Thursday, May 30, 2013

Part II: International Women's Day

Old Soviet-era poster for Women's Day, proclaiming an end to "kitchen slavery."

In the pantheon of made-up, Hallmark-bankrolled holidays, International Women's Day is not the worst offender -- at least on paper. 

For one, it's not wholly manufactured.  Its origins harken back to the spirit of early 20th century revolution, and its contemporary counterpart is the grandchild of a century of political and social change.  One can even overlook the commercialized modern-day incarnation in Kazakhstan to see it as an interesting by-product of Soviet legacy and, simultaneously, an internalized reflection of changes in Soviet society over time. Through a purely objective lens, this holiday's social history is far more fascinating than my favorite revisionist historical holiday, American Thanksgiving.  (To be fair, this is largely due to Thanksgiving's emphasis on pie). 

After enduring my first-ever Women's Day celebration, at least in a part of the world where it is a national holiday, I can confidently say that I have discovered my least favorite holiday on the planet.

In Kazakhstan, as in Russia and other parts of the former Socialist sphere, Women's Day has metamorphosed into an appalling hybrid of Valentine's Day and Mother's Day with little substantive content.  Women are showered with flowers, chocolates, perfumes and gifts from all the men in their lives.  They are reminded about their special "virtues" -- mostly by men -- and praised for their roles as mothers and caretakers of the country's future -- again by men.  Political leaders, of course, will pay some lip service to the contributions of working women to the economy, but even that is couched in patronizing rhetoric about women's innate abilities to be amazing employees and great mothers/wives.  Kazakhstan's President Nursultan Nazarbayev, for example, highlighted women's "sacred" mission to raise a new generation even as he discussed the lack of women in leadership positions in the state administration. (He also honored a 32-year-old woman with seven (!) children with a special gold medal at the ceremony).

Women's Day tulips at work.
While none of this sounds particularly offensive, there are broader ramifications to reducing a holiday presumably celebrating half the world's population to a second-rate Valentine's Day. (Besides, Valentine's Day hasn't yet been declared a national holiday anywhere).  National holidays, after all, are public rituals that play important roles in shaping culture, identity and nation-building.  When compared to 'Defenders of the Fatherland Day' -- the de facto Men's Day that was celebrated with a sense of dignity -- the public celebration of Women's Day bordered on cartoonish frivolity. Billboards lined the streets of Astana for May 7 with poignant quotes from veterans about their experiences from World War II.  Not a single billboard I saw on March 8 quoted Kazakhstani women, famous or otherwise, on their accomplishments or challenges.  Instead, the city was adorned with flowers, which were incidentally recycled a few weeks later for the Nauryz celebration.  The imbalance of this symbolism is telling, even if it is unintentional.  

City decorations aside, what bothered me most about the holiday festivities was something much more fundamental.  Under the guise of giving women deserved recognition for their work in and out of the home (incidentally, in both the Soviet and post-Soviet eras, women end up working just as hard -- if not harder -- on Women's Day since the day off from work is an excuse for family and friend gatherings for which they do most of the heavy lifting at home), it relegates women to passivity. Men recognize women for their "special roles."  Men buy women gifts.  Men give lofty speeches extolling the virtues of women.  Men plan the special events at workplaces.  Women, ironically, don't seem to have much of an active role in celebrating "their day." 

Now, I can probably guess what you're thinking: stop being such a judgmental Westerner.  

Indeed, I gave a lot of thought to why I was feeling this visceral hatred that I normally only reserve for holier-than-thou vegans and sorority girls who wear black leggings in lieu of pants.  Was this just my Western liberal bias?  Or, worse, was I becoming one of those expatriates who criticizes everything about the country they're living in because it doesn't conform to their values?  While I admit I am especially intolerant of social norms that bestow special status -- and consequently, special rules -- on women, I do not believe it is culturally insensitive to question practices and values that promote racism, sexism, or homophobia.  One can still respect the differences in cultural, or social traditions and challenge the basis on which they are formed.  

Pausing each year for a moment to recognize the contributions -- and, yes, even the "roles" -- of women in society is a worthy cause, but it's a cause that deserves more than just chocolate, flowers, and empty compliments from the menfolk.  Perhaps it's time for a new Women's Day tradition in Kazakhstan -- for women to take charge of the celebrations!

Bonus: Here are some selections from several poems that appeared in my inbox on March 8 for Women's Day. 

"Each woman is gentle, caring and kind.
We must respect, both her body and mind."

"Let will this Day of the Springtime
For You particularly miraculous"

Next time on Wanderlost...

