Features

My memories of working in Saudi Arabia

by Dr. Nihal D. Amerasekera
Consultant Radiologist (UK)
It was a cold wet day in London in March 1984 when I received a phone call from Jeddah Saudi Arabia. At the other end was a radiologist friend from London who was now the director of the department at King Khalid Hospital Jeddah. After exchanging the usual pleasantries he got down to business and wanted me to take up a 4 week teaching and work assignment in that hospital. I agreed without much hesitation and pondered about the decision later.

This was the beginning of a happy association with Jeddah over a period of 15 years. I spent a total of 6 months in this harsh and unforgiving climate. The hospital in Jeddah was managed by a British company who wanted to see me at their head office near London with my passport, CV and several photographs. After a short interview they showed a video of the hospital and its surrounds and issued strict instructions of do’s and dont’s. There were more dont’s as you can imagine.

It was a Saudi Air flight from Heathrow airport and I recall the ultra strict security. When the check-in staff saw my passport and found I was a doctor they upgraded me to 1st Class. I travelled in luxury to my destination. When I disembarked in the late evening what hit me was the intense heat - as if I had peeped into a furnace. The terminal was packed with people. Many were on pilgrimage to Mecca and some had come for employment mostly from the near and far east. After a long wait at immigration all were tired and the tempers were fraying. Every baggage was opened and every item was scrutinized with a fine toothcomb. Magazines with bikini clad women were confiscated.

As I emerged after all this I questioned my decision to take up this job. At the Arrivals was a man from the hospital who whisked me away into his people carrier. I arrived at the hospital late at night and was shown my accommodation which was called The Motel. I slumped on my easy chair dreaming of a cold shower and a good night’s sleep. I slept well that night.

Induction

In the Kingdom of Saudi Arabia Thursday and Friday constitute the weekend. It was a Monday and I was advised to get my ID card, the most valued document next to the passport. The bureaucracy and red tape is only second to the Indian subcontinent. Wheels of the establishment grinds very slowly and suffers from intitutionalized apathy. Whatever that has to be done they say inshallah bookra - ’God willing will be done tomorrow. The tremendous weight of regulations crushes common sense. The little man seated at the desk thinks he is the centre of the universe and perhaps he is when he is the only one able to do a job for you. I survived the first day with difficulty obtaining the necessary documentation to get on with the job at hand.

King Khalid Hospital is a 500—bed facility completed in 1982. It is one of the most modern and best equipped hospitals in Saudi Arabia built in an oasis on the road to Mecca. There was a multinational staff from 40 countries totalling approximately 2,000. It is situated about 30 miles from Jeddah City. The hospital is surrounded by tall mountains which are brown and devoid of any trees - parched by the sun since Biblical times. The desert was all around the hospital as far as the eye could see. In this oasis there was the hospital, the Camp – for the minor staff and the so called Medical City for the doctors, administrators and other senior staff.

The hospital had the most magnificent buildings spreading over a wide area. Its marble floors, tall ceilings and the shiny marble walls took my breath away by its sheer beauty. On the walls were inscriptions from the Koran which stood out. This is the most splendid hospital I have ever seen.

The work

I was taken to the Director of Radiology who showed me the ropes and the rota. The workload of the department was reasonable and the on—calls were not too onerous. Many of the radiographers were British or Irish with some Filipinos and were friendly and made wonderful company. During quiet periods the staff played card games and drank gallons of tea. Some had time even to knit while playing cards. As the days passed I got the hang of what was required. It takes diplomacy, dignity and decorum to deal with the Saudi patients and doctors. A refusal or a NO is taken personally and such news has to be broken gently. The work was interesting and intellectually challenging. The patients were mostly Bedouins.

There were some middle class Saudis and the families of the National Guard who sought attention at the hospital. What struck me most was the many old men who had pretty young wives. They came to Radiology to investigate their wives - why they cannot conceive not quite realising most of the time the man’s age was the problem. Not firing on all cylinders! All the diseases of the developing world were seen in abundance. Congenital diseases and bone abnormalities were common which was partly due to consanguineous marriages. Once we had a man who had taken the female contraceptive pill himself for several months having misinterpreted the instructions.

I was once greatly honoured to be asked to treat a real Saudi Princess. She came with her entourage to the Ultrasound department. Her lady-in-waiting warned me to be gentle with her and I took her advise not wanting to languish in a Saudi jail for the rest of my life. The Princess was kind and courteous and spoke fluent English. After the examination she thanked me generously and one of her aides handed me a small package containing a Seiko watch. That was the closest I have come to Royalty anywhere in the world.

Most patients spoke only Arabic and I had a very pretty lady interpreter with me at all times. It was part of my duty to teach medical students. They were from affluent Saudi families, spoke good English and were mighty keen to learn the trade. The students followed me at work and I got to know many of them well. They had a certain arrogance which was common to most rich Saudis but were mostly very able and well trained.

