This is the trick to creative work: it requires a slip-state of being, not unlike love. A state in which you are both most yourself and most alive and yet least sure of your own boundaries, and therefore open to everything and everyone outside of you.

...the fragile constructions of grey breath and thought that were his theories for changing the world without setting foot in it. 

My boundaries weave in & out - broken away by a night in the air, holding onto a small foot through a perspex cot. Back as I discuss discharging patients we can't find, reporting to child protection. Blown away again as the toddler with head lice reaches for the pearl hanging around my neck.

Medicine is creation, at times: the art of sifting for the treasure, the piece that completes the puzzle. The shared building of future hope, the push to trust in another. This point of connection teeters out beyond the edges of comfort, requires a willingness to set foot in the world, to be bruised by it and, at times, to be swept away.

A slip-state of being.



With thanks to Anna Funder, whose words I have cherry picked for my own ends.  

I define myself by what I do.

I've known this for a while. Ever since my year 12 biology teacher suggested that, in fact, he did think I could do medicine, it's been me. Ok, so I've been other things too - a bookshop sales assistant, a friend, a public speaker, a daughter, a foreigner - all of which have been more or less terrifying at times - but it comes back to this.

I want to be good at it. Others can be better, but I want to live up to my own expectations. And sometimes, I don't.

Does that make my expectations unreasonable? Sometimes they are. I talk through them with others and occasionally have to be reminded that that's ok. As long as the outcome is good, or not bad, then the process can be acceptable rather than perfect. I'm just as human as the people I treat, and must remain grounded in that.

The last few weeks have shaken my confidence - or at least, made me re-evaluate my expectations. The kids involved are fine - and my involvement with them helped them towards that outcome. But my idea of my own responses, my own level of practice and perhaps even my sense of who I am, has taken a hit.

Is it the settling in crash that did not yet happen? Perhaps.
Is it the new consultant imposter syndrome, that would be inevitable wherever I practice? Perhaps.
Is it being tired, in an unfamiliar place in the middle of the night? Quite possibly.
Is it that I push beyond my comfort zone? I should not then balk at feeling uncomfortable.

Is this where I am supposed to be?
I think so.

Is it who I am?
It's a big part of it.

Can I do better?
Yes.

So I look back, look for areas to strengthen.
And keep looking forward. 

I've been drained recently. New environments, new people, new systems. Being called in the middle of the night and needing to perform. Flying. A lot. The heat. The intensity of others, and the inability to control my time.

This spoke to me today.

Via Sarah.

Sometimes, life just happens.
And you run along trying to play catch up. Or wondering if it's all an elaborate joke.

I'm pinching myself. And still grinning.

Earning my stripes; or, The Importance of Not Being Earnest

“What these communities need is not more people. It’s fewer people. They don’t need another enthusiastic young white woman who arrives for a year or so then leaves again.”

The experienced GP isn't talking about me. He’s talking about the lack of consistent allied health and child development services. But I am standing next to him as he throws this out, and it cuts as it flies past.

I’m learning a new system, new places, new cultures. As for any other new cultural immersion, having read the right books and knowing the right words are important. It seems a necessary step to read, and that I am doing. I am reading government reports, internal audits, historical narrative about Jandamarra and watching The Circuit.  In Cambodia, it was pronouncing Khmer “kmai” not “kmair”; here I speak of “Bidgy” and am going there for the first time this week.

Learning a new lingo is fun, and we throw ourselves in enthusiastically. The novice scuba diver buys a full gear set before learning how to equalise her ears. The gardener starts discussing the merits of heirloom tomatoes before he ever hears the words, “dynamic lifter.”  We pontificate and debate, demonstrating that we’re in the club, to anyone willing to listen.

The experienced craftsmen just get on with it.

This adoption of new words and places is a developmental stage – one that enables new perspective, hopefully enlarges the world-view in the process. For some, the debate and the cause becomes the issue – and lord knows we need strong advocates.

