Sunday, December 20, 2015

Things that go "khalas" in the night

Being a cynical sort of gal, it's a long time since I believed in ghouls, ghosties and things that go bump in the night. But, you don't have to spend long time living in the UAE to realise that cynicism about the occult and the supernatural may not necessarily be the majority view here.

I remember, when I first came to live here, being astounded that news stories about possession and hauntings by Jinn - the name for ghost or spirit in Islamic mythology, also spelt Djinn -  frequently make it into the UAE national newspapers. I assumed other expats would feel the same level of astonishment. But during a dinner with a group of friends, a couple of us joked about Jinn hiding possessions, being responsible for missing car keys and bad days at work, that sort of thing, only for one of the party to tell us in all seriousness that they were fairly sure the strange noises coming from the ceiling above their apartment were caused by an evil spirit.

It is with this in mind that we set off for Ras Al Khaimah's "ghost village", also known as Jazirat Al Hamra, on the outskirts of the Northern Emirate's main settlement. The village is said to be the inspiration for the horror movie Jinn which was partly filmed on location.

Rumours abound about why this small settlement of fishermen was abandoned over night. Some say it was some kind of chemical incident, but my favourite is that the residents were spooked one night by spirits floating towards them from the sea, and they packed their things and ran away in fright en masse. For the cynic, such a thing could be explained away by some kind of sea fret or mist.

Walking around the place, it certainly does have the air of somewhere left in a hurry:

The history of the place is plain to see - with coral from the sea built into the stone work. 

As is quite often the way when one has a small child in tow, I did not take nearly enough pictures, but Jazirat Al Hamra is definitely worth a visit for anyone at all interested in the history of the UAE. The traditional style houses, mosques and a small, picturesque fort are still in tact, neatly demonstrating how the lives of the people have UAE have changed beyond recognition in a mere half century.

The mystery surrounding the place is a source of fascination for many - you don't have to look far to find accounts from those who have visited at night in search of a supernatural experience.

But, sadly, for fans all things spooky, there is a perfectly reasonable explanation for the abandonment of the village. It seems in truth, the departure was not wholesale over night, but came about due to disputes between local families and offers of better living conditions and jobs elsewhere. You will also find accounts of some past residents and their descendants visiting regularly to remember the happy times they spent living there, particularly on national holidays.

It's also a good day out for ex-pats, particularly if you combine it with lunch at the Banyan Tree Ras Al Khaimah Beach, followed by a cocktail at the resort's sister hotel in the desert. The beach hotel appeals to me particularly as you have to get on a little boat to get to it. Both hotels are handily in The Entertainer as well, if, like us, you don't really live on a Banyan Tree budget.

So, with the departure of the villagers explained, the question remains, would I spend a night there with a crew of ghost hunters?

Hell no.

Friday, September 25, 2015

Moving, just keep moving

Since I packed my bags and departed for university in 1997, I have moved residence, if you include moving between different digs, I reckon, 15 times. And wouldn’t you know it? We're about to fuel up the magic carpet and embark on move number 16 at the end of next week.

Desert Baby needs her own room - the best we can afford without shelling out most of our income on rent in town is a one bed - so we’re moving to the ‘Burbs, baby, where property is (comparatively) cheap, the air is clean(ish, if you don’t count the airport emissions) and the people are friendly(ish).

You may have read about the infamous Dubai property crash in 2008. Well, one of my old bosses, a real estate firm CEO, would tell you that lessons have been learned from that experience, that there is a mature secondary market now, people don’t buy into the property market hype in the same way as they used to. My response to that, would be: “Meh.”  

I’ve been in our fair Emirate four and a half years, so I may not fall for the same old tricks as unfortunate newbies do, such as agreeing to sign non-renewable contracts so the landlord can turf you out in favour or someone willing to pay a much higher rent at the end of a year, but the market can still be somewhat hair-raising.

Touch wood, in a week’s time, we should be settled into our new place.  If you're embarking on the same task, particularly for the first time, here are my top 10 need to know rants about the joyful process that is renting property in Dubai, some of which I picked up from my brief career interlude working as a copywriter for an estate agent, and the rest from bitter experience.

Upfront rent

Unless you negotiate with your landlord otherwise, you will be expected pay your rent one year in advance, either in one cheque, or in a series of post-dated cheques. Rents are advertised per annum rather than per month, so try not to have a heart attack when you see the prices. On top of this you will need to also find a deposit for DEWA (electricity and water provider) a landlord deposit, (usually five percent of the annual rent) and if you've used an agent, their commission (also usually five per cent).

How the heck do people afford to pay all that at once?

Some expats, although fewer and fewer, get generous financial packages from their employers to allow them to set up home in Dubai. Many receive a housing allowance as part of their salary, and this can be drawn up to a year in advance. The first year Him Indoors did this, his cheque was refused, for some piffling reason to do with an irregular mark on it. The best way to solve this quickly was for him to draw the money in cash and hand it over. Him indoors had to go to work, so I had to sit in the bank waiting for our new landlord, who was two hours late, clutching AED85,000 in cash in a brown envelope. Those who don’t get a housing allowance have three other choices: Apply to their work for a salary advance, take out a bank loan to pay their rent, or save like mad before they even think about coming to Dubai and renting a place to live.

More on those post-dated cheques

Many of us fortunate enough to receive a housing allowance pay in one cheque so we can forget about rent until three months prior to the end of our contracts when it’s time to think about renewing or moving. Those who don’t have that option pay in two or more post-dated cheques. When the market is really in the doldrums, or a property is a bit dodgy, the landlord may allow up to 12 cheques, so you’re effectively paying the rent monthly. You can tell when the market is overheating, as landlords start demanding one cheque for even rat-infested “studios” (bedsits) with a view of Dubai Municipal Waste Dumping Area.