Working hours

In hospital we worked from 8-12 and 2-5 p.m. The long lunch break was wonderful. There were three canteens - one for the minor staff, one for the senior staff and the other for the locals serving Arabic cuisine. For the minor staff who were mostly from India, Pakistan, Sri Lanka and Bangladesh the food was delicious and tasted like the curries back home. The senior staff had European food. In the main the food was exceptionally good and well presented. I have often had my meals with the Sri Lankan workers who were a lovely bunch – salt of the earth.

In the main European canteen there was a separate area for females who wore their head scarfs at all times. Within the hospital and in the medical city the laws were liberal and the guards who kept a close eye in general overlooked some of the indiscretions of the numerous Europeans who lived and worked there. Attached to the hospital was a Mosque and every Moslem was expected to visit and pray the recommended 5 times a day. There was a certain rigid pious atmosphere in the Kingdom which the Moslems seem to accept with much grace. My lasting memory of Jeddah is the calmness and serenity of the early morning call for prayer to the faithful which rings and echoes on the surrounding hills.

The day

The sun shines every morning and there is never a cloud in the sky. As the sun rises the heat becomes unbearable. Between 11 a.m. and 3 p.m. very few people venture into the open. The whole of the hospital, motel, camps and the apartments are air conditioned. Evenings are very pleasant indeed. I often took a stroll along the well lit streets of the medical city after dinner. The inky night sky was often lit up by the moon and bright luminous milky way. The numerous fireflies often reminded me of my childhood in Sri Lanka.

Lunch break

In the long lunch breaks I often sat on a bench at the front corridor of the hospital and watched the world go by. There is hardly a breeze and the heat is often unbearable. The red and violet bougainvillea add colour to the otherwise drab landscape. They seem to thrive in this inhospitable terrain. I saw the rich and the poor come into hospital. It is generally believed the Saudi women have no rights and lead a dog’s life. As I observed this is a false notion and nothing can be further from the truth. The women were belligerent and assertive as anywhere else in the world and the men seem to accept this as long as their wives observe the dress code and family etiquette. I have seen some fierce arguments where the men finally gave in.

There was a beautiful Mosque annexed to the hospital and I saw the faithful walk in for their prayers. I remember walking into a Mosque in Colombo. That wasn’t to receive spiritual sustenance but to satisfy my youthful curiosity many years ago. I was most impressed by its simplicity and cleanliness

The medical city

The medical city is a large complex of apartments, shops, sports facilities and an Olympic size swimming pool. The apartments were fully equipped with all modern facilities. The single females were segregated and no male was allowed into their apartments at any time. There were beautifully laid out gardens and water fountains which made life bearable in the middle of the desert. Saudi Arabia is well known for its ban on alcohol. Lord Bacchus is too cunning and saw to it that those who persevered got their way. I spent a Christmas in Jeddah and there was indeed no shortage of drinks of all kinds.

It was a most memorable Christmas in a country where December 25th is just another day. I personally preferred the non-alcoholic lager which was freely available. We worked as usual and no decorations or fireworks were allowed. I am pretty certain the guards knew what went on but turned a blind eye as long as we all behaved well. Every weekend there was a party in the medical city and life was good.

Sri Lankan hospital workers

There was a large Sri Lankan contingent of minor staff who lived in the camp just a short walk away from my accommodation. They were a wonderfully united bunch who looked after each other and shared their joys and sorrows. I cannot speak highly enough of my countrymen who behaved impeccably in this often harsh and unforgiving environment. In the evenings I frequently went to see them at the camp. A single large room was shared by upto 4 people. They had their own recreational facilities. Nimal Fernando from "Channa," Moratuwa, was one of their leaders. I got to know many of them over several years and knew of their families, problems and aspirations. We had mutual respect for each other and during each of my several visits became their mentor and physician.

Often they cooked a Sri Lankan meal in the evening which we all shared. Some were gardeners, telephone operators, security guards, shop assistants and clerks. Others worked within the hospital in sterilisation units and did office work. We had a Lankan barber who did my hair listening to his vast collection of old Sinhala music from the films. It certainly brought back memories of my youth. He knew all the gossip of those living in the medical city and was well liked. After all every one needed a hair cut at some stage.

Shantha and Neville were brothers from Matara and were swimming pool attendants and life savers. They saved lives and were well liked by the girls. Many of the workforce had families in Sri Lanka and have lived in Saudi Arabia for 5 to 10 years. They had missed their children growing up and their usual milestones which we all take for granted. They earned good money and bought land, built houses, educated their children and spent for their weddings. This in itself is a marvellous achievement. The sacrifice has been worth their while. They had now virtually broken the cycle of poverty.

