17 April 2015

Another side of Saudi Arabia

JEDDAH, Kingdom of Saudi Arabia (KSA)—At 2 a.m. the morning after my arrival, Saudi Arabia’s health minister, Abdullah al-Rabeeah, was removed from office by King Abdullah for claiming he did not know why the number of people with MERS (Middle Eastern Respiratory Syndrome) was increasing, thereby admitting he had been unable to address the problem. 

The unfortunate turn of events for al-Rabeeah meant I was one of the first people to meet his interim replacement, His Excellence Acting Minister for Health Adel Faqih, Saudi Arabia’s labor minister, who now serves in both roles. Faqih presented me, later that morning, with my “hadyyah” (gift) for presenting at The Second International Health Specialties Conference in Riyadh, KSA, sponsored by the Saudi Commission for Health Specialties.

Apparently some folk
think I'm OK! 
(Click photo to read text.)
According to colleagues here, the sacked minister, an engineer by background, was popular and had made a good impression on my nursing colleagues, some of whom met him. However, politics is politics the world over, and, frankly, honesty does not pay if you wish to keep your job.

International conference
My paper at the conference was on the difference ethics can make to health care, but I also gave a preconference workshop to 150 nurses and physicians on getting papers published. Among the attendees was my former PhD student, Mansout Alyami, who works at the Ministry for Health. The workshop was the most popular of the two sessions, with an additional 150 people being turned away.

This was especially surprising as I was competing for participants with such luminaries as Geoff Norman, PhD, of McMaster University who, I now realise, is one of the world’s foremost experts on medical education. I was very pleased to get to know Norman over the course of the conference, and his presentation on myths in medical education reinforced many of the things I had long held doubts about, such as learning styles, self-assessment, high-fidelity simulation (essentially a waste of money), and the predictive value of multiple-choice tests (turns out they’re pretty good). Norman, who backs all this up with evidence, has already sent me his portfolio of research papers and reviews on these issues.

Jeddah
After three days in the oppressive heat, oppressive atmosphere (especially for women), and dry dust of Riyadh, I flew to Jeddah on the coast to participate in a scientific forum at Fakeeh College of Nursing & Medical Sciences, where I presented three papers over two days. Another former PhD student, Wafaa Aljohani, who is a faculty member at the school, facilitated my visit. I also met former PhD student Samira Alsenany, who works at King AbdulAziz University, the oldest university in KSA.

A preserved building in the old town of Jeddah,
included in UNESCO’s World Heritage List.
 
Compared with Riyadh, Jeddah is a coastal paradise. In addition to the weather being cooler, it is less dusty and less oppressive in many ways than Riyadh. The population is cosmopolitan, and, because the city is close to the holy cities of Mecca and Medina, it is a tourist destination. This was my first sight of the Red Sea where, as the Old Testament describes, Moses parted the water and crossed from Egypt to the Promised Land. I can imagine that, all those thousands of years ago, this place did not look very promising.

International family
The Watson family is scattered across the globe. Another contingent is in Florida, where Mrs. Watson and our youngest daughter arrived this week. Our daughter is taking part in a street-dancing competition at Daytona Beach, and Mrs. Watson will continue training for the London Marathon.

My ambitions are modest by comparison. I am training for a 10-kilometre race, and managed to run 13 miles over four days along the seafront in Jeddah. My next visit to the Middle East is in May, when I go to Bahrain, but a visit to Genoa, Italy comes before that.

Podcasting continues, if you want to listen to my daily reflections on Jeddah. With my new Veho MUVI Mini Cam, claimed to be the smallest video camera in the world, I posted on YouTube a compilation of video segments, all in one 48-minute clip, that range from Hull to Riyadh. Persevere—or fast-forward—to take a cultural tour of Riyadh and hear the call to prayer going out.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

02 April 2015

Facing up to demographic change in China

LUZHOU, Sichuan Province, China—Luzhou City has the same population as my native Scotland: 5 million people. The UK could be dropped into Sichuan Province, and it would take a major expedition to find it. The size and scale of everything in China is impressive, but its growing population is presenting problems.

The one-child policy was misguided. It failed to curb population growth and led to asymmetric growth whereby China has a surplus of men. The policy also led to another demographic change. By 2050, if the trend continues, the proportion of the population that is younger and economically active will be outweighed by the older and more dependent proportion. This change in the dependency ratio means that an increasingly older population will require care when fewer people are available to look after them.

While in Luzhou, I participated in a conference at Affiliated Hospital of Luzhou Medical University on elder health promotion and nursing care. The session I presented was titled “Preparing nurses to work with older people.” This was my second visit, and they honoured me with a three-year visiting professorship and signed a memorandum of understanding with my university.

Reunion
It was good to see old friends. Not the least was my translator, Daniel Kuwei Liu, an extraordinary young man fluent in English and French. Formerly located in Luzhou, he now works in Beijing. When the opportunity arose to translate for me, he made himself available. Much frustrates me about working in China, but the sincere loyalty of many Chinese people to old friends is salutary. 

With Daniel Kuwei Liu and conference delegates.
Another loyal friend who has featured in blogs passim, Sally Chan, PhD, RN, FAAN, now head of nursing and midwifery at The University of Newcastle, New South Wales, Australia, also addressed the conference. Chan made a previous appearance in this blog when she was head of nursing at National University of Singapore. In addition to addressing the conference, Chan and I met with senior staff members of the hospital affiliated with the university, and we also gave short speeches to nursing students. We were asked many questions about ourselves and how nursing could be developed.

Sally Chan and Yours Truly.
Nursing is considered a relatively low-status occupation in China, and the image of the profession is poor. I hope the opportunity that the students had to hear from a global nursing academic like Chan and the editor-in-chief of a major nursing journal lifted their vision. Men are particularly lacking in nursing here, and the few men present were interested to see someone who had spent his career in the profession. However, above all else, everyone was astonished to hear I had eight children and only one wife.

The mighty Yangtze
Luzhou is situated on the banks of the Yangtze River, which runs from the Himalayas to Shanghai. On my previous visit, pollution was such that I could not see the river. This time, I managed two three-mile runs along the riverbanks in the early morning. Air quality was good, and the temperature and humidity were bearable. On the first day, I shared the banks with assorted joggers, dancers, martial artists, and fishers. On the second day, it was raining, and the few people I saw looked at me as if I was crazy.

Sichuan Province is famous for the pandas near the capital city, Chengdu, and also for the cuisine which is—famously—spicy. I was rendered speechless at least twice when I swallowed a chili. There is a particular seed here that makes your mouth go numb. For a few minutes, you speak as if you have just left a dental surgery. This passes, though, and my best advice is not to speak until the effect wears off.

“Hot pot” cooking is also very common, although not unique to Sichuan Province. This is a process of cooking your own food in a steaming pot into which a rich variety of ingredients can be added. Frankly, it is not my favourite way to eat, as it is hard work. That and the constant way of toasting, common in Sichuan, whereby everyone leaves their place and goes round the table offering thanks and clinking glasses. You barely consume one uninterrupted mouthful and are exhausted by the end of the evening.

I go home for Easter Sunday and a few days of leisure but will address the PhD Experience Conference at the University of Hull, slated for 7-8 April. At the end of the week, I go to the Middle East, to Saudi Arabia. I fly to Riyadh, which I have visited before, but will also visit Jeddah for the first time. This will be another reunion with old friends and former PhD students. It’s not all hard work!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.