Sunday, May 11, 2014

LOSING MY MOTHER TO ALZHEIMERS

http://blogs.tribune.com.pk/story/20983/losing-ammi-to-alzheimers-bit-by-bit/

For my mother, who is leaving us bit by bit taking her memories along with her. But our memories of her will stay with us of a mother who loved us and cared for us always, like mothers everywhere.
The writer, Jarod Kintz, once said,
“Alzheimer not only steals from you, it steals the very thing you need to remember what’s been stolen.” 
He was right.
That theft is exactly what causes the agitation that immobilises my mother. My mother has Alzheimer’s and she knows that there is something she cannot remember. But she cannot figure out what that something is and it tears her apart.
She would tell me hurtfully, when she could, that her memory is gone.  She was right; it makes you wonder how and where it could have disappeared to. The memories that my mother has lost were important to her, to us, but I guess we’ll never know.
What are memories?
We tend to call memories weak or powerful – so are memories a form of energy?
But if energy cannot be destroyed, if they simply change form, where do memories go when we lose them? Do they float around like midges in the air? Do my mother’s memories scatter every time she tries to grab one then coalesce again as a cloud composed of sparkling names and incidents born years ago?
A cloud – is that why today she seems to emerge only now and then like the sun from behind a cloud to make a random remark before returning once again into what I see as oblivion.
Is she lost amidst a swirling cloud of her past?
What were my mother’s memories anyway?
I wish I had asked my mother about her memories while I had the chance. How many times have I heard this from so many people, and I say it now. I wish I’d heard her stories, written them down even, remembered them, but they weren’t important to me when I was young and I didn’t do any of those things.
Now all I remember are strange exotic names like birds of jewelled plumage that live in a foreign land, Melur, Visakapattam, Negapattam, Kodaikanal, Gudur. She mentioned them often and I don’t even know why. Kodaikanal is a hill resort, this I know now, courtesy of the internet. I suppose they went there, my mother and her family. That was once her reality, before we, her children, became a part of it.
But she doesn’t recognise us now, she doesn’t recognise me. Not when I or any of us hug her, kiss her or put a spoonful of food into her mouth. There is nothing more disorienting than your own mother looking at you and not knowing who you are, not telling you to wear something different, not frowning at you forgetting to put something away in its place.
Has she gone back to her original reality, the one without our father and the five of us?
I think she has.
My mother was a great cook and very hospitable. Regardless of losing other memories, she still remembers her manners, until recently, when she falteringly asked us to give our guests ‘something to eat’. She also never reveals her overwhelming agitation in front of guests. A psychiatrist told us that social manners linger after everything else is gone. I have, in fact, till recently been upstaged by halwas because she remembered how to make them.
The word ‘Madras’ is a magic word for her now as is her maiden name ‘Sayeed’. They wake her up and bring a light into her eyes for a very fleeting moment. For her, her distant past is her reality now. At least she has that.
What is reality, after all? Is my reality different to another’s? Is each person’s reality different to another’s?
There is a metaphysical theory relating to this called ‘solipsism’ which says that,
“The self is the only existing reality and that all other reality, including the external world and other persons, are representations of that self, that they have no independent existence”.
Does it therefore mean that we, my mother’s children are no longer real, because we do not exist in her reality?
Does it also mean that if her children neglect a mother, the only ‘real’ sufferers are the children and not the mother? Does a direct result of their actions exist only in their reality? That in her ‘reality’, she does not suffer? Does it mean, in short, that if we did not care for our mother, she would nevertheless happily exist in some hill resort in Madras?
What a dangerous belief, an awful one at that. David Foster Wallace said that,
“When a solipsist dies, everything goes with him.”
No, whatever ‘everything’ is, it doesn’t die because joy and suffering remain. Who cares whose reality they are in at the time that they exist? It is hard to watch a person suffer whichever reality it may be in, because if each man is answerable to a higher authority for his actions, that suffering would be each man’s reality; his conscience, his record, his heartbeat, his entire world. That, in the final analysis appears the determining question then, our belief in accountability, in the presence or absence of God. That is the question that makes us humane.
Isn’t it terribly odd that it is the existence of the Divine that should determine the existence of humanity among humans?

