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What's Up, Doc?

Before having Jasper, I used to pride myself on being one of those people who very rarely visited a doctor. Or perhaps I should say, in between becoming an adult and having Jasper, I prided myself on being one of those people who very rarely visited a doctor. Aged 3 I was in and out of Accident and Emergency like a yoyo for a vast range of self-inflicted sillinesses, including but not limited to biting clean through my tongue while jumping on the sofa and needing 7 stitches in my upper lip after an incident involving a toy tractor, forever after known as the ‘cut-a-face tractor’. While at school I would sometimes enlist a doctor or nurse to help me get out of a class or activity I didn’t fancy attending. I had notes to say my fingers were too busted from netball to go to orchestra practice, or that my nose was too snotty for me to go swimming in the outdoor pool in midwinter. Or that I was allergic to garlic and should therefore require a special meal to be cooked for me any time the school cooks were serving anything potent enough to offend my taste buds, and my digestive system. I did genuinely suffer from migraines but as anyone who suffers from migraines knows, the doctors can’t always help on those. The last time I did need to summon a doctor for help with a particularly aggressive migraine, it was actually Tony who escorted a doctor to Dylan and I’s downtown Yangon apartment. He then sat at the dining table waiting patiently while Dylan was given instructions on how to administer a suppository should the injection already delivered into the meat of my backside not do the trick in restoring my speech and vision. Thankfully, Dylan has never had to deploy this procedural knowledge. Since having Jasper, however, I have seen more doctors on more occasions than I can count, and never for me. Whether I’ve been asking about a rash, a cough or an immunisation, it feels as though I’ve been trundling back and forth from various doctors at least once a month.


Back in Myanmar, the coup had a devastating effect on the medical system, with doctors being arrested when they returned to work after having joined the Civil Disobedience Movement, a move by the military that was as counterintuitive in the middle of a pandemic as it was brutal. But despite the majority of hospitals and clinics being closed due to a notable lack of doctors, we still managed to get our fill of treatments and services. It sounds ridiculous to say, but some tests were just so cheap that it seemed foolish not to take advantage of them. There was the time Jasper had his tummy ultrasounded for the bargain price of $10, because he hadn’t pooped for 3 days. And the time he visited a specialist dermatologist to be told he had a very ordinary heat rash due to it being summer in Yangon. We even managed to pack in a quick doctor’s visit during our two-week Irish hideaway between Myanmar and the UK, due to Jasper getting a sudden fever and rash. During Jasper’s and my 6 months in Jersey, which unhappily coincided with the winter snot season, we were back and forth from the doctor as rarely as I deemed prudent, but still almost monthly. For the most part, I would say that Jasper is a happy, healthy baby, but he doesn’t half succumb to phlegm.


Photos: (i) Jasper luxuriating in the downtown Pun Hlaing Clinic facilities in Yangon, (ii) Jasper's first ultrasound on the 'outside'


What I loved about the Jersey system was that it was a system. As soon as we were registered into it, the system alerted me with a nice, crisp, paper letter whenever Jasper needed jabs, boosters and check-ups, and we even received a few free books as part of the overall baby wellness program. It was comforting to know that even if my mind were otherwise engaged, Jasper wouldn’t miss his jabs, because the system knew he needed them. Back in Myanmar, we had a wonderful doctor who took such personal interest in Jasper that he would call me directly to suggest we came in for a jab that was either about to expire, or was the last of its kind in stock and he had sneakily kept it back for Jasper. The coup did no favours to the pharmaceutical supply chain in Myanmar either. Here in India, I am still getting my head around the paediatric medical system, but initial indications are that money talks. And with money, so do doctors. Whenever, wherever and to whomever so needs. When we arrived in India, Jasper was 16 months old, so I had a couple of months to find a doctor who could administer his 18 month vaccinations. Unlike in the UK and Jersey, where a family GP can and will deal with all members of the family in the same appointment if you’re lucky, in Mumbai the practice, among the middle classes at least, is for paediatricians to handle the littles. We were introduced to a popular and well-respected paediatrician by our doctorly neighbours, whose cousin the paediatrician happens to be, so I didn’t have to do any searching myself. Fortunately for Jasper, the Myanmar and India vaccination programs are similar, so he was able to slot quite smoothly back into a tropical-disease heavy schedule without too much catch-up.


