If It Ain’t Broke? CRH is Definitely Broke

Local news headlines are reporting that the regional hospital on the western end of the island is having difficulties with the decades old ventilation system, forcing most of its services to be badly curtailed. As the only Type A hospital outside of the KSAC its services are integral to regional health stability. Not just the most critical patients but also the day to day management of stable patients depend on this hospital’s functions.

Which is perhaps why in an effort to avoid national panic, the Government (through the media) has downplayed the potentially longstanding and severe effects of the situation. Ventilation issues are the problem, they quip, and point to engineers assessing the situation, the plans in place to fix it. Never mind that every day brings the shut down or relocation of some critical department. Never mind that daily staff and patients are exposed to unknown airborne chemicals with unforeseeable effects to their physical health.

The problem as Dr. Christopher Tufton rightly pointed out is primarily one of neglect. For decades the ventilation at CRH has not been working and none of our successive governments has bothered to fix it. So when a simple problem of airborne irritants occurs there was no ventilation  system in place to redirect the fumes. And when they did turn the system on the problem only worsened. (This is a classic example of sick building syndrome).

Internationally speaking, workplace hazards are problems ripe for litigation. It is the responsibility of the employer to ensure that the employee is not placed at unnecessary risk in carrying out his or her duties (the so-called ‘due diligence‘). Where unavoidable this risk should be carefully calculated.

Human lives are at stake.

Healthcare workers are put at risk in so many other ways: needle-stick injuries, violent patients, contamination with blood or other bodily fluids, the constant exposure to illness. We mitigate these risks as best as we can, accepting them as part and parcel of our call to service. But the continued pressure to work in an environment with unidentified and potentially catastrophic risk is, I think, too much to ask. What the media (and therefore the public) have yet to fully realize is that human lives are at stake: patients, medical and non-medical staff, siblings, spouses, parents, children.

I don’t envy the Health Minister’s seat right now, backed into a corner with IMF restraints and the demands of an ailing health sector. And just as you said, Dr. Tufton, there is no quick fix. But the people working and convalescing in this contaminated institution cannot be left to languish while the situation is slowly rectified. Decisive action is needed if lives are to be saved. Come Dr. Tufton, do sumn before sumn do wi.

Ode to Cat

My cat turns one year old this month, and I love her more than I ever thought I could love another living creature. I love this cat more than my mother. More than my partner. And though my mother would be a little annoyed, my partner is unfazed. Perhaps because my cat loves him more than she loves me.

Cat comes first. Her delight at dismembering roaches, frogs, lizards takes first place over my delight at having a floor devoid of tiny animal guts. Her disgust with hours old cat chow takes precedence over my sad attempts to ration her (expensive) food. Her desire to be on my lap right at this very moment even though I have to get ready for work supersedes my need to get ready for work.

Cats aren’t usually paraded as the most affectionate of pets but it is a goddamn miracle whenever she chooses to hop into one of our laps at the dinner table. The ensuing nuzzle-and-purr I am convinced are mere tools to ensnare us even further and I wish I would resist (especially when she hops off to bring a cockroach home and it inevitably runs across my bare feet) but she is just so precious dammit.

Of course I get mad at her. She destroys the furniture, bites my ear when I don’t wake up on time to feed her, scratches my feet at play, and have I mentioned bringing creepy crawlies into the house? But even in her craziest, sprint-across-the-house-at-2am-for-no-goddamn-reason moments I still manage to lose myself in her huge – eyes (the crazy eyes) and that faint meow so unique to her.

She widens my heart one feline stretch at a time, indulges my need to cuddle, teaches me about acceptance and patience and selflessness. She’s everything I ever imagined a cat would be (plus some other things I never thought of – roaches, again).

Now excuse me while I put some alcohol on my fresh claw marks.

Sankofa: Critiquing our Coverage of Culture

I have been remiss. Too often I forget that this is a space of growth, questions and a conscious quest for truth. It is too easy to descend into aggravated polemics without stopping to consider and critique. It’s the writer’s equivalent of chewing with your mouth open.

