Big, Bad Hillbrow Isn’t so Big and Bad

Like many large cities, several “neighbourhoods” dominate Joburg’s city centre.  One of these central neighbourhoods is Hillbrow.  This is where my work is located.  However, this area has a bad reputation for crime (mugging, murder, rape, car-jackings, etc.), poverty and all of the negative things for which Johannesburg is associated.  During the day it’s relatively safe to do brief walking (i.e. on occasion I cross the street to go to the other RHRU building or around the block to the BP petrol station to get airtime for my phone), but it’s basically a no-go zone at night.   Although I’ve passed through there a couple times during darkness, i.e. to go to the Ellis Park Stadium for the Spain v. Paraguay game, when it’s bathed in an eerie, dim, yellow-orange light from the street lights.  Anj, Aleefia and I are half joking when we tease about the rule that we’ve made for night driving: drive AWAY from the Telkom SA tower (the tower that dominates the Joburg city skyline and is at the heart of Hillbrow) even if we need to go in that general direction for any period of time.  However, as part of our orientation to the Research Unit, some of the staff arranged for a walking tour for first-thing Monday morning.  What a great way to begin the week.  [Insert here the expletive of your choice that expresses the feeling of impending doom] 

We nervously walked to the office of the woman who would be taking us around for the three hours.  Yep, three whole hours spent that would not be under the protection of the security guard-patrolled, double-gated, barbed wire and electric fenced RHRU facility.   However, we quickly discovered that we were in good hands.  Yael, the woman who would be conducting the tour, formerly was involved in urban planning for the City of Johannesburg (CoJ).  She began by telling us very interesting facts about the city, the largest in the world that is not located on any body of water.  For example:

• The city once used to be a magnet for peoples around the world—Europeans, Asians, etc.  During the 1960’s and 70’s, the city was rapidly developed; more skyscrapers were built here in that period of time than in places like New York to accommodate the influx of people and capitol.
• Under the apartheid regime, the city was systematically underdeveloped. Hillbrow had NO budget!  People simply abandoned their properties because the value of the buildings had crashed.  Once true democracy came to SA in 1994, street lights, sidewalks and other basic amenities that not only cleaned up the area to make it look nicer, but safer as well, were added.  
• The area is undergoing a change of “complexion”; now the area is commonly referred to as “the United States of Africa” because this is where all of the migrants from the rest of the continent come for economic opportunities.  Furthermore, Yael and I were the only “whities” and Aleefia and Anj were the only people of Indian descent walking around the area (pretty much everywhere else is a nice blend of all different races).

Surprisingly, many of the insecurities that Anj, Aleefia and I had melted away as we walked around Hillbrow and the area surrounding the RHRU.  Yael was completely at ease telling us how the city has invested in making people feel safe and secure by introducing regulations that forced building owners to take control of their buildings, allowing private companies to purchase buildings and provide services like security and install “green areas” within the city limits.  She continually said “hello” to the security guards that patrol the area and random individuals.  She explained to us which building owners that were following regulations and those that weren’t, pointed out the illegal shabeens(?)—informal bars/restaurants—and stalls that sold random goods along the sides of the street and took us to a park/soccer pitch that was located a couple blocks from the RHRU.

 Yael’s hands-on approach really dispelled the myths and misconceptions of Hillbrow for us.  It was easy to get caught up in the hype of Hillbrow/Joburg that simply seems to be, at times, scare mongering.  The masses of people who are continually walking around have stories, reasons for being just like you and I.  They are real people with real lives, hopes and dreams, insecurities, etc.  Each of us commented that this realisation helped us get over some of the feelings of nervousness and fear that has sometimes overwhelmingly loomed over us when in the area.

The Hillbrow tour ended with a quick walk round Constitution Hill (“Conhill”), where the South African Constitutional Court is now located.  The “hill” was built by the Boers of one of the Boer (Afrikaner) Republics  (I can’t remember which—First or Second) and housed the old, backward fort (the façade faced the inside!), prisons and other miscellaneous Afrikaner-run institutions (again, can’t remember…).  It has been transformed into a wonderful mix of museum, courthouse and art gallery.   We will have to go back over lunch one of these days to eat in the café and spend an hour or so in the different sections.

The rest of the week was spent, for the most part, sitting in my office trying to make contact and speak with the appropriate officials: university, health facility, governmental, etc.  I’m starting to think that research is all administration and little to no data collection (which still hasn’t happened yet despite my time here being half finished—three of six weeks remain!)!  It’s frustrating and making me become ever more glad that I’m going to medical school and not, as of now, pursuing a PhD and a career based solely on research.  Although I’ve had more internal meetings with my research team and other RHRU individuals that could assist me with or advise me on certain aspects of my study, I was able to “break out” of Hillbrow to make several more health facility visits to seek permission from clinic managers to include them in my study.  I also was able to make some progress, albeit very limited, on gaining ethical approval from Univ. of Wits Medical School (which is at the crux of my heartache).  I really would like to complete my study, but I’m realising more and more that I NEED a backup plan.  Does any one have an extra data set that they need analysing?  I haven’t started to panic yet, so at least that’s one of the good things that is happening! 

The Best Way to End a “Blah” Week: WORLD CUP MATCH!