Tuesday, May 6, 2014

THE GATEKEEPER'S WIFE AND OTHER STORIES

by Rukhsana Ahmad


  • The gatekeeper’s wife
http://pique.pk/culture/06-May-2014/the-gatekeeper-s-wife

A book review by Rabia Ahmed
Pique May 2014

This is good writing, if good writing is one that keeps you reading and makes you think


That list of books written by Pakistani writers in English grows before you can lay down the last book and Rukhsana Ahmad, a recurring name, has added another book on that list with her collection of short stories.  It is entitled ‘The Gatekeeper’s Wife and other stories.’
Rukhsana Ahmad grew up in Karachi, studied English literature and linguistics at Karachi University and taught there briefly before moving to England where she continued studying English at Reading University. 
Ahmad’s plays, stories, translations and reviews have been produced on the radio and stage, and printed for several years, and one of her plays reached the finals for the Susan Smith Blackburn International Prize.  Ahmad’s first novel ‘The Hope Chest’ was published in 1996 by Virago.  Writing about that novel Fay Weldon said, ‘What a find Ahmad is! She writes about women’s legacy of grief without self-pity and if there is anger, it surfaces as wit.’
It is no surprise that this new paperback printed by Ilqa Publications (Readings) is such an enjoyable read.  In fact Bapsi Sidhwa has called Rukhsana Ahmad ‘a magnificent writer.’
‘The Gatekeeper’s Wife and other stories’ is a collection of Ahmad’s short fiction. The story that gives the book its name was first printed in Lakshmi’s Holstrom’s collection ‘The Inner Courtyard’ where, as Ahmad says, she was euphoric to find herself in the company of Ismat Chughtai, Mahasweta Devi and Ambai.  It was also dramatised and produced in theatre.
Ahmad has long championed the cause of Asian writers, and women in particular, and is a founding member of the Asian Women Writers’ Collective.  In fact one of her best stories in this current collection ‘Cassandra and the Viaduct’ printed first in 1994 also by Virago in a book called Flaming Spirit, was taken from writings of that Collective.
Ahmad’s stories are set in Pakistan and England like the stories of most Pakistani English writers that shuttle between Britain/the US and Pakistan reflecting these writers’ own experiences and the changes of person and values that arise as a result of the entire migrant experience.  Cassandra in Cassandra and the Viaduct is really Qaiser, a young girl who lives with her family in Wandsworth in England, and who has ‘surrendered her unusual Pakistani name with its impossible glottal fricative at the beginning’ to become Cassandra or ‘the more user friendly Cass or Cassie.’
Her best story however is the last one in this collection, ‘A Day For Naggo,’ which was first printed in 1988 by The Women’s Press.  The story raises a strong voice for the rights of women and minorities and in a masterly piece of fiction which is not fictitious in the least portrays the treatment of both in Pakistan. I would, if I could, make this one compulsory reading for everyone in the country. Naggo is a young mother who lives in a tiny house, an encroachment on the bungalow of a larger house in Lahore where she works.  Like countless other women she labours tirelessly to raise a pathetic income for her growing family, even washing a load of clothes a few hours after delivering her first child. It does not even occur to her otherwise benign husband that he could help her, and he sleeps while she works. The story reminds the reader that all women and mothers, and not just female doctors and managers at banks are working women with rights to a proper wage and holidays. Yet there are no care services for the children of these working women and no contracts ensuring their wages, vacations, bonuses and other rights. It is a striking piece of writing that points out that it is never easy to bring about change but it can be done, and that those who think of themselves as liberal and the educated women who themselves work have no empathy for the rights of the downtrodden.
This is good writing, if good writing is one that keeps you reading and makes you think.                


A DIGNIFIED OLD AGE

May 2014
  • A dignified old age
  • http://pique.pk/society/06-May-2014/a-dignified-old-age

Caring for the aged: Are we resting on our laurels when it comes to looking after our elderly?


