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@kunley_drukpa

Sep 9, 2024 • 13 tweets • 7 min read • Read on X

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AMERICAN MEDICAL STUDENT IN HAITI DESCRIBES WORKING WITH HAITIANS - A Thread 🧵

Haitians have been making the news yet again - A Short Thread once more re-sharing the Infamous Blog Post of a Medical Student’s Experience in Haiti about ‘How Haitians Think’ 🇭🇹

It has proven hard for me to appreciate exactly how confused the Haitians are about some things. Gail, our program director, explained that she has a lot of trouble with her Haitian office staff because they don't understand the concept of sorting numerically. Not just "they don't want to do it" or "it never occurred to them", but after months and months of attempted explanation they don't understand that sorting alphabetically or numerically is even a thing. Not only has this messed up her office work, but it makes dealing with the Haitian bureaucracy - harrowing at the best of times - positively unbearable.

Gail told the story of the time she asked a city office for some paperwork regarding Doctors Without Borders. The local official took out a drawer full of paperwork and looked through every single paper individually to see if it was the one she wanted. Then he started looking for the next drawer. After five hours, the official finally said that the paper wasn't in his office.

Part of it is Haitian education. Even if you're one of the lucky ones who can afford to go to school, your first problem is that the schools can't afford paper: one of our hosts told stories of Haitian high schoolers who were at the level of Western 5th graders because they kept forgetting everything: they couldn't afford the paper to take notes on!

The other problem is more systemic: schools teach everything by uninspired lecture even when it's completely inappropriate: a worker at our camp took a "computer skills" course where no one ever touched a computer: it was just a teacher standing in front of the class saying "And then you would click the word FILE on top of the screen, and then you'd scroll down to where it said SAVE, and then you'd type in a name for the file..." and so obviously people come out of the class with no clue how to use an actual computer. There's the money issue - they couldn't afford a computer for every student - and a cultural issue where actually going to school is considered nothing more than an annoying and ritualistic intermediate step between having enough money to go to school and getting a cushy job that requires education.

There are some doctors and nurses, who are just as bad - though none at our compound, which is run by this great charity that seems to be really on top of things. We heard horror stories of people graduating from nursing school without even knowing how to take a blood pressure - a nurse who used to work at the clinic would just make her blood pressure readings up, and give completely nonsensical numbers like "2/19". That's another thing. Haitians have a culture of tending not to admit they're wrong, so when cornered this nurse absolutely insisted that the blood pressure had been 2/19 and made a big fuss out of it. There are supposed to be doctors who are not much better, although as I mentioned our doctors are great.

But I was going to talk about the patients. I don't really blame the patients. I think they're reacting as best they can to the perceived inadequacies around nurses and doctors. But they seem to have this insane mindset, exactly the opposite of that prevailing in parts of the States, where medicine is good. In particular, getting more medicine of any type is always a good thing and will make them healthier, and doctors are these strange heartless people who will prevent them from taking a stomach medication just because maybe they don't have a stomach problem at this exact moment. As a result, they lie like heck. I didn't realize exactly how much they were lying until I heard the story, now a legend at our clinic, of the man who came in complaining of vaginal discharge. He had heard some woman come in complaining of vaginal discharge and get lots of medication for it, so he figured he should try his luck with the same. And this wasn't an isolated incident, either. Complaints will go in "fads", so that if a guy comes in complaining of ear pain and gets lots of medicine, on his way out he'll mention it to the other patients in line and they'll all mention ear pain too - or so the translators and veteran staff have told me.

I haven't gotten any men with vaginal discharges yet, but many (most) of the patients I've seen have just complained of pains in every part of their body and seen if any of them stick. A typical consultation will be a guy who comes in complaining of fever, coughing, sneezing, belly pain, body pain, stomach pain, and headache. The temperature comes back normal (not that our thermometers are any good), abdominal, ear, and throat exams reveal nothing, and we send them away with vitamins and tylenol or maybe ibuprofen.

My cousin Samantha and my friend Charlotte, both of whom have come with us, have studied medical anthropology and think this is fascinating. I am maybe a little fascinated by it, but after the intellectual clarity of medical school, where every case has textbook symptoms that lead inevitably towards some clever but retrospectively obvious diagnosis, I'm mostly just annoyed.

Also, if I ask a question of the form "do you have X", people almost always answer yes. "Are you coughing?" "Yes." "Are you coughing up sputum?" "Yes." "Is the sputum green?" Yes." "Is the sputum coalescing into little sputum people who dance the polka on your handkerchief?" "Yes".

