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My wife and I have four children, and three of them were born in Pakistan.  All three of them were born in the summer, which demonstrates a lack of good timing on our part.  Being pregnant, I am reliably assured, is no picnic, and the discomfort of lugging around a swelling belly is made significantly increased when it is forty degrees outside, and humid to boot.

It was with a sense of relief, therefore, that we pulled up outside a private clinic in Islamabad for the birth of our fourth child, my wife feeling happy that she would at least be relieved of the burden of pregnancy, and I was also feeling happy that I would be relieved from worrying about whether the baby was ok.

Pregnancy, after all, is something rather miraculous, and in many ways rather strange.  The sense of love for the child-that-is-to-be is powerful – and yet in the early stages it is an odd love, for an anonymous blob of tissue, tiny and helpless, growing silently and invisibly in the womb.  During each of our pregnancies I have found myself wondering what the child will be like, what it will look like, how it will laugh and cry and play – and all this at a stage when it consists of little more than a bundle of cells buried somewhere inside my wife’s tummy.  It is also an anxious love.  We are desperate for our babies to thrive, to develop normally, and even in the West this cannot always be taken for granted.

We walked into the clinic feeling relieved, therefore, but also anxious.  The various stages of medical assessments and preparations came and went, and my wife was prepared for surgery.  I put on scrubs and went in to sit next to her in the operating room.  And then, a few minutes later, came the sound of my son’s first tentative screech.  I started crying.  I always do.

Later that day, while my wife was recovering, I took my son in my arms and went for a walk down the corridor to comfort him.  The corridor was lined with women, mostly mothers or mothers-in-law of the other women who had come to the clinic to give birth.  They looked up at me silently as I passed.  There is a barrier between men and women in Pakistan, a barrier of culture and honour.  I would not talk to a woman in the street, even if she were a friend of my wife’s.  It would be awkward for both of us.  I have not even met all of my wife’s friends; some of them I have never even seen with their hair uncovered.  So when the women in the corridor looked up at me it was with the usual sense of silent curiosity.  They would not speak to me, nor I to them.

But then the saw the bundle in my arms, swaddled in blankets against the fierce air-conditioning, and the barrier broke down.  “Mashallah” said one as I passed, “Praise God”.  Then a second echoed her, and a third, and I walked down the corridor with a foolish grin on my face, accompanied by the faint whispers of Pakistani grandmothers quietly praising God for the safe arrival of my son.

Our son woke us at 4am.  He was obviously distressed, coughing and gasping, clutching at his throat.  Despite this he was quite calm as he informed us, in a matter-of-fact manner, that he had a coin stuck in his throat.

Bad dream?  No.  He was insistent, and clearly awake.  He had thought that the cool metal would soothe the sore throat from which he had been suffering for a couple of days.  I bundled him into the car and took off for the hospital.

Contrary to what you might expect, excellent medical care is widely available in Pakistan.  Many hospitals here offer superb services and are staffed by Western-trained professionals.  We were attended to quickly and courteously.  Once they had ascertained that the coin was lodged in the oesophagus and not the trachea – in other words, that my son was not about to suffocate to death – we were sent to the front desk to register.

I walked up to the desk and signed the requisite forms.  The man behind the desk glanced up at me with the kind of bleary-eyed brusqueness that one tends to get from hospital clerks who are forced to work at 4am.

“50,000 rupees” he snapped, before glancing back at his computer.  In Pakistan you pay for medical treatment before you receive it.

I had come prepared.  With one swipe of my credit card the bill was paid.  I signed the receipt and was about to walk off when I heard the person behind me exclaim, in panic:

“50,000 rupees?  I don’t have that kind of money!”.

It was an middle-aged man, accompanied by his wife and their child, a girl with vomit all down the front of her sweater.  The clerk yawned and pointed to a sign above his desk which read “Advance Payment Required Before Treatment Offered”.  He shrugged.

The man sighed, turned round, and headed for the exit.  He walked out into the night, followed by his wife and daughter.  I turned back, my receipt safely in my hand, and walked back to my son.

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One night in June I started to feel pain in my stomach.  This is common around here, what with the tap water containing more bacteria than a microbiologist’s petri dish, so I thought little of it.  When the pain got worse, and then even worse, I started to wonder if I should do something about it.  And when it became unbearably painful I asked a friend to drive me to a hospital in the mountains, some three hours away.  That journey, over bumpy mountain roads in the middle of the night with me vomiting into a bucket every fifteen minutes, is a story in its own right.

                 To cut a long story short it ended up being a very serious problem indeed which required some particularly invasive and unpleasant surgery on my intestines.  This required a two-month period of convalescence in the UK, as it was 45 degrees in our home city in Pakistan, a temperature not exactly conducive to recovery from a major illness.  We flew home and spent two months resting, eating good food, visiting family and friends, and trying to persuade people that we couldn’t wait to return to Pakistan again.

And now we’re back.  It’s great to be home.  Normal service, whatever that means, will shortly resume on this blog…