What is with Dubai estate agents? Seriously? Isn’t it easy money? Why are they (mainly) so dreadful?

Oh, habibis, if only I knew. The first agent that Him Indoors and I ever dealt with was a dream. She spoke fluent English, she negotiated well on our behalf with our landlord, she answered phonecalls, she returned emails, she dealt with queries efficiently. *Sigh*. What happened to her? Her employer obviously spotted she was pretty good as she got promoted, and as far as I’m aware, she is still working as an area manager for the same agency and no longer deals directly with clients. 

Agents are a strange breed here. Examples include many who don’t bother to turn up to show you round a property, and if they do, they won’t know anything about it, such as details about who pays what charges, when the construction next door is due to be complete and what the heck it is they’re building. Another agent Him Indoors dealt with recently spoke some English, to a degree, but the only directions he could give to the property were “It’s near Spinneys”. There are about 30 branches of Spinneys in Dubai, but even when this was pointed out to him, his response was “It’s near Spinneys?” “Which Spinneys?” “It’s near Spinneys”, in the manner of the way Hodor says “Hodor” in Game of Thrones

These are the people to whom you routinely hand over a commission of five per cent of your annual rent. Money you will never see again. I’ll just let that sink in.  

And what about the landlords? What’s their problem?

The cretin-like behavior extends to landlords, even when it comes to viewings. Him Indoors and I were unfortunate enough to be looking for a new place at the height of the post EXPO2020 bid victory hype in March 2014, and we looked round a tiny one bed flat in a not particularly nice building in Jumeirah Lakes Towers. It had a view of a building site, eye-wateringly horrible carpets and the tenant had clearly done a bunk. Their crappy clothes were hanging out of the broken wardrobe, a pan of something congealed was still on the stove, toothpaste was smeared around the bathroom sink, with something worse smeared round the toilet and the balcony was covered in cigarette ends and other rubbish. The rent being asked, from memory, was AED90,000 per annum, that’s 16,000 sterling. All credit to the agent, she had more front than Blackpool, as she didn’t even bat an eyelid about the revolting state of the flat, but politely agreed with us when we said it probably wasn’t the property for us.

I have given the question of what the hell is wrong with these people quite a lot of thought during my time in Dubai, other than the fact that many of them are foreign investors who have little or nothing to do with their property and simply hand the running of it over to an agent. To be fair, I have heard tell of landlords who *sharp intake of breath* don’t try to impose huge increases, don’t try to turf you out as soon as the market looks like it’s on the up, and *faints* carry out and/or pay for maintenance.

I’ve always suspected that due to aforementioned property crash, many buy-to-let landlords feel they were sold something that did not quite fulfill the huge income potential they were promised, so they resent the heck out of tenants. To give you an idea of what I’m talking about, we rented a property in Downtown in March 2011 for AED85,000 (just over 15,000 sterling) per annum as that was the market rate. The landlord told us that in the “good times” prior to the property crash, he had rented it for AED200,000 (nearly 36,000 sterling). This may have been a bit of an exaggeration, but, no wonder he was a bit shirty with us when we phoned him in the first week to tell him the fridge was knackered.

A bit more about maintenance

I detailed in a previous post some time ago about an incident I shall now refer to as "washingmachinegate" in which a landlord’s agent got pretty nasty with me when we had the temerity to ask him to fix or replace a broken appliance. It seems that several of the landlords from who we have had the misfortune to rent property see the payment of rent as the tenant effectively owning the property for the year. Therefore their view is that any issues, including, say, damaged paint from a water leak which was caused by a tap which wasn’t installed properly, broken washing machines, etc, are the tenant’s responsibility. This is hard to get your head round as a tenant, particularly a tenant with experience of the UK, where many landlords take more interest in and responsibility for their property.

“Why don’t you just buy a property so you don’t have to deal with this nonsense?”

What a brilliant idea. Thanks for suggesting that. Foreigners need a minimum 25 per cent deposit to buy property, so can you lend me hundreds of thousands of dirhams please? Go on, I’m an excellent prospect. My turnover in freelance commissions has been literally in the hundreds of pounds sterling since Desert Baby was born, and I have as yet no source of regular work, and if I do get regular work, I will need to pay for childcare, and, oh yes, I may want to move to a different country within the next year or so depending on my husband’s work. What do you mean you don’t want to lend me any money? Wait, stop laughing me out of your bank. You’re just mean.

If you’ll excuse the facetiousness, yes, buying property would be a way to avoid the silliness of Dubai landlords, but that’s not exactly straightforward. Raising the cash for the deposit would mean selling our UK property. Call me overly-cautious, and not to detract from the wondrous nature of the Dubai property market and the breathtakingly brilliant future prospects of the Emirate, but I think the London property market may be a slightly safer bet for the risk-averse.

“Big” landlords

Him Indoors and I are trying a new experiment this time by renting directly from a developer, to see if dealing with them when it comes to things like maintenance and renewal of contracts is any less irritating. Some developers have kept certain developments and derive income from renting the entire thing out. They have maintenance offices onsite with technicians ready to answer calls for set fees. I am also hoping that when it comes to renewals, if there is a rent increase, they will increase according to the government rent increase calculator and that’s it. Hoping. Examples of “big” landlords are Arenco and Al Ghandi Property.