In pursuit of critical discussion I have stumbled across The Nassau Guardian, the oldest and largest newspaper in The Bahamas. More specifically, their Arts and Culture segment where thought-provoking essays by Dr. Ian Bethell-Bennett and others are fanning new flames into discussions on race and identity.

It’s a Lifestyle section with more life than style, where the arts and culture pieces actually talk about art and culture. Dr. Bethell-Bennett delves critically into post-modern theories surrounding the manufacture of the Caribbean identity. His deconstruction of post-colonialism and its impact on Afro-Caribbean societies is not new but it’s so refreshing to hear someone wax poetic on the subject in a national newspaper.

I contrast our top two national newspapers: The Gleaner and the Jamaica Observer. The lifestyle section of both newspapers is filled mainly with light and fluffy pieces that don’t provide much food for thought. The Gleaner admittedly digs a touch deeper in its Arts and Leisure section, in that they comment on culturally relevant events. But the coverage is bare bones at best and leaves so much to be desired.

Is it merely that the first-world Bahamas with a supposedly higher percentage of tertiary-educated readers can easily devote segments of its newspaper to largely academic rhetoric? What is the interplay between economics and social commentary? Is socio-cultural criticism merely a luxury that Jamaicans cannot yet afford?

I don’t have the answers to these questions. All I know is that the discussions on race, culture and identity highlighted in The Nassau Guardian are critical to the future of Caribbean development.

A people without the knowledge of their past history, culture and origins is like a tree without roots.
–Marcus Garvey

The Only Culprits – in response to Glenn Tucker

Today the Jamaica Gleaner published a commentary piece from Glenn Tucker (educator and sociologist) about the “real culprits” behind child sex abuse. In the article, Mr. Tucker displays the same line of reasoning that allows rape culture to be so prevalent in our society – that of blaming anyone other than the perpetrator of the crime.

Mr. Tucker takes the point of view that our alternative Caribbean family structures are the main reason child sex abuse is taking place. He blames single mothers, absentee fathers, the revolving door of stepfathers – everyone except the actual person who should be blamed: the perpetrator.

I can’t argue that the way people raise their children leaves much to be desired. But as much grouse as I have with most parents in this country, there is no way I can condone blaming mothers and step-fathers for the actions of grown-ass men and women who prey on minors. Parents can do more to protect their children, certainly. But the argument that the blame lies entirely with the victim/victim’s parents is wholly reductive.

The entire tone of the piece is condescending and self-righteous, with Mr. Tucker seemingly placing himself above the “dalliances” of the hoi polloi – even so far as extricating himself from the responsibility of reporting suspected cases of abuse.

I know a mother who dolls up her daughter in nice short, sexy little dresses twice each week and sends her off to pastor for ‘driving lessons’. Four years later, when she became my friend at age 16 (do the math), she still did not know the difference between the stick and the ignition. This one is not likely to reach the courts, however, because she tells me gleefully that Pastor is “really, really good”.

Every citizen has a moral and ethical (and in some cases legal) responsibility to report cases like these, regardless of the child’s current age or the attitude of her parent. Failure to report abuse or suspected abuse is equally as heinous as committing the crime yourself.

The only thing necessary for the triumph of evil is for good men to do nothing
-Edmund Burke

Then Mr. Tucker attacks the hard-working investigators of these alleged cases; an attack, which as a primary care physician, I take very personally. No agency or institution is completely infallible, but we have to believe that the overall thrust of organisations like CISOCA and the CDA is in a positive direction.

His sentiments completely devalue the efforts of governmental and non-governmental agencies alike. And he fails to consider the roadblocks of financial and human resource limitations, the constraints of our justice system and the inherent rape culture/informer fi dead culture. He, the indifferent observer, is content to blame the people actively trying to deliver justice instead of the people who are perpetrating the crimes.

But it’s the final paragraph that sends chills down my spine, when Mr. Tucker includes himself in the group of “dirty old men”, referencing I presume the population of mature men of power eliciting sexual favours from minors in return for financial assistance.