A depressing number of our patients have split into two categories: patients with such minor self-limiting illnesses that there's not much we can do for them, and patients with such massive inevitably fatal illnesses that there's not much we can do with them. There are a few who slip in between: some asthma patients, hypertensives, diabetics, people with UTIs and other bacterial infections, a man with serous fluid in his knee that my father drained for him - but they're depressingly few. And even when we can help them by, say, giving an asthmatic a month's worth of asthma medication, it's worrying to think about what happens when the month is up. Coming back to our clinic requires traveling on awful Haitian roads and waiting in line in the awful Haitian weather with two hundred other people and then hoping there's even a doctor who will see you, so I don't know how many people return for refills or what the effect of having to do so on quality of life must be.

To be honest I think a lot of what we're giving are placebos. And placebos have their uses, but here I think we have lost the comparative advantage to our competitors, the witch doctors, who can placebo the heck out of us. One of our translators' grandfathers is a voodoo priest, and he was describing some of the stuff he did. It sounded pretty impressive, although at least no chickens get harmed during any of our treatments.

But we have certainly helped a few diabetics, people with bacterial infections, and the like; and we're connecting a lot of kids with vitamins (not to mention stickers), so I do think we're doing a bit of good. My father loves working in Haiti and has made best friends with all the translators and is always going out into Port-au-Prince to see the sights and taste the social life. I think it's great for my education, great for my resume, and great to be helping people, but I will breath such a sigh of relief when I get back on that plane to the States.

https://twitter.com/kunley_drukpa/status/1744017316231188749

Available at:

If you liked this Thread you may also like the Africa Resource Megathread - a compilation of similar stories and anecdotes from Africa web.archive.org/web/2018020111…

https://twitter.com/kunley_drukpa/status/1744017316231188749

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@kunley_drukpa

Apr 24

New Article published in The New Statesman about ‘The Yookay’. Article makes some attempts to be descriptive but I wanted to make a few comments on it and respond to some of the misconceptions in its framing 🧵

Author describes ‘cackling satirists’ ‘racialising’ critiques of change. It being racialised so-called is inescapable because that is the nature of the change, by normative historical standards this kind of change is remarkable. An ontological point not in and of itself ‘racist’

There is no connection between older variants of ‘Yookay’ used to make Marxist or Celtic Nationalist critiques of mid-late C20th Britain, I coined the term in 2023 as a comment on the Blairite overuse of ‘UK’ vs Britain. Commonality here is that it is an intuitive transliteration

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ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩

@kunley_drukpa

Apr 21

THOUGHTS ON THE ‘YOOKAY’ AESTHETIC - WHY MODERN BRITAIN IS SO AESTHETICALLY DISORIENTATING

🧵 Britain’s ongoing demographic transformation has in recent years made unavoidable in increasingly larger parts of the country what I and others have called the ‘Yookay Aesthetic’ - a historically novel aesthetic fusion between the aesthetics of disparate new migrant groups, the aesthetics of the worldview that facilitates their immigration into Britain (called variously ‘neoliberalism’, ‘late liberalism’, ‘immigrationisme’, ‘wokeness’ and ‘gay race communism’) and the aesthetics of the Historical Britain receiving the migrants. Its relatively recent aesthetic reification as a distinct new ‘thing’ has produced a fair few quite pronounced emotional reactions and I wanted to comment on why that is, the particular elements of the emerging ‘look’ that people find so provocative.

Many people have remarked that one of the most defining qualities of the aesthetic is how jarring the effect it produces is, its incongruity. The incongruity is something like this - a Samurai in front of the Pyramids, an Aztec on the Great Wall of China, a Bedouin in the Sistine Chapel. The non sequitur effect is jolting, disorientating. Not because it is inherently impossible for distinct worlds to ever ‘cross over’ but because we have such established and normative standards for what we expect to constitute those worlds that the effect when they do meet is discombobulating. That discombobulating effect is of course not a fact about the world, about their inherent incompatibility - the value judgement that the encounter is incongruous or incompatible is an intersubjective one - but it doesn’t emotionally diminish that discombobulating intersubjective valuation. The effect is further compounded too if in response to an aesthetic regarded as unappealing or ugly. Doubly so if there is the dimension of dispossession, the felt feeling of displacement at familiar aesthestics of home and place transmogrified into something that appears conspicuously alien.

