This past Friday, the School of Public Health at Sydney Uni held a graduation ceremony for the international students. Official University ceremonies are held in the spring, so this personal ceremony was really something special. Here are a few photos from the day:

Top row (L to R): Graduation photo in the Quad and one of many jumping pictures
Bottom row (L to R): cell phone bars and much of our international class in front of the School of Public Health
For explanation of the cell phone bars photo: http://www.youtube.com/watch?v=tDpX1X4uBO0

L to R: Photo in the Quad; Our goals in public health; Photo in front of the School of Public Health

Post-graduation celebration at Yogurtland. I love that this photo because it shows how international our cohort was. We represent Malawi, Nepal, Pakistan, United States, India, Nigeria, Australia, Belize, and Ecuador.
It will be wonderful to have colleagues all over the world!

 

 

During this semester, I have been working with Professor Bob Cumming at the University of Sydney on a South Sudan project. Although I knew next to nothing about South Sudan when I began this project, the country has grown near and dear to my heart. My work began with organizing a conference on 8 August that focused on maternal and child health and food security in South Sudan. It was an honor to meet and work with our keynote speakers, Professor Aggrey Abate, Vice Chancellor of the University of Juba, and Dr. Samson Baba, Director General of Community and Public Health.

After the conference, I have continued learning about South Sudan and the many challenges the country faces. Since health is my passion, let me highlight a few statistics:

• Life expectancy at birth is 53 years for men and 55 years for women.
• 1 in 10 children will die before their 5th birthday.
• There are approximately 120 physicians and 100 registered nurses to serve a population of 9 million. (An upcoming census will provide more accurate numbers.)
• Maternal mortality is the highest in the world at 2054 maternal deaths for every 100,000 live births. This means that pregnancy represents a very real health threat for women.
• 25 women die each day in childbirth. For comparison, approximately 20 women die each year in childbirth in Australia.
• While family planning methods and modern contraceptives were introduced in what was then Southern Sudan in 1999, only 1.5% of women are currently using a modern contraceptive method.

The 8 August conference generated a lot of excitement and interest in further collaborations between Australia and South Sudan to support public health training in South Sudan. The discussions were scheduled to continue when Professor Cumming traveled to South Sudan in October. So after the conference, I began researching public health curricula at schools such as the University of Nairobi, University of Rwanda, and Makerere University to support the work toward establishing public health training in South Sudan.

Where do we stand now? A huge leap and a bound forward and closer to beginning public health training courses in South Sudan!

One of the challenges in establishing public health training is overcoming serious literacy challenges. On average, three of four South Sudanese citizens is illiterate (higher illiteracy rates for women than men). High rates of illiteracy are a lasting legacy from the long years of liberation wars (what many refer to as civil wars) between what is now South Sudan and Sudan. During the wars, which lasted from 1955 to 1972 and from 1983 to 2005, education simply was not available.

Therefore, the proposal that will be presented to South Sudan’s Minister of Health in December is for a certificate program in public health that will be offered at the University of Juba. Individuals with a high school degree will be eligible to apply. The University of Sydney will work with South Sudan to develop the curriculum and to provide guest lecturers. The program will be structured on a month on/month off training model for two years of study. Training will focus on maternal and child health, increased childhood immunization rate, and increased access to clean water.

In addition, South Sudan will also soon be running accelerated education programs for adults who did not have the opportunity to go to school during the wars. It will allow these adults to gain high school certification in a shorter period of time, with the opportunity to continue on in their education in programs such as the public health certificate. In addition, South Sudanese students will now be eligible for Master’s level scholarships to study in Australia through AusAID.

Training programs may begin as early as 2015. This is a promising step toward building South Sudan’s capacity to meet the broad health needs of its citizens. It has been exciting to be part of this project and to learn how to develop and implement a system-building project.

Throughout my life I’ve had a few collections: polished rocks, beanie babies, stickers. Thanks to my cousins’ selection, I now, as an adult, have a burgeoning unicorn collection. But this year, during my International Public Health studies I’ve started a new, and admittedly, odd collection of (empty) cigarette boxes. This morning I found an empty package from China on the street and got a few “you’re crazy” looks when I excitedly picked it up and put it in my backpack. Hey — I own a fair number of Australian versions, but this is my first international package!

Makes you think twice about smoking, huh?

