Hi everyone!

It's been an exciting week here. Classes are in full swing, I did my first day of work at the Midwife Obstetric Unit (MOU) in Gugulethu, and I had drinks with members of my favorite South African band!

I'm very happy with my courses this semester. They are my last three! Introduction to Health Systems Research and Evaluation (yes I am in the health systems track and taking the intro course in my last semester...darn scheduling!), Qualitative Research Methods, and Theory and Application of Economic Evaluation. In plain terms, the first two course are a lot about methodology, so formulating research questions, research protocol design, and critical appraisal of articles. Economic Evaluation coincides nicely with the study I am working on. So far we have looked at costing and cost effectiveness analysis, and our study examines the cost effectiveness of various interventions of a PMTCT (prevention of mother to child transmission of HIV. Some folks are saying EMTCT now, for "the elimination of...," because taking ARVs during pregnancy along with other interventions reduces the risk of transmission to a child to almost nothing) program at a pre natal clinic in Gugulethu, a township nearby Cape Town.

Thursday was my first trip into Gugulethu (pronounced "goo-goo-lay-too"). Landon was kind enough to drive us and a medical student visiting from the States, Tori, came with us as well. I went in with an open mind, preparing for the worst after seeing pictures and film of townships lined with tiny shacks for living space. Sticking to the main roads, at least, Gugulethu (or "Gugs") was not exactly what I expected. For example, there is a mall there! I'm not sure if it is meant for residents or tourists. Most folks living in Gugs, to my knowledge, are employed on low income or not employed at all. The MOU and other health centres on the complex, are publicly funded and patients do not pay for care.

The MOU was both better and worse than I thought it would be! Worse only in the sense that there are SO many people waiting to be seen, and even when you hear about those things over and over, it is still different to see it with your own eyes. The most mindblowing line  for me was the wait for the pharmacy...rows and rows of benches just to get medicine! Can you imagine? Most of us get annoyed when one or two people are in front of us at Rite Aid. Can you imagine waiting hours? Sure, folks could also go to a private pharmacy, but that is far too expensive for most living in Gugs.

I found the staff at the MOU to be great, though, which was a pleasant surprise. In the MPH you hear tons of stories about apathetic healthcare staff, which I don't doubt are true. When you are seeing a bazillion patients a day, you are bound to get tired. But, speaking to the staff, it was clear that they were sensitive to patients' situations and needs. I kept thinking of my time at Planned Parenthood. And the fact that a positive HIV test was quite a rare thing for us...imagine the exhaustion of telling every second or third woman you see that she is HIV positive.

In any case, it was an amazing day for me. I'm sorta obsessed with operations (i.e. how a health centre is run) so observing and speaking to staff was absolutely fascinating. The next step of our study is to do a time study in order to measure the amount of time a woman spends at each chunk of her visit. This will help us calculate staff salaries and lost wages for patients per visit.

This is getting long, so I will just very quickly say--I had drinks with Zolani and Kyla from Freshlyground! A friend of a friend visiting from the States traveled with the band for some time and is very close friends with them. I totally blew it an was too embarrassed to say I was a big fan when I met them, but it was still pretty cool to hang out with them! In case you don't know their music, this is my current obsession by them: http://www.youtube.com/watch?v=k-5GzjsxGU0 it sounds one million times more beautiful live. I had the privilege of seeing them perform for the third time last weekend.

Okay, time to go DRIVE myself to the gym....that's right, I have graduated from driving lessons with an excellent instructor who helped build my driving confidence! Took my first solo drive in T's car on Sunday and it was a natural high! Still a little nervous to try again today, but practice makes perfect!

Love!
Kristen

When it Rains

Am I updating this blog instead of studying for my last exam tomorrow morning? You bet I am!

Dear readers, if there's one bizarre phenomena of this last year, it's been the oddness of my working status. It seems that every time I have a job offer (be it as a waitress, teacher, or public health-er) I have been offered numerous opportunities at once, with dry spells in between. Well, this last week has not been a dry spell, and don't you know it's right before I leave for the States (hooray!). Still, things are looking up for next year.

After months of barely a peep from the Learning Network (they're busy folks and I wasn't exactly seeking them out either), I was asked to do a research gig for about 40 hours that would actually pay me. Unfortunately, it's over the next couple of months so they'll be looking for another candidate. My friend Bob also recommended me for a fieldworker job. It's one of those jobs where they reeeeeally want you to speak Afrikaans or Xhosa, so I probably would have never gone for it on my own. They called me recently to say that they are interested in me for a slightly higher level position that sounds a bit more like coordinating fieldwork rather than doing it. I have an interview on Friday where I have to do a three minute presentation. We'll see how it goes. They explained that they have some positions where only English is required, so it sounds like a possibility.