The ‘Yookay’ in its birth pangs is a very tonally inconsistent phenomenon. Often a slap-dash blend of incongruous non-sequitur mishmash culture and aesthetic forms - the roadman in the balaclava, puffer jacket and thobe, the old Tudor building adorned with Urdu signage and draped in Palestine flags, Deliveroo riders congregated below a WWI war memorial playing Punjabi music aloud on speakerphone, large populations of Eritreans or Bolivians or Papuans appearing suddenly on the streets of Aberdeen or Aberystwyth etc. Early stage ‘Yookay’ represents a great, undifferentiated throwing together of the world in one place on top of an old and established British culture - whatever its final form it is still something that is very much in the process of being created and consolidated. You have some emerging staples already, the Roadman, the ‘Rubber Dinghy Rapids’ brand of Islam, MLE etc. but those new forms as a whole aren’t yet fully, properly settled. There is no historical weight to our encounters with ‘it’, we are unsure how we are supposed to respond to something so novel and incongruous by any normative standard which is still in so much flux. You are asked to engage with these new fusion forms as serious, authentic cultural expressions but you can’t help but meet those cultural expressions as jarring non-sequiturs. Their incredibly recent historical contingency is inescapable. Often too the new forms are not especially aesthetically ‘pleasing’ which only compounds the incongruity, how dispiriting people find them. “What the hell is going on here? What kind of weird mishmash is this?”

[1/3]

Of course you can become accustomed to these things over time, they are strange and novel now but they could become less so and far more quotidian and established in the future. They can also appear more strange to Brits than to immigrant diaspora groups, who might already be sentimental and nostalgic about these new forms - particularly where they live in fairly insular communities and have less references for what Historical Britain used to look like or less sentimental attachments to that older idea of Britain. A new aesthetic form that tends to repulse Brits especially when it is accompanied by a strong felt sense of loss might not do so for other groups. See eg, the spread of religious forms like Islam. Where the forms evolve next becomes a tussle between these two kinds of opposing reactions.

A qualification on this emotional response that further clouds our reactions to this novel non-sequitur aesthetic - when I created the ‘Yookay Aesthetics’ page I had expected a reaction to the content but I hadn’t expected the page to grow quite as quickly as it did, for there to be quite as strong a reaction to it as there was. At its core ‘Yookay Aesthetics’ (@MythoYookay) is (and this is my subjective value judgement) a ‘dark comedy’ page and so in its unavoidable in these kinds of curating exercises bias it will tend to prioritise more outrageous or absurd content, though it also has as its remit the aesthetics of the emerging New Britain in all its manifestations whether commonplace or novel in their rarity, ‘good’ or ‘bad’. Admittedly tonally inconsistent in that way, much like the ‘Yookay’ itself. For the record and in that sense, it is not supposed to be an “everything this account posts is bad” account. It is an aesthetics account. There is no commentary because implicit or overt judgements often cloud an unmediated aesthetic response (‘is’ vs ‘ought’) but, still, that hasn’t stopped people attempting to read commentary into it - so I wanted to say a little more about the the nature of the reactions people have had to it.

I coined the term ‘Yookay’ in 2023 (probably you can find earlier distinct uses because it is a fairly intuitive comedy transliteration) and it floated around in memes and posts for about a year before it became more conceptually consolidated in 2024. Again, the page is a satire page but I think there is also some merit to the exercise of just exhibiting the aesthetic because it does constitute a real and growing presence in Britain that is mostly otherwise unexplored but which will continue to gradually redefine more and more of the country.

‘Yookay Aesthetics’ gets three main criticisms, the first is that it places a lot of emphasis on the subject of race, the second is that it is depressing, the third is “actually, this image elicits the opposite response in me to ‘the one you were (the detractor claims) trying to provoke’.” I think the effects the images create that invites these criticisms all stem from a similar place. On the first criticism, because the nature of the change in Britain is inescapably race-based it is difficult for the subject to not in some way be race-related. Some people say, does race really matter? You be the judge. Let me say though that this change is happening because for many the answer is that it does not matter - or they at least think it does not matter. Thinking it does not matter in the abstract without a full understanding of what that change entails and then thinking it does not matter after the fact of the change having happened are of course two meaningfully distinct beliefs. Suffice it to say that either way even if a person wants to insist the change is unremarkable the material nature of the change would in any other set of historical circumstances be considered remarkable - even era defining. I don’t think it is inherently ‘bigoted’ to observe these shifts and the aesthetic changes that accompany them, some people will doubtless disagree though.

[2/3]

The latter two criticisms in large part stem from the kinds of priors people have. The account itself has followers from many different demographic and political backgrounds, eg nativists as well as migrant diasporas. These groups will tend to react in predictable ways ie “this is depressing” or “this is good actually.” Often the responses can be quite emotional, for many of the reasons mentioned above. Change of this nature is going to be emotionally raw and so the psychological mechanisms behind those responses are fairly intuitive. A particular emotional response to the aesthetic is of course a separate phenomenon to the aesthetic’s actual existence though.

