Everything has to end - last day in Singapore

Heute ist Freitag, unser letzter Tag in Singapore und auch unser letzter Famulaturtag. Netterweise koennen wir diesen Tag aber nutzen fuer diverse Wege wie grosses Postpaket nach Deutschland schicken, 2 Rucksaecke zu einem zusammenlegen, Gepaeck bei einem Freund unterstellen und nochmal unsere Gruppe an Famulanten treffen.
Das war wohl das Beste an der Famulatur - die Leute, die man getroffen hat. Auch wenn es in der Mehrzahl Deutsche und Oesterreicher waren - es war eine super Mischung und dadurch war immer volles Programm angesagt. Leerlauf gabs somit nicht, was auch ganz schoen anstrengend werden kann, um so mehr man ins Schlafdefizit kommt ;) Mit einer Sim-Karte und Handy ausgeruestet konnte man Gross-Singapore glatt einen familiaeren Touch verleihen. Auf jeden Fall ein herzliches Aufwiedersehen in Deutschland oder Oesterreich oder natuerlich auf der Insel zu Anne & Sebastian, Tobi, Dirk & Matthias, Michael, Susan, Brigit, Niece, Anh und Kathrin!

Wahnsinn wie schnell 4 Wochen rumgingen. Kaum zu glauben, dass ich einen Monat in Singapore war. Und es war wirklich schoen! Noch etwas mehr und man faengt an heimisch zu werden. Mittlerweile geh ich schon geziehlt meinen Essenswuenschen nach, kenne meine Buslinien in die Stadt und und lauf ganz selbstbewusst ohne entlarvenden Stadtplan die Strassen entlang :)
Wir machen uns heute mit der letzten Bahn auf zum etwas ausserhalb gelegenen Flughafen, um morgen frueh 6.20 nach Bali zu starten. Es koennte eventuell sein, dass ich in der naechsten Zeit nicht so oft ins Inernet komme, daher wenigstens die Plaene unserer weiteren Reise. Unsere grobe Route ist momentan: ca. 1 Woche Bali, dann nach Bangkok oder Phnom Penh fliegen und per Land- oder Wasserweg nach Vietnam, um dort ca. 2 Wochen Zeit zu haben. Holger muss Ende September wieder nach Singapore und dann heissts Bye Bye Asien, ich hab dann noch 3 Wochen Zeit Thailand zu erkunden.

Freu mich natuerlich trotzdem immer ueber alle Nachrichten!!! Viele liebe Gruesse aus Singapore! Und fuer diejenigen, die wieder anfangen, einen gelungenen Semesterstart!

Today's Topic: Forest of Signs and Singapore

Wie oft ich hier schon ueber Schilder geschmunzelt habe, hab ich zwar nicht gezaehlt, aber es passiert eigentlich taeglich. Singapore beeindruckt gar nicht so durch seine Verkehrswarnschilder auf der Strasse, eher durch die zahlreichen Verhaltenshinweise in Bussen, MRT, auf Muelleimern, in den Hawkern oder einfach mitten in der Stadt auf aufgehaengten Plakaten. Das geht von einfachen Verboten wie "No Littering" oder dezenten Ins-Gewissen-Sprechen "Please use the seatbelt for your own safety to prevent serious injuries", um dann fuer die noch nicht Ueberzeugten noch den Satz "prohibited by LAW" anzufuegen. Singapore wird dem Ruf 'a fine city' irgendwie schon sehr gerecht - von ueberall wird man freundlich erinnert: "No smoking - Fine $1000", "No littering - Fine $1000", "No Eating and Drinking (in the MRT) - Fine $500", "No Durians!", "No (bike) riding - Fine $1000", "No flammable goods - Fine $5000".

