This is Africa

Trust in God but fasten your camel well. Saladin, a lovely gentle tomcat had diarrhoea. The vet advised me not to give him any food for 24 hrs. It was so tough, Saladin just loves to eat and he doesn't need to "watch his figure". Anyhow, after nearly 20 hrs he got fed up, why stay in a house where there is nothing to eat and as I wouldn't let him walk out through the front door, he felt forced to climb from the roof, jump onto the awning. A boy discovered him and informed me. With the aid of a ladder I managed to take my little treasure safely down and convince him of my never ending love and that I am happy to provide food for him. Eileen and Allan look like twins, slim little tigers, approx. 6 months old. I found them one day as tiny baby cats lying in a cardboard box in front of my entrance door. I was aware they'll die if I don't offer them "asylum". At the vet's I happened to see a box with baby-milk powder, fairly expensive (75 Dinar including a bottle for feeding). Still, money well spent, I  decided. A lot of work, not just a case of 3 meals a day but every 4 hrs, longer break at night. After a while the little ones started "to fight" who can have the milk bottle first. Whenever Allan and Eileen see me they immediately start purring, always happy to see their "mum". I get a lot of love from my little fur-angels. Those who throw stones at cats, etc. don't know what they are missing!  Now, as autumn started, nights are already getting cold, it is the time of coughing, sneezing, also for cats. One approx. 6 months old cat, living outside, a regular customer at my cats' table, already suffered from a bad cold. One day she looked just awful, from the head down to her front leg covered in blood. I was shocked to see her like that and wondered what happened. Then I discovered that heavy sneezing must have caused this (like we sometimes get a bleeding nose). Thinking if kids/folks view it they may believe she is perhaps dangerous, better kill her; I needed a quick solution, possibly without consulting a vet. We asked a pharmacist whether he got a cough mixture suitable for babies and thus perhaps also for cats. Luckily it did work. When I tried to save an severely injured cat (thought she had been hit by a car, but the x-ray proofed it was the bullet of an air-gun) frightened to death she bit me and I ended up with a large blue spot. The vet advised me to get vaccinated against rabbis, though I felt sure her understandable fear was the sole reason she bit me, I followed the vet's advice and was surprised to find this vaccination (in a small hospital) was free of charge. Thank you Tunisia. Unfortunately it was not possible to save the cat's life. The bullet paralysed her back legs, an operation would be difficult and only pos. in Europe, perhaps, the clinic stated. So sad. - Lady: "Why do you throw your wrapping onto the pavement, don't you love your town?" Boy: "This isn't my town." Lady: "When then are you here?" Would it have made any difference if the question had been, don't you love your country? When I ask children to keep their town/ country clean, they suggest I should call the police and they make rude comments. A lot of education is required, if parents can't do this, then teachers are all the more demanded. Yet I've seen kids leaving  grammar school and dropping their fruit peelings right in front of the entrance door to the school yard. Don't they teach the importance of environment protection? It would be a good idea to make school classes collect rubbish off streets, let's say one day a month. It can raise their awareness of pollution. I've seen a cow's skull lying on the ground at a distance of approx. 12 meters from a rubbish container, I guess the law doesn't explicitly state that's not allowed? Folks here generally seem to believe various laws and regulations are just a non-binding suggestion; like collective taxi (mini buses) drivers wearing seat belts. Well they do, just to keep the police happy, as soon as the police is out of sight, they happily continue without and phoning while driving is very common. When you talk to a driver, he can't reply without looking at you (instead of concentrating on the traffic). During a heated discussion he will in addition start talking with his hands. This is just one of the reasons why I prefer travelling by bus, whenever possible. In addition the buses provide a safer journey,  better drivers. - As the weather is getting quite cold, stormy, unpleasant, in Europe and other parts of the world, we can still enjoy the sunshine at a pleasant temperature and tourists are very welcome to share it with the folks here.

Tee

The Misunderstanding, a Short Story

Always try to get the full story to avoid misunderstandings. Somewhere in Africa a man visited a police station during a break. Seeing the staff there drinking coffee he assumed this what they do all day. So he complained to his president that the police don't work. The president whose mind was occupied with bigger problems, misunderstood that the police force hasn't got enough work. He promised to deal with this and soon found a "solution". He worked out that if he would release 4 or 5 hundred criminals who are likely to continue stealing, this would supply the police with plenty of work. And so ordered the release of several hundred prisoners. The citizens who heard what happened were not happy as they felt there are already enough thieves out on the street and so they complained to the president. The president whose mind was occupied with bigger problems, misunderstood that the good citizens demanded he should release more prisoners. He promised to deal with this; it seemed to be a good way to save money on food, water, prison cells, prison guards, etc. And so he ordered the release of even more prisoners. When the citizens heard what happened, they decided to raise the walls of their houses and not complain again to the president. As the president didn't receive any more complaints he concluded that the good citizens of his country are all happy.

