Family Health Program.

The Unified Health System-- Brasil's national health care system-- is only 23 years old, but nearly 80% of the country's population depends on it for health care coverage. Obviously, this puts a lot of strain on the health care sector, and it becomes very imporant to have a strong primary care foundation to hold up the health status of the nation.

Enter the Family Health Program, a major component of SUS. The Family Health Program concentrates of of its efforts on the low income areas of the country, including the favelas of Rio de Janeiro.

The system works slightly differently depending on your residence. In the city of Rio de Janeiro, depending on your exact address, you can go to a particular office within the FHP-- and only that office. Each FHP covers many different districts within a region of the city, so to alleviate logistical issues, this approach is used (interestingly, if you live outside of the city of Rio de Janeiro, you can visit any FHP within your city). Of the FHP's I had the opportunitity to visit (one in Victor Valla, another in Padre Miguel--both in Zona Norte and one in Barra da Guaratiba), I was pretty impressed by the number of facilities that were offered. There was a dentist, a radiologist, a fully stocked pharmacy, etc. Even more, program were offered to the residents of the region, including lectures on health care issues such as dental care or leprosy, fitness classes, among others.

It seems that these clinics serve as a basis for good health promotion, but I could very easily see them being underused. A problem here--and most places around the world-- is that people wait till the last minute to seek health care, so facilities that focus on primary care are often underused. Unfortunate.

Why bus drivers drive fast in Rio.

Apparently, bus drivers get paid (or have some sort of incentive) according to the number of miles they clock while driving. If this is true, it explains a lot about why they're always jerking in and out of lanes, and driving at record speeds as if the vehicle is a motorcycle.

Building homes in favelas.

A friend of mine mentioned to me one of the processes of the way they build homes in favelas. We were discussing the differences in the infrastructues between the slums in Rio de Janeiro, countries in Africa, and India and how each place has a unique way of maintaining the areas.

In Rio, it's not uncommon for a homeowner to build a home in a favela without windows, flooring, etc. Just the basic four walls and a roof. When a new resident wants to build a home on top of yours, you can sell your roof to him, and use that money to add windows, then floors, etc. Apparently, the homes can be built in this sort-of add-on style--- not everything needs to exist in the beginning. We were also discussing how interesting it was that the concept of being "hood-rich"-- that is, being poor but using money to feign your status by buying material things-- exists all over the world. In the slums in India, people have cell phones, TVs. In Africa, many women use their money to buy nice clothes and jewelry. (Even in the US, people who are poor still manage to have nice cars, etc.) In Rio, I'm still unclear as to how people show their status.

Drug trafficking and health: a correlation.

On my visit to UPA-Rocinha (the emergency health care unit in the favela Rocinha), I learned about the different health care issues that the residents of Rocinha deal with. Rocinha isn't a pacified favela, meaning there is still drug-trafficking in the area. I didn't know it at the time, but the main substance that seems to run through the area is cocaine. Apparently, each favela/complex specializes in only particular types of drug-trafficking-- Rocinha doesn't deal with say, for example, crack-cocaine. Thus, it only makes sense that depending on the drug in the favela, different health problems/issues will arise for the residents of that area. In Rocinha, there aren't many cases of crack-abuse, and thus the UPA in Rocinha doesn't have the same facilities as the UPA in Manguinhos (where crack is trafficked good).

It was interesting to learn this, but now it's unclear to me how exactly the money is used to help the people in each UPA. Does SUS provide facilities depending on the types of health problems that are seen in the area? If they do, by providing these facilities for crack-dependents, are they really alleviating the problem?

There were quite a few brochures in all of the health clinics on smoking, dengue, and other health issues such as diabetes. But I didn't find any on drug abuse, which to me, was a little strange considering it's a health problem that should be dealth with. In addition, the health professionals in the clinics seemed to suggest that the facilities were provided for abusers if they overdosed and needed to get better, or if they were mentally unstable, etc. There wasn't much discussion on helping the patients stop abusing the drugs. Dealing with health issues related to drug trafficking is a tricky issue, but I'd like to know---culturally, at least-- how to approach this issue in Brazil. What form of communication do they find best to bring up discussions on these topics? A face to face conversation? Pamphlets? Videos?