Aber Singapore benutzt nicht nur Strafen, um seine Bevoelkerung auf den rechten Weg zu bringen! Es wimmelt hier auch nur so von Propagandaplakaten und Appellen. Vom "Singapore Spirit", "We are Singapore", "When going out - use the right protection: sunscreen" bis zu den (persoenlich auch fuer gut befunden) aufgestellten Schriften vor den Wohnvierteln "Let's keep our town clean!".
Einer meiner Favoriten ist, der Aufkleber in Bus und Bahn, in Anlehung an die bei uns bekannten Comics 'Liebe ist...': "Courtesy is ... giving the seat to someone who needs it more' und dann ein Bildchen von einem alten Mann mit Stock und einer schwangeren Frau mit Kind an der Hand :)
Letztendlich muss man Singapore auch mal zu Gute halten, dass sie mit ihren ganzen Verboten es geschafft haben Malaria auszurotten und fleissig am Dengue-Fever arbeiten, da stehendes Wasser wie z.B. in Blumentoepfen ebenfalls streng verboten ist und mit hohen Strafen geahndet wird. Und wohl aufgrund der Strafen und vielen Verhaltenshinweisen, halten sich auch Jugendliche daran ihren Muell in den Muelleimer zu werfen und nutzen die oeffentlichen Plaetze ohne sie zu zerstoeren. Es ist fasst so, als haben die Singaporianer den Wert und den Sinn verstanden, ihre Insel schoen zu erhalten und das durch alle Altersschichten hindurch und tun dies mit Stolz statt aus Zwang.

Bintan, Indonesia

It was the last weekend of our stay in Singapore and we decided to have a relaxing time on the beach on this beautiful island close to Singapore. It turned out to be totally different to our expectations. Though it was a fun weekend with our group of 5 Germans, 1 Austrian and 1 British! Indonesia is pure contrast to clean and regular Singapore.

Hello Indonesia

We finally decided on our next destination after completing the clinical elective next Friday. Today we booked our flight to Bali on 30th August. Cheapest one we could find was LionAir. Yes, we know it is on the Black List of Banned Airlines in Europe, but we decided to give it a try. So, we end up visiting Indonesia and might skip Malaysia instead.

If we manage to organize a trip for a bunch of students, we will go to Bintan, a little island belonging to Indonesia but easily reached by ferry from Singapore within an hour, on the upcoming weekend.

My New Favorits

1 Euro is about 2 Singapore Dollar

Drinks:
• Fresh Mango Lassi, often iceblended (S$ 3,00)
• Fresh Watermelon Juice
• Fresh Orange-Carrot Juice
• Fresh Lime Juice
• Fresh Sugarcane Juice (all S$ 1,50)
• Apple Juice with Aloe-Pieces (S$ 2,20/1l)
• Blueberry lemonade with starch bubbles (S$ 1,50)
• Milo Dinosaur (S$ 3,00)

Food:
• Chicken Rice (S$ 3,50)
• Char Sew Pau (S$ 0,60 – 1,00)
• Char Sew Rice (S$ 2,50 – 3,00)
• Rice with dark duck sauce (S$ 0,70)

• Fried Dumplings (S$ 8,00)

• Bean sprouts (S$ 0,70)
• Bee Hoon (Noodles) usually with vegetables or meat
• Mee Pok (without the fish and tofu) (S$ 3,00)
• Satay Chicken (S$ 0,50 per piece)
• Ketupat (Rice Cake) (S$ 0,50)

• Carrot Cake (no carrots!)

• Sweet & Sour Fish (S$ 2,00)
• Bahkwa ( a thin squared slice of pork roasted in a special honey sauce)
• Rice Porridge / Congee (S$ 3,00)
• Plain Prata with curry sauce (S$ 0,80)
• Banana Prata (S$ 2,00)
• Naan (S$ 1,00)
• Chicken Briyani (safran rice on banana leave and chicken) ((S$ 5,00)
• Murtabak Chicken (Prata with Chicken filling) (S$ 5,00 – 6,00)
• Dhall (cooked lentils in thick yellow sauce) (S$ 2,00)
• Popiah (S$ 1,70 – 2,00)

...to be continued...

Things I've tried

Very tasty north Indian food - rice, lentils and chicken.

