Recognising Catastrophe

These days the news from Egypt is pretty depressing for just about everyone. Voters are expected to choose soon between two candidates who are not the first choices of most of the voters, and who are fairly diametrically opposed. There is Dr. Morsi of the Muslim Brotherhood who terrifies all the voters who worry about Egypt turning into another Iran, while opposing him is Hosny Mubarak's last prime minister, Ahmed Shafik, who claims that everything will be different if he is elected president, but most people sort of doubt that. Faced with two miserable choices, everyone is seeing disaster everywhere they look.

Some of us make a habit of seeing disaster in everything and I'm one of those people, oddly enough. "Catastrophizing" is a psychological term for the act of seeing the worst case scenario in every situation, and when I was a grad student it was something that I would be reprimanded for by my clinician friends as being maladaptive. I had no idea it had a name because it was just how I dealt with things.  I've catastrophized all my life. As a child I would lie awake at night and wonder how I would manage if I were to wake up in the morning and not find my parents there to care for me. Whenever I attempted something new, applying to university for example, I would spend hours imagining that I would not be accepted and think of what it would mean to my life, how would I manage to make a living, and so on. Of course, I did get accepted, but life was always coming up with new challenges to give me something to worry about.

It was when I was in grad school that one of my friends called me on my habit, gave it a name, and told me that it was a really bad thing to do. To be quite honest, I wasn't really convinced. I'd been looking at worst case scenarios all my life and a habit like that is hard to change. But when I looked up the pattern, I noticed that catastrophizing was something that was supposed to lead to a sense of inability, worthlessness and so on. But in my experience my assumption of catastrophe in every situation had led me to explore all the possibilities of what could go wrong and as many of the possible solutions as I might be able to imagine. Rather than paralyzing me, it pushed me to explore the possible futures that I might face and to try to figure out how I would deal with them.

When I was only about twelve I read about the epidemics that swept through Europe decimating the population in the Middle Ages. I became fascinated with the Black Death, probably to a certain level of concern from my parents. But I learned about the causes, the cures, the effects on the political systems and economies of Europe along the way. When we decided to move to Egypt, I took an entire series of first aid and CPR courses from St. John's Ambulance in Toronto and threw myself (quite literally) into a Bronze level lifesaving course at the neighbourhood pool. I had an idea from my travels here about the general level of first aid in Egypt in the late 80's (like nonexistent) and was going to be prepared for the worst case scenario, which in this case was needing this knowledge. And I did need it. A month after we moved here, with my training I was able to recognise and deal with my husband's  heart attack. We got him to a cardiologist and into ICU immediately, postponing my widowhood by a good twelve years. I don't want to think about all the times that the first aid training came in handy: broken arms, choking victims, a visiting child who had a crowbar fall on his head from a neighbouring construction site...you name it, it happened at our house. People used to joke that the catastrophes happened around me because I knew how to deal with them and how to get people the care that they needed to survive them.

As I've grown older, my catastrophizing has become a good and faithful friend. When the bird flu broke out and began spreading, I was worried for my African Grey parrots so I learned all I could about the vectors, the signs, the problems...and I learned that parrots don't get it. By examining the catastrophe I realised that it wasn't really a catastrophe, no matter what the press said. I did have to slaughter my chickens when bird flu broke out at a chicken farm near me, but no people got sick at all and we were well provided with chicken soup for some time. Some research on swine flu also reassured me that I was highly unlikely to perish from that as well. When life turned interesting in Egypt during January 2011, I assured my children that I would be fine where I was, and although events were at times very frightening, albeit more for the people in the center of the city than for us out in the villages, I had no intention of evacuating. Instead I threw myself into finding out as much as possible about what was going on, what possible risks might be, what possible outcomes might be...in other words, what were the worst possible scenarios.

I've continued my preoccupation with trying to prepare for catastrophe for the past year and a half. I have no input into what might happen in Egypt. Due to a wonderfully weird bureaucratic glitch, I don't have my Egyptian citizenship despite having been married to an Egyptian, being mother to two Egyptians, and having lived here for almost 25 years, and I can't even vote. It's pretty frustrating although the thought of having to choose between two totally unwanted alternatives is not terribly appetising.  I wish I could really say that I've gained some understanding of what is happening in Egypt right now, of what we can expect, but I can't. I'm watching bemused like everyone else, wondering how on earth we got here. I have my own ideas of what would be the greater catastrophe for Egypt: Morsi for president or Shafik...but even that has variables that I can't predict. I don't know how invested the military is in seeing that Shafik win the election, what they will do to ensure that, how they would respond if Morsi won, or what the reaction would be if Shafik wins and people feel that the elections are a total sham.

There are times when imagining the worst case scenarios just can't really do justice to reality.  Do I feel incapacitated, frozen, unable to make decisions or act? Not really. I am frustrated, worried, and do feel that way too much is hanging in the balance. Am I about to take off and leave? No. None of my worst case scenarios include my leaving Egypt. I love my farm, my neighbours, my animals and my life here. I'd say that my absolute worst case scenario involves me not being able to move around Egypt freely and being stuck out here...and as far as I'm concerned that isn't a bad scenario at all.

