Kolkata: Durga puja and a leprosy trial Oct 2012

City celebrates Durga and we do our leprosy sums

My next stop was Kolkata, this city has managed to avoid India’s dash to modernity. The place is full of crumbling buildings and the stately Ambassador car tootles around the streets.  The architecture is a treat with many interesting 19 century buildings but this does not compensate for the obvious poverty. I also find the sight of rickshaw pulled by men offensive to human dignity.

Durga Puja is Kolkata’s big festival, many people would flee the city but I had arranged a review meeting of one of our leprosy studies so glimpsed the city festivities. Durga Puja lasts for 10 days and is when Durga renews her energy and defeats the evil in the world, bringing her female shakti energy. The festival happens around the temples and now these are covered in LED lights and each temple has its own flashing images, Ganesh or arjun. The temples also compete over designs and there are competitions between the temples with even sections for the most ecological temple. People are out all night at the temples and the police set up elaborate crowd control giving 2/3 road over to pedestrians. I found a list of nine things to do in Puja which included dancing, eating, catching up with friends, surrounding oneself with lights and wearing bling, sadly i had left my bling at home in London.

Instead of being out dancing all night in the temples we sat by day in a deserted leprosy hospital and toiled over the trial report. This is a big study involving 350 leprosy patients and we have added a new immune-suppressant drug to their treatment. As we have done the trials so people’s different strengths have emerged; Sundar Rao may be 78 and retired but he still has a very sharp statistical brain and keeps us on track.  Joydeepa is an enthusiastic clinician in West Bengal who skilfully enrolled and encouraged patients.  We also discovered that our young Tamilian physiotherapist has a great facility with data sets and understands what has happened to all the participants better than anyone else.  Disappointingly our treatment does not improve outcomes for leprosy patients with reactions.   Many trials do not have positive results and these results are just as important to generate to prevent people receiving useless treatments. But the intellectual satisfaction of having done a study properly does not compensate for the wish to find an improved treatment. 

Jan 2012

India: Sun Oct 21st

Maybe it is not surprising that there is a link between Wales and the Ghasi hills. The Welsh Presbyterian church git here in the 1800s, one Thomas Jones is much revered and had huge success with converting the population. We walked down to the village people were going to church looking serious and carrying black bibles. In the village of 250 souls there  were at least 5 welsh Presbyterian churches in varying degrees of plainness. Welsh hymns floated across the air. The house even looked Welsh with corrugated iron roofs. The gardens were lush with huge red flowers and lush vegetable patches, it felt like the end of a nice UK summer. WE walked down to viewpoint where one looked out over the cliffs and we saw the river winding through the forest and tiny villages deep in the forest.

On our journey back to Shillong i noticed how there was a gravel factory every 200 yards. The local people are busy excavating the whole mountain side and converting it into gravel for construction. It is a real eye sore. This is not regulated because the government doe s not own the land. It seemed a deep contradiction to the preservation of the forest. Mining also happens on a similarly haphazard way.

Back in Shillong we met up with Sandra’s and her family and had supper with Pat, the editor of The Shillong Times. She was a campaigner and seemed to have fast access to everyone in government.  

India: Sat Oct 20th

 Today we trekked out to see the living root bridges, a natural highlight of the area and a traditional way of using the forest resources. The sun was shining, despite Cheerapunjee being the wettest place on earth because the monsoon clods drop their rain when they reach the low mountains here. The jungle is so alive, the noise of crickets is earsplitting, huge butterflies flapped around black, yellow, brown and huge spiders guarded their webs. As we started out and we could see the waterfalls unlike yesterday. We walked down to a village and then trekked down through the forest walking on a set of about 2000 concrete steps, put in by the government with a plaque detailing the labour costs. People were coming up to market boys carrying small birds in bamboo cages. The forest was thick with a variety of trees, unfortunately our Ghasi gude was not familiar with the trees, when i asked him about the trees types he airly said “Jungle trees”! The root bridges were beautiful natural structures with thick roots growing out to the base and thinner roots forming the support pieces. They felt very strong and natural, unlike the wire bridges which we also crossed which felt fragile. The roots bridges take about 20 years to grow and last about 200. WE paused at villages in the forest, people had few possessions but we did see a school house. We had a refreshing swim in the cold blue mountain water. Then we had a hours climb up old stone steps to the top of a ridge, few people came along this path, our guide said he had last done this long walk a year ago. We got back to the village in time to have tea and enjoy the view down the steep cliffs to the Bangladesh plain with rivers. Omer was v keen to get back to Cheerapunjee for sun set and so we sped back up the hill and were just in time for the sunset and a rest.

India: Fri Oct 19th

Omer and I spent three hours in the Don Bosco museum in Shillong. This is a wonderful new museum spread out over 10 floors which describes life and traditions in the NE. There are galleries on fishing, hunting, crafts and religion. I had not appreciated that one could fish with bamboo in so many different ways. Because the museum had been built by the Jesuits there was a whole gallery devoted to 20 centuries of Christianity, In the topography section the Jesuit missions were located. There was also a fine installation piece by Dutch artists on the cultural DNA of the region. At the very top a steel frame skywalk  looped round the roof with 360 degree views of Shillong. It was not raining so we enjoyed the view. The city is spread over several hills and there are trees everywhere. There also films of local dances including a yak dance which reminded me of the Yaks i saw in Tibet last year. This area also feels close to Tibet and there is an Indo-Tibetan police force in Shillong. We then drove 2 hours to Cheerapunjee which is on the border with Bangladesh.. About half way we crossed into a deep valley withe the sides covered with dense forest. We crossed over to a huge waterfall which we only glimpsed through swirling  cloud. W.e reached cheerapunjee in time to see a beautiful sunset with the sun dipping down through purple clouds. This was Omer’s first mountain sunset.