Local cook BBQing assorted Satay Sticks (chicken, pork, beef, mutton).

Chicken Congee, savoury rice porridge, and Siew Mai with a meat filling.

Ice Kachang - crushed ice with syrup in rose and other artificial tastes and durian topping, and as a surprise you find kidney beans, corn and atap seeds and jelly cubes under the ice tower.

Famous durians - very smelly but sweet fruit.

Today's Topic: Food and Singapore

Singapore’s variety on dishes is just as numerous as its cultural background. It is a hotspot for Chinese, Malay and Indian food. And the best thing about it – it is cheap and so tasty, just like you are in the country itself!
The first thing you have to know about Singapore is: nobody cooks itself! Because it is so cheap to go out and grab some food, it would not be worth it doing it yourself. Even if you get something different everyday, it would take forever to make the round. And cooking all these dishes would be too complex and extensive – it will be very hard to be as good as what you get on the street. Though the consequence is, you hardly find someone (academic) who actually can cook. Not even a morning egg. But because here a morning egg barely sees any hot water… you eat it rather raw poured into a bowl ;)
The second thing you have to know about food in Singapore is the place where to get it! The best places are the hawkers (open halls with only fans) and food stalls (halls with aircon). Of course there are tons of them in Singapore and you’ll soon find your favorite ones. But for all you can be sure that the food you get there is cheap, fresh cooked and delicious. Please do not expect an nice neat restaurant with dimmed light and a waiter, it is rather crowded and it happens frequently that you share your installed table with total strangers. But be sure, they are usually locals!
I like the Maxwell Food Centre and the hawker in People’s Plaza, both located in Chinatown having all the typical Chinese dishes. It is nothing compared to the menue we know from German Chinese restaurants. It is so much more, more than you actually would have thought of… chicken feet, fishball soup, bean sprout salad, chicken in all imaginary pieces, sea food, minced noodles, fish heads, innards, new kinds of vegetables, fresh juices with strange flavors, great spices and the best rice I ever had! There something for everyone. You have to love it.
In the business district and in Vivo City, an awarded shopping center, you can find some fancy food courts. A very nice and pretty hawker I can recommend is Lau Pa Sat Festival Market, which is constructed only out of iron, imported from Glasgow about a hundred years ago, and usually is crowded by business men around lunch time. For eating right under the clear sky try Newton Food Centre. Since they are not in Chinatown, you can find all different kind of food – Chinese, Malay, Indian and even some Burgers (for I don’t know who ).
All these food places have in common that you find round tables and usually 6 chairs around them all being fixed on the ground in the middle of the place. Surrounding the tables you find many little kitchen shops selling and cooking different kind of food and drinks. You leave your used plates and glasses on the table, there are workers to pick everything up. A nice detail and orientation is a blue DIN-A4 paper being displayed in every shop, letting the consumer know about the status of cleanliness. An A means the highest possible standard, but you can easily buy food until a C. Most hawker stalls have an A or a B, so it is rather safe to eat in those places. So, there's nothing in the way for a great food experience!
Going out to have good Indian food is just a bit different. The best place to go is, of course, Little India. There you don’t have hawkers, it is similar to restaurants. You have one kitchen/counter, where you usually can choose your food by picking it right off the counter and then you sit down on plastic chairs, and depending on how full it is, it happens that you share your table with a local. But to mention it, who were so far all very very friendly and interested. Little India never sleeps, so if you go there by 11 pm, the streets and food places are full of Indians. You should pick a place with lots of locals in it! The less glass the more local. The food there is generally good, but it’s best in the bit shabby looking places. And of course, also the cheapest. Don’t think, “oh, there are many tourists in, it must be good!” in little India they start to make their place more attractive to the tourists by putting in glass in the windows, having nice chairs and offering aircon (what of course makes it very comfortable). But the prices go up as well (still cheap though) and cooking becomes second placed. If you don’t find a menue, that’s a good sign ;). So far we’ve tried 4 or 5 different places and all were superb. Just pick one of these many along the streets and you won’t get disappointed.
One last place I would like to introduce is the seafood centre at the East Coast Park. Here you can go out in fancy and a bit pricier restaurants along the beach getting the best seafood of Singapore. There, Holger ordered the popular Pepper Crab, prawns and sweet & sour fish and I really liked it – me having almost no experience in seafood. The best place to make your first steps ;).

