time ever my oxygen saturation stats were low and my temperature continued to climb. At least by day two of my incarceration it was taking less than two hours to give me paracetamol to lower my temperature. My CRP (an infection marker or a sign of inflammation) had risen from the 128 which concerned my GP to 200.

I’d fallen out with most of the staff over various issues – like not bringing me something to spit into after using the nebulizer to try to loosen phlegm. Excuse for not providing the container – “Your cough hasn’t been productive.” The timings of the IV antibiotics (I know they weren’t actually doing any good but I harboured a vague hope that if administered as prescribed they might) so one occasion the 4pm dose was going to be at 4.30 but the cannula had ‘tissued’ and had to be removed. The nurse struggled to insert another and after a couple of goes asked a junior doctor who said they’d be along after seeing two patients. It was well over an hour later when the doctor arrived, put in the cannula – but wouldn’t give the antibiotic (nurse’s job) so I waited again. It was finally administered about 7.20pm, over 12 hours after the previous one. I used to think timings of medication mattered, were important. Silly me.

I was suddenly moved to a ward. When a nurse came to give my antibiotic I pointed out it was only three hours since my last dose. They checked and said it showed on the computer it had been raised at 4.20pm – so even though the dose hadn’t been administered then, that’s what showed on the computer.  

View from the ward window, somewhat hindered by the blinds – and the window doesn’t open.

The consultant who came in the morning (the one who first told me about my tumour back in July) said she doesn’t think its pneumonia and suspects pneumonitis – in which case antibiotics will do nothing as pneumonitis requires steroids. She orders a CT scan, which I have done at 5.30pm. Next morning the scan report proves her suspicions were correct. I started on steroids – temperature subsided immediately and when there were no further spikes I was allowed to come home. I’m still coughing and am very breathless. I hope it improves soon. If I sit very still and quiet and don’t talk, the coughing isn’t so bad. Maybe the universe is simply trying to make me stop talking!

In case you are reading this and thinking, “She’s a right old ‘Moaning Minnie’, full of complaints and criticisms,” I should say they were validated by various members of staff – nurses and doctors – both on the CAU and on the ward.  

There is some good news – maybe. Although the CT scan was to see if I did have pneumonitis, it obviously showed up the tumour and there has been some reduction in size. I have an appointment with the oncologist on Monday at which I will learn more about what’s actually happening to the cancer – as opposed to the side effucks from the radiotherapy.

I hope my next update will be a lot sooner.

MarySmith’sPlace ~ Cancer Diary 12

Monday, November 23: Last week was what I think of as my ‘medical’ week, starting with the pre-chemo blood check, followed by the pre-chemo assessment and, finally, the chemotherapy session itself on Friday. It’s a sleepless week of worrying about something going wrong to prevent me from allowing them to drip toxins into my body.

This was the last of my prescribed four cycles of chemo. I was asked if I wanted to ‘ring the bell’ but declined. I’m not tempting fate. I did have a happy, school’s out feeling when I came home – which lasted all the way through to Sunday. I should have written my second blog post about being pregnant in Pakistan when the DH was arrested in Afghanistan but couldn’t concentrate.

This is the first time the ‘meh-ness’ has hit so soon, and so hard, after the chemo. Maybe having my flu vaccine this morning hasn’t helped. I don’t think I’ve felt this level of tiredness before. I apologise for not being able to keep up with the blogs I follow at the moment, and not being able to reply to letters and emails. I’ll be back on form before long. I will respond to comments here, though maybe not quite as speedily as usual.

It’s not all doom and gloom and feeling crap. I did manage a couple of walks last week – just as well because since starting treatment I have gained about a stone in weight and feel disgustingly fat and frumpy. With and undiminished appetite, lack of exercise is definitely to blame – and maybe a few more treats than usual. And, today, I’m too tired for Pilates class – when I really need it!

Sandy Hills, Dumfries & Galloway

I have the date for my next scan – Wednesday, December 02 – though as yet have no idea when the results will come through and when I’ll next meet the oncologist to discuss what’s next.  

