Tuesday, July 31, 2012

Just breathe

There's something so inexplicably peaceful about surfing. It's in the sense of being so absolutely finite, so very, very small. The feeling of tons of water rushing over your body when you duck under a wave. It's in the taste of salt. Its when the sea drips from your hair onto your shoulders as you wait for the next wave.  

And there's this magical moment, once you've struggled past the breakers, when you get out to the open, flat ocean. The water slaps the bottom of your board and you can wiggle your toes in the seaweed floating by. One of my favorite things in the world to do is get out there, past the waves, out into the calm ocean, and just lay on the board. Stretched out on the board, eyes closed, rocking with the gentle swells....nothing else in the world matters. You just breathe and smell the sea. You just are. 

More than anything right now, I want to be back in SD and just float out there on the ocean. And just breathe. 

Sunday, July 29, 2012

Final therapy


"If your paper is robust, solid, comprehensive and concise; if your presentation is strong and well put-together; if you understand the concepts and can defend your analysis well...you'll probably get 30/35 on your final."

That's a B. Awesome. 

Spent a good couple hours at a new cafe tonight working on our final project/papers....and when we wanted to just melt, we took pictures.







Good therapy. 

Saturday, July 28, 2012

The King and the People



I don't normally like to post twice in a day, but this is a really interesting debate about Jordan's political system. The speakers debate the monarchy, freedom, and Al-Jazeera's newest focus: reform vs. revolution. It's intriguing to watch, especially having been here among the people themselves. The monarchy here is well established and seem to be rather endeared to the Jordanian people. Pictures of the royal family are hung in every restaurant, posted on the sides of buildings, the King's picture is often seen taped inside taxi windows and countless cars tout crown stickers on the back. At the same time, while most are not anti-monarchical, Jordanians want deep reform. They want the monarchy to institute reforms, and if King Abdullah were to implement more democratic policies, the monarchy could possibly secure itself a future. And yet, public demand is weak; while there have been demonstrations for the past 18 months, they've been relatively sporadic and public involvement is lacking.

It's intriguing to watch this and listen to these highly-educated, high-profile people discuss these issues. With that in mind, I love being able to go out on the street and talk to the taxi drivers, the doctors in the clinics, the restaurant workers, and our neighbors in our apartment. In the five weeks living here in Amman, the capital city, I haven't felt or seen the "ethnic tension" so widely described by the media. In fact, the people are most concerned and upset about tighter water rationing than anything else. 1000 syrian "guests" arrived in Amman two days ago, and we continue to accept more every day. The kingdom is allocating services to them - electricity, water, medical care - and the Jordanian citizens are feeling neglected. If there's any tension, it's over these basic services....or at least, that's what we've observed.

The situation is complex and multi-facited. There are many perspectives, many demands, many voices wanting to be heard from a multitude of ethnicities, demographics, and religions. I'm not a journalist and I'm not here to investigate, but having lived among and worked with both Palestinians and Jordanians these past few weeks, I haven't felt tension to the extent the news is claiming. I don't discredit or doubt the words of the people at the table. I want to explore what they say more and research the subtleties of the situation. Yet I believe, as in many situations, you cannot apply blanket statements - especially to Jordan; a patchwork country of so many different kinds of people.

This may be naive and simply because I've been fairly protected here, but again and again, the Jordanians present themselves as hopeful. The people I talk to speak of freedom, of possibilities, of trying to work make a better life for themselves and their families. They're optimistic. It's an interesting dichotomy: listening to the educated elites who describe political/ethnic tension and the need for reform, and the every-day, mostly poor, people who love to smile and want to survive.

I find the difference between what you hear and what you see fascinating. I think it's all true. I want to know more. I don't want to leave. 

Day in the Life


Ben snores quietly on the couch. Teni sits compiling data into frequency tables. There are cords and massive water bottles everywhere. Upstairs, the people have been taking shifts sleeping and reading, waking each other up every hour or so throughout the night to keep the rotations going. We made curry for dinner and are about to order McDonalds for dessert. Lana Del Rey plays on a laptop...we've had her stuck in our heads for 3 days; we're sick of the song, but love it too much to stop singing it. Someone brings out the nutella. Someone else starts rattling off health statistics about GDPs and medical budgets. It's organized chaos. It's exciting. 

Friday, July 27, 2012

Ramadan


By day the city is empty, quiet, and hot. The busy, crowded streets are suddenly devoid of cars and nearly all the stores and restaurants are closed. If they can, people sleep late or stay inside. Taxi drivers going are grouchy because they can't smoke. You have to hide your water bottle inside your purse so no-one sees.