So far no fast food yet, hurray! Only a Sunday at Mac Donalds when Holger needs to use the bathroom. However prices are cheaper here. A Sunday for 75 cents and a meal for 3 Euro. Starbucks is really nice if you want a place to chill and something to cool down. A large frappuccino for about 3,70 euro.

First Experiences on the Ward

Stationsunterricht ist definitiv was anderes, aber das heute kam dem am naechsten von dem was ich bisher hatte. War heute auf meiner ersten Visite auf anscheinend mehreren Stationen, oder war es eine auf mehreren Etagen? Es war definitiv spannend, aber eher weil alles so anders ist anstatt des Fachlichen. Weil das hab ich mit all den Abkuerzungen, die hier die Alltagssprache beherrschen, so gut wie nicht verstanden. Bei all den STO, TDI, TCU, PCR, M usw. war ich froh, wenn ich die Hauptdiagnose mitbekommen habe... mit Pankreatitis, Oesophagus-Ca und Adhaesions kann ich dann doch schon mehr anfangen. Aber selbst wenn ganz normal gesprochen wird, und mir meine Fragen beantwortet werden, versteh ich nur die Haelfte, denn hier ist es Singlish und kein English. Ingsamt geht alles ziehmlich schnell, letztendlich kennen die Aerzte die Patienten ja auch schon, und stellen uns ihn nicht erst noch vor ;). Immerhin kannte ich dann doch schon einige und deren Geschichte aus dem Op und so war es nett zu sehen, wie sie sich so machen.
Die Stationen sind auf den ersten Blick sehr aehnlich wie bei uns aufgebaut, man erkennt die Krankenhausstruktur sofort. Allerdings sind die Patientenzimmer sehr unterschiedlich. Die General Surgery Station besteht aus vielen Zimmern mit mindestens 6 Betten oder ein grosses Zimmer mit 10 Betten. Die Betten ansich haben Vorhaenge, die einmal herum gezogen werden koennen. Bei Visite und koerperlicher Untersuchung wird dies immer getan. Es gibt auch keine Toiletten fuer die Zimmer, sondern nur Gemeinschaftsbaeder auf dem Gang. Wie das nicht so fuss-fitte Patienten handhaben, hab ich noch nicht rausgefunden. Ein Arztzimmer gibt es auch nicht wirklich, es ist eher eine offene Nische auf dem Gang. Apropos Gang - da wuseln soooo viele Aerzte rum, so dass es erst mal gedauert hat sein Team zu finden. Die sogenannten vielzaehligen House Officers machen taeglich eine Art praevisite. Auf der Station arbeiten alle Teams 1 bis 6, jedoch hat jedes Team seine eigenen Patienten, die es behandelt. Verglichen zu Deutschland gibt es auch viel mehr Schwestern pro Patient. Manchmal hab ich den Eindruck das SGH ist hier und da noch etwas veraltet und dann gibt es wiederum soviel modernes. In jedem Patientenzimmer steht ein PC mit Flatscreen, wo jederzeit die Befunde und Bildgebung abgerufen werden kann, was bei der Visite wirklich praktisch war. Jeder Patient hat zugeordnetes Pflegepersonal, was auch an der Tuer mit Namensschildchen deutlich sichtbar ist. Singapore hat ebenso viele Sprachen wie Ethnitaeten. Daher waren es heute nicht nur die Abkuerzungen, die mir bei den Arzt-Unter-Sich-Gespraechen, das Leben schwer machten, sondern auch die Arzt-Patienten-Kommunikation, welche je nach Patient auf Chinesisch - Mandarin oder Kantonese, Malay oder Tamil, und ab und zu Englisch ;) stattfand. Beeindruckender Weise hatte wir in unserem 6er Gespann auch immer mindestens einen, der sich verstaendigen konnte. Gerade die aeltere Bevoelkerung (70% Chinesen in Singapore) spricht fast nur Chinesisch und kein Englisch. Aber ein wirklich nettes Detail ist dafuer die grosse Plakette ueber dem Patienten-Bett. Da findet man jeweils den Namen des Patienten, den behandelnden Arzt, die Sprache des Patienten, Art und Weise der Nahrungszufuhr und gegebenenfalls Besonderheiten wie Medikamenten-Allergien oder Sturzgefaehrdung. Damit bekommt man sofort die wichtigsten Infos auf einen Blick.