Know your stuff

Don’t get caught out like him indoors and I did when we got kicked out of our first apartment. We got evicted because we were told our landlord wanted to live in the property himself. This is legal, but the landlord has to give you 12 months’ notice, rather than kick you out straight away like ours did, ditto if they want to sell the property. As far as I’m aware, the law states that Dubai residential tenancy agreements are automatically renewed at the end of the year unless 90 days’ notice is given by either side prior to the end of the contract. Technically, if you’re planning to leave, you need to give that 90 days notice before the end of the contract, or you could be liable for the next year’s rent. However, I have never heard of a landlord enforcing this. You also need to know that tenancy agreements are technically enforced by law, so if you want to leave early, there may well be penalties to pay to your landlord, for example, an extra two months' rent. As for rent increases, they are supposedly regulated by the government, so your landlord can only increase the rent if the rental increase calculator says so. Click here to check it out. 

..      Good luck

You have my sympathy. Really. If you end up with a duff landlord, you can consider opening a case at RERA  the Real Estate Regulatory Agency. 


Friday, July 3, 2015

Mum (to be)'s gone to Iceland (with apologies to my friends who are of Icelandic heritage)

For Brits, Iceland is not just a breathtakingly beautiful island state between Greenland and Norway, it's a cheap supermarket where you buy frozen foods high in additives and low in nutrition with the slogan "Mum's gone to Iceland".

Let's all take a moment to think of those mums, dejectedly pushing their trollies between aisles of frozen chicken tikka bites, sausage rolls and arctic rolls, thinking: "Why the f*** have I gone to Iceland again? Why? Why hasn't Dad? It's the normative gender stereotypes of modern day advertising that really piss me off, as they seem to reinforce my position as the poor sod who has to brave this vision of fluorescent-lit hell to buy frozen polystyrene masquerading as food."

Anyway, that's the feminist bit out of the way, let's get on with this "What I did on my holidays" post. 

Last summer I was pregnant with Desert Baby, a fact I may have mentioned one or two times in the course of the past nine months or so, and due to a saga involving passports, we were confined to the UAE for the duration. Spending the hot season here can be trying at the best of the times for a spoilt ex-pat, but when knocked up, it's a form of purgatory, because you can't even partake of the consolations of brunching and swim up bars to pass the searingly hot and humid days quicker.

By the time we had resolved the passport debacle and cobbled together our annual leave, we were more fed up than usual and desperate for cool air. And so, in late October we chartered a long boat to Iceland, home of Vikings, sagas, rotted fermented shark-based snacks and fantastical prices. We found found ourselves a place to stay through airbnb and spent a week trotting around Reykjavik, hiring the world's smallest four-wheel drive to explore the countryside and generally wrapping up in winter coats, turning our faces into the bitingly cold wind and saying: "Aaaaaaaaaaaaaaaaaaaaahhhhhhhhhhhh."

We saw the Northern Lights, which locals refer to as "dancing Elves". I think at six months gone and up in the middle of the night in freezing conditions to view them, I may not have been entirely predisposed to appreciate them, but the pictures (taken by him indoors as I lack the technical ability and patience) suggest it was a pretty impressive sight.

 We also visited the Blue Lagoon geothermal spa, described by the guide books as a "shameless tourist ripoff" which may be true, but, frankly, we have lived in Dubai for getting on for five years, so an attraction has to be fairly far beyond a shameless ripoff to put us off. While you are there, you can get a massage, which means meandering through the naturally heated water to float on a rubber mat while said massage takes place in the open air. You are dunked under the warm water every now and then to make sure you don't get too chilly on the cool air.

Ripoff it may be, but I enjoyed the heck out of that massage. The attraction was also pretty popular with a large party of British teenagers, presumably all from the same posh school, providing him indoors and I with plenty of opportunities for snorting laughs. For me, it was at the girls stressing about their super model, St Tropez sprayed and designer bikini clad figures in the changing rooms, while I looked on in frank envy as I squeezed my pregnant bulk into a swimming costume. For him, it was overhearing a bunch of teenage boys say: "I'm gonna exfoliate sooo hard" while smearing on gallons of the restorative pots of gritty white mud placed at convenient intervals around the main pool. Times have changed since us 30 somethings were teens and applied Biactol to our pimpled complexions under cover of darkness, I tell thee.

One of the fascinating things about Iceland is its natural geothermal resources, which I managed, somewhat ineptly, to capture on video at Geyser. Because, you see, geysers are all named after Geyser, the place where this rather brilliant example of the  phenomenon is located. I am not even going to begin to try to explain the science behind them because I will make a total t*t of myself, but from what I gathered, this incredible natural force provides sustainable energy meaning Iceland is far less reliant on fossil fuels than the rest of us.

I will let the pictures do the rest of the talking, apart from my four other favourite fascinating facts about Iceland.

1. Icelanders refer to each other by their first names, even in formal situations. For example, Snorri Sturluson, writer of some of the most famous Icelandic Sagas and 13th century politician, who met a bloody end typical of the age, is largely referred to as "Snorri".

2. Icelanders like to eat fermented, rotted shark as a snack, washed down with a spirit, the name of which translates as "Black Death".

3. Many Icelanders believe in elves, and that rocks are the homes of elves, and that terrible things will happen if these homes of the elves are moved or destroyed. So, you will find rocks built around or disrupting building projects, with claims that the rocks cannot be moved due to mysterious mystical or super natural forces, with bulldozers grinding to a halt, pneumatic drills breaking and shovels bending.