Because of the extent of family disorganisation in this country, it is us dirty old men who are keeping the bodies and souls of these ‘victims’ together, making them graduate from school. And university, in some cases.
Jamaica Gleaner February 6, 2017 (emphasis mine)

The meaning is ambiguous but the paragraph lends itself to a much more sinister interpretation. And I don’t think Mr. Tucker is the only university graduate who feels this way. If these are the opinions of the people teaching our children and leading our communities, it’s going to be a lot harder to fix our culture than I thought.

You are (meant to be) here.

I am often overwhelmed by day to day decision-making. Simple choices like what to have for breakfast, or which route to drive home, or what outfit to wear build themselves up in my mind, until somehow they have acquired more space than they should. Suddenly my decision to stop at the supermarket after work has the same weight as deciding to pursue postgraduate education.

Often, too, it feels like all my decisions are the wrong ones. When I follow my instincts, when I don’t follow my instincts – no matter how I try to weigh the pros and cons I still end up feeling like I let the right choice slip away.

Last week I was running late to pick my partner up from work. As usual my series of choices led me down the wrong path: tardiness. But as I crested the hill, I caught a glimpse of the sunset on the horizon. The brilliantly scarlet star was seconds away from sinking out of view, and I got to watch those seconds.

Almost instantly I felt a wave of calm and certainty. All the choices I had made that day – wrong, right or indifferent – had led me to this exact moment, and I couldn’t have timed it better if I tried. It suddenly didn’t matter that I was late – lateness happens. All that mattered was that I was exactly where I was supposed to be.

 

From Preatoria to Hopefield

Some thoughts on “The Problem with Black Hair”

Jamaican girls with unmixed African hair – that super coiled, cry when it combing out, deceptively short until you tug on a strand hair – have mostly always relaxed their hair. Which, like most major life decisions, is totally okay when it’s a choice. Not so okay when  mothers relax their 5 year old’s hair because they just can’t bother to comb it.

Recently there’s been a movement toward “embracing your curls” – which some of my more cynical and curlier friends have decried as a purely “mixed girl hair” movement. African hair doesn’t bounce around your ears in curly waves, they complain, no matter how much product you put in it. Fair point, but short accessorized afros are steadily gaining pace among trendy hairstyles of the 21st century. And I am so happy when I see people not giving up on their natural hair for the sake of having it easy.

If you know me, you would know that statement is more than a little hypocritical, because my sole purpose in locking my hair was to have a low maintenance hairstyle. I hate combing my hair, bitterly, but I didn’t want to relax it because chemicals are terrifying. Locs were the compromise.

It helped my decision that locs are still relatively uncommon in this part of the island – the Kingston liberal arts and hipster scene is awash with dreads both real and temporary but in Montego Bay I’ve found locs are largely restricted to the working class. And I like to make minor stirs when I can, upset people’s predisposed notions.

The radically opposing points of view on black hair simply cannot find middle ground. There is the “natural camp” and the “neat camp” and for some reason they have decided that never the twain shall meet. Obviously one can be natural and neat, if one only adjusts and compromises the meanings behind those adjectives.

The afro is going to face the same uphill battle that locks did, because of its historic associations. Once upon a time, the only people with locs or afros were people who couldn’t afford to straighten their hair (read: poor people) or people who were rebelling against society (read: criminals). This antipathy toward hair that isn’t long and straight with no strand out of place is as entrenched as our antipathy toward melanin, toward the spectrum of sexuality, toward difference on a whole.

But the world is moving forward, tentatively. Acceptance is in.

Gender. Sex. Silence. Survival.

All across the globe, gender revolutions are happening. And it’s not just in National Geographic’s January 2017 Gender Revolution issue. From the Women’s March in Washington D.C. (and others like it around the world) to the #saytheirname movement in Jamaica and the wider Caribbean, the concept of gender and sexual autonomy have become the prescient buzzwords of the new year.