Singapore National Day 2008

This Saturday was Singapore's National Day which is really important for this multicultural country and lots of celebrations were going on.

The biggest and well organized one being the npd08 = national day parade - a 3 hour mega show on a stage in Marina Bay involving tenthousands of actors, a flight show of the national air force and ending with a nice firework in the bay. It is said that 200.000 people watched it in the bay and even more on the tv... at least for us...our elective student group of 10 people... found it very very crowded in the city. The government puts a lot of money into the event. All the houses were decorated with the National Flag and the motto of the day was "Celebrating the Singapore Spirit" and it is praising the ambitions, goals and characteristics of the nation. Find out more about this on Wikipedia.

Pics of the Perhentian Islands

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The island was beautiful. Small and desolated, great corals, jungle and a basic accomodation where you fell right on the beach. And a monkey as a pet :) (ehm, i am that shiny because i just put on sunscreen, examplary ;)

Singapore and the Singapore General Hospital

I stayed 2 nights in a hostal with holger before I moved into the sisters quarter of the hospital where men and female are strictly separated. The shared room is simple but really ok, even with an own bathroom and a small couch. However no air condition, and yes, Singapore is very hot and humid. I am dying every night while trying to get some sleep.

On Monday my clinical elective in the general surgery department officially started. But I had to report there first on Tuesday, so it was nice to have another day off. Tuesday we had a powerpoint introduction with all the rules of the hospital and code of conduct and we were introduced to our department and supervisors. Singapore is a rather strict country and the hospitals and sister quarters have a lot of rules for medical students – you have to dress very formal, men with tie, no shirts, short skirts and slippers allowed. You have to wear your nametag all the time. Today we had a 2 hour lecture about infection control and mask fitting. It was quite boring but it seemed they take it very serious. Actually the same precautions we take in Germany, when to wash your hand, how to handle mrsa patients and so on. So we thought they were really strict with sterility as well, but just to find out in the OT (operation theatre = OP) that they are a bit slack there. At least it was the impression of our first day in the OT. But it was surpisrising that all new students including the singaporians had to take part in that lecture or otherwise you are not allowed to work in the hospital.
SGH is huge and kind of a 9-story labyrinth with many hallways and even more people. Nurses wear all different colors depending of the department, doctors are dressed very formal but wearing the white coat only on the wards. I am in the general surgery department, which is devided into 6 teams. I am 2 weeks team 3: head and neck surgery and the other 2 weeks team 6: transplant surgery. They only do liver transplant here, however there is only 1 every month. So not really a lot. Each team has its own specialty but they are all doing the general surgery as well. Each team has one operation day of the week – team 1 on Mondays, team 2 on Tuesdays and so on. As well as the on call duty for each team one day a week, which is from 8 to 8. if we want we can take part in that and stay overnight, but I am not sure if I want to ;)
The OT was very modern – the dressing room was big and with pink lockers, the upcoming operations were shown on large flat screens and the instruments such as a mobile ct? in the hallway were very new. But with entering the operation room itself it felt like 20 years ago… they still use rather numerous greens sheets to cover the patient instead of the self-sticking ones, I felt they were really incautiously with allowing also non-sterile people too close to the table. And the patient is brought right into the operation room fully awake. Then lots of people are moving around preparing the operation while his waiting to get anesthetized. I believe it is kind of traumatizing for the patient to see the actual OT rather then a quiet neat room with only the 2 anesthetists and peacefully sleeping away. So far it was no hands on for us elective students. When going out, you usually throw all worn clothes and shoes into a basket to get washed and sanitized. Surprisingly after a whole lecture of infection control you put the used shoes right back to where you took them without any cleaning.

