KING FADH ARMED FORCES HOSPITAL,SAUDI ARABIA 1992-1993.
JEDDAH, a Saudi Arabian Port city on the Red Sea, is a modern commercial hub and gateway for pilgrimages to the Islamic holy cities of Mecca and Medina. A population of about 4 million enjoys fine beaches, world class diving and fishing experiences and quality Resort hotels. Jeddah’s 45 km Cor- niche road along the seafront is lined by enormous sculptures and also anchors the King Fahd fountain.
Each sculpture is in the middle of a huge roundabout and each one was erected by the city as a tribute to each company who were involved in the modernisation and expansion of Jeddah when the oil royalties were acquired.One roundabout has a full sized aeroplane plonked high up in the middle,another a large car and others have large symbols of the company’s contribution to the city.
Jeddah’s historic district dates back to the 7th century and the name of the city means ”grandmother”.
Until 1928 there was a tomb in the city ,allegedly belonging to the biblical “Eve”(she was the “grandmother”).Eve’s reputed tomb was destroyed by the Saudi Government whose Wahhabi leanings taught that it encouraged idolatry.
WHAT BROUGHT ABOUT THE JEDDAH JOB?
I was taking a well earned break back in England revisiting Dad, brother Ian and others, as well as grovelling for some games of cricket with my local Chittlehamholt Team.The locals at the Exeter Inn in the village(our Club pub) welcomed me back with the usual, ”Well, bugger me, here’s the bloody Tasmanian devil come back again.You looking for a few games this year Doc?”
Now you do need to know how to clinch a deal with these guys,most of whom were still sitting on the same bar seats that they had occupied nightly for 5-20 years but could still wield a good willow and were as adept at sledging batsmen as any Australian. Some could trundle up to bowl a reasonably flighted ball on the tricky locally prepared wicket.Some had large oscillating tummies when they trundled, some didn’t The important thing was that they were still my mates and had been for donkey’s years
All would abruptly respond to my call of ”Barman I’ll shout the house on the next round,” though I only did this when the bar was having a quiet night and i’d had a good look around.
To clinch a few games I sometimes bought a nice quality new cricket bat, gloves,protector and pads and presented them early to the Captain or a Selector.
I was waiting to go into bat the next Saturday. I had brought a Medical Journal with me and was trolling through the ”Overseas Medical Opportunities” when I saw the words “Jeddah,Saudi Arabia”.
That was like offering candy to kids.
I read this bureaucratic,spiced up advert over and over again.
It must have given me that long lost adrenaline rush…the expectation, the possibilities,the chickens coming home to roost again,…because I thrashed the ball with the willow so hard, and with such precision ,that I doubled our score (albeit from only 18 to 36).
In a low scoring match,we achieved our second win of the summer.
The following day I chased up the advert and spoke to a Secretary,who was sitting next to a Board member, who spoke with me at length.
WHAT WAS GOING ON IN JEDDAH ? WHAT WAS IT ALL ABOUT?
After the first Gulf war was over,Kuwait ,though battled scarred,was safe and Saddam Hussein’s army had slunk back into Iraq leaving a serious power vacuum in the whole region.Eventually another Gulf war would emerge and Saddam would be killed though even this could not settle a seriously unsettled Middle East and it’s external ramifications.
In the meantime Saudi Arabia had spent Squillions of money on the war and had to seriously reorganise and tighten their budgeting.
Many Military Hospital Programs suffered and, one of these was The King Fahd Armed Forces Hospital in Jeddah, which provided medical services to some 300,000 people including the military and their families.
There had been massive Staff and Departmental losses and the Saudi royal family had demanded an updating and upgrading of the program to levels consistent with Tertiary status.
Interim staff had seriously compromised the Program, and had embarrassed the Royal Family,in particular Prince Sultan(owner of Saudi Airways and Patron of the Armed Forces Hospital) .
A combined recruiting group based at Guys Hospital and St Thomas’s Hospital in London ,was contracted to recruit whatever teams were necessary to take the Program to Tertiary Hospital levels and beyond.
Primary Care and the ED were pivotal to providing quality health care for the program.After discussions and an interview with Dr Stanton Adair, Chief of those Departments, I was welcomed and appointed as his Deputy.
I started the job in April 1992.
SO WHAT RESPONSIBILITIES DID I HAVE AS DEPUTY CHIEF?
As Deputy Chief I held Clinical and administrative responsibilities in a Dept which,during 1992, provided 366,000 Primary Care and ED consultations, and became Acting Chief when Dr Stanton Adair was on leave from the Dept locally,Nationally or Internationally.
I was Physician -in -Charge of the Main Hospital Primary Care Dept and was directly responsible for the Post Graduate Education Program for our 71 GP’s, up to FRACGP and MRCGP(UK) requirement levels.
The Dept had a database of 40 GP’s on my arrival and 71 at the end of my one year contract.
20 doctors were Westerners and the remainder were recruited from Saudi Arabia,Egypt,Jordan ,Pakistan,India and Sudan.
I was responsible for recruiting, interviewing, selecting, and orientating all Primary Health and ED doctors,and assisting with annual performance assessment reviews.
I assisted the Chief in developing a Policy and Procedure Manual,developing a Departmental Brochure for new recruits,expanding Health Education initiatives,upgrading the Hospital Formulary and producing and managing the Dept’s Monthly Roster.I also served on the following Hospital Committees:-
.Drugs and Therapeutics
.Medical Education
.Research
.Medical Audit
The Primary Care Dept had responsibilities for the administration and provision of medical services to the following:-
.The Main Primary Care Dept of the King Fahd Armed Forces Hospital
.The Accident and Emergency Unit
.The Royal Saudi Air Base Jeddah
.The Old Air Base
.The Royal Saudi Naval Base
.The Air Defence Institute
.The Air Command Base
.Quadema Naval Base
.The Military Screening Unit
.The Employee Health Unit
.Prince Sultans Private Palace
Departmental Doctors were also supplied ,from time to time, for variable periods and variable reasons to:-
.King Fahd’s Jeddah Palace
.Prince Naif’s Palace
.The Royal Guard
.The Mecca Haj
.Conferences held in Jeddah for V.I.P.’s and visiting dignitaries, including for International Muslim Delegates attending the World Islamic Conference in 1992.
Three weeks after my arrival I personally took charge of a massive,urgent Meningococcal Meningitis Immunisation campaign for 45000 military personnel and their families prior to their Haj pilgrimage to Mecca,following an outbreak of 52 cases of meningitis in Mecca during the Holy Month of Ramadan.