The Sri Lankans working in the hospital received free treatment of the highest quality including bypass grafts free of charge. Food and lodging too were free and all their wages went straight back to their accounts at home. As I write I can see their smiling faces and their willingness to help me and each other in every way they can.

Jeddah City

In the evenings and weekends I took the hospital bus to Jeddah City. The bus goes past the wealth of the affluent Saudis and the squalor of the destitute. White houses with flat roofs is the norm and every house has a large water tank at the top. Jeddah is the gateway to the two Holy Mosques, Mecca and Medina, and is the commercial and industrial centre. Jeddah is one of the oldest cities in the Arabian Peninsula and it began about 2,500 years ago as a tiny fishing settlement. It is situated in the middle of the eastern coast of the Red Sea and has expanded on a colossal scale in the past 20 years growing from a population of about 30,000 in 1947 to one and a half million in 2002. The population of Jeddah has doubled between the boom years of 1974 and 1980. It is now the Kingdom’s principal seaport. Jeddah remained under Ottoman influence and was released from Turkish rule in 1915. The buildings of old Jeddah are tall and graceful, constructed of coral limestone and decorated with intricately beautiful wooden facades typical of Turkish architecture of that era.

Markets

The souks or markets are the heartbeat of Old Jeddah and is still an exciting and picturesque part of today’s scene. The splendid gold souk with its gold chains elegantly displayed hanging boldly from the ceiling is a sight never to be missed.

There is a Filipino souk selling everything from T-shirts to screw drivers. The carpet souk is run by the Afghans and Persians and is a place for real bargains. I have often wandered through the narrow cobbled streets buying stuff from the vendors drinking the strong Arabic coffee. They sold those delicious Shawarma – kebabs and onions wrapped in a thin roti. The place was always packed with people. Everyone felt safe despite the milling crowds.

The markets are a haven for pirated software, games and music CD’s. New shopping centres, office building and apartment blocks are springing up everywhere. Stretches of former desert have now become part of an expanding, concrete city. Jeddah has successfully managed to combine the dignity and traditions of the past with the dynamism of the modern business world.

During prayer times all the shops close and this occurs 5 times a day. All the women wear their head scarfs (tarhar), The long black dress the abaya and the face mask the burqa. Those who don’t follow this experience the wrath of the Muthawas – the religious police. Women are not allowed to drive vehicles or travel alone as a passenger except with her husband. If stopped by the police they may have to prove they are married showing the marriage certificate. These are the laws of the land. All Saudis adhere to the laws and it is the duty of all foreigners to abide by them too.

Norwegian friend

Once I remember a Norwegian radiologist who worked in the hospital. He was in his mid sixties and lived alone in an apartment in the medical city. His family lived in Norway. We became good friends and in the evenings he took me in his car to Jeddah City and to the various other places of interest. He was fine company and knew the history of the area well. He particularly loved the desert and spent weekends there all on his own. It was my in-built caution that prevented me from joining him.

About a year after my return to England I had a phone call from my Norwegian friend who wanted me to work at King Khalid Hospital again. He made it a point to tell me I have to join him on a weekend trip to a far away desert. I agreed reluctantly. When I went to King Khalid Hospital the staff in the department were in a sombre mood. They finally broke the news that the Norwegian radiologist had gone into the desert the previous weekend and has not returned. Helicopters and search parties looked for him for over a week. They finally found his body in the desert beside his jeep. Apparently a front tyre had got stuck in the sand and he had got a heart attack whilst clearing the sand with a spade. As there was no help he had died. It was a sad goodbye to a warm hearted and sincere friend.

The religion

The hospital is 40 km from Mecca. It is the most holy city in Islam. The city is revered from being the first place created on earth, as well as the place where Ibrahim together with his son Isma’il, built the Ka’ba. The Ka’ba, the centre of Islam, is a rectangular building made of bricks. Around the Ka’ba is the great mosque. Around the mosque, in between the mountains, are the houses that make up Mecca. On numerous occasions I have seen on television the mass of pilgrims walking round the Ka’ba – a splendid awe— inspiring sight. Every year some 2 million pilgrims attend the haj. Some come to Mecca for the umra. There is a regular free bus service from the hospital to Mecca every day of the year.

During Ramazan work in Saudi Arabia virtually comes to a standstill. The Moslem hospital workers are allowed to start work at 10 a.m. and also leave earlier as they are fasting. This is the time of the year when the number of road traffic accidents increase keeping the accident departments on full alert. The Kingdom must be one of the safest countries in the world due to its harsh punishments for crime. Women can go about their duties unmolested and robberies are rare. The punishment for rape is death and for robbery - amputation of the hand. The Sharia law certainly is a deterrent and I have the greatest respect for the Muslim religion and their strict code of conduct.

