Friday, February 27, 2009

Jeg snakker litt norsk

Hei hei!

The good news (and in some ways bad news) is that we have had our first signs of the weather to come- we have had a very warm week, with temperatures hovering near 0 degrees for the last few days. There is still plenty of snow, but a lot has melted. We have to hope it doesn't suddenly get cold again, as it will get very icy if that were to happen.

I'm now well into my pediatric rotation, having spent time on the wards, in the NICU and at outpatient clinics. Next week I'm off to health care centres where they do well-baby exams. These are not at the hospital I've been assigned to, but are out in the community. Interestingly, I also spent some time in 'emergency' on Tuesday, but it was not as interesting as I had hoped. Firstly, being winter, every child had a viral respiratory tract infection. Secondly, all patients must attend an after hours clinic in the centre of Oslo before being sent to the unit I was in. Thus, they are sort of triaged as to whether they can be managed in the clinic or in the hospital. Finally, there is also a separate emergency department for surgical emergencies (eg appendicitis) and trauma cases, meaning that the unit I was in was ghost-like quiet for several of the hours I was there. It's been interesting going on the wards as there's such an emphasis on cleanliness, eg the first thing doctors say to us is to outline the rules about hand washing, donning separate gowns and gloves for each infectious patient and isolating any patient who has been to hospital overseas to prevent spread of golden staph. But with all these precautions (which I agree are sensible, given Norway has no golden staph), the same doctors will bring their stethoscopes into each room without disinfecting them between patients, thereby providing just as good a transport route for bacteria as hands! Admittedly, the cleanliness thing is adhered to better than in Aus, but it seems funny that some things are forgotten about.

Similarly, there is a high emphasis on research. For example, whilst we gown and glove for patients with respiratory infections, we do not wear masks because apparently research has found no benefit in doing so. Having said that, I've come down with a cough this week, which I'm wondering if I picked up in the wards!

For good or for bad, Australia has a better screening program than Norway, for example the heel prick blood test that our infants receive screens for a far larger amount of things than the Norwegian one (this may change soon). Equally, Oslo (it varies by regions) does not routinely screen pregnant women for group B strep (unless they have had a previous baby with an infection from group B strep). This is not accidental: the doctor I asked about it put forward a strong argument justifying this decision (eg spreading antibiotic resistance by treating some women unnecessarily).

Anyway, on to some other observations about life in Norway. Child care is very well organised and there are child care centres everywhere. It's always funny to walk past and see these kids bundled up to the nines running around, sliding down slippery dips and sledding down gentle slopes at these centres. Apparently, if the weather is above -10 degrees they are allowed to play outside. Kids seem to start quite young in child care, and stay there until they start school (I think at age 6 or 7).

I've mentioned before how well educated the population is. I now have some examples to add to this: the other day I was in town when a beggar asked me for money. Thinking I could get out of it by not understanding Norwegian, I told her as much and was shocked when she switched to English and continued her conversation with me! In another case, I was approached outside the main train station by a man standing in a group of people of all ages and races. He spoke in rapid Norwegian and I pulled out my trump card "Jeg snakker ikke norsk (I don't speak Norwegian)". He again replied in English, offering me the opportunity to buy some hash!

I went to the Norwegian resistance museum the other day, which outlined the history of the German occupation of Norway in WW2 and the resistance to this occupation. The Norwegian teachers were told they had to join a Nazi union and teach the children about Nazism. Of all the teachers in Norway at the time, only a very very tiny number agreed to join (I think something lik e98% refused to). The remaining teachers were repeatedly asked to join, but claimed they could not go against their conscience. This lead to 6 or 700 of the teachers being sent by cattle car to a concentration camp in the far north of Norway. Even then after some months of forced labour and little food, they still refused to join, and after some time the authorities gave up and allowed them to return. Norwegian resistance groups were formed and assisted to some degree by the allies, when it helped their war efforts. Whilst quite patriotic, the museum was an interesting exploration of life in Norway during the occupation and the military tactics used by both sides involving Norway.

