This piece dates from my time as Director of ACBAR, the Agency Coordinating body which had at the time 60-odd NGO’s affiliated all operating in Afghanistan. It was the job from hell, and left me drained to the point at which I needed a couple of months off after I left. I dealt with the Taliban government on an almost daily basis, and got to know some of them quite well. A couple I am still in touch with and they are an invaluable source in my understanding of the ongoing mess that is Afghanistan. The piece gives a flavour of the complexity of the work. It was always edgy and we lived on caffeine, alcohol, adrenaline and nicotine. I have not read the piece for many years but as far as I can recall at this distance of time it is an accurate record of a few days in a hectic life. The ‘Three Witches of Kabul’ referred to are all now dead, with Nancy dying in Kabul not so long ago. She probably did more to preserve Afghan cultural heritage than any other single individual. Most of the other players are long dispersed and I have lost touch with all bar one, two if you count SAM who is still in play in Afg but not mentioned in this piece. At the time the piece was written the UK had no diplomatic relations with the Taliban government and I was one of the conduits via which diplomacy was continued in the absence of formal structures.

27^TH July. Islamabad. Conference room at UNOCHA, the UN HQ for all operations related to Afghanistan. The room is large, dominated by a huge satellite image of Afghanistan and no other decoration or embellishment. This is a room where you do serious stuff, and we were doing serious stuff that day. The Meeting started prompt at 11, and finished shortly before 1.

Erik de Mul was in the Chair. He is Head of UNOCHA and had just completed a wearing round of discussions with the Taliban in Kabul and Kandahar. There were five Ambassadors, six First Secretary’s, the Heads of all the UN agencies and their Number 2’s, the Pakistani Minister for Refugees, the UN RCO for Kabul, the Directors of Save the Children and CARE, myself and a very few personal private secretaries. It was a rarefied group and the mood was grim and gloomy from the beginning.

The events we were discussing are worth recounting in some detail, and started on the 5th July. On that day the Taliban Ministry of Planning issued a letter to various NGO’s (including my own) asking for information on the numbers of female Afghan staff they employed. On the 6^th there was a further letter to UNOCHA and ACBAR, in part saying ‘no UN/NGO’s can hire Afghan women temporarily/regularly because such an action is against the Islamic Emirates policy’ and we were invited to attend a meeting at the Ministry of Planning for clarification on the 10^th. Most agencies adopted a heads-down-wait-and-see approach. Some sent their female staff on leave.

On the 9^th shit and fan got together.   Mary McMakin is one of the Three Witches of Kabul, all women in their 70’s who have lived and worked in Afghanistan for much of their lives. One of them, Nancy Hatch-Dupree is reckoned to be the single greatest living authority on Afghanistan and she is currently working for me. The third is out of play at the moment.

Mary runs a small NGO in Kabul giving relief to war widows. She is an out spoken and vituperative old bat, who gives the Taliban and anybody else who gets in her way a tongue-lashing in at least half a dozen languages. Her work is of minimal importance, but she is an icon par excellence. She had had an ongoing battle with the Minister of Vice and Virtue for years, and it all came to a head on that day. V and V had been trying to nail Mary for months, and the letter from MoP was just what they were looking for. Mary employed 7Afghan women in minor capacities, and 6 men. V and V kicked the door in, beat Mary with sticks (she’s 73 and slightly disabled) accused her of fostering immorality and of being a spy, and carted her and her entire staff off to prison.

Thus was born a very minor international incident, that had us all running round like mad things for several days. The men were released the same day, and told lurid tales of Mary’s incarceration. Late on the day of her arrest she was given permission to leave, but refused to leave her female staff and started a sit-in at the ‘Reformatory’ where she was being held.

My Kabul office and the UN RCO took the helm. My people did all the ‘behind the scenes stuff’ while the UN handled ‘front of house’. I co-ordinated with Eliane, the RCO in Kabul via satphone. It worked well and there were mutual congratulations afterwards, as relations between ACBAR and UN have not always been of the sweetest. The US Deputy Consul here in Pesh flew quietly to Kabul and let it be known that were anything untoward happen to Mary then things of a whizzy-bangy nature were likely to fall on sensitive parts of the Taliban body politic.

Come the 10^th Mary was still in clink, the US was making grumbly diplomatic noises and the hawks in the UN in New York were plotting withdrawal. I and others were mildly harassed by the worlds press, who like nothing better than little old ladies getting duffed over by Big Nasty Men. The meeting with the MoP went ahead as planned and was chaired by the Deputy Minister. It was also attended by some of the more unruly elements of the NGO community, who did not ease relations by jeering and catcalling at the Dep Min, who was deeply upset. (I have subsequently made a diplomatic – a very diplomatic – apology to the Dep Min on behalf of the NGOs and the offending persons have found themselves rapidly redeployed to a less sensitive posting.) The Dep Min summarised the situation, said that this was a final decision taken by the ruling council, superceded all previous edicts on the subject of women working and that all Afghan women working in NGOs should be dismissed at once. En passe.

On the 12^th Erik de Mul went to Kandahar to meet with the Minister of Foreign Affairs, one Muttawakil, who hitherto had been a regular gent to deal with. I had met him a couple of times, got on OK, but Erik found him somewhat different this time. He also met with at least seven other Ministers, and felt that he may be getting somewhere.

Also on the 12^th Mary and her staff were released. She was asked to leave the country but not actually deported, thus leaving the door open for a future return. I saw her the next morning in my office. She was as combative as ever, had not the slightest insight into the international kerfuffle she had been at the centre of and wanted to make all sorts of unhelpful and inflammatory statements to the press. Poor Roger Kenna, the Dep US Consul who had actually brought her out (she is a US citizen) sat squirming in one of my less comfortable chairs as Mary ranted on. I understand that the Dr from the US compound eventually applied the chemical cosh and laid her out for 24 hours. Relief all round.

It is perhaps worth explaining at this point that the issue of women in employment in Afghanistan is probably the biggest single impediment to the normalisation of relations with the Taliban after Osama bin Laden (who I have heard today may be dead of a kidney disease). To the Taliban, female involvement in anything other than childbearing and housework is complete anathema. To the western agencies and donors, women have a right to be in the workplace or any other place they choose to be. This is not just a PC position by the west, there is an inalienable civil and human rights issue underpinning their thinking, and here East and West, the Very Old and the Relatively New, collide head on.

Erik gravitates to Kabul on the 16^th, having not got much beyond a verbal statement on the part of the Taliban to the effect that they were not going to rescind the decree but if the agencies and donors would just keep the volume down for a month, then the issue could be quietly laid to rest. More Ministerial meetings all round. ACBAR dealt with the so-called ‘line Ministries’- the second tier of Government who are the programme implementers and with whom the NGO and UN agencies work most closely – and usually well. Erik and his small team dealt with V and V and Justice – or would have done had they consented to meet with him. Things ground on until the 20^th when he left Kabul, nothing resolved exactly but maybe a bit of what the Americans call ‘wiggle room’ – a small space in which negotiations may continue.

Things racked up a notch after he left. Another letter, this time couched in very threatening and explicit terms come out of the MoP (but clearly the work of Vand V and Justice, in whom the real power resides) and arrived on our collective desks. It threatened prosecution of any women violating the decree, and for the first time prosecution of the NGOs employing them.

I arrived in Kabul on the afternoon of 22^nd and picked up where Erik had left off, except that I was principally concerned with the security of local staff and clarifying the position regarding foreign women in employment.

Assorted meetings came and went, Eliane and I exchanged confidences and gossip, there was an ACBAR members meeting which I chaired, and a meeting of the Kabul NGO Forum. There was a sense that we were heading towards a confrontation with the Taliban, and that none of us thought this to be a helpful move, but it was being driven by the hawks in New York who were about as far removed from the reality of Kabul as it was possible to be. There was a general resolution among the NGO and UN players that the only reason we should withdraw was if there was a serious worsening of the security situation. We refined this down on the evening of 23^rd to say that we only pull out if there is actual fighting in the city.