So many changes are taking place in the landscape of gender – now we’re talking about it openly, for one. Compare the evolution of gender into terms like ‘non-binary’, against the potential backpedaling of the US government away from reproductive autonomy. What a time to be alive.

Of course, negative reactions are to be expected. When Loop JA posted their article on Trina, a Jamaican trans woman featured in the National Geographic issue, almost every comment disparaged the young woman – calling her ‘it’, saying she should have died in one of the many attacks on her life. And somehow in the same breath, being angry that she ‘chose’ to portray Jamaica as way more violently homophobic than it actually is.

It’s true that not all Jamaican gays/trans-folks/bisexuals experience life the same way. Jaevion Nelson (long time human rights activist) points out that by focusing on the most brutal stories we forget about the voices who are not so downtrodden, but equally important. There is no one way to be gay/trans/non-binary and Nat Geo should have considered that in their piece, instead of perpetuating the horror crusade that has become de rigueur in discussions about Jamaican homophobia.

This is not to say that there aren’t things about Jamaica that are downright horrifying. Take the recent travesty involving a Moravian pastor caught in a “compromising position” with a 15 year old girl. (Which is being handled terribly by the media, might I add).

The Moravian church has a lot to answer for, but the culture of silence isn’t only perpetuated by church-goers and elders. The silencing of young girls is so entrenched in our society that it seems impossible to break.

The silence of mothers should not be passed to their daughters. Daughters do not need to inherit the silence of their mothers.
–Ijeoma Umebinyo

Organisations like We Change JA and the Women’s Resource and Outreach Centre (along with dozens of human rights activists) are writing letters and editorials that demand an end to the secrecy. The #saytheirnames movement is growing.

But human rights movements always gather momentum really well only to fizzle out as the public loses interest. Right now everyone is interested in what WROC and the activists have to say but in another nine days those groups will be behind the scenes again, unobtrusively working to change the way our society thinks.

What great catalyst will it take to shake Jamaicans out of their indifference? When will one million women march together for gender equality, sexual autonomy, reproductive rights? Is it to be a slow, inevitable downward spiral, despite the desperate efforts of an enlightened few?

Will we wake up in time to save ourselves?

To the Fifteen y/o Girl (and all the others like her)

Dear heart,

I don’t know why this happened to you. Why the people who were supposed to protect you failed to do so. I don’t know why you had to be the one whose case made such a public splash. Why your darkest, most painful moments became a matter of great national debate. Why your life was suddenly split open.

I don’t know how you are coping, reeling from all of this. How you will recover. How far the other side of that bridge must appear. How alone you must feel.

But you are not alone. You. Are. Not. Alone.

And It. Was. Not. Your. Fault.

And You. Are. More. Than. This.

Right now it may feel like you will never be anything more than a victim, or a bad girl, or the centre of a horrible horrible story. But you will be. You are more than that and you will continue to be so much more.

It will take time. Healing takes time. And courage. And faith – in yourself, dear heart. It might seem so impossible now but there will come a time when you forget to think about this chapter in your life. When the pain hurts a little less. When you start to love yourself again.

You cannot yet understand how the strands of your life will recover from this hopeless tangle. But we must ask you to trust that you are strong enough and brave enough to survive this. If only because you have to.

There are hands and hearts waiting to help you. All you’ve got to do is ask.

Reframing Misconceptions

I make a habit of naivety.

Not always on purpose, but often enough that even my super-oblivious brain has recognized the trend. In his more romantic moments, my current partner says that my optimism is the perfect antithesis to his cynicism. In less romantic moments, he expresses great concern about my intelligence.

Running headlong and heedless from hospital medicine into primary care with the half-baked hopes of “fixing Jamaica’s healthcare problem at the source” will not rank highly in my self estimation. And it was silly of me to think for a second that the only thing broken was the almost universal lack of health education among Jamaican patients.

I will probably never know how wrong I was, because I will probably never fully comprehend the multiplicity of the flaws afflicting the delivery and reception of our healthcare. From patient contact to policy making, I think there are a myriad of ways for either the system or the client to fail each other.