But for me, I’m not sure where I stand. I know I barely qualify as adolescent in the world of Aboriginal healthcare. I’m perpetually tempted to blurt out, “When I was in…” or “In North Queensland we…” and I need to consciously tie down my tongue to avoid it. I remind myself that spouting my credentials lessens their value, if they ever had relevance anyway, and that getting defensive when people assume I know nothing is a guaranteed way to stay there.

So how to avoid being that enthusiastic young white woman, who brings her PC notions and her bleeding heart to the desert – for a few months only? I’m white. The GPs seem to think I’m young. I’m a woman. I’m here (partly) because of health inequity. And I only have a three month contract, and am not ready to commit to twenty years just yet.

I’m not sure that it means signing up for the rest of my career, though. I think it means to learn whenever I can, to listen and absorb and be curious, not to take my brief experience working elsewhere in Australia and interpreting my current situation to fit. To shut up in order to learn the local situation. To mature in my understanding, and just get on with it.

I hope that, as I do so, I can move beyond the Cause. To see individuals and negotiate solutions. To be energetic, not blindly enthusiastic. To advocate for the people I meet.

And in the meantime, forgive me if I pontificate every now and then.

"It's nice hanging out with people you don't have to start from scratch with."

My friend D hugged me goodbye. We worked together years back - me newly returned from overseas, she finding her own new directions. In the years since, we've spent more time together outside Melbourne than in it.

The walls in my serviced apartment have neutral hangings in variations on beige. The linen is white, the couch a light taupe in a land of red pindan dust. I've moved a table, bought some books, blu-tacked up a map of the Kimberley where a framed cushion cover previously hung. But my best purchase has been a sheet of plastic, 20" x 48", designed to hold photographs. I sifted through a few years' worth of folders on the computer, through a few facebook albums, and only chose ones that made me smile.

So now, I have a banner of faces and places. Fun days, foliage, sunshine and laughter. They farewell me as I leave the house, spring out as I flick the lightswitch, smile as I turn it off at the end of the day. After a colourful weekend of visitors, the faces stand out against the off-white walls.

It's nice hanging out with people I don't have to start from scratch with.

Settling in

I wonder how many posts I've written with that title?

Another month, another place. A new set of faces, acronyms, protocols, institutional culture. And that's just the admin office.

So far, all is well. Have met many, many people, seen a few patients, hopefully not put my foot in it too many times, found the supermarket, been to Zumba, three art galleries, two live music nights, a parade and the fireworks, and answered the phone. A lot. Tonight... we'll see what the on-call night holds.

For now, this is one of the reasons I'm here:

North Melbourne II

Petrol station. Peak hour. As always, a little bit late. Queue. The pump ticks over, ever so slowly, and I head inside to pay.

I fumble with my wallet - has to be cash. The visa card PIN still eludes me - haven't used it in six months. Receipt, library card, I'm sure I've got the right change somewhere... A coin falls out onto the counter & I stare at it, trying to connect country and currency. It's five pesos. Keep hunting.

The young Indian guy behind the counter perks up.

What's that?

Oh, Filipino pesos. Been back two weeks - need to clean out my wallet!

(Find $50. Pay. Guy gets change, then, shyly...)

Can I have it?

What? The coin?

Yeah. I collect them. 

I hunt through, find the 5P, a 10P, a one. Hand them over, grin, start heading out.

He calls after me, Here! Take one of these! Holds out an Aero bar from the bowl on the counter. He's remarkably happy, but I'd already restrained myself from an impulse buy.

Thanks, but they're only worth about 30 cents. 

As I unlock my car, the woman behind me walks out of the shop.

I would have taken the chocolate, love.

North Melbourne I

My step is light tonight. My fingers are chilled, my nose even more so, but the stars are out, out there beyond the street lights. I stride across Elizabeth St, still too slow for the crossing, a hurried jog against the orange lights for the last few paces.

I carry a paper bag, four new books - I never can restrain myself, despite my groaning shelves. It swings with my step. The op shop is lit, as always - this new haven of junk keeps odd hours. In the window, two golden male mannequins have a new sign: $850 each. They are headless but well endowed; I can imagine there have been offers.

I climb my stairs and again the bag put out for donation catches my eye. Not much, but maybe useful to someone. I have been clearing a little, scraping off a few layers, many to go but progress nonetheless. The last box went to the place on the corner.