Late on the same evening my survey team and their manager were 50mtrs from a bombing in the city centre. They were having their evening meal in an outside café when Ali the Bomber pressed the button a bit prematurely and projected small irregularly shaped parts of himself on to their chicken jalfrezi. The manager turned up at our office (from where I had heard the blast) about half an hour later looking like a man in urgent need of another job and a change of underwear. Fortunately, none of them was hurt. The next night the city was lightly rocketed from the north.

Nothing got any better. On the morning of the 25^th CARE, a very large Canadian NGO, heard that the decree had been signed into law by none other than Mullah Omar himself, and that it would be applied across the country with the full weight and severity of Shariah law.

I attended a small ad-hoc meeting later the same morning, putting together a position statement from the NGO’s to the UN and the donors and then headed back to Peshawar, arriving, knackered, about 8 in the evening.

The 26^th was a day for reflection and trying to fit the pieces together. Clearly things were bad and maybe getting worse. There was unease in the NGO community about the meeting of the 27^th, which certain parties had tried to exclude the NGOs and the UN Kabul people from. For reasons of sensitivity I will draw a veil over some of the more unpleasant arm twisting and eye gouging and general backstabbing that goes on here, but believe me there is no love lost between the various agencies, and if there is a chance of giving somebody a bloody good kicking then the chances are you will have to join a long queue. Suffice to say that myself, S W of CARE and A W of Save the Children were duly placed on the guest list for the Big Meeting. We are all shameless thugs, get on famously and have a reputation for painless surgery, the consequence of which is that the victim rarely notices they have lost a leg until they actually keel over.

Erik de Mul summarised the above in slightly more diplomatic language and opened the meeting to the floor. He revealed that the 27^th was an unofficial and unpublicised deadline for the Taliban, and that the UN was expecting to hear from them on or before that day. They hadn’t.

We all had a crack at it in our various ways. There was consensus that it made no sense to push the NGO’s further down the road of quasi-diplomacy. They were already at the limits of what could reasonably be expected in the absence of a formal diplomatic structure, and to expect them to go any furhter in negotiation with the powerful political ministries of Vice and Virtue and Justice would compromise them quite impossibly. The Thugs heaved a sigh of relief at this one as we had feared that the Hawks would want to push us forward as the ‘natural’ negotiators of a way out of this one.  But skilful footwork by Erik and Mike Sackett of WFP had protected the neutrality of the NGOs and left the diplomacy where it should be – with the donor nations and the UN. Trouble was, they didn’t want it. There was much wriggling and squirming and shuffling of responsibilities across the table.

The players added detail here and there – M S that Muttawakil was actually hostile to him, Eliane that the decree was going to go nationwide within days, myself that the bakery project survey which was to employ 600 women was the likely trigger for all this mess.

There was consensus (among those that actually trod the streets of Kabul) that there was a battle-royal raging within the Taliban. The Hardliners had successfully ambushed the Moderates, got the Decree rushed past Mullah Omar, hotfooted back to Kabul and proceeded to undo the work of the last two years. The Moderates had lost face and respect, the Hardliners crowed and toured the streets in their Toyotas visiting Islamic unpleasantness on all and sundry.

The Meeting eventually got to a point where it agreed that a confrontation was inevitable, but that it should be the donors and the UN not the NGOs that do the confronting, and that the NGOs would continue their low-key diplomacy. It also emerged that there are objective concerns about the safety of male local staff in agencies which supported work with women. This had never been an issue in the past, and ‘Security’ went up the agenda for just about everybody. Ann Freckleton, the Ice Qeen who sits on the British DFID moneybags, surprised all and sundry by making a constructive offer – the Brits will pay for security training for local as well as expat staff, and we can ‘bring them out’ to Pesh for a four day course courtesy of HMG.

It was also agreed that a demarche would be issued to the Taliban Ambassador in Islamabad on Friday 28^th, a diplomatic note delivered by the Swiss (the current Chair of the Afghan Support Group) telling Mr. T what the world thought of him and his evil minions.

We then turned to the thorny question of ‘What do we do with the Paks?’ Pakistan openly supports the Taliban for their own machiavellian reasons. Erik expressed the opinion that they were no better or worse than the Taliban. There was general agreement that were there to be major population movements as a result of the drought (almost certain) and a subsequent influx of refugees into Pakistan, then the aid community would not fund up relief for them, and Pak would have to find funds elsewhere. This is an extremely big stick to beat the Paks with, but there was unanimous agreement that they could no longer have their cake and eat it. A Messenger was appointed to take this news to General Musharraf, despite the fact that his Minister for Refugees was sitting stony faced on the sidelines of The Meeting (he had observer status only.)

The Donors decided to meet on the following day to agree a position and spin-management clicked into top gear. Kofi Annan wanted an immediate update at the end of the meeting, and spoke to Erik on a satphone for 10 minutes.

We sat there at the end of it all, weary and dispirited. The Thugs knew that they were back in the front line again, and that business as-unusual would continue. We lunched and planned, got in our jeeps and drove back to Peshawar. We collectively condemned a lot of people to a slow death by starvation on that day. We never gave it a thought.

——————————————————————————————————–

As I recall we got back to Pesh, adjourned to the American Club bar and stayed there till we fell over.

Another piece from a far past and like everything else closely based on real events. I still have the complete upper set of teeth that were glued in so firmly 15 years ago. Money well spent I feel.

Transylvania, 1893.

There was once a Master and a Servant, and they lived in a faraway land. Or quite close by if you lived in Transylvania. The Master was a diabolical fiend, striving all his life to create a living creature from the body parts left over from local feasts. His demented cries of rage and frustration rang out from the castle wherein he lived. Verily did folks kak their Daks at these fell sounds. Feersum Enjins were constructed to better manufacture this facsimile of human life. Eventually, and following the script closely, the Master was successful. A creature was duly created with primitive electricity belting thro its hand-carved veins and arteries, and it sprung to life bang on cue in the middle of a thunderstorm of special effects and much rushing about by Best Boys and Gaffers. The Creature, having been shown the script that Master and Servant were working to, roared and raged a bit, slew a peasant here and there and then buggered off to make a lucrative living in the B-movie industry.

Everybody seemed happy with this arrangement. The Master had a nice little earner going renting out the Feersum Enjins to cigar chewing movie moguls. The local people were happy as well, as they got good paid work running here and there in rustic attire and screaming their heads off every time there was a full moon. The only one who was not happy was the Servant. Film parts were few and far between, and a life spent in the abattoirs and blood-vats of his Master had done little to prepare him for the jobs market in the wider world. The Servant was a man of limited stature…a bit on the tall side for a dwarf, a lot on the short side for a regular bloke. Stood on a box when he went for a pee in the gents at the local hostelry. Widely overlooked by anything of a female persuasion. Small hump. Pronounced limp. Lithp.

The Master was not an unkind man, and he saw how sad his servant had become, sitting on a stool by the kitchen fire tapping a spare femur against the kettle singing merrily thereon. Sighing. Aching for the old days of nocturnal butchery and the occasional foray into post-mortem gardening in the graveyards of towns nearby. The Master called him into his study…

“Igor…?”

“Yeth Marthter?”

“Is it not true that thou art a carbuncle and a blot on the face of humanity?”

“Thertainly ith, Marthter.”

“Well Igor, I feel that I must take pity on you, and have devised a plan, a cunning plan. Would you like to know what it is?”

“Yeth pleeth Marthter…Oooo yeth pleeth!”

“Very well. I am now rich beyond the dreams of avarice; with so much money I wipe my bum on the stuff. Wenches pop in ter polish me plonker on a daily basis. Got everything I am ever likely ter need. Can’t see you languishing there by the firegrate. I know there’s not much of a market for Igor’s these days and you have been the most faithful of servants, so I am going to make you a once-in-lifetime offer, Igor…a chance to retrain, to give up this life forever and find yourself a place in the world, perhaps in a far off land of your choice, there to ply a trade and be a credit to yer dear old Mum and Dad. So whaddaya say Igor…whaddaya wanna do with life?”