This campaign was marred initially,despite it’s urgency,by the constant interference of Religious Mataawa Police who separated all women and girls from their male families and ordered that they be taken to another venue for their injections because if they rolled up their sleeves there was a possibility that a man might take a glimpse of the skin of a lady’s upper arm and thus cause a serious religious offence.These types if incidences provide typical examples of the need for cultural respect at all times,especially at times of crisis management (a common situation to be thrust into in Saudi Arabia!)
WHAT WAS LIVING IN JEDDAH LIKE?COLLEAGUES, ACCOMMODATION,TRAVEL,SPORTS FACILITIES ETC.
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My Colleagues at the Armed Forces Hospital were a joy to work with.
My Chief,Dr Stanton Adair and I, worked really well and purposefully together,enjoyed each other’s company,shared the same aspirations and sense of humour and never had a cross word in my year working with him.His family resided in the same Compound as I. Stanton had great administrative skills and had signed a 5 year contract with the Program and was always available to further the betterment of the Armed Forces Hospital.Our working and social relationships were excellent.
,All Senior Staff were accommodated at the Arabian Homes Sierra Compound approx a 10 minutes vehicle ride from the Hospital. My accommodation was a Spanish style 2 bedroom first floor unit overlooking a shared swimming pool and next to an excellent Tennis court. The apartment was serviced daily by a contracting company. It was newly completely fully furnished with TV,Radio and had gadgets galore.There were no Saudis in the Compound, and no Religious police, so the whole atmosphere was calm and without interference or interruption. Basically, if you wanted to sleep, you slept,and if you wanted to swim, play tennis,squash or badminton, walk or run around the Compound …you just did it!The Program provided me with a Camry type car and my only expense was petrol (which was cheaper than water).
Jeddah was, indeed, a very beautiful Red Sea Resort and important Islamic City. It had fewer restrictions than those experienced in Riyadh.
I was very fortunate in having daughters Tara and Alicia visit me for the Xmas, New Year period 1992.
.We shared many special, hilarious times together and they were in great demand as company to the US marines Special Service Forces who were always hanging around the Arabian Homes Sierra Compound.Tara and her new Marine diving friend went diving over a 300 ft deep ledge at the Sheraton Hotel Red Sea Resort at the stroke of Midnight on New Years eve.
We drove up the 6000 metre mountain road to Taif ,a summer residence of the Royal Family.This road has 365 right angled bends,is infested with untamed baboons and leads into one of the world’s largest rose growing areas .The roses,finally end up in one of the world’s most expensive body scents.
On our way back from Taif we stopped to say ”hello” (in Arabic) to a couple of Camel farmers,shared our water and sun screen moisturiser with them and then were allowed to take photos of the girls with the farmers.My photos show that the farmers were very liberal in where they placed their hands on the girls upper torsos when they linked arms for the photos.
As we left the Camel farmers pointed to a herd of 3000 camels in the far distance towards the hills.These were special moments.
Jeddah, for me , has many memories of crisis event management at work and I elaborate some of these now.
None are embellished…they happened as they happened,and are not recorded in any way as a criticism of the management of the situations I encountered.
What they do illustrate is that we should always be prepared to expect the unexpected,not panic, and preferably have at least some logical algorithmic plan to deal with it.
WHAT ARE “MAJOR DISASTERS”, DO THEY HAVE THEM IN SAUDI ARABIA AND HOW ON EARTH ARE THEY MANAGED?
The commonest Major disasters in Saudi Arabia are Flooding(especially in Riyadh, Jeddah and Dammam city regions),Sandstorms,Disease epidemics(such as Swine flu, Severe acute respiratory disease and Rift Valley fever.That is a surprise isn’t it?
Both Jeddah and Dammam are coastal cities and Riyadh is surrounded by valley. All face yearly incidences of flooding causing natural disasters.
Stampedes at Mecca during the Haj have on a few occasions caused human -made disasters, resulting in up to 1500 deaths in one incident about 30 years ago.Fires have caused some hundreds of deaths in Mecca during Pilgrimages.Similarly, multiple pile- up road crashes involving hundreds of persons have been another major contributor,and we know that, although Saudi has half the population of Australia, it has three times as many road deaths.
Low-magnitude earthquakes rarely reach more than level 4 on the Richter scale despite the existence of many seismic and volcanic areas throughout the country.
Hundreds of aeroplanes fly cross the country daily, especially when Pilgrimage times approach. On 11th July 1991 a Nigerian Nation Air plane crashed 2.8 miles from Jeddah International Airport. 261 persons,(mainly Pilgrims), perished.This disaster happened less than six months prior to my arrival at the Armed Forces Hospital ad Deputy Chief.
Similarly, in July 1976 a Lockheed -c-130 Hercules plane,travelling from Riyadh to Jeddah with 287 passengers on board, blew up in midair.Most were Pilgrims,some were Diplomats,others business folk.Terrorism was not suspected.
Each Organisation involved in Healthcare is responsible for Disaster management in every City.There has always been inadequacies in the Saudi health care system in terms of disaster response.Much of this is due to the inadequacy of disaster training for Health care workers.
Although it is a difficult problem, there is always an urgent need to develop disaster-competent healthcare personnel by adopting standard disaster operation competencies against which the readiness of Saudi healthcare workers can be assessed.
Nurses,in recent times have been considered the most viable healthcare workers in Saudi because they have already been trained to be first responders in the event of such disasters.
Further factors are the standards governing the response system.Because of the complexity of disaster response within the health care system and the establishment of a disaster field with specific criteria and resilient standards,effective disaster management requires the integration of multiple sectors throughout the health system.
These measures must include the establishment of educational training and simulation drills suitable for all personnel involved in responding,the development of preventive plans,the establishment of early warning network systems and the provision of necessary equipment and community education.
In 1992 ,when I arrived,as Deputy Chief I carried the small ”Major Disaster Phone when my chief was unavailable.The Phone was similar to the ones seen in the TV Series “Mash”and there was no such thing as Apple, Google,Facebook,Twitter or other high powered Social Media contact-ability! This phone contained the Emergency button that fired off both a warning and a request for immediate action from me in response to”MAJOR DISASTER,MAJOR DISASTER ,MAJOR DISASTER. RETURN IMMEDIATELY TO BASE.” It was certainly noisy enough to hear, but, apart from pressing the”MESSAGE RECEIVED ” button,there was no conversational access!!
It was the weekend in Jeddah and a thousand and one dangerous drivers were enjoying moments of freedom,flashing their vehicle lights and beeping their horns, thankful that Friday prayers were over,they were still alive, and now they could “play.”
I was 15 km from the Hospital ,driving a Military sedan,and with a Mozart Horn Concerto blaring at top decibels.