In this way, to my mind (in a strictly dispassionate sense) the most compelling argument against this change if it is made, this Yookayification, has always been at its heart aesthetic and moral. There are other quality of life arguments people make about economics, crime and safety, loss of rights and so on but we can imagine a hypothetical New British State in which those issues were redressed - and then what would the argument against it be? The sense of dispossession, of loss, of your home environment becoming increasingly jarring, alien - coupled as it happens to be with those other attendant losses in quality of life - seems to be the most powerful motivator. It might be a less compelling force in a hypothetical ‘Basically Fine Most Competent Pragmatic New Multicultural Britain’ but the argument from ‘felt loss of place’ and ‘moral unfairness’ against that arrangement are still perhaps the strongest argument you can field, at least on an emotional level.

The important corollary of that here is that the urgency of the felt need to respond to the aesthetic is either something you ‘feel’ or you don’t. You can only rationally argue yourself into a specific view on it to a certain extent - past that point your innate emotional response will do the rest of the heavy lifting for you. Many elements of this aesthetic are a kind of Rorschach test. If you look at these images and they ‘feel’ disparaging in some indiscernible way it is unlikely that the kinds of visual and cultural changes highlighted there as indicative of a trend are going to bother or motivate you in the way they might do for others. “What’s the issue?” Well, for you probably nothing. Equally in that way if you look at these images and feel upset, depressed, frustrated etc. you might make the accusation that the images are implicitly intentionally demoralising or provocative. They might feel gratuitously overwhelmingly because they so directly tap into that sense of growing alienation a person feels, that sense of loss of place. Others still might just feel apathetic, not care either way. Whatever the case, the images are real reflections of the real world, sometimes chosen for some aesthetic quality to be sure but still of the world - the emotional response is to some reified element of the world.

This is again part of the nature of the process, why people have such different reactions to the changes on the basis of totally incommensurable priors. In a sense, whatever the outcome of this historical process of change it won’t particularly matter to people in the more long term future. Very few people have properly historical memories. If you have 500 years of ‘Yookay’ then the descendants of the new country’s ‘founding stock’ will in general not particularly care about the particular cultures that were displaced to create that new country, not just because they would not otherwise exist but because people rarely think in historical terms, understand historical processes, think of themselves as actors within a particular historical milieu. If they do they often do so selectively and in a self-aggrandising way.

For the moment though, the process is raw and immediate and has yet to be settled decisively. Whatever the outcome the encounter is now producing jarring but distinct new aesthetic forms.

[3/3]

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@kunley_drukpa

Apr 14

🇨🇦 THE MULTICULTURAL TORONTO ACCENT: A THREAD

High levels of immigration into many western countries are creating new fusion dialects - one of the most distinct is MTE Multicultural Toronto English, an emerging new urban dialect in Toronto Canada. A short thread with examples 🧵

“Two Two’s”

“Wozzles”

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@kunley_drukpa

Apr 14

GHIBLI YOOKAY

Compilation Thread of Ghibli Edits of Modern Britain AKA ‘The Yookay’ 🧵

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@kunley_drukpa

Apr 4

https://twitter.com/thatcheffendi/status/1908107464563622362

“Bro I went Turkey and Saudi, they’re not even fasting bro what is happening the Ummah has fallen this is certified haram”

“Calm down. You live in England”

“Bro they didn’t choose deen they’re on a mad dunya ting. Djinn possession 100%”

“You can’t even speak English properly”

https://twitter.com/thatcheffendi/status/1908107464563622362

https://twitter.com/kunley_drukpa/status/1891519285459374368

About Ibn Khaldun-maxxing on the peripheries

https://twitter.com/kunley_drukpa/status/1891519285459374368

https://twitter.com/elbasque/status/1908208848269103197

As the Muqaddimah relates, every few generations a great and vitalistic force will sweep in from the provinces and cleanse the decadent metropole

https://twitter.com/elbasque/status/1908208848269103197

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@kunley_drukpa

Apr 3

https://twitter.com/chrisrugaber/status/1907870405706076585

Nice to finally see someone with the balls to take on Big Vanilla and the powerful Madagascan Lobby

https://twitter.com/chrisrugaber/status/1907870405706076585

Vanilla is not even native to Madagascar yet they have an 80% global market share what is going on. A location from a Final Fantasy game pretending to be a country as a front for a criminal ‘Vanilla Industry’

No strong opinion on tariff policy for you except hopefully Madagascar gets what it fucking deserves sorry

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