VER-SUS

For the past two weeks, I've been taking part in an event conducted by the municiplatiy of Rio de Janeiro and SUS (Sistem Unico de Saude, the national health care system in Brazil). The event VER-SUS (literally translates to 'to see SUS') was an eye-opening experience about the public health care system in Brazil.

If you want to read more about what we did, here are links to the other students' blogs:

http://www.otics.org/rio/destaques/novos-blogs-para-ver-o-sus

You had the mumps?

I was discussing vaccinations with the students from Rio Grande do Sul that also participated in VER-SUS these past weeks, and was shocked to learn that they had mumps and measles when they were younger. It wasn't till about 10 years ago that immunizations at an early age seemed to be really enforced--a majority of the kids got these diseases, and only got immunizations or vaccinations (if needed) when they were almost 10!

Apparently this is changing now, but it's pretty eye-opening how different the pace of developments are here and in the US.

On staying in.

You would think that with the sun out and the beach only a few minutes away, I would constantly be by the coast, but it's actually surprising how much time I spend at home, inside. Part of it is the heat-- I can't bear to be out in the direct sunlight during the middle of the day-- but part of it is also the fact that in many ways, when you don't really have a sense of direction, it's very easy to become quite lazy and stay in. I'm figuring out very quickly that it's good to have things to do, all the time. But unlike college, where I was packed with activities from morning to night, I'm experiencing quite the opposite in Rio. I have (at times) too much time on my hands during the day, and I'm not quite sure what to do with it. I know all this will change very soon, as I begin my research and start my questionnaires next month (I hope). But until then, it's been a pretty slow couple months, this past December and January.

I'm off to find some time to kill--

My laptop is alive.

How the Ministry of Health prepares for Carnaval.

There's signs everywhere promoting sexual health-- use of condoms, where to find birth control. The ad campaigns on TV are the best.

Footvolley.

I've started taking footvolley (here known as futevolei) lessons out in Ipanema on Mondays and Wednesdays. Futvolei is essentially beach volley, but rather than using your hands to create a volley, you use your feet, legs, head, chest, and shoulders-- that is, the same techniques when playing soccer. It's not as easy as it looks-- and trust me, it never really looks that easy.

Futvolei was apparently started in Rio de Janeiro in 1965, when soccer players wanted to practice but couldn't because of the football ban during the time. They found that playing on the beach, using the volleyball courts, was a way for them to keep the spirit of the game alive and use the techniques of soccer-- without breaking any rules.

The running on the beach is not the difficult part-- it's actually getting used to the weight of the ball, which is decently heavy (it is, after all, a soccer ball). On top of that, there's a certain balance that you need to find between being aggressive, and waiting for the ball to come to the exact position you want in order to volley it over. I'm still learning the basic techniques, but I can feel myself improving in just one week. I haven't had the courage yet to join in an actual game-- the other students always stay later to play-- but maybe by the middle of next month.

Health care in a comunidade (favela).

Yesterday I had the opportunity to visit UPA Manguinhos, a emergency treatment center located in the Complex of Manguinhos. While Fiocruz is also located in Manguinos, it is separated from the favela by fences that surround the entire campus, and high-security officials monitoring the premise. While Manguinhos still suffers from drug trafficking, I was able to enter the favela to visit the health care unit as a part of VER-SUS, a health event going on among RGS students.

Braille.

They seem to be really accommodating to the blind in Rio. All the supermarkets have braille tags on the foods, and even menus in restaurants-- they have a braille version. I'm especially impressed with living in Urca, where it seems like the stoplights were made thinking about someone who can't see (they buzz for you to cross the street). On the other hand, there's so much construction, I'm always nervous that the blind are going to trip and fall because they can't see what's going on.