It appeared about six months ago; the usual collection of dusty coats but styled for hipster appeal. The mannequins are out of place in their pricing - it seems a genuine op shop, rather than Vintage. The banners are cartoony, emblazoned "Community First" with cutesy faces. The board has a strategically placed bald kid, Czech and Korean flags. It's a big Korean neighbourhood. Donations needed!

The Salvos are four blocks away - a car ride, finding a park. At least I know what they stand for. Community First are 50m away, yet I'm a tad uneasy about an op shop open at 9 on a Monday night. Whose bald kid did they use for the picture? He looks neither Czech nor Korean.

My bag of donations fills up.

First night travelling in Laos

March, 2012. A flight, an official meeting, a dusty bumpy 4WD drive, a guesthouse with a bare concrete floor and cold bucket shower...

We walk through a mostly pitch-dark town to the only restaurant. It's 7pm and they are out of food. After negotiation, they serve us sticky rice, egg, salad leaves and a wad of mekong algae.

Afterwards, wandering back, we hear rhythmic twanging & see lights up ahead - a group of a dozen women on their haunches in the fluorescent light, a cloud of carded cotton in the middle of their tarp. They each hold a bow held sideways that they put into a pile of cotton, then hit it with a piece of wood, the vibration loosening up the fibres and sending them floating around in the air.

There is a loom off to the side, and when we express a bit of interest one of the wrinkled older ladies with a towel wrapped around her head beetles off & brings back her weaving - carded, spun, dyed and woven by hand. She names her price, and I feel like I should bargain - upwards. I buy a 2m length for $3.60, and she kneels & presses the money to her forehead as she thanks me.

It's more fun in the Philippines*

...this time!

So, it's my fourth visit to Manila. The first was my first overseas travel, a whirlwind introduction to the world for a naive young woman. It's the third time here this year, and I haven't necessarily loved it. Manila is big, busy and dirty, the food's generally average, and I was living slightly too close to the red light district to relax. But I vaguely amused myself to look down from the aeroplane and feel something akin to homecoming - at least, a sense of familiarity, that it wasn't all brand new again, unlike most of my other touchdowns this year.

After a stint at the office, I rode with my boss to the other side of town, unlocked the door to a friend's apartment, and realised that this time, it would all be a bit different.

Twenty-sixth floor, with a glimpse of the sunset. Soft couches, tropical plants, funky artwork and a swimming pool downstairs. An oven, a cupboard full of spices and all the ingredients for a banana cake - in short, heaven.

To get to work, I tag along in my supervisor's diplomatic-plated car. Dinner at Japanese or Moroccan or Serbian, real wholegrain bread from the market, a real wine shop a couple of blocks away. I catch the train home - a squishy cultural experience - and meander past water-featured international hotels, through the Stock Exchange Plaza and under lantern-lit trees across the park. My guard is down, and that is fine.

This week - a special two hour drive out of town to the best restaurant in the country. A music festival, a live soccer match. Pedicures, dancing until three, fresh citrus juice and good coffee. A new apartment with a view onto the park. And a farewell cake with my name on it.

Walking through the dark streets to another new friend's house, I realised - I'm happy. For an introvert who finds some connections with people a challenge, I've met so many amazing and wonderfully fascinating people. For a perfectionist medico who doesn't like being told what to do, I've been able to handle being on a much lower rung again - and thrived. I've seen that public health changes are possible, but that the clinical side is where it's at for me - at least in part. I can see that my career path will stay rather windy, but that spaces in the systemic gaps are where the interesting stuff lies. It's ok to fly in and out, as long as there is community to be had. And letting myself off the hook once in a while makes life a lot more fun.

So, a big thanks to the gorgeous bubbly CK, who very generously lent me her place while she went gallivanting around South-East Asia. The cute and funny J, who subsequently gave me his keys and is currently enjoying Thailand. K and KiBo and the other wonderful warm characters who have let me into their lives, fed me, refreshed me and taken me out onto the town.

And N, can't wait to explore some more of the country with you!

*Actual advertising slogan.