Two weeks down, four to go.   Although my time in Joburg is one-third finished, this past week was a bit stressful.   The best way to explain it is that it was a “TIA” (“this is Africa”) week—nothing that needed to get finished was able to be finished and no one could have been bothered.  The relaxed, snail’s pace of the way that life and work events unfold have been testing my Western-moulded expectations and experiences of the way in which everything should be conducted in a structured, efficient and timely manner.  I keep reminding myself that I’ve functioned successfully on Africa time before, but it takes time to get reacquainted with the mentality and lifestyle.  However, I’ve never had a degree outcome that depends on what happens here, so it’s a bit hard to reassure oneself with that thought floating through one’s mind!

The problem is approval from relevant bodies, specifically from the Wits Medical School’s Human Research Ethics Committee (HREC).  I’ve gotten conditional approval, but I haven’t been able to get hold of the minutes of the meeting in which my project protocol was reviewed.  I need the minutes so I can address the specific comments of one of my reviewers for full approval!  The woman responsible for that has taken an entire week to transcribe them!  Without full approval, I can’t schedule interviews to get my data.  So it’s been two whole weeks and I have nothing.  This week doesn’t look promising for data collection, either (apparently it takes about a week for the turnaround).  I also need provincial and city approval for which the applications have not yet been submitted because I don’t have proper permission from the university.  AAAAAAARRRRRRRRRRGGGGGGGGGGHHHHHHHHHH!  Hopefully I’ll look back on all of this and realise that it wasn’t at all bad as it sometimes feels.

Apparently I shouldn’t be worried, though.  My supervisor, who is now in Canada for a conference and will be there until Friday evening (!MORE STRESS!), doesn’t seem to be concerned.  She’s said that I’ve got plenty of time to get my data, but probably at the expense of my final week here that should be spent working on the write-up (including the critical step of interpreting my findings).  She’s also given me comfort in the fact that she has been advising me to focus on actually writing my thesis, or at least outlining it and thinking about its contents, as well as other logistical things that are, according to her, usually forgotten.  She is an alumnus of LSHTM (that’s how I got into contact with her), so I’ll be sure to keep in mind her experience from going through the process for herself!  

Some good things have come out of the week, which was not a waste.  I have at least had time to select the majority of my study participants and am in the process of contacting/lining-up my final interviews.  I’ve also been able to finalise my questionnaires and get better acquainted with my research team and co-workers at the RHRU.  I’ll just have to push back the interviews/data collection to the next and following weeks instead of this and next week!

Another great thing about the week was the arrival of the other LSHTM students who are conducting their summer projects in Joburg.  Out of the six of us, half (including myself) work at the RHRU!  The best part is that my two “co-workers” live about 5-10min drive away from me.  We’ve hired a car, so I can actually do things with friends in the evenings and on weekends!!!!!! I’m no longer confined to work and my one-room cottage!  FREEDOM!  I no longer feel like a lone prisoner who is behind locked bars, electric fences and barbed wire.  Another nice thing is that four of us are on my course—Control of Infectious Diseases—so I actually am friends with these people, too!  The other two are really nice as well, so we should all get along.

The six of us have already done several things together: a night out for dinner in Melville (the young, college student-filled suburb that is next to Emmarentia, where I’m staying), an evening at a park to watch the Ghana v. Uruguay match at a FIFA Fan Fest (one of the many parks that has a big screen for watching selected World Cup matches, along with food stands and a stage for a live band) and an ACTUAL, LIVE WORLD CUP MATCH!!!!!!!!!!!

After thinking and assuming that I wouldn’t be able to go to one of the FIFA World Cup matches, I DID!  We’ve been trying for the past several days to get tickets to one of the matches in Joburg from the website, but the connection kept timing out so we weren’t able to secure the tickets.  I was so disappointed that we couldn’t see the Ghana v. Uruguay game at Soccer City (it may have worked out for the best because I was hoping, like nearly everyone else, Ghana would win and go on to grab the title for Africa, but they didn’t!!!).   However, once Aleefia, Anj and I finished watching the Germany v. Argentina game (JA, GERMANY!!!!! FANTASTISCH!  SUPER! GET THE 4^th STAR!!!!!) at one of the malls in the area, we went back to their house to hang out.  Earlier in the day Anj nearly got tickets for the Spain v. Paraguay match (another timed-out connection!), but she still kept thinking about it and checked when we arrived.  Tickets were still available, so she tried to get them in one last effort.  SUCCESS!!!!  ¡ESPAÑA v. PARAGUAY!

We rushed out of the house with one and a half hour until the match started.  Anj and Aleefia are living with a Wits professor, so we were able to park EXTREMELY close to the Park-and-Ride busses that shuttle people from where they park to the stadium.  Luckily the match was at Ellis Park Stadium, the closest of the two Joburg venues.  We hopped onto the bus to the stadium, where we had to run round (well, Aleefia and Anj did most of the running) to get the tickets and verify them.  We missed the start of the match by about 10 minutes, but it was exciting nonetheless.

The night air was cool and crisp, and the constant buzz of the vuvuzelas in the glowing white light-bathed stadium was intoxicating.  With the exception of the random, nearby blast of the brightly-coloured and -decorated plastic horns that seemingly blew off your ear, the vuvuzelas actually became background noise that, surprisingly, added to the high-energy atmosphere.  It was apparent that almost everyone was cheering for Spain given all of the Spanish flags, scarves, wigs, hats, etc. of all shapes and sizes that adorned every visible part of many people.  Everything was red and yellow.  Although we lacked the apparel, each of us was cheering for Spain.  Furthermore, our seats were excellent. They were on the corner of the stadium overlooking one of the goals.  It was easy to see and was the perfect position to see the only goal of the game, which belonged to Spain.  WOW!  The night was the best one so far during the time in SA!   To witness firsthand Africa’s [first] World Cup was truly a spectacular, once-in-a-lifetime opportunity!