In recent years, the smoking rate has dropped to between 16-20% in Australia. Much of Australia’s recent success in decreasing smoking rates stems from the World Health Organization’s Framework Convention on Tobacco Control (FCTC), the first WHO international treaty. It was adopted by the World Health Assembly (the meeting of WHO Member States) in 2003 and came into force in 2005.

The FCTC includes provisions to limit lobbying interactions between lawmakers and the tobacco industry, increase taxes on tobacco products (one of the most effective measures to decrease tobacco consumption), limit exposure to passive smoking, increase public awareness of the health consequences of smoking, regulate the contents of tobacco products, ban tobacco advertising, and include health warning labels on tobacco products, among other targeted measures. The FCTC calls for at least 30% of package space to be dedicated to health warnings, but encourages countries to adopt more aggressive measures where 50% or more of the package is covered by a health warning. In Australia, graphic health warnings are mandated to cover at least 75% of the package. However, the FCTC is only binding for countries that have both signed and ratified the treaty, which is why we haven’t seen these changes in the United States. The US has signed the FCTC, but has not (and will not) ratify the treaty.

Australia was the first country to introduce plain packaging of tobacco products as part of aggressive government-supported measures to reduce the use of tobacco products. Plain packaging, also known as generic packaging, requires that all branding is removed from tobacco packaging and regulates the size, font, and placement of the tobacco manufacturer’s name. It also mandates that health warnings are prominently included on the package. Products must be sold in a uniform olive green package, the color determined through research to be “least attractive.”

Implementation of the legislation in Australia began on January 1, 2012, with all measures implemented by the end of the year. The evidence behind the policy shows that plain packaging will increase the salience of health warning messages, reduce misleading messages on tobacco product packages, and reduce the attractiveness of tobacco products for both adults and children.

While the FCTC regulation and Australia’s legislation has not been without legal challenges from the tobacco industry, plain packaging is a big step toward decreasing worldwide rates of smoking. Based on the success in Australia, countries such as Canada, European Union countries, the United Kingdom, France, Norway, India, Ireland and New Zealand are all considering adopting their own plain packaging measures. The United States is conspicuously absent from this this and inconspicuously influenced by the tobacco lobby to go soft on tobacco reduction measures. Knowing the indisputable negative health consequences of smoking, let’s work together to encourage the United States (and all countries worldwide) to take a strong stance to support their citizens’ health and to decrease tobacco use. Let’s put health interests ahead of industry interests.

Thanks to my connection through Rotary to one of the organizers of the International Fleet Review, I felt like I had special inside knowledge about the event months before the publicity came out. The International Fleet Review ran October 3-11 in Sydney to commemorate 100 years since the first Royal Australian Navy ships entered Sydney Harbour on October 4, 1913. It was the biggest event in Sydney since the 2000 Olympics!

The celebration included 17 historical tall ships entering the harbour on the first day of the celebration, followed by more than 40 warships sent by countries around the world entered the harbour on the second day. Even Prince Harry made a 24-hour trip to Sydney to participate in the formal ceremonial fleet review. I’m not sure what happened in his schedule, but somehow we just couldn’t connect for afternoon tea. Next time, I reckon.

But what I was most excited about was the fireworks and light display on the harbour. In the style of the International Fleet Review, the planned fireworks were the largest display in Sydney in more than 25 years. So think about that: we’re talking bigger display than New Year’s Eve! Talk about a good time to be in living in Sydney!

With a group of friends, we picnicked at Mrs. MacQuarie’s point before the fireworks.

The display was more than I had imagined — and I’d been imagining this for months! The fireworks, which were set off from rooftops, barges along the harbour, decks of Royal Australian Navy ships, and even from the Harbour Bridge, were choreographed to music and a light display on both sides of the Opera House. (My favorites were the fireworks from the bottom of the Harbour Bridge.)

Photo credits T. Yuen.

As I watched, I couldn’t help but feel pride to be part of not only the event, but part of this beautiful, warm, and welcoming country. Australia offers so much to those who arrive, encourages a healthy lifestyle, provides many opportunities to get outside or to get involved with the community, supports education, and promotes work-life balance. What was interesting is that all of us watching the fireworks (and only one was Australian), felt the same pride in being in Australia. I feel so lucky to have the opportunity to be studying in this marvelous country!