Jasper’s first appointment was arranged via WhatsApp, with me messaging the paediatrician to ask about the process for registering a new patient who would soon be in need of vaccinations, and the paediatrician responding with the instruction to come to the clinic the following day at 11.30am for an appointment. Or at least, I thought it was an appointment. Knowing that in the UK, appointments are short and patient lateness is not tolerated despite doctor lateness being expected, we set off in good time and arrived at around 11.15am. We were met with utter confusion from the security guard and a couple of cleaners who were busy opening up the clinic. When some nurses and admin staff arrived, they explained that the clinic opened at 11.30 and the doctor would arrive around 12pm. Still happy to have arrived early, some of us took a seat, while others looked at the fish in the aquarium stationed at one end of the room. We were a party of three; Jasper, Seema and I. I was essentially the bag-carrier and the wallet while Seema and Jasper entertained one another. As we waited for the doctor to arrive, people began to pour into the waiting room. The room started off as comfortable in size, then became cosy, then busy, then crowded until finally, by the time the doctor arrived, it was elbow-to-elbow, standing room only. Given that every patient, no matter how small, is more often than not accompanied by not one but two ‘attendants’, a small space fills up very quickly. And given that many of these attendants are swathed in beautiful but billowing fabrics, a stray toddler who drops his toy car and decides to try and fetch it, disappears from view very quickly no matter how blond he might be! It turns out that the appointment system in India works the same as it did in Myanmar, where everyone is given the same time to show up, and then it’s first-come-first-served for the order in which the doctor sees the patients. In our case, having showed up before the clinic had even opened, we were first out of the gate. This system drove me insane back in Myanmar, because of how many hours of my life were eaten up, waiting first for the admin staff to acknowledge my presence, then for them to add me to the right list, then for the doctor to show up, then for my slot in the queue to reach the top. Give me a 10 minute window to aim for and put the onus on me to anticipate traffic accordingly any day.



Photo: Deep in conversation with the clinic fish at the Cheers Clinic, Kemps Corner.


Doctors in India are incredible, I’ll give them that. Our friend Saumil regularly hands out remote diagnoses and prescriptions while playing cricket, using headphones under his helmet while staring down Dylan’s fast bowls in the evenings. And from the stories he’s told us, he’s all but unable to attend a party within the compound lest it turn into an impromptu clinic as random residents take advantage of his good nature and quick-fire diagnoses to list out their ailments over drinks. Jasper’s new paediatrician also works at the speed of light, whirling through questionnaires, procedures and check ups in a matter of seconds. Granted, there are a lot of assistants doing some of the note-taking, preparation and sanitisation, but it is an impressively well-oiled machine, even if I leave the consultation room feeling like I’ve been spun round 10 times before being asked to safely navigate a way through the crush outside to the cashier counter. On our first flying visit, after taking Jasper’s history, giving him a once-over and jabbing him three times, the doctor bid us farewell by saying, “Talk to Dolly about packages. She’ll get you signed up to something.”


Dolly, it turned out, was equally efficient and our talk lasted a matter of seconds, while a stream of people barged through the thoroughfare we had created by standing a conversational distance apart. Over the hubbub, she essentially told me that a lump sum would buy me an all-inclusive package or membership. The package covered all appointment and vaccination costs, opened the door to preferential appointment bookings, including the doctor coming to us at home if we weren’t inclined to make the trip to the surgery, and afforded me the privilege of calling or messaging the paediatrician on WhatsApp whenever I wanted. I needed to check with Dylan first, so I yelled a thank you at Dolly, over a passing head, paid for the appointment and vaccinations Jasper had just received, and battled my way to the door outside which Seema and Jasper were waiting. My initial hesitation was that Dolly had offered me a 5 year package for 100,000 rupees which is around 1000 pounds or $1200 USD. Even though Dylan’s project should keep us here for 5 years, our recent experience in Myanmar has made me reluctant to commit to anything with a high price tag and a long validity period. Furthermore I didn’t really want the temptation of being able to ask a doctor every time Jasper had the slightest issue, because I believed that would lead down a slippery slope towards mollycoddling and later, hypochondria.


