Monday, July 31, 2006

Remembering Don

Recently I lost a wonderful mentor. In medicine when you lose a good mentor, you lose a great deal more. You lose a warm friend, a supportive colleague, a committed teacher and an inspiring leader. What begins as a somewhat distant professor and student relationship gradually modulates over time into a delicious blend of collegiality and friendship.

It comforts me somewhat to know that I am not alone in my sorrow. Like all great mentors, Don has many mentates, a word adapted from Kurt Vonnegut and science fiction to better describe the disciplineship involved in having a mentor.

I first met Don when he was head of the Janeway Hospital in St. John’s charged with establishing pediatric training in Newfoundland’s first medical school. He had come to the Janeway from Montreal with his wife, Liz, also a pediatrician. This wasn’t the first time they had undertaken such a challenge. With their five young children in tow, they had gone off to Nairobi for McGill University to help establish pediatric specialty training in Kenya ten years earlier.

At the time we met, I was the travelling doctor of the northern Labrador coast for Grenfell Health Services. Residing in the Inuit hamlet of Nain, the most northern settled community on the coast, I traveled back and forth from Nain to the other Inuit and Innu settlements staffed with nursing practitioners along the coast, Rigolet, Postville, Hopedale, Davis Inlet and Makkovik. Most of our pediatric referrals went to Goose Bay but occasionally when tertiary care was required a child would be sent to St. John’s, more than 1500 miles to the south.

On one visit to Davis Inlet, a tiny community of 250 Nascaupi normadic hunters still living on the land, the nurses and I resuscitated a dehydrated, convulsing nine month old infant and sent him on the long trip to St. John’s ICU. We called regularly for updates for the parents and ourselves. Then one day two Mounties (RCMP) in full uniform flew into the tiny hamlet to arrest the parents for child abuse. Luckily, as this was a rather unusual task at that time, they first dropped by the nursing station where the nurse recognized an enormous mistake had been made. The parents were well known to us, and not abusing the child.

The Mounties were sympathetic. They said they had other things that needed to be done on this visit to the coast, but while they could delay a little they could not ignore the instruction. Their order had come directly from the Department of Justice and even their bosses were unable to withdrawn it. This was something you will understand, that took a number of phone calls to ascertain.

We were frantic and not sure what to do. We were unable to find out who was on the Child Abuse team and calls to the doctors, ward and ICU failed to produce anything useful. Finally I contacted the head of the Janeway. By this time I was under a full head of steam. Dr. Hillman heard me out and asked a few pertinent questions. He seemed to appreciate what a miscarriage of justice this would be and how devastating in this small community. Then he asked, “What can I do?". I was so taken aback, I was, for a short minute, speechless. I had been hearing so many versions of, “It really isn’t my problem”, or “I think it is too late” that I was totally unprepared for someone who cared.

“ Well,” I said, much bolder than I actually felt, thinking we might as well go for bust, ” we need someone to phone the Minister of Justice and withdraw this order”.

“Done”, said Don, “anything else?”

Obviously a busy man, I thought, so better get it all in now.

“Well, that Child Abuse team needs an overhaul.” I said. “They didn’t even contact us and our numbers and names are in the kid’s chart. “

“That might take a bit longer,” he said, “but I agree.”

Don was like that, decisive and willing to take responsibility. He was also a master at sorting the fluff from the seeds, seeing through the histrionics to the wound. He had time to listen to an inarticulate cry from the wilderness and to really get the full impact of the story behind it. This combination was decidedly unusual in tertiary care centers, which, at that time, had a remarkable lack of interest in their more remote service areas. He had done the right thing and I was grateful. I didn’t give it much further thought.

A couple of months later, I needed a supervisor for my community medicine residency. It had to be someone in Newfoundland with a fellowship. My main supervisor suggested Liz Hillman, whom he had met at the Medical Council. Liz willingly agreed and a six week spell in St. John’s was organized in ambulatory pediatrics for me. No mention was made of the Mountie Episode, as I came to call it. I assumed Don had not made the connection that I was the irrate doctor on the coast.