As I was thinking about all of this, quite serendipitously one of my children's friends posted a link to an excellent New Yorker article on the internet. Entitled Failure And Rescue, this article suggests that life is unpredictable, but that how we face our catastrophes determines how much we succeed.  He uses the story of surgery that almost went terribly wrong but ended up in success because people were aware of the possibilities of problems, recognised the signs and were able to deal with them. Sometimes catastrophizing is an adaptive trait.


copyright 2012 Maryanne Stroud Gabbani

A Chance For Research/Activism in Hospitals

I'm typing on top of the world right now. For the past three weeks I've had my right hand in a half cast because I tripped on a piece of wood in my living room and flew through the air hitting my kitchen door with my middle finger, breaking the bone inside my hand. That's right, it was that finger that is so useful in driving through Cairo traffic. I got an xray and went to visit my good friend and orthopedic surgeon, Dr. Mostafa, who has already reconstructed my left shoulder for me two years ago and did a double knee replacement for me last summer. He laughs over the fact that I'm the age of his mother but manage to do some pretty creative stuff to my poor old body....calls me his "bad boy"! Today I did a second xray to show that the break is knitting well, was given a brace to protect my hand for a while, and a prescription for some calcium to help the hand finish its work.

Body issues taken care of, Mostafa and I caught up on what's been happening lately. Despite being a very busy orthopedic surgeon here in Cairo, he's lately agreed to help at one of the government hospitals in administration. A government hospital job isn't going to make him rich. Salaries in them are laughable. He's doing it because he realises that someone needs to try to help this hospital improve. The salaries for the staff are too low. Cleaners might make LE 300 a month, a wage that will feed no one, so they don't work too hard and they try to get tips from patients. Who can blame them? Nurses here are not well paid or well trained and they are looked at by most Egyptians as being only slightly more respectable than prostitutes or dancers. Not great. Mostafa told me that in learning more about how the hospital was working...or not working as the case may be... he found that the communications between patients and staff are not good, with patients often being highly suspicious of the staff. We talked about how the Egyptian habit of bringing family members to a hospital to help care for a patient, while still definitely necessary, can often be counterproductive in terms of contagion. This is especially true in cancer wards where chemo patients are taking immune system battering meds while surrounded by possible sources of infection. He shook his head in wonder that he's surprised that the stress of trying to analyse and treat a seriously ill institution is not simply breaking him down. Somehow he's staying calm about the whole thing.

It occurred to me that this could be a chance made in heaven for some serious university students to help him do some research on what was working and not working in the hospital. Anthropology, sociology, medical and urban planning students could find some fascinating data here. As well, there is a major opportunity for community organisers to help to establish something like a hospital auxiliary, perhaps a group for would-be nurses to learn about their chosen field...something like the Candystripers that work as volunteers in hospitals in the US and Canada. I'm going to put word out about this chance for research and/or activism and let's see what happens. The government hospitals have long been disastrous in Egypt and have been the source of much head-shaking and concern, but perhaps the better way to view the problem is to see it as an opportunity for parts of our society to come together to seek solutions. Doing research and setting up programs hasn't been so easy in the "old" Egypt because pretty much everyone had something to hide. Perhaps this is the time to change all of this. If you know of anyone who might be interested in helping in this project, or maybe with another one like it, do contact me and I will put you in touch with my overworked friend.



copyright 2011 Maryanne Stroud Gabbani

Summer in The Cities

It's 9:30 am. I've been up for a couple of hours, even had a shower, but you wouldn't know that now. I'm sitting here utterly dripping wet with a towel on my table to keep my arms from soaking the table top, and all I've done is to feed birds and make myself a cup of tea. Still, I'm very happy to have done that since this summer has been devoted to recovering from a bilateral knee replacement done at the beginning of July. I'm now walking around the house (where the ground is level) without crutches and thinking seriously of when I'll be able to get back on a horse. That's probably not for a while yet. I'm happy to wait until the temperatures drop to at least about 34C/93F...that's about 5 degrees C lower than they are now.

It hasn't been a boring summer, despite the time spent recovering from surgery. For the first few weeks, I couldn't sit in a normal chair with any comfort and was checking my email on my laptop from a battered old lazyboy chair donated by a friend. That wasn't bad, but a laptop REALLY heats up your lap and virgin naugahyde doesn't exactly dissipate heat, so computer work was necessarily short and sweet. Once I was able to sit up for some lengths of time (and another wonderful friend found me a lapboard to help insulate my healing knee incisions from the fiery laptop) I started transcribing my father's journals for friends and family. My father was an interesting character who worked in many capacities but primarily as a computer modeling expert for the US Department of Defense...back in the days when being a modeling expert also meant inventing most of what you needed to do it with. When he retired, he moved up to British Columbia where my sister was attending university for a while and helped to set up the internet in the Pacific Northwest. He died in 1978 and his journals ended up with my sister who sent them to me in New York this spring when I was visiting my kids there. As children we always knew that our dad did something that the US Navy didn't want him talking about. (No fears there, Navy folk...he even took his secrecy stuff seriously in the journals.) We knew he worked on the Space Program some, but really other than as a guy who loved talking, camping, fishing, hiking and taking a nap on a Saturday afternoon, we didn't know a lot about our father. So this is a labour of love for me.