New South Wales has been facing serious bushfires. The state is now in a declared state of emergency. At one point last week, more than 100 fires were burning in the area with one-third burning out of control. We are now down to 56 fires and 12 out of control, but it’s been a very different experience. I know what to expect and how to react to serious thunderstorms or tornadoes, but bushfires are a new breed. Last Thursday I kept looking out the window because the sky had the same kind of odd light that comes before a severe thunderstorm. I would peer out the window, check my weather app on my phone, see that it said sunny and warm, and peer out the window again in confusion. Dan eventually started texting me from the United States after seeing photos on Facebook of the smoke and postings about the fires. His texts pushed me to actually go outside to see what was going on.

When I popped outside at 4:00 in the afternoon, the sky was covered in brown smoke (hence the storm-like quality).

Sydney’s skies have largely remained smoky for the last week — more like smog, but with a definite campfire smell in the air. We’ve been battling fires since then, with poor conditions predicted for the next several days. For those who have visited, there are serious concerns in the Blue Mountains where they fear fires will link up into one large fire. These fires are coming early in the season, which leads to additional worries.

On the public health side, the bushfires are a prime example of the connection between environment and health. The smoke is causing very poor air quality. NSW Government warns that the general population may begin to experience health effects and should limit or reschedule strenuous outdoor activities. Sensitive groups are at higher risk and should avoid strenuous outdoor activities. Children, older adults, and those with lung conditions should be especially careful.

My heart goes out to the families affected and to the fire fighters working so diligently to product our NSW communities, as well as to those who are experiencing negative health effects as a result of the bushfires.

As my time in Sydney begins to wind down, I am getting sentimental about the people, places, and foods I will miss. Today, I’d like to talk about one of my favorite foods: Emporium of Chocolate. Since Dan and I accidentally found The Rocks Markets in March, Emporium of Chocolate has been our weekly special treat. They make the most delicious Brazilian chocolates and drive me to the market each weekend, even if I have no other shopping to do. A large part of what encouraged Dan and I to go back over and over…and over…was their warm and genuine customer service. I have always felt welcome as I mull over which flavor is coming home with me each week. And it’s a difficult decision with flavors ranging from the more traditional dulce de leche to the more exotic white chocolate with lime zest and cachaça.

Last week, I skillfully managed to steal one of their prop display chocolates instead of taking home an actual chocolate. (With the warm weather, they keep the chocolates in a fridge to avoid sending melted chocolates home with their customers.) My biggest disappointment when I figured this out was that I was going to have to wait a week for another Emporium of Chocolate treat.

When I went back to the markets this weekend, I decided it best to return their prop. Despite my error, they not only replaced the stolen prop with an actual chocolate, but gave me another four bonus chocolates! As if I wasn’t a dedicated customer before, this has confirmed it.

I highly encourage anyone living in or visiting Sydney to check them out — you will be glad you did. Now, if I can only figure out how to get them to set up a shop in California…

Once again, the Master of International Public Health Cultural Night was the place to be last week! We attracted quite a number of international students beyond our program, I think because the legend of our awesomeness has spread across Sydney Uni.

I felt a difference in the energy this semester. We’ve all been working together quite intently for nearly a year. So the combination of our collective sense of purpose as we near the end of our studies and the intensity of this semester elevated the celebration to a level above that of first semester’s “getting to know you” joy.

As before, we had a spread of delicious foods representing countries all around the world. We also featured a fashion show, with an added catwalk this semester. And, if you read my first note about Cultural Night in the first semester, you’ll be happy to know that I did better in the fashion show this time, wearing my “home state’s traditional costume on Saturdays during football season.” (See photos below of the Nebraskan in Husker football game day wear.)

Program friends from Ecuador (who happened to study at Wesleyan in my home city!) and India.

 

MIPHers representing Nigeria, USA, Australia, Vietnam, Democratic Republic of Congo and India. I love the wide range of backgrounds in our program and how this contributes to our learning and expanded thinking.

This year also included presentations about students’ home countries, giving us a chance to learn a bit more about some of the countries our classmates are from. It was almost like a tourism push, because the travel bug in me started chirping.

East Timorese Leadership Scholars sharing a dance about being happy. And it really did make you feel happy and want to join in the dancing!

And, of course, what would Cultural Night be without dancing? As one friend said, “Mathematics is not the international language – it’s the Macarena.” Somehow, everyone seems to know it!

Dancing fools!

The celebration also featured a crowning of a Cultural Night King, Queen and Dancing Queen (not gender specific).

Cultural Night King and Queen.

Another success! Now, again, how do we make these style of international potlucks a more frequent event?