Some of you may remember back at the start of this, when I was in my ‘I’m-not-going-to-see-Christmas phase, I started blitzing the house, sorting and clearing out photos, letters, books. I’ve calmed down a bit since then. I sold some of my Scottish books to Andrew Wilson at Beltie Books (great coffee and fabulous home-baking as well as books) in Wigtown. Last week he sent me a poem he’s written about me and my books. It’s lovely and made me cry – I still can’t read it aloud all the way through without my voice breaking. I feel so touched by his friendship and his words, which I will treasure, and the knowledge my books will be cherished.

Sadness of second hand books
we had never seen their like before
these books,
they were so wonderful.
she said she could tell us a story
about each book
these ones she was selling;

but each book was itself
a story, of Scotland
no dates and battles, kings and queens
but the story of our people
Blind Harry, Irvine Welsh, Wendy Wood
McDiarmaid, McIlvannie, McCaig

Neil Gunn, every author
that should be known and loved,
and grace the shelves
of every writer on Scotland,
it was a Bard’s collection
yet they filled me with sadness.

they were from a writer
one who penned verses
on Galloway’s Gaelic places
*inflexible tongues could not say them
and memory forgot their meaning
but the Bard remembered

the Bard told their story
and now she was handing the baton
on to me, with her books;
her own battle with cancer
ahead of her, but her books…
her books would carry our story forward.
                                                                        Andrew Wilson

* words from Mary Smith’s poem “Lost in Translation”

MarySmith’sPlace – Afghan adventures #23 a bit about party politics – Afghan style

By now I had spent nearly two months in Jaghoray and it was almost the end of August. It was almost time to move on, if I was to reach the other clinics before winter. Jon, the project co-ordinator returned to Qolijou and I went to discuss travel plans. The idea was for me to spend some time in each, helping with any admin tasks, stock taking and generally being there to sort any other problems. Jon would return to Pakistan to collect the money and essential supplies the clinics needed before winter closed the road. We would meet at the clinic in Lal-sar-Jangal and return to Pakistan together.

My room in the clinic

 

At the hospital, one of the translators greeted me, adding, ‘Have you come to visit your landlord’s mother?’ I was mystified until I found Rosanna setting up the x ray equipment for Gul Agha’s mother who was lying, grey faced, clutching at her stomach.

The x ray room where they were able to see where the fragments of metal had gone in

‘Chi shud? – What happened?’ I asked, appalled at her appearance. Her only answer was to groan and grab my hand. The translator explained, ‘Hisb-i-Islami attacked Gul Agha’s house in Sangsuragh. His mother was standing behind the gate when a rocket went through it. She is really lucky to be alive but we think pieces of metal have lodged in her stomach.’

 

‘What about the rest of the family, Latifa, Gul Agha ….?’

‘Latifa was slightly injured in her leg, nothing serious. Gul Agha is all right but they captured his brother Hazrat.’

Gul Agha’s mother and Sughra

Gul Agha appeared then – a miniature Rambo, weighed down by his bandoliers, Kalashnikov in hand – but when he spoke to his mother, his expression softened until he looked like any other young boy, stricken with fear for his mum.  I expressed my sympathy and concern and asked if I could visit Latifa at home.  ‘Yes, of course, she will be happy to see you. I have to go now.’  The smile slipped and he looked grim again. ‘I have to do something to get Hazrat back.’

The x ray showed the fragments of metal had missed the major intestines and, although she would be in hospital for some time and suffer a great deal of pain, Fatima would make a full recovery.

Jon and I left immediately for the village. In neighbouring village of Kat-i-Sang people tried to dissuade us from continuing, insisting that it was too dangerous. We carried on, wondering if we were being naive in our assumption that reports of any incident were always lavishly embellished. Gul Agha had said it was all right to visit, we reassured ourselves.

Sughra spotted our approach, running to meet us so, before going to visit Latifa, we first had call at Baqul’s house. We answered queries about Fatima’s condition. I also explained I would soon be leaving, although I would be back before winter. I asked her mum for permission to take Sughra to the bazaar for a shopping expedition with me and Jon the next day. We took our leave and headed towards Gul Agha’s house.

