When she was a little girl, before she had even finished elementary school, the only thing Bibi liked to watch on television were shows about hospitals. She always wondered what it would be like to be there. Whenever anyone got hurt or sick at home, she was the one who would take care of them, she was the one who had, as she says, the will and the guts to do it.
Bibi Sattuar was born in Paramaribo in 1983, the first daughter of a Guyanan Indian couple who arrived in Suriname thirty years ago, looking for work. Suriname - the former Dutch Guiana - is 165,000 square kilometres of tropical rain forest and has only about 492,000 inhabitants, almost all of whom live on the coast.
Through the years Bibi's father had many jobs, while Bibi's mother stayed at home to take care of her and her brother. Her parents never made a lot of money, but were able to raise and educate their children. Bibi's mother always said that they were privileged: just imagine, she would say, your ancestors were brought over to these lands as slaves and now we are free, we can make a decent living; what else could we want? Bibi would often reply that she wanted a little more, that she wanted to be a nurse - because she had always dreamed of it and because she craved for an education. In her family, the men worked with their hands as carpenters or mechanics, jobs that called for little formal training and provided quick money, while the women stayed at home.
You didn't want to be a doctor?
Yes, maybe. But it was impossible. Medical school is too expensive and my family couldn't pay it. The nurse training is different, you study and work at the same tim
But her parents did not want her to study. Her mother told her that it was foolishness: she had to get married, have children and look after her home, like she did, like every woman in the family did. Bibi grew desperate.
I saw my aunts, my cousins, my mother who had to stay at home and depend on their husbands. In my family, the women were tied to their homes and could not do anything without their husbands' approval. I could not stand the idea of living like that.
When she finished high school, her grades were good enough to get her into a health assistant career, which lasted for three years. After that, she could continue her studies to become a registered nurse. But her mother said that her high school degree was more than enough. And Bibi had to accept that. Her mother told her:
You couldn't do it, anyway
Of course I can.
No, I know you. You are my daughter, and I know you can't.
For almost two years, Bibi had to stay at home. She took half a dozen computing courses and got her driver's licence, but she was not satisfied. Finally, in mid-2005, a friend helped her to fill out the forms to sign up for Paramaribo's nursing school. She was accepted, and her mother finally gave up trying to convince her otherwise: she said that if Bibi insisted on making mistakes she was no longer going to try to stop her.
Now I have to finish it, even if just out of pride, so that my mother can not say that she was right. But that's not why I'm doing it.
In October 2005, Bibi started her courses -a combination of classroom work and hands-on training at Sint Vincentius Hospital. Bibi is quite pleased, although the work can be tough: sometimes it is hard to feed, clean or help a patient. It is always tough to deal with certain injuries, with people on the verge of death. Bibi is friendly by nature, but sometimes having to behave in that manner, even with rude patients is the hardest part of her job.
It becomes difficult when a patient tells you that you have to do something because he or she is paying you. It's a really hard job and the pay is very bad. It's not always easy to go on.
"Healthcare workers who move represent an irreplaceable loss in human resources to already weakened health systems in developing countries."
Five of her thirty-three classmates have already dropped out of the programme "because being a nurse is not for just anybody". Bibi does not even consider dropping out, but she complains that her life has become quite difficult. She spends eight hours a day in the hospital and earns only 50 Suriname dollars, about $US 18 a month. That is not even enough to cover her transportation costs, let alone books and photocopies, or the mandatory uniform. Only two of her classmates are men: Bibi thinks that they cannot take the things that women can:
My brother always tells me that he would never do what I'm doing, working and studying so much and getting nothing in return. He prefers to work in a supermarket. Women are more patient.
Bibi speaks good English. She says that now the hospital is her whole life. She does not have a boyfriend. Her parents don't want her to, and besides, she says, a boyfriend is "a headache". Now she has to finish her studies and that keeps her busy all the time.
But you must go out occasionally.
No, my parents don't like it when I go out. I was not brought up that way. I was taught that if you have a boyfriend, it's serious, and if it's not serious, you don't have a boyfriend. What really matters is getting my degree.