S..t,what the f..k is it? Pilgrims rising upwards to the green pastures from their aircraft, Diplomats on an incineration descent, or is something really gross happening in Mecca or are Shiite terrorists spoiling for a fight with the Sunnis ?
I simply put my foot on the accelerator,said a little prayer, and arrived safely back through the security gate 10 minutes later.
The Program Director and the Chief of Security are initially the only persons with early information about the cause and whereabouts of a Major Disaster. No briefings occur with any other persons ,whatever their Rank or position in the Organisation, until some clarity exists.
The Armed Forces Hospital already had an initial prepared response plan for any eventuality.
Firstly, each employee, at whatever level and wherever they worked, as part of their orientation,is given a card which spells out their initial response duties. This card is kept visible in their Dept. All cards are read, immediately, when the possibility arises of a Major Event and each Dept Manager quickly checks and reports to the Security Chiefs that they have a preparedness situation with employees present and awaiting instructions.
Of course there a number of bells, horns and whistles going off and they all convey specific meanings requiring actions.
All employees are strictly required to have a good level of the English language, in addition to their own “home country ” language,as a condition of employment.Failure to respond to an Emergency call is a serious offence and carries with it significant ramifications for the employee.
When the level of preparedness is correct,the Security Chief and Program Director announce,over widespread megaphones,the nature of the Disaster and the requirement levels of our response.
The eight Chiefs of Dept meet urgently for briefings with the Chief Coordinator of Security and the Program Director in the Communications and Operations Room and the Chiefs of Dept convey and initiate whatever actions are deemed necessary to perform their coordinated role.
Without Initial plans, with built in flexibility, and excellent coordination,the management of Major Disasters can produce panic and degenerate into chaos,especially when the response is prolonged over several hours,days or longer.
A major part of situation management is honesty,keeping everyone up to date, and making sure that everyone has timely breaks of duty.
At the end, of this type of project, it is vitally important to debrief in a frank, honest and thorough way, audit all performance, change what needs to be changed,re-examine preventive measures and individually thank each employee for their role,time and dedication.
SO, IN THE END, WHAT EXACTLY WAS THIS MAJOR DISASTER ALL ABOUT,FLOODS,FIRES,PLANE CRASHES,TERRORISM,or CAR CRASHES?
In fact it was a ,very much, kept quiet,Practice run which could have covered any of the above occurrences,and was very successful ..phew!
OH DEAR, THE PRINCES AND THE KING’S PALACE KEEP WANTING TO
TAKE MY CONTRACTED DOCTORS AWAY TO THEIR PALACES TO LOOK AFTER THEIR RELATIVES AND THEY DON’T SEEM TO COME BACK.
I had steadily been recruiting good doctors for the Program when some of the Princes decided that having a doctor in their palace would be handy and the best place to nick them from was the King Fahd Armed Forces Hospital because they’ve been thoroughly checked out and many of them are Muslims.
That’s OK, I guess, if you are the King and the Hospital is named after you!
An excellent middle -age Jordanian Muslim GP, who had been living in the Kingdom for many years with his family, had regularly applied for Saudi citizenship, but had always been turned down. He never got an explanation and could never ask for one.
King Fahd’s Palace Manager phoned me one morning to say that the King’s favourite aunt had recently had a mild stroke, was old and a bit feeble, and the King was requesting a doctor to come to the Palace to look after her. No timelines were suggested although ”as long as it was necessary” was my Royal brief.
Dr J (from Jordan) was the immediate willing cab off the rank and the old Saudi lady took a liking to him straight away. Each phone call I made to enquire of the lady’s progress seemed to get a brief but emphatic reply such as “It is unlikely that Dr J will be returning to the Hospital for sometime.”
Six months went by and then Dr J arrived at the Primary Heath Care Dept to see me.
He thanked me for recommending his appointment as Palace doctor, offered me a ride in his personal Physician’s brand new top of the range Mercedes and announced that the King had recently granted him and his family Saudi Citizenship. That was the last that I saw of him, though I am certain that his symbiotic relationship persisted as ad- infinatum as was convenient to both parties.
A granddaughter in the Royal Family had qualified, as a doctor, the previous year, found that work was hard and irksome and suffered a nervous breakdown.
One of our contracted English nurses looked after her for some weeks and, as the young doctor got better, she seemed to have developed a strong friendship with the nurse, and become very dependent on her being with her virtually all of the time.
She flatly refused other professional advice.
Whenever the nurse indicated that she really did have other things to tend to in her life, the young doctor reverted to her previous symptoms and splashed expensive gifts, including a sports car and lots of 22 carat Saudi gold bracelets, watches and a necklace in her direction. They would then travel extensively and expensively to wherever the nurse wished to go.
The constraints on the English Nurse began to seriously affect her own mental health, judgement and coping mechanisms. She suffered panic attacks and severe insomnia.
I am unaware of the health outcomes of either of these two young women. The reader should, perhaps, reflect and consider the dangers of these types of manipulative entrapment relationships.
PRINCE SULTAN WAS OUR PATRON.DID HE EVER REQUEST THAT DOCTORS WERE TRANSFERRED FROM THE HOSPITAL TO HIS PALACE?
Prince Sultan was a real nice guy.He was known colloquially as Sultan the Good.He was our Program Patron and had played a major role in the defence of Saudi Arabia in the First Gulf war.
Prince Sultan bin Abdul aziz- Al- Saud,his formal name, was the Saudi Defence Minister from 1963 to 2011 and was Crown Prince of Saudi Arabia from 2005 to 2011. Sadly he died ,age 87,and Sultan’s brother, Crown Prince Naiyef, became Heir Apparent to King Fahd.
Sultan was a major ally and friend of the West. He owned Saudi Airlines, and had major interests in the Saudi Oilfields, Health and National and International Recruitment Companies, Hotels and International Real Estate. At one point he was allegedly worth $270 billion dollars. He also, incidentally had 32 children from multiple wives.
Crown Prince Nayef had a chequered life, survived a number of attempted assassinations and in his latter years was expelled from the Royal family.
I certainly received a phone call from the Director General in charge of the Armed Forces Program. It went like this…”Dr Tucker, as you know Prince Sultan has a Medical Centre attached to his Riyadh Palace. He has an Orthopaedic Surgeon who travels everywhere with him, because of his Knee and Hip problem.
“The Prince wants you to provide a 24 hour x 7 days a week Medical Service at his Jeddah Palace and insists that the doctors providing these services are Muslims. Will you organise this for him?”
I was surprised. I answered in the affirmative, but asked,’ ‘When would you like me to do this Sir?”