Before I did my surgery, I spent some time with my kids in New York. My daughter was taking a break after her comprehensives and we found ourselves wandering over the lower portions of Manhattan running errands and doing shopping. Our peregrinations took us near the site of the new Muslim community center that suddenly became the source of such vitriol lately. I must confess to being utterly bewildered by the willingness of certain portions of the media to whip Americans into a fearful frenzy over nothing at all. I think many of the hate-mongering reports, especially from Fox (can't call it "news" when most of what they say has no basis in fact) are horrifying. I must confess that the fact that Rupert Murdoch is comfortable with a Saudi partner who is helping to fund the community center SHOULD give some of the protesters pause. The manipulation is just a bit obvious but no one seems to want to see it. As someone old enough to remember changes in US laws about race and women, old enough to remember the aftermath of the imprisonment of US citizens because they happened to be Japanese (many second generation) during WWII, I wonder if American society is actually making any progress at all in becoming what it could be.

Of course life in Egypt continues to provide wonder, bewilderment, and the odd hearty laugh. Recently the art world was rocked with the news that thieves had made off with a $50 million Van Gogh painting of a vase of flowers from the Mahmoud Khalil museum in Giza. It wasn't a difficult theft since none of the alarms in the museum and only seven of the forty-three security cameras were working at the time. This morning's news item about the government's plans to build a nuclear reactor to take up the power needs not met by natural gas and oil just below the assessment of the security at the museum left me gasping. We can't keep the security at a museum up to par and we are supposed to be comfortable with a nuclear reactor? I don't think so. And why in heaven's name isn't Egypt a forerunner in solar energy...with about 360 days of sunshine what couldn't we run on solar energy?

The world is a puzzling place.




copyright 2010 Maryanne Stroud Gabbani

With A Little Help From My Friends

I'm sitting at home this July and really, really at home for a change. I built my home to provide shelter for me from the sun and wind, to be a place to sleep in, and to be small and easy to care for. I have two small steps that go from the house to the garden, installed with the thinking that as I get older, the last thing I want is to have to deal with a bunch of stairs. There are no steps inside the house and everything inside is within easy hobbling distance. All of this is really useful right now because I had a bilateral knee replacement last week and I am not allowed to even tackle the little stairs to the garden until my staples come out.
The decision to do a knee replacement was a difficult one. On one hand, I began suffering serious pain in my knees last fall and walking was becoming torture. If walking on the smooth sidewalks of New York in June was bad, one can just imagine what it was like on the uneven ground of my farm. And if I couldn't walk comfortably to see my horses and to move around....what was the point of having legs anyway? Oddly enough, riding was the one thing that I could do for hours without any pain at all...but you can't live on a horse, no matter how much it might seem like a good idea.

I started doing research on knee replacement, talking to friends and family who have had it done. My younger brother had his done, which made me suspect that part of the problem was genetic, a malformation of the knees that my doctor had noticed when he looked at my xrays last fall. He said that I needed to do them both but we could either do them one at a time or at the same time. The real issue for doing two at once was aftercare. Friends here asked in astonishment "You are going to do a surgery like this in Egypt?" But the surgery itself wasn't nearly the concern that managing for the first two weeks after surgery was. We have some very good hospitals here and excellent doctors, though our nursing leaves me homesick for Canada. But on the other hand, the hospitals are set up here with the understanding that you will have a friend or family member staying with you to assist you. I decided that a lot of pain once was better than a lot of pain twice and opted for the bilateral surgery.

The surgery itself was in a relatively new hospital in Medinat Nasr with a very nicely equipped operating theatre. I was having an epidural with some interesting goofy juice to keep me out of the doctors' way. It was a long surgery, about 6 hours or so, and I recall coming to some incomplete consciousness (no pain...and I wouldn't swear about the consciousness) to be aware of the sounds of hammers, drills, and other power tools. I exited the semi-consciousness as quickly as possible as power tools should never be associated with someone's body....EVER. The first few days after surgery are best not remembered much....catheters, drains, yuck. But they were fine with the pain meds and we coped ok. The day after the surgery, I was given a walker to practice standing up and walking a bit, but it was the much anticipated removal of the tubes that provided the stimulus to get up and walk to the bathroom. Little triumphs, like washing my hair over the sink in the bathroom so that at least part of my body felt fresh, made huge differences to me. I was in the hospital for 5 days including the day of surgery and friends stayed with me in shifts for the time.