4. The population of Iceland is roughly 300,000 people. Many Icelanders can trace their ancestry back to the country's original settlers, ergo, finding someone who you are not related to in one way or another to marry can be tricky. A result of this is the foreigners often "do very well" in terms of naughtiness as locals are keen to look for opportunities to breed outside their own nationality. This crude generalisation is in the guide books and everything. It might have been that I was a bit touchy due to being Dubai Sand Witch with added beach ball stomach, but I had to give a very stern look to a beautiful Icelandic teenager who gave some rather lascivious glances to him indoors while serving us meat soup, the ancestrally Viking hussy.

Anyway, more pics below.

My actual dream home. 

Such vehicle owners, so at home in Dubai, have also made their way to Iceland, it would appear.

We popped down this road to see if Bjork would invite us in for a shot of Black Death, but she was a bit busy believing in beauty with Venus as a boy
Practical stuff: There are tons of options for flights to Iceland from Dubai, but no direct flights. We flew with Qatar Airways via Doha and London, picking up an Icelandair flight to Reykjavik. You can get a taxi to the centre of town from the airport, but it's far cheaper to get a bus, and unless you're a millionaire, you're going to have to watch your pennies while you're there as the cost of living is sky high. Bus tickets are available in arrivals.  

Tuesday, April 14, 2015

Get your t**s out! Breastfeeding in Dubai

I feel the urge to start this post by saying that I don't want to enter into the breastfeeding debate that seems to crop up in the press on an almost daily basis at the moment. Well, it appears that way to me, perhaps because I may be somewhat tuned into it. If you can and want to breastfeed, then well done you. If you don't, don't. Why would you give a s*** about what I think about your parenting choices anyway?

For what it's worth, yes I am "exclusively" as the medical professionals like to term it, breastfeeding Desert Baby, and yes, it was a bloomin' struggle getting it established. My experience of it was this: After she was born, the nurses asked if I was going to breastfeed, I said "yes" they brought me a special gown to enable flapping my engorged mammaries out with relative ease, and Desert Baby made vague, slightly anaesthetised newborn attempts at putting her mouth in the right direction, and away we went. Simple. Except it wasn't that simple at all. For the first few weeks at least, it hurt like f***, because I had failed to acquire the fabled "technique" that one thousand and one patronising YouTube videos by various alpha mummies who suckle seven kids at once deem to be of paramount importance. There was weeping, there were feelings of inadequacy, there was a tear-sodden, hysterical refusal to allow a nurse to give Desert Baby formula during one particularly grim night in hospital, but we got there in the end, and Mini Me is so far gaining weight at the speed she should.

I could bore on for hours on this subject, but I shan't, but I will say, there are various breastfeeding or "lactation" consultants in Dubai but they were of little or no use to me because they all seemed to be on holiday for two or three weeks when I really needed them. I was recommended this place instead, where you can pay a small fee for an appointment with a midwife who will take a look at you feeding your baby, and advise you. Or, if you're at the so tired and hysterical that you can't get out of the house without slices of toast stuck to your hair with your nightie on backwards having not showered for a week phase, they will visit you at home for a slightly larger fee.

It all worked out for me in the end, as I had plenty of help and advice from a big sister who had been through the same thing less than two years earlier, but I am conscious of the fact that it does not work out for many women in the UAE, for a number of reasons, some of which will probably make another post at some point. But in the mean-time, this is my attempt at being all touchy feely and helpful and in a "sisters are doing it for themselves" way. It's primarily for ladies who might think that getting your t*** out in public in order to feed your squalling child in a country where public nudity is punishable by prison sentences on occasion is a bad idea. It isn't.

Breastfeeding is a topic much discussed in the UAE, partly due to this law, which does not just encourage mothers to breastfeed their babies but requires it, for the first two years. Far be it from me to try to speculate on the motivation of this law, as I would not know where to start, but, as far as I am concerned, it means mums have the green light to breastfeed in public as long as they abide by standards of modesty normally expected in the UAE.

A lifetime ago, pre Desert Baby, I thought about things other than how fast my genius child is growing and how very advanced she is for being able to simultaneously crack a smile and make noises like Wellington's war horse charging into battle when she fills her nappy. At that time, I got somewhat hot and bothered about the UAE dress code debate in this post. Yes, you are required to dress modestly covering your knees and shoulders in Dubai, although many expats ignore those requirements, and, you would think flopping a t** out would be a problem because of that.

Like so many things here, the truth of it is that staying out of trouble is a matter of common sense, which in this case, requires investing in one of these. Other brands are available, including this one. I have Bebe Au Lait, and it's alright, does the job, although it has a pattern like Smarties and it makes me feel like a demented children's party entertainer who has just one trick - making a baby appear. It was the only one available in Mothercare other than a black one, which I decided would be too warm. The Nuroo one looks way nicer when used, at least, it did on the very chic lady I met at a mother and baby group yesterday. Actually, it may be that she was just super cool and stylish compared with me, which wouldn't be difficult at the moment as I am currently rocking an eclectic combination of maternity clothes and a succession of increasingly peculiar breastfeeding tops.