”Well it’s 4-30 pm now so I will have a vehicle ready to pick you up to take you to the Palace at 6 pm.”
”Thank you, I look forward to that, Sir”.
A top level, spotless, Sahara Toyota, and a couple of massively fit bodyguards, took me to the Palace. It was guarded by four gun- toting Saudi military in heavy uniform. We needed to pass through a number of these entrances before entering the Sanctum Sanctorum containing the actual Palace. Fortuitously, neither I, nor my bodyguards, were subjected to a strip search for a SIIED(a Surgically Implanted Incendiary Explosive Device usually tucked inside of the rectum!) Oddly enough Prince Sultan’s brother, Prince Nayef, was almost assassinated by a villain using this particular method of execution. Nayef lost a number of fingers in the explosion but his bodyguard lost his life as he threw himself across the Prince’s body in an attempt to shield him.
The Medical Centre was brand new, purpose built but yet to be used. Beautifully decorated ,even having gold plated taps and shower accessories and the very best of every thing else.
I was now able to visualise, with a floor Plan, how things could be arranged.
Although the Prince would have liked all sorts of Specialists working there as well as Physios and a podiatrist, the Program Director would only budget for two GP’s working 12 hour shifts each 7 days a week. Even though it was quite clear that the workload was going to be minimal, and that most of the time the doctors would be watching TV sleeping, cooking or playing with the Princes grandchildren, the deal had to be 24 hour cover x 7 days a week.
This deal presented another problem, in as much as the two Egyptian Doctors who would be in attendance, could only legally work for 48 hours a week before claiming overtime rates!
The doctors were happy, their Egyptian spouses were happy(financially anyway) and the chances of their families receiving upgraded accommodation in the Program(with support from the Prince) escalated.
This arrangement became a more permanent feature of my monthly roistering duties.
Some months after Prince Sultan’s successful opening of his Palace Medical Centre, Prince Nayef made an unsuccessful application to have one installed at HIS Jeddah Palace.
THE ADDICTION PROBLEMS OF THE “PETHIDINE PRINCESSES.”
Yes! It does sound as though I was working on a film set of Alice in Wonderland and indeed ‘Through the looking glass’ as well, but ,as they say, “Truth will out”.
Before all of the mind blowing drugs of the 2000 and 2020’s eras were made available, on most street corners, or, at the touch of a phone pad, there were many choices available. Magic mushrooms, LSD, petrol, glue and countless other synthetic concoctions, apart from alcohol, were accessible, at a price, to poison temporarily or permanently, the brain cells of our, (and your, grandchildren),and older generations.
Small time, and big time users and dealers, graduated into Methamphetamine, Ecstasy, Ice, Fentanyl, other opioids and synthetic mind blowing substances, when marijuana was either unavailable or insufficient for your required purposes.
Doctors, who frivolously write scripts for addictive drugs, make their available purchase and retail price cheaper. Addictions are fortified and maintained. Unscrupulous doctors are rightly struck off the Medical Register for this despicable, greedy, unethical and criminal behaviour.
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In the early 1990’s smart, rich, bored and action- seeking Saudi Princesses, together with one or more friends, frequented the Emergency Departments of Saudi Hospitals , Public or Private, Military or Other. They had found a way of tapping the kicks of the drug world and , boy ,did they ever use and abuse it.
The Saudi Royal family has about 50000 members but only about 2000 are extraordinarily rich, through whatever means. I have little interest in the origins of the addictive Psycho-dynamics of these local ladies accept to say they were clearly pretty prevalent and ruthless.
The Pethidine Princesses, from my experience, had intelligence, power and money, but were confined by their inability to seek drugs outside of a protected system. They had learned all of the medical terms, histories, key words and symptoms that would set off red flags inside of many mainly foreign and job dependent doctors working in Emergency or Primary care departments. The Princesses would take control of the consultation and wedge a doctor, by implication of threat and power position, so that refusal to supply requested drugs would have severe repercussions on the doctor ‘s ability to continue working at that particular Hospital.
Issues associated with complaints against a doctor, backed up by attending companions or friends, invariably clinched a deal in favour of the Princess, compromised the doctors and wrecked their careers.
In another Hospital , of which I was familiar, a young Saudi Prince obtained multiple addictive drugs and was found dead at his home a few days later.
We immediately contacted our Program Chiefs and pointed out our vulnerabilities to our own doctors. A ruling was passed through Committee that a client could only receive drugs of addiction with a Psychiatrists approval. Psychiatrists in our group of Hospitals were as rare as hens’ teeth so that this was a completely useless guideline.
Prince Sultan(our Patron) came to the rescue when he demanded, and was given the names of, members of the Royal Family who were demanding drugs from our doctors .(This was apparently Ethically OK in local laws
A Law was enacted, by him, banning the supply of all of these drugs in unwarranted situations and we were no longer bothered with the problem.
Curiously, but understandably, the Pethidine Princesses took their demands to a couple of other, non-military Hospitals.
Prince Sultan’s ,powerful leadership, overall administrative and face- saving tactics, thankfully won the day.
EMERGENCY DOCTOR “HARRY” RECEIVED AN INSTANT DISMISSAL, VIA THE RELIGIOUS POLICE, AND I HAD TO APPROVE AND ARRANGE FOR HIS EXPULSION FROM SAUDI ARABIA….BUT THAT’S NOT ALL!
Dr” Harry” was an excellent doctor who came to the ED Dept, from Ireland, six years prior to my arrival, was always obliging and pleasant, and lived at a Villa in Arabian Homes close to mine.
He had returned from leave in Dublin two weeks previously, having married his gorgeous girl friend. They had enjoyed most of their honeymoon in The Alps except the bit when she fell off her skis and broke her rt ankle.
After day surgery in the Resort, she returned to Ireland in a below knee Plaster of Paris. She and Harry had agreed that she should rest in Ireland for 3 weeks, to make sure that healing was in progress, and had booked a flight for her to arrive in Jeddah on the 8th of the month. In the meantime Harry returned on his own to Jeddah to work in ED and prepare the Villa home for her arrival.
He was very happy and worked a few extra nights to help out his Colleagues.
Two days before her arrival in Jeddah, after he had worked six straight nights in ED, he had a good days rest and was looking forward to a good nights sleep. At 6 pm he drank a couple of whiskies (He kept some illicitly in his wardrobe) to assist him nodding off to sleep.
His villa phone rang and he was asked if he could possibly work one extra night because another of the ED doctors had developed Influenza and a high fever.
Dr ”Harry”, ever the obliging colleague, quickly showered, put on his doctors gear and arrived at ED within 30 minutes to work.