Thoughts on the public health system, Ver-SUS

Observing emergency clinics during the middle of the night in Rocinha. Interviewing patients at the UPA 24 hrs in Manguinhos about their experiences in the emergency room. Learning about how the municipality of Rio de Janeiro tracks the spread of disease at the Prefeitura. These are just some of the experiences of VER-SUS—a project initiated by the Ministry of Health and the Municipality of Rio de Janeiro to provide university students with a more tangible understanding of the Sistema Unico de Saude (SUS), the public health system of Brazil.

Over the course of two weeks in January, I visited and learned about the various aspects of the public health system in Brazil. Unlike the United States, Brazil has a universal health care system that is mandated to provide care and access to all the country’s residents. Compared to other global health citizens, SUS is a relatively new system. It was in part developed by the National School of Public Health at Fiocruz, but has roots in European and North American ideologies about health. SUS is more that a system to deliver healthcare—it is an ideological approach to health, guided by principles such as universality, equity, social control, and regionalization.

The core of SUS is its decentralized structure. The system distributes responsibility and authority of healthcare to the federal, state, and municipal level. Because of this organization, municipal governments have had the freedom to create innovative and successful programs (namely, Programa Saude da Familia) that have become fundamental components of the public health system in Brazil. As a participant in VER-SUS, I saw how the municipal government of Rio de Janeiro provides health care to its residents.

I visited several Clinicas da Programa Saude da Familia during VER-SUS. These visits were effective at helping me understand the philosophies of public health in Brazil and how they are represented within the structure of the system, as well as the differences between health care in Brazil and in the United States. Because SUS is a holistic system—treating social and environmental factors affecting health just as important as disease itself, activities and resources are provided for residents to improve their quality of life. I saw artwork on the walls on the clinics from activities that the clinic offered. Elderly residents were using the exercise stations to improve their cardiovascular health. Members of the community came to learn about dental health at a free lecture given in one of the classrooms in the clinic. In the United States, healthcare primarily works to treat—rather than to prevent and promote. Within the health units such as clinics and hospitals, there are very few opportunities to promote healthcare. However, unlike in Brazil, the United States places a strict emphasis on teaching about healthcare within the public education system. Courses on sexual education, lectures offered to parents and children about menstruation, and family planning units are found in most public schools. In addition, physical education is a required component of all school schedules until college. Thus, you can still find ways in which the United States promotes health, just not in the same atmosphere as Brazil.

One component of VER-SUS that participants were not allowed to see was how the community health agents—the watchdogs of the Programa Saude da Familia—function. Community health agents are integral to the success of PSF, and I would have liked to learn how their days work, how they observe their micro-areas, and the ways they compartmentalize and disseminate this information. In university, the students of VER-SUS learn about how the healthcare system is structured, from the highest level (the federal government) to the lowest level (the community health agents). See how the foundation works would help piece together the weaknesses and strengths of PSF. In addition, this is a very unique component of the healthcare system that is unique to Brazil. This type of system does not exist in the United States.

Other highlights of VER-SUS included a site visit to the Center for Psychosocial Care, CAPS, in Rocinha, and visits to the UPA-24 hour units (emergency clinics set up in low-income neighborhoods). CAPS house people with mental disabilities, and provide support and care with the intention of helping patients reintroduce themselves into society. The program reminded me of care homes and domestic abuse centers that are in the United States (which are usually not publically funded), but usually in high-risk areas. I was especially impressed with the UPA-24 hour units, which seemed to be well equipped (though perhaps under-staffed. What struck me the most were the types of problems the centers deal with. Brazil is undergoing an epidemiological transition with the double burden of infectious diseases and increased risk of chronic diseases in the aging population. The health system must care for a population at risk from violence related trauma, vector-borne communicable disease such as dengue and malaria as well as high levels of diabetes and high blood pressure. In addition to this, regions like Rio de Janeiro, deal with health consequences from drug trafficking within the low-income neighborhoods, domestic violence, and neighborhood violence, more common to these regions.