But by night, Amman is transformed into a bustling, exciting, food-filled place. I'm almost sure if you translated "رمضان" (the word for Ramadan) into English, it'd be spelled "feast".


The fourth pillar of Islam, Ramadan is a sacred month of fasting based on the lunar calendar. From July 19th until August 18th, all participants are required to fast from sunrise to sunset; no food, water, or smoking. You start your day with suhoor, a pre-dawn breakfast of usually dates, water, breads and nuts. Once the sun rises, the entire city fasts until around 7:30pm when iftar finally comes and you can break the fast. All the restaurants are closed and many shops wait until night to open. Because water is forbidden, people stay in their homes to conserve energy. And since smoking is also off-limits, everyone is on-edge, from the taxi drivers to our doctors in the clinics. Patience levels are low. But after iftar, everything changes. People can eat and drink, shops are open, there are fireworks everywhere, twinkly lights hang from windows and doorframes, and people are whistling. It's eating, drinking, smoking, singing in the streets, and happiness till dawn.



Most of us aren't fasting, but we joined our friends from SIT, one of the directors from the Ministry of Health, the chief of UNRWA's field health program, our professor, and all their families at a fancy restaurant for iftar. It was delicious and there was so much food. It's bad, nearly every night of Ramadan, we all are in serious food-coma.

Which, speaking of food-babies, I'm gonna go waddle to bed. Ramadan kareem!
!رمضان كريم

Thursday, July 26, 2012

Tuesday, July 24, 2012

Blue Irises


        
I'm in love with Wild Jordan. It's more than just an amazing study spot; it's a place to think, to watch the city, to escape. And at the moment, to dream.





Someday, I want a house like this. Or at least a room like this. Quiet and serene with smooth concrete floors and walls full of books. The kind of room you can silently pad around in your socks in. A place where you can curl up inside a massive couch and read and read and read. I want it to be open and soothing and warm; the kind of place you could sit with good friends and a glass of wine and talk until dawn. I want sunshine and walls of glass. There'll be chimes in the window and they'll quietly sing in the breeze. And there'll be blue irises on the table.


Monday, July 23, 2012

Chin up

I'm taking a study break to breathe, blog, and grab something to eat. Mac & cheese cooks fast and there are fresh nectarines Devon and I found at Spinny's, the local grocery store. That plus more turkish coffee and I'm regaining life again.

Today was hard. The last week has, again, been a flurry of flashcards, written assignments, hours spent reading at Wild Jordan, early mornings at the clinic, and late nights annotating in the livingroom. Our two midterms were last Thursday and we got our scores back today. One went okay, and one warranted a "I'm highly disappointed in you" from my professor. Awesome.

But there's a guy almost 8000 miles away in Peru who made me smile, even when I wanted to curl up in a ball and give up. And he can give the closest technology comes to cyber-hugs.

Soooo, I'm back in the livingroom studying. There's only two weeks left. Hardest two weeks, but only two weeks. Tonight's gonna be more data entry, a paper, and a hypothesis with calculations and frequency tables. But I've got turkish coffee, Peruvian hugs that are always there, and a brother who quotes Bob Marley at me. This'll happen. 

Saturday, July 21, 2012

Wild Jordan


Best study place in the world. 

Friday, July 20, 2012

Men in Black and Turkish Coffee

The morning is quiet and still; we're basking in the fact that it's 11:30am and we have nowhere to go. Five of us girls are spread about the livingroom on our laptops facebooking, entering data, reading the news, letting our brains just rest. I'm curled up among a zillion pillows, Turkish coffee steaming beside me - the most powerful coffee in the world, I'm sure - Josh Groban is on repeat, and I'm being careful not to let my feet touch the floor too much. A massive cockroach scuttled by last night, crawled up the tall bookcase facing the couches, and camped out on top waving its skinny antennae as it watched us. Eeep.

Men in Black moment! I need his fearlessness....and shiny, black, cockroach squishing shoes. 

I've spent the morning perusing the UCSD course catalogue and emailing academic advisors. I discovered the sociology department has a strong research component to it, complete with great professors and practical applications for personal interests. At least that's what it says on paper and I'd really like to explore it. As intense and frustrating as this program is, it's made me realize sociological/epidemiological research is *fascinating* and I want to do my own. But I want to learn to do it right (our questionnaire right now has at least 6 of the 8 biases we're learning to avoid), and the UCSD classes sound like exactly what I need. The more I learn here, the more I realize how little I know, so naturally I want to take them all. Soooo, trying to figure out how to pull that off. I'm just gonna be a professional student.

Or maybe I'll go into osteopathic medicine. 

Or maybe I'll just go make more Turkish coffee and take a shower. 