Finally I was sprung to go home to my vast relief...and the relief of my staff and friend Kelly who came here for a holiday and found herself dogsitting. The staff shut the dogs into the back garden while I arrived so that I could maneuver myself into a chair in peace, then we barricaded my knees with the walker and loosed the hounds. A walker is a terrific fence. After about 5 minutes of insanity on the part of the dog pack, they settled down to the reality that I was really back and not going anywhere soon. They'd never seen a walker before but very quickly learned to get out of the way as I was hobbling around the house. We'd made some helpful adjustments to the house, like adding a twin mattress on top of my king-sized mattress so that my bed was at an easier height for me to get in and out by myself, and getting a toilet seat extender to put on top of the toilet for the same reason. When your legs are functioning in a pretty funky manner, you really appreciate having a tall toilet and bed. Another friend had donated an old lazyboy chair to the living room and that has really been a lifesaver as I can adjust my body to stay comfortable.

The first "setback" was actually a very useful lesson for me. After I'd been home about 24 hours and the residual pain meds from the hospital had worn off, I had a really tough early morning with muscle cramps running up and down my right leg. I was in tears and called Kelly in the guesthouse. A friend of mine who is a massage therapist was staying there for my first week home, and she came over and massaged the muscles in my leg until I could relax enough to sleep again. The lesson learned was that while the orthopods can give you pretty shiny new knees to work with, it's your old muscles who are going to be doing the work, and probably not without complaint at first. While I expected pain from the surgery site, I was unprepared for the muscle cramps. Magnesium supplements, massage, and a mild anti-inflammtory took care of that issue and I was humbled before my 60 yr old muscles.

Now I have about 3 days before the staples come out of my knees and I will be given the go ahead to hobble around my garden where I should be hobbling and to begin my serious physiotherapy. The movement in the new knees is a wonder to me. After what I realise has been very long time of pain and discomfort, these new bionic knees slide so smoothly with my leg movement that I am in awe and remember the joy of free movement again. I've been resting a lot between wanders around my tiny house...my body is quite happy to tell me to remember my age and not push things too hard. Pushing things too hard is part of what got me here in the first place.

Would I do the surgery here again? In a heartbeat. My doctor did a beautiful job on the surgery and my friends have been so amazingly supportive of me, popping by with gazpacho soup, fruit cake and fresh cherries and helping with the few summer clients that come by, my staff have been there to handle all my responsibilities, and the core group of nurses (the two Mona's, Kelly and Sabine) who have been so very helpful in my post-operative care. I am amazed at the love and care that have surrounded me. I went in to fix my knees, but came out with a new appreciation for my life.

copyright 2010 Maryanne Stroud Gabbani

Up In Smoke

Ramadan has begun; we are on our second day now. Many people are fasting, refraining from food, water, and cigarettes during the daylight hours and then breaking their fast with tea and a cigarette to battle those headaches that are the result of the sudden withdrawal. After the breaking of the fast, many people go out to spend the evening in the Ramadan tents where they have soft drinks, tea, coffee...and shisha. A shisha is a water pipe, sometimes called a hubblebubble, that supposedly "filters" the smoke through water. An article today in the BBC goes into some detail on why smoking shisha is really not a great idea.

Years ago I spent a semester teaching health (aka: Sex, drugs, and alcohol) to some middle schoolers who were astonished to see the crud that was washed out of a shisha pipe hose after use...and this was what accumulated AFTER the "filtering"! The smell of the flavoured shisha tobacco is actually quite nice and I like to run across it on an evening breeze. Maybe the fact that I've never been a smoker keeps me from understanding the attraction of shisha, but the health hazards are serious.

So have a cup of mint tea instead. Ramadan Mubarak.

copyright 2009 Maryanne Stroud Gabbani

Watch For This Film Somewhere

I've been really remiss in my posting to my blogs lately but it's really hard to type with one arm tied to one's body. My shoulder surgery is slowing me down. I am, however, still able to wander the net reading interesting articles. This is an interview with Mai Iskander who created a film about some of the young men in the zebaleen culture here in Cairo. One of the points that she brings up is the fact that the garbage of Cairo is roughly 50% organic and this organic waste was fed to the pigs that the government slaughtered a few months back. Not having pigs has caused the closure of a number of shops where Cairo residents could buy pork products, which is an inconvenience, has cost the zebaleen considerable income, which is a tragedy...but what I want to know is what is happening to the organic waste of roughly 15 million people? And in this summer heat? EWWWWWW!

copyright 2009 Maryanne Stroud Gabbani

It's Here!

Despite all the government's poorly thought out destruction of the recycling program of the zebaleen, the infamous "swine flu" has arrived, like most tourists, by jet. Various cases have been reported in Cairo, including (unsubstantiated as far as I can tell) rumours of one at the drive-thru McDonalds in Maadi, prompting closures and quarantines. AUC's dorm in Zamalek was one of the early victims. Kim, at Whazzup Egypt!!! has an excellent post of recommendations by the WHO on the handling of influenza, whether H1N1 or any other type. Highly recommended reading.

copyright 2009 Maryanne Stroud Gabbani

Knocking On The Door

It was reported that there have actually been a few cases of the dreaded "swine" flu, much more politically correctly called H1N1, in Cairo. A young woman from Florida and a young man from New Jersey, both living in the AUC hostel in Zamalek, were diagnosed with it and the hostel was quarantined. I'll bet that the other students really loved THAT! So all the pig slaughter comes to naught, but heaven help the politician that suggests that the government proceed to slaughtering 747's and their like...or even that they not be allowed to land. There goes the total economy should that happen.