Last Friday a group of international medical students and I went to a cabin in the woods owned by the medicine students group. Many people and organisations in Norway own cabins, ranging from basic huts to large luxurious homes. These cabins are usually some hike or ski away from main roads and are similar to beach houses that many Aussies own- used for weekends away with friends. The medicine one we went to (a small group of exchange students, plus about 40 Norwegian medical students- mainly 1st years) was about 45 min walk up hill through a forest from the bus stop (but cars could drive reasonably close to deliver supplies). When we arrived (hot from the cracking pace the Norwegians walked at), it was freezing! There is no electricity in this cabin, so it was quite dark and cold until a fire was lit and dinner started. Upstairs was bunks and rooms with mattresses and downstairs a large room with a long table, a couch and a fireplace and various decorations including road signs, skulls and whale bones; as well as a kitchen and a cellar. Outside, some distance from the cabin was a long drop toilet. There used to be a sauna and hot tub but these burnt down the last time the medical students went to the cabin!

It was a fantastic, really Norwegian night, with a raging fire, candles lit for light and a cosy traditional log cabin atmosphere. After a few drinks and a quiz, we were handed dinner and later song books printed especially for the cabin, with a mix of Norwegian and English songs such as the beatles, songs from monty python and old time songs such as 'on the sunny side of the street'. There was a giant sing along and we learnt a few norwegian songs too! As the night progressed, things got crazier- including a group of guys who stripped down to their undies and went swimming in the snow.

The whole place is built of wood, with running water only in the kitchen. There are candles everywhere, including candles in the toilet that were precariously close to the toilet paper roll! The whole place burnt down about 10 years ago, and there was a fire in the sauna and hot tub (outside) last year. I'm surprised that fire did not happen more often: drunk, crazy people, a wooden cabin and candles are never a good mix!

I've been eagerly booking trips away with the recent ryan air sales. In two weeks time I am going on an amazing voyage from Bergen to Kirkenes on a coastal steamer/ferry/cruise ship called the Hurtigruten. It's a seven day trip with the opportunity to see amazing scenery, visit small towns, cross the Arctic circle, go to the north cape, hopefully go dog sledding and finally get off 10km from the Norwegian-Russian border. We also hope to see the Northern lights at some stage on the journey as well!

If you're interested in it, see http://www.hurtigruten.co.uk/classic-north.asp

I've also booked cheap flights to Frankfurt for a weekend, to Copenhagen on the ferry, to London for a weekend and hope to go to Stockholm as well. I have a week off before Easter and am still trying to work out what to do then!

Meanwhile, my Norwegian is slowly improving (hence the title of this post- I speak a little Norwegian) and I think I am slowly becoming immune to the high prices (or better at finding cheap deals!)

All the best to you all, and I hope for an end to the fire season as soon as possible.

Anneke

Tuesday, February 24, 2009

Let it snow!

I will update more later in the week, but until then, thought this article from an English-speaking newspaper may interest you:

http://www.norwaypost.no/content/view/21673/1/

It's about the massive amount of snow we've had lately.

My Norwegian teacher (amongst many others) cannot believe what snowy winter we have been having!

Anneke

Monday, February 16, 2009

photos part seven- sledding





1) getting off the train with sleds
2) Zoe and I hit the track again. Watch out Norwegians!
3) The view from the sled (note the shoulder of the driver, carefully steering to allow the photographer to take the pictures)

photos part six- various celebrations

















1) the international oven-tray sledding team
2) post-sledding warm up (taken from outside)
3) anaestesien, the med students pub
4) dinner with my housemates (the male is missing)
5) the fastest way to chill wine- the gutter.
6) feature of my Australia Day costume
7) Australia Day, with subtle Norwegian influence. Note also the Southern Cross costume.
8) Cricket in the snow.




photos part five- downhill skiing (aka falling)

1) The slopes at night. Note the supine figure with red trousers slightly to the right of centre and compare to the upright, well-balanced figures in the bottom left hand corner.
2) Sunsets are amazing
3) Upright red trousered figure, looking very nervous.
4) My 1st 10 minutes on skis. I fell entering this conveyor belt and held up traffic for a good 5 min as I struggled to get up.