Don had a way of taking in much more than any narrow view of his specialty or corner of the world would dictate. It wasn’t long before he decided since there was no community medicine grand rounds for me that I ought to come to his Pediatric rounds, to get in some critical thinking. He was a pediatric endocrinologist and really grilled his residents, but he made an effort to direct my way challenging community questions that added to the rounds and also sent me scurrying to the books. He challenged all of us to provide solid evidence and to support our points. He wanted us to see the whole picture and the connections. It was no surprise to me to find his residents scored near the top, even though the program was a new one.

Don’s greatest success was not however in pediatric endocrinology, despite his academic excellence, but in international health. With Liz, he created a world wide linkage of medical education projects and people over the years. In his so-called retirement he continued to lead problem based learning workshops for students in Ottawa and McMaster and built up the international health program in Ottawa. He was working with Liz on a project to document some of the medical education successes in East Africa for the Royal College of Physicians and Surgeons of Canada when he died.

I did one of those mapping exercises of my connections and jobs in international health and found that almost all of them link in one way or other back to Liz and Don. Others too have been influenced greatly by them over the years. One of the first online guest books I have seen is attached to Don’s obituary. It has attracted comments from Uganda, Kenya, Pakistan, China, Malaysia, US and Canada. The guest book allows those of us who have known and worked with Don to acknowledge our global connectedness and caring, and indeed our common medical origins. This appreciation of our global connectedness in medicine was one of Don's great gifts to us and is surely a much needed antidote for the alienation so many in the world feel today.

A year ago, I needed a dose of Don and Liz's optimism and enthusiasm for global health. We had a chance to link up while they were being entertained as WWII veterans in the Netherlands and I was visiting friends in The Hague. I turned up in the lobby of an overbooked hotel in Appledorn and soon was bedded down in a pullout couch in their room. Don’s army buddy, a retired judge, had kept a diary of all the places they had traversed in Holland during the war, so the following day, a young Dutch family who had adopted Liz and Don, escorted the whole group of us around to the various sites. Don and Liz had this wonderful knack of making friends everywhere they went. And once again, as was so often the case, the whole time I was with them, supposedly on holiday, we were reviewing articles, plotting projects and exchanging connections.

Just last November, when Don was 80, he and Liz joined me in East Africa to teach pediatric residents and students and to provide feedback on student inclusion in a child health project. He and Liz set off for a long bus ride to Gulu in the war-torn north of Uganda with several potential projects in their pocket for an isolated hospital there. Just one month before he died, we received word that a Pakistani project we had prepared at the request of an NGO working in North West Frontier Province had been funded for two years.

I had a dream the other night that he hadn’t really died. I believe my dreams are the real, unvarnished truth, the gold as Marion Woodman says. This dream was so real I woke up thinking I had made a big, Mark Twain type of mistake, as in "the stories of my death have been greatly exaggerated". Then I recognized the gold. One can’t lose a mentor, it is a gift that never ends. I will always have access to him over my shoulder. Just writing up the story of how we met, I can hear him laughing, "Whose version do you want to hear?".

His gift of mentoring will continue to manifest though his wife, Liz. Then, too, its pretty hard to be sad about such a productive, fruitful, wonderful more than 60 years of medical service.

Photos: Don and Liz receive the Order of Canada; Don & Liz at the 60th celebrations of VE day in Holland and Don & Liz in a dugout canoe, Lake Bunyonyi, Uganda.


Saturday, July 29, 2006

River Cruise

The department had a brilliant idea this year and arranged a river cruise for our annual party with families. A river cruise includes a meal, a tour up and down the river as well as a cultural show.

Kuching is described as "without a doubt the most pleasant and interesting city in Borneo and one of the most attractive cities in South East Asia" by the Lonely Planet. This I can attest to. The river cruise is one of the many day attractions available.

The South Bank is now a destination on its own with a Chinese pagoda, towering palm trees, playgrounds for children, green spaces and ornate light posts along the harbour. The walk along the harbour has been paved and landscaped to provide a lively promenade at the water edge right in the center of the city.
We stroll over to the pier from our hotel where we will be staying overnight.

The river boat sets off in the early evening from the south bank of the Sungai Sarawak River. We have the whole lower deck to ourselves where we are provided with a sumptuous buffet dinner of crab, prawn, fish and chicken accompanied by spicy fiddleheads, okra and bitter gourd. There seems to be plenty of variety to satisfy the children as well as the gourmets in our group. The dinner is followed by huge platters of fresh pineapple, musk melon, winter melon, mangoapples and rambutan.