One of the other events that I found interesting was the visit to the Epi Info center at the Prefeitura. Similar to the Center for Disease Protection in the United States, the Prefeitura has a department that serves to monitor the progress of spread of cases of diseases. The CDP in the US functions in a similar role, and I later found out that the Oswaldo Cruz Institute has a center that research and tracks this information. I found it interesting that even though the systems are quite different; they seem to use similar tracking devices.

After my two weeks at VER-SUS, I’ve got a better look at the way the system functions, on the surface. I was able to understand the order and structure of the programs within the municipality of Rio, on a very tactile level. I’m still left with questions on the cost-effectiveness of this system, and I wasn’t able to understand the obstacles that SUS has to deal with—something that I found find important for a public health student in Brazil to understand, especially if they can see it on a municipal level.

In the United States, I’ve had plenty of experience observing surgeries, sitting in on physician-patient consultations, and shadowing doctors. My experiences are not so rare in the US, where many high school and college students choose to spend their afternoons and weekends volunteering in hospitals and clinics, but after VER-SUS, I seemed to get the sense that this sort of practical experience is rare in Brazil. Apart from the students that spent the night in the CAPS center. The experiences I gained, as an American, during VER-SUS, were unparalleled to what I could have observed had I tried finding these opportunities on my own. But I’ve had much more experience of this nature in the United States, and it struck me interesting that most of these students had never worked inside a SUS operated clinic. For example, through my experiences in the United States, I was better able to understand the disorganization and weak infrastructure of the hospitals in rural areas, find out how physicians treat their patients—and what needs to change during their training in medical school, and see how doctors interact with administration.

Projects like VER-SUS need to be implemented on a permanent level within the infrastructure of the educational system in Brazil. It’s important to offer students these opportunities at the high school, if not college level, to help them better understand the field they are entering. I gained a lot of insight about the public health system in Brazil during VER-SUS, but I hope that my peers in Brazil learn these things much earlier during their educational trajectory.

Cultural Differences in Research.

Over my time here, I've really realized how American my upbringing has been, and how-- in many senses-- it shapes the way I view and do things. Apparently, education in the United States is very pragmatic-- we're very much DOERS over THINKERS. That being said, when we come to a country that prides themselves on theories and such, it become difficult to work and collaborate. I experienced this a bit here, in Brazil. My research group and particularly, my two advisors, are wonderful in understanding where I come from, and why I think the way I do, but even in the US I'm pretty fast-paced-- so here I go a million miles per second, I think. Having to wait for research clearance, continually reread articles, reformat, rethink-- it's not something I'm used to. But I'm learning. I appreciate the Brazilians ability to appreciate theories and have context for things that they learn (I had never heard of Facoult prior to this week-- the famous French philosopher who created the theories of the health system in Brazil). I hope that I can go back with a clearer picture of the way things work here, to help me understand how to collaborate with international researchers in the future. It's also important for me to try to reach a balance and actually think about theories, etc.

Parque Lage.

This Sunday, a friend and I ventured to Parque Lage, the often-referred to site of where Snoop Dog made that (link) video. It was well worth the trek, after being misdirected probably about three times by three different Brasilians.... but the place is quite beautiful, and really tranquil. We ate at the cafe inside, which has fun Moroccon-esque seating-- odd tables and chairs, pillows on the floor, cute little corners filled with artwork...

The rain in Rio.

If anyone has been following the international news, the state of Rio de Janeiro has been receiving record amounts of rain-- the same rain that may or may not have destroyed my laptop. There aren't strict numbers, but the rains have caused the most deaths in Brasil history (from rainstorms).

For more information:

http://www.nytimes.com/pages/world/americas/index.html

http://www.nytimes.com/aponline/2011/01/12/world/americas/AP-LT-Brazil-Flood-Deaths.html?ref=americas

http://www.nytimes.com/2011/01/14/world/americas/14brazil.html?ref=americas

A funny thought.

Tom Jobim said it best, "New York is great, but it is shitty. Rio de Janeiro is shitty, but its great."

Curiosity.