India Thurs Oct 18th

Sandra, like me, packs her days full. So today we had a crash course in Ghasi culture and beliefs. We started off spending an hour wandering through a sacred forest. This is an area kept untouched by the tribes and has trees, medicinal plants and pure water there. We wandered in and along a narrow path, orchids bloomed, birds were flitting around. The sunshine filtered through the trees on to the stream. A fine quiet place. We then headed back to shilling, pausing for tea and rice cakes with green paste in a tiny tea shop where the woman had the brightest shining pans. In Shillong we stopped to look at the Martin Luther University, where Sandra’s husband Glen’s is vice chancellor. He has had the drab conctere exterior decorated by local artists.We then headed to Sandra’s office. She has reclaimed a tiny space in the dept of health. The adjacent rooms were packed from floor to ceiling with boxes of malaria tabs, Falciparum malaria is a big problem here. She and the central planners in Delhi have big plans to create  a Shillong Indian Insitute of Public health. A site has been identified on the edge of town and 21 acres fenced off. Right now it has pine trees and birds were flitting around. I wonder what building will come up here.  In the evening Omer and i walked down to the bazaar for supper. People were out buying presents for the upcoming Durga Puuja and Omer said it reminded him of sudan just before thier Eid celebration  

Blog from North East india Oct 2012

This series of blogs will come from a work trip to India. I have a busy programme with a visit to Sandra Albert, DrPH student in Shillong, NE India, Then a meeting Kolkata to review the results of a trial that we have done trying to improve the treatment of leprosy reactions. Then i have four days in Mumbai reviewing the work of Omer, a Sudanese PhD student who is working on neuropathic pain. Ideally i would have visited these sites in reverse order because the visit to NE India is the lightest of the trips and is shall be having a weekend in a nature reserve at the wettest place on earth. But holidays and other peoples availability meant that I shall start in North East India. This is a huge area which borders Nepal, Bhutan, Tibet and Myanmar. It is very wet because it has a heavy monsoon which is dropped on the land when the clods meet the mountains there.  It is also distinctive in not having the caste system, instead people belong to tribes. They are also mainly Chrisitian and they feel a long way from Delhi.

Wed  Oct 17^th

On my flight from London  i sat next to a young Indian woman who had her pilots licence and had lived in Shillong for  a year and was v enthusiastic about it especially the shopping. I then had a fabulous flight from Delhi to Gauwahati in Assam. First we flew over the flat plains of N india , then over the Ganges which had loops of river. There were forests on the hillsides, these then became small clumps around farmhouses and the area flattened out into a huge rice paddy. My Sudanese student Omer met me at the airport and we then had a 4 hour taxi ride to Shillong, the capital of Meghalaya. Gauwahati was flat but we soon ascended into the hill road. It was a long journey shared with countless Indian lorries with their bight logos of animals and goddesses on the lorry sides. In Shillong we stayed in a newly opened B+B. It is cold up here, ones needs jackets. The book at the B+B had a good description of Shillong architecture which seems to be a cross of India and Home counties in the capital. The houses have verandahs and peaked corrugated iron roofs.

Why read Annie Matthews?

It is a well written book that is really two novels, about a Victorian life as a governess in Holland and then an Edwardian life as a hotelier in Scarborough.   The author, David Lockwood, was deeply impressed by his grandmother’s life story which she told him when they were together in Winchester during the second world war. He grew up  in  the hotel in Scarborough and had observed her at her hotelier work. He also had a deep knowledge and understanding of the Victorian and Edwardian eras and so he gives her life a novel like context.  He depicts places and dresses and customs with a poets eye.  It is a compelling book to read, once started one wants to know what happens to Annie and her family.  It took David ten years to write the book, in his retirement and initially it did not find a publisher. My mother Willy then published it in 2011.

You can buy Annie Matthews from Dr W Lockwood-Mom, 61A Camden Rd, Brecon, LD37RT

For more information about Annie Matthews  visit www.dnjtravlesblogspot.com

Caribbean island with a dark side: Reflections after a visit to Cuba Aug 2012

A summer biking holiday in Cuba- I was looking forward to seeing the architecture and hearing Cuban music and experiencing the island as I rode across it. I did all this but I also discovered that Cuba has a darker side of unemployment, censorship and repression. These darker aspects put a shadow across my pleasure in the lighter, brighter Cuba that the tourist board promotes.

I went on an Exodus holiday with 17 other cyclists, age range 16- 64 and the oldest was the father of the youngest. Teachers dominated the group with a quarter being Irish. We rode across the island for 14 days and moved on almost every night. So we saw a lot but there was little time for reflection or even rest.  So I returned fit but exhausted.

We experienced the huge range of terrain in Cuba. The first day we cycled over high rolling uplands in the morning and were in the swamps around the Bay of Pigs area in the afternoon.  Another day we biked along a coast road with deep blue sea to one side. I liked the mountains best and we had a morning walking in the Sierra Maestra. We had climbed up through dense forest and looked across lush green vistas with big trees and palms and blue sky overhead. We saw into people’s homes because our toilet stops were arranged at the homes of our guides’ friends along our route. Most of the homes had few possessions, in the kitchen women cooked on small electric elements and many had a pressure cooker, popularised as part of an energy saving drive. Nearly all had a TV. One of the few homes with decorations had pictures of the Virgin of Cuba, Fidel and an ecological advertisement about saving energy and illustrated Cuba’s populist themes of religion, revolution and self–sufficiency. 

