Cuyahoga River

Cuyahoga River
Cuyahoga River in the Valley

Monday, January 28, 2008

A Tribute to a War-Torn Land

"A Thousand Splendid Suns" by Khaled Hosseini is an eloquent story about women abused and frightened and with no hope, about the terrible wars in Afghanistan, about the juxtaposition between what was and what became, and about the landscape of the country the author was born in. Again, I have read a book about the Middle East, with Pakistan again in the background, the place to which Afghan refugees flee. Published in May 2007, this book has gone back to press almost daily since its first week on sale, and over 1,400,000 copies were sold in the first six weeks. It was #1 on the New York Times bestseller list for four straight weeks.

"A Thousand Splendid Suns" is the superior book, but Hosseini's "The Kite Runner", a fictionalized autobiography all the way down to his friendship with a Hazara servant whom he taught to read, made me think. "The Kite Runner" movie was true to the book because Hosseini's soul was poured into the film as much as it's poured into is books.

Miriam, the bastard child of a maid and a rich man, is introduced as a young girl living in a hidden hovel created by her father on the outskirts of a city in Afghanistan. Her mother commits suicide when Miriam leaves on an adventure and the 15-year-old girl (without as much guilt as one would think she'd have) is taken to her father’s house until her father’s wives find her a suitable husband. In the car, with her father’s arm draped over her shoulder, “For the first time, Miriam could hear him with Nana’s ears. She could hear so clearly now the insincerity that had always lurked beneath, the hollow, false assurances.” This is the moment when Miriam grew up--her father showed her she was essentially alone and he wasn't going to be there for her. She is quickly married to an unsavory middle-aged shoemaker from Kabul.

Laila, a young girl with an educated father who no longer teaches during the reign of the Communist regime, and her friend Tariq, beloved son of an older couple, a boy who lost a leg to a bomb and wears a prosthetic leg, are soulmates. When the Taliban come into town and Tariq’s family makes plans to leave, Tariq confesses his love for Laila, but she cannot leave her father. As Laila says, “the irony crushed her.” Contemplating their own move some time later, Laila's beloved father says, “It’s strange to think that I’ll be sleeping beneath another city’s skies soon.” Laila response is, “Oh, Babi. We’ll come back.” but Laila is left bereft when her home is blown up in a bombing.

Rasheed, motivated by wanting an heir, brings Laila into his home with Miriam, and after a stranger tells her about Tariq’s death, the choiceless Laila agrees to marry Rasheed. Laila’s secret is that she’s already pregnant with Tariq’s baby, but for a time, Laila is the favored wife because Rasheed wants a child. It’s difficult to be the favored wife when the first wife Miriam shoots her “a cheerless glance and went back to slicing the stem off a bell pepper and strimming strips of fat from meat. A hurtful silence would fill the room, and Laila could almost see the wordless hostility radiating from Miriam like waves of heat rising from asphalt. She would retreat back to her room, sit on the bed, and watch the snow falling.” When the baby is born, Rasheed’s incensed that Laila bears a girl-child and Laila then falls prey to the mistreatment and abuse Miriam has born for twenty years. The two women become unlikely friends in the horrible situation they find themselves in. They live in a country where women cannot go into the streets showing their faces and they cannot go anywhere alone, and when Laila tries to escape to Pakistan with Miriam and Aziza, they are found out and taken back to Rasheed, who beats them.

The Taliban make it difficult for people to work and Rasheed loses his business to a bomb, although on the morning of September 27, 1996, Laila felt that the Taliban coming into Kabul would be their salvation. It soon becomes clear that the Taliban will make the life of women more restrictive than it already is. Trusting Laila tells Rasheed that the Taliban cannot treat people as they do and Rasheed replies, “spoken like the arrogant daughter of a poetry-reading university man that you are. How urbane, how Tajik, of you. You think this is some new, radical idea the Taliban are bringing?” He tells her the Taliban are taking them back to their roots, their tribal history.

The author claims to have had difficulty getting into the heads of his female characters until he let go and just let them be human beings, but I feel he did a great job at letting us feel how Laila felt. He also comes to understand Miriam, who fights for Laila in the god-forsaken woman's hospital set up by the Taliban and where Laila must give birth: “Miriam saw now the sacrifices a mother made. Decency was but one. She thought ruefully of Nana, of the sacrifices that she too had made . . . Miriam wished she’d understood then what she understood now about motherhood.” War-ravaged Afghanistan, with its political troubles, religious fanaticism, crumbling infrastructure, desperate and suffering population, confused moral fabric, and fractured womanhood is graphically and honestly displayed.

