Dangerous places

BMJ 2005; 330 doi: (Published 02 June 2005) Cite this as: BMJ 2005;330:1337
  1. James Owen Drife, professor of obstetrics and gynaecology
  1. Leeds

    Risky destinations bother me less as I get older. Uzbekistan, a few months ago, felt safe. I heard the president was autocratic but relatively restrained in comparison with his neighbour in Turkmenistan, who has closed all regional hospitals and renamed January after himself.

    A British passport, a World Health Organization schedule, and a police checkpoint outside our hotel gave me a sense of reassurance. The only time I felt anxious in Tashkent was when the lobby filled up with GIs. Hey, with y'all here, we're a target.

    Nepal, several weeks later, was equally undemocratic. The king had seized power, apparently exasperated by parliament's failure to quell Maoist insurgency. Outside the royal palace, wary sentries crouched behind sandbags. On the streets, one blown-out shop was being repaired but otherwise life was normal. We checked our email in internet cabins to the sound of traffic tooting outside.

    These two countries, north and south of the mountains, had much in common. Each had once been part of an empire whose influence could still be felt. In Tashkent we lectured through Russian translators. In Kathmandu schoolchildren wore English-style uniforms, and the local radio, playing requests, broke into “Happy Birthday.”

    Both places inspire heartache in the visitor. Uzbekistan has ancient, evocative architecture and markets almost unchanged since Marco Polo's day. Nepal has the Himalayas: the tourist flights at dawn are stunning, I'm told. These timeless countries could be magnets for visitors. Instead, men shoot one another.

    Doctors in both places are wonderfully hospitable, but their official salaries are too small to live on. Compromises have to be made, and the rural poor lose out on medical care. Slowly you realise that this is normal across much of the world.

    Neither country is in fact dangerous for foreigners. It is the natives who are at risk, especially the women. In Nepal one in 135 pregnancies ends in the mother's death.

    When you check on the internet you can easily find data on a nation's population, economics, and oil reserves. Webmasters could help by making the maternal mortality rate a headline statistic. It is a clear indicator of how civilised a country is. Who knows, it might shame some autocrats into action.

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