“Oooooo Marthter…you are tho kind. I am but a humble Igor, unworthy of anything but the kicks and pricks of a menial drudge. But if you were willing Marthter, there ith one thing I really and truly would like to be…a dream beyond hope for such as me…”

“Come on Igor…spit it out man…what is it you want to do?”

“I want to be a dentitht Marthter. I want to be able to take peopleth teeth out. With plierth and other thingth. And I want a Nursie to help me and she mutht have big tit-th.”

“Very well Igor. Your wish is granted. A dentitht – sorry dentist – thou shalt be. And where in the world would you like to be a dentist Igor?”

“Karachi, Marthter…pleeth…Karachi…in Pakithtarn.”[1]

Karachi, Pakithtarn, June 2004

Doctor Rodney Mulvery FRCI (Fellow of the Royal College of Igors) plies his terrible trade in a dungeon at the 7^th Day Adventist Hospital in Saddar, one of the least beguiling parts of a city that is completely devoid of attraction for all except those with a fetish for rubbish. This is the place where your Correspondent has laid his head these last nine months when he is in the city. As might be inferred from the name of the hospital, it was founded by American 7^th Day Adventists about a hundred years ago and has been at the top end of health care in the city ever since. It is a private company, and altho it has a missionary origin is now a part of the burgeoning private healthcare sector in Pakistan, and has to pay its way like any other business, so when your Correspondent intimated that he might be interested in contracting some dental work of Great Wall proportions eyes lit up right and left. Dentistry, wherever you are in the world, aint cheap.

Despite all indications to the contrary your Correspondent was, at one time, a child. He was born in the dark and cold days after WW2, at the end of the dreadful winter of 1947, the first child of Dorothy and Patrick Cork. She a nurse, he a wounded veteran of the Eighth Army. And quite possibly something else as well, probably the Royal Signals. Childhood was unremarkable for the young Cork, until in the same year he had both glandular fever and appendicitis, with long spells in hospital for both. Whilst there he appears to have been fed a diet of undiluted antibiotics, then in the early stages of their development. Wonder drugs they may have been, but what was little known or understood at the time was the disastrous effect they could have on dentition, both thro childhood and in later life. So young Cork grew up being dragged weeping in and out of various dentists in west London, south London, Stockport, Bedford, Rochdale and finally Northampton, and left school at sixteen with a much patched and visibly battered, set of his own teeth.  Things did not improve down the years, and despite a lifetime spent taking risks of one sort or another, and generally being a bit of a gung-ho chappie, your Correspondent had a lifelong fear of dentists, and covered his miserable teeth with a splendid moustache as soon as nature and hormones allowed. The splendid moustache has grown over the years into something of an institution, occasionally measured against other similar outcrops, and usually coming out tops – only being significantly beaten in recent years by a policeman in Gilgit who could actually loop the ends of his specimen over the tops of his ears.

Every year there would be resolutions made that ‘The teeth will get fixed’ and they never did. The inside of the Cork mouth remained a place of shame and disrepair. The decline in the availability of dentistry under the National Health Service in UK was a contributing factor, and the vast sums of money required by dentists to perform the most basic of procedures further dissuaded him from action.

But the cogs and gears move on, and life winds its way through, and it reached a point where, on a whim, your Correspondent asked one day about the quality of dentistry at the 7-Day. Top notch he was assured. Our dentists are trained in America, Italy the Philippines and in the garage just around the corner from where we are now, where they do the heavy-duty extractions. The ones that need the ropes. And a harness. Block. Tackle. Plierth.

Those of you who had a traditional education may well have read the story of Huckleberry Finn, in which there is a classic of the literature of dentistry that involves a piece of string tied to a tooth and the violent sudden slamming of a door – the handle of which is attached the other end of the piece of string. Given that your Correspondent had recently interviewed a doctor at a rural health centre in the Punjab who performed major surgery without general anaesthetic, a sterile environment, any qualified nurses within miles and a range of instruments better suited to the adjustment of the primary drive shaft of a large tank, thoughts of friend Finn loomed large. 

‘Be not afraid’ – said the hospital administrator, for we have a dentist of the finest pedigree, coming from a long line of torturers who emigrated here many moons back. Doctor Rodney ‘Igor’ Mulvery is this very paragon, a dentitht of unparalleled skill and a dab hand with the plierths, even if I do say so myself. So, very much afraid despite the reassurances, your Correspondent went to the lair of the Wild Mulvery, there to peruse the price list for services about to be rendered.

The dentistry department of the 7-Day is in a little annexe at the back on the ground floor, and is dominated by a large promotional display of Colgate products in one corner and a set of chairs and a table with all the usual magazines that you find in dentists the world over – S + M monthly, the February issue of ‘The catheter’ and ‘Rubber Glove Quarterly’. Behind a desk next to a computer terminal sat the receptionist, who handed over the list of charges – which were extremely reasonable compared to everything else of a similar nature seen elsewhere in the world. The receptionist was quite definitely not of the golden-skinned lissom Australian variety, but very definitely was of the prop-forward variety, with a certain Igor-ish bent. Whilst standing at the counter and mulling over the pricelist your Correspondent became aware of the fact that somebody was talking to his penis.

“Good morning. How are you today? I hear you would like some work done here at the 7-Day, and I am delighted to thay that we can offer an excellent thervice at exemplary rate-th, ath I am sure you can thee.”

It’s not every day you get your Willie addressed as directly as this, especially in a voice accented with a curious mix of Pakistani English and something vaguely middle-European. Looking down, there was Doctor Mulvery who had sneaked in under the radar and was now beaming up at your Correspondent with the kind of smile that would have sat well on the lips of Josef Mengele.

Doctor Mulvery was indeed extremely small, but as genial a torturer as you could ever wish to meet. He rattled on at length about how qualified everybody was in the Dentistry Department, their record for cleanliness – the certificate being held up for my inspection by a large cockroach – and their all round ability to cut the dental mustard. Muthtard. Two rooms led off the reception, both equipped with state of the art gizmos, lights, drills reclining chairth and yeth, plierth, sitting prominently on the instrument tray beside the room belonging to the Wild Mulvery. ‘Errrrr…they look like plierths…’ says twitching Correspondent, pointing to the implement in question. WM assured that they were in fact forceps and only very rarely used, on especially intractable cases, where greater leverage was required.

Invited to sit down and open wide it was a step into the dark. Forget all notions of privacy and an air of professional reserve, once the WM got a look inside the Cork oral cavity it was Eyes Light Up Full Igor With Bells And Whistles and why don’t you folks all come in here and have a good look at this load of old rubbish! So they did. The Receptionist arrived, a couple of assistants, a cleaner dropped by to empty the bins and got a look as well, and finally, having rung the Chief Medical Officer of the hospital (another Igor, and brother to the one currently half-way down the Cork throat) to come and get an eyeful, there was quite an audience. The WM offered a multi-lingual commentary on his initial appraisal, with heads nodding and bobbing in front of the Cork eyes, which were dilated to the size of golf-balls and standing out on stalks a-la Wily Coyote on spotting Acme anvil descending at terminal velocity in the direction of his head.

‘Yeth…interethting…very interethting…ve haff never seen anything qvite like zith before…hmmmm…are you very rich Mr. Cork…?

‘Errrr…no, not really…why…?

‘Vell….zere ith zee bridgeworkth, and the root canal therapy, and then the upper and lower dentureth, and the extractionth…maybe fifty thousand rupees?

A quick calculation suggested that £500 was about right, and considering a UK dentist of Mr. Corks acquaintance had once had a look, screwed up his face in horror and said ‘Three grand…if you’re lucky’ – it sounded like a bargain.

And so it came to pass that the very next morning Mr. Cork held hands with himself and made the jump. An hour later he wondered quite what all the fuss had been about and why the devil had he not done this years ago when there was still a National Health dental service.