The whole group.

I always enjoy going to Rotary Sydney Cove (my sponsor club) meetings for the welcoming people and for the interesting and wide variety of speakers. At the last meeting, it was no different. But this time, I had the added bonus of getting to play at being an Olympic gold medal winner – and believe me, I pretended so hard I almost had myself convinced.

Our most recent speaker was Liesl Tesch, gold medal winner in the Sailing Regatta at the 2012 London Paralympic games. Perhaps most impressively, sailing was a new sport for Liesl and one she picked up only a few years before the Games. Liesl and her sailing partner, Daniel Fitzgibbon, only started sailing together in December 2010 (before the summer 2012 Olympics). Think about that: she learned a new sport in a short time and got so good at it she not only qualified to the Olympics, but won the gold medal. Liesl also has two silver medals and a bronze medal in basketball from the last four Olympics Games. (Talk about a long and incredibly productive sporting career!)

Liesl became paralyzed at age 19 after a bicycling accident. Although she was told she would never walk again, she has gained enough strength to stand and even to walk short distances. I attribute this showing the doctors what’s what to her energetic personality and bubbly spirit. Liesl has been a basketball coach all over the world, but is now a high school teacher on the New South Wales central coast. Her students must love her! But I also bet they leave class exhausted after trying to keep up with Liesl’s intensity.

Liesl’s speech at the Rotary meeting was inspiring. I think most of all, I was impressed by her warmth. When I approached her after the meeting to see if, just maybe, I could get a picture with her, she grabbed her four Olympic medals and said, “Here! Put them on!” I just stared at her like she was nuts. She was going to let me wear her hard-won Olympic medals? Even the gold? Yep – that’s just part of who she is. (Side note: those are heavy medals! You need to be an athlete to be able to hold yourself up if you’re going to wear those medals around for more than a few minutes.)

Wearing four Olympic medals. No big deal. Or a VERY cool deal!

Once again, Rotary has provided new and life-expanding opportunities. And for Liesl, I just ask, “What are your training tips…?”

“So, you seem to be thoroughly enjoying the Australian culture and studying a lot. Do you do anything else?”

A good question. The answer (fortunately) is yes. I’ve been working on a couple of volunteer projects to gain public health experience. Rotary has allowed me to get involved with Rotary Oceania Medical Aid for Children (ROMAC). ROMAC brings children from surrounding low income countries to Australia and New Zealand to receive life-saving and dignity-restoring surgeries not available in their home countries. My current project has focused on analyzing the health system in the Solomon Islands to make strategic recommendations to further strengthen ROMAC’s work. I have really been enjoying this project, largely because of the opportunity to connect and build a global network.

Through a professor at the University of Sydney, I was connected to a professor and physician at San Diego State University in California. She then helped connect me to one of the pediatricians in the Solomon Islands. The ROMAC Director of Operations also helped connect me to a physician, so I was able to work on that network from two directions. Both of those physicians then helped further connect me to a network of doctors and nurses in the Solomon Islands, allowing me to ask questions to fill the gap in my research and to learn from the people on the ground. Who knows better? And what’s so exciting is that I now have this new network to continue to learn from!

I’ve also been working with Professor Bob Cumming at Sydney Uni on a South Sudan project. My volunteer time with Bob began in June with work to organize a week-long symposium for August that featured Dr. Samson Baba, the Director of Community and Public Health at the Ministry of Health in South Sudan, and Professor Aggrey Abate, Vice Chancellor of the University of Juba. I enjoy the logistics of a project and learned quite a bit from during the process, never having worked on a University Symposium before. I organized flights, hotels, insurance and event catering, plus a heap of other details.

I also coordinated visits with Sydney University staff across several days and with Canberra leaders for a day meeting with government officials. (For those from the United States, this is like arranging meetings with officials in Washington, DC.) What was most encouraging to me about the Canberra piece was that, as a student with no credentials to my name (yet!), I was able to set up these meetings and coordinate a very productive schedule for our visiting dignitaries. Our Thursday symposium, Australia’s Engagement with the World’s Newest Country – South Sudan, had over 120 registered participants and went off quite well.

Part of the trip’s purpose was to lay the groundwork for a discussion about future partnership with the University of Sydney and the University of Juba in developing a School of Public Health. This is thrilling to me, because these types of long-term public health projects are what really get me going and are what I envision for my future work in the field. I am thankful to have the opportunity to learn how a project like this starts and moves forward and to play even a small role in helping it progress. I’m currently researching curricula that will help shape the curriculum for future public health students in South Sudan. This is such an exciting project and I am looking forward to how it continues to grow!