Speeches are given, departmental roles passed on, gifts bestowed and farewells are made to those leaving. A beloved professor, who has been instrumental in setting up the medical school as well as the department and in establishing the Master's program in Public Health is leaving so there is a mood of appreciation as well as of loss. After the meal we join others on the upper deck of the cruise ship to watch the river sights as we move slowly downstream and then up.

The original government house of James Brooke, called the Istana, on the north shore can be seen etched against the sky. The single remaining building of Fort Marguerita sits straight and proud on the south bank. Further downriver the magestic golden tops of the green and white minarets of the riverside mosque towers above the bank.

Tampangs, local river taxis ply back and forth on the river. You can take one of the regular commuter tampangs across, in fact many people commute that way, for 30 sens (about 0.10 USD). It is undoubtedly among the cheapest water transport in the world. We have done it just for the boat ride. It costs slighty more to make a short tour of the harbour but again is well worth it.

Boats of different sizes, shapes and purposes are tied up along the river. There is activity at the Brooke Dockworks.
As we head upriver we reach the Prime Ministers home almost at the mouth. This is where we turn around.

Later as darkness falls we are treated to a cultural display with Iban, Malay and Bidayuh dances. The dancers are very good at getting audience participation and have most of the group up and moving at some time in the night.

We return to the dock late but with the South bank so well lighted we feel secure walking home.
Most of our group spend the rest of the night shopping.

Malaysians hold some kind of record for recreational shopping even in South East Asia and my friends are no exceptions. Amazingly according to polsters, 15% of Malaysians spend time in recreational shopping or maybe it is that Malaysians spend 15% of their time recreational shopping? Recreational shopping is shopping without intent to buy. The malls of course have responded to this and are full of things to do and see.

When I ask my colleagues what they did at the shopping mall, they say they contributed to the recreational shopping statistic as they met up with all the others in the group. Of course shopping malls are air conditioned so that may account for part of the attraction. But whether you want to shop recreationally or not, Kuching has one fine river cruise waiting for you.

Photos: Promenade on South Bank; tampangs; mosque; cultural show and sunset over PM's house.


Tuesday, July 25, 2006

Longhouse Visit near Bintangor

About 50 miles east of Kuching, longhouses begin to appear. Most are located along rivers, some visible from the road. In the forest the longhouses are perched atop long pole stilts high above the rainforest floor. They are an example of linked cooperative housing that has been around for ages. Hand hewn long boats that hold as many as 60 men are collected on the river below the longhouse with paths leading up the bank. The long boats are almost unchanged in appearance from the war boats that established the Sea Dyaks as fierce pirates of the South China Sea. Young Iban men still race them, a wondrous sight of 80 synchronized paddles flashing as they fly across Kuching harbour.

The distinctive feature of a longhouse is the communal area, a long, tall, covered area opposite the doors, that extends the length of the longhouse. The communal area has a floor of hand-sawn, dark, wide planks from the rainforest smoothed and polished by the passage of many feet. I can’t imagine the effort required to do the work by hand. And it has created a floor that actively responds to your barefooted crossing. The ceilings are high and with the many large windows ensure Borneo breezes can move through.

When I first heard students talk about doors, I thought I had misunderstood or that they were talking in Malay and it just sounded like English, or any of the numerous assumptions one makes when confused. This happens fairly frequently here with the constant switching between English, Chinese, Bahasa Malay and Burmese that surrounds me. Finally after it has gone on for a while, as in, "How many doors? Is that all the doors? Are there any doors on the other side", I inquire, “Why are we talking about doors?” This was before I had actually been inside a longhouse. I like to think the penny would have dropped if I had visited a longhouse before we had started to design survey questions for people living in one, but that may be wishful thinking. There is a shocked silence as if I have really this time confirmed how ignorant Europeans are, then a gentle, tinkling giggling that swells into rolling-on-the-floor laughter until someone gasps out, "Behind each door is a household” as a translation for me.

This longhouse near Bintangor has 114 doors. The walls of the longhouse are panelled in the same dark woods of the rainforest as are the floors. All of the work was done by those who live here with materials drawn from their world. The walls are unadorned so their beauty catches you full force when you first enter. Hilton has built a longhouse Hotel at Batang Ai which most guests reach by helicopter from Kuching. Miraculously, although the communal areas lack the people and easy camaraderie of the Iban porches, the architect has managed to replicate that same powerful sense of the longhouse.

