the karma wheel

So I guess I've been bragging a little too much about how things are so great here and it's really not so different from Europe or even the States.

I believe that karma decided it's time to be a bit more modest, for I haven't had hot water since I got home from work on Monday. It's already the second time for me without hot water. (The first time was literally one day after my arrival--welcome to the former Soviet world.)

See, in Soviet times they "prophylactically" would shut the hot water off in certain regions while they worked on the pipes. It was so that they wouldn't have any problems in the winter, where it would be really ugly without hot water. I remember being able to tell what people in my office in St Petersburg didn't have hot water for the month--they were bathing more sparingly than usual. Evidently this prophylaxis is still in use, but not for month-long stretches at a time.

Although I must admit, there's a little part of me that enjoys going to the faucet each time, wondering if the hot water will be there. Sometimes I try to guess what the odds are that it will be there. Other times, I do the "oh please oh please oh please" before I turn the faucet on. Depending on the outcome, you can do the happy dance if your hot water has returned, and be all "Damn!" if there isn't.

See what you guys take for granted over there???? I bet you don't give cranking the hot water handle on your faucet a second thought. And here I've developed a whole ritual around it.

This morning, common decency wouldn't allow me to go without showering for another day, so I woke up a half-hour early to do the heating water dance. I pull out all of the pots I own, fill 'em up, light all four burners on the stove, and drink some coffee whilst patiently waiting for the water to heat up. Then I arrange the hot water pots strategically around the tub, then mix with cold water. I have the perfect-sized saucepan for pouring water over me. Thus, I bathe.

The first time it took me all 4 pots of water. This time, I was done after using only 2. Am I getting good at economizing, or what????

Have I mentioned that there is a recycling bin right on the streetcorner from me? I did the happy dance when I spotted it my first weekend here, and my friends laughed at me. They assured me that it goes in the trash with the rest of the garbage. Regardless of what is indeed the case (I can't believe they'd go to the trouble of putting over 100 of these bins throughout the city and then not actually recycle), I faithfully recycle on my way to work every day.

Tonight I'm going to my friend's house to make them gazpacho and pizza. They also were asking me about chili, which I'll make for them once the weather is cooler. They have a bottle of Tobasco they are very excited about using. Which leads me to the question: How did the McIllenhy (sp?) family manage to get Tobasco into every country in the world? It's everywhere.

I have my SPSS syntax nearly perfect for the provider data collection forms and am spewing out indicators for each site like there's no tomorrow. Then I'll do the women's pregnancy and postabortion forms, then the neonatal ICU. The goal is for me to generate all of the data for three time intervals for the five sites in the Karaganda oblast I am visiting next week. Then we can look at the data, see what they're doing well, see where there may be data entry error, and work with the clinicians to talk about ways to improve the indicators that need improvement. I'm seeing some "rebounding" in some sites. The baseline data show very high numbers of un-sound, non-evidence based practices (like giving women spasmolytics during labor). Then the numbers decline drastically at the second data collection time, after they've had training on best practices. Then the numbers start coming back up again during the third data collection--especially if they've had a lot of staff turnover. Which is why we have mentoring visits. A WHO-trained/approved expert comes and reinforces what is evidence-based, what is not, and where they need to improve.