So, the question is, do people hassle you for breastfeeding in Dubai? The answer is, as far as I can see, no. Here is a list of places I have breastfed using my "nursing cover" without problems:

1. La Brioche cafe, Bay Avenue, Executive Towers, Business Bay
2. Cafe di Roma, also in ET.
3. Cafe Rumi, ET.
4. Chez Sushi, ET.
5. Tangerine, Thai restaurant, ET.
6. Omar Khayyam, Iranian restaurant, ET.
7. La Fragola (gelato, pancakes and waffles, don't judge me, I'm breastfeeding), ET.
8. Costa Coffee, 2nd floor, The Dubai Mall.
9. Carluccio's, The Dubai Mall.
10. Social House, also TDM.
11. On the floor in the shade at the Taste of Dubai food festival, Media City.
12. On a bench in the foyer of TDM's cinema parking, when him and indoors and I were having a forgetful new parent "where did we leave the car?" moment and Desert Baby decided she didn't fancy waiting for us to get her home.
13. The cafe at Mediclinic Welcare Garhoud Hospital.
14. Poolside at ET.
15. Poolside at the Emirates Grand Hotel.
16. Caribou Coffee inside Dubai Aquarium, TDM.
17. Ikea restaurant, Festival City.
18. Other places that I can't remember.

No one has raised an eyebrow at any of these venues when I have fed Desert Baby. What this tells you, apart from the inordinate amount of time I have spent in cafes in the past couple of months, is that if you feel embarrassed or shy about feeding your baby in public, you don't need to be. The only time it has even been mentioned to me is when a waitress offered to move my pot of tea slightly closer so I could reach it, thus, feed and drink tea simultaneously. Now that's civilised.

So, go forth and feed your children habibtis, be not shy with thy mammaries. Now, if anyone's got any tips on how to take a baby for a walk in her pram when it's 40C plus, I would love to hear them.

Wednesday, March 18, 2015

An incomplete guide to the cost of having a baby in Dubai

Here I am, back with another post about having a baby. The reasons for this are as follows: 

1. Desert Baby is nearly six weeks old, and although I am getting the hang of this parenting lark, my brain is basically a lump of breast milk cheese. To be frank, there is not much else going on in my head at the moment.

2. I spent quite a lot of the time on the phone and trotting around hospitals in the run up to Desert Baby's birth in the name of research, all of which could have been prevented if hospitals posted their costs on their websites. Some now do, but many don't, so this post includes a non-comprehensive guide to the costs. I should add that the hospitals mentioned are the ones affiliated to my insurance company, so they are the ones that I looked at when thinking about where to have Desert Baby. There are many more options in Dubai and the wider UAE including government hospitals, for which the costs are likely to be lower, or in some cases, higher.  

The first thing you need to do is check your health insurance maternity coverage. I was told by our insurer that we were covered, but when I started to look into what actually was covered, I found out that there was a financial limit. This is common, and it's also fairly common that the financial limit does not cover the full cost of the birth, unless you go to the cheapest hospital you can find. You also need to check, as mentioned above, which hospitals have a direct billing arrangement with your insurance company, as this makes the administrative side much simpler. 

It is probably no surprise that if you really want to, or have gold-plated insurance, you can spend an absolute s***load of money having a baby in our fair Emirate. For example, if you are so inclined, you can pay AED104,700 (just under GBP19,500 at current exchange rates) on having your baby delivered by cesarean section at City Hospital if you opt to stay in the Royal Suite. Bear in mind there may well be additional costs if you have a multiple birth, for stem cell collection, and for little luxuries like blood transfusions, medication and other "consumables" as well as neonatal intensive care and treatment of complications. If you are not feeling particularly monarchical, you can opt for the "normal" delivery, if medically viable, which starts from AED 12,500 and still have your own private room. Mediclinic Welcare Garhoud prices are similar, as the hospital is part of the same group. 

At the other end of the scale, there is Belhoul Specialty Hospital, where a straightforward hospital birth on a shared ward will set you back AED 6,000 (GBP 1,115). 

Various other options include the Canadian Specialist Hospital, starting at AED 10,800 for a "normal" birth and a shared room, up to AED 37,000 for a cesarean delivery and accommodation in the royal suite, and the American Hospital - starting from AED 11,950 for a normal delivery, Saudi German Hospital starts from AED 9,000.  

So far, so not as bad as it could be, you may be thinking, particularly when you compare it to the USA, for example, which can be pretty horrendous when it comes to childbirth costs according to this article.

Well, it is not quite as simple as that, as you also need to bear in mind the cost of all your antenatal care. Most hospitals offer a prenatal package which starts at either 12 weeks or around 25 weeks, and includes scans and various tests such as the dreaded glucose tolerance test (GTT) which detects gestational diabetes. They typically range from around AED 3,000-5,000 and more. But, you need to keep in mind that if your pregnancy is deemed in any way "complicated" there will likely be additional costs for treatment and extra tests on top of that. I never sat down and calculated how much my various tests and extra appointments for high blood pressure and blood sugar costs me, and frankly, I don't want to.

The potential for financial trickiness does not end once the baby has been delivered. One way new parents quickly get into financial strife in the UAE is if their baby is unexpectedly born prematurely. I have a friend whose baby was born seven weeks early, and she and her husband were presented with a bill for AED 40,000 for the cost of her son's stay in the neonatal intensive care unit. Her health insurance company charmingly decided that premature birth was classified as a "birth defect" and initially refused to cough up, saying they don't cover birth defects. This is, of course, exactly what you want when your infant child's health is hanging in the balance - a battle over health insurance. After a lot of back and forth, the insurer eventually saw the error of their ways and agreed to cover 70 per cent of the costs. 