 Before finishing, I’d like to wish all of my fellow Americans, friends and family alike, a safe and a “Happy 4^th of July”!  Please enjoy yourselves for my overseas American friends and I who are missing the festivities at home!  No worries because the World Cup will be my treat for the holiday, although the fireworks and good company that goes along with Independence Day were surely missed!

Joburg!

As most of you know I’m now in Johannesburg, South Africa for my summer project.  Sadly, it’s not beautiful Cape Town.  However, the city isn’t as bad as people have made it out to be.  Yes, it does have its fair share of problems (more than others in many cases), but it’s like any other city—you need to be aware of your surroundings and act as if you belong.  The best way to describe it is like a massive, overpopulated Detroit: public transportation is either nonexistent in places or too dangerous to use, everything is rundown (but not abandoned) and could use a good scrub-down and it’s unsafe to walk around.  Many of the suburbs, i.e. Emmarentia where I am staying, are actually quite lovely.  Once you look past all of the electric fencing, high gates/walls, barbed wire and colourful signs exclaiming the security company that is protecting the premises, the houses are like those that you’d see in the States (large, with manicured lawns and large cars parked in the driveway).  For the most part, the weather has been pleasantly surprising.  Everyone keeps complaining how cold it is, but it has been hovering around the 20’s (high 60’s, low 70’s) if not warmer since I’ve gotten here.  Only one day has been cold and cloudy.  I’d kill for these winters (but not for the brownish-gray layer of smog that covers the region)!

My in-country supervisor was kind enough to allow me to stay in her cottage, which is behind her house.  As previously stated, I’m staying in the suburb of Emmarentia, which is about a 10-15min drive from my workplace in Hillbrow (the city’s centre). Apparently one of my friends from Connaught has family who lives in this suburb!  Crazy.  Anyway, it’s quite cosy—a one-bedroom room with a kitchenette and bathroom (it’s bigger than my room at Connaught and is the first time that I’ve ever had to cook for myself because I’m not living in some form of residence hall!).  It feels safe, and I’m happy with it.  Unfortunately the cottage lacks an Internet connection.  I’ve decided that I’m not going to get a wireless modem.  Getting the USB doesn’t seem to be cost effective for the short time that I’m here.  It would be nice to have the connection at home so I don’t have to spend working hours doing personal things (i.e. sending emails, video chatting on Skype or blogging), but I’ll surely be able to manage.  The Internet-free time allows me to read, finish project-related tasks, etc.  I feel rather disconnected from everyone and everything, though.   

Like all of the other areas, one can’t escape the World Cup fever (and fervour).  There are flags of all of the qualifying countries everywhere—on my supervisor’s house, along the roads, along the outside of the building where I work, under motorway bridges, etc.  A game is always on somewhere (EVERY bar and restaurant has turned on a game) and one can’t escape the random honk of a vuvuzela, the [highly irritating] plastic trumpet-like horn that sounds like a drone of bees (last Wednesday, Bafana Bafana, South Africa’s national team was playing and throughout the day the frequency of the vuvuzelas increased up until the match, while everyone was wearing the yellow with green trimmed soccer jersey and some form of the South African flag on their person—wig, scarf, face paint, etc.).  

I also like my place of work—the Reproductive Health & HIV Research Unit of the University of the Witwatersrand.  It has got a great reputation for doing world-class research and the staff is great, especially my research team!  It’s kind of odd to think that I’m in charge of a team of about five people, all of whom have been/will be helping me with things like translating surveys, accompanying me to do my interviews and facility assessments and logistical tasks like going through files.  Thanks in part to them, I have a feeling that my project will go well!

Speaking of the project, if you don’t already know:

The title is “Acyclovir for managing herpes simplex virus type 2 (HSV-2) and HIV-1 infection in South Africa: Experiences of guideline implementation by policymakers, health providers and patients” and the objectives are to:

• Understand and document clinicians’ knowledge and opinions regarding HSV-2 treatment and care, and how this outlook influences treatment practices in primary health care (PHC)/STI clinics compared to HIV treatment clinics.
• Describe and understand former randomised controlled trial participants’ experiences and attitudes toward STI and HSV-2 treatment, and their experience when trying to access acyclovir at PHC clinics.
• Understand and document experiences of policymakers in drafting and implementing the new guidelines and whether this process was influenced by the WHO guidelines on genital ulcer disease management.

The study will provide important insights into the potential challenges to policy implementation from multiple perspectives. The results are likely to be relevant for service providers and policymakers by identifying factors that may influence treatment access more generally.

I’ve been here for one week now (five to go).  During that time I’ve been meeting with my research team to establish the process by which I select the patients, healthcare providers and policymakers, as well as visited some of the clinics.  The clinics were in Orange Farm, which is a “rural area” about 30-45min drive outside of the city centre and from the RHRU offices in Hillbrow.  I’ve also been meeting the RHRU staff and going through the RCT participant records with the intention of selecting them for interview.  On Friday, I went to the Wits Human Research Ethics Committee meeting, which was reviewing my project protocol.  There were some clarification needed, so I’ll have to wait about another week until [hopefully] it is fully approved.  Mostly it has been logistical things, with little to no data collection!  Apparently research isn’t all research!    

