3 Weeks in London: Health Determinants

 Individual heath determinants are all around us, in everything we do, every day. Right when we're born we already have things weighing against us--our genes and environment. As we grow up, our behaviors weigh into our health, too. This includes our attitude, beliefs, and actions. Even the kind of job you have as an adult can determine your health. For example, men that are at high positions in a company will have a MUCH healthier and stress-free life than the janitors of the company. Why? Because the less control you have over your own job, the more stressful it is! I like to say that my job is stressful because I work with crazy kids, but in reality, I have a LOT of say with what we can and can't do, and the stress doesn't come from the job, but the kids.

 One day while we were heading to class, the station for the underground train that we usually use was flooded, which meant no trains. Thankfully, we had a transit card that let us ride any transit. This includes the trains as well as the busses. So, instead of freaking out about not being able to take our usual train, we hopped on the next bus that was going the way we needed to go, and that was that! On another occasion, we were all going out of town to Windsor for the whole day, and when we went to the Underground station I realized that I didn't have my transit card on me. Instead of going back to where we were staying, because we were already late, I just went ahead and bought a day use card from the station. Both of these examples could have brought me a lot of stress, but because I didn't grow up having chronic stressors in my life, they were simply just minor hassles that I could easily get over.

 Something I think a lot of us take for grated is how easy it is to get around in our neighborhoods. Now that I've lived in Corvallis for a few years, I know that if I ever needed to get somewhere, I could walk, drive, ride my bike, or take the bus. Unfortunately for a lot of people, that isn't the case. In some neighborhoods it's close to impossible to feel safe, and walking around by yourself isn't something that people think of doing.

In London, they have two things to help with getting around without a car. One of the things they have all over the city is bike racks with bikes that you can rent, right then and there. Not only does this let people travel easier around town if they don't have a car, but it also increases exercise.

The other thing that they have are these notices in crossing areas. Most places in London pedestrians don't have the right-of-way, and driver get very upset if you're in their way. They also drive on the "wrong" side of the street there, and to help pedestrians to remember (and not get hit by a car) the city has pained "Look Right" and "Look Left" all over the streets. Whether they were think of this or not, the city has greatly increased the overall health of the people in their city by posting these reminders. 

 Another thing that's very popular in London is smoking. Of course, everyone knows that smoking is bad, and that tobacco is the leading cause of death worldwide, but did you know that there is a thing called "third hand" smoke? Third hand smoke is when you come in contact with items that have been contaminated by tobacco smoke, so clothes, cars, and furniture that have been around a smoker are now considered things that can also be harmful for you.

There are many other drugs that can be harmful for you and, and the biggest one is alcohol. Everyone has their own blood alcohol content that is considered "safe" for them, meaning that everyone can drink so much and still be under the legal limit. If someone goes over their limit and decides to drive, they are putting many more people than themselves at risk.

Did you know that going to college increases your lifespan? The more education you receive, the higher your chances of living to an old age become. But just because you did four to eight years of secondary schooling, doesn't mean that you will outlive your less educated counterparts. Some people need to take more medicines than others, be in for a condition, or just for pain. It's important to always know how you are supposed to take medicines, so you can protect your body. For example, taking pain killers without eating food can be very harmful to your organs, and can wear them down greatly over time. Also, taking antibiotics too often can also be detrimental to your health. 

Having kids is a big decision to make, and the fact that the women in poor countries seem to have little say in the matter makes it very stressful. Here in the United States, and as well as other wealthy countries, our ability to decide when (and where) we have babies greatly decreases out overall stress, and helps us to determine when the safest time is. Because most women wait until later in life to have kids, their bodies are fully developed and able to carry, and they are also able to make sure that they are financially able to care for their child once it is born.

A personal health detriment that I am very passionate about is nutrition. There are many places around the United Staes where people lack proper nutrition. There are also some cases where people just don't have much food available to them. In either case, the lack of proper nutrition can cause many health disparities. It can stunt growth, impede neurological development, and can cause stress within families. One of the most important things we can do is make sure that me provide food to children. In many places in Oregon and around the country there are reduced and free lunch programs that help to feed our nations youth. Without programs like this, children are less likely to succeed in school, and are more likely to be under chronic stress.

Lastly, LGBT individuals have been climbing a slow uphill battle for basic rights that are already available to most of the population. In many states, the legislation has already been passed to allow people of the LGBT community to get married, and in a few states, transgendered individuals are being allowed to use whichever bathroom they see fit within public settings regardless of where they are in their transition. Something that is important, and obvious for most people, is that people of the LGBT community are people. They are under attack now just like African Americans were back in the times of slavery. When future generations look back at what's going on now, they will look back with the same eyes that we are currently looking at the slavery years with. All people deserve the same rights and respect no matter what.