The home the threesome inhabit becomes a living hell even though Laila evenutally bears Rasheed a son upon whom Rasheed rains affection. The family begins to starve under the Taliban. Eventually Aziza, Laila's first-born who Rasheed now knows as Tariq’s child, is put into an orphanage which Laila visits despite severe restrictions. This was the saddest and most tragic of passages in the book, the time when the entire family was starving and they had to give up one of the children. Unfortunately, the situation is not uncommon in Afghanistan.

On the day Tariq shows up in their doorway, alive, their love for each other thrives even though hard living had worn them down. In the climax of the book, Rasheed tries to choke Laila to death after finding out about the visit from Tariq. In the Muslim world, pride is man’s #1 treasure and a wife spending time alone with a man uncovered is a terrible thing. One wonders why Tariq put Laila into harm’s way in that way, but it may have been because he’d been in a refugee camp and then in prison and had no idea how mistreatment of women had become part of the culture of Afghanistan under the Taliban. Miriam, stronger than life, saves Miriam by killing Rasheed with a shovel to the head. The women are faced with what to do—they put Rasheed’s body in the shed, but they know full well one or both of them will die for the murder. Miriam does not convince Laila that Laila’s life means more than hers, but in the end Laila agrees that she should take the opportunity to flee with Tariq and the children. Miriam is willing to die if it can give Laila and her children a better life.

Tariq and Laila and the children end up in peaceful Murree, Pakistan. On their wedding night, Laila remembers the “ease with which they would crowd the air between them with words” when they were young, and now, “it was blessing enough to know that he was here.” In the middle of the night, she found their hands “still clamped together, in the white-knuckle, anxious way of children clutching balloon strings.” Laila thinks about Miriam’s death and wonders about the life she and Tariq have made as hotel workers and asks “Did she sacrifice herself so she, Laila, could be a maid in a foreign land?” And her father had always said she would do great things. It is time to go home, but only after she makes a pilgrimage to Herat, where Miriam was born, to find Miriam, and to find herself.

Laila finds Mullah Faizullah’s home and his son Hamza welcomes her and wants to hear the story of Miriam, so Laila tells him everything she knows about Miriam’s life after she left her native land. When Laila is done, the son says his father was very fond of Miriam and he sometimes joined his father on his weekly visits to Miriam. Laila is led to the tiny kolba where Miriam spent her first fifteen years and sits and listens to the wind filtering through the willows; she closes her eyes and soaks up the feel of the place. She sees Miriam, feels her moving and reciting verses from the Koran, and then imagines a young Miriam sitting at the table making a doll by the glow of an oil lamp, and the vision is so real, she hears Miriam’s voice say, “Laila jo?” Startled, the moment ends, and Hamza announces has something for her. He gives her a box that Jalil gave to Faizullah before he died, for Miriam. Inside is a letter expressing a father’s love and regret as well as a sack of money.

The phrase “a thousand splendid sons” is from a poem by 17th-century Saib-e-Tabrizi to describe leaving behind a beloved city, and is quoted when Laila’s family prepares to leave Kabul and again when she decides to return there from Pakistan. It’s mentioned at the end of the book, “Miriam is in Laila’s own heart, where she shines with the bursting radiance of a thousand suns.” The phrase is an affectionate nod to Hosseini’s own Kabul and to the feelings Laila has for Miriam, who has become a mother to her, despite the fact that they shared a husband. Laila is without knowledge of Miriam's ultimate fate, but in jail during her final days, she returns to her self, the self that had been lost over her adult life, and dreams of being with those she loved, her father, her beloved Mullah Faizullah, and Nana, and in her childhood home. It is a prayerful time, a quiet end to a troubled life.

Laila, Tariq, and the children return to Kabul and work with the kind-hearted administrator of the orphanage, Zaman, to improve the orphanage. When Laila sees their pictures in a newspaper article reporting the renovations at the orphanage, she remembers her friend Hasina’s words, “You’re going to be somebody. I know one day I’ll pick up a newspaper and find your picture on the front page.” In Kabul they make a difference in the lives of children whose lives have been torn apart, quite literally. And Miriam is there in everything they’ve done, but mostly, Miriam is in Laila’s own heart, where she shines with the bursting radiance of a thousand suns.

Khaled Hosseini was born in Kabul in 1965 to an Afghan Foreign Ministry diplomat and high school teacher. During his childhood they lived a few years in Tehran and a few years in Paris. They planned to return to Kabul in 1980, but Afghanistan had already witnessed a bloody communist coup and invasion of the Soviet army. They were granted political asylum in the United States and settled in San Jose, living through several years of hardship for a period of time. Hosseini earned a degree in biology in 1988 from Santa Clara University and entered medical school at University of California in 1993. He completed his residency in Los Angeles. He was an internist between 1996 and 2004. He began writing "The King Runner" in 2001 and it was published in 2003. It was an international best seller and published in 38 countries; after 120 weeks, it’s still #4 on The New York Times Bestseller List. In 2006 he was named a goodwill envoy to the United Nations Refugee Agency. He says “I have been on an extended sabbatical from medicine, and have spent the last two years focusing on my writing, something that had long been a dream of mine. My days are shaped now around the creation of stories.” That young boy, Amir, in Hosseini’s first novel was unmistakably the writer.