Within the next couple of weeks I will be conducting my interviews and facility assessments.  I will be presenting my work to some of the RHRU staff and writing up the work for my thesis.  I’m also going to be able to do some shadowing as well, i.e. doing a ride-along on the RHRU-associated mobile clinic!  There are three other LSHTM students in Joburg, two of which will be working at the RHRU, so the weekends will be devoted to exploring the greater Joburg area and possibly further. 

I will try to blog about these experiences on a weekly basis.  However, as you know, I’m not the best at keeping up with this thing…so please have patience.   The slow Internet at work and absent connection at home will make it a bit more difficult to keep up. 

Last weeks in London

Hi everyone.  Sorry it’s taken me so long to post.  Things have been quite crazy lately.  Since the last post I’ve had three weeks of reading weeks in preparation for my two exam papers, which occurred on 14 and 16 June.  Each was three hours long and I had to answer four questions within that time period. 

The first paper was on my Term 1 courses: Intro to Disease Agents and Their Control, Basic Statistics and Epidemiology and Extended Epidemiology.  I chose to skip the Health Policy, Processes and Power question because I figured it’d be wise to focus on epi.  Answering a question on Basic Epi was compulsory, so I revised for three subjects instead of spreading the limited time among four different topics.   The second paper integrated all that we’ve learned over the past year, with an emphasis on infectious diseases of course.   The exams went well (or so I think/hope!). Time was of the essence for both papers, in which I had to scramble to finish my final thoughts (more so for Paper 1, even though I did four mock papers and had plenty of time for them!).  The examination conditions were uncomfortable and unpleasant, though.  We were put in a conference centre with rows and rows of desks.   Like everything in London/Britain/Europe, the space provided was extremely limited.  When we got in the room the invigilators, a bunch of old and cranky Brits, kept yelling at us that we were “in exam conditions—NO COMMUNICATING WITH YOUR NEIGHBOUR IN ANY WAY”, “TIME’S UP; WRITING UTENSILS DOWN”, etc.

It was a relief to finish the exams, which always seemed to be months away.  However, with relief came sadness as the time had come for people to start leaving (me included!).  I didn’t realise what good friends that I had made and how attached that I had become to so many people.  My Connaught Hall friends had already started to leave as their courses had finished (pretty much everyone finished before LSHTM, even the postgrads!).  By the time to sit exams came round, it was pretty much just me and the other LSHTM students.  It didn’t feel like home anymore.  I was getting sick of saying “goodbye” and became mentally ready to leave as well.  The end of the year party, which was a blast, was an excellent distraction from the thought of what was to come later on in the evening.  All good things must come to an end, though.  Laughs soon turned into tears as the final song played and we stumbled home for the last time in our separate directions.   

Although the ‘year’ together had come to an end, I wasn’t particularly depressed.  I had the strong feeling of comfort because I knew that I’d share a future rendez-vous or two with all of those people who were important to me.  Maybe I was more ready than I thought to move on to my summer project, medical school in the fall and my career/life after that, but I couldn’t wait to let these people go do and experience the wonderful things that were waiting for them.  Our chosen field of work/interest is small enough that we will surely bump into each other once again, if not more.  Each of us is a future leader in our respective public health endeavour.  The meetings, whether by chance or intention, will be due to personal reasons if not for work!

Within this time frame, both before and after exams, I had a few visitors as well.  They were able to get my mind off of the stressful and seemingly gloomy events of the first weeks of June.  A très bonne amie from Alma, Nicole, came for a day and an afternoon and so did Denise, the cute German young woman who I met on the train from Croatia to Germany, for a job interview outside of London. 


Now, I'm in Johannesburg, South Africa to complete my summer project.  More about this will be in the upcoming post (I need to take and upload some pictures for it.).  Stay tuned!

Eventful Easter Holiday: The Triumphant Return (Part IV of IV)

Destination: München.  Time of departure: 13.00.  ETA: 21.30.  Scheiße.  Although the train was 20-30 min. late, I was able to get a seat in a compartment to myself.  Score.  It didn't seem as if it would be that bad.  However, the conductor told me that the compartment in which I was sitting only was going to Villach, Austria (3ish hours away) when he came to collect tickets.  Although he said that I could stay until then, I'd have to change compartments at that time.  Ugh.  I decided to venture into the compartments of the train that were going all the way so I didn't have to worry about some mishap occurring and me being stuck in southern Austria.

Only one seat was available in the next compartment.  It was next to an attractive young woman who appeared to be my age (plus, a higher proportion of young people spoke English, so I figured I would actually be able to communicate with her).  I asked if the seat was available.  The first thing out of her mouth was: "FINALLY!  Someone who speaks English!"  Good life choice.  I sat down and we talked pretty much the entire train ride.  Denise was from Germany and was doing her Master's thesis research in Montenegro (something on tourism development and economics).  I found out that she was from Bonn!  I've been there!  Although she didn't live in Köln (Cologne), the neighbouring/COOLEST city in the country, THANK GOD her hometown wasn't Düsseldorf or I'd have had to leave.  There's a big rivalry between the two cities, and Köln wins in all of the right categories.