Dr. Mulvery was the very soul of reassurance, the audience of the first examination was banished to the wings, massive doses of local anaesthetic were administered producing pain-free extraction and over a period of seven days nine teeth came out, a front incisor was extensively excavated in root-canal therapy and all looked set fair for the installation of the new pearlies in the near future. But there was just the one hurdle to get over, the very last tooth to come out, the left rear lower molar, and did it want to come? Nope. So it was, right at the end, a job for the plierths. He tugged and pulled and yanked and assistants held the Cork head straight but no matter what he did the little bugger would not budge. He managed to get the top of the tooth off, tried dissecting the gum away, panted and heaved and then said ‘Ah…now I thee…tooth ith fixed to bone. Thith happenth thometimeth.’

As this epic thtruggle was taking place the WM was interrupted in his ministrations by a phone call, which in true Pakithstani fashion he took whilst on the job, cradling the receiver twixt ear and shoulder as he tugged mightily at the stubborn molar. His father had disappeared.  Puff of smoke…Pater vanishes. Put him on the train for Lahore last night, train arrived Lahore this morning, and no Pater. Older brother there to meet Pater…family distress raises by the minute…search of Lahore station…still no Pater. Pater is apparently in his mid-seventies and a tad confused at the best of times, so maybe not the best person to make a nighttime journey of 1000kms unaccompanied. All this was relayed at foghorn level directly into the face of your Correspondent, who, it has to be said, was not mightily impressed to be sidelined mid-molar by a missing Pater. Phone was handed to a slender assistant, (thmall tit-th, thadly) and work resumed, to be interrupted again by a call on the mobile this time, taken with another assistant holding the phone while excavations and manipulations continued. Matters had progressed, and the missing Pater was now the subject of a police enquiry, tho the Lahore police would have difficulty finding their own arses without both hands and a map. Matters were still unresolved when the session ended, and the last seen of the WM was him lithping into both mobile and landline simultaneously in the hope of locating missing Pater. It later transpired that the barmy old bugger had got off the train a station early and caught a taxi to his home village, and was blissfully asleep while the family had fantasies about kidnap and ransom. There was no extra charge for light entertainment when the bill was finally presented.

So the situation as this is typed is that the rooted rear molar is going to stay where it is and will be healed over to sit under a denture – a strange thing made of skeletal surgical steel – and the dead roots will eventually atrophy and be easily removed – at least that’s what the WM said. Excitement over, and feeling somewhat battered and bruised it was off to find a working ATM so that the bill could get paid; as dentistry, as with other health services is strictly COD in Karachi.

ATM’s are a relatively recent innovation as far as Pakithtarn is contherned. They are still widely misunderstood, and even more widely out of action or offline when you want to use them. The children of the family in the village were astonished to see Uncle Chris put a bit of plastic in a hole in the wall, press a couple of buttons, and get cash in his sweaty hand.  People still form small crowds and watch as the ATMs that have suddenly appeared in Karachi over the last year perform their financial magic. It can be a profoundly unsettling experience to have half a dozen penniless beggars looking – literally – over your shoulder as you punch in the PIN, but there are as yet no Urban Myths about robbers running off with cashcards and the like. Eventually, after a search of the foetid streets of Karachi with a thunderstorm pending and loudspeaker vans going around warning people not to lean on electricity poles if it rained,[2] there it was, a functioning ATM in a posh part of the city that loved my card and even said ‘Thank you’ when I took my cash. Considering that this was at the Muslim Commercial Bank, not a bank ever renowned for its ability to innovate, something of a leap into the twentieth century! Cash in hand it was back to the 7-Day and a bill of 6,400 rupees, about £64.00 or $110.00.

The final tetht of the WM and his squad will begin on the 1^st July, when the Great Denture Construction begins. It is hoped that the new teeth will be fitted and roadtested by the 8^th July, the day of the wedding of Sharoon and Sara, and that they will shine out from the wedding photos as they have never shone before – in fact since I was about seven, to be precise.

Some of life’s journeys we make harder for ourselves than they ever needed to be. Getting my teeth fixed was an act of considerable courage for me, and the battles of will and fear that went on inside me in the days and hours prior to Dr. Mulvery working his wizardry will be forever hidden from public view. But altho I now look like the victim of an RTA my head is just that little bit higher than it was a week ago, and I say to people ‘I’m down here getting my teeth fixed…they’re good at the 7-Day y’know…little chap called Igor something-or-other does the bithneth…very reasonable rateth…hardly hurt at all.’ And in three weeks time I will be able to give Rose the smile she has never ever had from me, and it will all have been worth it.

Thank you, Igor.

No problem, Marthter.

Chrith Cork

7-Day Hothpital

Karachi

16^th June 2004, 20.05 PST

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[1] Apologies are due to many, including…Mary Shelley, Terry Pratchett, Tony Robinson and the authors of the Blackadder series and probably a few others besides. Sorry.

[2] A surprising number of people find their demise in a casual lean against electrical poles in Pakistan. Especially when it rains for the first time after a long dry spell. 32 people died in this way in Karachi last year, said the Dawn newspaper today.

This was written when I spent 18 months living in my home village on the edge of the desert where I tried, mostly unsuccessfully to jump start a local NGO. You win some, you lose some. Re-reading the piece 14 or 15 years after I wrote it I feel no need to change anything. All the incidents I describe really did happen, nothing made up. It is one of my longer pieces so those of you with a short attention span may need a breather here and there. Now read on…

No, not the chemical or surgical castration of Dubya, much as it might be of benefit to the wider world, but the very imprecise practice of looking after oneself and ones fellows in remote stations, postings where there is no doctor. Or at least not one you would want to have lay hands on you.

Talk to any aid worker who has kicked around a bit and eventually there will be the ‘Did I ever tell you about…’ moment that is likely to involve fire, flood, act of god, warfare or personal accident or any combination of all; and how their impromptu intervention had saved/shortened/made even more miserable, a human life. What virtually all aid workers who work either for small organisations in poorly resourced areas, or are lone operators far from just about everything that modern medicine has to offer, will be the Bush Doctoring story to top all Bush Doctoring stories; only to be topped, after another round of drinks is got in, by something even more outrageous than the last tale of derring-do and personal inexactitude. The following pages therefore come with a health warning – there has been no attempt to sanitise or tone down anything you are about to read, on the contrary it will be talked up and embroidered (but still remaining on the side of Truth and the Angels) in an effort to brighten otherwise placid and trauma-free lives. You’ve been warned.

First and foremost – I am not a doctor, and have never pretended or aspired to be one. But force of circumstance, high-risk adventure activities like big-wall ice climbing and mountaineering generally, long-range cycle expeditions and an occasional acquaintance with things of a whizzy-bangy nature have persuaded me of the wisdom of acquiring the rudiments of first aid. So I have my Red Cross Certificates in just about anything an unlicensed person can do to themselves or others, a mountain rescue medicine course duly certificated (allowing emergency amputations, never used) and two utterly invaluable books – ‘Where there is no doctor’ and ‘Disabled village children’ both by a saintly man called David Werner, who sadly died not so long ago. David Werner was himself disabled, and wrote his original ‘Where there is no doctor’ book in Spanish almost forty years ago, when he was working in Mexico among mountain farmers (who farmed in, but did not actually grow, mountains.) It is now translated into about 43 languages, used in over 100 countries as a basic village health worker text and is regularly updated. My copy, much battered and heavily annotated over the years, was published by the Voluntary Health Association of India in 1994, and needs replacing. Anybody who would like to do me a real favour should send me a current copy. If I get more than one, no worries, I will pass them on to others who can use them even more effectively than myself. The spur for putting finger to keyboard today was a visit by a woman to the house this morning, coming to see Dosi, my sister-in-law and Keeper of the Village Condom.[1]

Dosi is an officially-recognised Treasure. Not only is she a wife and mother of surpassing quality, she has a smile of mega-wattage, a filthy sense of humour, the ability to make a decent cup of tea and, quite crucially, the training and aptitude that allows her to operate as a basic health worker. BHW’s are often the only local people with any formal medical knowledge or training, and they are the ones that give out the simple medicines, administer the vaccinations for polio and other ailments, do the health education and generally act as the community first line of defence in the eternal battle against disease.