Alright, I might be a just a little too proud of this last one, but you have to understand that after MONTHS of not getting even close to working in sexual or reproductive health, even a glimmer of hope is amazing. An email went out to the MPH students requesting a student to work for about 40 hours with Landon Myer to edit a document. It's in the heart of finals, so I knew most people probably wouldn't respond. Maybe I shouldn't have either, but the work started when I only had one exam left, and I figured I could balance it all. I've heard amazing things about Landon and his research, and I figured if editing was a way to get in the door, I would jump at it. He does a lot of HIV research, but more recently has also been focusing on IUDs, which I am completely obsessed with.

I met with Landon, who is awesome, discovered that when you're editing a giant NIH grant it is COMPLETELY possible to spend 40 hours editing it, if not more, and that because it is such "menial" work, he was willing to may me r20 (about 3 USD) extra per hour of the normal student rate to do it. I've been working hard, making sure everything is as perfect as possible to make a good first impression. Things are hectic with the grant right now (due Thursday!) but on Friday he talked to me a little about my interests and said that we should sit down and talk about future work after the grant is finished, because there are a lot of exciting projects coming up next year. I really really hope something works out, because his research is exactly the kind of stuff I'd like to be a part of!

Also, I am officially done at Bella. Still love the food and the people, but I really want to focus my energies more on projects such as the above. Here and there I've been doing the breast pump thing and, if I haven't mentioned, I also did a brief gig with Stellenbosch University doing some data extraction, which was my first official paid public health job here.

So, things are looking up! Even doing the editing over the last few days (which I strangely enjoy, by the way), it felt so wonderful to have work to do again. It was tiring, but fulfilling. I'm looking forward to more of that next year!

Yes, I almost through finals! Earlier this week I took Health, Policy, and Planning, which I actually felt I did quite well on. Evidence Based Healthcare was a bit scary at first--the format of the exam was definitely not how I studied, but after freaking out for five minutes I read the questions and realized I knew how to answer them. I actually finished about half an hour early, even with checking it over. Tomorrow, I have Economics of Health Systems. It was my first ever economics course and entirely new material for me. I learned a TON and really enjoyed it, but I think at this point my getting a solid B is inevitable. In a way, that is freeing because I feel less stressed studying for it. The chances of my doing miraculously well and pulling out a high A on the exam are slim, but I certainly know enough that I don't expect anything below a B. In a little over 24 hours, I will officially be done with my first year of grad school!

Well, I'd better put my money where my mouth is and go do some studying. Oh, and Thomas is great--in a couple of hours he'll be getting home from his last Nigeria trip. Having him home once a week has been AMAZING. Let's hope there are some more gigs like that in our future.

Love!
Kristen

Back from Break

Hi folks,

Oh my, it is August 1st! I will use the university break as my excuse for not updating. The Namibia trip did not pan out, but I did a couple of day trips and spent time with friends. It was a good stress relief. I received "firsts" which are sorta like As in three of my courses and am waiting to hear about the last course. It was my most challenging class (Public Health and Society) so I'm not expecting a first, but hopefully I did well.

I am still working at the Italian restaurant and should be starting with the music school soon. I don't have any private students yet,  but I'll be teaching a woodwind sectional class with clarinet and saxophone. Should be a challenge, but I am looking forward to it.

Class has started again and I've just finished my block classes. I decided to take three courses rather than two. My plan is too finish all of my course work by the end of the next semester so that I am free to travel during my last semester (when I'm writing my thesis) if the opportunity arrises. I'm really enjoying my courses this semester, which are more Health Systems focused: Health Policy and Planning and Economics of Health Systems. I'm also taking Evidence Based Health Care, which isn't health systems focused, but the concepts can certainly be applied (using research to make policy decisions rather than clinical decisions).

Thomas and I are still doing well, though it's been difficult for me that so much of his work is in Joburg. It's the reality of our situation and while it's better than living in different countries, it's still hard. I think this is worth mentioning. There are some positive things about long (or short!) distance relationships, including having "self" time. However, at the end of the day, I think most of us would rather have the person you love nearby. I'm really surprised there isn't more information/support out there for people doing the long distance thang, what with globalization and all. Surely someone somewhere should be making money off of this? :)

I'm still lacking in the activism department, buuuuut the Cape Town Slut Walk is coming up! We were also treated to two famous feminist thinkers visiting Cape Town last week: Judith Butler and Raewyn Connell. Butler didn't come to speak about feminism--her topic was about Zionism, but I really loved what she had to say (what I could follow, at least!). Connell spoke about Transexual rights in relation to feminism and was a really good talk. She feels that women whom are transexual should be working towards policy change for women that includes trans women, as opposed to policy targeted only at transexual women. I both agree and disagree with her, but I definitely see where she is coming from. My only concern is how to actually make "women" an inclusive term, especially under a legal setting. For non-trans feminists, she urged that we spend some time learning about what the lives of trans women (and men) are like. She gave us a reading list and I plan on checking at least one of the books out.

Time for me to get back to the reading grind. Sorry to have disappeared for so long, but I plan to be updating regularly now. Love!