The train passed through Slovenia and Austria, which were both very pretty.  The mountains and the villages and cities that speckled the countryside make each country, especially Austria, great places to visit.  You can't help but think to yourself: "the hills are alive with the sound of music!"  Haha.  Darkness didn't fall until we entered Germany.  By that time, I was starting to get nervous about what was going to happen when the train arrived in München.  Denise was kind enough to call ahead to some of her friends (two of whom would meet us at the train station) and her mom to ask about the possible options for me once I got there.  The options didn't look good.  Apparently the French railway workers were striking, so travelling through the country was not an option: no Paris meant no Eurostar train (directly to London) and no Calais meant no ferry to Dover.  VRAIMENT ?!  POUR QUOI MAINTENANT ?  Je ne voulais que retourner à Londres ! WTF?!  The only choice was Belgium; one could get the Eurostar from Brussels or the ferry from Oost Ende.  At least there were other options than France.

We finally arrived in München and met up with Denise's friends.  All three were kind enough to help me locate the automated ticket machines.  However, the machine wouldn't let me book the ticket.  The route was mapped out--München to Köln to Brussels to London--but there was no option to purchase the seats.  That meant that it was sold out.  ARGH!  It said to see a ticket agent.  By then it was 22.  The ticket offices were closed.  NEIN!  We went to the information desk, but they said that they couldn't sell any tickets.  Denise and her friends said that it was possible to speak with the conductor of the train as they are able to sell tickets.  When they spoke to the men in charge of the Köln section of the train, the conductors said that it was all sold out and that I'd have to wait until the morning to get on another train.  That was apparently the best option.  The next trains weren't until 3 or 5.  However, after thinking about all of my options, I wanted to try and get as far as I could until there were no options left.  A section of the train was going to Stuttgart, and the woman who was in charge of that section of the train said that she could only sell me a ticket to there.  I'd have to wait to see if there were any seats when in Stuttgart.  The train left at 22.45 with me on it.  Tschüß, Denise.  It was the most abrupt "goodbye" that I've ever made.

As I went to pay for the ticket, the woman told me to wait.  There could possibly be a seat.  She'd check to see.  It was about 2 when we pulled into Stuttgart.  Still no seat available.  I bought the damn ticket to Stuttgart.  The heightened tiredness, along with the sobering fact that I'd be spending the night in a random German city train station, was starting to kick in.  It felt as if I was stranded.  A new conductor for the Köln section of the train was taking tickets, so I tried to see if there were available seats.  I wasn't the only person.  Too bad for me that everyone else could understand German.  The woman started to walk away.  I had to ask again if there were any seats.  I caught up with her and asked.  She coldly told me that she was checking, and that I had to wait there.  Just as the train was about to pull away, she came back and told the 6 of us who were waiting that there were in fact seats!  Finally--no dead end here!

ARSCHLÖCHER!  There were seats all along!  I saw two seats that were available (on which two men were propping up their feet whilst sleeping) in the compartment across from the fold-down seat in the aisle on which I was sitting!  Moreover, when the conductor was coming around to take tickets, she told me to sit in another compartment in which there was a free seat!  At least I was able to sit on something with cushions and catch a few hours of sleep until we arrived in Köln at 6.

The train was about 20 minutes late.  I still needed to buy the tickets to Brussels and London.  This was a problem because the earliest trains out were at 6.44 to Brussels and 9.30 to London.  By the time that I queued for the tickets and made it to the agent, it was too late to catch those trains.  In response to my request to be on the next train to London, he gave out a little laugh and said that the next train was not for three days.  FML.  After a minute or so of searching, he said that there was actually a seat on the 14.30 train (for arrival in London St. Pancras--which is a 7 min walk from my hall--at 15.30).  FANTASTISCH!  I'd arrive in Brussels at 10 and leave at 14.30.  PERFECT!  I'd never seen Brussels before, so I'd get to explore the city AND get back to London that afternoon!!!!!

Brussels was pretty, and it was a nice day.  Luckily the city's centre was small, so I was able to walk around and see many of the major sites before hopping on the Eurostar (which had an empty seat next to me!) to return home.  FINALLY!  What was supposed to be a 2.5 hour flight ended up being a 26 hour ride across the continent.  At least I got to see two extra countries, and saved $100 (when my flight refund is processed).  The adventure would have been a lot more fun if I didn't have to have been back for classes (of which I only missed three days)!

Fin.

Eventful Easter Holiday (Part III of IV)

Flight = cancelled.  School started the next day, and it was disappointing to miss class.  However, there was nothing that could be done.  The airline had a toll-free number, which I was able to call and get on a flight to London that left on Tuesday evening.  Fine.  Book it.  Michael cooked a nice lunch whilst I was sorting everything out.  After eating, I decided to move on.  Zagreb, Croatia was a two-hour train ride away and Michael said it was supposed to be nice (he was going there next).  I wanted to go to Budapest, Hungary, but it was too far away and there was too little time.  It seemed as if his research on Slovenia payed off (for the both of us!), so why not listen and go to Croatia?  There was nothing left to do or see in Ljubljana, so I purchased a return ticket to Slovenia and was on the next train out of the country.  The real adventure began.

The train ride to Zagreb, Hrvatska (Croatia) was pleasant.  We passed through hills and small towns, snaked along rivers and dashed across green fields.  We stopped at the border on both the Slovenian/European Union and Croatian sides.  It was actually kind of odd to go through a border on the continent that you actually had to show your passport and got a stamp.  It was obvious that EU membership/money made a difference to Slovenia.  You could immediately see the difference between the two countries--Croatia was visibly more run-down and poorer.  The countryside and villages through which we passed were decent, although the ride into Zagreb was not impressive (as was the case with Ljubljana).  Again, to use an apropos cliché, it was foolish to judge this book by the cover.