She works for an offshoot of the French NGO, Medicins du Monde, gets 2000 rupees a month for being on day and night duty, and is very good at her job. We are now moving out of the season where respiratory ailments are the order of the day, into the season of diahorrea, heatstroke, malaria and assorted ailments of the eye. Glaucoma and trachoma are common, but by far the commonest is conjunctivitis. This is invariably caused by dust irritation, and the lady who showed up today had a nasty dose of it.

She sat on the bed in the communal sitting room while I was eating breakfast and copping my fix of BBC News that always accompanies it. We exchanged felicitations and Dosi said she had come suffering from an allergy. I looked across at her and said ‘No, not an allergy, an irritation’ and went on to explain the difference between allergy and irritation/infection, complete with drawings and my trusty volume of ‘Where there is no doctor’. I explained to the woman that wiping her eyes with a filthy dupatta was not a good idea; neither was sleeping under a pile of children who were likely to catch it as a result. We found an appropriate tube of ointment and I showed Dosi how to turn back the upper and lower eyelids to properly apply it, with me doing the demonstration on one eye, and she then repeating it on the other. Nobody had shown her how to do this procedure, and she had been giving out the medicine for conjunctivitis and telling patients to rub it on their eyelids, not to put it underneath. There followed a long discussion about basic health care generally, and the seed for this piece was sown.

The first serious piece of bush doctoring I ever did was in the Atlas Mountains, near the village of Sidi Chamarouche, in 1976. I was a member of a small group of enthusiastic mountaineers who were also social work students at the time. We were bloody miles from anywhere, it was Ramadan, and our guide Lassen was hazy about our precise whereabouts (we had no maps). We were sitting in the shade for lunch minding our own business when around the corner hove a big pickup, filled with a bunch of very unhappy looking men. With guns.

Hello, we’re the Polisario.

The Polisario were a bunch of Freedom Fighters battling the government of the day, and we had wandered slap-bang into one of their areas of control. They had an unsavoury reputation in terms of their treatment of tourists, and were not noticeably impressed by our invitation to lunch. Lassen fell over himself trying to retrieve the situation, but it seemed they wanted us to stay put. So we sat for half an hour looking glum and pondered our fate. Then one of them came over with Lassen and speaking in Arabic through him asked if any of us was a doctor. None of us were. Well what about medical kit, does anybody have medical kit? In fact we all did, of sorts, but I was the unofficial medicine man for the group, being the only one to have had any sort of training or experience, and also having an above average medical kit. So my colleagues volunteered me for the job. Job! Feeling distinctly nervous I went with Lassen and Mr. Polisario to the pickup truck, not knowing what I was going to find, and dreading it whatever it might be. And it certainly was not what I expected or feared.

On the bed of the truck lay a very old woman. She was awake and alert, and sat up when I stood at the tailgate. Mr Polisario introduced her to me and Lassen as his Mother, and could I help her? Cutting to the chase, Mum had got an infection in the middle finger of her (IIRC) left hand, a huge puce and white and red thing that was hot and hard to the touch. It looked like a torpedo attached to her finger. She was clearly in pain and running a huge fever. She had had it for a week. I said she needed to see a doctor, not me. Mr. Polisario not happy with this, and said so. I had my medical bag with me and explained it was just for very simple things, not the sort of problem his Mum had. But I did have a couple of sealed scalpels, curved needles with attached gut and several courses of my old favourite Ceporex, a good all-purpose anti-biotic.  There comes a time when you have to take the occasional risk, and this was one of them. These guys were playing hardball, and wanted something done jaldi-jaldi. I asked to talk to my friends first, and went back and explained things to them. For social workers they reached a decision with commendable swiftness, and volunteered me yet again as surgeon-elect. Back at the pick up it time to shit or get off the pot. I had Mum sit on the ground, told Lassen to explain what I was going to do and that I had no anaesthetic, and that I was not a real doctor, and she just looked at me and nodded. I poured a sachet of concentrated disinfectant on her finger, wiped it with a tissue, and quickly ran the scalpel the length of the finger, from the top of the palm to the top of the pad above her fingernail. I had no idea – again – what to expect beyond lots of pus and some blood, but got neither. What I got was a splitting of the skin to reveal a solid whitish shape that I at first mistook for bone, but which turned out to be some sort of capsule of infection that popped out like a pea when I pressed the sides of the wound. It fell to the ground between her legs, looking like an unpleasant insect or giant grub. She actually smiled at me. Mr. Polisario smiled. Lassen smiled. I nearly threw up. I irrigated the wound with another sachet of disinfectant, which must have been excruciating but she never flinched, and then ran a half-dozen stitches up it drawing it as tight as I dared. Taped it over with gauze-backed Micropore and Bobs a very close relative. Out comes a course of Ceporex, instructions written out by Lassen in Arabic as to dosage, and International Friendship broke out all round. Back were slapped, hands shaken, mint tea drunk in vast quantities and we wandered off in the late afternoon, eventually finding the Toubkal base camp as night fell. We climbed Toubkal over the next couple of days, dropped down the arête to the roadhead and were in Marrakech a week later. Piece of cake. Except that I had galloping dysentery and no medication, having given it to one of my colleagues in the mistaken belief that I was immune to such things.

It was to be ten years before I was called upon to try a similar trick, and in not dissimilar circumstances, but this time in Nepal. I was climbing and trekking in the Everest region with a group of mates from the Old Dungeon Ghyll pub in Langdale, a famous climbers haunt in the English Lake District. We’d had a bit of a muck-about on Everest, getting up to Camp II before discretion got the better part of valour, knocked off Island Peak and been knocked off by Pumori. Quietly satisfied, we were doing a long high circuit back to the roadhead at Jiri when one of our Sherpas came down with something nasty. Sherpas are the local tribespeople who have made a decent living out of the mountaineering fraternity for a hundred years or more, and are themselves formidable mountaineers, with Tensing Norgay being the first Sherpa to climb Everest with Ed Hilary in 1953. We had an excellent bunch of Sherpas, male and female, who had looked after us for a month, and to whom we had got very close. Norbu was not the sharpest Sherpa in the box, but he was always cheerful, and it was a surprise when, one morning, he was not on duty as per usual and lay in his tent, inert. We thought he might have died in the night of mountain sickness, that can even kill experienced Sherpas, but Tony, an ex-soldier got in and had a look and declared him alive but ill. Again, no sign of doctor and the nearest was at Kundon, where there was a tiny hospital manned by volunteers, two days away. This time we did have maps and knew where we were, but our yaks had gone round by another route to meet us below Namche Bazaar, and we were with just what we carried, all the heavy kit and equipment having gone with the yaks.

Norbu had a version of what the Polisario Mum had, but infinitely worse. He had either cut himself or got an infected wound at some point, and one of his arms was a weeping heaving mess of infection, pus, caked muck and – and this was a good thing – maggots. The maggots were probably keeping things at bay, munching on this and that and generally doing the maggoty business. It needed debriding, a job that fell to Tony and I, and a bit of a clean up but not too much, followed by a Serious Conference. We snipped away the rotten flesh with the nail scissors on a Swiss Army knife. (Which I still have with me.) He could not walk, we had no stretcher and it was improvisation time. Between us we had six amps of morphine, a couple of field dressings and assorted painkillers and various treatments for the shits. In the end, we lashed three frame sacs together, tied Norbu to them, and carried him for 36 hours to the Kundon hospital. Sadly, he lost his arm, but we did our best for him. I saw him a couple of years later, with a Heath Robinson prosthetic, showing tourists around the remains of the Rongbuk monastery, that had burnt down on the very day that the electricity supply was turned on for the first time. Ho hum. The price of progress.