Part III: Adventures in Running

Thursday, May 23, 2013

Return of the Blog: Part I

A friend and I were discussing recently how difficult it was seeming of late to blog about something "interesting."  As you've no doubt noticed, beloved reader, I haven't posted anything for almost five months, which I partly attribute to wanting only to share what I find new and fascinating about living here in Astana.  After eight months here, things are beginning to feel more or less normalized, and my life has acquired the kind of mundanity that doesn't inspire great blog posts.  And, yet, blogging -- like any form of public writing -- is at its core an act of constructed intimacy, of sharing selected parts of one's everyday life in an effort to find some relevance in them.  So, here goes… 

Part I: The Hospital

If what Uncle Lev said about happy families is correct, then I’d like to say the same about hospitals: they are indeed all alike.  Before you scoff at this idea of comparing the Mayo Clinic to a rural hospital in Botswana, consider the commonalities that do exist in every hospital regardless of geography.  

The smell of disinfectant.  The sounds of illness.  The harried faces of doctors and nurses.  And, of course, the endless waiting.

When I broke my elbow in January – on a foolish attempt to beat back impending old age through ice-skating – I made a few visits to the local hospital to get it examined and fixed up.  The hospital, like most things in Astana, is a brand new building – and, like most new buildings in Astana, was undergoing ремонт ("repair") at the time of my visit.  Expatriates in Astana generally receive treatment at an international clinic, but with my local health insurance, I didn't have much of a choice as to where I went.  Perhaps my naiveté, combined with a childhood of visits to third-world hospitals/doctors, made me less apprehensive than some of my colleagues about getting treatment at the quote "local hospital." The hospital facilities were clean and well-equipped, and my doctor had the right combination of tiredness and gruff competence I instantly recognized as a universal trait in ER doctors around the world.  Besides, a broken elbow is a common-enough ailment that I imagine even the most poorly-trained doctor could fix without too much trouble. 

Getting my cast off for a final X-Ray at the hospital. 
This experience was, on the whole, much more pleasant – and far cheaper, costing me a grand total of 0 – than my previous visit to the hospital in the United States a year earlier.  An unplanned visit to the ER with a gastrointestinal infection last year nearly cost me several thousand dollars after my insurance refused to pay the hospital bill on the grounds that I should have followed their procedure by contacting their 24-hour doctor on the phone (in between vomiting, of course) to get permission to go to the ER.  While the insurance company eventually caved in to my demands, the entire experience left me – as many other Americans can attest to – with the distinct feeling that getting sick or in an accident would ruin my life with or without insurance. 

Free (and first-ever) ambulance ride to the hospital.
Since my unexpected foray into the medical world of Kazakhstan, I have been trying to better understand the health care system in this country.  The collapse of the Soviet Union meant that Kazakhstan, like many other post-Soviet states, had to figure out how to retain the free, universal health care system that was no longer centrally funded.  Today's system, as far as I can make out, is a combination of guaranteed public benefits paid for by the state, including emergency, outpatient and inpatient care, and user fees for services outside those benefits such as medications that are either paid by private insurance or patients.  The majority of hospitals and polyclinics are publicly-owned, though there are a growing number of private hospitals and public-private ventures. 

By American standards, Kazakhstanis seem to have it pretty great, considering that an uninsured working adult in the United States could hardly walk into an ER and expect free treatment. 

However, when you look a bit closer at the numbers**, the Kazakhstani system is not without its flaws.  For one, government expenditure on health care is low – less than 5 percent of the GDP in 2009 – and is one of the lowest in the countries of the Commonwealth of Independent States.  Salaries for health care workers, especially nurses, are low.  The resource imbalance between rural and urban areas is marked, but even living in the capital city doesn't ensure better treatment.  A neighbor told me once that it took several trips to get her 3-year-old daughter treated for a fever because the clinic was overwhelmed with patients on that day.  Because one's official place of residence determines which clinic in the city one can visit, her options were limited.  In short, Kazakhstan faces the same health care challenges as many other middle-income countries around the world.

Overall, would I rather have been treated in the United States?  Absolutely.  Despite the costs associated with medical treatment, I do believe the average American patient rarely questions the quality of the care and has recourse when things go awry. (I read a report that suggested that a state commission here began tracking medical errors and negligence only recently).  While the problems faced here in Kazakhstan differ from those in the United States, they are governed by two underlying questions: how much do we invest in the health of our community, and whose responsibility is that investment?  Let us hope that these two societies – and their governments – decide to tackle these questions in the near future.   

Or, at the very least, before my next broken bone. 

**This comprehensive European Observatory on Health Systems and Policies report on Kazakhstan was helpful. 

Next time on Wanderlost… 

Part II: International Women’s Day