Phnom Penh weekend #2: The last

Friday night: White linen table cloths, pasta, wine. The trek to the Irish pub doesn't pay off; the music is shrill and the crowd building up to match. Our plan to go clubbing takes an earlier course than intended.

Two blocks away, the music is pumping outside. The bouncers do a genuine pat-down here; the combination of alcohol, guns and entitlement is potent. Inside, laser lights bounce off red velvet curtains and crystal chandeliers, while fake Angkor statues brood in the corners. Apart from a few guys playing pool, we are the only customers, the space echoing around us as the DJ's macbook plays his set list. He can't be bothered and sits at the bar instead.

The bored girls in halter tops aren't customers. They check facebook and nurse their beers, cast a desultory eye over us - one guy, four girls, no interest - and turn back to their phones. One of us has spent the week interviewing prostitutes, but she isn't going to bring her work to theirs. 

Gradually the place starts to fill up. One young Khmer guy's t-shirt asks the reader to hug him; his friend duly obliges. Gay night, or rich kids in Bieber haircuts? We can't really tell.

As the crowd swells, we head downstairs to the dance floor. Expat guys in their 40s & 50s, mostly on their own, do the traditional pan-Western shuffle as the Khmer boys wiggle in groups. The hostesses drag themselves from their seats and start to dance at the railings, or do laps up & down the stair case in diamante stilettos. We can only keep up our enthusiasm for so long before we pop out onto the street, searching for late night snacks and a tuktuk home. No business here.

Saturday, we enter the concrete and barbed wire that was S21 prison, where the mugshots of the dead echo through every room. The torture was going on here the year I was born, and the "No laughing" signs aren't necessary. 

Afterwards, a completely superficial distraction is required, and we have the resources to detach when we want to. Cuban night, but this time it's the expats on show.

The Latin band have their choreography sorted out, the brass players dripping with sweat as they turn with the rhythm. But reggaeton is quite a sight, and the restaurant courtyard is visible from the street. The two female singers, in tiny white shorts, give it their all, and the moto drivers crowd five deep in appreciation.

Again, I'm not at home here, and the images of the day clamour in my brain. I can't dance tonight, not with the fatigue of this morning. The glass between myself and Khmer society has cracked a little, and threatens to cut me.

I can't dance and I can't watch these girls dance - not Latinas, not Khmer. I can't watch these men watching them, the power to purchase and the powerlessness of the street. I can't watch the faces in the prison, watching me through the camera, watching their captors as they were captured for eternity. I can retreat to my white linen sheets and lock my door, but I can't maintain the illusion, not today.

Does témoignage apply here?

It's all I can manage.

Religion, election, Nicole Kidman

It's the commune (local) elections this weekend. The Cambodian People's Party has been in power since the 90s, and under other names since before that. The legitimacy of this depends on who you happen to be talking to... which is one reason not to.

The streets have been full of demonstrations for several weeks. Yesterday, a campaign truck blasting political K-Pop woke me at 6, and the background buzz of amplified music filtered through the office windows all day. The major street a few hundred metres away was blocked with a wall of tuk-tuks, all with huge loudspeakers lined up in a row. Slow convoys of thirty trucks wind through the streets, each carrying 50 or 60 people cheering and waving flags, their free caps all matching.

It's all pretty light hearted. At least it seems so.

Everyone knows who will win anyway.

Bus from Battambang

Our hospital visit has gone well, over by lunchtime. My supervisor is staying for training, my other two colleagues heading back tonight. Why not join them? Five hour ride – should just scrape in before the after-dark travel curfew. We grab lunch and settle in at the bus station, our three days working together having built a strange cross-cultural deference but little connection. Their older age and our gender difference would make it more formal anyway, without the murky traumatic past that haunts so many in this country.

The midday heat beats down on us and the kids in front stare. I use my plastic folder to fan myself, still dressed for meetings in business skirt and shirt. Our fellow passengers loll, their heads wrapped in checked cloth and woven hats.

In due course, we start to load up. My roller case seems big here – under the bus it goes. Boxes of soft drink, sacks of rambutans and motorbike tyres follow. It's durian season, and I'm thankful they go into cargo also. Find our seats, open my novel and we're on our way.