I think it may be because of the incredibly high prices of cell phone plans here, but unlike in the United States, where everyone always seems to be on their phones, I hardly see people here pick up their cell to make a call. In fact, when someone is on the phone, you can tell-- their voice travels all the way to the other side of the room, subway car, or bus-- and everyone turns and stares at them. (I don't think I've ever been stared at in the United States for speaking on a cell phone). It will be interesting to come back to the US and see how I feel about this...

(On the other hand, unlike in the US where people seem to multitask and do work wherever they have time-- the bus, the subway, the plane-- I hardly see people take their work on their commute. As vezes (sometimes) I would see UFRJ students read on the bus, but it was rare. Interesting, right?)

Rain got into my laptop...

on Tuesday. So it's been off, sitting in my room to dry for the past couple days. I'm crossing my fingers for it to work when I turn it back on, but there are no promises.... last time I'll EVER leave my computer outside (the rain from the window splashed onto the keyboard).

Beach Volley Schools.

Escola de Vôlei do Betinho
Praia do Leblon
Coordenação: Roberto Bosch Filho (Betinho)
www.voleibetinho.com.br
Tempo de funcionamento: 9 anos

Escola de Vôlei do Betinho
Praia de Ipanema (em frente ao Country Club)
Coordenação: Roberto Bosch Filho (Betinho)
Informações: www.voleibetinho.com.br
Tempo de funcionamento: 4 anos

Escola de Vôlei da Letícia
Praia de Ipanema (em frente a Farme de Amoedo)
Coordenação: Letícia Pessoa
Tempo de funcionamento: 15 anos

Escola de Vôlei da Rejane
Praia de Copacabana (em frente a Souza Lima)
Coordenação: Rejane Secches e Claudio Motta
Tempo de funcionamento: 13 anos

Escola de Vôlei do Renato França
Praia de Copacabana (em frente a Hilário de Gouvêa)
Coordenação: Renato França
Tempo de funcionamento: 14 anos

Escola de Vôlei do Big
Praia de Copacabana (em frente a Praça do Lido)
Coordenação: Marcelo Carvalhães (Big) e Dudu
Tempo de funcionamento: 5 anos

Escola de Vôlei do Big
Praia do Flamengo (em frente a rua Tucumã)
Coordenação: Marcelo Carvalhães (Big) e Fabiane Albrachet
Tempo de funcionamento: 10 anos

Rowing in Urca.

My apartment-mate has been a rower for a few years now, and last Saturday I ventured out with her to Praia de Urca to try rowing with her and her club. Let me just tell you know-- if you want the most spectacular view of Rio, I think you have to be in the water in the morning, when people are just starting to wake up, and there are hints of activity on the street. Girls running along Praia do Flamengo. Boys carrying their surfboards to the metro and the bus. Old woman getting ready for their morning walks.... You catch whispers of it all as you glide by in the water, right along the Sugar Loaf.

The practices are early (I have to be out the door by 5:45 AM), but it's worth it. To be that close to such amazing natural structures is something that can rarely be experienced, and I don't think it ever gets old. I went again today, and even though it was pouring (Saturday was warm and not a cloud in the sky), it was just as enjoyable as the first time.

If you're interested in rowing (clarification, it's called "remar" in Portuguese, but I think it's more canoeing that actually rowing/crew) there are several clubs in Urca. Just go down to the waters, ask around about the hours and sign up.

The prices I think are around 60 reais a month, but you'll probably need to purchase a paddle, which can run around 300 reais. A little expensive, but if you live in the city I think it's worth the investment.

Umbu.

A fruit from the Northeast.

beach volley.

I tried beach volley for the first time yesterday, which is a bit ironic considered I have the exact build to do it. I'm tall, lanky and look like I could pull it off. But it's much harder than it looks, trust me. I play a game with three other Cariocas probably at least twice my age, but three times better than me. The sports in Rio are a bit addictive.... if you are interested in trying beach volley, here are some good places:

Escola de Volei Leticia Pessoa

Avenida Vieria Souto, entre Vincius de Moraes e Farme de Amoedo, Ipanema

Monday through Friday: 8AM-10 AM, 5 PM to 8 PM.