Proof I'm a nerd (as if you needed more)

As I head off for my exam in biostatistics, I am comforted that I understood most of what he is talking about and found it hilarious! Click to enjoy "Baby Got Stat"

LAST FINAL OF THE FIRST SEMESTER TODAY! :-D

This update brought to you by finals

I am reading through my notes from my gender and health course and feel compelled to share some of the thoughts and facts. I'm not including citations here (I have enough school work to do as it is!) but of course if you want to know more about how I got the info just let me know! This is a pretty random list as things strike me....

HIV
HIV prevention needs to be sex positive. HIV is caused by a virus, not by sex!

As of 2009, there were approx 33.3 million people living with HIV globally. About 67% of those people live in Sub-Saharan Africa.

The prevalence (amount of people currently living with HIV) of HIV in South Africa is about 11%. 

In a state of povery and hunger, HIV prevention may not be people's priority. (And HIV can also lead to poverty, thus creating a cycle)

Gender Violence
South Africa has one of the highest rates of reported rapes in the world. Still, it's estimated that only 1 out of 20 rapes are reported (Gender Justice Research Unit).

Cervical Cancer
HPV, a sexually transmitted virus, MUST be present to have cervical cancer. In other words, 100% of women everywhere with cervical cancer have HPV. However, there are more than 100 strains of HPV, many of which are not linked to cancer. Additionally, a woman who has a cancer causing strain can clear the strain (i.e. her immune system fights it off) without cancer developing.

There is more cervical cancer prevalence in developing countries and is highest in Africa.

Prevalence of cervical cancer is 2 to 5 times higher in HIV+ women.

Maternal Health
Rates of maternal mortality are higher in Africa than elsewhere. Of the top ten countries with the worst maternal mortality rates, 9 are in Africa. 1 in 7 women for Niger, 1 in 87 for South Africa.

Estimated 60-80% of pregnancies in South Africa end in c-section. The World Health Organization recommeds a country rate of 10-15%.


Random, I know. More real udaptes soon! Finals are over June 14th, woo hoo!

Because Heather Said I Had To

Why hello there everyone! I recently tried to update, but was thwarted by blogspot's website being down. However, thanks to my friend Heather, I was reminded that I still needed a new entry.

When we last left our heroine, she was learning to drive, anticipating May homework, and complacently settling for her job.

Well, I am still learning to drive, though honestly am feeling less optimistic about it. I experienced what I'm pretty sure was an actual panic attack during an attempt to drive to the Waterfront with Thomas and have been very turned off by even the thought of driving since. I did have another lesson last week where I drove to Hout Bay and back. It was a relaxed ride, kinda what I needed to "get back on the horse," but I've neglected to schedule another lesson yet. I can't remember the last time I felt so much anxiety about something!

In happier news, I have a new serving job! I was getting more and more disasatisfied with my previous job--it was dead almost every night, staff were treated horribly, and I was having more and more shifts with this terrible manager. On Friday, I went to have a haircut with the fabulous Natalie. While she was making my hair look amazing (seriously), I vented to her about my job. When I told her where I was working she was like, "I'm sorry but that place is a DIVE," and I had to agree! After telling her about my horrible manager, she was really encouraging to get myself out of there. She told me about a few restaurants in the area where she knew the owners took care of their staff and suggested I go drop off my CV.

I left early for work so that I could stop into a few places. Well, as it turned out, the very first place I walked into had just placed an ad in the paper for a part time waitress and after the owners spoke with me for a few minutes, they hired me on the spot! It is basically an Italian restaurant, pastas and pizza, and closer to me than my previous job. I had eaten there before I knew the food was good, they got steady business, and it is a nice atmosphere (not at all a "dive"). Went to work that night and told them it would be my last evening. Hooray!

I was glad I got to say good bye to a waitress I'm friends with there, although I know I'll see her again soon (we're planning to go out one night). Just a few things about her. She is from Zimbabwe originally, but now has been living in Cape Town with her boyfriend for a year or so. Before that, they were long distance with him in Zim and they did not see each other for TWO YEARS. They are very close and when I asked her about if they wanted to get married, she said that they did, but that he did not save enough yet to pay the bride price (I'm not sure of the word used in Zimbabwe) to her family. I felt so bad for her--she expressed frustration that they were bound to that tradition even though it was not important to her or her partner, but because of her family's expectations. Their families don't even know they live together in Cape Town! However, there is a happy ending. Her partner recently got a new job where he has been making better money and she told me a couple of weeks ago that they were going to be able to get married before the end of the year! So glad for her. I can't imagine how relieved she must feel.

Anyway, back to the new job. I began training today and, while it's still just a serving job, so far it has proved to be SO MUCH better than the last place! Staff are treated kindly and with respect--each shift that you work you get a free meal and drink. The owners are a married couple, the woman being Italian South African and the man being from Italy, I believe. The woman, Carla, was there with me for most of today and she was very pleasant and helpful. You can also tell that she takes a lot of pride in the restaurant which is really refreshing. I worked with her husband a little bit before my shift ended and he was also quite pleasant. Overall, I'm very happy with the change.