About twenty yards from our destination we were taken completely by surprise as a dozen armed mujahideen leapt from the trees and surrounded us, Kalashnikovs pointing menacingly at us. Obediently, we froze.

Another would-be Tarzan jumped from the branches, rushed towards us, and suddenly threw his arms around Jon in a huge bear hug. They indulged in a bit of back slapping and hugging and went through the necessary enquiries about each other’s health then the muj indicated with a grin, that we could proceed. ‘Who was that?’  I asked.

Jon shrugged. ‘No idea, don’t remember ever meeting him before. Seems he knows me, though.’

Latifa was delighted to have visitors and, once assured that her mother was all right, embarked with relish on the story of the attack. She didn’t seem particularly concerned about the fate of her little brother, positive that Gul Agha would soon secure his release. Her own injury, which was nothing more than a slight scratch on her leg, was proudly displayed.

 Latifa with her sister-in-law, Gul Agha’s wife and their first baby 

I asked about the people hiding in the trees.  ‘Oh,’ Latifa replied, ‘they are guarding the house in case they try to attack us again. They are from Hisb-i-Islami.’

I was confused. ‘I thought it was Hisb-i-Islami who attacked you?  Gul Agha is with Nasre.’

Latifa nodded. ‘Yes, it was people from Hisb-i-Islami who fired on the house but they are strangers. These guards are Hisbi, but they are from our village. They don’t want any more fighting.’

Gul Agha in proud daddy mode

I was surprised, and heartened, to hear that village loyalties took priority over those of the Party. Much later, on my return to Jaghoray I was astonished to learn that Latifa was engaged to be married to a man from Hisb-i-Islami – the same man who had taken her brother prisoner. Gul Agha (who had succeeded in getting Hazrat freed – I think without blood being shed) was hoping to put an end to Hisbi by joining the two political parties in marriage. Latifa, who had always made clear her views against marriage, was not in favour of her brother’s political manoeuvring and had objected strenuously, but unsuccessfully. Shakespeare, I thought, could have done something with this storyline.

Back at Hussain’s clinic everyone was excitedly embroidering their version of events in Sangsuragh. These now included details of the enemy storming the house and being mowed down mercilessly by Gul Agha, from his stand at the top of the stairs. When Hussain heard of our plan to take Sughra to the bazaar the next day, he immediately informed me that it was impossible, that it was too dangerous for me to go to Sangsuragh to collect Sughra.

I did rather enjoy watching his expression when I told him I had not only already been there already today, I had visited Gul Agha’s house too.

Me, Jon and Ismail, Hussain’s field assistant. Jon was tickling Ismail so he wouldn’t stand all solemn and unsmiling.

MarySmith’sPlace – Afghan adventures #22 with fighting and kidnappings

Now we were living on the building site work on the new clinic was speeding up and patients seemed unconcerned about the makeshift consulting room. I still spent part of the day writing out case notes and prescriptions. It was good practice for my language skills and could listen to the gossip – even if I did still need Hussain to translate much of it.

Much of the talk was about the fighting which had recently taken place. From what people were saying it had been more than the usual inter-party skirmish and several days of heavy fighting had resulted in casualties, both dead and injured, on both sides.

We decided to visit the Qolijou hospital.

Qolijou Hospital from the mountain behind. Built at a time Soviet air strikes were a possibility, it’s well camouflaged

The grounds were swarming with mujahideen and a weary Rosanna was in the outpatient department.

A group of mujahideen posing for their photo – they don’t usually point their guns at each other!

She and the translators had been kept busy patching up the wounded. The stranger with her introduced himself as the “prisoner doctor”. He was an Egyptian surgeon, brought to the hospital to operate on one of Nasre’s men, critically injured in the fighting. I had heard of four foreigners who the Nasre Party had kidnapped a year earlier. They had been sent by an Islamic Arabic organisation to work on a programme it was funding in a Pushtoon area.

