More Clinics

You'll never guess what I did today. Yup, more clinic tours. Actually we went to the ambulance center today. It's not an emergency room, but it's where all the emergency personel leave from to go to pick up people in the ambulances. They have 5 teams of 3-4 persons each. Consisting of a doctor, a nurse, and a driver. They have at least one four wheel drive van for winter. We rode inside on and it was pretty similar to ours except that there were no IV stands or oxygen tanks, just an empty van with 2 seats and a stretcher. All their medical supplies are put together in metal toolbox kits. They have radio contact with the command center where we were, but they take the sick people to the hospital according to diagnosis, and only if they need to be hospitalized actually.
From there we went to the city hospital which was in a bit better shape except for the remodeling they were doing. My favorite thing about it was their oxygen system... It comes through little pipes! One for each bed and they just turn a nob and attach a measuring maching to regulate the flow and that's it! There is a big oxygen tank outside that supplies them! I asked them if they ever had any problems with the oxygen running out and they said no.
Now a few funny side notes:
1. Russians make good use of their small apartments. Ours has three rooms. One is exclusively the parents bedroom. The other two are a family room and study. The "study" is my bedroom. Guess what the couch in there doubles as? Yup my bed. I just take the back cushions off and spread my sheets and blankets out and voila! Then in the morning I have to fold them up and put them back away.
2. Last night we had fish... Not very cooked either. I think it was salted and smoked or something? It tasted a little like salmon, but didn't look like it. I thought that for sure my head would be in the toilet by the time dinner was over... But I survived with only mild digestion problems. I am sure that I will need to be treated for mercury poisoning when I get home though... We were never allowed to eat fish as missionaries.
3. The reason that my host mom said we needed to eat the fish is because there is no vitamin D in the milk here and you can only get it from fish and the sun.... Also the iodine is in certain types of bread here, not in the salt.

rushing again

I will write a quick explanation. Yesterday’s blog entries were probably a little cryptic. By the time they finally fixed the internet my host family was waiting for me in the car. So I just pasted in what I had written the last few days and left. I had so many nice letters in my mailbox and I didn’t have time to answer any of them, but I will try to send you all individual letters as time permits. The internet guy is not here this morning and so I am again writing a message on one computer while waiting to be able to use the other computer.I should add something about the 15 hour train ride that happened between the Moscow entry and the one after it. We were in a 4 person sleeper car. It was just Tracey, a Russian guy and me. The guy turned out to be very friendly and we chatted until about 10 pm while Tracey was sleeping off the Vodka party she and some others in our group had had the night before. I slept pretty well in my sleeping bag liner.The train was only scheduled to stop for 2 minutes in Chapaevsk—that gives you some indication of the size of the town J We made sure that we were ready to jump out before it stopped.Yesterday we went around to all of the different clinics along this street which, kak raz, is called medical street. We went to the AIDS testing center and to the laboratory where they do the first blood analysis. If they test positive, then they have to give more blood and to send it to Samara for a confirmatory diagnosis. They also test for hep A&B and other STDs there in the lab. They are building a nice new looking children’s hospital across the street, but in the mean time they are really “roughing” it, even by Russian standards, as far as their amenities go.A few really impressive things came up about their system here in Chapaevsk. One is that they are able to keep people’s HIV status confidential. They do not have a separate clinic for the HIV positive people to receive medical treatment and HIV positive people are apparently not experience the same medical discrimination as those I read about in St. Petersburg. I think that this has everything to do with the dynamic group of doctors with whom I am working. Also, I think that the size of the town allows them to move programs into action pretty quickly. The second thing, which is actually almost too surprising to be true is that so far all of the pregnant mothers with HIV/AIDS have received ARVs and since their program started no babies have been born with HIV. They still have don’t have the technology available to confirm that babies are not HIV positive until they are 18 months old. I need to go around to tour some more clinics again today. Next week we will start working in/with each of the clinics on a more individual basis.Just a little more about the rest of today. We went to the drug rehabilitation clinic today and talked with some drug addicts who are receiving treatment. It was really interesting to hear them talk about methadone... They know that it exists and they were asking us why the doctors there don't give it to them. Tough situation. The Russian government doesn't allow methodone treatment at all. They seemed pretty satisfied with the treatment that they were getting in other ways... The doctors do give them some other drug substitutes to ease the transition, but nothing even close to as strong as methodone. But they receive free treatment unless they want to remain anonymous... Yes there is a special room cordonned off for the people in rehab who want their efforts to remain "anonymous" and are willing to pay for it. Anonymous AIDS tests are also more expensive than the ones where you give your name etc. I think that the fees are just to discourage them from anonimity. It's not as though their files were any less confidential... It's pretty sad. They are basicly just there taking a break from drugs for as long as they can manage, they all said that they were sure that they would start using again soon after they got out of rehab.Then we went to a technical school to talk about AIDS with a class of future auto mechanics. (a high risk group). Their understanding and reactions were pretty similar to what you would see in the US. The major difference is the focus on Narcotics (IV drug use) as the main risk factor... Whereas in the US it's more focused around sex.