School is going well. I handed in my first big paper of the month last week and felt really good about it. I'm currently working on my last paper of the semester, which is by far the most difficult. It's for the same course that I had to write the history paper. I have to discuss the causes/risk factors for homicide in South Africa and El Salvador (I chose the countries and topic) and then design public health interventions for each countries in what is essentially a fifteen page paper. Oh my. I go back and forth between feeling confident and feeling like it is next to impossible, but pretty much everyone in our class is feeling the same way. I think this might be one of the hardest courses that I take, so I'm very much looking forward to it simply being over!

No news on the thesis stuff. The Learning Network is still and option, but not set in stone. I'm putting my search on the shelf for a little bit. I also officially handed in the paperwork to be in the Health Systems track last week.

That's all of my news for now. Surely I'll be looking to do a little more procrastinating in a week or so and will write again then.

Love to the States!

Hello, hello, America!

In just a few days I'll be able to start telling people I've been living in Cape Town for three months. Wow! It does feel longer sometimes. Christmas back in the States seems very far away.

Just a brief update here. The last week has been nice. Schoolwork has really let up since the last paper (did fairly well on it!), but I'm trying to keep myself motivated so I don't procrastinate on projects. I've met with two professors about potential thesis topics. They were both very interesting and fitting to me. I've always had a difficult time making decisions, largely because I'm interested in so many things! Right now I am pursuing one of the options further, but I would like to know more before I share the details. The fantastic news: that opportunity might lead to paid work. Fingers crossed!

Which brings me to my next update, which is that I'm looking for new jobs. I've found the environment there to be very frustrating as of late. It's been slow, I don't get much support from management, and the complete lack of teamwork is really disheartening. I know I'm not perfect either, but I see ways that it would be so easy to start getting us to work as a team and simply no effort is being made. Bah! Thankfully, there is a server and a bar tender that really seem to "get" it, and they definitely make life more tolerable there. One of the managers is also quite good, but unfortunately I don't work with her most of the time. I have no idea if/when another opportunity will work out (that will actually be better) but I'm looking.

Tomorrow morning I'm meeting with the Health Systems department head to officially change my MPH track. I've given it thought, and I think it's the best route for me. So barring her talking me out of it for some reason, I should be a on the health systems track as of tomorrow! I'll explain more later what that means.

Also, the gym is going well! Feeling healthier each day. :)

I'm feeling sleepy and have an early morning tomorrow, so that's all for now. It should be a fun, full day at school tomorrow and then Thomas will be getting home tomorrow night! Very excited to show him our beautiful new couch:

Goodnight, all!

Life is Good

Hello, hello!

I am writing to you all in good spirits! The last week was certainly busy with lots of prepping and paper writing, but I handed in my first Biostats assignment and turned in a major paper for my Gender and Health course which was a gender analysis of rape in South Africa. I put a lot of reading, note taking, and thought into the paper and am pretty proud of the work I did. We'll see what the professor thinks though! Regardless of the mark, I certainly learned a lot from the research process.

Although I am giving myself a bit of a break, I don't want to lose momentum. I have two more big papers due at the end of May. One will be on homicide in South Africa and El Salvador and the other I still need to choose a final topic for, but will be an evaluation of how gender sensitive a program is. Although I won't be turning in my mini-dissertation until the end of next year, I decided to contact some people doing research at UCT to learn about what they are doing and see if it might be appropriate for my project. Hopefully at least one of them gets back to me with interest. Will let y'all know if something pans out!

As per usual I am changing my mind often about what I want to do with my degree when I graduate. Currently, I've been thinking a lot about ways to improve health services, both for staff and patients. A friend of mine used to be a nurse here and actually changed careers because she became so frustrated with the system and barriers to giving good care. We also did a class on childbirth in South Africa last week and talked a lot about patient abuse and neglect in that setting, something that also came up in the abortion lecture and likely exists in other health care settings as well. They are such large problems that it is hard to know where to begin to address them, but it would something I would certainly be interested in dedicating my career to. Of course science and medicine are incredibly important, but why deliver those services without treating patients with dignity and care? And isn't mistreatment detrimental to health outcomes (well actually, I don't know, will have to look into what research has been done)? These are things I would be interested in further examining not only in South Africa but in the U.S. as well.

As for my social life, it's doing well! Thursday night an MPHer from Italy, Annibale, had a group of us over for "International Dinner" night. We were all supposed to bring a dish from our culture. Well, I didn't have time to even attempt cooking something, so I bought an apple tart (closest thing I could find to apple pie, one of the few dishes I could associate with America!) and ice cream. I was glad it was the only dessert and folks seemed to enjoy it. We also had guacamole, curry, lentil rice, AWESOME pasta, and arepas (by Federico and Nany, los colombianos). And of course, lots of wine. :) It was really nice to spend more time with the MPHers outside of class to just talk and enjoy delicious food. We all agreed it should happen again soon.