As we travelled I realised how much censorship there is. The only newspaper is the party paper, “Granma” and I only saw that a couple of times and no-one was reading it. There were no other newspapers and no magazines. I also did not see any paper or pens, nobody was writing anything. There were a few libraries in towns and schools. These were stocked with  texts such as Castro’s speeches and communist economic analysis. I did see a copy of Victor Hugo’s “Les Miserables” in one library. It is a paradox that the Cuban government is very proud of its high literacy rates but there is little evidence of people using that literacy. I also talked to a Cuban journalist one day who was delighted to have my week old Guardian, he had infrequent access to the internet.  Cubans are barely allowed to use the internet, they can only access a few pages under government control. People also feel trapped; they have no passports and cannot travel. The journalist I talked to had a Spanish passport and had travelled to Barcelona, paid for by Spanish friends. This had been a huge trip for him and I was interested that he had returned and felt loyal to the regime. Our guide had also avoided answering our questions and on the last day we were each allowed to write down one question on a sheet of paper that was circulated. He then answered these questions very honestly but also in the safety of the bus and on the last day. There is also a very active secret police monitoring what people are saying. However news from the outside world is broadcast and Cubans knew all about the Olympics in London and had cheered on their own athletes (who won 14 medals).  Politically it felt just like East Germany in the 1980s with a repressed population.

We experienced the centrally run communist style economy. There are ration shops providing  essentials such as rice and beans are provided by a monthly ration, these looked poor quality and there were also a few other goods, even plastic buckets were very expensive.  There are a few shops with luxury goods such as bicycles and washing machines. There were a few markets but very little trading occurring, is such a contrast to Africa where people set up stalls anywhere. One of the communist features of the Cuban economy is that people cannot take out loans. This is good for averting debt crises but bad if you want to stimulate your economy.

Unemployment was visible with many young and middle aged people standing around the towns and villages. Many people have moved to the countryside and are living as subsistence farmers with  banana trees, vegetables and pigs. Keeping pigs and eating pork is popular in Cuba, when the government liberalised the laws on keeping pigs they were flooded with 14000 applications for keeping pigs the next week. Cuba is very fertile and well watered and it was saddening to see little large scale organised agriculture, beyond a few large sugar cane farms. There is no effective distribution system for agricultural produce. Farmers are now allowed to sell part of their crop privately but the government is very bad at paying them for the crops that they do produce and this does not incentivise farmers. We visited a farmers market and it felt empty with a few stalls selling shrivelled garlic bulbs.

Given the hot humid climate it is astonishing that Cubans keep their ancient American cars alive and functioning long beyond their expected life span. Only a few new cars have been imported recently. In the poorer parts of the island there are not even bicycles. In much of the island donkey and cart is the main means of transport.

There is a dual currency system. Tourists pay for everything in “convertible pesos” which are worth about 25 Cuban pesos. One pays with these in hotels, restaurants and shops. This also creates differentials, a Cuban working in the tourist sector can earn in a week with tips in convertible pesos  what a doctor earns in two months. Cubans can also go to bars where they pay in convertible but with the price differential one would have to want to really impress the person one was with. What is curious is that whether the price is convertible or Cuban just seems to be known rather than displayed. Our guide said that Cubans just knew which currency to pay in. Foreigners can only buy Cuban pesos on the street.  

Cubans have very good health indicators and they are over- doctored with one doctor or nurse being responsible for 1400 people and having to visit them every two weeks which seemed very invasive. I can see how they have effective public health measures but I suspect that even their primary care is quite minimal with little access to modern drugs. I was also surprised to see modest numbers of obese people, I wondered whether some unemployed people have a very sedentary life style. Maybe Cuba is a good example of how one can improve health indicators by improving water, sanitation and having effective vaccines together with a basic level of nutrition being available for everyone. Cubans certainly have better health indicators than their Jamaican or Haitian neighbours with longer life expectancy, lower maternal mortality and better water access

Cuban does seem to have social safety nets and I was left feeling that if I had to be poor I would prefer to live in Cuba than elsewhere.

Our bike ride taking us through villages exposed us to a surprising amount of Cuba and

                          

I left Cuba with my head full of questions, what will happen to the economy, how can civil rights be improved, what will happen post Raul? I could see that the communist economy does not work as a market; people are not rewarded by producing goods. It is sad that Cuba has not offered an alternative economic model to our own failing capitalist version. The Cuban economy is now as dependent on tourists as they were on sugar 50 years ago. This creates differentials between the Cubans and the tourists and between the Cubans themselves. The US trade embargo is counter-productive, it worsens the Cuban economy and promotes the absence of human rights. As I travelled I became more aware of the absence of free speech and access to the outside world.  I am now emailing the journalist whom I met but he can only go online for a couple of hours a month through a foreign student. Political opponents of the regime have also been imprisoned. I have also followed the blogger Yoani Sanchez  www.desdecuba.com/generaciony who describes life in Cuba with its repressions in a wry and insightful way. Cubans cannot stay abreast of medical and scientific developments if researchers do not have access to the internet. Since I was there the government has announced that they will be easing restrictions on travel but for many people this means going into exile. Cuba again risks haemorrhaging talented people overseas. Yoani Sanchez fears that 2013 will be a year of goodbyes, but promises to stay herself, to keep the door open. Of course if she continues blogging with her insightful, wistful pieces about Cuba she might be forced to leave. I doubt that her blogs are read with appreciation by the secret police. 