photos part four- cross country skiing adventures




1. possible routes, including Dakar.
2. skis outside the cabin for a waffle break.
3. Rest stop after skiing across frozen lake.
4. The views are amazing
5. At the train station before setting off.

photos part three- life in Oslo




1)
view from my walk to uni
2) forest on my way to uni
3) snow storm!
4) The best thing since sliced bread- when I buy bread at the supermarket, I have to slice it myself!
5) snow storm!
6) Wealthy Oslo
7) The train lines
8) Place for skis on train lines



photos part two- sights in Oslo

1) Akershus Festning (Akershus Fortress)
2) Oslo Harbour, fortress in the background
3) inside the Nobel Peace museum
4) outside the Nobel Peace museum






5) IKEA
6) Vigeland sculpture park- the tower is made from 1 piece of stone
7) Vigeland sculpture park- circle of life
8) Viking ship

photos part one- Sogn Studentby (where I live)






1) view from the corridor window
2) my street
3) view from my room
4) my kitchen balcony
5) view from balcony
6) the supermarket at Sogn

Friday, February 13, 2009

Parties, Paeds and Pretty sights

Hi,

I am sitting in my room at 10:05pm struggling to stay awake after an epic (~15km) cross country ski trip today. We set off at 11am and caught the metro to our starting point, Frognerseteren. After a very shaky start I eventually found a rhythm and was soon only falling over when going round corners on downhill slopes (tricky!) or avoiding objects (dogs, children, trees). My falls however were often in deep snow and I was nowhere near the picture of gracefulness as I climbed out, then slipped down again, long skis and pole waving in the air. The uni hires out cross country skis for about $80AU for the whole season, but I had previously missed out when I went to get some. Unfortunately, my housemate broke her scaphoid (wrist) slipping on some ice and hence I'm now able to borrow her skis.

In Norway, there are cross country trails absolutely everywhere. Maintained by a special public organisation, they are free for all to use. They even have lights on many routes so that people can go at night. Another feature of the trails is that there are gorgeous cabins dotted across the trails in which you can have a cup of tea, eat your lunch or buy cakes and waffles. As a result, it seems every Norwegian spends their weekend skiing, bringing along their grandparents, children and dogs. Kids as young as 2-3 have their own skis and families go skiing together, setting off from all around the city, as if they were going for a stroll in the woods. And I can see why- the views were simply breathtaking, as we skied through forests, across frozen lakes and in the hills with sweeping views of valleys filled with snow-covered fir trees. It was a beautiful day- the sky was cloudless and blue and the sun was shining. In fact, I may have gotten a bit burnt. This weather is deceptive- it looks like a postcard from inside, but its far colder on days that are sunny and not snowing because there is no cloud cover to trap heat. I'm aching all over now, but it was worth it!

The past week I have been at the hospital, attending paediatric outpatient clinics. We seem to have a lot less clinical exposure in Norway, with only 3 mornings a week at the hospital, followed by 3 afternoons of pracs, seminars or lectures. Thursday is a study day, with nothing scheduled, and Friday is tutes, seminars or lectures. I attended 3 different outpatients clinics with a Norwegian student, Olve, who was very nice about translating for me and asking the doctor to speak to us in English if we were being taught something. I met a few bilingual kids: one of whom was 6 and effortlessly switched between English (her father's mother tongue) and Norwegian depending on who she was talking to.

At the hospital, we all change into white scrubs and a white coat, with 'indoor' shoes to prevent the mud and melting snow being tramped around the hospital. Doctors seem to have a lot of time for students, and I did not get any indication that they resented speaking in English (it seems to be seen as an opportunity to practice). The health care system is very advanced, all medication for children under 12 is free, as is the health care required by pregnant women. Maternity leave is something like a year, and the father gets a fair bit of time as well, with the opportunity for the father to use some of the mother's leave if that suits the family better. I found it interesting to chat to the doctors about the guidelines for prescribing though and I wonder if there is a tendency to prescribe earlier in the course of an illness (eg asthma) here because it is free. Furthermore, whilst in Australia we tend to tread carefully with expensive treatments and medications (eg MRI) I think maybe there is less hesitation here. Whether or not that is a good thing, I'm not sure.