Within the hour a Religious Policeman, whose son Dr Harry was examining, accused Harry of drinking spirits illegally and demanded that he take a ”Breath Test ” for alcohol. Very uncomfortable moments ensued.
Yes, the test was positive, and all Hell broke loose, in the ED, led by this very angry Muttawa and backed up by his fervent friends. The Muttawas are officials of the vice squad which enforces religious observance and public morality on behalf of the National Authorities.
A protesting Harry was arrested, handcuffed, dragged out of ED and locked up whilst his premises were raided and the whisky bottle retrieved by Muttawas.
The Armed Forces Hospital Program Director was contacted immediately, an on the spot decision was made that Harry had seriously offended the Program, Islam and the Kingdom and arrangements had to be made to expel him from Saudi Arabia within 24 hours.
I was Acting Chief at the time and contacted Dr Stanton Adair, who was on leave. Regrettably, the Muttawas’ collectively refused to budge, I had to debrief Harry and make arrangements for his expulsion.
A further series of complexities hit the fan.
Harry’s phone was removed and no consideration taken as to what was to be done with his private car, furniture, personal and other owned items. We tried, a number of times ,using my phone, to contact his wife and her family in Ireland, only to be told that she had flown to London to catch her booked flight to Jeddah and no-one was able to contact her to explain Harry’s predicament. Saudi Airways would not divulge who was on their flights, and, as such she was uncontactable.
Dr Harry was taken to the Jeddah airport, accompanied by special security officials. He was aware of the time of his wife’s arrival from copies of her bookings which he had been allowed to keep.
His dear wife arrived at Jeddah on the flight from London and joined a massively long line of incoming passengers. She had expected her husband to meet her because only he was allowed to have documentation for an incoming wife’s arrival.
In the absence of those documents she was ushered into a special Transit Lounge and declared an unwanted alien. She was then told that she would be put on the next flight from Jeddah back to London at her own expense. The program Security Officials accompanied by a Representative from the Military administration met with the distraught wife to debrief her and facilitate her return.
She was last seen still wearing her heavy Rt Ankle Plaster of Paris, and hobbling through the Exit Gates, accompanied by Security.
Their joint possessions in the Jeddah villa were impounded pending future disposal instructions.
MORE PARTY GROG, MORE MUTTAWAS, MORE ARRESTS AND BRUTAL FLOGGINGS USING THE CANE ON 33 FILOPINO EMPLOYEES OF THE ARMED FORCES HOSPITAL.
Thirty- three Filipino members of the Hospital staff attended a Contract finishing party in a large house not far from the Hospital.
Usually these parties were happy, fairly noisy, inoffensive and celebratory. Friends turned up to wish those leaving well, brought presents with them, and chatted incessantly about families.
At the end of the evening, everyone would return, quietly and respectfully, to their own lodgings or apartments, tired but relaxed and ready to face another hard day’s work tomorrow.
It just didn’t follow the usual party pattern on this particular evening.
Some stupid idiot had brought illicit grog to the party, for a bit of a laugh.
Half way through the party, a number of Religious Muttawas, accompanied by Security trained German Shepherd dogs, bashed down the entrances with axes, halted the partying, and seized the empty grog bottles and whatever alcohol that was left.
Forty persons were arrested, thirty -three of whom were our contracted Filipinos . All were arrested, nurses, admin staff, cleaners, receptionists, mechanics , porters, painters and others. Twenty three were women and eleven were men.
At the initial interviews almost everyone denied any knowledge of knowing that alcohol was either going to brought to the party or was actually there. Some suggested that they had had their Coca Cola and other fizzy drinks spiked by unknown persons.
Because individual guilt was almost impossible to assess, on available evidence, the Muttawas charged every one at the Party and arranged for a Court hearing the following day.
The Hospital Administration was unable, in fact not allowed, to present any evidence to defend their staff because the Charges for the offences had to be heard and dealt with by a National Religious Offences Court. The ”run of the mill” Saudi Police also could not interfere, in any way, with this process.
The following day all of the alleged offenders were charged in the Arabic language. They were unable to prepare a defence in Arabic (or any other language).All were found ”Guilty” of a list of offences, the nature of which they were unaware, and all were sentenced to “Flogging using the Cane.”
Now, the Holy month of Ramadan was just beginning and punishments like this could only be administered after the end of Ramadan.
The Filipinos were allowed to continue working in the Hospital during this period but had home curfews imposed after work hours. They would be given a few options after their punishment including being expelled from the Kingdom, but paying their own fares back to the Philippines, or staying on, if their employer agreed, but signing new harsher contracts. Basically they were wedge all ways!
In the middle of Ramadan the King is allowed to grant Amnesties to various “criminals.”
Collectively a large(unspecified number) of the Program’s Staff signed a Plea Document ,which was forwarded to the King requesting his Majesty’s consideration to grant an Amnesty for the release of the Filipinos. This was rejected some days later, without comment.
After the end of the Holy Month they were collected in gender groups. The women were taken, after 24 hours, to the basement of the Religious Court, and each was given a flimsy nightdress to wear as they bent over.
A Muttawa, holding a copy of the Koran under his rt arm, lashed each woman 50 times across her shoulders, back and buttocks with the cane.
The Koran book’s tight position prevents the Muttawa from getting a swing at the body and only allows the blows to be delivered at his wrist level.
Part of my job, as Primary Care Physician in Charge, was to examine and debrief most of these traumatised young women in The Employee Health Clinic collectively and individually.
The infliction of the cane caused significant wheals across the painful inflicted area, and , surprisingly, virtually no bleeding.
We roistered a team, to assist the women, in very many ways, and the Program Director encouraged us to help them, in every conceivable way possible, bearing in mind the Mental humiliation and Trauma as well as the Physical pain and damage that they had endured.
Post Traumatic Stress Disorder is almost inevitable in these situations but its’ development and management was sadly less understood in Jeddah in 1992 than it is in 2021.
The eleven Filipino men were not caned in the Religious Court basement. Instead they were taken to the Eggshell Mosque, in the Main Jeddah thoroughfare, bent down with their arms leaning against the wall and thrashed eighty seven times, from the nape of their necks to their Achilles heel tendons, in the usual manner. They were then bundled into vehicles, which returned them to the Armed Forces Hospital, for examination debriefing and treatment.
The Eggshell mosque is surrounded by high rise apartments and Business office buildings.
It is here, in Jeddah, that Eastern Saudi Arabian executions and major floggings take place. The site is strategically placed so that people living, or working, locally can obtain better views than if you were simply on the ground level.
In Riyadh it is ground level viewing only.
This Holy Month was certainly the most unhappy time of my entire career.