Destination Singapore

Yes, getting to Singapore was quite an adventure as well. After arriving in Mersing early in the morning, because we were told to take the first ferry at 7.30am to make sure we don’t miss the bus at 12pm. so we still had plenty of time left to get a nice breakfast.

I soon found out it was the best choice to already buy the ticket a couple of days ago, since Friday to Sunday all locals are on the road as well. So people trying to get tickets to Singapore on Friday morning were not lucky because all buses were sold out. Well I got a ticket, but no bus came at 12pm… after getting quite nervous I got into talking with a family and I was still trying to find out where the bus would arrive in Singapore a man came up to me “why don’t you just ask me, I am from Singapore”  so at least I knew then what to tell holger to come pick me up. My bus eventually arrived 1 hour delayed, but I was finally on my way to Singapore. Amazingly it costs 10 RM (like 2 Euro) to get to Singapore by bus but 35 RM one way to get to the island Tioman by ferry (51km). At the ticket counter they told me it would take 3 hours… so I told holger I would be there around 4pm. well, at 4pm we only where in Johor Bahru and haven”t even crossed the border yet… by that time holger reassured me he’s going to pick me up and a friend as well. As time went by we eventually crossed the bridge and at around 6pm we finally completed the passport and security check only to arrive around 6.30pm at the bus station where holger and youheng were waiting since 4pm… I am still sorry you guys. But it was so nice to be picked up by car and directly having dinner in a recommended area with local food (i mean when i have 2 locals with me ;) ). And since then it is a food experience for me with having new stuff every day. And the food is sooooo good – we only had Chinese and Indian food so far and I am not sure if I will make it at least once around everything. I probably miss the cultural shock compared to the food shock ;)

Monkey portrait

I shot it in the Batu Caves. There were a lot of these monkeys. The mama with her kid just sat in perfect light allowing me to take that picture.

Last days in Malaysia - Pulau Tioman

I finally arrived in Singapore. I am here for about 6 days now.
But first to catch up with the last stop of my trip – Pulau Tioman. It was very beautiful – but in a different way to the Perhentian Islands. Much bigger and also more crowded with more resorts, more the chalet type for budget travelling, the beaches were pretty though more rocky, but you could hike to some very isolated and sandy ones. The water was great – warm and blue with lots of things to see when snorkeling. But the highlight of the island really was the jungle which started right behind the beach and was almost untouched. I met a girl in my dorm and we did one day of hiking. It was steep and a rough walk up and down a tiny path you really had to look out for, and sometimes we had to climb rocks because it was still such a pure untouched piece of nature. so I didn’t bring my big and heavy camera, unfortunately I don’t have any pictures of the day as well. Only the memories in my head. hiking through the jungle was an adventure and relaxing meditation at the same time. It was quiet and you were all on your own. But since the jungle is never quiet, there were all these noises – birds, insects, the wind through the leaves, monkeys… that was the most fun and impressive part: you could see animals in their wild life and true surroundings, getting along perfectly without any interference of humans. So we meet lizards, were surrounded by lots of colorful butterflies, huge ants, monkey families up in the trees and of course lots n lots of mosquitos. We were dropping wet and boiling, but it was great and in the end we were rewarded with a gorgeous desolated sandy beach and a great coral reef to snorkel.

Pics of Kuala Lumpur and the Batu Caves

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Some impressions of my first days in Kuala Lumpur (Petronas Twin Towers, a typical market in Little India and Chinatown) and the near by Batu caves, a Hindu pilger place. You can find mopeds everywhere in Malaysia and usually the whole family rides on it. This is a shot from my bus stop on the way to Kota Bharu, where the kids were picked up from school :)