If there is any chance at all that your baby may be born prematurely (and I am fully aware of the fact that in the majority of cases, there is no way of knowing whether this will happen) you really need to do your homework as to how you are going to cover the cost of your child's care. First, is neonatal intensive care covered by your insurer? Ask them, then ask again, as I have often found I got different answers depending on who I spoke to at the provider. If it isn't, you need a backup plan, as stories like this one crop up all too regularly in the UAE press - families caught out by huge medical bills when their offspring unexpectedly arrive early, needing intensive care, and without adequate health insurance. If you're not insured and you haven't got a friend or relative who can bail you out, or, a sympathetic employer or bank to lend you the money, your only option is to rely on the kindness of strangers.

Finally, one thing that has really struck me about not just having a baby but healthcare in general in the UAE, is that people tend to set a lot of store by selecting their care by the individual doctor, rather than the hospital, although, being Dubai, things like valet parking and presidential suites are likely high on the agenda for many. 

For what it's worth, from my experience, aside from small hands, slim fingers and short fingernails (I don't need to go into details of reasons behind those particular requirements) a good ob/gyn needs to be able understand you and your cultural background when it comes to childbirth. Believe me, there are some wildly differing ideas out there about what women will want and expect from childbirth. 

Tuesday, February 24, 2015

Born in the UAE

I swore to myself before Desert Baby was born that I would not become one of those irritating people who thinks they have been there, done it all, just because they have managed to squeeze out a child, and starts dispensing advice to all and sundry. But having a baby in Dubai is one of those experiences about which you find yourself looking back thinking: "If only I had known X, I would have done Y" particularly when it comes to matters concerning health insurance, so I now can't help myself from delivering nuggets of childbirth chat to anyone I think might conceivably conceive.

If I can get the one key bit advice out of the way before I thrill you with my "born in the UAE" experience, it is this: To anyone embarking on the "magical journey" to parenthood in Dubai (apart from never use that phrase "magical journey" again, seriously, have a word with yourself): Shop around, find the right doctor to whom you feel happy and confident talking about your unmentionables, because you're going to have to talk about them - a lot. If this means spending more money than you would like, you are just going to have to loosen your purse strings and go for it, as you don't want to have a flounce and change healthcare providers at 35 weeks when you lose confidence in your ob/gyn, like I did.

So it was that my baby girl was delivered by a Maltese doctor who trained in the UK, and was the second of three doctors I saw during my pregnancy. I had previously ruled him out because the cost of the hospital he works for was above what my health insurance budget would allow (see above). In the end though, the training in the UK was key for me because I find doctors who have experience of the system in dear old Blighty tend to get where I am coming from. Ie, as a patient who has grown up with the NHS - I won't expect and don't want interventions, screenings, tests etc to happen unless necessary, and I don't expect to be handed five different types of antibiotics and hospital grade painkillers at every routine appointment - I just want to turn up, get checked and if everything is fine, be sent on my way.

I switched doctors relatively late on as at 26 weeks, my previous doctor had started making sinister mutterings about wanting to deliver via c section a few weeks early, because of the alleged gargantuan size of my baby according to scan measurements. When I suggested to her that large baby is not a reason in itself to deliver by c section, further sinister mutterings, this time about gestational diabetes emerged, and then inducing before my due date was floated as an idea, and then a random glucose test of my urine revealed a dodgy result, so I was summoned to hospital to have my blood sugar tested on Christmas Day, told no sweets and few carbs throughout the festive season, and sent to an endocrinologist for assessment. I dutifully attended the endocrinologist appointment, and found he could not have been less interested in my very slightly raised blood sugar levels if he tried, and at that point, I sensed a falling out was about to occur with my ob/gyn doctor.

This was all made doubly irksome by the fact that none of this was covered by my health insurance. Despite having the best level of cover available on the scheme provided by him indoors' company, as with most providers, there is a financial limit when it comes to maternity coverage, which in our case did not even cover the whole of the cost of the delivery, so all antenatal and postnatal costs came out of our own pockets.

The even more frustrating factor in this for me was that this desert-born baby of mine is a fairly average size for a baby born in Europe, maybe on the large side, but by no means excessive. She was just under 8lbs 4oz (3.74kg) and 52cm tall when she was born, admittedly a week early, but the fuss that was made about her size during my pregnancy was such that I half expected her to be born 3ft tall, in school uniform with scabby knees and a satchel slung over her shoulder, offering me her first tooth to put under her pillow. Or, possibly wearing a gown and mortarboard ready for her university graduation while engaging me in a debate on Middle Eastern politics.

No amount of my gesturing to my own substantial nearly 5ft 8ins frame, and mentions of the fact that him indoors is just under 6ft, that my brother, dad and two uncles are all well over 6ft, that I have an aunt who is nearly 6ft for God's sake, that I was over 4kg when I was born, and my brother over 4.5kg, would stem the level of concern about Desert Baby's projected size. The tide of whispered tales of the behemoth child that I was carrying seemed to echo through hospital corridors as I waddled to my various appointments.

To be fair, the fact is, if you will excuse the crude generalisation, the majority of babies born in the UAE tend not to be that big, for reasons to do with ethnic backgrounds and other factors. So, the prospect of delivering a large child probably frightens the heck out of a lot of doctors here, as they may not have that much experience of it. Maltese Doc seemed to realise that I had quite enough of people banging on about the size of my baby, and while he admitted he wasn't overly delighted about the prospect of delivering a baby weighing over 4kg, he didn't harp on about it in the way my previous doctor had. But, by the time I saw him at around 34 weeks, he ended up diagnosing me with gestational hypertension. I suspect this was at least partly brought on by various people prior to him speculating about the vastness of my bump, how big the baby was, and how I should definitely have a c section for my own good to avoid being split in half by the birth of the burgeoning beast growing within me.

