Sunday, July 06, 2008

Alive and Well in Pakistan

Preparations for the workshop are going well. The flow charts for 5 STI syndromes have been made into posters. I have been working on the coffee table in the lobby because there is no space in my room.

There is a bit of a glitch though. The only information about the Ministry of Health STI syndromes used in Pakistan has been obtained from the reproductive manual. It doesn’t seem flow charts have been used much because the flow charts don’t flow well. Rather than a streamlined approach to the drug of choice for each syndrome, with alternatives for pregnant women or penicillin allergy, as is supposed to happen in the syndromic approach, there are ten different drugs suggested for urethral discharge.
This, I am advised, is b
ecause there are no drugs in the government basic health units so patients are given prescriptions which they take to the local pharmacy. So what the doctor prescribes depends what the pharmacy has. Oh, this is something that needs to be fixed. Frontier has done what the government should have done and purchased bulk drugs for their units. So I guess part of what we will be doing at the workshop is sorting out which drugs are currently being used. Not the best approach, but who knows?

We have decided, given the high incidence of Hepatitis B and C in the North West Frontier Province to include sessions on infection control as well as Hepatitis in the workshop. Dr. Wagma is going to assist us with some gender sensitivity. We worked out a format during her visit yesterday which will serve to emphasis the importance of gender issues in sexually transmitted diseases including HIV/AIDS.

There are several wonderful bookshops here in Islamabad. I noticed in one, a mammoth pile of Naomi Kline’s recent book, Shock Doctrine. I read a not very laudatory review, but gather that it would make eminent sense to educated Pakistanis. Naomi lives on the Sunshine Coast, or at least has a house there, which makes her a sort of neighbour of mine, I suppose, and it is a wonderful feeling to see a big pile of her books for sale here, on Canada Day if you please!

But my best find in the book shop was a book called Alive and Well in Pakistan by Ethan Casey. He includes a quote written by Joan Didion in the New York Review of Books on the anniversary of the attack on the World Trade Center. Her article is called Fixed Opinions or The Hinge of History. My bookclub just finished her book, The Year of Magical Thinking, when she mentions writing the article, but I haven’t seen the article. Here is Ethan Casey’s quote that has me wanting to read the whole article:

“repeated pieties that would come to seem in some ways as destructive as the event itself…The final allowable word on those who attacked us was to be that they were evildoers or wrongdoers, peculiar constructions which seem to suggest that those who used them were transmitting messages from some final authority…We have come in this country to tolerate many such fixed opinions, or national pieties each with its own baffles of invective and counterinvective, of euphemism and downright misstatement."

Lots of links and lots to think about. And some photos of various kinds of transportation in Pakistan, a couple by my friend Dale.

Photos: Decorated lorry, donkey being feed on roadside; QingQi driver with Kung Fu art; Ox with load.



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