Zagreb was a bigger, more eye-pleasing version of Ljubljana.  The entire city could have used a thorough powerwash and re-plastering/re-cementing.  Actually, the old buildings with decaying facades looked quite rustic and regal.  There were plenty of green spaces that had trees and flowers in bloom, which were gorgeous.  The churches in the city were pretty, and the hill up which the city crawled and over which you could look over the city offered splendid views on the warm, sunny day.  Colourful restaurants and shops lined the upper town's (hill) streets were overflowing with people walking, chatting and eating under the outside tables with umbrellas.  It was very pleasurable.  However, I was anxious to get back to London.

Tuesday couldn't have come soon enough.  It seems as if I could only spend 1.5-2ish days in a city before becoming bored and wanting to move on.  The fact that I was missing class, and my friends who I hadn't seen in 3+ weeks, didn't help the matter.  I was constantly checking the internet at the crappy hostel in which I was staying (appropriately named, "Funk Hostel") for information on my flight and Gatwick Airport/British airspace.  The airline stated that there would be an update on my flight at noon, and the British airspace was closed until 19.00.  My flight was supposed to land at 19.25.  Gatwick's website, which provided updates about the status of the volcanic ash and resulting airport closures, stated that it was unlikely that the airspace would be open at all on that day.  Shit.  However, the day before I spotted the airline office from the place on the main square at which I was sitting for lunch.  It was time to go and check the status of the flight.  They told me to come back at 12 when the main office would provide them with information and they could act appropriately.  For curiosity, I asked when the next available flight was to London; it was Sunday.

By this time Michael was supposed to be arriving by train in Zagreb.  His train was late, so I enquired about train tickets to London.  They only had seats available on the train to München (Munich), Germany.  Another bloke, who was standing in the queue behind me, was waiting to book a ticket to get to Edinburgh, Scotland.  He too had no luck, and proposed getting the train to München and then renting a car to get from there to Paris (to catch the Eurostar train), to which there were no train seats available that day, or to all the way to London.  Michael finally arrived and I explained my situation as the Croat called his wife, who apparently was a travel agent.  After some thought and discussion, I decided to pass on waiting for the official announcement on the flight (which was 99% likely to be cancelled) and book the ticket to Germany.  That was the first of many decisions to take a train where I didn't know what the hell would happen on the other end.  When, if seemingly ever, would I get home?!

To be continued...  The end is next (I promise)!

Eventful Easter Holiday (Part II)

Checking the monitors for the latest flight information is good practice at the airport.  In doing so, I noticed that my flight to Ljubljana, Slovenia was not on the "abflug" (departures) board.  Shit.  Trying to find the Adria Airways--the national airline of Slovenia's--desk was a bit of a challenge, but I eventually located it.  The airport was busy, but nothing out of the ordinary seemed to be happening.  The agent told me that my flight was cancelled due to construction at the country's main airport, and that I should have gotten notification of the status.  I didn't.  He was surprisingly understanding and readily rebooked me on a flight to Klagenfurt, which is in the south of Austria near the border to Slovenia.  The agent said that the airline would cover my transportation to Ljubljana.  The friend that I was meeting there the next afternoon had told me about a city called Bled (pronounced "Blade"), which was on the way to Ljubljana.  Apparently it was supposed to be gorgeous, so I arranged to be dropped off there instead.  A bus could take me the rest of the way after exploring the city and surrounding area for a day.

The "mishap" actually worked out well--I flew closer to Bled and got a free taxi ride there.  The Austrian and Slovenian countrysides were pretty: mountains + small villages + clear rivers.  However, the best was yet to come.  Bled was one of the most stunning, picturesque places to which I've ever been.  WOW.  That word pretty much sums it up.  The tiny city was on a lake.  The lake was surrounded by hills, behind which were the Julian Alps.  In the middle of the lake was an island on which a church sat.  A castle to which you could climb sat atop one of the lakeside hills and offered gorgeous views of the surrounding areas.  WOW.

I spent the afternoon in Bled walking around the lake.  It seemed as if many people were only walking around half of it, but I convinced myself that it was probably worth it to walk round it.  That was a good life choice--the scenes just kept getting prettier.  The side opposite of the castle and city allowed you to see the mountains, as well as the castle and city themselves.  The sun kept peeking out among the intermittently spaced clouds, too.   The reflection of the mountains and church off of the clear, black lake was the best part.  WOW.  It took me about 3-ish hours to walk the circumference of the lake, but the fresh, warm air was a good de-stresser from the morning's events (and leaving Austria behind).

Once finished with the scenic walk, I hopped on a bus to Ljubljana (pronounced "Loob-lee-ah-nah"), the country's capital.  The ride on the way in made the city appear as if it was nothing special and not worth visiting.  Bled was still on my mind.  However, the city's centre was quaint and lovely.  I climbed the hill on which the castle atop the city was sitting.  It was much nicer than Bled's castle, with the exception of the views that it offered.  The city views were good, though.

After gauging the surroundings, I headed back to the hostel to meet one of my buddies from London, Michael.  We re-climbed the hill to see the castle and the city that was spread out beneath it.  We were then explored the city.  Not too long after we set off from the castle, it was time to eat.  The river that ran through the city's centre was too much to ignore, especially the bars and restaurants that lined it.  We spent the rest of the evening chatting and having a few drinks.