The thing those thinking about getting knocked up need to realise is, and I expect this applies everywhere, not just the UAE, is that when you get pregnant, random people who don't really know you from Adam will start to advise you on how/when you should give birth, and this is vital piece of advice number 2: Ignore people who start telling you that you should have a c section, unless you have come to that decision yourself for whatever reason, or unless they're a medical professional and have valid medical reasons for doing so. The reason for this is they're not the ones who have to be sliced open, and more importantly, heal from being sliced open, of which more later. However, if you decide to have a c section for whatever reason, good on you. You're clearly much more decisive than I was during my pregnancy. Personally, I hated the idea of turning up on an allotted day to be sliced open as if I was having my tonsils out.

Gestational hypertension, hospital induced or not, meant that I needed extra monitoring, so I found myself attending a routine CTG (cardiotocography) appointment on 5th February, to monitor Desert Baby's heartbeat to make sure the hypertension, her alleged prodigious size and my slightly raised blood sugar had not had a negative impact on her. For those of you who haven't experienced this, you lie on a hospital bed with large bands strapped around your bump, making you look like Humpty Dumpty's internally injured cousin.

I had dropped him indoors off at work and arrived early at the hospital, obediently sitting in the cafe sipping green tea in an attempt to remain calm to try to avoid yet another high blood pressure reading. As I sat there, I started to notice what could be very early stage contractions. "Good," I thought, "this could be the early stages of labour which could mean she is going to arrive of her own accord so medical types can stop dangling the threat of induction/c section over my head."

I wasn't noticing a whole lot of movement from Desert Baby at this point, but this wasn't unusual, as she often seemed to sleep for significant periods of time, particularly during the day when I was out and about. However, after the CTG, when I took the results to  Maltese Doc, his usually deadpan brow furrowed slightly, because the baby should have been showing more movement than she was, so I was sent back for another session. At this stage, I thought nothing of it, as I had grown used to being sent for repeat blood pressure checks to see if initially alarming results were in fact a problem, and they invariably weren't.

I must confess I was probably naive to be so certain that everything was fine and it was just medical types being over cautious, in the way medical types are meant to be. Now I look back, there was something of a serious mood in the consultation room as I blithely got up and set off for the labour ward once more.

So there I was again, half egg, half woman, marooned like a harpooned whale on the deck of a ship, being CTG-ed to my heart's content, alone in the labour room. Part way through the test, an alarm sounded, and a nurse came into the room. My memory of what happened starts to get sketchy at that point, but I seem to remember telling the nurse: "An alarm just went off, and I am not feeling much movement," at which point she put an oxygen mask on my face and told me to breathe deeply.

A person less stubbornly determined that everything was absofloggin'lutely fine and all a bit of a fuss about nothing, would probably have already been properly frightened by this point, but it was the oxygen mask that finally did it for me. It was at this point, when most people would probably think: "Oh no, please save my baby", or, "Oh no, I must call him indoors", or, "Oh no, something terrible has happened," whereas for me: The cold pressure of the oxygen mask on my flabby, pregnant face really made me think: "Oh, b*ll**ks".

Buttons were pressed, more alarms sounded, and various other medical types came into the room, including a staff nurse, who told me to change positions, which got Desert Baby's heart rate moving again, as it turned out the reason for the alarm sounding was a dramatic dip in heart rate. Then a doctor arrived, who announced, when a second major dip in the heart rate occurred, that we were going for an emergency c section under general anesthetic.

I realise now that most people would have called their partners when sent for a second CTG in one day but all kinds of boring factors like not wanting to waste him indoors' leave and not second guessing there actually being something wrong had prevented me from doing so. So, then began part one of a somewhat farcical preparation for an emergency operation. Nurses dragged my tent-like dress over my head and ripped off my underwear and threw a surgical gown over me while I was muttering into my phone: "They want to do an emergency c section now because the baby's heart rate keeps dropping, they want to do it now, you have to come now.... Come now." Luckily his place of work is five minutes from the hospital, so he was there before Desert Baby was born and sat with her while she was being treated and I was still having my innards sewn up and posted back in.

The bit before the operation was all a bit Middle Eastern Holby City as they pushed my bed towards the operating theatre with the doctor shouting into the phone about what I had eaten for breakfast. This would have all been terrifying, but luckily the theatre staff lightened the mood for me by quickly descending the situation into pure comedy farce as we waited for Maltese doc to arrive to commence the slicing.***

"How much do you weigh? 70kg?" asked the anesthetist

I had already had a pre-med at this point so was dozy enough that I failed to give the snort of derision that those who know me well would have expected at this vast underestimation of my bloated eight and three quarter month pregnant carcass. I am fairly sure I uttered something along the lines of "70kg? You're having a laugh ain'tchya? Try 100kg."

I lay there, pondering silently to myself whether there are people vain enough to vastly understate their weight for the sake of not repeating the true horror of the actual figure in front of a team of medical professionals, thus risking getting less anesthetic than they need, and, horror of horrors, waking up mid slice. I am personally pretty vain, I thought, but not that friggin' vain.

The hilarity continued when when what they call the "sign in" was started, where the medical types read aloud various things like allergies etc, when I heard the anesthetist state: "This lady is not allergic to any medication".

For most people this would not be a worry. For me, this was a point where I think I went from a bit worried and mildly confused due to a pre-med drugged state to downright arsey. The reason for that, dear reader, is that I am allergic to a medication. The medication I am allergic to is in fact an anesthetic, moreover an anesthetic commonly used in c sections.