Last weekend, we went to a party at the students cafe/pub/party house/band performance space, Chateau Neuf. This is not solely associated with University of Oslo, but with all the students groups in Oslo. The following day I was exhausted, so had a quiet day strolling in the city and then some friends over to watch a DVD in my room. They had just left and I was heading to bed at 11:30pm when my intercom phone rang. I let my Czech friend in again who rushed in to tell me they were building a snow man, would I like to join them. When I got outside we realised the snow was too fresh (having snowed all day) for a snow man, so we grabbed the trays from their oven and hit the hill outside their place, sledding down it on our trays. It took a fair while to create a path as the snow was so thick (and we got a bit distracted with snow fights) but once the path had reached the bottom her housemate filled a bin bag with pillows and we whizzed down on that! Frozen, with snow down our shirts, in our shoes and all through our hair, we retired to their kitchen for late night tea, vodka, waffles and good company. It was a fantastic, spontaneous, fun night.

Well, I keep thinking of things to say, but forget them when I sit down to write, so I apologise for the spotty nature of this post.

Finally, the fires made the front page of the paper and I have had many people ask me questions about them. I have been reading the Age website and I wish to pass on my sympathy if any of you have been affected by them.

Best Wishes,

Anneke

Friday, February 6, 2009

The first few weeks

Hello again from Oslo, where the weather reached -12 yesterday.

Last weekend was fantastic, we had a wide selection of parties to attend on the Friday night (including one at the med students pub again!). Then on Saturday we rode the urban train line up the mountain to Frognerseteren (there is a webcam there, if you're interested see link on the right), where we hired sleds. Then we were off, down a 2km sledding track known as the corkscrew. It twists and turns down the mountain, taking about 15 min, then you grab the sled and jump on the train back up the mountain to begin again! Awesome fun and something you can do all day, as the train is heated and takes about 15-20min to get you back up. Steering sleds is an interesting challenge, especially the fast ones. I had one major spill, I hit a wall, then the sled and I parted ways, leaving me in the path of oncoming sledders, who had a collision whilst trying to avoid me. I recovered and stopped to help the boy, but forgot to secure my sled, so anyone further down would have seen a lone sled building up speed, followed by a red-troused, green-hatted madwoman running down a mountain behind it. The most fun however were when there were two of us on a sled. We laughed and swore the whole way down the mountain! Bruised and happy we returned for showers and a warm drink then all trooped to someones house for dinner.

The following day, a Czech girl and I managed to join a uni-run tour of the National Gallery, and saw one version of The Scream (Munch), which has the dubious honour of having been stolen twice from the gallery. The uni has a program of events for international students, many of which are free (except overnight trips). The weekend before I went on a free bus tour of the city, with entry into museums and a tour guide for 2.5 hours. Other activities include a free coffee hour on Friday afternoons, tours to many of the major galleries and sights, walking tours, rock climbing excursions, skiing trips, free Norwegian film nights (with English subtitles), a rafting trip and tours to the fjords. The people who run the accommodation also arrange activities, including a weekly trivia night at the student pub at our accommodation, a ghost tour of the castle, dance classes and other exciting activities. So despite this being an expensive country, I think students are looked after quite well.

My first two weeks of uni have been lectures and anatomy and histology pracs, so I am yet to spend time doing clinical stuff. But as our lectures have been run in the hospital we have been able to gain some idea of what to expect. The first novelty is that when we arrive at the hospital in the morning we have to change into 'hospital clothes'- white scrubs and a white coat with our indoor shoes. No more ironing shirts for the hospital! The other thing I have seen so far is that there are lots of scooters in the hospital. These are used for transporting patients' files around the hospital! The have baskets of different sizes and people ride them from one end of the hospital to another. Very cool!

There are so many people from around the world here and the unofficial second language is English. Whilst it may be some people's third language, it is the common language amongst most students here. Thus it is hard to learn Norwegian. I started classes the other day and am surprised at how much easier it is to read signs and so on. The classes are twice a week, totalling 5 hrs a week for 12 weeks, and best of all, they are offered free to exchange students. We were also given the option of an extra 30 hours of lessons for free, but they started before I arrived. Apparently these lessons would cost around $3000 if we had to pay for them! It is interesting as well, because in most situations here native English speakers are rare, and such we are sometimes consulted on the pronunciation and meaning of words. I think my English may actually be improving, as I can't use slang here, whilst there will be a whole group of Norwegians saying words like 'hypertrophy' with an Australian accent. But the level of English is so outstanding that I am sometimes struggling to answer the questions!