all that I haven' t been able to send

Well, today is Sunday, but we had class all day anyway. Well, that is to say until 4pm. I was in the higher level language class and felt good about my pronunciation & reading. (We had a poem that we had to read out loud today- homework from yesterday). But I have forgotten the grammar almost completely. It’s so much harder than French where I can just sort of feel if it sounds right or not. I guess it would have been better if I had learned from native Russian speakers more at the beginning of my mission.
The nice elderly teacher was funny and made us come out of our comfort zones with grammar and oral exercises. I also thought that here explainations of the history of the words and their roots etc was extremely interesting and helpful.
More than anything I am excited to get out of this big American herd and into a real Russian family for the next 2 months. I can’t get my groove back until then.

the next days
This is the second blog entry that I will just be typing to send off at some point. The internet here is still not working. “Soon” they say—we’ll see. Chapaevsk is a VERY small town of 70,000 people. Smaller than any town that I was in on my mission. There is no internet café… That I can see so far. Very few shops… and yet they seem to have a fairly well organized program. Yesterday we met in a round table with all of the organizations involved in the medical association and also in some way or another with AIDS prevention and care. I recorded the meeting and tour of the health clinic on my little digital player. I think that I will have Pasha or Alla transcribe and translate it for me so that for research purposes I can say that it was done by a professional.
I have a “chauffer” here. They haven’t showed me anything about the bus system yet. I am supposed to get that tonight. In the mean time the medical associations driver has beeen taking me back and forth.
I went to see a soccer game last night in which several male members of the medical association were playing. It was fun except for the mosquitoes. Then I saw them at home again after that… I guess because of the river they are everywhere around here. 
And I have to say that I feel like I am 16 or so again at my host family. They don’t get that I am independent. Now they are responsible for me and so they seem to be very careful and protective. Going to Ufa is a big deal for them and I will have to work with them to see when it is convenient for them. Whereas I of course thought that I would just plan it with my bosses and then just take public transportation to the train… Here we see clear examples of the American independence vs. the social interdependence of the Russians I guess… and I have always been extra-independent myself I guess.
The water is turned off today. At least it’s not the electricity. I am staying in a different family than the one they gave me information about. They switched our two families. The other family has a computer with internet and a dog. My family has a cat and a broken computer.
Also I tried to put a Russian sim card in my phone instead of my at&t one and there is some kind of extra company protective code. Great. Not surprising. Why would they want me to be able to switch out sim cards and not have to pay their outrageous 6$ an hour charges. So I am trying to decide either to rent or buy a Russian cell phone. I wonder if my ATT card would work in it??

Funny Things

I keep forgetting to write about the funny little happenings here... They make a blog more interesting to read I think. So here are a few things:
1. I forgot that the heat does not get turned on in Russia until October 15 th or so. My bedroom in the dormitory is freezing at night! My travel alarm clock says that it is 65 F, but I think it feels colder than that. I am so glad that I brought my sleeping bag liner!
2. Yesterday night when I was walking back to a metro stop from Red Square I was going around some cars and I hit my head on a metal billboard! Now I have a nice little goose egg plus scab.
3. This actually a bit scary- Also as we were walking home from the metro (it was close to midnight) we passed these two guys drinking beer in a parked car. We started to walk a little faster. Then about 5 minutes later they drove up and parked near where we were walking. We just kep walking and I got out my key chain alarm. Nothing happened of course. I think they were just checking us out.
4. One of our speakers, a representative from the state dept. also served in some parts of my mission in the early 1990s. Small world... or it could also be said missions are doors to other opportunities.
5. I don't know if anyone remembers form my mission, but there is only one main color of TP in Russia - Pink!! I have recently seen some with just the color of recycled paper... But that was a first.
6. Every time I go in or out of the dorm bldg I have to show a permission card and then get beeped through a turnstyle. Sort of like the metro. There is always a gueard on duty. At least it makes me feel safe.