Yes, I understand cultural differences and their impact on how life (and death) is saved or lost depending on Religious or other beliefs and requirements, or demands, within or outside of a country. To inflict punishment, for discipline at this level, conflicts with all of my personal medical, and humanitarian principles.
To try to’ ‘Kick against the goad” from within a regime is foolish, but to leave it forever, without mention, in limbo, is unforgivable.
Yes, some things have improved, with recent regime changes in Saudi Arabia, in particular.
Crown Prince Mohammad bin Salmon in 2020,through a Supreme Court Command , banned the use of caning, whipping or Flogging. It has been replaced with deferred prison sentences, imprisonment, or fines ,or a combination of the three. Hundreds of lashes could previously have been ordered for a variety of offences including murder, extramarital sex, homosexuality and various breaches of the peace. In addition, women have had certain previous bans lifted, particularly in relation to watching films in the Cinema and driving vehicles (under certain conditions).
The powers of Mutawas have been very substantially reduced, with widespread curbing and monitoring of their activities.
Despite the First Amendment Laws in the USA being the subject of hot challenges for change in 2021,it is unlikely that Saudi Arabia will alter its’ views on freedom of speech in the foreseeable decade or so.
THE NEVER ENDING TROUBLES IN SOMALIA AND IT’S CAPITAL, MOGADISHU.EVERYBODY’S PROBLEM BUT NOBODY HAD OR HAS ANY ANSWERS IN 199O, 2OOO,2010, OR 2020.
A brief background understanding of Somalia’s problems is offered here to clarify my connection with Saudi Arabia’s involvement there in 1992 and onward.
In 1990 -1992 Customary Law in Somalia temporarily collapsed due to tribal in- fighting, involving Islamist terrorists and other groups.
In Dec 1992 the US began Operation Restore Hope to assist, in an humanitarian way in coping with a burgeoning famine. UN Military Observers, followed by a larger number of Peacekeeping forces arrived, and a further 25,000 US soldiers later.
Somalian forces shot down two Black Hawk helicopters in a battle which led to the deaths of 18 US Marines and many hundreds of Somalis. The dead US soldiers were dragged through the streets of the capital Mogadishu by crowds of local civilians and SNA forces and the event was shown on American television, causing an outcry across America .
In Oct 1993 elite American troops launched a raid on the Capital to try to capture the powerful Warlord General Mohamed Farah Aideed, who had been Chairman of the Somalian Peoples Congress for some years .
The General escaped capture. He died from a gunshot wound in a tribal war on 1 August 1996.
US troops have persisted in Somalia from 2007 to 2021. Even in 2019 there were 22,000 soldiers and police from six African Countries deployed in Somalia to protect the Government.
So how was I involved through my work at the Armed Forces Military Hospital in Jeddah ?
I was sitting quietly in my office at the Armed Forces Hospital.
It was Thursday morning at 11am sometime in 1992. I was checking my tennis gear in readiness for an important match later in the day. Thursday was the start of the Saudi weekend and Friday was equivalent to an expats Sunday.
I estimated that I could knock off, from work, on time at 12 noon.
The phone rang and I politely answered ,saying…”Hello, Dr Alan Tucker, Deputy Chief of Primary Care, how can I help you?”
“Ah, Dr Tucker, this is General Mahmoud. The King has just contacted me and he wants me to send Saudi military troops to Mogadishu in Somalia. I understand that they all need to be immunised and vaccinated to stop them from getting diseases over there. I want you to organise this for me.You can do this, can’t you?”
I took a couple of deep breaths. I knew that there were many questions to ask him without thinking much about it. He sounded demanding…that’s his job.
“Yes , of course I can, but I will need to get some initial details from you, Sir,” I spluttered uneasily.
”What details Doctor Tucker?”
Well Sir, briefly, at this point in time, the following ones, and could you possibly answer them one at a time ,if that’s OK?”
‘A. “Of course ,go ahead.”
Qu. ”When do they have to leave Jeddah Sir?”
A. “Half on Sunday and the rest on Monday.”
Qu. “How many are going to Mogadishu?”
A. “That is a Military secret, I cannot tell you.”
Qu. “Do you know which diseases need to be immunised against?”
A. I have know idea. You must find this out.”
Qu . “Do they have any Military records to say what they have already been immunised against or what medicines they are taking?”
A.”I have no idea. You CAN do this for me can’t you Dr Tucker?”
Qu. ”Yes, of course! Can I phone you back on this line in five minutes, Sir?”
A. “Yes”.
A number of ghastly scenarios split my thought processes asunder for the next minute. I was certain that the request was impossible to fulfil for the following reasons:-
1. This afternoon was a half day off, for working folks, and tomorrow was a Holy Day .Therefore all sources of vaccination supplies were unavailable today and tomorrow and he wants half of them to go in two and a half days.
2. He hasn’t said how many troops need to be done or where they can be contacted.
3. I cannot get an experienced Team to help me do the job and accurately make appropriate records for the Military .
4. I will need to check the recommended requirements re-drugs and vaccines, for Somalia, and their possible side effects and then wait until the day they supposed to go to see if we’ve got enough stuff !
5.I must, and will, say a smidgen of a genuine prayer to seek guidance and inspiration from above. I must then find out when the earliest flight to Sydney, is available, in the likelihood of my failing to meet the General’s request from the King.
One minute left for inspiration (or not) before fronting of the testy General.
How can I put him in a position to change his mind? YESSSSSSSSSS!!! By George I think I’ve got it!!
”General Mahmoud, good to hear you again. Yes I can help you but there will be one or two mushkillas (Arabic meaning ”little problems.”)
He shouted at me ..”.MAFI MUSHKILLAS.” In English it really means “there can’t be any problems.”
“Well, Sir,” I spluttered ,”There are two actually, the first is that I really must know, roughly, how many persons we are going to vaccinate so as to make an immediate order”
”Not more than one thousand,” the General confirmed, ”What is the other little Mushkilla Dr Tucker?”
“Well Sir, i’ m sure that you have many Saudi Air Force Pilots flying our special Saudi Troops out across the Red Sea to Mogadishu? I’m sure also that you are aware that many of the vaccines and tablets can cause quite serious side effects during the first few days after they have been given…..things like high fevers, headaches, sometimes confusion, muscle pains and weakness and blurring of the vision. These are things that my team cannot possibly prevent and it is not possible to predict which persons will be affected. As I say, my team and my Department cannot take the responsibility for these things and medically it would be correct to be very cautious and allow at least seven days for all of these problems to resolve, as they will. However if you , and the King ,are still happy to go ahead with the flights ,on your current schedule, I will make a note of our discussion for the record. What would you like to do?”