That was until Jasper had a sudden issue with his nether regions, one Friday evening, and the all-too-familiar, Myanmar-induced fear of not knowing what to do in a medical emergency surfaced. Out of panic, looking at redness and swelling that was clearly causing Jasper quite some discomfort, I messaged the paediatrician. At the same time, Dylan messaged our doctor friend, who then closed the circle by having a quick chat with his cousin the paediatrician who was, incidentally, at Ferrari World in Abu Dhabi at the same time as he was responding to me. Luckily for Jasper, the verdict was that he didn’t have anything seriously wrong. It appeared that he had merely been bitten by something, right on the crease of his nappy. The little jig he had been doing, pointing to his groin and pulling at his nappy, with his face contorted in a “please do something” expression had been the clearest communication of the type and location of pain he’d ever given us, for which we were grateful. As grateful as he was, perhaps, when we ran him a cool bath to soothe his bits in for a good half hour. We did pop upstairs for our doctor friend to give him a once-over, and thanks to a 24 hour pharmacy who accepts prescriptions via WhatsApp, were able to get a delivery of the necessary ointment and medication to help reduce the symptoms. I felt guilty messaging the paediatrician while he was on holiday, especially as we hadn’t yet bought into a privilege package, but as our friend kept telling us “anything you need, you can ask him. This is what he’s there for!” As a try-before-you-buy, this little experience was a deal clincher, and so I confirmed I would be buying into a package when we went for another round of vaccinations a few days later.


When I called the surgery to book our second appointment, I was again directed to, and given a direct phone number for Dolly to discuss packages. This time she explained there was a shorter, slightly less intense package that would see Jasper through the rest of his early childhood inoculations, as long as we were happy to visit the clinic. Once I had confirmed that this package seemed fine, Dolly impressed upon me in no uncertain terms that I could call her any time to request an appointment or to ask questions, in the same way I should absolutely message or call the paediatrician, at any time of day or night, weekday or weekend. I thanked Dolly, noted the time and date that we should go to the clinic, but made noises to the effect that I didn’t think I would need to pester the doctor. For our second appointment, I decided it wasn’t worth arriving so early, which, thanks to the unpredictability of the Mumbai traffic, meant we arrived a little late. This time we couldn’t even get inside the waiting room, let alone terrorise the fish. I squeezed through to the cashier, paid the package fee and settled in for a long wait of dancing the ‘can I pass’ shuffle with the other adults in the room, when suddenly Jasper’s name was called. Again, we were in and out in a matter of 5 short minutes that comprised a feeding questionnaire, 3 jabs and a height measure. It was so quick that I didn’t have a chance to ask if this was due to our being newly anointed package members, and made a “thank you but of course we won’t be needing it” gesture when the doctor told me to message or call any time I wanted.


That is, until Jasper started showing the rather ugly symptoms of the dreaded hand, foot and mouth disease which apparently does the rounds in Mumbai every monsoon season. It’s uncommon but not unheard of in the UK, and it’s rife among preschool-aged children here. It’s highly contagious and usually presents with a fever first, followed by sometimes painful boils and rash on the child’s hands, feet and mouth. Hence the name. We had been on high alert, looking for symptoms since some of Jasper’s classmates had been off school with it, but we thought we had avoided this round of it. My motivation for bugging the doctor this time actually wasn’t for any medical advice, it was more so that I could confirm whether or not Jasper had it, so we knew whether to isolate him from the other babies in the compound. Over the weekend, via a series of photos in response to the paediatrician’s very attentive check-ins and questions, we established that yes, Jasper had the plague. We also established that having a doctor on WhatsApp is a luxury that’s not to be sniffed at. Sadly, for Jasper, this means he not only can’t go to school for a week but he also can’t play with the other kids in our compound, something he neither understands nor wants to accept. He desperately wants to play on the slide downstairs in our building and no amount of “Look, Jasper, a ball!” is able to bring him back from the heaving sobs and tumbling tears each time we have to drag him away from the door to the play area. Thank goodness for Paddington on TV, though. All it takes is the train whistle from the start of the opening credits and we have a happy Jasper once more. I am counting down the days until I can ask the paediatrician to WhatsApp me a clearance certificate so Jasper can resume his enviable social life.


Photo: Jasper in his new isolation teepee.


Photo: Making up for Jasper's missed school field trip to the Hanging Gardens of Mumbai with a solo trip there instead.

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