Messy business, birth. Very messy. Not made any easier when the delivery in question is a breech, arm out first, mother is a first-timer, likewise Doctor, and I am holding the aforementioned ‘Where there is no doctor’ which the Doc is consulting at regular intervals. The scene is illuminated by my Petzl head-torch. All this is going on in the back of a jeep on the side of a mountain at two in the morning. A tribal had awaked Dr. Zahid and me in our separate residences. He was from one of the valleys in Nagar, deep in the Karakorams of northern Pakistan in late summer 1996. Dr. Zahid was the only Doc for 100kms in any direction, and I was his boss. Ayoub, my driver had taken both of us to the point where the woman had been brought down to a place close to the road by her family members, a move that was later to cost all of us dear. Zahid was a properly qualified and practising doctor, but what he knew about medicine and women you could get on the back of a packet of tampons. He had never delivered a baby in his life, but had seen a film of it once. He had no idea what might be involved in a caesarean section and was deeply worried about the whole business. My role in this imminent disaster was to hold his bag of spanners, provide encouraging advice along the lines of ‘Hmmm…that looks about right, Zahid’ keep my headlight on the area of operation and stop Ayoub the driver from fainting. I later learned that he had never seen a woman’s genitals for real and was suffering from almost terminal embarrassment. The husband had drifted off into the rocks somewhere and Dr. Zahid and I were quite literally on a voyage of discovery. WTIND is pretty good on most things, but when it comes to birth of a complicated variety, and very specifically where there is an arm where there should not be an arm, it says in big caps ‘TAKE PATIENT TO NEAREST HOSPITAL IMMEDIATELY.’ Gilgit was the nearest, four hours to the south, and we didn’t have four hours.

The decision to actually cut the woman was Zahids. She was screaming and thrashing about, we had no painkillers and in the end Ayoub had to sit on her chest and hold her arms. I sat to one side holding the book, which had a picture of a traditional caesarean and a brief ‘how to if you have to’ and wearing a brave smile that I hoped suffused Dr. Zahid with overweening confidence. He cleaned her with fluid from an IV drip, said a prayer and got on with the carving. And not a bad job, in my humble opinion. It was a bit ragged, but he managed to extract the infant, deliver the placenta, cut this and that, clean up the woman and do the necessary embroidery and at the end of 45 minutes the world had another citizen, the woman was alive and we were quite pleased with ourselves. A decision was taken to try and get her to an unmanned BHU in Hunza, a couple of hours away, that whilst it had nothing beyond a few pills and a clean bed, was at least better than the bloodied jeep she was in. Husband returned to drive jeep, Zahid and I followed. We broke the lock on the door to the BHU at about 5 a.m. and found an Aga Khan LHV who lived close by, who agreed to look after the woman. Then our problems really started.

You’d think there would be pats on the back all round for that little epic, but not so. Local conservative religious persons took strong exception to the breach of purdah that had occurred, in that I had been present at the birth, as had Ayoub and Dr. Zahid. Nobody in the religious fraternity were in the slightest concerned for the poor woman or child, only for the cultural Nazi-ism that occasionally prevailed in Nagar. Slogans appeared on rocks close to my house and office, calling me a Zionist spy, my wife Rose ‘a leader of prostitutes’ (she was a women’s development worker at the time) and threatening us all with death. This was serious stuff, and required immediate action on the part of various members of my management committee to calm things down. Matters were not helped when the Crazies dynamited a jeep at the BHU where we had taken the woman and child, and poured burning kerosene down the chimney when the Lady Health Visitors were in residence a week later. The woman herself was evacuated to Islamabad, as there was a real risk that she would be killed, along with the child, for having ‘dishonoured’ her tribe. Her husband bravely stood out against the Crazies, later going on to be elected as a member of the local Union Council, the bottom tier of local government. It all blew over after a month or so, but it was a bit tricky for a while.

Dr. Zahid was party to another little escapade the following year, when we decided to have a crack at getting some health care into the most remote part of my operating area, the Hispar valley. Hispar really is about as far out on the edge as you would ever want to live. It is the most remote part of a remote area, only accessible for three or four months of the year, and lived in by quite the oddest bunch of humans I have ever encountered in my life. Hispar was (some say still is) the area used by the Mir of Nagar as an open prison, where he banished subjects who had fallen out of favour. There they lived scratching a living at the bottom of the glacier in the most marginal of environments. In recent years there had been attempts to improve their lot. There were about a thousand of them, all living in a single large village. The Aga Khan Rural Support Programme had built a mini-hydel for them, a pocket size hydroelectric generator, which they had promptly pillaged and sold off for scrap. A government tax collector had made the serious mistake of getting in in 1995. They killed him and left the body in the middle of Hura Bridge, the last place where you can cross the river with a vehicle below their village. Beyond the bridge there is a track that is blasted with stonefall, or drops occasionally into a washout. The last time any health service had got in, according to the director of Aga Khan Health Services in Gilgit, was fifteen years before. And they were not about to use valuable helicopter time and fuel by trying again. Perhaps not the most promising of populations to try a little outreach operation with.

But they had come to us, apparently because they felt we were somehow ‘OK’, in the person of quite the smelliest visitor I ever had in my office. This man, who turned up one day in late spring looking like he had dropped from the set of Planet of the Apes, stunk like a pile of corpses. He was even considered smelly by the Nagrocis, who collectively are the smelliest people on the face of the Earth. It was the kind of smell that instantly contracts the throat and engages the gag reaction. He was stooped, spoke a form of Burushiski that even Rose found difficult, and it was some time before we actually found out what he wanted and where he was from. When I told my management committee a day later that there had been a request for a health camp from the Hispar people there was a stunned silence, followed by the Nagar version of ROFLMAO. Serious debate followed, as there was real concern that this might be a ploy to lure us in, kill us and take our jeep. Despite the somewhat ‘jokey’ feel the idea of an open prison might have, there were some VERY serious criminals in Hispar – killers, robbers and bandits. So we sent a dak-wallah with a letter on a stick (no, I didn’t make that up) that he left on their message point on the Hura Bridge. We wanted to have safe passage assurances, and for a couple of their people to come down and stay in Lower Nagar at Askurdas until we were safely returned. They astonished us by agreeing, and the dak-wallah brought back a couple of their reps four days later.

It was to be me, Rose, Zahid, Ayoub the driver and the doctors assistant at the time whose name now escapes me. We crammed the Daihatsu Rocky with everything we could think of inside and out, put extra fuel tanks on top, and water, said our goodbyes and off we went at dawn. I have to admit to having Blackie under my arm, and Rose her old Webley revolver on her belt. Ayoub had his sawn-off PA under the seat and a couple of grenades. We made it to Hura by about 11 in the morning, the road being reasonably good that far, and had a close recce by field glass before going on. All quiet. We could see something white on the dak-stick they used for messages on the bridge, and it turned out to be another surprise. It was in English, from a man who had agreed to go and set up a school for the Hisparis, saying that he had arrived two days before, they were peaceable and cooperative, and we would be OK. Rose vaguely knew the author of the letter, a Hunzakut from Karimabad, and said he was a good egg.

Beyond Hura, it got interesting. Ayoub is one of the very finest mountain drivers in the whole of Pakistan, and the track even taxed his skills. There was negative camber on the track above the river; rocks falling from the thaw above hit us, the armoured windscreen starred, our poor Rocky even more battered than ever before. At one point I thought Ayoub had lost it and was about to give the ‘bale out’ order when he did something fiddly with his fingers on the dashboard. Like he was playing an instrument of some sort. I shouted ‘What the fuck are you doing Ayoub?’ and he immediately shouted back ‘Turning jeep into heli Mister Chris’. A comforting man to have around, Ayoub. He later told me that he was sure we would be OK because I was wearing my Jadoo Topee, or Magic Hat. Ayoub had been convinced that my most disreputable hat, the filthy cricketing number I still wear, was bulletproof,[2] and that as long as I wore it no harm could come to us. I make sure I have it close by me always, just in case he was right. After a couple of hours of this we emerged on to the little plateau where Hispar village sits, driving past a very un-encouraging graveyard and the ruins of the hydel.

And there in the middle of the road was the teacher who had left the message on the bridge and with him the Simian Wotsit who had made the first contact with Naunehal Development Organisation, of which I was Director.