On his blog, Hosseini says “the struggle of Afghan women was simply too compelling, too tragic, and too important and relevant a story, and both as an Afghan and as a writer, I knew that I couldn’t resist writing about it.” He goes on to explain how he went back to Kabul in 2003 and he heard story after story about women who had been raped, beaten, imprisoned, humiliated, women who had seen their husbands blown to pieces, seen their kids starve to death. He said, “I came away humbled by the enormity of the suffering that these women had endured. And I came away humbled by the fight that these women had in them, by their resilience and their courage.” The character Miriam’s mother instructs her “Like a compass needle that points north, a man’s accusing finger always finds a woman.”

Hosseini also writes about visiting Afghan refugees who were being forced to return to their homeland from Pakistan and Iran, and their homeland is not equipped to handle the influx of people; Afghanistan is still in need of international support. Touring Afghanistan was like Amir said, “I feel like a tourist in my own country . . . But the most striking thing to me was that despite the atrocities, the unspeakable brutalities, and the hardships Afghans had endured, they had not lost their humility, their grace, their hospitality, or their sense of hope.” While "The Kite Runner" was being filmed, in Afghanistan and China, Participant Productions and Paramount Vantage started partnering with various NGOs to train 1000 Afghan teachers over the next two years and built fifty rural libraries in Afghanistan.

Hosseini says his mission in writing his books was not about the good that came out of the books. He just wanted to tell a good story. “I have never sat down to write with broad, sweeping ideas in mind, and certainly never with a specific agenda. It is quite a burden for a writer to feel a responsibility to represent his or her own culture and to educate others about it. For me it always starts from a very personal, intimate place, about human connections, and then expands from there.”

Sunday, January 13, 2008

Mountains Beyond Mountains


By Claudia J. Taller

Although lofty thoughts and contemplation will not solve the world’s problems, being reminded of world issues and possible solutions can spur us to make our own contribution. Paul Farmer, MD, speaks on “Global Health Equity” on February 7 at Cleveland's Palace Theater on Playhouse Square. I read reporter Tracy Kidder’s book on Farmer, entitled "Mountains Beyond Mountains, The Quest of Dr. Paul Farmer, a Man Who Would Cure the World" with my book discussion group this past year. Dr. Farmer is admirable and deserves to be heard.

The energetic and passionate Farmer insists on making a difference in the world. In doing so, he inspires us to be better people. Paul Farmer is the Presley Professor of Medical Anthropology at Harvard University and Co-founder of Partners in Health which is his project in Haiti begun when he was a young medical student at Harvard. He’s an advocate for and provider of free healthcare for the world’s poor and he oversees healthcare projects in such far flung places as Russia, Rwanda and Peru, in addition to Haiti.

Farmer came from humble beginnings. His salesman father uprooted the family from Birmingham to teach in Brooksville, a small town north of Tampa, where they lived in the Bluebird Inn, an old school bus, at a campground. Later the large family lived on a houseboat. To avoid onerous houseboat chores, the children in the family became busy in extracurricular activities, and Farmer was popular with the girls in school because, his mother said, “’He listened to them.” And one of his main priorities was maternal mortality because the deaths of mothers led to catastrophes in families. He escaped to Duke and then to Harvard, going to medical school while working in Haiti, the beginning of his double life in Boston and Haiti. He wrote his senior anthropology thesis on gender inequality and depression, and his mentor as Rudolf Virchow who was “’the principal architect of the foundations of scientific medicine,’ the first to propose that basic units of biological life were self-producing cells, and that the study of disease should focus on changes in the cell.”

Farmer grew up Catholic, but he had a problem with “the cult of resignation” in which people were to accept their lot patiently, waiting for the afterlife. His religion was that the world was wrong for screwing over the poor and God was keeping score. He was drawn back to Catholicism as an act of solidarity. And when Aristide won the election, nothing ever moved Farmer so deeply, because it was the first time the people could choose and “at last, after centuries of misery, of slavery and subsequent misrule and foreign interference, the people of Haiti had claimed their country.” Soon after, Farmer wrote “The Uses of Haiti” while in a Quebec hotel room for ten days. But Farmer never felt he’d done enough, and lived his whole life in what he called “the long defeat,” never quite making it all happen.