Slow Internet connection

This has been such a painful internet visit. I had to fix the cookie blocker on this computer so that this would work. THen it takes a million year to load anything. Good thing I had to buy a 45 minute pass.
I am currently under Red Square in the huge mall called "ohotny ryad". It's very western. One of the many reasons that I like the regions better than Moscow. Today we had some really informative discussions with people from AFEW, Russia's People living with AIDS group, the Trans atlantic partnership Against AIDS, and the Russian Union of youth. It's great to be here learning about how their programs are working. Especially since their is so little documentation of them outside of Russia. The government stats about AIDS are of course skewed to be substantially lower than the actual burden of the disease. I hope they don't shut down my site for saying that :) The media in Russia is just barely starting to open up to the idea of using public health advertisements. I got a CD rom of the latest set of commercials that TPAA made for TV. They will be useful for my health communications class.
I am having serious phone issues. I bought a phone card, but it is just a long distance card. To use a pay phone I first have to find a Taxaphone Card and so far I have tried all the kiosk at three different metro stops and ALL of them are sold out!! SO today I was able to borrow the GRINT office phone to use my phone card on to call Lincoln. Also this long distance card that I bought will not work on phone outside of Moscow or St. Petersburg. Fabulous.
Tonight we went out to get Georgian cuisine. I had this harmless looking Georgian Salad that I think was seasoned with hot pepper juice or something. Spicyness! I also had shashliki which are a lot like shishkabobs. They were good.
I am trying to enjoy everything. This is going to be such a quick trip compared to my mission. I am so happy to be here! :)

Moscow

I am here. I need to write first about yesterday at the Russian Embassy dinner though. I was talking with one of the Russian girls and she all of the sudden said that she wasn't feeling well. I put my arm around her so that I could help her out to the couches. She started to sway and the color drained out of her face. Then she fainted and I had to catch her! It was pretty scary. The embassy has their own doctor I guess so they sent for him and of course by the time he got there some people had already carried her out to the couch and she was feeling a little bit better.
The flight was okay. I hate not having a window seat. My neck is little kinked and I am still a bit groggy from the time change, but I am here :)
My first impression is that of familiarity. I feel pretty comfortable with my surroundings and the language. It has brought back some memories and a lot of feelings from my mission. The main one being that I love Russians. Their country (urban areas) is pretty grey and dirty, but they are so welcoming and friendly.
We just had lunch at the cafeteria. I had Borsh, peroshki, and crab salad. Not as good as some babushki made for me before, but tasty for a cafeteria style lunch. I forgot how much I love their black bread too.
We are staying in the dorms here at the humanitarian university and will be here until Monday morning.

Orientation

Yesterday I got up at 6:30 am so I would be able to leave by 7:30 to take the metro 45 minutes all the way down to GWU only spend another 30 minutes on the shuttle to George Town and arrive exactly on time at 9 am for the opening remarks. Not that driving down there in traffic would have been any faster.
The welcome, going over schedules that I already received via email, and discussions on the history of American volunteerism were interesting, but I felt like it was a waste of time when I have so many other more pressing things to work on. We met up with the Russian volunteers for lunch and then things got a lot more interesting. I forgot how exhausting the translating and speaking a foreign language are at first!
We were all excited to meet each other. After lunch we met up in the lobby to go to Rock Creek Park for "team building exercises"-- which I think is not the best name for it... Since we as teams won't be working together after this. But it was a beautiful humid 85 degree day and I love playing outside. We divided into smaller groups and then went around to the various challenges. I love games like this where you brainstorm, work together and then trouble shoot. It's nice when it's something more tangible than a public health program. One game was getting everyone through a differnt hole in a giant spider web without them touching- you could only use each hole once & some were high up. We had to plan for the last people to have ways of getting through without anyone to lift them etc. I love a good challenge.
After we spent four hours playing outside some of us decided to meet up and go down to this great Ethiopian restaurant that I had heard about. :) It's called Zed's. It was so much fun! We were all stuffing ourselves using our hands (I passed around my package of antibacterial handwipes first of course) and the spongy flat bread, passing around the big platter that all of the foods we ordered were piled on. By the end of dinner it was past 8pm and I headed back down to the metro for the ride home.