By now, it was Sunday.  My flight was to leave from Maribor, 100+ km away from the city, at 18.35.  I had a few hours before I had to catch the bus to the airport, so Michael and I went to a national history museum to occupy the time.  By this time, stories were starting to circulate around the hostel of a volcanic ash cloud that was covering Europe and causing travel chaos across the continent.  We got back to the hostel around lunchtime to check the status of my flight.  It wasn't good news.  Little did I know that this would be the beginning of an epic journey to get back to London.

To be continued...            

Eventful Easter Holiday (Part I)

The Easter Holiday was scheduled to be three weeks long.  It started out with the weekend in Amsterdam!  What a crazy city.  I took the night bus because it was the cheapest option.  We went via the chunnel, from Dover to Calais, by train!  Yes--there are trains that can transport tour busses!  This was at 2-3 in the morning, so the sleep was not good quality.  However, the city made up for it.  The canals and cycles, in addition to the picturesque facades of the buildings that lined the waterways, were gorgeous.  You had to really watch out, though, with the cyclists zipping around the pavements and streets.  It was nice to walk around the city and stop in a few museums, which were free because I was able to borrow one of my Dutch friend's Museumkaart.  DANK U WEL, Ellen!  The best part of the trip was meeting up with some of my friends from Connaught.  The reason that I went was to spend time with them.  The timing wasn't perfect--I had to go a day earlier because of my schedule--but the 1.5 day that we spent together was great.  We walked around the city, ate at this delicious restaurant that Ellen recommended and spent time relaxing in bars and coffee shops.  We even rented cycles and did a boat tour!!!  Those were interesting.  However, despite the fact that I really enjoyed the Dutch/Amsterdam outlook and approach to life and activities that one could and should be able to do to enjoy and live it, it was time to go home after a few days.      


After the long, sleepless bus ride and wait in the airport, I made it back to the States, albeit extremely briefly.  It was wonderful to see a limited number of family members and friends, as well as eat the overly abundant greasy foods and not continually be surrounded by large amounts of people [who speak differently] in cramped quarters.  Michigan seemed deserted--no one walking or riding their bicycles and vast, empty, brown fields.  As familiar as everything was, I felt as if I was a only a visitor who was stuck in the middle of leaving that life behind and adapting to a new life in a far-off place.  Even though I'm going back to go to medical school and the thought occupied my mind, the feeling didn't abate.

As per usual, I was ready to return to London at the end of the extended week.  While going back home made me realise how much I appreciated the truly great people who I have in the States, it did the same for those in London.  It's amazing to think of the meaningful relationships that you can build in such a short time.  Hopefully they are able to stand the test of time and distance when the London-based portion of the academic year expires in a short two months when I finish exams and leave for Johannesburg, South Africa for my summer project!

Once back in London, it wasn't long before home caught up with me.  One of my cousins came to visit me in London.  He was on a business trip, but he was at least able to spare a half day of his time.  We saw some of the major sites of the city: Westminster, the London Eye, Buckingham Palace and St. James Park, etc.  It was a nice afternoon even though I had to venture into the touristy parts of the city.

The next day I embarked on my final European holiday during my time here.  This time it was to Bratislava, Slovakia.  Ryanair considers it as a Vienna airport, so I figured that I'd stop there before visiting Austria and continuing on to Slovenia.  Plus, I'm getting really spoiled in the fact that countries/cities in Western Europe are starting to blend together and becoming rather unexciting.  So, why not Eastern Europe?!

Bratislava was a bad life choice.  A better name would be "Boringislava".  It was a relatively small, unassuming city with a plain hilltop castle, uninspiring architecture and glum people.  The rain and cold didn't help, either.  It took me less than half the day to encircle the city's centre, climb up to and see the castle and weave my way in and out of the pitiful old town.  Absolutely nothing stood out about it, with the exception of it being ridiculously cheap.  LAME.  DON'T WASTE YOUR TIME.

The next morning, less than one day after my arrival, I ran to the bus station to get the hell out of there.  The next stop was Vienna, Austria.  NOW THAT'S WHAT YOU CALL A CITY!  Everything about it blew Boringislava out of the water: the palaces, buildings, monuments, churches, etc. were lovely.  It was still raining, but the city actually felt that it was both alive and thriving, in addition to having a rich history.            

One of my coursemates was able to meet me in Vienna.  She is Austrian, but comes from Salzburg ("The hills are alive with the sound of music"!).  Haha.  Sorry, Lisi--couldn't help it!  We spent my second and final day in Vienna walking around the city, climbing the tower of the main church and just hanging out/relaxing.  Her visit made my time in Wien.  I was able to meet several of her friends; they were very amicable and fun to be around.  The trip was starting to really become enjoyable!

Sadly, it was time to move on.  I wasn't ready to leave just yet, but the allure of the upcoming destination, Slovenia, allowed me to leave without being too loth to go.  Little did I know that my travels would soon become wrought with logistical mishaps...

To be continued.                        

Long Time, No Blog

Sorry, folks!  It's been a busy few weeks…

Friday, 5 March
Field trip!  My Epidemiology & Control of Communicable Diseases course held the day's activities at the Health Protection Agency's (HPA) Centre for Infections (CfI).  The HPA is basically the UK's version of the US Centers for Disease Control and Prevention (CDC).  The roles and responsibilities are quite different in some aspects, but that's the best comparison to make!  The lectures on outbreaks of Salmonella and TB in the UK were the most interesting parts of the day.  If a career in HIV/AIDS doesn't work out for me, I may go into outbreak investigation and control.  It's exciting and is a great exercise for your brain!  Instead of food borne illness investigation, it would be something like ebola in Central Africa.  Now that's cool.