The New York Times (click on this post's title) had a article assessing the likelihood that this flu would become seriously dangerous rather than a mild discomfort (if one is basically healthy) that spreads fairly easily. They still didn't come up with a really good justification for the pigs.


copyright 2009 Maryanne Stroud Gabbani

Getting a Grip on Ourselves

Now that everyone's forgotten the panic over pigs in the astonishment that one of the better connected businessmen in Egypt has actually been convicted of murder, the World Health Organisation has decided that swine flu probably isn't a pandemic after all. In fact, the word "pandemic" simply means a disease found everywhere like the common cold or tonsilitis, but it sounds too much like epidemic, a word associated with people dying of cholera or typhoid or bubonic plague although it really just means "found everywhere" as well. So now the WHO has to find a new way to categorise things in a way that hopefully will not spread the panic that the "swine flu pandemic" has. Overall, swine flu has barely killed anyone and is probably a great deal less dangerous than the "just the flu" that everyone gets every winter.

Go tell it to the poor pigs.

copyright 2009 Maryanne Stroud Gabbani

Watching out for Influenza A (H1N1)

Having watched the drop in trade in pork (a perfectly reasonable meat when prepared properly) and the slaughter of many innocent pigs, the WHO has changed the name of this version of influenza to the slightly less inflammatory Influenza A (H1N1). Probably a case of closing the barn door after inviting the butcher in, however. My condolences to the pigs who really have nothing at all to do with anything. No pigs have been ill from the erstwhile "swine flu" and forcing the slaughter of them is a serious hardship for the zebaleen of Mokattam who are one of the best recycling services in the world.

copyright 2009 Maryanne Stroud Gabbani

Issuing The Pigs Their Wings

It was announced on international news that the Egyptian government would force farmers to slaughter all their pigs to prevent swine flu. This is almost as intelligent as Paris Hilton telling people that she wasn't worried about it because she doesn't eat pork. The pigs are irrelevant at this stage. The flu is transmitted from human contact and according to some WHO officials isn't nearly the threat that the bird flu is. I suspect the combination of the word "swine", the cultural taboo on pork, and the almost universal ignorance among bureuacrats of how disease is spread is almost irresistible. There are quite a number of modern, properly run pig farms in Egypt...just as we have quite a few properly run examples of almost anything here...except maybe government officials.

copyright 2009 Maryanne Stroud Gabbani

Having To Say Good-bye

I've known Omar Abdel Salam for over fifteen years. He's still a young man, about 45 years old, father of a number of children, the youngest of whom is about eleven. Happily, all the older ones are married, many of them with young children of their own. When I first met him, he was a groom at Sakkara Country Club, one of the best. But he wanted more from his life and as our ancient farrier at the Club was losing his sight, Omar convinced Am Yaseen to take him on as an apprentice blacksmith. It wasn't the optimal arrangement since Yaseen was in his late 80's and almost blind, but Omar learned all that he could from the old man.

A while later, an American farrier came to do some work at the breeding farms and a group of us arranged for Omar to work with her to learn more about his craft. He was less than thrilled at the idea but watching Sara turn an iron bar into a perfect eggbar shoe in about 15 minutes convinced him that she had something to teach him. In the following years, Omar took on two apprentices, one of his sons and another young man, and he taught them much of what he knew, having realised from his own experience that waiting until he was too old wasn't a good plan for anyone.

Omar and his boys have been taking care of my horses' feet for about 10 years now and he's more than just my farrier. Omar is a friend, someone whose company I always looked forward to when it came time to shoe and trim my horses. Sara still comes occasionally and she always makes it a point to bring something interesting in terms of tools for Omar. Farriers' tools are not in plentiful supply here and for the past few years he's been working against a tool account with me. I keep track of his tab and order rasps, cutters, nippers and so on for him and his boys.

The last time Omar came to me in February he was complaining of dizziness that was driving him nuts. He'd been to doctors who had been treating him for an inner ear infection, but he was still dizzy. He had Shaban do most of the trimming and nailing of shoes, but when we needed to shape a new horseshoe, he got out his anvil, seated himself in front of it and set to work. He was going to see a neurologist the next day, having felt that he'd exhausted the ear possibilities. The next thing I heard was that Omar was in the hospital. When his son and Shaban came to do my horses just recently, they told me that he was diagnosed with brain cancer. The doctors had done a biopsy removing part of one tumor that was pressing on the nerves that were making him dizzy, but there were five more that they couldn't really touch as they were mixed up with his optical nerves and other rather important items. Damn.