There followed two days of non-stop doctoring and grassroots development work. To their credit, the Hisparis had decided it was time to come in from the cold, both literally and metaphorically, and wanted to join the rest of humanity. There is a tool that I use with emerging communities called PRA, or Participatory Rural Appraisal, which is designed to allow those of us doing the developing to respond appropriately to those who want the development, using a timetable and agenda that they are comfortable with. I had a confab with the teacher and got Plan A together. Zahid and his oppo set up surgery in the ruins of an ancient government building (which a couple of years later was revived as the first VRRHC -Very Remote Rural Health Centre – in Pakistan. See…I DO win some!) and I tried to work out with a consortium of local people just what they were hoping to get out of the exercise. PRA involves quite a bit of sitting around with stones that get moved about to represent different situations. This can go on for hours. Days. Rose interpreted the crude Burushiski (she speaks eight languages at the last count and is currently working on her Spanish) and eventually took over from me as Zahid had asked for my assistance at the med camp. It was not so much assistance that he needed, as moral support and a second witness as to what he was seeing in case nobody believed him later.

It’s not every day you see somebody with three legs, or several people born with a single eye, admittedly not in the centre of their forehead. Or a range of such grotesque physical deformities that it could only point to very long-term inbreeding by this group of people. There were simply far too many oddities for it to be anything other than genetic malfunction. Statistically in this size of population there might be two or three, here there were dozens, of different forms and severity. And so it proved to be. There were not only cousin marriages, but also relationships that had produced offspring in pairings that traduced natures laws.

Not only were they having trouble on the genetic front, there was an alarming incidence of goitre, pointing to them not using iodised salt in cooking. Children with hugely distended thyroids were presented to us, as were children who had been imperfectly circumcised with predictable grisly results. In health terms it was an absolute disaster area. There was a very high incidence of respiratory illness in young children because of the practice of covering their faces with a gauze mesh until they were five or so, to prevent their eyes being invaded by evil spirits. I took picture after picture, and held patient after patient for Zahid, who was heroic on those two days. He did knife-and-fork tidy-ups on the worst of the botched circumcisions, excised growths, freed webbed fingers and toes and generally did all that could be asked of him and more. The people had cleared a house for us to stay in, and we all bedded down together on that first night, exhausted and wondering at what we were seeing and had got ourselves into. The next day was much the same, except that we were now infested with lice ourselves, having picked them up from the house we slept in.

Plan A turned out pretty well in the end. The community was clearly in crisis and urgent need of every kind of help. Fortunately, the teacher who had volunteered to stay with them was also a competent social organiser, and he was the base on which a development programme eventually grew over the next year. The government agreed to fund medicines if we would take them in, and we scrounged educational materials, health education stuff from an NGO in Lahore and generally pulled out the stops for the Hisparis. It wasn’t all plain sailing, but our efforts – and theirs- bore edible fruit remarkably quickly. The last I heard, a year ago, was that they had established a small guest house to serve trekkers coming over the Hispar glacier and had got themselves on the tourist map. A local woman had started to train as an LHV courtesy of the Aga Khan Health Service in Karimabad. Dr. Zahid and myself had long moved on, but those two days in Hispar will be with me for a very long time.

These days, its all a lot less adventurous. The worst I am likely to encounter is a vehicle breakdown in somewhere remote, but somebody always knows where I am, and I am never that far from help. And the population is not armed, a big plus on the development side; but the problems of providing a health service to a diverse and dispersed population remain. As do the difficulties of working with a corrupt bureaucracy, bloody minded local officials and the downright dim-witted. Some days it feels completely pointless, as you confront yet another case of a woman who has twelve live children, assorted still births and whose husband is beating her for not producing more sons. Or the Xtian priests who try to cure deafness and diabetes by casting out devils (it happened in my own family here in the recent past) or the kids suffering from vitamin A deficiency because the goodness has been boiled out of their meagre diets by ‘cultural’ cooking methods. And on other days, when shy ladies turn up to scuttle off with a handful of condoms, or a man asks for a vasectomy referral, or a family builds a latrine, you think the other way. My actual bush-doctoring is limited to a little gentle advice to men and women who are far better trained and skilled than myself for the most part, and who are beginning to provide primary services at a recognisably satisfactory level. The TB and hepatitis problems are intractable, and we have a severe malaria problem in the village right now, and there are rumours of a fresh rabies wave on its way in from the desert. I had to shoot a mad dog the last time this happened, and frightened myself half to death in the process. But that’s a tale for another day.

Chris Cork

Chak 74-A Fatimapur

27^th March 2004, 20.00hrs PST

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[1] There is actually more than one, but re-rolls are not uncommon here and are sold as such in some bazaars.

[2] This was based on the fact that we had both, on one occasion, run through gunfire to gain the shelter of the underside of the Rocky. I was wearing The Hat at the time. Of such stuff are legends born.

No.

No?

No…no ticket for Jhelum.

Why not?

Not possible for ticket to Jhelum.

But the ‘Pindi bus, it goes thro Jhelum.

Not possible.

But it does go thro Jhelum, look, on the map in your brochure, Jhelum.

No, not possible.

Why is it not possible if your bus goes thro the bloody place?

Because of ladies.

Ladies?

Yes, not possible because of ladies.

What is the ladies problem?

The men, the men getting on the bus, these are the ladies problem.

What men?

With no tickets only for the ladies on the bus and tea.

You mean the men who want to see the hostess ladies?

Yes, these men. So no stop at Jhelum.

But there are already men on the bus…

I don’t understand you…not possible for Jhelum ticket.

How about if I go to Lahore and change for Jhelum from there?

OK, I will ask the Manager.

No, not possible.

Not possible to get a ticket for Jhelum or a ticket for Lahore to change?

Not at all possible. Ticketing problem.

But you have a computer ticketing service.

Ah yes, but the system is down today. Saturday, you see.

The system is always down on Saturdays?

…hmmmm…usually.

So where could I get a bus that goes to Jhelum?

At bus station.

Any bus station? Any one in Bahawalpur?

No…only one.

So which one?

I am not sure.

Not sure?

…hmmmm…maybe by Farid Gate there is bus station for Jhelum.

There is no bus station at Farid Gate, only rickshaw stand…

…ahhh…yes you are right. Maybe further up road…

But you think that is where I can get Jhelum bus, maybe?

…hmmm…maybe…maybe not…

Thank you

No problem Sir.

Sargodha?

No, Jhelum. Jhelum…near ‘Pindi.

You want bus for ‘Pindi?

No Jhelum.

…ahhh! Jhelum! Yes, over there…Niazi travels…they bus go Jhelum.

Thank you.

No problem.

Jhelum? Hmmmm…maybe.

C’mon, you must know if you have a bus to Jhelum.

Yes, Sir, we do.

OK I want to go on Monday, at what time does it leave?

Maybe you don’t want to go to Jhelum, sir.

Yes, I do, I want to go to Jhelum.

There are no tickets, sorry Sir.

You are fully booked for Monday and today is Saturday?

No Sir, not book full but no tickets.

Why?

Problems…many problems.

Like what? All I want is to go to Jhelum, what is the problem with that?

Road is problem, Sir.

Road? Problem? How is road problem?

Very bad Sir. You would not like it.

What sort of bad? Bumpy? Bumpy no problem for me.

No Sir, very bad road. Not bumpy. Very good road to Jhelum.

Not bumpy bad road?

Very bad. Train is better.

Train?

Yes train.

Why is train better?

Because then there is no bad road and you are happy.

I will be very happy if you sell me a ticket to Jhelum…

Very problem Sir…

…ahhh…is problem dacoo?[1]

Sometimes Sir, and very problem for goras.[2]

Always dacoo this road?

…hmmm…sometimes…

…so better get train?

…yes Sir, better train.

Thank you.

No problem sir.

So which train is best to get for Jhelum?

Not possible.

But the Rohi and the Awam expresses go to Jhelum…it says so here.

Yes they do but not possible. Booked.

How do you know they are booked?

Maybe they are booked.

But you don’t know if they are booked?

…maybe…

So tell me the times of trains to Jhelum.

They are in the night.

At what time they leave Bahawalpur? And is there a sleeper coach?

No Sir, no sleeper, only a/c lower.

Any Parlour class?

No.

So only hard?

Yes.

So at what time and how long it takes to Jhelum?

Very very long.

How long?

Many hours. Many.

