At attention, hhhhup! Salute hhhhhup! At ease hhhhup!

So this time a long story, with the travel to jepara, first week experiences in the hospital and more.

On the saturday the 26th we made our way to Jepara, leaving Semarang and the RSDK.
Jepara is a gathering of villages grown together to form a really spread out city. Nothing like semarang.

With a black minivan we travelled the DISTANCE to jepara. Ofcourse this van had no seat-belts, and sometimes overtook cars exceeding 80km an hour barely missing the opposite traffic. The view during the travel was extraordinary, ecpecially the traffic. Imagine trucks with stock loosely piled up to a meter above the truckers cabine, with some indonesians just sitting on top of that. Imagine how they, (and the cargo), would get catapulted if he ever hit the breaks, and i can't imagine getting catapulted from 3-4m high is healthy. Apart from the traffic we had a good view of the palmtree's and the more idylic sceneries as you would find in a folder from the tourist agency.

The rumah sakit Kartini is a lot smaller hospital and looks very inviting.
Our homestay is shared with some other co-assistants, and a few residents. (the new surgeon here). The mosquito infestation is also of much larger proportions, having killed 7 on my first night, and trying to plug all the holes and gaps in my windows which allowed them to keep pouring in.

The first week after our arrival we had a good share of the experiences in store for us.

At 7:00 a.m. there is an appel in front of the hospital which everyone needs to attend, very militairy style with salutes etc. Ofcourse noone told us however we were also expected to be asked in front and introduce ourselves to the entire hospital staff..... Which kinda took us by suprise. But nevertheless a fun experience. What they actually call when saluting is hard to make out really, but it should be something as in the title, but then in indonesian slang. :P
At Friday there also is a complementary workout at 6:30, aerobics. As most people know this wasn’t really my cup of tea, i do not really have the best rhytm sense. Still at least i tried! Which was more then a lot of the other co-ass did, only 2 out of 5 male Co-ass attended the training, even though it wasn’t voluntary. And no, mum, sanne or whoever takes an extreme pleasure in watching me humiliate myself, i already made sure no video’s pop up from sanne B’s her videocamera. It’s just a matter of leaverage.

This week i was appointed to the surgery department. Which only does surgery in the morning 9:00-14:00. It was a bit hard to also assist on the operations since a lot of them are operations in a style not seen a lot in the netherlands. For instance Gangrene debridement and small amputations where carried out by just the co-ass under supervision by a nurse of doktor. Not really the kind of “small surgery” i am familiar with. Still it makes it perfectly clear WHY we have diabetes nurses in the netherlands and regular follow up. It makes really no sense at all seeing a diabetic with an skyrocketing Glucose (medicines, what?), with 3 chronic ulcers (a.k.a. holes) in his feet, and gangrene up to his knee refusing amputation for both financial and emotional reasons. How did it come this far, and second for the non med schooled, the gangrene will be his death without amputation. A full debridement (opening the skin above every puspocket), can hardly be survivable with a diabetic leg as this, still that was the only thing we could do now without permission to amputate.

Apart from the operations i also did my shifts in the IGD or emergency department. The scala of patiënts here is quite diverse, although 3 groups clearly stand out. These are the following:
1. Traffic accidents, and then i mean a LOT. The motorcycles here may look nice, but the way people drive here is a very unhealthy habbit. Unfortunately it is often the weakest participans who pay. Often busses or cars take over at huge speeds, sometimes hitting an opposing car or more often motercycle. (they just sound the horn for the motor to get out of the way). Most people i saw still had minor injury’s except 2. One a middle aged male broke 4 ribs, hematothorax and skull-fracture lived, wonderfully with his brainfunction intact. One boy of 10 who got hit by a bus while crossing the street was less lucky, and had a GCS(glascow coma scale, 3= lowest(deep coma), 15= highest(no coma)) of 3 at the start, with the typical Foetus-posture, which signifies major brain damage. At the moment he is a pediatrics but still only has a GCS of 5-6. Chances of him recovering are slim. Apart from these there were about 10 minor victims (some simple fractures/cuts/ minor head trauma)

2. Malaria, officialy malaria falciparum is not endemic here, but with 2 patiënts with malaria falciparum and one with a chronic Vivax, i really doubt that statement.