People of course are many in a longhouse, especially little people, with approximately 15% of the population under five. The layout of the longhouse makes it possible to easily care for groups of children and engage them early in the tasks of the longhouse. During the day nets are patched, rattan mats woven, baskets created and cloth woven in the covered communal spaces often surrounded by small children. Parallel to the roofed part of longhouses there is an floor extension made of poles and covered with rattan mats, that is only partly covered. Tasks such as winnowing, drying, sorting and processing crops are done on here on the porch with children underfoot.

Today the 4th year students who have been working in this longhouse are having a celebration with some health education thrown in and the longhouse is decked out. This longhouse has two sections facing each other and is set closer to the ground than most. The display is set up in one side while the food and entertainment is on the other side. A decked out longhouse has its pua kumbu displayed. Pua kumbu are the woven art of the Iban, a textile which is well known amongst textile connoisseurs and museums because of the exquisite and intricate patterns created using the warp-ikat technique. Ikat hand woven blankets are the high art of the Iban. At present there are weavers in only a few longhouses but more young women are learning.

Pua kumbu are made of two parallel strips of cloth woven on a backstrap loom and then sewn together in the middle. Shorter sections of cloth are used for women’s skirts and made into vests and shirts for the men. This style of ikat is found throughout Southeast Asia in the sophisticated cultures of Laos, Burma, Cambodia and Thailand as well as in China and Japan. The version found in Borneo uses natural dyes of creamy red brown, chocolate brown, black, burnished red and ochre with designs that are not only finely geometric but that depict the animals and events of their lives. Pua kumbu are vibrant with crocodiles, people, spirits and birds as well as the decorative images found elsewhere. It is amazing that such an art survived in Borneo and astounding that it flourished.

Pua kumbus play an important part in the rituals and culture of the Iban whose oral culture goes back at least 40 generations. The pua kumbu are historical documents that captured spectacular feats, celebrate history and delight the eye. They pulsate with liveliness. The rest of the world is only now discovering pua kumbus. The cost of smaller pieces has increased four or five times over four years, with some of the older finer examples selling for thousands of dollars.

I am absorbed by the beautiful collection of pua kumbus owned by this longhouse. An elder
watches me taking close-ups of them all and smiles. He has a gentle, engaging face. I greet him and he suggests through an interpreter that I take pictures of his tattoos, positioning himself so more of them can be seen. There now are few people under 40 years old with tattoos. He is, they inform me, over 80 and the tattoos attest to an active life as a warrior. I wonder where he was during the Japanese occupation of the war and what stories he could tell. I hope there is some program where the young people are collecting the stories of the elders here, but when I inquire, no one seems to know.

The longhouse we are visiting is progressive and has a female chief. We are invited into the living quarters. Behind the doors, the individual homes contain sleeping and cooking spaces. Ancient enamelled Chinese pots hold quantities of rice, stacks of rattan mats lean against the wall, babies are lulled to sleep in swinging hammocks as do the Cree Indians in the north and baskets and knives are suspended from the wall ready for use.

We are treated to an orchestra of brass gongs and women dancing in their filigree silver headdresses with long languid hand movements. It’s a whole new world for me and I am grateful to see it as it is now.

Photos: Longhouse with drying mats outside; longboats tied up on the river side; communal porch; kitchen wall; babe in hammock, pua kumbus, pua kumba with overlay showing how warp threads are tied; elder with tattoos; Iban dancer.


Thursday, July 20, 2006

Across the Rajang River

Some wonderful travel books about Borneo have helped make it into an exotic destination. Redmond O’Hanlon headed Into the Heart of Borneo while Eric Hansen was the Stranger in the Forest. Michael Crichton’s Travels, includes Borneo in his tales of out-of-the-way places. The mighty Rajang river is the usual route taken, guides are procured and life-threatening adventures ensue. Quantities of tuak, a local homebrew, are consumed in long houses along route and wild parties continue through the night. Hospitality upriver is legendary but not always what gets classified as family entertainment. But the tourist industry is nothing if not remarkably adaptive and when I was in the local tourist office purchasing tickets for the Rainforest World Music Festival there were several families booking trips up the Rajang River.