The desert

Despite its parched terrain and the forbidding landscape the desert has its own beauty. This is most evident during the rainy season in December when it comes alive. The soil is not used to soaking up water which remains on the surface making lakes and fast flowing streams within just a few hours. It rains incessantly for days and suddenly stops and the sun shines again. Within these few days the mountains and valleys become a carpet of green and purple with grass and many coloured flowers. This is a very pretty sight indeed.

As I had imagined the desert is not all sand. There are many rocks and pebbles of all sizes. Despite the heat and the dry atmosphere the desert is full of life with lizards, scorpions, insects and small snakes. The ubiquitous beige terrain and the scorched air supports life and has done so from the beginning of time. The oasis of the hospital is a haven for numerous colourful birds. Many have migrated to escape the harsh winters in Southern Africa and Scandinavia.

I have driven on the highway towards Mecca with my uncle Neville Weerasekera who was an engineer in the petroleum industry. The desert roads are long, straight and seem to go on forever. Looking at the road ahead one can see mirages and the haze rising from heat of the road. From the road the desert appears rather featureless except for a few Bedouin tents and camel trains. The Bedouins are the true people of the desert and are known for their hospitality. They regard it as a tribal duty to welcome strangers.

Non Muslims are not allowed into Mecca and we took the "Christian bypass". The desert although very hot during the day it does become rather cold at night. Sandstorms are another scourge of the desert. I experienced one in the month of July. One mid afternoon when the sun should be at its brightest, suddenly darkness descended on the whole area, It was like a fog and visibility was reduced to a few yards. We were advised to stay indoors and it was many hours before it cleared and the sun reappeared. Sand was everywhere covering the cars buildings and even the trees. No one ventures out in a sandstorm.

My uncle in Jeddah

I was very fortunate indeed to have my uncle Neville Weerasekera in Jeddah. He had been there for nearly 15 years and knew the roads like the palm of his hand. He lived in the leafy suburbs of the city with my aunt in a comfortable house with a tall karapincha tree at the rear. They were always most hospitable and treated me lavishly. On one of my trips he was on his own, the family being on holiday in London. He came to see me every day in his Volvo car and we travelled around seeing the sights. I grew up with him in our grandparent’s home in Nugegoda. He took me to school on my first day in January 1950. This was a wonderful opportunity which we made use of to recall the past, exchange views and relate our own plans for the future.

There is no substitute to a chat one-to-one. I didn’t realise what a good cook he was and still remember the delicious thora fish curry he made. The strong fruit juice wasn’t bad either. I have vivid recollections of those happy times and thank him for his generosity. I wish him a long and happy retirement in Sri Lanka.

The decline

After the Gulf war there was a palpable change in the ethos at the hospital and the working conditions of all foreign staff. The pay did not keep pace with worldwide inflation and appeared less attractive. There was a natural progression to greater Saudi-ization which perhaps came too quickly with a resultant drop in the standard of healthcare. Many felt the various strictures of life in the Kingdom was not worth the sacrifice when pay and conditions have improved elsewhere. My last visit to Jeddah was in 1996. I enjoyed my time there enormously and miss the wonderful staff, the sunny days and the arid landscape. Even now when I eat a Shawarma it reminds me of the buzz in the souks and the warm night air. Most of all I miss the Sri Lankans in the camp. They brought sunshine into my life in a foreign land.

A bad experience

On my last visit to Jeddah the Hospital coach had forgotten to pick me up from the airport. I didn’t have any Saudi riyals but had some pounds sterling. I went across to the official airport information desk and explained my plight. He just waived his hand and asked me to get lost. I asked several security guards in the airport premises who understood me but were unwilling to help. I saw several telephone boxes which needed Saudi coins to operate. There were many shops in the arrivals area and I asked all of them to exchange some money to make a call. To my surprise none of them were willing to help. I felt now that I was in real trouble being in a foreign country without any local currency, without a friend in sight and unable to get to my destination.

I was angry and disappointed at the lack of compassion shown to me by so many people who could have quite easily helped. Jeddah is a scary place for a foreigner who cannot speak Arabic and alone. Getting into a taxi not knowing the local lingo is not for the fainthearted. I spoke about my plight to almost every one without a positive response. When I was relating my story to a bystander, a well dressed gentleman overheard our conversation introduced himself as a Sri Lankan and offered to help me. He took me by the hand and spoke to a taxi driver in Arabic giving instructions to take me to my destination. Before leaving he handed me his business card.

The next day I phoned to thank him. This was indeed an extraordinary experience which could have ended in disaster. Sadly I lost the business card of this Sri Lankan Muslim whose kindness I cannot ever forget. As the years have passed I consider this as yet another life’s experience and do not hold it against the Saudis.

I dedicate these memoirs to this stranger from heaven I met at Jeddah Airport.. "Inshallah" we will have the good fortune to meet again.


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