A little more information

I have been emailing the daughter of the family that I will be staying with. Her name is Irina. She is a student. I am not sure whether she is in High School or college. Only her parents, her and their dog (Rikky) live in the 3 bedroom apartment... That is pretty unusual for there to be no other grandparents or aunts and uncles living in the house. I assume that means that they are fairly well off. She also responds pretty quickly to my emails and I think that they may have email or at least a computer at their house. :)
Ira (the friend version of "irina") seems sweet and has a pretty good understanding of english. Although most of her messages are pretty short. I am looking forward to having a friendly host sister.

More improvements

With just the tiniest bit of help :) I finally managed to add something to the side bar of my blog- Please notice the new "Blogs I Read" links... Only two for now... I guess that I don't have many friends with blogs.

Tricky Policies

I had a discussion with one of USAID's gurus of Eastern Europe about the needle exchange part of my internship (working with IV drug users) and what was allowed under USAID policy. Everytime I mention it to USAID people they say that's something I definitely need to be careful of - not doing something against the policy. Anyway, here is part of the response I got back from the guru... You'll see how tricky it is.

HIV/AIDS Prevention Programs for Injecting Drug Users (IDUs): USAID is committed to supporting effective strategies to prevent the spread of the HIV/AIDS pandemic by injecting drug users. However, USG policy is not to use federal funds for the purchase or distribution of injection equipment (needles and syringes) for injecting illegal drugs. Therefore, USAID funds may not be used to purchase commodities to be used in either a needle/syringe exchange program or research programs on needle/syringe exchange. See the Administrator’s December 30, 2002 cable (State 267675).
Many other activities targeting IDU and HIV/AIDS reduction are acceptable in a USAID-funded program. Examples include the following:
Providing factual information about the medical risks associated with the sharing or re-use of needles, syringes, and other drug equipment; ! ! !
Supporting certain program components of a comprehensive risk reduction program, including but not limited to community outreach;
Educating about the risks of injecting drugs and sharing needles;
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Referring to health care and drug treatment services for IDUs; ! ! ! ! !
Counseling and testing;
Condom purchase and distribution;
Substance abuse treatment; and
Safe sex education.

It's still hard to tell if handing out siringes that I in no way used USAID's money to purchase is going to be allowed?? At least that's only one part of my internship activities. I probably am worrying too much. I just wanted to see if anyone else understood this better than me.

How to Reach Me in Russia

I just received this information about the apartment/family that I will be living with. Please keep in mind I won't actually be there until September 27th. Before that I will be having an orientation in Moscow. The time difference is 9 hours later than EST.

Phone: 8-84639-2-5323
Host(s)/landlord/landlady: Olga Nikolayevna, the Dremovs
Brief description (number of rooms, facilities, location, etc.):
A five-storey building, a three-room apartment is on the first floor. The volunteer will have a separate room, weekdays - breakfasts and dinners provided, weekends – breakfasts, lunch and dinners. There lives a pet-dog in the house.

I hope the dog is cute and not too smelly! I'm also excited to eat so many russian-made meals. It was not something I really got to do very often on my mission :)

Progress

Well, I figured out that the picture was not working because the file was too big so I compressed it, but now the little version is blurry... ??? Shouldn't smaller make it sharper not blurrier?

Here I am 

Technical Difficulties

Umm I thought that I posted the URL for this picture so that it would go into my profile box, but yet again, not quite saavy enough to get this blog just right. Will keep trying though...

Test Post #1

Having promised EVERYONE I know that I will "keep in touch" while I am away on my internship, I am attempting make this blog. Now to see if it's working....