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Wednesday, May 21, 2003

News From the Eastern Front

It may come as no surprise, but I'm not the only crazy member of our family. I have a son. He is a medic, currently doing complementary studies into health system administration (you might be able to discern where all this is leading, MSF, WHO???). Well as part of the course they have to do a health system evaluation in a foreign clime using a pre-prepared 'toolkit'. So where does the clever guy choose to go: Georgia. But not the one with Atlanta at its heart, oh no, that would be to easy. He had to choose the one right next to Chechenya. (Don't worry another day I'll introduce my brother, and you'll get to see what 'crazy' really is). Apart from all the guns and alchohol, perhaps the most noteworthy thing is the difficulty he had in finding an intenet connection.

The flight was to Yerevan in Armenia, and was full of young men, most of whom were flying on to Tashkent. They all had a kind of 'eastern' look about them, apart from the fact they were messing around with loads of brand new camcorders and other gadgets. There seemed to have been a shit load of shopping going on in Harrods by these guys and they were all determined to bring it on as hand luggage, much to the stewardesses consternation. Ha ha.

Anyway, we arrived in Armenia a few hours later (about 00.00 local time). We'd befriended an old american guy working over there (on some agriculture project... and yes pig farming was a big part of the equation) on the plane, and after messing around with some very bureaucratic (but good looking) officials in the airport and sorting out visas we eventually set foot on foreign soil. The army dudes in the airport were NOT to be messed with. This American was meeting some interpreters so they helped us with sorting out taxis for our 6hr trip by car to Tiblisi... which was damn lucky really. Anyway, $100 between 5 of us wasn't a bad price, considerring that there was always the possibility of a bit of bullet dodging somewhere along the way. The night journey began.

Armenia is amazing. Its high and very cold at night. The towns we saw at dawn were the most macarbe place you will ever go. Truly strange. We found ourselves driving through these incredibly steep craggy gorges and eventually comng across factory towns like no other i have ever seen. The side of the mountains steeped in the greenest grass i have ever seen, but then there would be these ginormous factories, with smokestacks pouring forth and rivers of what looked like the most rancid and caustic effluent imaginable. Terrifying. Factories lying like rotting grey skeletons in the middle of stunning backdrops.The roads were shit but our driver (Tico) was pleasant enough. Happy for the cash.

We arrived in Tiblisi monday morning. Slept all afternoon after arriving at our pad and then met a rather interesting chap called UKA. He's a manager at the local health clinic. about 25 yrs old. Georgia is notably better off than Armenia. You can see it as soon as you cross the border... almost immediately. Before i go on let me say two things.I have never seen so much alcohol drunk in all my life. All these people are alcoholics. Secondly, I have been eating the BEST food of my LIFE for the past two weeks.UKA took us out by way of introduction on mon night. He was what they call the tamada (basically the drinking boss for the night) and he made us drink the most incredible amount of booze. That night, i was interviewed by georgian television (and on tv the next day), offered a couple of whores by Uka (its only polite), drove around in numerous ladas, met a lot of good looking women and a lot more whih i won't go into.

Tuesday.... well a bad day for the brain. We met more contacts and settled in. The health system is in a state and basically there is a huge informal economy in health over here. Things work better than you would imagine but obviously the main issue is financing. They still use much of the same organisational structure that was established in the soviet period, and it seems to me that they recognise how valuable aspects of it were. However they are in the process of reforming a large part of primary vare which i will tell you more about in another email. We have met some very interesting people.

The next few days were spent interviewing people and gathering data, workjing on the toolkit and implementing it. They have loads too many doctors over here (it is very popular) and so they have a pretty inefficient health system. They spend only around 1.5% of gdp on health care as well. The weekend was great. Fri... more drinking and eating, some dancing, we met guys with guns and gangsters, raced around the pothole infested roads of Tiblisi in souped up ladas and bmw's played footy, met ex-secret service, engaged in some more street racing, went out to the countryside and saw some old churches from the 6th century, sang with the georgian equivalent of andrew llyod weber, were offered more hookers. ALL georgians are alcoholics.I shall leave it there and be in touch again soon... there is a lot more to tell, especially about the health system. (the computer place is now shutting. I It was an hours walk to this place and its getting late).

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