In Pakistan people are increasingly concerned about old age and its related issues with every new candle on the cake.  Odd, isn’t it, seeing that our culture lays such stress on caring for the aged? In fact we feel rather superior to Western cultures on this account.
Well, Mark Twain said that all generalisations are false including this one, and this particular one is certainly so, because as reported by AFP, Pakistan figures as the third worst country to grow old in.  Western countries on the other hand are among the best in a list of ninety one countries ranked by an International advocacy group and the UN, comparing relevant data.  Sweden is the first among the best ten followed by Norway, Germany, Netherlands, Canada, Switzerland, New Zealand, USA, Iceland, and Japan. Britain at thirteenth ranks ahead of Australia and France. Lower down are China at thirty five and India at seventy three; Pakistan ranks eighty ninth, ahead only of Tanzania, and Afghanistan.
The fact is there are many institutions for the aged in the West, and many more studies and protocols that deal with geriatric care.  This is misread as proof that Western children abandon their parents.  This post on the web represents public opinion in Pakistan: ‘It is an absolute disgrace that old people’s homes have sprouted in Pakistan. The idea of putting old parents in old people’s home has sprung from the west, and that despicable act has caught up in Pakistan.’
The presence of aged care facilities is actually characteristic of a society that cares for its elderly, one that is concerned enough for their quality of life to be unwilling to abandon the welfare of its aged to chance.  This includes all elderly persons, not just those lucky enough to possess families willing and able to care for them.
It is well to remember that a room in the family home is no guarantee of care. With the best will in the world and in spite of our cultural values, children may not always be able to care for parents, much more so today. Cultural values change because of several factors, such as in this case the dispersion of families around the world, or from rural to urban settings physically separating the young from the old. In todays expensive times the reason for being unable to provide care may also be monetary for the less affluent.
Some individuals would rather live independently.  There are others who have neither children, nor carers in the family, nor funds. What are the options for all these people when independence is no longer possible?
Old people’s homes are a necessity. In fact ‘respite care’ is also required, for carers who can place the person he or she looks after in a respite home for a short while in case of emergency such as the carer’s own ill health or temporary absence.
In Pakistan aged care facilities do exist although not abundantly as in the West. These are run mostly by non government organisations and some by the government.  However all their numbers together are woefully insufficient for the population and its requirements. Typically, the Edhi Foundation runs the largest number of homes for the aged, caring between them for the greatest number of persons at all levels of disability and care. 
The institutional care that is available in Pakistan is almost exclusively for the poor, not for the affluent. For those who can pay, the only option if the family does not bear this responsibility is private care provided by professional carers supplied by agencies that specialise in this field.  Full time care by unqualified carers costs around Rs 30,000 a month. The cost of skilled nursing is much higher. It is only a small fraction of the population that can pay this amount in addition to other essential requirements, such as food and utility bills. Funds however are only part of the problem. There is great risk of ill treatment and security threats at the hands of carers if unsupervised.
Care for the affluent in the West includes ‘independent living homes’ where the Management provides help if required and takes care of transport, maintenance and arduous chores. The level of care increases with the disability.  In Pakistan the Parsi community has residential colonies for its people regardless of age or wealth. These include homes where the rent is nominal, community centres and welfare organisations. The colony is maintained by the wealthier section of the community.
According to an Alzheimer’s Disease International report, ‘elderly care needs are set to treble by the year 2050,’ and warns that the world is set for an Alzheimer’s epidemic. It also says that as world population ages ‘the traditional system of informal care by family, friends and the community will need much greater support.’
While Western populations shrink and the existing population lives much longer requiring expensive care, aged care for the growing population of poorer countries is more than a question of finances. It calls for a change of attitude.  One reason for the lack of aged care facilities in Pakistan is that this poor country is unable to afford it, another that the governmental will to provide it is absent, which explains the preponderance of NGOs in the field. 
Another huge reason is popular attitude towards the issue.
Society is unfortunately not always the intelligent entity it needs to be because of the misguided values of the very culture it encompasses.
Located on a busy road in the Lahore cantonment, in a purpose built building on four acres of land is a remarkable place: a children’s school as well as a clean and peaceful home for the aged, a beautiful juxtaposition of old and young, surrounded by gardens. This home is administered by a trust set up by the owners of a leading brand of shoes in Pakistan.
The approximately twenty five elderly inmates of the home are all over sixty years of age, and poor. Here they are fed, clothed, housed and their medical needs taken care of free of charge. The organisation does not accept any person financially able to afford care.
Several of these aged residents have children, and some of these children would have cared for their parents, but being daughters, they are not allowed to do so. This is because of an outstandingly senseless cultural norm which says that parents must live with their sons, not with married daughters. 
Even religion which lays great stress on the responsibility of parents and children, both sons and daughters, towards each other is overridden in this case. So although these residents’ daughters are married to ‘very religious men,’ the parents live here because of the cultural reasons mentioned above.
Pakistan’s issues are growing with the rapidity of its population.  Aged care is just one of these issues, and it too requires serious and urgent thought.  But to achieve results we must cultivate the habit of questioning tradition and some of our most commonly held views. It is the only way to bring about meaningful change.