Saturday was the night of the birthday party my customers invited me to. They are a really friendly group, so I figured why not, but didn't know what to expect. I had no reason to be nervous as everyone at the party were just as warm and welcoming as my regulars. It was quite the fun event that I could go on in detail about....summarized version: amazing spicy seafood curry, monk cleansing the house, one of my adorable regulars, Shane, regailing us with Whitney Houston songs (amazing coming out of a boy!), Dutch lesson from folks from the Netherlands and, once again, lots of good wine! I also met one of Shane's friends who works for Desmond Tutu HIV Foundation and has been working on the research that shows ARV treatment can prevent HIV infection in those uninfected--kinda like meeting a local rock star, imho!

I was torn about whether to leave such a fun gathering, but headed out a little after midnight to catch up with some MPHers out for a lady's night in town. From there, I decided to go dancing with Eliana at a place called DecoDance, which she always talks about. It's a more expensive cab ride for me, but it was a really fun time--they play a lot of hits from the '80s and '90s and we really enjoyed ourselves. It felt to get out and dance after all of that paper writing!

I guess the last update is that I LOVE my gym! I met with one of their staff on Friday and she helped me with an exercise plan. This is SO hopefully for me because I am a planner and really need structure for motivation. I'm planning on doing yoga once a week in addition to my regular workouts, and will probably be checking out a dance class on Saturday. There is also a yummy smoothie place in the gym, so I treated myself today. They have those frequent buyer cards and if you buy a smoothie on a Monday you get two stickers instead of one. So I've decided that for each week a stick to my workout plan, I will reward myself the following Monday with a smoothie!

Oh and Thomas is wonderful. :) He's away again for two weeks but I have a lot of good things going for me to keep me busy til he gets back. Our couch should be arriving in a little over week which, speaking for both of us, we are super excited about! He also got us a coffee table and microwave, so once the couch arrives we'll be pretty settled in.

I can't delude myself into believing I'm never going to feel homesick again, but my first wave has passed and I am soaking up the sun and loving life here. I think part of what was helpful was to begin planning my visit home in the winter--hopefully I'll be back in time for Thanksgiving!

That's all for now. Remember, I have skype at home now, so get in touch with me if you want to have a chat! Sundays are best for me, usually.

Love y'all,
Kristen

The Abortion Entry

If you know me well, you knew this was coming. Maybe you didn't know it was coming. This post isn't meant to be controversial in anyway or start up moral debates.

On Tuesday we had a lecture on abortion in South Africa in my Gender and Health course. Prior to the class, we read two studies that the guest speaker, Jane Harries, had conducted: one on health workers' attitudes on abortion and the other on delays in seeking abortion until the second trimester. She also recently did another study but is having trouble finding a publisher. As one might imagine, it can be difficult for researchers to receive support in examining abortion.

It's impossible to cover everything that I learned in one entry, so I'll try to summarize my thoughts (all of the info is coming from her presentation and studies. Email me if you want more detailed info). First of all, South Africa has some of the most liberal abortion legislation in the world. This is a recent development that occurred in 1996; prior to that it was very restricted. Most of the rest of African nations still have very restrictive laws on abortion, which leads to unsafe, illegal abortions. Approximately 68,000 women die every year from illegal abortion and many more are injured, often permanently. Keep in mind that abortion is an extremely safe procedure when done in a legitimate medical setting, so the liberal laws in South Africa have saved thousands of lives. Abortion is available on demand in the first trimester of pregnancy, though it is more restricted in the second trimester (only for pregnancies resulting from rape or incest, fetal abnormality, life threat to the woman carrying, or if the woman can prove low income status). Abortions are also FREE in the public sector. Yes, free! In the U.S, first trimester abortions cost about $300-$700 depending on where you are, and second trimester procedures can be $2000-3000. Something else exciting is that "mid-level" providers, such as midwives, are allowed to perform first trimester abortions here with MVA. (By the way, abortion rights are increasingly under attack in the U.S. If you'd like to learn more and support abortion access in the U.S., please click here).

Something surprising was the high percentage of South African abortions that occur in the second trimester. Later term abortions are relatively rare in the States, but here they account for 20+% of all abortions. Harries' study on delays in seeking abortion covered most of the same issues I've heard from women back home, so I haven't drawn a conclusion myself for why there are more delays here.

Probably the biggest shock for me was that medication abortion is very commonly used for second trimester procedures. Back home, it was offered to nine weeks at the latest, and to seven weeks in the FDA approved version. Here, a woman in the second trimester can be admitted to a hospital, administered medication, and then waits it out until she passes the pregnancy. To me, I can only imagine that that is a very difficult, painful (physically and emotionally) process for the woman. I would really love to see a study on women's experiences of second trimester medication abortion (I believe that is what Harries' latest study examines, so I am going to try and get my hands on it!).

Overall, despite the liberal legislation, there are certainly problems with the implementation. When the most recent legislation came out in the nineties, very few doctors were trained or prepared to offer abortion services. Also, the stigma of abortion often keeps providers from getting training even when they are seeking it out. Most disheartening to me was to hear that there isn't much pre or post abortion counseling being given to clients, and that includes contraceptive counseling. I wish there were some type of organization to offer these services, even outside of the clinic setting, like CHOICE or Exhale back home. Giving women safe spaces to discuss their health, particularly with a professional, is something that I am very passionate about. I wish I could find away to be involved with such initiatives here.