Conversely if I was poor and had to choose where to live then Cuba would be on my list, life there is much better than in many places. One has free medical treatment and no worries about unexpected medical expenses which is a luxury that my Indian friends do not have. There is a social safety net. The free education again provides something that my Indian friends might envy.  I guess that the government makes Cuban aware of these comparative advantages and this probably helps to dampen potential revolution. There is also a huge genuine pride in the Cuban revolution and doing things in a Cuban manner.  I left feeling that I would not want to go back as a tourist but would go back if there was a work related opportunity.

Jan 2013

Cuba A new History Richard Gott

The Cuba Reader Ed Chomsky, Carr, Smorkaloff

Aug 23 Havana

Being tourists in Havana but also hearing the inside story of Cuban life today

Our last day and we walked around old Havana admiring the colonial architecture. We were taken to a tourist market where we could buy art ranging from African pieces to erotic lovelies. This was real Tourist tat, made to capture foreign currency and  I wondered why paint was available for workers to paint for tourists but there is none for the school children to use. We also visited National hotel a big art deco building. So many important people have stayed there that there is now a decade wise depiction of the film stars, musicians and more recently politicians who have stayed there.

Our guide Raimondo had allowed us to write down one question each about Cuba which he promised he would answer on the last day, our questions covered currency, censorship, travel, tourism teaching, buildings and health care and i wondered whether he would answer them or duck them.  I was surprised at his openness in answering many of the questions. A picture emerged of a Cuba that is sorely lacking in human rights and where people want the freedom to travel and communicate with others.

So i ended this holiday feeling that i had enjoyed being in Cuba, seeing the towns and the architecture, but i felt very uncomfortable about the lack of human rights and feel that i would not want to visit again until that improves. It was a rather downbeat note for coming home. I was also exhausted after our heavy programme of biking, seeing new sights and dancing and needed a weekend to recover.

Aug 22 Santa Clara to Havana

Cuban censorship and revolutionary fervour.

When i offered my week old Guardian to a man picking up a newspaper in the Spanish colonial town of Remedios i opened up a tale of isolation and repression. The man was an unemployed journalist with minimal access to the internet. He had a Spanish passport and had been to Barcelona last year, the ticket bought by friends there. He related how it would take him seven years of all his salary to buy a ticket. He also told me that a bartender in the tourist area earns more in a week than a doctor in a fortnight. I have noticed the absence of newspapers and magazines, also that no-one in Cuba is writing with pen and paper. Later our guide told us how the government censors all the news and uses secret police. Critics of the regime find themselves in prison. Many Cubans appear loyal to their country but they would still like to travel but cannot since the government controls all the passports.   

I think we have seen every revolutionary monument in Cuba. Our guide Raimondo was deeply committed to the revolution and its history. It reached its apotheosis today with our visit to the Che museum in Santa Clara. A key battle in the revolution was fought there when the revolutionaries captured an armoured car in 1958. The site has been nicely preserved with railway carriages displaying the battle and a new concrete sculpture integrated into it. Che was an attractive revolutionary but he has been sanctified in the museum there. The display about his life captures his early life, his revolutionary zeal, his militarism and internationalism in a respectful display, even the spurs he used as a guerrilla in the Cuban sierra maestra. A vast statue of Che is battle fatigues looks out on the countryside from atop the museum. Communism meets Catholicism with the beautification of St Che. I wonder what Che himself would have made of it.  Castro himself seems to avoid a personality cult, his birthday was barely noticed but he is in posters exhorting people to live up to the revolution.

Day 12: Camaguey

Rural Cuba, a fine community centre, and back to Camaguey and salsa. Beautiful day for a ride that started with a long descent. Our water stop was in a community shelter with poetic slogans such as "trenches full of ideas not stones".
We also stopped at a large community centre built in vernacular style the 1960s with Cuban American money and it housed a stage and dance room. Now all that was there was a dilapidated library. A rather poignant reminder of what could have been here.
We stopped in a bus station where people were crowding onto a primitive windowless people-carrier like something from the Third Reich. Many people are sitting around in the villages - evidence of under employment.
Ended the day dancing at an open air salsa bar where a plump moustachioed male voclaist serenaded us.

Day 10: Santiago churches and cemeteries

Day of churches, streets and cemeteries. We started the day visiting the Church of Our Lady of Cuba which was a vast airy church where the priest was celebrating mass. People came dressed in white and yellow and offered sunflowers and lit candles. It is a fusion of African and Catholic faiths aand the strength of devotion was touching. We then had a morning walking round Santiago where one sees every style of architeture,  highlights included a revolutionary monument made of a series of vast  metal rectangles set in the ground like a series of machete strokes. Then we walked around the streets with colonial style houses and Soviet style wiring. People were out in the squares relaxing . I explored an eccentric bookshop with books, rum bottles and notices all stacked up in an array. Santiago cemetery is a mass of white marble monuments and a large early 20 c mausoleum to Jose Marti who was the first Cuban nationalist. He looks down benevolently but every half half hour there is a changing of the guard and three young Cuban soldiers goose step out to change. It felt too militaristic for me and contrasted with the peace inside his tomb . The Bacardi family also have a very showy black memorial.  We then bussed up to the north of th island. 