Postcript Health care System

More than 70% of medicines consumed in Africa are imported, only Algeria, Morocco, Egypt and South Africa are able to produce enough drugs and medicines for the local market. Ethiopia is a model country for local investments and developed manufacturing capacity, offering increased access to quality assured medication. Generics are produced at very low costs, for many years mainly supplied by India and China. They are supposed to be as good as the original, sold a lot in Europe too, yet some patients are not as happy with these as with the original (in a few cases less effective and/or more side-effects, yet the concerned health insurances as a rule don't want to meet the extra costs). Generics represent a chance to make more necessary medication available to folks with little or no income. Manufacturing in Tunisia and local knowledge further reduces the costs.- The pharmacy industry justifies their high prices (in particular in Germany) with survey and development costs and tends to forget to mention their huge profits and money spent on advertising and lobbying works. Well they take what they can get. If you have the misfortune to suffer a rare illness, you may well discover that there is no suitable medicament on the market. This is not because it can't be developed, but rather that the pharmacy industry doesn't expect large profits in this case and therefore just isn't interested. On the other hand, whenever a representative of the pharmacy industry has a chance to discover, through natives, new healing herbs or plants, they tend "to forget" to offer even a minor share to the concerned natives. ( In some cases NGOs managed to explain the natives' rights.) - From time to time, in particular concerning more expensive imports, your dispensing chemists may not be able to sell the medication you require and suggest a different one, as his supplier didn't deliver what he ordered. With a bit of luck you can perhaps thus discover a new good product. Supply and demand don't always match, more expert planning could be helpful,  not just here. But to be fair, large improvements have been made since the revolution and this is likely to continue now that the number of tourists returning is rising.

The Health Care System

 Not surprising, rich people live on average 10 years longer than the poor, this is due to life style, healthier food (not so much junk/fast food), usually better education and being in a position to afford first class medication and specialists. Generally speaking the health system isn't bad here, the best in Africa actually. Yet most private hospitals and medical facilities are located in major cities.Thus in rural areas universal access to basic health care is limited. You may have to travel quite a distance to the next clinic/ medical facility and in case of an emergency loose precious time. The poor can obtain a paper that entitles them to free health care in government funded clinics, but they may have to wait for 3-4 months for an appointment or without an appointment spent several hours in the waiting room. I visited a clinic once only to discover approx. 500 patients had already arrived, so I left to see a private expert instead. Those who can afford this are lucky, yet you can always find many patients in the waiting rooms of the various medical practitioners and specialists. Quite a few studied in Europe, often France or Germany. The usual consulting fee is 50 Dinar in Souse, appears to be less in some other towns, e.g. in Kairouan, (a good, dedicated general practitioner in modest facility charged only 30 Dinar) extra pay for injections etc. Blood tests and x-rays are carried out in other specialist practises, unless you are in a hospital or clinic. Smaller medical facilities for out-patients, opening hours rather limited, and maybe only 1 or 2 employed practitioners, perhaps less qualified, charge less. Hospitals are said to be better equipped, the standard is generally much higher and this included the doctors' qualification and therefore you are required to pay more for consultations. Most expatriates and foreign visitors use private clinics. Many Tunisians buy into insurance schemes which partially refund costs of treatment. If you are forced to continue paying health insurance contributions of and to an European country (not at all a small amount), according to an agreement between the Tunisian government and the concerned country, the "CNAM" (Tunisian national health insurance) receives a minor amount of your contributions and this can entitle you to get a little  bit refunded if you go to the state funded clinic for treatment, or are chronically ill and get your prescriptions from there. My personal experience with CNAM: bad service, unfriendly staff - though I never ever even received a milliem (smallest coin here, rarely ever used) from them. Quite a few expats are unhappy with that system, but they are often unaware how small the amount of money is that European countries/ health insurances actually pay. Most opticians, dentists (73 %), pharmacists (80%) and doctors (50 %) work in the private sector, some part-time in hospitals or clinics as well. In the clinics' dispensaries the poor can obtain their medication for free - but it is not always available due to faults in the public procurement system, perhaps even false prescriptions, wrong distribution (corruption, the government tries to solve this). So they may be forced to buy their medication at the pharmacist' who is expected to provide cheap medicine. Though the price is certainly much lower there than e.g. in Germany, the price is also influenced by the country of origin. Imports from Italy, France, Swiss or Germany (supposed to be of higher quality) are quite a bit more expensive than local productions, (still an attractive price for European tourists) and this reduces the demands and supply. Thus you can't always get what you want, even if you can afford a higher price. Some pharmacists are in addition doctors and can therefore provide professional advice to customers who want to save time and money for consulting a surgeon, and one can get an injection there for 1 instead of 10 Dinar. This method may not always be advisable and I would think that those who should receive a thorough medical examination will be advised accordingly. - Many illnesses are caused by constant stress, this could be reduced by noise-restricting laws, not just for companies but for private households and individuals as well. I am under the impression that folks here love creating quite unnecessary noise with which they "pollute" the air, just like children, and not surprisingly everybody (including me meanwhile) seems to be very nervous and it leads to high blood pressure or even worse illnesses. (I need noise-proof walls). Scientists say sugar is the number one killer. For unknown reasons in Arabic countries and in Turkey folks use extreme amounts of sugar, this is the sugar one can see in tea, coffee and on cakes, and and then there is in addition the less obvious sugar in soft drinks and in various ready-made foods on sale. In soft drinks it is very high, mend to give flavour and make you addicted (very sweet, your flavour). Junk food is very popular among children and teens, as I can see by the wrappings on my pavement, every day, they learnt quickly that in spite of the new law/ regulation (to achieve a beautifully clean Tunisia) they can continue their old bad habit to dump their rubbish anywhere, no one there to impose a fine! Hope this will change one day. For a healthier population we need more education work, less fast food and instead slow-food restaurants as well as information for parents concerning the importance of healthy home-cooking.