And what do you think you'll do when you get your degree?
I will probably leave.
Yes, I'll go abroad.
In Suriname, brain drain is a major problem in health care: doctors and, above all, nurses leave the country as soon as they can, generally as soon as they finish their studies. Bibi attributes the problem to the low pay for medical professionals. Her starting salary would be about 550 Surinamese dollars -about $US 200 a month.
It's unfair that you work so hard and don't even have enough to pay the bills. With so little money, you are lucky if you can make ends meet and not go into debt. And to get even that much, you have to work hard every day. I want to save money for the future. I like this job; it's what I have always wanted to do. But here I can't make a living, and if I have to go somewhere else to keep doing what I chose, I will.
The work is hard, but the fact that so many professionals leave makes it even harder. It is a vicious cycle: the more people leave, the more people want to leave because those who stay have to work harder to cover for those who have gone.,/
And there is no shortage of opportunities. In the past, Dutch companies would occasionally publish an ad in a local paper looking for nurses. Still there are relatives and friends in other countries, tip-offs at work, casual comments - and everything points in the same direction. One of Bibi's aunts is a nurse in Canada. A few months ago, while Bibi's mother and her aunt were talking on the phone, her mother mentioned that Bibi was attending nursing school. Her aunt replied "Oh, so when she gets her degree she can come here to work with me." Since then, Canada has been on the horizon.
What do you know about Canada?
Well, nothing. Just that it's very cold there.
Can you imagine yourself living somewhere else?
Yes, I can imagine myself anywhere. In life, you have to have ambition. If not, you get stuck. I'm brave and want to get ahead, so I'm not worried about what life might be like elsewhere.
But if you go somewhere else, would it just be because they pay you better or are there other reasons as well?
No, there's no other reason. It's just that I work hard and want to be paid what I deserve.
All of Bibi's classmates in her programme say that they consider leaving Suriname. The destinations they mention most often are the Netherlands, Curaçao and Aruba, the US, the UK and Canada. They generally know very little about the countries to which they may wish to go to, all they know is they want to leave. For these women, the idea of emigrating is not just a day-dream but a near certainty.
And if you leave, do you think you will come back?
I don't know. I'm going to try to live in some place where life is better. Here it looks like you'll always be stuck in the same place.
What would a better life be like?
I don't know.owning my own home, maybe having a car, being able to make ends meet.
All material things.
Yes, the rest comes later.
But you know there is a need for doctors and nurses here. If you go, you are contributing to that problem.
Yes, but I don't care. If I can go, I will.
Like Bibi, her classmate S. discovered her vocation at an early age. She tells us about that afternoon. She arrived at her home in a small town, in the countryside and heard her neighbour crying for help, and saw that she was in labour. S. found two plastic bags which she put on her hands by way of gloves. She grabbed onto the baby's head, which was already sticking out, and told the neighbour to push. The delivery turned out well and the experience led S., who was 12 years old at the time, to decide that she wanted to be a midwife. But six months later, the baby got sick. She was salivating a great deal. Her mother took her to the local hospital, but its only doctor had left a month earlier and the only health professional left was a veterinarian. The veterinarian prescribed some medicine, and S. always suspected that it was not the right one. The baby's condition further deteriorated over the next two days and S. asked her cousin to take her and the baby to the hospital. For lack of other transportation they had to go by bike. By the time they arrived, the little girl was dead. S. had to carry the dead baby home again in her arms. For S. the lack of medical care is not an abstraction, but even so she has decided that she wants to work abroad.
Doesn't it make you feel guilty to contribute to what makes that these things keep happening?
No, why should it? I'm not the one who has to solve them.
It is as if the country has not managed to convince its citizens to participate in a collective project. They all know that if they leave they will harm it in some way, but they plan on going anyway. Bibi sums it up:
You mean, you'd go even though you know that you won't be there while your country needs you?
If they need me, they also have to meet my needs. It should be a give-and-take, shouldn't it?