I have been rereading the books so I know that real adventures in these parts set off from the Sibu wharf in Kuching, head down the Sarawak river to the South China Sea and then turn east for 5 or 6 hours until they reach the mouth of the Rajang river. The Rajang is a busy water channel in a way that most of our rivers are no longer. It has ocean going ships as well as tugs, fishing boats, Chinese river launches and log filled barges.
Sibu is the premier port on the Rajang, and lies a couple of hours in from the mouth. One of the early Chinese trading centers and settlements, it is a modern bustling port. Locals refer to it as a cowboy town by which they mean, I think, that there is a certain kind of Wild West lawlessness that is common to harbours around the world. It has the best selection of DVDs I have seen, most of them from China, as well as a lovely waterside park and a bustling harbour.

I am flying in for an overnight visit. The harbour and river remain the hub of Sibu. Malay houses perch serenely on tall stilts over the banks, their curtains flapping in the breeze. Water taxis ply their trade along the river edge. Hanging orchid gardens are suspended from windows, sheltered from excessive sun by black net.

In the 4th year of the five year medical course, students do three months of field work. As a group they meet and discuss health concerns with a rural community to arrive at a topic of study. The communities are very keen to have the students so efforts are made to go to different areas. The WHO directive of “No survey without service“ is taken seriously and towards the end of the community stay not only do students report to the community on their findings but some intervention, usually health education, is undertaken. The students will be staying in a village outside Sarekei, which is further inland across a couple of rivers.

There are approximately 80 students in each class with 10-20 per group. Staff from the school stay with the students in the field, so the movement and organization of such placements are massive undertakings. In this area, medical education in the developing world is ahead of the rest of the world in connecting with the community in a meaningful way.

A brand new bridge takes us across the Rajang. I miss the forty minute ferry that used to be required with vendors at both ends who sold guava slices coated in spices, ice cream and hot snacks. There is a rhythm about working ferries that adds to a river. The loading and unloading of trucks, motorbikes and vehicles, the sweep of ferries past each other midstream and the swing of their extended front lip over the concrete loading platform on each side.

We drive for an hour, the roadsides edged with wild bamboo orchids, to reach Sarikei, where two small ferries maneuver back and forth in a slow dance to deliver us right into the heart of Sarikei.

We meet up with the students in the divisional headquarters after they have visited the village. They have prepared a knowledge, attitudes and practices (KAP) survey on hypertension. Our students speak Bahasa Malay, but they have found that they don’t understand the dialect in this village all that well. Field work provides an invigorating dose of reality and is an eye-opener on many levels.

The acting in charge, a medical assistant, gives us an overview of the health in his region. A map showing the health units is prominently displayed on the wall. The area covered is extensive, settlements are small and scattered and the whole area crisscrossed by rivers but few roads. The single, new hospital in Sarikei serves a huge hinterland.

I caution my students when looking at the facts to be alert to the "factoids". "Factoids", by my definition, are facts with a charge, usually an emotional one. The "factoid" that jumps out at me from all the statistics presented about this division is that although 24 posts have been assigned for physicians, only 4 have been filled and none of the physicians are on site.

The concentration of physicians in urban areas is a serious problem everywhere but it serves as another reminder of why we are here and why this program is so crucial. As we leave, the district nurse reminds the students that they are going to need their bednets and a plan to ensure a safe water supply. It is one thing to know something, it is quite another to actually have to deal with it yourself.

Back in Sibu, river taxis move people and things from one site to another. Long boats are clustered at various spots along the bank. What Sibu doesn’t seem to have is many container boats. Boats on the Rajang appear to be loaded and unloaded by heavily laden men moving steadily up and down the sloping planks between the deck and the dock. We watch a Chinese craft unload huge creamy slabs, the men tramping up the gangplank to heave them in the back of a waiting truck. I take pictures not really knowing what I am looking at. Later my colleagues tell me the slabs are latex which has been treated with formic acid to produce large sheets which are then folded over on themselves.

The price of rubber on the world market has recently gone up, a situation that has generated much interest here and talk of new plantations. I’m not sure what is driving this demand but one is aware here of how dependent on primary extraction industries, developing countries are. Indeed they seem to be the only ones still producing basics such as sugar, cotton, coffee, rubber, jute, etc. So I can’t help hoping that we continue to require such products.
While the push right now in Malaysia is to produce more doctors, I think as I head home that if Western experience is any guide, such measures are not anywhere near the whole answer. What we probably should be focusing on now is how to best support, equip and prepare those health workers who stay in rural areas to better do their work, both here and in North America.