Tel: 9841-3833; 7823-2770

Esolinha de Volei de Praia

Av. Delfim Moreira, 900, Leblon

Monday through Friday: 8-9 AM, 6-8 PM

Escola de Volei do Betinho

Av. Delfim Moreira, Leblon, Posto 11

Monday through Friday: 7 AM to 10 AM, 5:30 PM to 9:30 PM

Tel: 9888-1885/2246-3475

(The one I went to in Copacabana is right on Posto 3, and has classes Monday through Friday 8-9AM, 8-9 PM)

Prices: I've found that they range from 80-90 reais per month, for as many lessons as you want a week. Not bad, in my opinion, for a guaranteed 5 hours of sun and sweat and fun.

Becoming a familiar face.

I've already mentioned the joys of starting to feel at home in Rio, feeling like a regular when I bump into people on the street, but I'm starting to become a local at my neighborhood joints, which in itself is an experience that I don't think I've had, even when I lived in New York. About once a week, when I don't feel like cooking, I head to my neighborhood Arab restaurant, and order a kibe or esfiha. They make a really good homemade hot sauce that (I think) is the best part of the meal, and I get my fix of spice for the week. Today, after a hot day and no food in the fridge, I headed over, where the same two men recognized me. One of them even saw me riding around on the beach earlier this afternoon, which was a little bizarre (I'm not sure I want to be that recognizable), but they know that I probably will order something vegetarian, and they find it sort-of funny to watch me consume such large amounts of "pimenta." When I first tried the sauce, one of the men told the other he couldn't BELIEVE I could eat something so spicy. I guess they haven't met a lot of Indians. A lot of Indians from the SOUTH of India.

Bom (insert word here).

I was at the beach today, blending in quite nicely to what my mother called a colony of ants that situate themselves on the sands of Ipanema, when I started hearing a trend of sentences... "Bom trabalha".... "Bom appetite"...."Bom viagem"...."Bom dormir"... ok, maybe not the last one.

It seems to be a trend in Rio (and maybe in Brasil) to wish others well in whatever they do... the most common way seems to be saying "Bom" and adding the verb of whatever the other person is about to do at the end of the sentence. Afterwards, when I was longboarding in Copacabana, I heard the same thing "Bom skate-ista."

It's pretty funny, because in the United States we hardly wish others well in such mundane things like your standard meals, going for a run, going to a show. It's kind of nice, and seems to stem for the overall friendliness of the people in Rio.

Frescoball.

I attempted frescoball yesterday on the beach, a sport that is unique to the sands of Rio. It originated in Copacabana in the late 1940's, but it remains a pretty big hit among the locals. The sports people play on the beach are incredible, from beach volley to foot volley to soccer (true football)... but frescoball is something that I think everyone can do. I think the American sport closest to it is ping pong or tennis, but rather than having a table to hit the ball down onto, you hit the ball with your racket towards the other person. I believe the point of the game is to hit the ball every time it comes on your side, but I think the first few times you play you have to get used to the idea that you really need to move(!) in the sand if you want to be able to actually have a decent volley with the other person. I played with just one other girl, but it's common for people to play in larger groups.

It's fantastic how people can manage to play these sports underneath the boiling sun. I can hardly get out from under my guarda-sol (sun umbrella) until 6 PM, but people play footvolley and other sports even around 1 PM. What's more incredible is that some people don't even USE an umbrella-- they bask in the 37 degree (celcius!) heat, applying bronzing oil every 15 minutes to their already incredibly-dark bodies. I don't know what to think-- whether I'm concerned for their health or whether I'm impressed by their resilience and ability to stay in the sun; I think it's a mix of both.

Electronica.

Yesterday, my apartment-mate and I went to an electronic-dance party. I'm not a fan of electronic dance, and I think that yesterday night only solidified the idea that I probably never want to go to another electronic dance party ever again. If you can imagine every beef-head Carioc(o) located in one area (Forte de Copacabana) half-attempting to dance, but mostly just attempting to find girls to hook up with, you've got a pretty good image of the event.

It's interesting to me to see the different sides of Rio, and how there really is something here for everyone.

