Thursday, 7 May 2009

Adventures in infertility

The journey that infertility takes you on has lots of unexpected turns. Certainly moving out to the Gulf has put a whole new perspective on it. One of my concerns about leaving the UK was leaving the NHS behind, because I was being treated there by an excellent gynaecologist and I was firmly "in the system", something that my fellow Brits will understand is quite a feat!

Although we have great health insurance out here, it doesn't cover anything more than "investigations into infertility". Although this might be slightly helpful, providing cover for blood tests etc, it's not going to help at all should be need any further treatment than Clomid. Luckily, there's a national health service out here too, and despite its chaotic exterior, it has a great reputation for fertility treatment. What's interesting is that very few expats take advantage of it, so I felt like a real adventurer heading to my nearest primary care centre yesterday for my health card.

Finding it was like classic farce; the rather tired building was actually hidden behind a vast new one they've built but not yet opened, and the whole complex was hidden behind the most monstrous road works known to man. All the parking was on scrub land, any which way the locals could fit, and when I went in I went through the men's entrance (of course!!!) and had to be ushered through to the women's section by a rather embarrassed male indian orderly.

Once there, it was far from clear what I was supposed to do next. Arab women here are generally covered from head to toe in the black abaya, with their faces covered too, so it's particularly difficult to make eye contact and work out whether you're being spoken to or not. They also do not believe in queueing. It's quite incredible watching a crowd of women jostling for the attention of the women behind the desk, thrusting their paperwork over the head/under the arm/through the legs of the woman in front.

Luckily, my embarrassed orderly pointed me in the direction of the cashier, where there wasn't a queue. When I told her I needed to enrol she found an English speaking nurse who told me what ID was needed, and then once this was done pointed in the direction of a corridor to the left and told me to "wait there". Once I got there I saw a hole in the wall marked "medical cards - women" and the tell-tale mass of abayas. I stood in the "queue" for about half an hour, being overtaken endlessly, before the advice of an English gulf-based nurse friend came back to me - "don't queue, because the locals don't. Push in. You're white and western. Use it." Sadly, I couldn't see any other option, so I adopted the approach of standing directly behind the woman being served, and, being considerably taller, managed to attract her attention and receive my card.

Anyhow, health card achieved, I decided I would go the whole hog and wait to see a GP. This proved more difficult than I'd expected, as when I was handed the number card which told me where I was in the waiting list, it was in Arabic script. I also realised I had no idea what the number sounded like either, so being called in Arabic would be no help at all! So I asked a few of the women if they spoke English, and they were very friendly and wrote the number down in English for me, and one in particular, who didn't have her face covered, came and sat down next to me. She told me she was Sudanese, and finding that I was British, launched into a tale about how her son was severely disabled and that she'd recently been to the UK for an operation for him, which had been performed by a famous British surgeon who I met quite recently! The world is indeed a small place.

Anyhow, after waiting for about 30 minutes she told me I might as well knock on the doctor's door between consultations and ask how long I'd have to wait, which I did, again remembering my nurse friend's advice. On doing this the doctor told me that I was number 28, and she was now on 36. I had been leap-frogged! But nevermind, she said, come in and sit down. She explained to the Arab woman who barged in just after me what had happened, and she seemed to accept it with resignation - all's fair in love and queue barging here, it seems.

My conversation with the doctor was fascinating. Instead of asking how long we'd been trying for a baby, she asked how many years we had been married. Out here, contraception clearly isn't an issue! Once you're married, that's it. I also found out the other day that in order to get a smear test on the national health system you need to produce a marriage certificate. Anyhow, she asked me whether I wanted to have an ultrasound and blood tests done there at the centre or whether I'd just prefer an immediate referral. I said I'd prefer the referral, and she said "Yes, that's a good idea. You don't need this (meaning the chaotic doctor's surgery) do you? It's like a zoo out there!" Which seemed to be a rather good analogy. Particularly as it was next door to the ACTUAL zoo. Poetic, really.

Oh, and my nurse friend's other piece of advice about handling the system was "Cry. They don't know what to do, but want to help".

Luckily I didn't need this piece of advice on this occasion, but I'm keeping it in reserve...


  1. A...d...o....p....t... :-)

    We love our adopted child just as much as our bio one... It was and is a crazy journey I wouldn't trade for anything (well... maybe a TBM850... just kidding!) Seriously, the journey both before and after was and is incredible. I was worried I'd feel differently about an adopted (i.e., "not mine") child... man, was I wrong. Think about it.

  2. Oh my... seriously I thought my expat health care issues were challenging, and I at least live in an English speaking country. I can't imagine how I would handle that whole situation! Good luck with everything!!




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