The ward in the hospital

En route they, three doctors and a teacher had been taken hostage. No one seemed to say with certainty what Nasre hoped to gain by this, nor even if negotiations were taking place. Some said Nasre wanted money, others believed the Party was demanding the organisation should build and supply a hospital for Nasre in Hazara Jat. Until meeting the Egyptian doctor I’d never known whether to believe the story or not.

What can happen if picking up a landmine. This lad lost his sight and a hand.

We went to the staff room for tea and he was allowed to speak with us in English (there were enough Nasre spies amongst the Translators to report back if any attempt was made to pass on messages to the outside world). ‘Mostly our days are spent in a mountain cave, hobbled by leg chains so we don’t try to escape,’ he told us. ‘They took our watches and radios. Otherwise, we are well enough treated.’

A bit luckier, only part of his hand gone after playing with a bomb

I’d hear one of the men had tried to escape and been shot but didn’t like to ask. The hostages had no idea if negotiations were taking place or what their fate might be, and that, along with their enforced inactivity, was the most difficult thing to bear. ‘We would be happy to use our skills but are not allowed. Only when mujahideen were in need of treatment are we asked for our medical knowledge.’

Following this last battle one seriously injured mujahid was brought to the surgeon who explained he could do nothing in the cave, the man required urgent surgery. Nasre commanders decided to bring patient and doctor, along with what looked like half their fighting force to guard the prisoner, to Qolijou where the necessary operation had been carried out. The surgeon was being allowed to remain twenty four hours in the hospital to care for the patient during the intensive, post- operative phase, and then he was to be returned to his mountain prison. ‘I hope,’ he added, ‘they will bring me back after ten days to reverse the colostomy. In the meantime, I shall try to convince Nasre to allow me, and my colleagues, to work here more often. We could do many surgical procedures, and teach the translators how to carry out the more simple operations. So much could be done for the people.’

The hospital pharmacy

Unfortunately, the patient died less than a week later so, sadly, the “prisoner doctor” never returned to Qolijou. The hostages were, I heard, finally released, after about two years in captivity.

The X ray room

I wish I’d known the outcome sooner. It may have had me less anxious when my husband, Jon, the programme co-ordinator was kidnapped in Jaghoray a couple of years later. I was six months pregnant in Quetta, Pakistan when I received the news. As I was thirty-six and considered rather old to be having a first baby – elderly primagravida, as they put it – it had been agreed (reluctantly in my case) I shouldn’t accompany him on a tour of the clinics in case anything happened. As it was I had no idea if they would demand money, keep him for months or years, or shoot him. He did get back to Pakistan before the birth of our son – but that’s a story for another time.

MarySmith’sPlace – Afghan adventures #21 – in which we go camping.

When we arrived home, everyone trooped out to welcome me and I felt extraordinarily glad to be back, although there was an air of suppressed excitement about Hussain which made me wonder what was afoot.

Ali Baba and Ismail vied with each other telling me tales of the recent fighting. Throughout my stay in Malestan I had never heard a shot fired in anger, nor heard of any fighting. The three Parties in that district seemed content to maintain a peaceful status quo – or perhaps they shared Mubarak’s apathy for anything troublesome.

While I was unpacking Hussain asked, ‘Well, Mum, what did you think of Malestan?’  Before I could open my mouth, he proceeded to answer the question himself, ‘The people are not as educated as Jaghoray people, and of course they are much poorer.’

I replied, ‘Well, I admit Jaghoray is more prosperous but Malestan is peaceful – and the women are much more free, which I liked.’

Hussain snorted.  ‘Free? Free to work all day in the fields! Is that what you call freedom?  Our women don’t need to be field workers. Their husbands can provide for them; they are free to stay at home.’ I was still trying to formulate a suitable reply, hampered by my knowledge that in the UK in the 1950s and 60s some men did not want their wives to take jobs outside the home because it reflected badly on their ability to provide for their families, but Hussain had moved on.