Well I might head off to bed and add some more a bit later.

See ya,

Anneke

Sunday, February 1, 2009

Oslo!

Well, here I am in Oslo at last!

I had a lovely time in Dublin with Ros and Boz, catching up, sleeping and hitting the shops for some winter essentials. I also watched Obama's inauguration, at a much more respectible time of the day than it was in Aus!

It took me a whole days travel to cover the short distance from Dublin to Oslo: a 6:15 am airport bus, a 9am flight to Heathrow, a 30 minute walk between the terminals, another flight to Oslo, a train into the city and a walk to the youth hostel, arriving 7pm! Flying over Norway was so exciting- the whole country seemed to be covered by a thick white blanket of snow, with gorgeous trees laden with snow and sparsely populated villages. The airport in Oslo was stunning also, all glass and wood, very new. I met up with Sundar, another Melbourne Uni student and we set off into town together. Stepping out of the airport directly onto the train platform, all we could see was snow- snow on the tracks and huge piles of snow all around! The train even had special rests for ski poles.

Arriving in Oslo City itself was so exciting, we had to find our way along icy paths whilst carrying our bags and trying to avoid falling over! We made it to the youth hostel and set off in search of dinner. Big shock. A bottle of water cost $5 and the ingredients for ham and cheese sandwiches: bread, margarine, ham in a tube and norwegian brown cheese cost more than a complete meal in Australia! But we did quite well for ourselves with the sangas as takeaway pizzas are $AU 25-40, Burger King burgers around $15 and eating in a restaurant completely out of the question!

The following day we set off for our accommodation, in Sogn studentby, which is about 20 min from the city by metro train. It is on the outskirts of town, halfway up some mountains. We had quite a complicated system when we got there: first to Krinsja studentby to get keys for several rooms, then trek to Sogn to look at the rooms, then trek back to Krinsja to return the keys for the rooms we didn't want, then back to Sogn with our luggage. Sogn and Kringsa are about 15-20 min walk apart, along a snowy footpath on the side of a hill. It was so amazing seeing the blanket of snow over everything, but we had to be careful not to slip as the wheels on our suitcase froze!

Sogn is a massive village of student apartments, more than 1000 students live here. There are family apartments with kindergartens and playgrounds, a gym, supermarket, student pub, laundries and mail rooms. Sogn is one of a number of similar complexes in Oslo (Krinsja is another) run by SiO- a student group which is independent of any particular university. Sogn is located near Ulleval Stadium, which has a metro station, and Sogn also has a bus stop right outside the door, which goes to my hospital, uni and into town.

The moving in process took most of the morning and then we were free to settle into out rooms. We were given furnished rooms with a desk, bed, wardrobe and bookshelf. Curtains however are not part of the furnishing! Luckily the last group of Aussies here left all their stuff for us, so the only household item I have had to buy was a clothes horse (still, any excuse for the free bus to Ikea!). I live in an apartment with 5 others: 1 Norwegian, 1 American, 2 Chinese and a Spanish girl. We have a communal kitchen with our own cupboards, and a communal bathroom. Luckily, the kitchen already has lots of equipment so I did not need to buy any of that either!

After settling into our rooms we set off to the University to register and receive our information packs. The Uni is about a 10 minute walk from our accommodation, but the Medical building is at a different site. This was when we learnt our 2nd lesson about Norway. They love order and bureaucracy. Anywhere you go that would otherwise involve some sort of queuing system requires you to take a number upon entry (even if there is no one else in the place). After some delay your number is called and you go to the particular counter. This system is used in banks, post offices, doctors surgeries, university help desks, shops, chemists, the police- everywhere! Sometimes you are required to choose from a variety of options before receiving your number such that you can be assigned to the correct desk. The other thing is the number of forms you have to fill in. I think most of Norway has now seen the ugly picture in my passport, used as ID for everything. Furthermore, I am invited to participate in this by receiving cards. I have been given separate ID or access cards for the following: the external door to my apartment (as well as keys), the laundry, the University buildings, 2 different hospitals, public transport as well as a semester card stating I am a current Uni student. Each card has required me to attend a different location, take a number, show my passport, get a photo taken or give a current photo, fill in a form, sign a different form for receipt of the card and finally receive the card!