3 Weeks in London: Global Heath

While in London, we discussed issues that are related to health around the globe. Global Health is a collection of problems that is based largely on ethics and a collected vision of how the world should be.

One of the first things we talked about were the Millennium Development Goals set in place by the United Nations as world-wide goals to be met by the year 2016. We touched on almost every goal while in class while looking at case studies, country-wide problems, and regional beliefs concerning the goals. The goals are:

1. Eradicate extreme poverty and hunger

1. Achieve universal primary education

1. Promote gender equality and empower women

1. Reduce child mortality

1. Improve maternal health

1. Combat HIV/AIDS, malaria and other diseases

1. Ensure environmental sustainability

1. Global partnership for development

When looking at these goals we had to understand that before we even can think about improving the water quality, lowering the infant and maternal mortality rates, or helping educate people from remote areas, we have to think about what they think of us. If someone you didn't know came to your house, started speaking in a language you didn't know, and gave you pills that they wanted you to take for some reason that you didn't know, would you take the pills? The likely answer is no.

What about if your country is suddenly in conflict with another, or disaster struck? Would you want people to come in, patch up the problem and leave? Of course not. The people in a country in conflict or in war could benefit the most from people that would come in and help them be successful by themselves. What every organization that goes to give aid over seas needs to do is create a way to help the local people how to deliver services themselves, so when the aid leaves they aren't left to spiral back to the way things were.

Often you will see people fundraising for certain diseases like HIV/AIDS, Malaria, or Cancer. A mindset that a lot of people have is that it's an "A" or "B" situation, meaning that they can donate to one OR the other. But really if you think about it, you can choose to donate to both. Maybe you have to split what you would normally give to one organization up between two or more, or maybe you can afford to support multiple organizations with the same original pledge amount, either way there is an option "C" when you are wanting to help a cause.

One of the largest world-wide challenges is dealing with access to fresh water. In rural areas of Sub-Saharan Africa and Asia there is little access to water, and what water there is generally is unclean. The biggest issue with unclean water is when it has been contaminated by human fecal matter. While we said that 68% of the world has access to a sanitation facility, this doesn't mean that it is necessarily a toilet like the ones present in the Western world. In fact, up until a few hundred years ago London didn't even have modern plumbing, and the citizens used the River Thames for everything from their "toilet" to their source of drinking water. Around this time, the preferred method of wiping after using the toilet was by using the neck of a swan!

In many places, when the water is unclean the food is also unclean and often un-edible because of the fecal contamination. Without access to edible food, communities become malnourished, and must rely on foreign aid for food. It is sometimes hard to think about how lucky we are when it comes to food availability. For most people living in the Western world, we can very easily travel a short distance to purchase what ever food we want, be it locally grown produce or food imported from around the world.

By far one of the most important things we talked about it being able to minimize maternal and infant mortality rates. Proper sanitation is a great way to minimize the infection rate of infants and children with low immune systems, but another huge way to reduce this is by delaying the age at which women get pregnant and give birth. According to the World Health Organization, over 16 million women between the ages of 15 and 19 give birth every year. Many of these pregnancies are because the parents of girls in low income countries are in need of money, and one of the easiest ways is to marry them off. A way that the more wealthy countries deal with unwanted pregnancies is the use of birth control. Also, women in wealthy countries generally have more set plans for their lives, and usually having kids is behind many other things.

http://www.who.int/mediacentre/factsheets/fs364/en/

The last major thing we talked about was the advances of medicine throughout the history of London, and the "factory line" that was the soldiers lives. When wounded in battle, the soldiers were sent back to London by train where they entered a queue where they would either be cast aside to die, or put in another line to be reassessed. This happened quite a few times until either the soldier died, was diagnosed with a mental disorder (now known as PTSD), or was deemed well enough to be sent back to war.

Those who didn't survive were often grouped with many other men and put into unmarked graves. In London, this park is one of the large graves of over 20,000 men who dies during WWI. There were no actual memorials, so the park is what is there to remind everyone of the many casualties.

However, now many of the wealthy countries have universal healthcare so that everyone in their country receives care regardless of their income. In some wealthy countries, there are still private practices, where you have to either pay out of pocket, or but special insurance. In some cases, the private practices struggle to find patients, and on the flip side, many of the public services are often overwhelmed by the number of people they have to serve.

3 Weeks in London: I was a Tourist

With over 8 million residents, 100 theaters, and more than 16 million visitors each year, London has a lot to see and do. During my time here I've done things from seeing Big Ben, to riding the Underground, to going to the local zoo. 