‘I’m very worried about how slowly the work is going on the new clinic. Sometimes when I go there to check only one man is working, the rest have gone to do some other job. They know that we are too busy to supervise them. I think we have to move in now, and then they will work faster. What do you think?’

‘I think you’re mad. How can we move in? The roof isn’t on yet. Where would we sleep, where would Baqul cook, how could you run the clinic?  There isn’t even a latrine!’

‘We can build a latrine in a few hours and we can live and work in tents.’ He flapped his hand about airily, all problems solved. I knew there was no point in arguing.

‘When were you thinking of moving?’

He gave me one of his most engaging grins, ‘Tomorrow.’

I began walking towards the door. ‘Where are you going? Don’t be angry.’

At the door, I turned, ‘I’m going to ask Baqul for hot water for a bath – it sounds like I might not have the chance of one for a while.’

It was actually two more days before the move was made – two days of frenzied activity, begging tents, hiring transport and packing all the equipment, furnishings and medicines.  A large notice on the door stated normal clinic timings would be kept at the Mazar Bibi clinic.  It seemed a bit hard on Latifa who was scheduled to have her ears syringed the day we moved. She now faced a three hour walk to reach the new clinic.

Saying goodbye to friends in the village was painful. Sughra spent the morning in tears. We all knew we would not see each other for a long time, despite the fact I would only be an hour’s drive away. For them, that meant a six hour round trip on foot – not possible for a social visit – and I understood that Hussain would be unwilling to bring me back to Sangsuragh very often. He could barely conceal his delight at leaving the village and moving into his own home territory.

I have absolutely no idea what Hussain and and I are doing – obviously looking at something fascinating!

Excited as a boy scout on his first camping trip, he was eager to show me our new quarters.  One tent contained the medicines and was to serve as the consulting room. A smaller tent accommodated Baqul, his collection of pots, pans and other culinary equipment.  He was already busy, fussing over a primus stove outside his ‘kitchen’. The third, largest tent was our living and sleeping quarters and I was surprised, and delighted, to discover it was luxuriously different from my notions of roughing it under canvas. The well flattened earth floor had been covered by our brightly striped gilims, mattresses and cushions were arranged invitingly around the canvas walls.  A central flap converted the large living space into two sleeping rooms. The gas lamps hung from hooks, and even my bookcase had been set in place. Very ‘days of the Raj-ish’.

Hard at work. The new clinic starts to take shape

The temporary latrine was a hundred yards up the mountain, offering a great view of the surrounding countryside.

Temporary latrine

Interior view

Baqul, by some feat of magic on his primus stove, provided a feast. After dinner we sat outside watching the moon rise from behind the mountain and tried naming the stars. The Milky Way was a broad band of white sweeping across the sky, and it was astonishing to see how many stars could be seen in Orion, which at home I picked out by his belt. Occasionally we would glimpse a shooting star. Jawad explained that everyone in the world has his or her own star in the sky and when that person dies his star falls down. I told how we wish on a falling star.

We sat talking late into the night. When we could stifle our yawns no longer we retired to bed. Ali Baba, Ismail and Jawad shared one room. Hussain shared mine, explaining that he thought I might be afraid to sleep by myself. I suspected the real reason was that there wasn’t a great deal of room left once the other three laid out their sleeping bags and blankets.

Hussain had been right – our presence certainly ensured the building work sped up considerably. Before long there was a roof on the consulting room, though patients had been arriving long before it was on – and another over the bathroom.

MarySmith’sPlace -Afghan adventures #19 #Health #Leprosy

Malestan clinic – this was taken the previous year

Mubarak’s clinic was a shambles. The premises, rented from a local farmer, consisted of several dreary rooms round a central courtyard. I suspected if just one of the posters Mubarak had stuck on the walls to brighten the place up was removed, not only the plaster, but the whole wall would crumble.

Mubarak in his consulting room

Peeping through a doorway into the medicine store, my heart sank. Medicines were heaped on narrow shelves in total disarray. The floor was almost entirely covered by cardboard boxes, some of which had been torn open allowing plastic drip bottles and crepe bandages to spill onto the dusty floor.