Photos: Sibu Chinese park, Malay home onstilts, suspended orchid garden, ferry in Sarekei, bamboo orchids by roadside, new Sarekei hospital, offloading latex slabs, and latex slabs in back of truck


Saturday, July 15, 2006

The White Rajahs of Sarawak

I was asked to do a three hour session with the First Year class. Simple stuff, such as What is Health?, Doctors and Healers and Incidence and Prevalence. The students are in their second week, young and fresh, the majority of them from Sarawak, a mix of Chinese, Malay, Iban, Bidiyuh, Indian and Melanau. I wanted to inspire and motivate them so spent some time collecting examples and illustrations. Compelling examples of traditional medicine and some home truths about the road ahead.were needed. I included the Code of Muslim Physician as well as the Hippocratic Oath and pointed out their similarities.

It's been a while since I had read the Oath through and I had forgotten how many gods and goddesses are invoked on our behalf. It doesn't feel as if they were in my corner today. The medical curriculum is problem based, which for most of the students is a big change from the rote learning of their earlier schooling. I used a short case study, questions, examples and buzz groups to try to make the learning more interactive, but it didn't feel like it really hummed. Competent and comprehensive maybe but not inspiring. Maybe partly to do with three hours in one stretch. So I am feeling depleted and will save my story about the trip to Sibu and respond now to the "Where is that place, I can't find it?" requests from some of you.

Borneo, lying in the South China Sea, is the third largest island in the world, coming after Greenland and Papua New Guinea. The island, covered with lush tropical rainforest, straddles the equator. A backbone of high mountains separates the northern and southern portions of the island and results in a number of fast flowing rivers that descend to the coast. The rivers have provided access to the interior in the past and in the present. Logging is still done selectively, but has helped to open up the interior.

The southern part of Borneo, much the larger, is called Kelamantan, and belongs to Indonesia. The northern portion of Borneo, consisting of Sarawak and Sabah was known as British Borneo before it became part of Malaysia following WWII.

The first white Rajah, James Brooke, was born in India, his father a judge for the East India Company. James set off in 1839 in a schooner from Singapore to explore what was called then the East Indies. He was asked by some Singapore traders to deliver a present to the heir of the Sultan of Brunei, who had assisted with a group of ship-wrecked British soldiers. At that time, Brunei, a tiny sultanate lying between Sabah and Sarawak, was having trouble controlling and taxing the coastal regions of Borneo due to an increase in marauding groups Sea Dayak pirates and disaffected Malay chiefs. The warlike Sea Dayaks were said to be content with collecting heads, leaving the plunder to the Malays.

On meeting James Brooke, the Sultan’s heir, Rajah Muda Hasim, offered to make him a Governor of the area around Kuching, in return for assistance in quelling the revolt. James set about the task with vigor and managed to crush much of the revolt. Two years later the Sultan of Brunei confirmed the original offer “in perpetuity” in return for an annual tribute. From the original, tiny toehold around Kuching that James acquired in 1839, the land holdings of what came to be called the White Rajahs, were increased every ten years or so until it encompassed most of what is now Sarawak.

When James Brooke arrived in Borneo, a number of the groups of Sea Dayaks such as the Iban and the Land Dayaks, which include Bidayuh, Kenyah, Kayan and others, were head hunters. The White Rajahs ruled for about 100 years. James was followed by his nephew, Charles who ruled for 49 years before his son Vyner took over. This Boy’s Own dynasty of white potentates ended when Charles’s son Vyner fled to Sydney on the arrival of the Japanese in WWII. Following the war, Sarawak along with Sabah became part of Malaysia.

On and off throughout their rule, the White Rajahs attempted to convince Britian to accept Sarawak as a colony. The biographies of the Ranees, as the wives of the Rajahs called themselves, document their concern with their precarious position at court.