To add to the challenge, working hours here are far less than Australia. Some offices that issue these cards only open for 3 hours a day! Others close at 3. Even the Police, with whom I had to register within 7 days of arrival, will only accept people who took a number before 11am (I got there very early in the morning, 20 minutes before they opened and got number 43 in the queue!) Whilst at the Police station I also submitted my application for a temporary residence permit. They did not accept just a photocopy of the picture page of my passport- they wanted every page, but agreed to accept only the pages that had stamps on!!!

Oslo is a lovely city, with very well educated citizens. There is snow everywhere, but not much rain, so it is not hard to keep warm provided you dress sensibly. The level of sophistication in English language skills from every resident I have spoken to (shopkeepers, people giving me directions, maintenance men at the accommodation, medical students, doctors) is outstanding. In fact, many German students choose Oslo for exchange in all subject areas because they wish to improve their English! Oslo has half the population of Adelaide yet (despite the $6 for 1 hour ticket) their public transport is excellent- great coverage, very fast and regular. They have trams, metro trains (the T-bane), intercity trains, buses and ferries. The metro will even take you to a ski resort! For 330NOK ($65ish) a month students get unlimited travel on all public transport. Walking is also a reasonable option as it is quite a small city.

The most obvious thing about Norway is the cost. I'd heard it was expensive, but nothing can prepare you for the shock of 300g of mince costing around $AU 12. My diet has undergone major change- meat is something I now eat once a week as a special occasion (unless someone is giving us a free meal!), a thermos flask prevents me paying more than 5-6 dollars for a cup of tea and carrots have become my snack food! Alcohol is horribly expensive. Supermarkets can sell beer and cider (items with low alcohol content) for a strict number of hours in the day. Cider (500mL) is delicious, and costs $AU6 for 1/2 litre can. Spirits and wines can only be bought from state-owned Vinmonopolet. Prices there will turn your hair grey. 700mL of the crappiest vodka is $AU50+ and wine starts at around $20. Cask wine, the students' friend is Australia costs in excess of $70!!! There is some interesting info on the justification for this system here: http://www.vinmonopolet.no (there is an english link on the bottom left).

The social life so far has been excellent. I have met so many people, mainly international students, at various kitchen parties in the student accommodation. Notably, the medical student building has a bar in the basement, where I've attended 2 parties so far!! Because its so expensive to go out, parties at bars and things start very late, around 10 or 11, and people have drinks at home beforehand.

The day before we started Uni we celebrated Australia Day from 2pm (the time it was midnight in Aus) with a cricket game with Anzac biscuits in the snow, followed by a kitchen party at the apartment of one of the other Aussie medical students. We taught everyone to say 'Cheers, mate' instead of skol (Norwegian cheers)!

There are 10 Aussies on med exchange, 5 from Melbourne Uni and 5 from Newcastle, and there are another 17 med exchange students from Germany, France, Czech Republic, England and Spain. There are also 60 or 70 Norwegian students, all of whom have been so polite and eager to help us. They tell each other off if one slips into speaking Norwegian and have been instructed to ensure we are never left out of the loop. The university has been fantastic about ensuring we know where to go and pairing us up with a Norwegian for any placements we do. So far, we have just had lectures, anatomy pracs and histology and our actual hospital placements start 1 one more week. The timetable is quite relaxed compared to Melbourne, and we even have a day off (study day) each Thursday! Domus Medica (the Med building) and Rikshospitalet, the hospital where our lectures have been, are about a 15 min walk away, taking a path that goes through a snowy forest. It's a magic start to the day!

Well this is a very long post, and I will post some more in the next few days. It's been a fun two weeks and I am looking forward to my time ahead!

Anneke