Wednesday - Friday, 10 - 12 March
More outbreak investigations!  ECCD was the culprit again.  The course is known for its outbreak control exercise, where you are assigned in a team and have to investigate, define and implement control measures for an outbreak of a disease [in W. Africa after a funeral].  It was great, but tiring.  We had to interview the "attendees", perform statistical analyses and write a four-page report that was due on Friday night.  It was gruelling to spend extended hours sitting in front of a computer screen, articulating what was happening or what needed to happen or why something was happening and writing a coherent report.  In the end, I enjoyed my group and think that we did well.  The School is excellent for providing seminar experiences that make learning fun and interactive!

Alas, things will only get busier.  There are only two weeks left in Term 2!  This year's flying!

Intellectual and Not-So-Intellectual Week

Weekend (too bad it's basically over...)!  Is it just me, or do the weeks seem to be getting longer?  Here's the breakdown:

Monday- The second half of the second term began.  My courses for the next five weeks are Designing Disease Control Programmes in Developing Countries (DDCPDC) and Epidemiology and Control of Communicable Diseases (ECCD).  As you can probably tell, the School fancies acronyms.  I don't blame it; try saying the names of my courses, in addition to my school--the London School of Hygiene & Tropical Medicine--10 times fast.  Each course should be worthwhile: in DDCPDC, I'm working extensively in a group to tackle malaria in southeast Liberia and ECCD has been rumoured to be one of the hardest, but most beneficial, courses taught at the School.  I'm looking forward to a challenging but rewarding term!

Tuesday- The Chief Medical Officer (CMO) of the UK, Sir Liam Donaldson, visited the School to speak about the role of the CMO in the UK, his career and his achievements.  The UK's CMO is the equivalent of the US's Surgeon General.  The presentation was captivating, especially when Sir Donaldson spoke about his role in addressing several hospital trust scandals that rocked the country in the past decade (i.e. dead children's organs being harvested without their parents' consent OR under misleading circumstances, with the bodies being disposed of as general rubbish). The high calibre of lecturers and presenters at the LSTHM continues to be impressive!

Wednesday (day)- A second, extremely influential individual spoke at the School on his [former] role in the UK [government].  The previous top drugs adviser for the UK [Home Office], Professor David Nutt, gave a presentation on harm assessments for regulating drugs.  In short, he was sacked by the Home Secretary for criticising the drugs policy in the UK.  The "criticism" was based off of scientific evidence showing how alcohol and tobacco are more dangerous and harmful than some illegal drugs (i.e. marijuana and ecstasy).  Click here for a good BBC article on the story.  It was a phenomenal presentation on the relationship between science and politics, and evidence-based policymaking.  I'll keep my opinions on the story to myself (I'm sure you can guess some of my thoughts and the side that I take... Ask if you're inclined to do so) so you can make your own decision on how you feel about both the il/legality of assorted chemical substances compared to others and the role of [independent] advising [on/for science] in government!          

Wednesday (night)- FOOTBALL MATCH!  I've now been properly introduced to English culture and lifestyle.  A few of my coursemates and I went to a Premier League football (the 'Merican translation, of course, is "soccer") match between my local London team, Tottenham Hotspur, and Bolton.  It was a BLAST!  Half of the experience was the game (Tottenham won 4-nil!), with the other being the audience.  The stadium was PACKED and resonated with the drunken fans' chants and songs.  Furthermore, the way that many of the fans spoke was brilliantly entertaining: "hey, friend"= "oy, mate!", "my" = "me", etc.  Many of my British mates say that you can tell the social class of someone by his/her accent.  The more you encounter the wide array of people who live in/around London, the more you realise that it's true...  The bobbies on horses and riot police outside of the stadium also added a thrilling element to the experience as well!  Sadly there were no [exceptionally] rowdy football hooligans on which the bobbies needed to use their equipment.  Honestly, it was probably one of the most fun sporting event to which I've ever been!  I love the UK.            

Thursday- It's been waaaaaaaaay too long since I have seen a theatre production.  One of my hallmates was in the UCL production of Shakespeare's Measure for Measure.  I went to the show with some of my fellow hallmates.  The acting was rather good, and it was refreshing to be privy to an aspect of the fine arts once again!       

Polish Pal

Last week was Reading Week.  I actually spent the first half of the week in London.  This was supposed to be used for school-related projects or work.  However, the second half of the week--Thursday through Sunday--was allocated for travel!  One of my co-workers at Cedar Point lives and studies in northern Poland, Gdańsk to be precise, so I figured that I'd give her a visit because we became good friends over the summer and weren't able to meet [in Dublin] as we planned.

The long weekend was really great.  Daria and I were able to have a relaxing, stress-free time.  We explored Gdańsk's centre and harbour, in addition to the nearby cities of Sopot and Gdynia.  Each of the cities were located on the Baltic Sea, and were bitterly cold.  There was quite a bit of snow on the ground as well.  It actually reminded me of Michigan (with a bit less sunshine and more Eastern European flavour, though)!

It was nice to catch-up with one another and to see someone who I knew from the States.  We couldn't be bothered to see absolutely everything in the cities and always be in "tourist mode".  We watched a couple films, hung out with a couple of her friends, frequented coffee shops and talked about what was happening in our lives.  Although the topic of conversation usually related to our experiences as servers at Cedar Point (or seemed to end-up there) and had time to reflect on my (and our) experiences there, I enjoyed myself.