Er, Doctor, would you wash your hands, please?

Global Handwashing Day was October 15, so, in keeping with the Southeast Asian time scheme, we celebrated it on October 21. Things are always a bit slower in this part of the world. Anyway, my health unit was asked to “participate” in a program sponsored by the consulate and our public affairs office. We were told there would be presentations to an audience of nursing students selected from various hospitals around the city.

The time was set for Friday morning and, since that is the time I routinely supervise vegetable sanitizing—not to mention that I don’t speak the local language—Mehroon, my Urdu-speaking colleague, volunteered to represent our office. We only heard about this event a week before it was scheduled and, three days before it was to happen, we were told the presentation—now singular—was us!

Mehroon and our computer-whiz administrative assistant put together an amazing PowerPoint presentation, complete with videos from Centers for Disease Control, to drive home the point that hands spread germs and germs make people ill. The presentation especially focused on hand washing prior to touching patients in the hospital and how microbes can be spread from one patient to the next by staff members who are not particular about hygiene.

Mehroon teaches proper handwashing technique.

Mehroon strongly encouraged the nursing students to remind family members, hospital staff and—gasp!— physicians to remember to wash hands or use hand sanitizer between patients. Evidently, there was a bit of worried discussion about the latter suggestion. Sure, it is reasonable to instruct families and other staff members might be amenable, but the physician? The students were absolutely sure that offering this suggestion to the physician would not be tolerated.

I’ve been in medicine for a long time, and I remember those days—not that they are completely gone—when physicians were at the top of the heap, and no one dared to suggest or question. Most of the docs I know now think that type of isolated existence is lonely and not very safe, and they welcome rapport with the health care team. It is a worthy concept, and I hope some of these nursing students take the dare and mention what they learned for Global Handwashing Day, maybe even to a physician.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Go fly, kite!

I grew up amongst seagulls; a noisy, messy bunch, but not at all threatening, even when they came in large groups searching for treats. Once I left Texas, I was largely removed from groups of flying critters, except for occasional swooping pigeons, but living overseas has changed all that.

In Africa, swarms of fruit bats filled the sky at dusk, darting in and out of the trees and, sometimes, flying so close to me as I walked I could hear the “swoosh” of their giant wings.

In Islamabad, we had crows. To discourage them from roosting, we hung fake owls in the trees—owls are evidently a natural enemy of crows—along with shiny strips of twirling metal. It didn’t work. The crows would foul the ground below the trees and make a terrible racket at both dawn and dusk. The worst was when they became infected with H1N5 (avian influenza). Dead birds, scattered by the dozens around the grounds of the embassy, caused a minor panic.

Karachi has kites, black kites to be exact. These large, rather intimidating birds soar and swoop in groups all day long, not unlike vultures waiting for carrion to appear.

Black kite

My apartment has a very nice balcony with some lovely teak furniture. It might be a nice place to sit and read a book. I say might because I will never know. The kites like to land on the balcony rail and sit on the arm of the teak chair, and they are aggressive. I got a good look at a kite perched outside my window, and that thick, curved beak and the menacing talons were enough for me. My balcony belongs to the kites. I will never venture there.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

It's just my southern hospitality!

If you have had even a passing interest in world news, you know that the United States and Pakistan are in an ongoing spat, and a number of issues this past year have caused dissatisfaction on both sides. This past week, the most recent political upheaval inspired a peaceful protest march to the U.S. consulate in Karachi. The consulate was informed there would be a protest of possibly a few hundred people, but that the protesters would not be allowed to actually reach the compound.

I should explain that the consulate in Karachi is in a self-contained compound surrounded by a high wall and is under tight security. Our office building, where all the work takes place, is about 150 yards from the residential building, where we all live. Between the two is a totally open area of sidewalks and palm trees but, since the wall is so high, it is impossible to look into the compound from the street. Or so I thought.

As I was leaving the consulate, one of the security officers cautioned me to go straight to the residence as the protesters had been allowed, in spite of what we had been told, to move up the street outside the compound and they were gathering right then. I moved on through the entrance and began my walk to the residence. I was about a third of the way when I heard the music and shouting. It wasn’t threatening shouting, and it wasn’t cheering. It was just lots of noise coming from the area outside the wall and, when I looked in that direction, I was absolutely shocked to see people—lots and lots of people—standing above the level of the wall.

So there I am in the middle of the otherwise deserted area between the two buildings, looking at these folks who are looking right back at me. Many of them were waving their arms, and it seemed to me they were waving at me. I didn’t feel threatened at all, but it certainly ran through my mind that this was a situation I had not anticipated and with which I was not completely comfortable. While I saw no indication of hostility, I also know it only takes one person with ill intent to turn a situation violent.

I quickly considered my options. I didn’t want to turn around, as that would put my back to the crowd. Instead, I did what every good southern woman from the United States would do in that situation. I smiled my biggest smile, waved at the crowd and kept moving forward to the residence, reaching it without incident.

Later, I learned that the crowd came with buses and people had climbed on top of the buses to see into the compound, thus giving me the impression they were standing above the wall. And the initial estimate of several hundred turned out to be several thousand, though that was not obvious from the numbers I saw levitating above the wall.

I have caught a lot of ribbing from my colleagues for waving at the protesters, and more than a few have suggested that the “waving” I perceived was, perhaps, less than friendly. I choose to remember my version of the event. It is the southern way.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.