Day 9: mountains to Santiago

A day of experiencing Cuban resourcefulness and then the salsa in Santiago We walked through the forest in the morning visiting small homesteads and farms growing cocoa and avocados. Life is quite remote up there and everyone travels on foot or by mule. One of our party almost collapsed on the walk through dehydration. She had drunk a litre of mojitos the previous night. So one of the other women, Maggie walked between us for half an hour until we reached a home. Here the midwife was visiting because there was a 3-day old baby. Here we revived Jane and the men made a hammock and carried her down to the hotel at an amazing pace, that is their ambulance!  I was touched by their kindness and resourcefulness,

We had a fine afternoon ride across rolling countryside and then a wonderful 4km downhill ride to Santiago. Spent the evening hearing an excellent salsa band at a famous bar with a balcony on the street  and the female  vocalist sang like Amy Winehouse. Ended the evening with drinks on the 15 th floor bar at our hotel. What contrasts in that day.

Day 8: Banoa to the mountains El Solton

Today's ride was one of the toughest 60 km and with mountain climbs at the end. We had our food and water stops in small squares. One was hosting a sports day and kids played volleyball, the kit was minimal and I saw worn out boxing gloves and shuttlecocks made of maize cobs. There were several chess games being played . Public toilets here are less than pristine so our guide Raimondo arranges toilet stops every 20 km and it is a chance to see inside a Cuban home. Today's home was quite well off with pictures of Claudia Schiffer, the Cuban virgin and a cartoon about ozone depletion so touching on beauty, religion and politics. 

We stayed in a beautiful mountain hotel resort in huts clustered in the tropical rain forest beside a huge natural pool. The barman also made generous mojitos and we shared life stories and internet dating experiences.

Day 7: Camaguey to Banoa

A day for enjoying Cuban sculpture. In the morning we went round Camaguey in bicci taxis. Camaguey is a lively city with cyclists buzzing around and lively people. We had a city tour perched in bicci taxis after seeing churches we saw a artist's gallery. She did paintings and ceramic work featuring womens heads. In the afternoon I did not bike but went in the coach chilling out and catching up on my thoughts. Flat countryside with rice paddy fields. The afternoon ended with a violent tropical storm with lightening bolts coming down all around us. We stayed right on the square in Banoa  with the noisiest of starlings. After supper we  found a street full of zany street sculptures and a book shop. The cities in this western part of Cuba feel intelectually livelier.

Day 1: Havana

In Havana!
Fine morning ride through the city passing colonial and revolutionary architecture. Paused in Independence Square with a huge billboard of Che. Then by bus to Matanzas, a town on the on coast. Stayed in a beautifully restored hotel on the main square. I walked out and could not find any shops, where do Cubans buy their houshold stuff? The tourist economy is very strange with foreigners having "convertible" pesos to use in hotels and bars. The absence of advertising is also strking. Nice group with a majority of teachers...

Day 6: Trinidad to Camaguey

We started off with a fine cool ride and then climbed up a high tower built in the 19 c  to  check on slaves. Now it is a major tourist attraction and surrounded by stalls of fine white tableclothes painstakingly made at home by Cuban women. We also had  a ride in an old train this looked 19 century but had come from the USSR in 1970. The ride up to lunch was through rolling countryside, a few cowboys were riding round and  we passed  a  state cattle farm.  It was so hot that we stopped at lunchtime. We then had a brief visit to Sancti Spiritus where there were shops for Cubans to buy shoes and clothes.

Then on to Camaguey where we stayed in cell like rooms in colonial elegance. Since this an Aug holiday 85 percent of the group are teachers or students and a quarter are Irish and bring a mellow humour... Age range 16 to 68. Everyone seems easy going and we have gelled well. Our leader is a  black Cuban, his grandfather was brought over as a slave from Nigeria which brings slavery to touching distance.

Day 5 (Tues 14th): Trinidad - rest day

Spent the rest day appreciating the elegance of Trinidad and chilling out by the pool. Trinidad is a beautifully preserved old Spanish colonial town with houses painted in hues of blue and pink. One of the most interesting places was the Museo Historico in the former home of a sugar magnate. The elegant rooms with tompe d'oiel were preserved and I could imagine relaxing at the piano.  Trinidad revolutionary history was captured in documents and artefacts on the move away from slavery.  The  bell tower was crowded with  people  being photographed against the beautiful view for their Facebook page. Seeing a monastery that had been turned into a revolutionary museum warmed me.

Trinidad is heaving with shops selling tourist tat, acres of Che fridge magnets and Fidel in a cigar shape and I wondered about the economics of producing these goods for tourist pesos rather than consumables for Cubans. I wonder what the Cubans themselves think about the tourists who have so much in comparison to themselves.

I have also noticed an absence of engagement with the outside world. I have not seen any newspapers or magazines and certainly no internet cafes and very low mobile phone use. 

Day 4 (Mon 13th): Cienfegos to Trinidad, Castro's birthday

We biked 88 km at 35 deg and by the end I had almost lost the will to live. In the morning we rode across a rolling upland with beautiful views. Later we crossed several rivers draining in the Caribbean where people  were out on the beaches. We also went into a village store which had no signs outside, inside it had pitiful stocks of rice, beans, spaghetti and expensive plastic buckets. The male household head holds the ration book and the rations are insufficient for a month so then people pay market prices. Poor quality and no choice. Very tough running a household here. 

I have been wanting to dance since I arrived so a group of us went down and danced salsa and heard rumba in open-air bars to celebrate my roommate's (Tamsin) birthday. Surprisingly there were no big celebrations for Castro.

