Safra is Arabic meaning "journey". My new journey extends my 38 year career in American healthcare as a care provider and manager. On March 3, 2010 I boarded a plane to the Kingdom of Saudi Arabia where significant change is taking place in how care is delivered to its people as the private sector is emerging in the Kingdom. I share my experiences and thoughts from my new workplace and my new home for the consideration of others who have already or may be planning to undertake their own safra.
“The farther one goes The less one knows” -Lao Tsu, c. 550 BC
Living in Saudi Arabia has helped me to learn directly about the people, and political system of this country and the Middle East.Today I watched television broadcasts showing the misery of Egypt as their people protested for freedom.I visited Egypt a few weeks ago to stand in the very location at the Cairo Museum where rioting and destruction are happening now.Here all is stable and calm.Some rumors floated this week about minor protests in Jeddah about the unemployment situation and issues over flooding following a second year of heavy rainfall.Life goes on without missing a beat in Riyadh.
I am now at the one-year mark as an expatriate.It is strange to think of myself in this way, as someone who belongs in California and not here.My enthusiasm to have an international work opportunity and to make a good impression among people of Saudi Arabia as an American importing valuable “western” hospital practice is a bit more realistic now. I had earlier underestimated the challenges of this endeavor.
I am an expat, but the meaning of this label isn’t clear.When among westerners, expat means you are someone who is anxious do some work, to get something done, eager to demonstrate the “right” way.Not all expats are equal. Those from impoverished or third-world countries don’t receive the privileges of North Americans, Europeans and Britons. Demographic information like expat headcounts by country or region of origin are dissected into groupings of professionals or laborers. All of the data sources are suspect. The numbers don’t true-up when compared against each other. I have accepted the idea that the Kingdom is populated by about 24 million people of which 4 million are expats with 1 million being professionals. Some think that professional expats are overpaid and have privileges that others don’t receive.
Expat can be a derogatory term associated with our transient nature or a concern that we are overpaid.Expat contracts are for time periods of between one to five years, and most have provisions that allow the employer (also known as the Sponsor of the work visa) to end employment at-will for breaking work rules, committing legal offenses, or becoming redundant.This at-will employment contributes to the volatility of the expat work force.As the Kingdom builds internal capability by educating its people, the Interior Ministry increasingly limits the number and types of visas issued to professional expats. This effort to train and employee Saudis makes sense.The absence of sufficient number of on-the-job training slots for new technical and academic graduates to gain journey level skills is hindering this transition. (My recall of the literature is that a new graduate requires 10,000 hours -- five years -- of working time to be fully qualified.)To the concern that we are overpaid, I don’t agree.Tax benefits for all of the Western expats do afford a lift in our wages; our hourly rates are only equal to what we would have earned at home. At least this is true for me.Adapting to a different culture, living thousands of miles away from family and friends, and becoming only an observer of life (not a new experience for my Canadian friends) isn’t entirely offset by salary gains.
Never in my wildest dreams did I imagine how difficult it would be to get my house fixed-up enough to have working Internet and television connections, or repairs made to provide hot water or air-conditioning.It took almost nine months to settle my living arrangements.Now it is finally possible to go home at the end of each day to prepare a meal and relax.
It is still surprising to find myself tired and emotionally exhausted at the end of workday.Every day is an ongoing challenge to get access to information and help from co-workers. Asking for assistance, to be greeted with an announcement that what I ask is difficult and requires invoking God's blessing before beginning worries me.Most often my colleague takes action and progress occurs, but my worry sometimes turns into 4-in-the-morning awakenings and an early ride to the office.
But what about my time at work?One person told me in the first two weeks of working here that I didn’t bring anything meaningful to the hospital as all that I knew was available on the Internet.Fortunately most staff is open to discussing ideas and incorporating new information into ways of doing things differently.Work life, the committees and hallway conversations are much as they occur at home.
My enthusiasm for working here isn’t any less than it was a year ago, as the level of my involvement in the operations of the medical division is engaging.I know you must think that the politics in America, with independently practicing physicians possibly losing control to business people (accountable care organizations and insurance companies), is at least as emotionally charged as anything in Saudi. Let me assure you that the differences are real.
The experience is in me now and I am being shaped by it.Insha’Allah tomorrow will go well.
Josh Beckett, Major League Baseball right-handed starting pitcher for the Boston Red Sox.
In Batha, a local souk about the size of Dodger Stadium and its parking lots, stores sell sewing machines. Really big stores dedicated to the art and practice of making stuff out of cloth like curtains, shirts, and even tents.The machines are bright sunburst yellow and candy apple red with names to match their Indian origins.I like the big 220-volt Screaming Tiger and Red Bird models.Of course, Singer machines are still available but now only using the name with little resemblance to the original brand.It seems that sewing machine stores like these don’t really exist today in the West.
When I was about 3 years old and inside of a Singer Sewing Store, my first kleptomaniac act occurred.Singer, then a very big brand of sewing machines, ran retail outlets catering to housewives by selling cloth, sewing machines, cutting patterns, and needles to make fashionable clothes for the whole family, why just like in Vogue Magazine. My mom sewed a lot of the dresses that she and my sister wore. The shop was busy with big women, perhaps even fat.(It was Honolulu in the poor part of town where locals shopped and dined at noodle counters.Starch diets satisfied hunger, were tasty and cheap, but led then and now to making eaters into large people.)
I was a small child and didn’t know that taking something without paying for it was bad.But, I think Mr. Singer bore a great deal of responsibility as he had installed a large rack with sewing needles and thread bobbins beginning at about my height and reaching well into the clouds in the middle of the store, just next to the register counter.The colors and shapes were impressive. I suspect that stolen package of needles might have cost 10 or 15 cents, but it was to be a really great gift for my mom. She could use the needles to sew and we didn’t have much money. In fact, we were on state aid, getting a monthly check for food and a rundown apartment.All of this thinking didn’t really enter into my head at that time but works well now to add “reason” to my criminal behavior.The package was small and fit nicely into my pants pocket until we got home.
To say the very least, I was shocked and disappointed in my mother who did not thank me for the gift!She yelled at me, made me put my shoes on, and took me directly to the store up to an old man who was the manager.Then, she made me give him the needles and say that I was sorry.I did say that I was sorry, which was not true.I looked sorry with tears running down my face and having wet myself in the process, but I learned an important lesson that day: Never give women needles as gifts.To this day, it isn’t clear to me why women don’t appreciate needling gifts.