This is where my optimism wanes. I doubt myself. It’s one thing to be exasperated by a  health illiterate patient in the emergency department, mentally berating primary care doctors for not taking the time to have proper dialogue with their clients. It is quite another thing to be confronted by climbing physician:patient ratios, dwindling consultation times, and perhaps the most frustrating of all: repeat offenders. The patients who, despite adequate counselling and interventions, persist in their unhealthy behaviours.

Cynicism rolls in like a dark cloud, closely followed by the lightning storm of burnout. The horizon of my imagined clinical nirvana (where patients and physicians work together to help patients live longer, better lives) all but disappears.

And yet.

The dream of an effective and efficient health care system isn’t inherently stupid. Yes, I was foolish to think I could effect change just by wishing for it hard enough, but the bottom line is that change needs to be effected. And the nugget of reality at the core of my fantasy is the desire to be a part of that process.

If I just re-frame my ideas of how exactly health care reform will happen (a lot more meetings and red tape, and a lot less glitter and fairy dust), the cloud of cynicism drifts out of sight. It will be longer, more tedious and may not turn out quite the way I expect (like most adult dreams) but that is okay. I don’t have to throw away the dream, I only have to take it down from that lofty shelf and actually work at it.

It would be easier to be cynical.

Check Yourself (before you wreck yourself)

Walking past a beach full of cavorting young people and wondering why everyone is in underwear instead of swimsuits is privilege. Getting annoyed by having to walk/take the bus because you don’t own a car (yet) is privilege. Being able to pay your bills, pay your rent and put food on the table is privilege. Speaking English fluently is a privilege.

Like an off-the-rack blouse, privilege comes in many colours.

privilege (n): a special right, advantage, or immunity granted or available only to a particular person or group.

 

I imagine it as a series of tiers, starting all the way at the tipitty top with the straight, white, rich, cis, able-bodied, Christian male and deviating as far down the ladder as the internet can imagine. And no one is immune to this ranking system, not even on this little island. Society forces you into boxes for ease of definition. (cue The Breakfast Club theme).

Privilege in Jamaica takes on many shades – it separates us along lines of class, colour, community, wealth, ethnicity, educational achievement, gender, sexuality and religion. For a population so small (less than half the size of New York or London), we try really hard to divide ourselves into even smaller groups.

In Jamaica, the most privileged group is the heterosexual (or apparently heterosexual), Christian, light-skinned upper class. You know at least one family that fits the description: mixed ethnicity and ‘good Christian character’ who can afford a house in Upper Snaandrew, and afford to send all their children to school a farrin.

By contrast the least privileged groups are from the inner city: girls with majority African features who dropped out of high school and struggle to afford basic amenities. I say girls, because even though young men are often sympathized with for their (self-inflicted) marginalization they have the privilege of physical autonomy – their bodies are their own.

But there are always exceptions to the rule, personalities who exist pon de baadaline. Scammers are envied for their lavish lifestyles (secured from ill-gotten gains) while living in communities on the wrong side of the tracks. Homosexual characters entertain the masses in grassroots plays, despite the overwhelmingly homophobic national atmosphere.

We experience the world through the lenses of our respective socialization, through the blinds of our privilege.

The way we observe and absorb privilege depends on which rung of the social ladder we cling to. Higher up, the status quo is fine – privilege is a myth, something amorphous and unrecognizable. Lower down, the disparities are glaringly, infuriatingly obvious. These frictions of willful ignorance and misplaced anger are the catalyst behind our sociopolitical unrest.

Even though privilege is the film through which we view society and ourselves, we don’t pay a lot of attention to it. But imagine if everyone acknowledged their advantages (and disadvantages), if the people with influence actively worked to empower the disenfranchised. Or if the marginalized and underprivileged populous united to overthrow the inequalities of a hugely biased system. What could we accomplish?

Socialism, probably. But what’s wrong with that?