Day 3 (Sun 12th): to Cienfuegos

Another hot day and fortunately we completed the biking in the morning along a beautiful coast road with deep blue sea on one side and forest on the inland side. Went down to the sea to dip our toes in but the coral was too sharp. Visited the Bay of Pigs Invasion Museum which was full of pictures of very young revolutionaries fighting off the USA-backed invasion. Ended the day in Cienfuegos which was founded by French settlers (1820) and so had a neoclassical square and town hall. Ended the day at a local carnival with packed crowds dancing on the seafront and drinking home brew dispensed from barrels. I watched the closing ceremony in London, Cuban-style, drinking moijtos.

Day 2 (Sat 11th Aug): to Bay of Pigs Swamp

Did all the biking in the morning through rolling conutryside with small farmhouses. Farmers using ox carts and smoking vast cigars. Small towns with crumbling colonial buildings. People live in small concrete bungalows with neat gardens. Obviously very houseproud. Endde the day in a Butlins-like beach resort in the swamp.

Not German but Italian, experiencing the South Tyrol.

I enjoyed the differences between Italian Verona and German south Tyrol.

I found the jubliee overdone so i was delighted to escape to Verona for a dermatology conference. Verona is a lovely city and walking around one sees the marks of past civilisations. The Roman arena is used for concerts and this design template is visible 20 centuries later in the Olympic stadium with stands for merchandise as well as sport tracks. There are wonderful 14 century frescoes in the St Fermo, the ceiling has 400 saints heads painted on it which reminded me of the saints heads one sees in Ethiopian churches, notably Gondar. The Venetian occupation can also be discerned in the pillars with the Venetian lion and the shapes of the windows. The imaginative new photography gallery (Sacvi Scaligeri) combines old and new with subterranean galleries built around the roman foundations and one walks over roman roads, drains, and swimming pools. The ancient cobbles were hard to negotiate with the buggy carrying Joan, Steve and Eglantine’s 8 week old baby.. The exhibition was of Robert Capa’s war photos and we experienced war in Spain, London, France, Germany and then Vietnam. He captures emotions brilliantly, the steadiness of men under fire, the dejection of refugees, the fear created by a rogue sniper in liberated Paris, firing on the celebrating crowd. The exhibition ends with a series of portraits of Capa’s friends, William Faulkner crossing a river in Wyoming, Picasso on the beach holding up an umbrella for his second wife, all capturing the person’s character.

 Verona at night was very Italian with people sitting outside the arena drinking and much promenading going on. I think one gets the best Italian ice creams in Verona, we had excellent ones from a long established shop and then even found a shop open after midnight for that late night ice cream.

I then headed to the south Tyrol with a train ticket costing 8 euros for a journey of 312km, and not even bought in advance, unlike British tickets. The train goes along the Adige valley up to Bolzano.

I first came to the German speaking south Tyrol in 1994 when my friend Jorg came as a summer locum family doctor in Kurtasch/cortaccio village. The area was in the Austrian empire and ceded to Italy in 1919.  The houses are Alpine with sloping wood roofs, and the towns have a Germanic look with large houses. The area feels prosperous, the orchards on the flat valley floor are neat and tidy, even the vines on the valley sides are neat and the area oozes quiet efficiency and prosperity. It feels more German lite than Italian. Jorg is German, married to an Italian doctor Tina, their kids Martha and Frederico are fluent in Italian, german and English as well as being passionate about modern dance and football respectively.

We went up towards the Brenner Pass and walked around a small lake surrounded by pine trees, the meadows were full of daisies and buttercups. The village church (Durnholz) was tiny with medieval frescoes showing the day of judgement. Outside were the memorials for the soldiers killed in the two world wars, they all had Germanic names and they had died all over the Austro-Hungarian empire (Germany, Italy, Ukraine). That afternoon there was a terrific storm and which was followed by beautiful scenes with light coming through clouds and water glistening on steep rock faces.

On Sunday morning i woke to the sound of a village brass band and a Tryolean village procession was celebrating Corpus Domini. The women were all in dirndl skirts and the boys wearing lederhosen and the men had hats with feathers. They all then tucked into wurst and beer sitting in the village.

These borderlands are interesting places where cultures and boundaries clash. Geography really defines the inhabitants of a place. Here the Alpine climate defines the housing, the food and the transport but it is the historical associations that define the language and the ethos, so the South Tryol for me feels more German than Italian. At least one can transcend these geographical and national differences by being a European and i came home laden with Italian cheese.

Ethiopia April 2012: Interactions between The Gulf, Buildings and Health services

I visited Ethiopia to see how Saba and her project for improving the treatment of leprosy reactions was progressing. When i last visited in July 2011 the drugs had only just arrived and she had to negotiate their release from the airport. The study is now in full flow. We had expected difficulty in  recruiting patients for the study on one of the chronic complications of leprosy, erytheme nodosum leprosum but these studies now have recruited enough patients. The other study on type 1 reactions  needs 100 patients and is accruing patients far more slowly. We talked about ways of improving the patient numbers and as well as talking to local referral centres Saba will also do a radio broadcast. Every week there is a half hour broadcast on leprosy on the Addis Ababa station contributed by the leprosy patients association and she will talk about the trials that we are doing. Hopefully this will encourage patients who at sitting at home ill to attend the hospital. 