”Doctor Tucker I will phone you back in five minutes.”
On the dot of five minutes General Mahmoud phoned and said, ”Doctor Tucker, thank you for your helpful discussion. The King has said that we will postpone the Mogadishu Exercise for a further 10 days.”
”You’re very welcome General .I will make all of the arrangements with your Dept. and will complete everything for you early next week.”
Everything was completed in the new time frame.
The Tennis Match? Yes I played, and lost against my best tennis mate, Nigerian Consultant, Bart. He played in the Davis cup for Nigeria 28 years previously but still played a powerful relentless and mean game. Funny thing was, though ,that every time I saw him wind up to do a big serve I kept thinking that he was a Somalian and not a Nigerian and that we were playing in Mogadishu and not Jeddah!!
I slept like a pig in clover that night.
700 Saudi troops were flown to Mogadishu, 13 days later,fully, and appropriately immunised,and within six weeks I was in a First Class Saudi Airways Seat on my way home via Bangkok and Sydney. Whoopee!
I worked for four months at the King Khalid National Guard Hospital, as Deputy Chief of Primary Care and Accident and Emergency, from March 1994 to June 1994 inclusive. During that time I caught up with former Chief Dr Stanton Adair and many of my previous colleagues at the King Fahd Armed Forces Hospital.
KING KHALID NATIONAL GUARD HOSPITAL,JEDDAH MARCH-JUNE ‘94
This was another of Saudi Arabia’s auspicious Military Hospitals, situated 30 km from the Holy City of Mecca and 800 metres from the five -lanes (each way) Mecca Highway.
My four- month appointment, as Deputy Chief of Primary Care and A and E , coincided with the actual Haj (Pilgrimage).
Over two million Pilgrims travelled along the Highway, either walking, or crammed like sardines into whatever vehicle, in whatever condition, would give them a lift.
Our A and E Dept , situated virtually adjacent to the Highway, was, to say the least, at saturation point 24 hours a day.
We did not run an Ambulance retrieval service to travel along the immediate Highway . Injured Pilgrims tended to be scooped up, by whatever vehicle was passing, and dumped, for Triaging and treatment (if still alive), as close to A and E as possible.
I recall, late one night, a Toyota pick-up truck, off -loading ten dead Hajjes onto the floor of the Entrance. There had been another road crash!
After we confirmed that they were dead, Pilgrimage Police contacted the nearest Mecca Official. Within the hour they were identified, removed and processed by the Authorities. At least it demonstrated how efficient the Organisers were.
Since I left the Armed Forces Hospital, a concept of Saudization of the work Force had been introduced for all jobs. This was desirable and would increase the jobs, where Saudis would be preferentially employed, by an increasing percentage annually. Our only problem was with accommodation.
In previous years all overseas employees were housed in quality Compounds where there were no Saudi families. The Saudis, now occupied all of the best accommodation, and reported all acts that they deemed against Islamist beliefs. This meant no sunbathing, or baring of flesh or using the luxurious swimming pools. Everyone had to be quiet during Prayers, and hilarity of any kind was frowned upon and reported.
This resulted in much bilateral resentment, and reduced many overseas applicants, where an oversea applicant was the only suitably experienced and appropriate choice .
Salaries were slashed, because of post-war re- budgeting. I had to recruit “the cheapest doctors from third world countries.”
Nevertheless, when you’ve been in Saudi a number of times, you learn how to ride the punches, keep up your appearance and personal standards and look forward to the smile on your bank managers face when you return home to boost your bank balance.
TWO EVENTS .ONE SAD AND ONE HAPPY,ARE WORTHY OF RECALL.
Patrick, (not his real name) , was a skilled scientist from the UK.
He was highly respected, and was the only person in the National Guard Hospital Program who had had full training in a particular form of Pathology testing. He had worked hard, and loyally, to upgrade his Unit to International standards and, as an employee, was irreplaceable.
During the 1994 Haj to Mecca he decided to drive his car the 800 metres from the King Khalid Hospital towards the busy highway.
He was off duty, parked on a quiet overpass, overlooking the Highway, to watch the spectacle of Mecca Highway traffic.He took some photos,listened to some car cassette music and rested ”away from the Madding crowd.
”After he’d finished work,and before leaving his apartment, Patrick had had a couple of large glasses of illicitly brewed alcohol,which he’d been given the previous day by a friend in Jeddah.
His peace was shattered by the bells and whistles of a Saudi Police car who had been informed that an unknown person, in a car, was parked without lights on, at the overpass.
Any Saudi ‘Copper’ would consider this unusual, suspicious,dangerous and possibly the work of a terrorist,especially during the Haj period.
Patrick was not happy. After a few simple questions the Police smelled alcohol on Patrick’s breath, arrested him on a number of obvious offences and whisked him away to the Hospital Slammer.
That was not the end of Patrick’s troubles …just the beginning, in fact.
This was a rematch of the old game of Cultural Custom versus convenience and Patrick was the bounty!
His Dept backers and the Administrators made the usual, futile justification, argument trying to justify the inexcusable with the alternative of losing an irreplaceable employee.
Eventually there was a Mexican stand-off in which both sides could not decide on what necessary , bilateral face- saving punishment , should , or should not, be inflicted.
The Committee- in- Charge of the hearings, vacillated, and lent towards suggesting that he should take three weeks leave and go back to the UK, because he was obviously stressed-out, having been working so hard and then committing an ”out of character”, unfortunate, misdemeanour.
The unofficial hope of the Committee was that the whole frigging thing would be yesterday’s news and forgotten about in 3-4 weeks .
Patrick, loved his job, was loyal, and felt that, that was, in the circumstances, an OK solution, given the circumstances.
After three weeks Patrick, returned from his holiday, and arrangements were made to finalise, for administrative purposes, this whole sorry mess.
To employ another person, would have been, at a cost of, perhaps, $60,000. It would have meant months and months of a change- over period , even, in the unlikely event that another suitable applicant could or would be appointed.
So, here’s the deal ,make an immediate decision to scuttle the whole event!
The Committee met, looking unusually different from the previous vacillating one, and decided that the offence was punishable, in Shariah Law, by a Flogging through the Courts .
Patrick was horrified, I was horrified. It appeared that so was everyone else “who had skin in the game.”
There was no access to appeal. Patrick was advised that the punishment would be carried out after he had been given one hour’s notice on a day yet to be announced.
Patrick and I met, for tactical debriefings, on a number of occasions during the next few days. I promised him that, as soon as he was aware of the hour of his Flogging, I would immediately visit him, wherever he was, and inject him intramuscularly with an injection of 150 mg of Pethidine ( a powerful pain preventer and reliever) and that I would be there to retrieve him after the Flogging.