We have been extremely lucky to have so many guests make the trip to Australia. Since my husband left for the United States in early September to start his PhD at Stanford, my latest visitors came at just the right time. Here are a few highlights from their visit to Sydney:

First of many trips to Circular Quay and the Sydney Opera House.

We started the day with a ferry ride into Circular Quay and a tour around the harbour and Sydney Opera House, followed by lunch at Mrs. Macquarie’s chair in the Royal Botanical Garden.

Double Bay, Sydney Ferry and Circular Quay views.

We then headed to the University of Sydney for a quick tour. They checked out the Law School while I went to class. We finished the day with Aussie-style sausages and traditional lamington for dessert.

The next day was a perfect beach day, minus a bit of the wind. I’m still finding sand in my bag/notes/book/anything I may (or may not) have taken to Bondi Beach on our second day. We enjoyed time on the beach and my bold guests even braved the chilly ocean water. For lunch we stopped at one of my favorite locations: Moo Burgers where Carl got to try kangaroo. We then walked from Bondi Beach to nearly Bronte Beach and back after lunch. Also, please take note of the matching cousin shirts!

Bondi Beach, Bondi to Bronte coastal walk and burgers at Moo Burgers.

Thanks to Karen and Carl’s excellent trip planning, we attended South Pacific at the Opera House that evening. It was, as expected, an incredible show. I watched South Pacific as a movie and remember very distinctly thinking, “This would be much better on stage.” And oh my. It was! What an experience!

Enjoying South Pacific at the Sydney Opera House.

Wednesday is an all-day class day for me, so Karen and Carl explored the city (and a local coffee house) before heading off on an overnight trip to the Blue Mountains in Katoomba.

Absolutely gorgeous views of the Blue Mountains.

On Thursday afternoon we toured Darling Harbour and ate Indian food at Zaaffran. The left-overs have now made it through an additional 4 meals. Even though we didn’t try the “World’s Smallest Dessert,” the choice was a spicy and delicious success.

Now, we thought Tuesday at Bondi Beach was windy, but cool is down a few degrees and whip up the wind about 20 km/hr and that’s Thursday. We walked across the Darling Harbour bridge (which will now forever be known as the Ice Bridge in my mind) to Strike Bar for a foosball table! Carl has pictures all over the world playing foosball, so we had to add a shot in the Southern Hemisphere to the list. Although Karen and I were, admittedly, weak opponents, we did manage to score a few goals. I won’t, however, mention how many of these goals we scored against ourselves and not against Carl.

Foosball Sydney-style!

We spent Friday trinket shopping and enjoying Newtown, including lunch at one of my favorites: Newtown Thai II. (Thanks, brother, for finding these excellent lunch specials in Newtown!) We made an afternoon stop at the Courthouse Hotel where Carl worked some of his lawyerly magic to get us free drinks.

Around the world people just know: “This is a guy I want to buy free drinks for!”

That evening, we made a trip out to a Sydney suburb to visit Karen’s good friend from high school, Cathy. I’m still amazed at how calm and put together Cathy and her family were, considering they were hosting us on Cathy’s due date for her third child.

Karen and our gracious host, Cathy.

On Saturday morning we visited The Rocks Market, another of my favorite activities in the city.

The weekend market at The Rocks.

Proof that we were still celebrating my birthday…or at least I was…!

We then took the ferry (we were all about maximizing the ferry usage!) to the Sydney Fish Market for fish and chips…and to gawk at some extremely large pelicans that hang out down there.

Sydney Fish Market in Pyrmont.

That evening we traveled out to Sydney Olympic Park (my first trip out there!) to attend a Semi-Final match for Australian Rules Football: Carlton Blues versus Sydney Swans. (Can you guess which team Carl was cheering for?)

Now, to be honest, I’ve leaned toward either rugby union or rugby league (still can’t tell the difference) since we got here. But, after going to this game, I totally see why AFL is so much fun! It’s a fast-paced, high-impact game that is basically a combination of American football, soccer, rugby, volleyball, hockey, basketball and a little bit of ultimate frisbee.

Australian Rules Football game at ANZ Stadium at Sydney Olympic Park.

Thank you for coming to Australia to visit!