I went to visit Omar today. He's been released from hospital and is back at home in the midst of his family, but has been going into the hospital for radiation therapy, I believe. My Arabic vocabulary gets a little shaky in these technical things. His wife told me that there are two more sessions and then they will do an MRI to compare it with the earlier one. My father died of brain cancer and I remember all too well the progression of his illness. My bet is that Omar will not be with us much longer. He seems at least twenty years older than he was last month and he tires easily, has trouble speaking and his eyes don't track very well. This is a very aggressive cancer, something that his son confirms to me. His family asked what they could do, would there be medications abroad that might help him. I had to say that I thought that it was most important to keep him happy, comfortable, and as pain-free as possible. The doctors have told them the same. My friends and neighbours who are all his clients have all sent word that if the family needs any help they are just to say so and we will be there in force. If only we could just bring Omar back.
copyright 2009 Maryanne Stroud Gabbani

A Spot of Trouble

About two weeks ago I found a sort of white blister on the knuckle of the middle finger of my right hand. The blister soon had a red ring around it and I scrubbed it hard with a surgical scrub, fearing that it was a spider bite. The knuckle swelled, the right hand hurt like crazy, but after about three days the swelling went down and I stopped worrying. A couple of days later I found another blister on the palm of my left hand, near the heel of my thumb. That one really hurt and within 36 hours I had another blister on the tip of my ring finger on the left hand. By this time, the right hand was much better aside from the fact that the hole left by the blister on the knuckle was taking its own sweet time to heal. As a matter of fact, even today it still isn't healed.

I began getting alarmed when the wound on the left hand turned black, blue and a bit green with red streaks running up my arm and an egg-sized lump under my left arm. I wasn't getting much sleep with my dreams being entirely about pain in my hands, and I was feeling pretty terrible. I did some research on the net and made an appointment with our family doctor. The research confirmed what I feared, that I'd been bitten by a brown recluse spider, probably while cutting chicory in the garden for the birds' breakfast. Egypt has its fair share of venomous spiders, as well as spiders that are supposed to be venomous and aren't. We have poisonous snakes and scorpions as well. Despite my hanging about in the sorts of places that critters like, I really haven't seen much in the way of evil ones, other than the recluses.

One very rainy winter in Alexandria there was a rash of brown recluse bites among friends of ours. Most of us caught things in time and escaped with sore, swollen bites, but one of the men didn't pay attention and ended up in surgery having his elbow joint cleaned out when the bite became necrotic and invaded the elbow. These cute little brown arachnids pack a wallop. They are relatively small, just over a half inch in diameter, and nocturnal, with a preference for hiding under vegetation in the garden or in clothes that have been tossed on the floor...a good reason to be tidy. But they aren't aggressive and only bite when someone "attacks" them by putting a hand or foot on or too near them. In fairness to the spiders, while they are not uncommon in Egypt just as in the southern United States, my kids never seemed to get bitten and there could have been tigers hiding in the rubbish tips that they called bedrooms in high school.

Two weeks on, I'm still taking antibiotics. The tip of my ring finger and the base of my thumb on my left hand are still so sensitive that I jump if I accidentally bang them on something. The bite on my right hand has a nasty deep scab that is slowly healing, and I put a layer of A&D ointment (not just for babies, you know!) on my hands about three times a day to help the healing. The lymph node is no longer swollen and I'm feeling pretty good...especially since the temperatures are down to a balmy 33 C these days. Do I still cut chicory for my birds? Nope. On his suggestion, I let the gardener do it. He has calluses on his hands that no spider could bite through.



copyright 2007 Maryanne Stroud Gabbani

Time Enough To Eat

Egyptian food is wonderful. Much of the wonderfulness of it comes from the freshness of the ingredients. I was cruising the news on the internet and found an interesting piece on Time online (you can reach it by clicking the title here) about how much of the cultural aspects of eating are being lost in the globalisation of fast food. My closest fast food place is probably about 15 km, a fact which never fails to please me. In Egypt fast food places all deliver, making it even easier to destroy yourself with food. On the other hand, sometimes I get an invitation to Mabrouka's and that is much, much better. Mabrouka is a widow about my own age with four sons and two daughters. Two of the sons are married, two are not yet...all of them live in the family house. The daughters are married and live nearby. Mabrouka grows her own poultry and buys produce in the village that is grown by her neighbours. She is a wonderful cook, as you can see in the photo. Dinner included chicken cooked with sliced potatoes in a tomato sauce (fresh tomatoes of course...not a can in her house) that were baked in a wood burning oven. The roast chicken was also baked in the oven and the stuffed aubergine, peppers, zucchini, and cabbage leaves were cooked on a stone top to the oven. It's more work than I want to do, but boy, do I appreciate her work. Dessert is usually fruit.