I tried once to tell the anesthetist, but no one seemed to hear me, so I tried again: "I am allergic to medication, it's an anesthetic, it's in my file," I burbled through my oxygen mask and drug induced haze to which the anesthetist responded: "Oh, what's it called?"

I was pretty bloomin' confused by this point, but I huffed something along the lines of: "I don't ruddy know, it's in my file, I can't pronounce it because it's got about 12 syllables. There's a card in my wallet that tells you all about it."

Perhaps unsurprisingly, none of the highly trained medical professionals in the operating theatre felt inclined to run back to the labour room and start rooting through my abandoned personal possessions, so I muttered something random about "Scoline" (the reaction that I would have if given the drug to which I am allergic is called Scoline Apnoea) and had begun to feel somewhat agitated, before thankfully, Maltese doc appeared like a Mediterranean Doctor Kildare (very ancient TV reference for those not in the know) and knew all about my allergy to Suxamethonium (I told you it was tricky to say, particularly when on drugs) and all seemed to be well. At least, I can only assume it was, because the last thing I remember was a nurse saying she was going to poke me in the throat when they administered the anesthetic and being poked in the stomach before slicing commenced. I then heard the words: "She has a beautiful baby girl" as I came round.

"Beautiful. Alright?!" I thought to myself. "Not massive or freakishly huge. So there," before collapsing into another drug-induced haze followed by four somewhat blurry days in hospital.

Now two weeks and five days old, and nestled on my lap as I write this, Desert Baby could not be more fine, she eats like a horse, sleeps reasonably well at night for one of her age, so I'm told, and has gained around 20 per cent in body weight since she was born.

The reason she suffered acute fetal distress was a thinner than average umbilical cord, which was under pressure as she reached her full term size and basically gave up the ghost and led to her her heart rate fluctuating dramatically and her to fill her amniotic fluid with meconium which can cause babies to "have a problem" according to the pediatrician. Her prodigious appetite and weight gain suggest to me that Desert Baby seems to have recovered with no long-lasting effects. OK, I will admit she is large. But she is now only as large as my brother was when he was born, damnit, leave her alone. Are you trying to make her have an eating disorder?

So, I ended up with the c section that I had resisted all along, but I am reconciled to it, mainly because there does not seem to be a way of diagnosing the particular issue that Desert Baby suffered during gestation, and if she hadn't been delivered as soon as her problematic heart rate was discovered,the outcome could have been very serious indeed.

A key reason I had resisted a c section was cost. I know it's daft to factor in the cost when it comes to healthcare, but this is, alas, one of the more unpleasant side effects of private medicine. Much of the cost can end up being borne by the patient, particularly when it comes to maternity coverage, so you have to think seriously about what you do and don't need in terms of procedures - c sections can easily double the cost of giving birth in UAE.

Another factor was extra time in hospital. I don't like being fussed over, no matter how well meaning and competent medical professionals are, and I hate not sleeping in my own bed unless on holiday. I don't know about you, but I also try to avoid being sliced open under general anesthetic unless strictly necessary. Something that sealed it for me was this article, published in the run up to Desert Baby's birth, and sure enough, I had identified the signs of being pressured into an unnecessary procedure by my previous doctor, and that made me more resistant to the idea than ever. I should add that at no point did I feel under pressure to undergo procedures from Maltese Doc. He was great all the way through and I would recommend him to anyone.

But seriously, habibtis ,we need to talk about c section being considered, the "easy option" that some people seem to think it is, usually those who have not had one, I suspect. Admittedly, you don't have all the pushing, shoving and pain of "natural" childbirth and yes, a c section is over within minutes if you're lucky, as opposed to what can be days of pain for the alternative. Perhaps if you have an elective operation and your surgeon has all the time in the world, the pain is less than that which I experienced, but two days after, I could just about stand in the shower on my own, but doing so made me feel like I was having my abdomen ripped open with rusty blunt daggers.

Five days after, I could just about manage a walk of about 600m, but I stopped on the way back, 100m short of our front door to tell him indoors that I could not make it because the pain was so horrible. After standing around looking pathetic for a bit, I did make it back, but for at least another week, the discomfort would cause me to regularly break out in a sweat if I walked too far or lifted anything heavier than Desert Baby. Yes, alright, she's a big girl, no need to bang on about it. *Sigh*

A c section of this type, for me at least, meant not being able to lift my baby up for at least two and a half days after she was born, and the only way I could feed her was lying on my side in bed. I think I only properly looked at her face on day three, as apart from feeding her, everything else, nappy changes, burping and walking up and down the hospital room to stop her crying all had to be done by him indoors because I was in no fit state. A friend tells me that her c section was fine and she felt OK the next day, so it's obviously not as bad for everybody, but please do me a favour and give anyone who tells you that it's "the easy option" a good kicking.

When all is said and done, I feel extremely fortunate to have made the decision I did to switch to the new doctor. He managed the right amount of monitoring to pick up on Desert Baby's distress without making me feel like he was ordering tests just for the sake of it to squeeze income out of my insurance company or my pocket, which is how I felt with my previous doctor.

Speaking honestly, if my previous doctor had told me I needed an emergency cesarean, I don't know whether I would have believed her, and there, my best beloveds, is the rub. If you don't feel confident in what they are telling you when it comes to matters of life and death, which childbirth is, let's not forget, then you are well and truly screwed. The moral of this particular story is: Think very hard before going for the cheaper option when choosing who is going to deliver your baby. You may think, like I did, that back up from friends' experience and info from Doctor Google is enough, but it isn't.

***NB, dramatic licence may have been used at this point due to memory impaired by drugs and fear.