Sunday, July 15, 2012

Ahmed

Ahmed (L) and his cousin

Our bus driver has a weathered face, tattooed arms, missing teeth, and smiling eyes. He loves Celine Dion and the Jordanian national anthem. His stained shirt smells of tea and cigarettes....and he's always making us laugh. He arrives early and waits for us slow Americans to emerge from our apartments early in the morning when we're still caffeine-deprived zombies. He laughs at our bad Arabic and will go out of his way to take us to market. He even climbs sand mountains in the dark with us to watch shooting stars whiz over the desert. 

Ahmed, Serge, Amelia 


Music is his thing. He's made sure we've listened to the national anthem plenty of times, the "good morning" song, and our share of Jordanian pop. Ahmed has a CD of arabic party music and on the hour and a half drive to Wadi Rum he nearly broke the speakers blasting it. The beat was irresistible, the lyrics unintelligible but so happy, and a dance party quickly ensued in the bus aisle. Our travel guide, Basheer, taught us the arabic moves and Ahmed turned up the volume at strategic points to emphasize the fact that we should definitely be dancing. He bounced in his seat to the music and as he honked the horn, he pulled the blue "evil eye" charm hanging from the rearview mirror. He thinks we think that's the horn and if you pretend to be delighted, he beams at himself.

So many times, we'll board the bus to find ourselves being serenaded by Celine Dion's My Heart Will Go On. We must have listened to it 4 or 5 times coming home from Petra. Ahmed has her programed in his phone and when the song reaches it's climax, he lets go of the wheel to spread his arms in the famous titanic flying pose. It's incredibly endearing and absolutely terrifying at the same time; Jordanian drivers are the worst ever and, more than anything, you want the driver's hands on the wheel. And yet, the way he turns around with laughing eyes and the biggest smile on his face makes you forget the cars whizzing by....inches away.


He'll be waiting outside our apartment in just a few hours to take us to class in the morning. He'll have a smile on his face and will probably ask if we've memorized any of his songs. We borrowed his party CD so we could download the music and we've been rocking out to it as we study and work on tedious databases. Who knows, we'll probably be listening to it again way too early in the morning tomorrow, and he'll be way too into it. And even though we'll be groggy, we'll kinda sorta love him for it. 

He's the best bus driver ever. And just a really cool guy. 

Thursday, July 12, 2012

Musings


There's a little terrace hidden within the concrete maze of Amman's streets. Wild Jordan is a branch of the Royal Society for the Conservation of Nature which works to develop socio-economic programs in all of Jordan's nature reserves, and this afternoon it was Devon and my escape. Its headquarters is a 3-story enclave tucked inside a residential neighborhood and has entire walls of glass so you can look over downtown Amman as you rest. The second floor has a little cafe that makes the most refreshing mint smoothies; we sipped and sat in silence as we wrote postcards to loved ones on the other side of the world. At noon the adhan called all Muslims to prayer, once again transforming the minarets into beacons of somber, beautiful song. It's like listening to gregorian chanting five times a day. I really love the sound.

It was wonderful getting to sit, think, laugh, and write together. Devon's an incredible roommate and the day had been a little intense, so we needed a break. Our first two tests were this morning, so the past week has been a flurry of flashcards, textbooks, and study sessions. Yesterday we studied for too many hours straight and were all a bit jittery this morning when we finally sat down to take it. I think we studied ourselves silly, but it paid off; the test went fairly well! We haven't gotten our results back yet of course, but we diagnosed meningococcal meningitis and kwashiorkor, so we're pretty thrilled. :)

After our tests, we toured the Al-Bashir Government Hospital. I'm struggling to know how to describe it, I'm still mulling it over in my mind. On one hand, the hospital director, emergency room chief, and natal ICU director were incredibly proud of their facilities and were eager to show us around the wards. In the emergency room, we toured the back rooms, operating theaters, bandaging wards, ambulance docks and more. And yet, as we passed through the narrow, concrete halls, I couldn't help but notice the puddles of murky water and urine on the floors. The blood stains on the hospital beds and gurneys. The patients sitting in up and down the stairwells and halls; bloodied bandages covering feet, hands, and heads. I'd peer into a dark room and see a doctor developing x-rays amid a cloud of cigarette smoke. Directions for emergency resuscitation procedures was taped up on the walls. Yet, this is their national public hospital and the directors are proud of it. Walking through the offices and observing the staff, they're working hard. They're doing their best. Their accomplishments are impressive: nearly 34,000 patients filter through those walls every week, 1 million every year. It's the biggest hospital in Jordan, located in one of the poorest neighborhoods of Amman. With 22 operating theaters, they manage nearly 3000 surgeries a year. They have a child abuse detection center, a regionally-recognized forensic science team, life-saving treatment for hundreds of thousands across the country, and are trying to implement more programs for the growing diabetic population.  It's still a contrast. A stark, obvious contrast. When I was pre-med, I toured the medical schools and hospitals at UCSF, UC Davis, and Stanford. I gaped at their incredible technology, their surgical robots, their enormous conference rooms, their mechanical cadavers students could practice on, their long white, sterile halls of prestige....and longed to be one of them. Yet, walking through the dark, wet halls of Al-Bashir today, that seemed almost embarrassingly utopic. Embarrassing is perhaps the wrong word. But we can leave, we can go back to our clean, quiet Western hospitals; a fact that made me realize, once again, how fortunate and  privileged we are. So, how to describe Al-Bashir? Intriguing, shocking, impressive, sobering, eye-opening, hopeful....not sure yet. It's still a blend of faces and facts and snap-shots in my mind. 