I wish I could say that since moving to the farm I've lost a ton of weight and become sleek and svelte, but that would be fibbing. I haven't but I know that my diet is a lot healthier than it was in the city. The temptation to just call for a pizza was always really a tough one. Now most of my meals are prepared from the things that we are growing on the farm. This depends on the season, but being able to freeze or dry vegetables makes them last. Like most of our neighbours, we are growing the summer crop of bamia, or okra. Part of the reason for this is because I find the flowers lovely. Fresh okra is eaten while still small, but the parrots and poultry appreciate the larger pods. When dried and ground into a powder, the pods are the basis of a Sudanese stew, moolah, of which I am inordinately fond in the winter. The pods have small spines on them and I'm always struck by the dedication of the okra farmers who have to pick their crop in the summer heat while completely wrapped in fabric to keep the spines out of their fingers, arms, legs, and faces. Much of the crop is frozen to provide okra for winter meals, since when it is cooked with the rich tomato sauce and small chunks of meat, it makes for a very filling meal...much more filling than is needed in summer.

Another summer crop that is more appreciated in the winter is molokheya, which could be called the Egyptian national dish. Molokheya is essentially a weed called swamp mallow other places, a tall plant with shiny oval leaves and small yellow flowers. It grows almost anywhere wild and is also planted in fields. The leaves are chopped if fresh, or crumbled when dry, and cooked in a chicken, rabbit, or beef stock to which is added a fried garlic, coriander and a bit of cumin. Hot pepper can be added to taste as well. The molokheya makes a rather mucilaginous soup...another word for sort of slimy...but it is known to be good for digestion. Once you get past the texture, and some people never do, it is wonderfully delicious over rice. We have a small field of it growing next to the longeing ring and I find the plants all over the garden popping up next to roses or behind palm trees. Welcome.
My parrots like peppers, my grooms love peppers, and I like them too. This year we planted hot peppers and I learned that if you pick them young, they are usually sweet, but if you wait for them to ripen to red, they pick up a lot on the heat scale. Peppers have a ton of Vitamin C among other things and are very good for you. I never had any idea how many peppers can be produced by relatively few plants. It's quite astonishing and I haven't had to buy peppers all year. We also are still working our way through the braided onions and garlic in the verandah, while it is almost time to plant again.

Zucchini is a vegetable that is planted all year round and it only takes about two months to complete the growing cycle. One of my friends in Alexandria called Egypt "the land of the eternal zucchini" because of the omnipresence of this vegetable. Yesterday I made a salad from gargeer (aka: Arugula) cut fresh from the garden, tomatoes and red onions also just picked, the first zucchini from our garden sauteed with garlic and mushrooms (the only bought items), with chopped roast chicken. Zucchini just out of the garden tastes NOTHING like the stuff that you get from the supermarket. In another week I'll be sending zucchini home with my grooms because there really are limits to how much I can eat, even with the poultry, rabbits, parrots, and tortoises helping.

Finally, being on the cusp of the mango and date seasons, we have a number of sweet options. The mangoes this year had a hard time with the summer heat, but they are just as juicy as ever. The new dates are just coming on the market in time for Ramadan in a couple of weeks, and the sweet red Zaghlouls are already being sold on the roadsides. Left for a couple of days they turn brown and softer, resembling the dates that are more common in Europe and North America. The grapes, both seedless and with seeds are still in season as are the guavas. As the weather cools, apples, oranges, and bananas will take their places.

The farmers here for the most part eat a vegetarian diet. Vegetables grown in the fields, cheese and yogurt from the family cow or buffalo, and bread or rice are the staples. Breakfast is often cooked beans known as foul (pronounced "fool") cooked with onions, garlic, cumin and lemon, and eaten with cheese and bread. Lunch may be bread, cheese, onions, and then dinner might be a vegetable stew. It's a healthier diet than is followed in the city by a long shot. Sometimes it's easy not to miss junk food.
copyright 2007 Maryanne Stroud Gabbani

A Time Out For Sunshine

For the past few days there have been sms' flashing around the mobile phone networks in Egypt warning people to avoid the sun from 11 am to 4 pm. Some of the warnings have been attributed to the UN (I didn't know that they had a weather department?) while others have had no attribution. Friends of mine have told me that there have been announcements on television as well. There's a certain Duh factor here. As long as I can remember, people have been warning that the most dangerous time of the day in the sun is during the hours between 11 and 4...and I can remember a fairly long time. I remember when they first invented sunscreen. Many of us, while we are miserably coping with our overheated summer weather, have been wondering what has changed to make these messages necessary. I guess it's awareness.

I did some net research to see if there have been any momentous happenings in the solar ray world, but no. I suspect that someone has finally noticed that ozonally speaking Egypt is not in the best of circumstances during the summer. As a matter of fact, according to some of the ozone maps that I was able to find while researching, we are in much the same situation as South Africa and Australia, two countries that push sun protection in a big, big way. So these messages seem to be A Good Thing. A look at the map above will show why. The grey and blue band along the equator indicates an area of lower ozone and higher risk. The turquoise band that overlaps Egypt and North Africa is a bit better, but it is the same colour as the band over South Africa and Australia. The green areas are better still, while the red spots are the best. It's sad, but definitely worth noting, that these are all over areas far away from the influence of human beings.

copyright 2007 Maryanne Stroud Gabbani

ER in Cairo

I was out riding with a few friends yesterday, just an hour jog in the countryside, training for two of them who want to improve their riding skills and training for my 5 year old gelding Figgy who is just now joining the working horse string. My mobile phone rang in my fanny pack attached to the front of my saddle and I slowed everyone to answer. Two of my neighbours and a friend had ridden down to Dahshur early that morning and it was one of them on the line to tell me that another had fallen from her horse and needed a pick up with a jeep. The four of us hastened back to the farm to go rescue Janie. Two of the friends went on home while one came with me after we collected cold water, a frozen jug of water, some arnica and some Rescue Remedy.