As soon as I arrived  at the hospital i was shown patients with difficult or unusual problems.  I saw patients with all types of leprosy reaction. Two patients had been on steroids for years but their immune systems are still reacting and their skin was inflamed and their nerves tender.  There is still a steady flow of leprosy patients into the hospital. Diagnosis and treatment of leprosy has been delegated out to the primary health care posts and now we are seeing many patients with advanced leprosy which  suggests that patients are not being diagnosed out in the periphery. I gave a talk on how diagnosis of leprosy is delayed in London and mused on the parallels between Ethiopia and London, in both places health workers need to be aware of the possibility of leprosy. In India new surveys have been done and many undiagnosed patients have been found. I suspect that if we did such surveys in Ethiopia we would also find many patients.  It is going to be a huge challenge for the next twenty years to try and diagnose patients. I can see that the last decades of my work will be concerned with enhancing leprosy diagnosis in different settings.  This partly a result of the premature announcement by WHO in 2004 that leprosy is eliminated s a public health problem. .

I again enjoyed Saba’s warm hospitality. Last time i wrote about the nanny who wanted to go to the Gulf to work. She got a job with a family and went with high hopes. There was then a seven  month silence and then she rang Saba one day. She had a sad tale to tell, she had been treated like a slave, working  18 hours a day with no breaks and she was not paid and imprisoned in the house. Fortunately she escaped, with her passport, and found refuge with helpful Ethiopians.  She now has  another job and is not  back in Ethiopia. I suspect that Saba only heard part of the tale and she was probably sexually abused as well. The new nanny, Alem, is another nice girl, she has just completed her education Alem’s sister who is working in the gulf is warning her not to go there. But the lure of the money in the Arabian Gulf is irresistible for Ethiopians.   Leo is now a fine 18 month old running around everywhere. He loves books and was delighted with the suitcase fo books that i brought from Saba sister here in London.  Less flatteringly he called me nona the Italian for granny. He clearly has a sharp sense of age. 

Addis is booming, with buildings going up everywhere, much of this work is funded by money from The Gulf  notably from Mody, a Ethiopian Saudi and the richest man in Addis . His building sites are badged with green and yellow painted hoardings and much of the town was encased in the Mody colours.  He also imports Filipino workers who work to a higher standard than the Ethiopians, as the poles do in London They also live in dormitories and have a minimal life style. The new Africa Union building is being built by the Chinese.   Mody  built the Sheraton  ten years ago and i was given a ticket for the very glamorous opening with Didi bridgewater singing jazz.  On The edge of town are acres of new six storey condo buildings, in the rain these look oppressive and East German like but In the afternoon these become lively vibrant spaces with all the ground floor being used as shops selling piles of fresh vegetables and newly butchered meat. Boys play football on the larger spaces and people sit on yellow plastic chairs at open air bars.  The nicest ones are painted grey and pink colours which give attractive local colours

We also had some time relaxing and swam in the hot volcanic spring fed pool at The Hilton. The outside air was cold so it was very refreshing. Afterwards we showered in the communal shower and i was surrounded by black voluptuousness and felt very white and stick-like.  We also visited the Taitu hotel ,  a large colonial style building form the 1930’s in the central piazza area. It still has a beautiful large wooden staircase and verandah that will be perfect for a post work drink on another visit. We spent an evening in a jazz venue hearing a group play 60’s style Ethiojazz which fuses jazz and traditional Ethiopian music. The line up was a little reminiscent of Buena vista social club but not quite so old.

I read Peter Gill’s book “Famine and Foreigners,  Ethiopia since Live Aid” and learnt a lot about the repression of democracy in the 2005 election. I had seen how little opposition there was in the 2010 election, this was not surprising because they have been driven overseas by violent repression. The absence of a free press is noticeable, the Ethiopian Daily Herald is clearly a mouth piece for government views and has such a tedious style that I barely stay awake to read about the latest government successes.  Soviet style central planning is still being used here.  In March 2012  DrTedros Ghebreyesus, the Ethiopian minister of health visited LSHTM and enthused over his plans for fast development of the health service. 2,000 new health posts have been established over the last 5 years each serving 25.000 populations. The health workers have many tasks including detecting leprosy, but the patients report that the health posts are often not staffed or the drugs are not available.  The other plan is to train 3000 doctors per year and flood the Horn of Africa with Ethiopian graduates. The difficulty is that no thought has been given to the curriculum or teachers in these new institutions. I met a very lively American trained Ethiopian returnee doc who was part of this programme. He exuded the enthusiasm of youth but i could see that he would probably not be around for troubleshooting in these new institutions.  I wonder what measures of outcome are being used to asses these projects. Alem , the new nanny has eight years of education but is functionally illiterate so the omens are not good.  I also saw signs of totalitarianism, all the hospital staff were taken off the hospital site for a day and a half in which they were harangued by the minister of health over their apparent poor performance of the hospital, attendance was compulsory and Saba was one of the few people left behind to look after the patients. This did not appear to have motivated people in the hospital.

So i had another interesting visit to Addis,  I enjoy staying in Saba’s household and getting  an inside view on Ethiopia. There visible improvements in the country but also worrying signs of repression and democratic development t here looks less likely.

Diana Lockwood

May 2012     

Capital Ring 2012

I decided to walk the capital ring route as my own mark of being a Londoner in The Olympic Year. It is a 78 miles route which loops round London going through parks and woods with Charing Cross as a central point about 10 miles away.

I started the walk with my 25 yr godson Alastair and we may do the whole walk together or i might link up with different friends for the different sections. I shall walk about 10 miles per section and i hope to enjoy the parks and architecture of different parts of London.   