Tuesday, July 10, 2012

"If it doesn't pop, fizz, or peel"...

...don't eat it.

We've all had woozy, upset stomaches for the past couple days and we can't figure out why. My stomach is a cramping roller-coaster....the water? Iffy shwarmas? Bad fruit? Contaminated ice-cream? Stress? Milk? We've all eaten different things making it hard to pinpoint anything specific, so now we're just paranoid and resorting to top ramen. Exclusively.

On top of it, it's pretty bad timing. We have our first exam on Thursday and too many hours studying infectious diseases makes Risa a total hypochondriac. I'm nearly convinced we're all gonna die of an epic mutant-strain of dyptho-meningi-malari-rubella. I can just see it in the news, "Public Health Students Die of Preventative Diseases". Ironic.

---
On a more positive, less morbid note, clinic continues to be incredible. Update to follow....soon....after the test. :)

Friday, July 6, 2012

Thursday, July 5, 2012

Where Feminism Doesn't Fly

Don't get me wrong when I say I'm not a radical feminist. I'm proud of and thankful for Anthony, Wollstonecraft, de Gouges, and the suffragettes. I'm a woman and I strongly believe in global women's rights and equality. Still, I'm no extremist.

But here in Jordan, the little feminist in me is having a hard time. It's the small things that get me; the split second moments and decisions that speak volumes about an underlying worldview. I respect the religious context. I've had the reasoning explained to me plenty of times. I understand that culture dictates women submit to men's "protection", but it's still a shock sometimes when I see it first hand.

Durring our orientation, one of the women was giving a fascinating lecture on cultural norms. From dress-codes to taxi etiquette, it was information we needed to know and she was finally clarifying old questions. Suddenly one of the men thought of something he wanted to add, completely cut her off, and finished the lecture. When she saw him darting over, she instantly gave him the floor and apologized multiple times. Apologized for what? What he was saying was nowhere as interesting or relevant, and, while of course I didn't say anything, inside I wanted to tell him how rude and unnecessary his interruption was.

There are rules that apply to us as well. For example, women are not allowed to sit in the front seat of a taxi. Even if there are three of you, you have to squeeze in the back seat, groceries, bags and all. So many times, I'll lean into the front window to see if the driver knows where we're going, upon confirmation open the front passenger door to get in, but then remember that's taboo. So no, we're all sardines in the back seat. Even if you're the only passenger! If you're a woman, you're in the back. I don't like it.

On top of it, men will hiss at you here. It's this quick little "pssss, psss"; the kind of sound you'd make if you're calling a kitten. It's incredibly derogatory and creeps me out. I am not an object. Do not hiss at me. But you cannot make eye contact; you just keep your eyes down and walk past. Ignore it, brush it off...keep going.

Hmm, looking over the post, I didn't plan on this turning into a rant. Jordan is amazing and I love being here. It's fascinating being immersed in a culture so very different from our own. The food is amazing, the classes are challenging, working in the clinics is so incredible and eye-opening....it's just that, in the subtle, daily, inter-gender exchanges, it's a bit of culture shock. You hear about women's rights (or lack thereof) in different countries, you read about submission and compliance, but until you see it, feel it, it tends to remain abstract in your mind. Coming from a western way of thinking, I find myself wanting to protest, but it's not my culture. Not my language. Not my place. 

Wednesday, July 4, 2012

As per requested...

....here are the nerd jokes. Now, keep in mind it was 2am and we'd had a long day studying infectious diseases, so naturally, we thought these were pretty witty. If you don't, just opt for the sympathy laugh. ;)

----------

Tuberculosis walks into a bar. The bartender says "we don't serve infectious diseases". Tuberculosis replies, "You're not a very good host."