I glance up occasionally at the rice paddies and wooden houses. My seat companion droops, surgical mask firmly in place as he snores through the kung fu comedy on screen. The kids behind me wiggle and giggle and fight.

Stop one: two hours later. Buy some banana chips and back on the bus. I churn through my novel. Stop two: another two hours. The sun starts to sink behind the palm trees and my colleagues estimate a "Six. And thirty" arrival.

Which, of course, was the big mistake.

Ten minutes later, it's strangely silent. The engine has stopped, but we coast for another half kilometre or so. We climb out, conveniently right next to a sign proclaiming "Phnom Penh, 40km."

There seems to be an overheating problem – at least, multiple bottles of water are being tipped into somewhere- mostly all over the engine as far as I can tell. Fifteen minutes, and the driver gets it going again – just as another bus pulls up to offer assistance. We wave them on and head back to our seats.

Another few kilometres, and the engine cuts out again. This time it's immediately restarted and we cruise at 30 ks, internal lights, TV and aircon all off. Those around me start to complain about how hot and airless it is; I give up on my novel and give thanks we're at least moving.

Another five minutes, and we're not.

I rise from my seat, and as I stand in the aisle, there's a sudden rush. People race back in and out again, panicked Khmer hitting my ears. I get off as fast as I can as smoke (steam?) pours from the back. We're not going any further.

We're in the dark, outside closed up houses on the side of the highway. Thirty or so people mill about, bubbling with aimless frustration at being stuck so close to home. I follow my colleagues to a bamboo platform, conscious of how conspicuous I am as young guys on motorbikes circle back to stare. We sit and eat longan fruit and wait for the replacement bus from Phnom Penh.

One of my colleagues fidgets. I recall his seven year-old son waiting for him, his determination to get back. His polite smile starts to wane and he paces.

After several attempts, he flags down a taxi driver. I'm unsure; I've been warned against private cars, especially after dark. But my colleagues reassure me, the tyres at least seem ok and we've only got 30ks to go. I get into the front seat, smile to see a seat belt, balk to discover it's only got one cross strap not two, and can't put on anyway as there's no clip for the buckle. Cross my fingers, instinctively (and no doubt highly effectively) brace myself against the dash, and we're moving again. The radio blares and LED decos light up the bonnet.

Until 200m down the road, when the taxi breaks down.

I start to giggle. My agitated colleague is not impressed. My desperate attempts to smother it fail spectacularly, and I try to at least look the other way.

The taxi driver gets us going again – another 200 metres, another breakdown. Still in sight of the bus. My colleagues attempt a push start and the car bumps up off the road with no flicker of life from the engine. The driver tinkers for a good while until another taxi pulls up.

My colleague negotiates and it appears we have another ride. But the two drivers yell at each other, and he starts to join in. I contemplate seeing if there's a guest house nearby and waiting until daylight as a full shouting match ensues. It's only when my colleague pulls out his wallet and the first driver opens the boot that I realise my bag's been held to ransom.

A brief walk up the dark roadside, the tension hanging in the air. We reach the second taxi, a small rusty sedan, and I realise it's already got four people in it.

I say, No.

It's hot, and we're stranded in the dark at the side of the road. I have to work with the man standing in front of me for the next four weeks. He's just fought and paid for the release of my bag, found us a ride and now the silly white girl is refusing. But she's also a doctor - can he yell at me and keep his job? He swears in Khmer, puts on a nervous grin and explains, "OK, four people in back, no problem."

But my gut tells me not to get into this car, and I'm bloody well going to listen.

I ask, Is there a guest house nearby? I stay. You go, no problem.

- No, no guesthouse. We go.
- No. Too many people. You go.
More swearing. The taxi driver starts to yell again, my colleague working up to it. Headlights flash past in the night.

And another bus pulls up, a beacon of light and plush seats and safety.
I buy three tickets and send up thanks.

If you'd asked me what I planned to do with my first weekend in Phnom Penh, I would perhaps have suggested a walk along the river, sleeping in, finding a good coffee.