Farmer is the kind of guy who can write a book on a plane during a fit of an obsessive need to make a point. He has published more than 200 articles, chapters and books and supports a “preferential option for the poor.” He’s been tireless in his mission to change the way healthcare is delivered to the poor. After reading Kidder’s book about Farmer, the audience is left with the true feeling that we should all be doing more.

Kidder portrays Farmer as relentless and untiring in striving to cure the world of TB and AIDS and any other infectious disease that comes along and ruins entire communities of poor people. Kidder did a fantastic job detailing Farmer’s world—we had a real sense of urgency and driven energy in the combat against both disease and poverty, for Farmer believes there’s not a lot of point in curing someone from TB if he’s just going to go back to a hut with a roof that leaks. He believes he should replace the banana leaves with tile and the dirt floor with cement and get the kids into school and the mothers healthy. Whenever he’s forced to make a choice between taking action on one thing or taking action on another, he’s failed because he wasn’t able to attend to both. In the midst of economic limitations, he forges ahead, having faith it will turn out all right. For the number one thing on Dr. Farmer’s agenda is saving his patients.

Kidder’s a great writer, a champion for causes, and is to be admired because he followed Farmer to Haiti and on flights to Peru and Paris and back to Boston. Kidder trailed Farmer as he stopped at the bedsides of the sickest and poorest of humanity. He lived Farmer’s life with him. The writing in the 300-page book is excellent; it’s trim but multi-layered with meaning. It gives us a lot of detailed information about battling cells and what the administered medicines do to the cells, but it’s not so dense that the lay reader decides to put the book down with a big sigh.

Tracy Kidder first came upon Farmer when he was in Haiti writing a story about the soldiers in Haiti. Farmer uncomfortably confronted Kidder about his belief system. Later, Kidder took Farmer to dinner in Boston and was intriqued that Farmer, with all his education and talent, seemed to like living amongst peasants in Haiti and in a church rectory in Haiti.

If a patient doesn’t show up for treatment, “this was one of the rules—someone had to go and find him . . . Farmer said, ‘the only noncompliant people are physicians. If the patient doesn’t get better, it’s your own fault. Fix it.’” There you go—it was all on him. How many doctors take on that kind of responsibility? How many human beings? The proverb “Beyond mountains there are mountains” purely describes this searching out of patients; the title of the book reflects Farmer’s way of looking at life—you just do it. Paul Farmer said, “The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.”

When Farmer talked about medicine, he said he didn’t know why people don’t get excited about it, and then, Kidder said, “He smiled at me, and his face turned bright, not red so much as glowing a luminescent smile. It affected me quite strongly, like a welcome gladly given, one you didn’t have to earn.” And that’s who Farmer was, what he passed on to the peasants who loved him. If a patient didn’t show up for treatment, “So—this was one of the rules—someone had to go and find him . . . Farmer said, ‘the only noncompliant people are physicians. If the patient doesn’t get better, it’s your own fault. Fix it.’” There you go—it was all on him. How many doctors take on that kind of responsibility? How many human beings? The proverb “Beyond mountains there are mountains” purely describes this searching out of patients; the title of the book reflects Farmer’s way of looking at life—you just do it.

The United States, like the World Health Organization, attempts to help the poor in ways that sometimes does more harm than good, like building a dam in the name of improvement only to leave people without fertile farmland. “Families had hurried away, carrying whatever they could save of their former lives, turning back now and then to watch the water drown their gardens and rise up the trunks of their mango trees . . . For most, there was nothing to do but settle in the steep surrounding hills, where farming meant erosion and widespread malnutrition, tending nearer every year toward famine.” Farmer had problems with white liberals, WL’s, with their ‘they’re poor but they’re happy’ line. “’But WL’s think all the world’s problems can e fixed without any cost to themselves. We don’t believe that. There’s a lot to be said for sacrifice, remorse, even pity. It’s what separates us from roaches.’”

Kidder describes a walk with Farmer to find a noncompliant patient and they were surrounded by women who talked. “One woman was telling him that they needed an additional community health worker up here, but mostly they were just passing the time. Is there a more widespread notion than the one that rural people are laconic, and is there a rural place anywhere in the world whose people really are?” Then, later, “I felt as if I could fall asleep, and as if I already had, enfolded in femininity.” One thing I like about Tracy Kidder is that he’s in there, and we’re experiencing his subject matter with him. Kind of like my own “walks” pieces.

When I told a friend about Paul Farmer, his response was, “he sounds like a saint.” That’s exactly what my book group thought. Paul Farmer would say he’s just a guy doing what needs to be done. That selfless attitude is what makes him a saint.