Two bacterium walk into a bar. The bartender says, "we don't serve bacteria in this bar." They reply, "We work here, we're staph."


Tuesday, July 3, 2012

Of Refugees and Beauty

There's something beautiful in the simplicity, chaos, and unpredictability of a small health clinic. It's like a dance; until you know the steps, you get lost in the chaos and whirlwind of people. Then suddenly the masses have names, you learn individuals' faces and pains, the doctors start to trust you, and you see patterns in the ebb and flow of patients. The chaos clears and you're left with simple people needing help.

Today was our first day in the refugee health clinics. I was part of the chronic disease unit at Baqa'a, the largest refugee camp in Amman. Over 80,100 Palestinians live there in concrete ghettos; the narrow streets are overshadowed by cardboard, corrugated metal, and webs of electrical lines. Driving down the hills into the valley, you can see the density of the camp. The homes are so close, the camp looks like a grey cloud sprawled across the landscape. We parked in front of the clinic: a boy on a donkey waved as he rode past, a little girl tiptoed around water pooling in the street cracks, and the street vendor chased flies from his grapes and apricots. Graffiti peppered the concrete walls with scrawling messages we couldn't read. A baby cried.

The clinic itself is small, clean, and white with blue highlights....the colors of UNRWA. Little curious eyes peer over the 2nd floor balcony as we enter and meet the clinic director. Two stories with 16 rooms, the clinic was built in 1994 by the French and then turned into a UNRWA health clinic just a few years ago. The doctor I'm shadowing said he sees about 50-60 patients a day. Between themselves, the four general and non-communicable disease doctors see over 700. It's incredible. A 3-year old with wide brown eyes and tight curls came in with severe meningitis after eating contaminated ice-cream. One boy had salmonella, another had herpes, a little girl came in with a facial fungus, and multiple dozens of middle-age and elderly came in with advanced diabetes or hypertension. It was sobering, but the doctor handled it with such grace and patience, even in the exasperating moments. Previously, he was an emergency room doctor at a government hospital, but he gave up the title and salary to work with the refugees. At one point during the surge of patients, he closed the door and looked at Matt and I. "You can't do this job for the salary. It's not about the money, it's about the people. That's the soul of medicine."

It was beautiful being at the clinic. Beautiful in a hot, sticky, dusty way. Beauty even in a cramped clinic with screaming babies, stressed nurses, demanding patients, and not enough time. Even amidst the clamor of hundreds of sick people, when you make that one mother smile with relief or counsel a man with pre-diabetic symptoms, the chaos becomes beautiful.

Sunday, July 1, 2012

Breakfast Musings

We're up early today, class starts in little over an hour. The nine of us girls on our floor managed to work out a shower schedule, so we're cleaner, awake, and happy. Our "living room" has three couches arranged in a horseshoe and we're all curled up with the pillows, laptops, and Jordanian yogurt. We've turned on the TV for white noise; I like subconsciously listening to arabic, even if I don't know what it means.

Today is our first day of class and I'm nervous. The professor is intense, the reading dense, and the assignments daunting. I'm unsure what to bring, how hard to study...is memorizing before the first lecture a little too much? I don't know. It'll probably be fine. A bunch of us lounged around talking late into the night about public health, epidemiology, and life. We quizzed each other on the textbooks, swapped history trivia, laughed about nerdy infectious disease jokes, and cheered when Spain won the Euro cup. I love being around other public health-ers. I love the exchange of ideas; one person will mention "herd immunity", someone else jumps in with the difference between endemic and epidemic outbreaks, while someone else quips "did you know 100% of people die?" We're a fun group - everyone is passionate, excited, and good-humored. We're all a bit out of our comfort zone, but it's an adventure and we just roll with the punches.

It's almost 8am and it's getting warm. My books are on the table. Laptop's charged. I've got my arabic words all written out in a notebook. Bring this day on!

United Nations Relief and Works Agency

Today was surreal. That's the only word I can find to describe it.

This picture makes it look like I'm standing in front of UNRWA, but I'm actually floating. On cloud 9.


We discovered today that the Chief of Public Health for all of the refugees under UNRWA will be listening to our final presentations at the end of our 5 weeks here. After compiling our research and crafting possible policies, we'll not only be graded, but we'll be speaking before the *chief*. It adds a level of intensity and intimidation, but I'm actually thrilled at the potential for tangible change. Dr. Abu-Zayed will be listening for ideas and potential solutions to discrepancies in camp health care. The head of public health for all of UNRWA will be listening to us and, while the chances of us discovering something new and original may not be incredibly high, I'm thrilled at the mere possibility.

Like I said, surreal.