I might not have mentioned taking part in a public novelty dancing world record attempt.

Yet, that's what I found myself doing this afternoon.

When we arrived, there were already about 500 people gathered, blue caps firmly in place, practicing the steps to the Madison. For those Aussies for whom this is unfamiliar, this is a Bus-Stop-like repeated dance involving step step kick, step step kick, clap, turn 90 degrees and do it all again. Anyone sensing a theme here?

It was being filmed, part of a BBC sponsored TV series aimed at engaging youth in current affairs, via a soap opera and radio show. My new French friend's contact was facilitating and somehow we ended up as official recorders. Thus, as the clouds broke onto a crowd swelling to 1200, we stood, the international neutral observers, one at the end of each row of 32, and watched for the requiring 5 minutes as the mostly Cambodian dancers stepped, clapped and occasionally cheered for the camera.

The guy at the head of my line had obviously been dragged into participate, and shuffled his way vaguely left and right, exactly opposite to the rest of the crowd. Next to him, a young beauty wiggled her way through the steps, resplendent in full denim suit (complete with bows) and fluffy slippers featuring cartoon kittens on each toe. Behind them, an awed three year old stared at the dancers around her, fixed to the spot. The rain set in properly, the music kept going, and the blue caps bobbed along.

Afterward, we had to sign an official declaration. Were we aware of Guinness World Record regulations? Was everyone in our row dancing? (I excluded the child. Sorry but I'm signing my life away here!) And the organiser pointed out the essential recorders - perched on top of tall buildings overlooking the square, the cameramen with the sniper-like setups to take in the whole thing in one sequence.

The rain eased and the leather jacketted hip hop boy band came on. Forget One Direction, Utopia is where it's at.

As long as you speak Khmer.

(Catch the world exclusive from next Sunday at http://www.youtube.com/user/loy9kh)

It's all about the light

Sometimes life develops a cinematic quality. The way the sunshine fills the room, the hum of passing traffic, the side comments of fellow passengers.

For me, it's been the entire week.

The presentation, the official nods, the gift of a silk scarf held prominent for the photo.

Rain clouds dripping onto a mustard Melbourne skyline.

Beers in a cozy booth.

Standing at the microphone, my voice resonating into the future. A room full of faces growing less intertwined.

The vacuum cleaner under our feet.

My grandmother waving from her open front door.

The crisp sunshine seeping into my soul.

A chance meeting of a boy from another place and time - the struggle for context as we glance at each other. Then again: different country, different boy.

And my trolley case wheels rumbling down another marble walkway.

Maybe it's being mindful.
Maybe it's being disconnected.

Maybe my lens is coming into focus.

A culinary tour

I've spent the last three weeks traveling around the country. 39 health facilities in 14 working days! Plus a lot of time sitting in the car, and a lot of time eating. The best way to experience a country's cuisine? Go with a local:

Mekong river algae, done two different ways, and the ubiquitous sticky rice. After dark in Pongxay.

The best Pho I've ever eaten, with the usual pile of lettuce, mint, basil, chives, lemon & beans. On the road back from Botene.

Self explanatory. Xayabuli ferry crossing.

Sour chicken soup & wild ginger flowers. Cooked by health centre staff, Phosaykhun.

Do you eat river pork?
Oh. You mean liver. And lung and uterus.

At 8 am.

The liver & lung are fine. The uterus... perhaps at a meal other than breakfast?

Chose not to partake this time.

Mini coconut-like fruit - be careful to catch the milk inside while biting into it. Xayphoutong.

Other memborable moments include:
Smoked buffalo meat
The live catfish given to us by another health centre, that jumped and dripped, trying to eat through its plastic bag gaol all the way home in the car.
Green papaya salad
The densest dark chocolate mousse I've ever eaten
Baguette sandwiches, done Lao style with sweet chilli sauce & coriander
Early-season specialty rice
Car food (apart from the corn): coconut wafers, oranges and sticky fresh tamarind pods
Korean sukiyaki-style BBQ
Black sticky rice and bean cakes, wrapped in banana leaves
Fried chicken & kebab-style grasshoppers - accidentally ended up chewing on the flattened chicken head
Fresh Lao coffee with condensed milk
Green snake bean salads
Hard boiled duck eggs, complete with embryos - the only other thing I've declined.