3. Snake bites. Here in indonesia, and ecpecially in jepara some cobra’s reside, and they don’t like humans crossing there territory. Since the furniture production in jepara lot of people enter the forests for lumber just with sandals or on their bare feet. I saw 3 patiënts with the results from that on the emergency department. The big suprise however was that it happens to be that the factory producing the antivenom is out of stock, which means no anti-venom for the bites. And as everyone already knows, cobras are some of the mostly deadly snakes around, the damage they can do to a human body is truly staggering. I really hope there soon comes another batch of antivenom, till that time you won’t see me wandering around in a forest, that’s for sure.

And ofcourse the football! We ofcourse watched all the dutch matches, and the 1/8 finals and 1/4 finals here in jepara. Completely in indonesian style ofcourse. Which was outside on a concrete badmintonfield with a big screen being watched by 100-200 indonesians sitting on the ground. Here and there some small cooking places popped up for the (way to sweet) indonesian coffee, or some casave. Too bad most indonesians really wanted brazil to win, still they congratulated us and also cheered for the dutch goals.

Regards to everyone reading this, i hope you also will find some time to react. I always enjoy reading them, and they are a big support for me here.

Greetings to all, take care.

3 weeks of Internship

So after a while, back again.

Internship in Semarang, for 3 weeks now, 2 weeks in the 'Penyakit Dalam' and 1 week in the Ruang Anak. Or 2 weeks internal medicine, and 1 week in the childrens ward.

So far an impressive episode, lots of new impressions and little time to contemplate and write about them.

In the internal medicine we saw all the typical tropical patiënts: Leptospirosis, Dengue, Thypoid fever and ofcourse HIV+TBC.

Leptospirosis is an hot issue atm, because as some may know and most who read it do not i guess, leptospirosis is a spirete which resides in water where enough rats poo and pie in and can enter a human by wounds/cracks in the feet. As our global heating screwed up the weather not only in europe but also in indonesiä, it is raining every day about now :P (though it gets better). Now you can say, so what? its tropical, it rains. IF you think that, that's correct if it was the wet season :P the funny part is that the wet season SHOULD have ended 2 months ago, apperently it didn't.

But i am getting away from the point. Semarang his old city is low, bad drainage, lots of rain and an utter load of rats and loads of garbage (old town isn't the cleanest part in semarang). Which all sums up to: loads of leptospirosis.

We only saw the worst patiënts on our ward, since the RSDK is the universital and 3rd line hospital of the region (3million patiënts), all the worst cases are brought there for a last change.

Still it was rather impressive and sad, to see 4 out of the 6 patiënts with leptospirosis die even though the best effort was taken in supporting them. It really humbles you and makes it clear just how dangerous the diseases here may be.

Also i got sick myself in the 2nd week, (Crohn and not watching out with the food in the warung equals= STUPID), so instead of being the tough guy here i took some antibiotics myself, probably the first time in my life (unless my mum drugged me as a child that is).

About the childrens ward, and a really interresting boy with Thallasemia i will read in my next update, allong with the fun things we did (watching football, hiking, chinatown, churches, budhist temples, confucionist temple's, beautifull mosque's and more).

For now i am going to find my bed again, and will try to not forget to place some pictures with this story tomorrow :P

Oh and yes, This story was in english, :P

(mum please translate for Els and Ap will ya? :P)

Vesãkha

English/dutch

Grafitti in Yogyakarta

24 mei. Toegevoegd op 8 juni.

Op een wandeling naar de winkel ontmoet ik enkele javanen welke op 2 muren aan de doorgaande weg een muur aan het verven zijn met daarop de leuzen: 'Dance with tears, no drugs' en 'maak je moeder trots, blijf van drugs af'.

Erg apart, aangezien drugs officieel je de doodstraf kunnen verdienen. Ook lijkt het me wel bijzonder nobel, maar ook een beetje apart je dagen door te brengen met het maken van 'gratis' kunst ter voorkoming van drugsgebruik.

De eerste artiest: Haivan Sodia (40) ('Fight back the tears no drugs', zie foto) Aan het werk met een vriend en zijn broer en een 2e vriend als psychologische support (rokend, lachend, toekijkend. Hij verteld dat hij een kunstenaar is van de universiteit in Yogyakarta en met name door de drugsproblematiek meewerkt. Zelf heeft hij er geen ervaring mee, maar geeft te kennen dat veel jeugd in yogja hier wel aan ten onder gaan, met name de studenten. Hij geeft aan er niet betaald voor te worden, echter geeft wel toe dat het via de overheid geregeld is. Een fooi neemt hij niet aan, zoals hij al zei, om het geld is het hem niet te doen.