The methods used by the White Rajahs to control and govern the territory were quite violent and the battles many. When they arrived many of the groups of Sea and Land Dayaks were headhunting hunters and foragers. By the end of their reign the original people of Borneo were poised for the 20th century with much of their culture and pride intact. How much of this was due to their influence is debatable.
While Sarawak is now part of Malaysia, there remains a spirit of independence about the place. On entering Sarawak from mainland Malaysia one is still required to show a passport and obtain a visa, as separate immigration is maintained. Even the past history of head hunting is not shrouded in secrecy or guilt. Some older longhouses continue to have a display of skulls suspended from the rafters from the days when it was part of warfare and a way of honouring your foe.

I am having trouble putting captions on photos. I have placed a drawing of skulls, a not very clear photo of same, maps of South China Sea and Sarawak, drawings of James Brooke, a Penan and Iban warrior as well as a photo of a Penan male. The drawings are from tourist brochures.


Wednesday, July 12, 2006

Gawai in a Bidayuh Village

I wasn’t quite 10 when I bought my first book. The year I was ten, my mother died, so my childhood easily separates into when my mother was there and when my mother was no longer there. I could have been 8 or 9 years old. There was a table in the Shop Easy store at the corner of St. Mary's and St. Anne's Rd covered with paperbacks. I found a small purple book called The White Rajahs of Sarawak with a picture on the front of one of the White Rajahs. Inside were even more sepia pictures of Land and Sea Dayaks in the rainforest and rivers of Borneo. It was well worth the 14 cents I paid for it even though it represented more than half of my weekly allowance.

Travel stories often start with such personal anecdotes. Bruce Chatwin starts In Patagonia with a story about a piece of prehistoric hide. Eric Hansen, who wrote Stranger In the Forest about his travels across Borneo, tells about stalking his mother's tea party with a bamboo spear. It might be a literary convention but it seems to me a means by which we seek to make sense of our lives. There might be other reasons why I am in Sarawak, but then again there might not.

I have arrived back for the second year to teach for three months in the MPH program at the University of Malaysia in Sarawak or UNIMAS as it is called. It is the start of the new university year. Last year's students are finishing off their exams. I teach epidemiology and management. Luckily it being my second year I have most of my sessions already made up into powerpoint presentations.

Shortly after I arrived in early June, the annual celebration of Gawai was held. Gawai means harvest so it's similar to Thanksgiving, especially for the Iban and Bidayuh groups which constitute the majority. We were invited by a Bidayuh friend, Rose, to visit her village. We were feted to speads of exotic sweets, sticky, coconut rice steamed in long stems of bamboo, and many special delicacies all laid out on rattan mats in her father’s home, her younger sister’s home and several of her cousins’ homes. While we were in each home, large family groups would arrive to visit and eat. Everyone was glad to see Rose who is pursuing her Phd. in Kuala Lumpur and was home for the holidays. We could hardly move through the tightly packed Bidayuh villages, they were so congested with cars coming and going. The visiting that takes place reminds me of the Open Houses of Christmas Eve when I was a kid. Wonderful eating, great parties and much socializing.

We lamented with Rose's Dad, the loss of his Padi (rice) house, mostly because it had a beautiful Bidayuh log staircase cut from a single log. Luckily I had taken a picture last year which I was able to share with them. In one of her cousin's home there was a stack of pepper bags from their own trees stored in the corner. The parents both hold jobs and do their farming in the evening when they get home. Pepper is one of the cash crops of Sarawak.

Many Bidayuh have plots of land around or beside their house. A few Bidayuh still live in long houses but most now live in separated houses in villages. Unlike the Malay in the rest of Malaysia, the Bidayuh are mainly Christian. Many, like Rose's family, are very devout. The Bidayuh are one of the ethnic groups that were called Land Dayaks and were favoured by the Rajahs. Most of them speak English and /or Malay partly because the numerous dialects make communication between the various subgroups difficult.

After a hectic day of feasting we staggered home full of good will and even better food. Sticky rice is the real treat and Rose's sisters had prepared a number of bamboo tubes of coconut flavoured sticky rice for us to take home.

Then the next day we drove to the white beach in Santubong, the only beach worth the name near Kuching according to the Lonely Planet. Being Gawai, it was crowded and overbooked so we completed a 250 km. drive to find an excellent seafood restaurant on the Sarawak River closer to home.

My Burmese friend Aye has collected more Bidayuh baskets since my last visit. Baskets in Sarawak are so exquisite it is hard not to collect. I'll add some pictures of Bidayuh baskets, a pepper tree, food laid out on rattan mats, log staircase and padi house.


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