My face must have registered my feelings because Mubarak spoke apologetically, ‘We have so little space it is a big problem for us to find a place for everything.  When we move to the new clinic it will be much better.’

‘When will the new clinic be ready? Wasn’t it supposed to be finished ages ago?’

‘Well, maybe after a few months. The problem is, the builders are also farmers, and now they have to work on their land. When the harvest is finished they will be able to carry on building. Maybe you should wait until we move before doing the stocktake. I can give you a list of the things we need. Already we need more supplies.’

I shook my head. ‘No, I think it’s better to find out what you have in stock here, so we know what you will need when you move.’ Mubarak gave a nod, which I guessed was non-committal and suggested I go and have tea while he saw the last of the day’s patients.

Baba and Khala, the couple who worked as watchman and cook/cleaner

Outside the living room my eye was caught by something stacked against the wall. Under a canvas covering was this year’s medicine supplies, not yet unpacked, although Mubarak was crying for more. Inside, I half expected to find last year’s unpacked boxes hidden under a table. Instead I found Khala, waiting to introduce me to two of her friends from the village.

Taking tea after dinner in the living room at the clinic.

When Mubarak joined us I assumed the women would leave immediately, or at least cover their faces and turn away from him as they would in Jaghoray. They did neither, greeting him warmly. One of the women patted a place near her and he sat down, taking the glass of tea she poured and laughing at some comment made by the other woman. I nearly choked. These women from Malestan were indeed very free.

As a leprosy patient Mubarak had gone to Karachi for treatment, later training as a leprosy technician. He’d worked in Pakistan until asked if he would return to Afghanistan to open a treatment centre in his own area. He admitted he’d been apprehensive about coming home. ‘The Russians were still trying to win control of the country, but more than that, I was afraid the community would not accept me because of the leprosy.’ In fact, people were so desperate for any kind of medical services to be provided they hailed Mubarak as a conquering hero.

Mubarak and his field assistant

At the end of the day Mubarak drove me to the house he shared with his mother, about half an hour’s drive away. The clinic guest room where I would have slept was currently occupied by Nasiba, a young woman with leprosy who had come from the north of Hazara Jat.

Her nose was depressed and she had huge, suppurating ulcers on the soles of both feet.  Another, on her side, had been caused by an accurately thrown stone. When still a child, she had been thrown out of her village when it was discovered she had leprosy. For the next ten to twelve years she had kept on walking, sleeping rough when she could not find shelter, begging for food. Sometimes people had been kind and given her food, discarded items of clothing, permission to sleep with the cow or goats for a night. Often, though, she was driven off by people terrified she might pass on her disease. Eventually she had been directed to Mubarak’s clinic.

He had started Nasiba on medication and each day he dressed her ulcers, which were slowly healing. Later, he would arrange for her to travel to Pakistan, to the leprosy centre in Karachi, where she would undergo reconstructive surgery on her nose. For now, though, she was content and happier than she could ever remember.

As we drove to Mubarak’s house I noted near the river everything was green and fresh with poplar trees in abundance. Things were later than in Jaghoray. There, the wheat had already been threshed but here it was only now being harvested.

The house was at the top of a steep incline, at the foot of which was the site for the clinic. It was a two storeyed house: the ground floor was used for the storage of animal fodder and wood and sleeping accommodation for a cow and some sheep. Two flights of stairs led to two front doors both of which were painted bright blue. The window sills were full of red geraniums. Mubarak’s mother was waiting for us; an elderly woman whose face was wrinkled like a walnut but who was still sprightly and welcomed me cheerfully. I was grateful she did not throw anything at me.

The three of us ate together. Mubarak laughed when I said I’d been surprised about the women talking to him. ‘Jaghoray women have no freedom. Malestan is different. Women here can talk to men when they meet. In the clinic we can even give women injections in the buttock.’  This was a concept of freedom I hadn’t previously contemplated.

Who couldn’t fall in love with such a landscape?