2e artiëst: Joel (30) west sumatra. Naar yogya gekomen om aan de kunst-academie te studeren. is met zijn 6 vrienden aan het werk. (zie foto's). Hij geeft duidelijk aan via de overheid de muurschildering te maken. Wederom werken uiteraard 2 van 7, rest ondersteuning. Hij krijgt er wat betaald voor, maar een schijntje, dus waarom te hard werken nietwaar? Een uitnodiging tot de kampung was ookal snel gemaakt, maar dit leek me toch niet al te verstandig. :P

2 verschillende groepen mensen, 2 verhalen. de vraag is natuurlijk wat de hele waarheid is. In ieder geval is het doen van de kunstacademie niet bepaald een ticket tot succes in Indonesië.

Soerabaja and travel to Yogjakarta

Arrived at Soerabaja airport. 14 may in the early morning.

After having acquired a rather overpriced cab (if you try to bargain suddenly most cab drivers are poor english speakers). I ended up in my hotel, one of the few 'good' budget hotels in soerabaja.

It has no use ranting about a hotel, ecpecially not in a country as poor as indonesïa, but paying 145.000/night for fungi bread, a shower with only hot 'boiling' water (not what you want in 35 degrees), ample working ACand the staff being kind but not able to speak any english andshabbyneighbourhood, made me do what most foreigners in surabaya do: sleep the jetlag and leave.

A stroll down the street at night made it possible to see a bit more from the city, but walking is a hazardous undertaking (only the poorest of people do that). I would have loved to show you pictures, but my appearance alone already drew attention from everyone in 100meters, soi think that walking around with a camera wouldn't really add more comfort for me.

But aquick description: Footpath lights are green while the 200 motorbikes and 20 cars/ 10sec apperently also have.
The pavement is often non-existant or being broken up with 2metre's deep holes for the plumiting, no these are not marked by a fence :D
If you walknext to the road you need tofeel cozy with traffic rushing by at10cm.
Crossing a road is more Caïro style: running lane by lane as traffic rushes by on both sides,hoping they have the courtesy to avoid you (which they often have currently).
The good part in this traffic chaos is that most drivers are like some michael schumachers on steroïds with the precision of a neuro-surgeon, how they squeeze their vehicles past eachother. Inthe netherlands peopleTAKEpriority, here you are mosty only GIVEN priority. Taking it here, would be a very unhealthy habit.

15th: 5hours train to yogjakarta was a pleasant ride, good AC, chairs able to support a big belanda. 125.000 and a 10.000 for the breakfast: noodle-soup. The landscape really shows what indonesiä has a lot, and thats Sawi's. They stretch as far as the eye can see, and are never left truly barren. The volcanic soil and loads and loads of work by indonesiän hands makes a fertile mix for producing huge amounts of rice.

In yogjakarta i got to the guesthouse from the language school rather fast. Noticing the more relaxed traffic here (you can get across a street without suiciding yourself) and more tidy streets and homes.
The guesthouse is a different story from my surabaya mansion, nice rooms, AC working, own toilet and battub (yes this toilet flushes!). unlimitedcofee/water and a good bed. And all that for the price of 150.000/night.

I hope to bring you some more pictures next time, but recent events (terrorist attack prevented, planned on killing the president and tourist on 17 aug in style of the Mumbaï shootout), makes me carefull of not standing out too much as a tourist.

Welcome

Indonesia, 2010. Co and culture.........

Right, not the most catchy title isn't it?

Still that is exactly what this site is about, how will a different culture influence me, will i like it? will i be craving for home in a week?

And most of all, how will that new culture cope with me?

If you happened to stroll past this site, or somehow got it passed on by me, a friend, or by a great chance: my mother (a.k.a. social animal). feel free to check what's on.
If you don't like reading this site, but feel obliged to do so by whatever reason. Don't feel forced.
I only write this down for those who like to read it and i don't expect everyone too.

All i ask, don't feel forced to check this site, only do so if you enjoy it.

How to follow this blog?

If thewelcome messagedidn't made you close the browser,you can findsome handyinformation here:

• On this site newstory's andphoto footage will be placed. on a fairly regular basis.
  
• There is a map where you can check mylocation and travel-plan.
  
• Myprofile will be updated to give some more information about myself.
  
• If you like to receive anmessage when there are updates, leave youre-mail in the box to the right of this page. The box is under 'Blijf op de hoogte!'.
  
• Some fellow students are making travels at the same time, you can check their links.

Feel free to comment on anythingofcourse.
I will be using english for most of the blog for my foreign friends.