The Capital Ring 1 April 1 Woolwich to New Eltham: Light, history and renewal

This 8 mile walk was suffused with a sense of new beginning. It was fun to be starting a new walk and spring was evident everywhere, in the fresh new leaves on the trees and the rustlings of small animals in the undergrowth.  The view of the Thames here is impressive, it is a quarter of a mile wide at this point and was reflecting the light. We looked upstream at the futurist domes of the Thames barrier and beyond to Canary Wharf. Opposite us the planes took off from my favourite airport, London City, favourite because of its size and speed and the wonderful views one gets of the City as one lands there.  Charlton Park seemed like a manicured space with mown lawns, mature trees and people playing football in the sun. The route wound through the woods of Shooters Hill and Oxleas woods. Underneath the triangular Severndrooge Tower, a dilapidated monument to a long forgotten battle in India we had a fantastic views out over south London to the north Downs.  We ended our walk in New Eltham where the streets were pink with cherry blossom and we replenished ourselves with fish and chips.  The Shard dominated the beginning and end of our journey. It rises straight out of London Bridge station and reflects the light in interesting angles. There was also another link to an older time on the river. The building work at London b ridge was enclosed in a huge Canaletto (1720) picture of the river full of barges and boatmen, very different to the nautical quietness on the river now.  We ended our day in The George pub, a balconied Southwark pub several centuries old. I sensed  London’s ongoing renewal , there were modern new waterside flats, a military hospital had been converted into private apartments and Woolwich has been improved with a fine new station in nautical white and blue.  

Hong Kong – Chinese, capitalist, communist, cosmopolitan and much more

I expected Hong Kong to be hot and tropical but it was cold and misty, i even had to wear my mountain jacket in bed. I spent two days there in February and I was struck by contrasting aspects of the city which is Chinese, corporate, consumerist, Communist, cosmopolitan and designer savvy.

The new rail link from the airport whisks one past vast numbers of new hi-rises  crowded together , then docks  and then into Kowloon. I stayed in a modest hotel in Kowloon, however it was an interesting area full of small work shops and little hole in the wall restaurants where I ate breakfast of noodle soup. The traditional Green temple was close by and people sold incense sticks and Bhuddist religious items in the open square. I walked straight down to the harbour front and was exhilarated by the view across the river of the hi-rises in the financial district ablaze with light and reflected into the water. My walk back was along streets  full of flashing neon lights. There was a busy night market next to the temple and one could buy any kind of computer, latest generation mobiles and tacky pictures of Hong Kong.

The next morning i walked back to the water front, this time through streets with every kind of designer shops, Luis Vuitton, Dolce & Gabbana, and i became a consumption refusenik and decided to give myself the challenge of buying no consumer items in Hong Kong, perhaps only possible in a very short stay. On the Hong Kong ferry I crossed the river full of boats and landed in the heart of the finance centre. Here streams of black suited financial workers were pouring out of the offices under covered walk ways for their lunch break. All the major architects seem to have built huge hi rises in this temple to modernity. There was a slim elegant building by Ceasr Pili, whereas  Jardine house is studded with circular windows and nicknamed  “the block of 1000 ass holes”. But even in the centre of the hi-rises  there are small Chinese gardens created with streams and rocks.  The Lonely Planet guide recommended visiting the Hong Kong office of development and i enjoyed a hour there following their exhibition about the future development for Hong Kong. They claimed that after public consultation new green sustainable cities of just 80 000 inhabitants would be built somehow I doubted that these ideals will survive financial pressures to create more houses cheaply.  The cathedral, a simple mid nineteenth century building is completely encircled by the temples to mammon. A contrasting building was the Museum of Tea drinking which was in an old colonial Savannah style building with two floors, a balcony and deep shuttered windows. The most interesting exhibits were in a competition that the museum had run for ceramicists over the last twenty years  challenging them to make a tea set of tray, pot, cups. This has unleashed creativity in the Hong Kong potters and entries ranged from very delicate glazed pieces to ones made to look like birds nests and one of cardboard from packing cases.

I read the south China Post newspaper to asses press freedom in Hong Kong. News from China was reported as from other provinces but the perspective seemed to be from a place just outside China. There was also a strong focus on financial news and news about corruption.  The Hong Kong census had just been published showing that Hong Kongers are older, richer and more are staying single. In Europe we are similar but are getting poorer.  Surprisingly  the violent protests in Tibet at their New Year and that the closure of Tibet to foreign tourists were reported.

I also found the Occupy Movement protesting outside the HSBC building. The camp was colourful with red paper dragons and kites and even a sofa to sit on. I chatted to the protesters who said that initially there had been a very heavy police presence but this had diminished. The head of the HSBC had also apparently been quite relaxed about the occupation in his basement- unlike the churchmen at St Pauls.  The concept of protesting against capitalism has been difficult to explain in Hong Kong, a frequent question is whether they want communism back. 

I could also see how many of the migrants to Hong Kong have a tough time with harsh employers and in the cathedral there was a place where exploited domestics could seek help, a modern form of sanctuary. I also glimpsed visible poverty seeing the washing hanging up to dry in the tenements by the hotel and I wondered how the washing would ever dry.

I was amazed by the abundance of food, one could buy any sort of dried fish or vegetables from the huge sacks in shops.  The temptation to eat was everywhere with restaurants ranging from stalls in the road to expensive ones. I had excellent fresh spicy fish.  i also found cool cosmopolitan bars where one could have wine and olives and overhear conversations about projects.

My guide book had advised me to go up The Peak on my first clear day and i had not appreciated the wisdom of this advice. After my first evening which was wonderfully clear i then experienced rain and mists swirling round the buildings so i shall have to leave The Peak for another visit. I was surprised and intrigued by the different facets of Hong Kong, it is so vibrant and lively but also so crowded and congested and well worth another visit.