And of course:

Ant egg soup.

Yum.

The Power of Corn

It's been a long hot day. We've just finished at the third health centre - this one doesn't even write down the number of births. On top of the core team of four, we have the provincial immunisation manager and a district representative along for the ride - four of us squished across the back seat as we bump along dusty roads. The driver's collection of cheesy soft rock blares through the speakers as my colleagues sing along: "Cos I am your ladee! And you are my maaaan..."

Abruptly, a whole lot of chatter breaks out and we pull over at a bamboo hut in the middle of a barren rice field. A minute later, I am handed a plastic bag full of sweet corn. Very recently boiled sweet corn.

"Whenever you reeech for mee..."

I try to unpeel my cob. As does the laughing provincial manager. Bump. Boiling water drips all over our legs.

"... gonna do all that I can..."

I get to practice one of my few Lao words as cries of "Hon! Hon!" (Hot! Hot!) erupt around me. The corn is indeed very Hon, and near impossible to hold. We jolt along, sliding from side to side, hot corn squeaking between our teeth. All I can do is giggle.

"We're heading for sumwair... somewhere I've never beeeeen..."

In Luang Prabang

Am getting geared up for a whirlwind tour of Laos - spending each of the next 13 nights in a different town! Our pilot day went well, we've tweaked the questions and most importantly, I got my two traditional skirts back from the tailor in time to meet with the provincial health director tomorrow.

An afternoon wandering the old Royal palace and striving up the hill to a stupa was a lovely way to start- there'll be a fair bit of car time ahead!

Crisis!

There's a nationwide shortage of tonic water.
None in the country. For the last four months.

Just what is an expat to do?

Tuk-tuk into town: 15,000 kip
One month bicycle rental: 250,000 kip
Chinese made helmet: 110,000 kip
Bike light: 17,000 kip
Having my own transport after trusting a real estate agent who can't read a map: priceless.

Only in the Philippines

...would the inflight entertainment on a major national airline consist of calling for volunteers to sing unaccompanied Karaoke into the intercom.
...would people get up & do it.
...would you see guys walking in between stopped traffic to sell, not garlands of flowers, gum or cigarettes, but a whole tray of bonsai trees.

The walk to work

Leave the apartment, check the lock.  Nearly called a locksmith last week.

Down 16 floors. Say “Good morning!” to the security guard as he opens the door. Sling the backpack diagonally across my front and out into the heat.

Left is the laundry service, four money changers, the most famous bar in Manila, and Kink Cakes, which sells exactly what you think it does.

Right is the way to the office.

Along the side of the shopping mall, closed at this hour. Stay to the right of the footpath, anything else confuses everybody.

Past the crowd outside the recruitment agency, spruiking dreams and jobs in the Middle East.

Down the 50cm step from footpath to road, helpfully matched with a wheelchair symbol on the other side.

Past the fallen tree, the Philippine Airlines training centre, the pedocab drivers asleep in their cabins while early 90s pop blasts from their speakers.

Right, and cross the road with care, between gaps in the jeepneys and motorbikes. Past the construction site proudly proclaiming, “182 days without recordable loss of work incident!” - as it has read for the last two weeks. Contemplate the use of the word, “recordable.”

Left again, past veggie stalls, cigarette stands, disabled beggars and the Supreme Court.

Right onto United Nations Avenue. We are the only UN agency in the street. Fight through the largest crowd, outside a “clearance centre.” This could be interpreted as referring to its demolition site appearance, but it is where all jobseekers must apply for a security check. The five-year-old kids do a brisk trade in Black Ballpens here.

And here we are, another smiling security guard, through the metal detector and into the compound: green lawns, regional flags, the walkway flanked by a koi pool with resident tortoises.

On the way home, more than half the trip is through the mall.

Hepatitis B - so what?

Hep B isn't the most obvious disease to choose. In Australia, we tend to think of it as a blood infection to avoid, but (even in the medical world) aren't really that aware of the consequences. The idea of a "carrier" implies that that person is pretty healthy, really, but not that they are themselves at risk.