I kept my word. It has to be said that Saudi justice was seen to have been done, as per cultural requirements. It is unfortunate, but true.
Patrick, having understood, and accepted, the situation, elected to stay on, in his loyal job as a skilled and irreplaceable scientist.
He won the admiration, and the hearts and minds, of expatriates, across the Kingdom, as his story spread far and wide.
I REALLY DID MEET AND TALK WITH THE RECENTLY RETIRED CHIEF SAUDI EXECUTIONER, SA’ID bin Mabrouk-al Bishi.
Two years previously , I read, in the Arabic News, an article stating that SA’ID, the Chief Saudi Executioner (known also as the Hangman or Headsman), was retiring and, even, though he had a huge family ,no-one seemed keen on taking his job .
In his press interview, he stated that he had been very pleased with his performances and that it had been his duty to serve Islam in the last 23 years .He also implied that “If you do the Crime, you must serve your Time”….and that for crimes such as Murder, drug trafficking armed robbery, rape and apostasy were all punishable by death, either execution or shooting. He particularly stressed that he never beheaded women because it would have meant uncovering the head, and exposing the neck and some of their back, and that would be defiling Islam. Instead he shot them in the head with a pistol.
His eldest son, Abdullah Bin SA’id Al -Bis hi did, in fact , succeed his father in the job, in 1993, and, at the age of 60 years continues his duties.
MY ELEVENTH HOUR ARRIVED AND SO DID THE FORMER CHIEF EXECUTIONER, A HUGE SAUDI OF TURKISH ORIGIN.IT WAS 11PM.
He was carrying something ,in a thick blanket, under his arm. I was informally introduced to him , by my Interpreter. He smiled respectfully and pleasant……..not the sort of greeting an assassin would have chosen, I noted.
It soon became obvious that he was not hiding his Sulthan (Executioner’s sword) in the blanket , but was carrying his whimpering nine year old granddaughter Narnia . She was suffering from a raging fever, headaches, cough, painful joints ,unable to stand and very dehydrated.
Although an Influenza epidemic was rampaging through Saudi at the time, and it was possible that she was a victim of the virus, there was something rather atypical about her illness that made me think twice and reflect intuitively about other possible diagnoses.
She was so dehydrated, and generally ill, my colleague and I quickly assessed her overall condition and her vital signs… (+Temp, heart rate, respiratory rate, blood pressure, oxygen sats, blood glucose,liver function tests, throat, nasal and sputum samples, u’s and e’s ,and urine tests. We kept extra blood for various serological tests and to use for other less common haematological investigations should the need arise). We put in an iv line and appropriate re- hydration as well as measures to reduce her high fever.
It was only then that we could spend some precious time finding out the history of her current illness and obtain firmer details which might be relevant to it’s causation.
The clues started to emerge when her Grandfather told us,mainly through the Interpreter, that Narnia, had spent the last 3 weeks at an isolated family farm, some 50 km from Jeddah. There had been four other relatives there, one with a young baby, but nobody else had been unwell while she was there.
There were chickens and animals around the smallholding, including scruffy dogs,some goats and six camels. Saudi camels only have one hump. Officially they are, therefore, Dromedaries and are an important production livestock for nomadic populations. In Saudi Arabia camel meat is consumed and camel milk is available “on tap at the teat”.
Camel milk is usually unpasteurised in these small communities, and is only occasionally boiled to reduce possible bacterial contamination.After all, who wants to go through the hassle of boiling your milk supply when the temperature in the desert is 38-46 degrees Centigrade; certainly not your average laid back, poorly educated, Nomadic family.
SOUNDS LIKE THE DROMEDARIES COULD HAVE BEEN PART OF THE CAUSE OF NARNIA’S ILLNESS ?
Wherever camels exist across the World, except in Australia for some reason, there is a bacterial disease,called Brucellosis, which they can catch and which travels in the blood stream.It can cause recurrent abortions , infertility, and spinal and other bone problems for a camel..Usually the Camel may just seem a bit lame and tired . Occasionally the large tear glands around the eyes become inflamed and the camel produces huge amounts of tears and appears to be crying!
Public Health education and vaccination initiatives vary, from country to country, and regular vaccination of Camels to prevent this disease, is mandatory in the Camel Racing Industry and where important production of livestock occurs.
Clearly the smaller the holding,the less the public health rules are adhered to, and the greater the chances of spread of the disease.Any herd found with an infected camel, is quarantined initially and the infected one destroyed.
Some other animals,such as pigs, goats, sheep and cows, can get infected. Most country Vets are vaccinated routinely because of their close association with these animals.
HOW IS THIS CONNECTED TO NARNIA’S ILLNESS ?
Narnia admitted to regularly drinking unpasteurised milk, which, understandably, had not been boiled.
The Brucellosis bacteria were secreted into the Camel’s milk, passed into Narnia and spread through various areas,and organs of her body.The time from which she drank it and it caused her illness could have been anything from 5 to 50 days.These timelines would fit in with Narnia’s travels.
Some people get over a mild attack of Brucellosis without treatment, whilst others can get serious heart valve damage, chronic recurring fevers, long term fatigue, life- long lower back pain and lethargy.
There were a number of antibiotic treatments available which we could have given Narnia.
Many involved 6 to 8 weeks of combined oral antibiotics ( an unachievable, compliance goal, for her, I believe), or intramuscular injections of Streptomycin for 14-21 days ( this could have caused complete nerve deafness as an unusual side effect……and what about the daily pain?).
A new drug, Cephtriaxone, given in an intravenous drip twice a day, had had, possibly, the very best treatment outcome results in the early 1990’s .
Narnia’s former Chief Executioner, Granddad, agreed to her immediate and long term management plan and promised to follow up the problems with the camels at his relative’s small holding.
I mused as to whether he would take his Sulthan, in a blanket, under his arm, at a later date, to the farm,sharpen it up and re- enact his professional skills on the poor dromedaries (using only a pistol on the females, of course).
Narnia made a complete recovery, after a week of IV Ceftrioxone, and , on an inquiry from Australia to the A and E Dept, by me, six months later,was thriving, happy and living a normal life as a little Saudi girl.
Sadly, her Granddad, SA’lD bin Mabrouk -a Bishi had passed peacefully into his next world a few weeks previously.
That was my last trip to Saudi Arabia.
Many people had very different views as to their experiences when they were working in the Kingdom.
Things change ,over the years.I have found that intrinsic cultures and beliefs change very little,and as a result there is usually very little that you can do about it. Who is right or who is wrong? God only knows …if there really is a God!
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