These are just some examples of the tools they used in medicine between the 1600s and the 1800s. The tools on the top are typical instruments that were used for amputation, a normal procedure that was typically done without anesthesia. When surgeons first started using anesthesia, chloroform was used. What is seen in movies where a cloth with chloroform instantly knocks a person out is actually not what really happens. Surgeons would use a small amount on a cloth covering the face, but they had to be careful not to use too much because that would cause the patient to overdose and die.

We visited the Royal College of Physicians, and got to take a tour about alcohol and medicine, as well as a tour about medicine and war. We learned about the advances of medicine throughout the history of London, and the "factory line" that was the soldiers lives. When wounded in battle, the soldiers were sent back to London by train where they entered a queue where they would either be cast aside to die, or put in another line to be reassessed. This happened quite a few times until either the soldier died, was diagnosed with a mental disorder (now known as PTSD), or was deemed well enough to be sent back to war.

While in London we did many of the typical "tourist" stops. We rode in the London Eye, and got to see the great city form high up in the air. Compared to cities like Los Angeles, I was surprised by the lack of smog on the horizon. However, this could have been because of the constant clouds covering the sky. 

On a tour about the history of toilets in London, we were shown the only lamppost in London that is still partially powered by methane gas. Back when plumbing and sewer systems were in their first years, all of the lamps were powered by "poo gas" throughout the city. Pretty gross, huh?

We also got to see the Tower of London, Abbey Road, Baker Street, and go on a river cruise all in the first week! The amount of culture and history in this city is SO vast that it would probably take months to see everything.

The Tower of London is home to the Crown Jewels. To get to see them, you have to go through a security system, and walk what seems to be five minutes into the vault. There's multiple diamonds over 100 karats, as well as many golden table setting, scepters, and the Royal Robes of Victoria the First.

Of the 200 plus museums in London, we made it to about 10 of them. The National Gallery, the National Portrait Gallery, The Welcome Collection, and many public health related museums, all free. The majority of London's museums are free, which is such an awesome thing because if you're ever bored and looking for something to do, you can easily find something that's free and that you can easily spend hours enjoying. While here, we also went to the Sherlock Holmes museum and the zoo. They both had a cost to enter, but once there, we easily spent hours looking around.

We also got to see A Midsummer Night's Dream and Shakespeare's Globe Theatre. The theater was amazing, and the fact that we were in such a historical place made standing for three hours bearable. Why were we standing? We were in the "peasants" area of the theater, which is located in front and around the stage. In Shakespeare's time, the peasants would stand in this area while the wealthy got to sit in the boxes and seats in the back and balcony. 

The play itself was a modernized version. The cast was dressed in "normal" clothes to todays standards, and the character of Helena was a Helenus. Having not one, but two gay men in the play really was a shock, but it didn't change the story one bit. The love square between Helenus, Lysander, Hermia, and Demetrius was still as heart wrenching as it was when I saw a more "classical" version.

One of the most interesting things about London is the variety of food that is available. While here, I had anything from the typical Fish and Chips, beautiful Mexican tacos, pizza, and even sushi. There's dozens of cultures, and hundreds of languages around the city, and it's hard to walk more than a block without hearing a language or accent that isn't English.

The "full English breakfast" is certainly a plate full. In the ancient Anglo-Saxon days, the gentry (the class right below the nobles) would honor guests with a full breakfast to show their wealth.

(https://www.englishbreakfastsociety.com/full-english-breakfast.html)

On our last day in London, we went to a restaurant near Tower Bridge where we enjoyed classic afternoon tea that consisted of tea, small sandwiches, and various pastries. 

The culture in London is incredibly different than that in Corvallis. There is no sign of the beloved Birkenstocks here unless they're being worn by a tourist. When you think of the "typical" person from the U.K. it's likely that you think of a man in a suit, or a woman in a skirt and nice blouse. This is EXACTLY what you can find in London, and let me tell you, if you don't look like that you can get some pretty weird looks for standing out.

We also took a couple trips outside of London to Windsor and Cambridge. While in Windsor we toured the castle, which is one of the current residents of the Royal Family. We also took a boat ride on the River Thames, and learned about the history of the area. There was also a fudge shop in Windsor called Fudge Kitchen that had some pretty awesome fudge and employees. 

In Cambridge, we went punting. Punting is when you get to sit in a really long, extra wide, canoe-like boat while someone "drives" you around with a long pole. We learned all about the different colleges within the University of Cambridge, and the history of a few of them. In this picture is Kings College Chapel, and one of the many punting boats on the river that day.