I ride in the Dahshur area quite frequently. The desert there is beautiful and the pyramids are easily as interesting and beautiful as Giza, although not as big. They are older though. The directions given would probably have stumped an ambulance driver, and even most of the local people around here wouldn't have had a good idea of the best way in to pick up our invalid. So horseback riding does have its rewards. We zipped off down the Mariouteya to the Dahshur turn, and then turned onto a dirt road before the entrance to the pyramid area. About a couple of kilometres down the road a turn over the canal into the tomb area of Dahshur gave us an entry into the desert close to the point where Janie's horse had fallen through a fox den with the result of her rolling over his shoulder and landing on her own on the sand breaking her collarbone.

The other riders collected horses, a groom that I'd brought would ride her horse home, and we packed Janie up into the jeep for the ride to the hospital. We'd only gone a few kilometres on the main road when a nasty floppy sound was the signal that I had a flat tire. Wonderful. And what a flat. The entire side of the tire was cut open, by what I have no idea. A quick call to Janie's daughter arranged a ride for my driver out to our parking place and a new car to continue to the hospital. While we were waiting, three different vehicles stopped by to offer assistance with the problem, but we told them we had someone coming. That's one of the things I really love about Egypt. When you have a problem, someone is going to help.

After a nice traffic jam on the Moneeb bridge we finally made it to Al Salam hospital on the Corniche in Maadi, our emergency room of choice...although that may change. About a year ago I'd taken another neighbour in there after a fall from a horse that broke her arm just below the shoulder, and a month or so ago Janie had taken a friend in late at night after a fall from a horse broke her tailbone. Yes, horseback riding can be dangerous, no question. In both of those cases, the doctors examined the women, made an x-ray, and sent them home with appropriate treatment, so we were expecting to be in the hospital for only an hour and a half or so, as long as the break in the collarbone wasn't too complicated. Something had changed, however, in the ER. A doctor first came and insisted that Janie had to lie on a back board, an object that looks like a surfboard with handles and is supposed to protect the spine in case of injury. Well, that's fine but where was it when we were collecting her in the desert, driving the jeep down the country roads, changing to the daughter's car and walking into the hospital? Seemed a bit like overkill to us but we humoured them. They very nicely gave Janie some pain killer IV and then hit us with a list of x-rays and diagnostic tests that were apparently "procedure". Must have new procedures, I guess. Despite our protests that a) she hadn't hit her head, lost consciousness, been confused or drowsy they wanted a CT scan on the brain. Ok, a bit much but reasonable. They wanted a bunch of x-rays on her back and pelvis as well as sonography on the pelvis and abdomen. Whoa Nelly! Janie had rolled off a horse that was also on the ground, hit the corner of her shoulder on the sand breaking her collarbone, but there had been no impact on her lower back, pelvis, head or even the other shoulder. The problem was very localised.

I was elected the official arguer because I'm very well-known to be stubborn and inflexible when necessary and I have a good understanding of medical procedures for basic first aid. We finally whittled the list down to something we felt was reasonable and would yield some actual information rather than a bunch of "You're fine"'s and a huge hospital bill. Six x-rays and a CT scan later we were told that she'd broken her collarbone (Well, duh. What did we tell you had happened?) but that it was a nice clean break that would have to heal in a sling. We'd walked into the ER at about 12 noon and it was 4:30 pm by the time we could leave. Janie hadn't even had coffee before going riding, her daughter hadn't had any breakfast before picking us up, and none of us had any lunch, so it was a pretty crabby group of women who left the hospital. That probably explains the vehemence of the final argument with the internal medicine guy who still wanted to have a sonography on the pelvic area. Fortunately for us, we already knew that the sonography man had gone home for dinner, so we told the doctor that if anything at all looked bad we would get back to them.

Both Janie and I are old hands here and remember when you had to walk into a hospital and tell the nurses and residents what kind of tests and treatments you needed rather than having some administrator tell us that "procedure" dictates what tests are performed. It's nice that they have all the new equipment and I'm sure that the procedures are useful, but it was so hard to get away from the idea that the driving force for the "procedures" was the balance sheet. I'm quite sure that the income for Al Salam will be rising in the near future because most people are neither as sure of what is wrong as we were, nor as determined in insisting on signing off on things that are unnecessary. I guess that progress has its price.

Oh, and by the way, the photos are just there for the viewing. They are pictures of the Dahshur area where they were riding. Pretty.

copyright 2007 Maryanne Stroud Gabbani