I'm going to leave the abortion portion of this entry there. But if you have questions or want more info, leave it in the comments or email me (disrespectful anti comments will be removed, so please show courtesy!).

Some updates in addition to all of that...we now have home internet (thank you, Thomas)! Schedule your skype call with me when you have time!

I've been a bit of a hermit this weekend after a bunch of classmates and I went out on Thursday to celebrate handing in our first paper. Tonight, I am going with my friends Bob and Ozie to some type of church gala dinner thingy. I have no idea what religion it's for, so it could be interesting! But it should be fun. Tomorrow night, Thomas gets home for a couple of days (yay!), so we're planning on possibly going to beach and also going out with the MPHers on Monday. I'm also going to try to persuade him that we should buy our couch this week!

Missing y'all!

Thar She Blows!

Hello folks,

Oh what a day. This morning, while the Telecom guy was here to install our internet (hooray! however, we won’t be totally up and running for at least a couple more days), the wind blew one of our balcony doors open (which were locked, by the way) and shattered the glass in one of the four doors. At the time, I was downstairs letting the guy out to check the box. At the sound of broken glass, I went upstairs to discover it!

The wind has been very, very strong since last night. I was loving it since we finally had a nice, cool evening, but obviously this is the downside. I have to say, our landlord was amazing about it—it’s already repaired. Phew. I couldn’t figure out what actually broke the glass, but the repair guy said very likely it was just a direct result of the wind. Geez.

Otherwise, it’s been an uneventful week. Studying, catching up on laundry, etc.

 I finally started that dreaded history paper and have a decent chunk complete. To prep, I read some of our professor’s (Howard Phillips) book UCT: The Formative Years. It was actually a really interesting read, especially as a student. When UCT first started training doctors, they were only able to provide the first year of medical school and then students would travel overseas to complete their studies. In 1920, they were able to offer the full program for the first time. It was soon evident that class rooms and clinical space were too limited for the amount of students training, so in the late ‘20s, they moved to a new Health Sciences campus in Observatory, which is where I take classes now! They also built Groote Schuur Hospital specially to be a University hospital, which I didn’t know. It was finished in 1938. I had thought the hospital was older than that.

Something else really interesting (and horrifying) was that originally Indian and Colored (people of mixed race) medical students were forced to complete clinical trainings abroad, as they were not to work in white wards. No one in the faculty really spoke up about it, because it was thought breaking that rule would place the medical program in jeopardy. Because of WWII, in 1943 Indian and Colored students were allowed to do clinical in Groote Schuur, but they weren’t allowed to see White patients—even if they were deceased! Seriously?! Seriously. And even that policy was thought of as liberal! His book says the policy continued until the 1960s, but I’m not sure what changes were put in place then.

Another interesting thing we learned in class was how the outbreak of the bubonic plague at the beginning of the twentieth century followed by the flu outbreak of 1918 (which was devastating…dead bodies in the streets, etc.) led to some of the first racially segregated living. The plague was blamed on dock workers (of color) for bringing it in with their cargo and they were driven out of Cape Town. A similar thing happened in 1918, especially because more and more Black residents were arriving.

I should totally get an A in this class, right? J

I’m working on some Epidemiology right now, since I had to miss class today for the repairs (thankfully this professor had made it very clear that it’s okay to miss class if we need to). Hopefully I’ll be posting this in an hour or so since my plan is to head to Sidewalk Café for dinner and internet! (actually, Sidewalk's internet cut out while I was there, probably due to the wind? So I'm posting this a day late, from another Vredehoek cafe with free internet that I recently discovered).

I’ve been spending so much time alone, it’s strange. Definitely missing my friends and family back home. <3

The Life!

Things are looking even more up since last I wrote!

Firstly, Thomas is home! He is in the other room doing his ironing as I type this. I get a weird joy out of doing normal things with him. Cooking and eating dinner, watching TV, being here when he gets home (or vice versa) is a beautiful kind of normal that we've never had before. Yesterday we went shopping and got some much needed things for our kitchen. Today's task is trying to figure out space for our (ahem, his) clothing. A pretty lazy Sunday before I begin Biostatistics tomorrow!

Last week was a good one at school. Monday began the block of Public Health and Society. This was a course I wasn't too interested in taking initially, but it's required, and I'm glad that it is! The three days we had were taught by health historian, so we studied definitions of public health from different time periods and also important health documents from South Africa. It really helped to contextualized where we are coming from and where we are going. Our first assignment is to do a comparison of different syllabuses of different time periods for public health at UCT. Hmm should be interesting!

On Wednesday, I went out to lunch with a few people from class: Kim and Whitney from the States, Yas from Swaziland (now a South African permanent resident through marriage), Federico from Colombia, and Bob from Swaziland. They're some of my favorite people I've met so far, so it was nice to spend more time with them. We also had a delicious lunch at a health food place. I had the most amazing mushroom and potato pie and fruit smoothie.