• One in four people chronically infected with hepatitis B will die of liver failure or liver cancer
• Approximately 278,000 people in our region die from the consequences of hep B per year
• Babies whose mothers are infected have a 90% chance of contracting hep B
• A vaccine dose at birth is the best way to prevent lifelong infection 
• Almost half of the people in the world with chronic hep B infection live in the Western Pacific region (which Australia is in).

Access to the birth dose vaccine, in many settings, can tell us about women's access to skilled birth attendants and the perinatal care system.

In Laos, 80% of women give birth without a skilled attendant. Less than 30% have any antenatal or postnatal care. About one in ten children die before their fifth birthday, although this number is falling. And the total government spending on health care is about US$1.90 per person. Per year.

Laos isn't going to meet the regional hepatitis B control milestone. It's not hard to see why. But in some ways, an international push for one priority can focus attention on others.

If you're interested in reading more, this is the place to do it. For the public health inclined, the paper by Rani has an interesting discussion on the motivations behind setting regional goals.

The settling in process

So, I've done this a few times before. Arrived in a new place, rushed around to get myself organised, put the pressure on in order to sort my life out as soon as possible, which will then allow me to relax.

I bought a house on the first day of work once.

Don't worry, I haven't done that.

All this is my way of preparing myself to settle a bit... but it requires a fair amount of energy in the meantime. Combined with the mandatory new-country-new-workplace-culture-shock First Thursday Meltdown, it's often not pretty.

So far, it's been smooth. My victories thus far are:
1. Getting on the plane at all. Some of you know why.
2. Knitting a fish.
3. Obtaining a phone number.
4. Realising the day before work that my normally fairly accurate sense of direction was flipped, and therefore I what I thought was North (the way to the office) was in fact South.
5. Finding an ATM that will recognise my card. See this for why this is an issue.
6. Obtaining an apartment. On a three week lease.
7. Realising before muesli-planning purchase that those are not shreds of coconut. They are squid flakes.
8. Toasting rolled oats in a wok.
9. Eating both lunch and dinner with different new people two days running.
10. Obtaining an ID badge with purty blue official logo button. Not needing it because the security guard already recognises me. 
10. Swimming 20 laps. OK, so it's the "condo" pool and it's only about 15m long. But I still swam.
11. Getting internet. I can now talk to you all.

So for now, this is home sweet home. 

And tomorrow is Thursday.

FAQ

So... where are you going?
Lots of places. Manila based, with a month in Laos and two months in Cambodia. Rough itinerary is:
Feb 4 - 28: Manila (this is in the Philippines, for those who may need reminding)
March: Vientiane, Laos
April: back to Manila with quick dash home
Late April - mid June: Phnom Penh, Cambodia
Late June: Manila
End of June: Home.

What are you going to be doing?
Doing an Internship placement with the Western Pacific Regional office of the World Health Organization (and trying to remember to spell that with a "z".) Focusing on Hepatitis B control via vaccination, specifically looking at promoting uptake of the vaccine dose given at birth. This is when children are most likely to get Hep B & keep the infection for life, so the best window to intervene with immunisation.

Where are you staying?
I have a hostel until Wednesday & will figure the rest out when I get there.

They're putting you up, right?
No, the internship is not a job as such, but a work placement, hence I need to sort out arrangements myself. I'm hoping to count it as a subject for my long-running Masters study.

Will you have internet?
Yes. I will based in big cities, not in the jungle like before. Manila has 12 million people - I'm pretty sure they have phones. I might even have one myself.
But seriously, I expect to get a local sim card so not sure about being textable on my current number, but will be here, on email, fb and skype.

Have you had all your shots?
One of the benefits of leaving the country so often is that I've actually had them all already... and don't need any boosters or anything!

What are you doing after you come back?
Drinking cocktails and knitting.

Off again...

Hello all who may occasionally drop in (all three of you) and welcome to everyone else! Once again I am jetting off for a few months of my life, thus resurrecting this blog seems the way to go. Please feel free to contact me by other means, but this way I'll not be cluttering up inboxes!