From the Botswana HIV/AIDS Handbook 2008

Lots of reading going on at the moment. Reading protocols, reading handbooks, reading more protocols. Feel like I have an never-ending jumble of inclusion and exclusion criteria in my head. Today I'm reading the Botswana HIV/AIDS Handbook. It's a fairly mundane read articulating treatment regimes, definitions for when to start and stop treatment etc etc. But one thing caught my eye, and perhaps gives a small insight into the uphill battle that is being faced in trying to reduce the burden of HIV in this country.

Sexual myths and misconceptions often interfere with safe sex messages, and

must be addressed candidly with patients. Such myths include the following:

o A woman with a wet or well-lubricated vagina is promiscuous, and

application of agents to decrease such wetness—which results in “dry

sex”—is necessary to prevent the impression of promiscuity.

o Self-masturbation is unnatural, or a cause of loss of fertility or energy.

o Sex with a virgin or infant will cure HIV infection.

o Condoms have worms or spread HIV.

o Condoms have large pores which permit HIV transmission.

o Showering after unprotected intercourse will prevent HIV infection.

Have a good weekend!

Arrival

It's been a bumpy few days. My arrival in Botswana was less than welcoming. A driver picked me up from the airport (very good, positive feelings all round) - and then dropped me off at the hotel saying "see you Monday". It's safe to say that Gaborone isn't the most happening of places on the weekend and with no clear idea of where I was in relation to the rest of the city it was a little isolating. To top it all off - no money. VISA runs a monopoly on the ATMs in Botswana and unless you have a VISA electronic card the ATMs refuse to give you money. So, with only Mastercard and Cirrus as my trusty plastic and American dollars in cash, which no one wanted to touch on the weekend, I was left to wonder the streets and eat at the hotel restaurant.

So far work has also been a little disappointing. The Botswanan's are polite, but distant and have a habit of not informing you about what is going on. I'm still not really sure what I'm doing here, although I have read the protocol of the '1066' trial that I'm supposed to be working on. Was told today that we can go ahead and recruit people, but the trial has strict inclusion criteria and after 4 months they haven't recruited anyone. Hmm...

On the up side the weather is lovely and I'm getting lots of time to think about my next move, which may be sooner than expected.

Heuriger

One of the things that I have fallen in love with this summer in Vienna has been the Heuriger. The best translation of Heuriger is Wine Hall, but for me it could be loosely defined as the 'Austrian Summer Pub/Beer Garden'.

Traditionally the Heuriger (today's wine) was owned by the local winemaker and served the most recent vintage's wine over the summer months. Today they run throughout the year, but still serve wine direct from the vineyard in 1/2 litre bottles. Mixed with mineral water it makes a delicious and refreshing evening drink.

To add to the unique experience many Heuriger still employ musicians to play traditional Viennese and Austrian folk songs. The first time I visited the Heuriger someone whispered in their ears that I was Australian and one of the first songs that they played our table was 'Waltzing Matlida'. It was a really touching experience to be so far from home, in an Austrian Heuriger and hear a song from home played on the Accordion and Guitar. Very special.

This will probably be my last post from Vienna. On Thursday I leave for Botswana and the adventure will continue there.

A New Beginning

The blog has been quiet of late. I've been resting and reflecting on what has been an incredibly busy year. My life has taken some unexpected turns. Twelve months ago I would never have imagined that I would be contemplating a move to Bostwana. But in three short weeks I will pack my suitcase again, this time bound for Gaborone.

I'm still a little unsure about what my job entails, but I'll be working for this group as a physician on their Clinial Trials Unit, managing the paediatric HIV/AIDs trials.

So the blog is changing a little, but the adventure continues. For now I am relaxing in Vienna.

One of the great things about Vienna, is it's close proximity to almost everything in Europe. A six day tour around the Alpes included a short stay in Turino, which was unexpectedly beautiful. And a trip through Mont Blanc to Geneva and back to Vienna. It's the wettest summer in 200 years in europe - so not fantastic photo material, but the food, wine and company have been wonderful.

Wine, Bubbles and Beer on the Charles

I'm going backwards a bit, but I couldn't leave graduation week behind without a mention to 'Wine, Beer and Bubbles on the Charles'. Much to the disgust of several friends and I, prior to "WBB" there was to be no graduation party prior to commencement. Used to a much more celebratory mood in Australia and Europe we set about organising our own event. Thankfully the Boston weather prevailed and with some last minute catering help from our parents we entertained 80 graduating students, their families and friends on the banks of the Charles River. The wine flowed, the tunes hummed on the ipod and the weather behaved remarkably. A beautiful sunset and some Salsa dancing at the end of the night and all declared the night a success!

More Japan...

It wasn't just to see the Cherry Blossoms that I went to Japan. The purpose of the trip was to try to understand Japan's secret to 'longevity'. Japan has the highest life expectancy in the world. Public Health calculations that use life expectancy use Japan's figures as a benchmark. As a population they enjoy better health, for longer, than anywhere else in the world.

Part of the trip included a visit to Okinawa - a small island, closer to Taiwan than Japan, that has the higest concentration of centenarians in the world. These two wonderful 'elders' let us in on a few of their secrets. The lady in the group shot was 90 years old. She had just had her cataracts done so couldn't drive - her eldest sister drove her to the community centre for lunch! The gentleman was 94 year olds, still living at home alone and gardening daily. Most of the vegetables he eats come from his backyard. His secret... go to hospital when you feel sick! A worthwhile tip to remember!

Surely, we thought that the secret must be in the food. So much fish, so many vegetables. And the sushi tastes so good, it must be healthy?

But then you see this. Everywhere. Japan has some of the most lax smoking laws of anywhere I've visited. You can still smoke in all retaurants and bars. Ironically you can't smoke on the street - it makes too much rubbish. But passive smoking inside is quite okay. At the fish market it was forbidden to wear perfume or deoderant, incase the smell infused into the fish - but smoking on the job was no problem. Longevity and smoking really can't go together?...

In the end I don't think we came up with an answer. Japan is full of contradictions. But the people were wonderful, the food delicious, public health legislation was patchy at best... and the sake - fantastic!

A Small Taste of Japan

I promise a full report is forthcoming, but a small taste of Japan... Green Tea, Sweet Potato and Red Bean Kit Kats!! Green tea is bright green white chocolate that tastes like, well, Green Tea. Sweet Potato was a bit of a let down, didn't really taste of anything. And the strangest most in need of the "Acquired Taste Factor" is Red Bean. It actually does taste like Red Bean, which I'm still not really sure if I like. There's another one sitting in my room if anyone is keen!