I also broke down Wednesday and finally started an antibiotic for my sickness. It seems to have done the trick, I'm feeling better everyday!

As I mentioned before, I was without internet for a week, but I should be more available in the coming week. Thomas and I are also talking about getting a different type of internet so that I will have it at home all of the time. Hopefully coming soon!

My days off (Thursday and Friday) were eaten by necessary repairs to our apartment. However, I now have a working front gate and no hole in the bedroom ceiling! It also gave me a chance to read. I just finished A Widow For One Year by John Irving, which Jennifer recommended to me. A wonderful book, I highly recommend it if you're looking for some well told fiction! I did also attempt to open my bank account on Friday, but they weren't happy with my proof of address. Hopefully I'll have it sorted out by the end of this week.

Excited for the coming week: intrigued to see what biostat is like (I'm thinking I will enjoy it, but eight hours a day for three days might be a bit much), and then Thomas, his sister Louise, and I are going to see Imogen Heap on Saturday! Absolutely cannot wait. Her music has been a part of our relationship for a long time (we bought and listened to her first solo album together in 2007) and I love her music. Check it out.

Time to get back to organizing. Hope to hear from y'all soon. Love!

January 23, 2011

Hi folks!

Unfortunately, I have been without internet for a week now! I wrote this last week but am only able to post now. Enjoy!

I have made it through my first week of block classes and am preparing for my second tomorrow. I am still surviving off of Sudafed, though on the whole I am feeling largely better besides a pesky cough that crops up here and there. 

Once I was feeling better, I immensely enjoyed my Gender and Health course! We had several guest lecturers which helped the long days go by more quickly. For a few years now, I have been on the 60percent listserv, which is based out of UCT and provides information about women and HIV (the name comes from the disproportionate ratio of women who have HIV vs men). Some of the guest lecturers were names I have seen before on that listserv that I am now finally meeting in person!  I also received a lecture on rape in South Africa by a woman whose book I own. Very exciting!

I am hoping to possibly intern with one of the organizations that provided guest lecturers. One is the Ivan Toms (health4men.co.za) health clinic, which works predominantly with men who have sex with men (MSM) and the other is Sonke Gender Justice, which is a larger organization working mostly changing the attitudes and understandings of men to achieve gender equality. I’ve really been on a kick lately for working with men and masculinities, so I’m thrilled there might be some opportunities with these organizations.

I have also been trying to make friends with my classmates. The Americans are nice, but I am also getting to know some of the South African (and other international students) as well. No bosom friends yet, but these things take time.

Getting home from school continues to be interesting. I have three different options, all of which are fine for now. The difficulty will be determining which is safest once the days are longer and I finish class when it is dark.

This weekend I had a visit from Thomas’ dad, Walter, as he was kind enough to drive Thomas’ car down after it was serviced in Durban. Overall, we had a good time. Last night we went out with some of his friends from the UK and we got home later than I normally would—those party animals! Today we went up to Signal Hill (which I am currently looking at out my window) to take some pictures of the City Bowl and harbor and then went to his Godfather’s son’s, Hans, home for tea. He and his wife Julia had a beautiful home. It was just stunning!

Tomorrow, Thomas will be home for a couple of hours before leaving for another job (fingers crossed that he will be able to pick me up from class so we can have a few minutes together!). However, I will have him home for about a week starting on Saturday. Monday-Wednesday I will have block class days of my next course, Public Health and Society, which is a compulsory course. My biggest goal for Thursday is to open a local bank account and then I will begin applying for jobs.

Home is beginning to feel further away. I can’t say that I’m sad here, but I am missing you all!

Too School for Cool

Hello friends!

I've just completed my second day of orientation, and overall I am very pleased!

I managed to register on my first day (which is quite the success after the hoops I jumped through at UKZN). It was a little tricky. Once my form was filled out, I discovered I need to register as an international student first. With the help of another international from California, Eliana, I was able to hop on the shuttle to another campus, get to the office, do what I needed (special thanks to the awesome desk worker who let me print off her computer despite the rules), and get back to the health sciences campus before long. There was still a problem with registering which made me a little late to part two of registration, but it's all sorted now.

The way the MPH program works is that each course begins with three block days, each from 8:30 to 4. Sounds awful, right? The trade off is that for the rest of the semester you only go to each course for two hours every two weeks. I go back and forth between how I feel about this, but I think it might work well, especially when I find a job.

I'm registered for four courses this semester (although they make you register for the first and second semesters at the beginning of the year): Public Health and Society (required), Intro to Epidemiology (required), Biostatistics 1 (may be required depending on my track), and Gender and Health (elective). I start my three day block for Gender and Health tomorrow, with some misgivings since it is being taught by a professor with a psych background, not a sociology background...we'll see how that goes.