So how many? And what time it leave Bahawalpur?

Maybe twelve.

Twelve hours travelling or it leaves at twelve?

Yes.

At what time it leaves?

…hmmm…9.30.

At night?

Yes.

So can I have a ticket for Monday?

No.

No?

No. This only enquiry this wallah along he tickets.

Hello. Ticket for Jhelum on Monday, a/c lower please. Awam Express.

Hmmmmm…maybe…hmmm…no. Booked.

What…all booked?

All booked.

There are 68 seats in a/c lower coach and they are all booked on Monday?

Yes, all booked. Maybe you go later?

No I want to go on Monday…or maybe Sunday. Any chance Sunday?

…hmmm…no…all booked.

Any other train go to Jhelum?

No, only Awam. Maybe you go by coach. Try Daewoo.

Thank you, I was there this morning, and they do not stop at Jhelum.

Hmmm…very problem sir. Go to ‘Pindi, then Jhelum bus.

But ‘Pindi is 70 miles on from Jhelum…

Hmmm…

Thank you.

No problem, Sir.

Ticket for ‘Pindi please, Sunday evening.

But we do not stop at Jhelum, this Manager he explain you.

That’s OK, just a ticket for ‘Pindi.

But you want to go to  Jhelum…

That’s right.

So why you want ticket for ‘Pindi? Train goes Jhelum. Niazi go Jhelum.

Train booked, Niazi say dacoo…maybe…

…ahhh…yes…dacoo on that road, this why we have armed guards on bus.

So why not go another route with no dacoo?

No Sir, this very good road through Jhelum, very fast.

I see…any chance of a ‘Pindi ticket for Sunday night?

Are you sure Sir, we not go Jhelum…

Just give me a ‘Pindi ticket.

Certainly Sir, that will be 550 rupees seat number sixteen, leave 9 p.m.

Thank you.

No problem, Sir.

Chris Cork

22^nd August 2004, 17.50 PST.

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It came as something of a shock when I recently crunched the numbers on my writing, published and unpublished, over the last 20-odd years. There are over 6,000 pieces mostly editorials, plus over 700 columns and op-ed pieces and then there is the unpublished stuff, possibly 300 or so, spread across three computers and a variety of external hard drives.

There is a plan. Well sort of. For years The Book has been talked of, started and stopped, and never really got the attention it deserves. But with my 72nd birthday waving from a near horizon and assorted clocks ticking it is time to get my arse in gear and do something about The Book. Shape has emerged. The Book will be a compendium of op-ed pieces written between January 2005 and December 2018 each with a commentary explaining context. Depending on space there may be a scattering of editorials but mostly it is going to be the Thursday Thunks, the weekly op-ed column that has chronicled the life and times of a Brit in Pak. Which leaves the bits and pieces that were never designed for the printed page. Some are quite long, running to 20 pages, some are designed to be humourous, and others are part of a series call the Ootergrams that ran in the early part of the first decade of this century. Some are quite intimate in that they touch on areas of my very private life and some, a large handful, are worth giving the light of day via this medium – a blog.

These are what I am calling The Pakistan Papers. The oldest date from the mid-90’s, the youngest late 2006. They cover my period in Afghanistan, NGO work, births, deaths and marriages, triumphs and disasters. None of them are deathless prose, but the least worst are the ones that are going to make the cut. They will be posted mostly unedited, as raw copy, except where I judge my family members in particular would not be pleased to find our internal matters laid before the world.

Having spent a couple of hours today reviewing potential content it is clear that there is much that is just too tedious for words alongside pieces that may be of interest beyond those who know me personally, and a few gems that sit on the fence of fit-to-print and best-to-go-in-the-blog.

Once they are posted here they become public property and I have no control over what is done with them. they can be copied, linked, plagiarised and commented upon, they in a sense cease to be ‘mine’ though they are ‘of me.’ The first couple will be appearing in a day or so. Watch this space.

Slightly to my surprise I find that the term ‘cloud cuckoo land’ has its origins in the far past, a play by Aristophanes called ‘The Birds’ written in 414BCE. I found the reference in my yellowing and now rather frail copy of Aristophanes plays published in the Penguin Classics series. It describes a place – a land – where there is a surfeit of over-optimistic fantasy. Where belief in the impossible possibly happening is widespread rather than an understanding of ground realities. The occupants of cloud-cuckoo land are naïve, perhaps deranged, and led by people who cannot be trusted with the key to the cupboard where the cookie-jar is kept.

Which brings us to the detentions and sequestration of properties by the government in the last week, all in the name of countering extremism, fighting terrorism and generally clearing out some of the darker corners on the state. Some high-profile figures and relatives of other high-profile figures have been taken into ‘protective custody’ and the mantra of the National Action Plan (NAP) has been invoked time after time as the roadmap to a cleaner safer country.

There is your bollox, the regular workaday stuff, the top bollox that tends to be in the fondling of our leaders and then there is the Utter Bollox, the very pinnacle of Mount Bollox. It is the realm of the Utter that we enter when considering quite what all this activity actually signals. And the fact is Dear Reader that this signals precisely zip, zilch and nada. Nothing.  Foxtrot-Alpha.

But…but…what about all those schools that have been taken over, all those madrassahs where an administrator has been appointed   and the charitable institutions which have been taken over? What about them? Well in respect of the latter I saw them in action in the immediate aftermath of the 2005 ‘quake, when the medical centre set up in Abbottabad, staffed and equipped in under 36 hours by one of the organisations that now finds itself getting a hiding – was truly a wonder to behold. Again in Sindh after catastrophic floods. These are organisations whose capacity to make emergency responses considerably exceeds that of both federal and provincial governments. Those that have now taken over lack the human and institutional capacity to replicate what has gone before in the event of another natural disaster. When you are having your broken leg fixed by a doctor whose socio-political views would make your hair fall out if you knew what their deepest darkest desires for the Land of the Pure were then yes, you are going to put your hand in your purse when the collection bowl comes around. Millions do, which in part accounts for the wealth of some of those now under the hammer.

But back to dear old NAP. As wish-lists go it was close to perfect. As a credible to-do list it fell far short. There has been no nationwide attempt to create or sustain a countervailing narrative to that so ably peddled by the extremists that have shoved the state to the right in the last decade. There has been tinkering at the margins in terms of interdicting foreign funding for extremist groups but it is half-hearted. We are years past the tipping point, the point at which the many shades of extremism had gained a primacy in the national collective consciousness. What little secular liberal space there was has shrunk almost to invisibility, sustained by Twitter and WhatsApp and FaceBook. There is no secular political organisation that commands a mass following. Woe betide anybody that taps that particular drum hoping to rally moderation because they quickly find themselves accused of being anti-nationalist, anti-Pakistan and not in tune with ‘our values’ and deepest pit of all – blasphemous. And we all know what happens to blasphemers do we not?

Thus I do not for one moment believe that the state be it deep or shallow, has the slightest intent to roll back extremism, but is closely engaged instead in a cloaking and deception operation that is going to satisfy the Financial Action Task Force (FATF) and allow organisations and individuals to rearrange themselves in such a way as to allow them to slip once again under the radar.

As in the past they will live to fight another day, and those now twiddling their thumbs will soon enough find themselves back from whence they came. No charges are pending. Nobody has appeared in court. No FIR has been registered and cloud cuckoo land goes its rainbow-hued way, drawn by a cohort of unicorns down a road strewn with petals.

OK…anybody up for a street corner meeting to celebrate the advances made in Pakistan on the human rights front over the last decade? Anybody…?

Given the uncertainty about my position at National Courier – I am currently on strike pending the payment of three months arrears – I decided to set up a blog to preserve the continuity of my weekly column. It has appeared with only a couple of missed every week since the 2nd week of January 2005. Here the format will be the same – a piece 700-800 words most likely appearing on a Thursday. It will be edgier than my mainstream print pieces, there are no editorial constraints, but it will continue to be a commentary on the life and times of a Brit in Pakistan. Watch this space.

Thanks for joining me!

Good company in a journey makes the way seem shorter. — Izaak Walton