As of now, I am registered in the "General" track for the MPH. There are five: General, Epidemiology, Health Economics, Clinical, and Health Systems. The Health Systems track is brand new, and actually was not available while I was applying. I am considering switching to that track, but decided to put off that decision until the end of the semester. Any thoughts from other MPHers out there? Biostatistics is not required in the Health Systems track, but I decided I definitely wanted to take it either way. Plus, I want to get a little taste of everything my first semester so that I can figure what I gravitate towards and am skilled in. I loved my intro to stat course I took over the summer, so maybe I'll love Biostat, too. Or figure out that I hate it. :) But either way, it's a skill I'd like to have.

Orientation has given me a chance to meet a variety of people. I've been trying to be friendly and introduce myself while also branching out and sitting with different folks once I've become friendly with others. I love being in this program, because we all have similar interests, yet enough variety to keep things interesting. There are a lot of doctors, but also plenty of folks like me without other medical degrees.

I've been trying to step out of my bubble and not gravitate towards Americans, but I have become friends (if you can call it that after two days) with two: Eliana (see above) and Phumelele. Eliana and I are too similar to not talk to each other--we both have backgrounds in reproductive health care and she did a "honors year" in gender studies at the African Gender Institute here at UCT last year (a program I was looking at for a while). Since she's been living here for a year, she has some good information, though she is also a bit tied up in her work, it seems. Phumelele is interesting because although she has a South African name (her mom is Zulu), she has an American accent since she mostly grew up in Pennsylvania and is a duel citizen. She is very outgoing and also has been living here a few months longer than me, working on campus.

I have been successful in meeting folks from South Africa as well,
including Malrich (not sure if that's spelling right) who was kind enough to drive me home last night since they provided us with a dinner in the evening, too late for me to take transportation besides a cab. I have also chatted with classmates from Germany and Colombia, and have classmates from the UK, Canada, Zambia, Namibia, DRC, Zimbabwe, and still more places!

Perhaps I should knock on wood, but taking transportation has been working out quite well. I take a taxi (basically a minibus taken as a group that follows a semi-set route) into town, which is super easy and cheap. Then I get on a city bus, which drops me off at Groote Schuur Hospital. From there, it is about a ten minute walk to the Health Sciences campus, which is where all of my classes are. Driving would probably be shorter, but at least I don't have to deal with the EXTREMELY limited parking at UCT! It's been a long time since I've lived in a new place, so it's funny to remember what that's like--learning to sit on the right side of the bus in the morning to be out of the sun, where your stops are, that sort of thing.

I had a very productive day between orientation, shopping, and having our landlord come by to see about fixing a couple of things. I bought some food, but I'm thinking I may need a pan for the oven (or at least some tin foil) to cook what I'd like. So I'll either save it for tomorrow, or treat myself to some pasta. As I said, tomorrow is the first day of classes, so I'll probably just do some leisure reading tonight before the homework starts up!

Hope all is well on that side! Until next time...

Visa, check. One week til take off!

Hello everyone, and welcome to my blog. I'll be updating here for the next two years while attending the University of Cape Town (UCT) and completing a Masters in Public Health (MPH).

The primary purpose of this blog is to keep in touch with friends and family back in the States. I will, thankfully, be living with one of my best friends and partner, Thomas, after spending three years in different countries. This is both of our first times living in Cape Town, so he'll be the only person I know there when I move. I'll certainly be missing you all!

If you followed my blog from when I was living in Durban and attending the University of KwaZulu-Natal (UKZN) for four months in 2007  ( you can read it here), you might remember that my posts came rather irregularly. I am following the lead of my friend Ashley whom did weekly updates while completing her Masters in England. Once I decide on a good weekly time in my new routine, I'll let y'all know when to expect posts. I should have fairly reliable internet to keep up.

The name of my blog came originally from reading one of my favorite quotes (from Rubyfruit Jungle), but it's coming to have a little more meaning for me. Sometimes I feel a little bit like a cliche--young American woman wanting to change the world, heading abroad to learn about HIV in Sub-Saharan Africa (HIV/AIDS won't necessarily be my focus, though I certainly have a strong interest in it). However, I like to think that this decision is being made for many good reasons and that I have my head on straight going into it. If I have time, I'll write another post this week about the "why" of going to UCT.

The list below my blog title (top of the page) summarizes what I plan on addressing on here. Admittedly, many of my posts might be quite mundane, just catching up. I hope to also reflect on what I learn about public health, the challenges of finding employment and a niche in the feminist scene, and of course my stumbling through South African culture. :) For Thomas' sake, I won't delve too deeply into our relationship on here, although I think addressing the joys and challenges of going from open long distance to living together is certainly an important piece of the next two years.

I'd like to have a bit of fun with this blog, so enjoy! To your right you can visit my virtual pet fish and below them is a little survey--answer it, why not! Comments are welcome on all posts. Anonymous comments are fine, but please put your first name at the end (if you're comfortable) so that I can think of you and respond!

My visa and passport finally returned home to me today, so it looks like after three years of thinking about it and eight months of intensely preparing for it, this is really happening. Here we go!