Living with a Brasilian.

I haven't had much time to update my blog with my housing situation, and I've been nervous to step too much in that category for fear of jinxing my fortune, but my after a couple transplants from Copacabana to Ipanema and now to Urca, it's been a really interesting experience living with a Carioca. Parts of me are adapting to her-- and thus Rio's-- lifestyle. Eating fresh bread in the morning with strong coffee sweetened with lots of sugar. Taking time to figure out what to do for the day. Being inherently active. Friendly to everyone who passes. It's interesting sharing a space with someone from a different culture, because you learn so much about life in this place, and how people move and live. I've been fortunate enough to have a research group that's very close-- and I can see with clear eyes how each person's life is different-- but when you share an apartment, the true nature of the Carioca seems to come out.

I know that I'm not even halfway over with my grant, but I can tell that my time here is too little. I fall in love with Rio a little bit more everyday, and each day it overwhelms me how much I can actually do. I've decided to fill my time with activities I've always wanted to pursue, and then a few that seem worth trying because I'm in the right place. Foot-volley, volleyball, surfing, rowing, forro, samba... it's a lot, but now is the time to figure it all out.

sugarcane juice.

Though Brasil has had a long and ardous history with sugarcane republics, for the first few months here I was actually oblivious to the abundant supply of sugarcane juice in Rio. Maybe it was because I didn't know the name, or maybe it was because I didn't see the machines, but they are in practically every suco stand, and are sometimes sold at the farmers markets (the ones in Botafogo definitely have them, and I'm pretty sure that the Friday farmers market in Ipanema has a stand as well). It's delicious and obviously super sweet-- but try it. It's called "caldo de cana" and when you enter a suco shop, juice try to look for the sugarcane press.

marmalada.

It's an expression used for a "bad call" or when something unjust happens, such as in a soccer game. My apartment-mate explained to me that it's not used very much now, but the typical way to have used the term would have been when watching a soccer game, the referee makes a wrong call.... "E marmalada!" Que interessante.

The value of money.

It's really interesting here how hard it is to get change for bills higher than 20 reais. If I ever give a 50 reais bill, I usually am met with resentment and I'm afraid that evil eyes are being cast on me by the cashier. I am too afraid to give 100 reais bills-- and it's a problem, because the banks tend to only give out 50 or 100 reais bills.

Is there a reasoning behind this? If it is so hard to find change, why do the banks continue to give us such large bills?

curiosity.

I don't know why the banks keep giving me 100 reais bills when I withdraw for say, something like the rent. It's really difficult to find someone who will split a 50, let alone a 100.

It took 20 years to build...

the Ipanema metro station. That's news to me.

three months.

I never got to update the blog yesterday, but it was my three month mark living here in Rio. I think that it takes about 2.5 months to really get accustomed to the city, feel like the language can somewhat slip off your tongue, and get to know some of the Cariocas. That being said, it's been an exhausting three months, and I'm so excited to spend the rest of my time here focusing more on my research project and starting activities that I've been meaning to do since day one (ahem, surfing). While I have been looking back at the past few months wondering what I've been doing (have I been wasting time? why hasn't my research project moved forward? why don't i have more friends? why have i been speaking so much English?) I realize that there is really no way to force yourself to acclimate more quickly to the country-- it happens organically. As for the other activities, it's incredibly hard to start taking a samba class when you are running around the city, trying to find housing.

While I wouldn't say I'm compltely settled into the city, I now feel like I have more time on my hands to do things. That being said, this week has been a little gross with the weather, and my research project has needed more attention than the previous month. I'm also starting to realize how little time nine months actually is-- it's really just enough to get a taste of living in another country; that's it. I can already tell that June is going to come too quickly and I'm not going to want to leave.

Lost in Translation.

I received comments from the CEP (the local ethics committee at Fiocruz) regarding my research project yesterday. They had a few comments and concerns about my project, specifically the pre-testing, and I have to re-submit a response to them addressing their concerns.

While some of the issues that were brought up were valid-- explaining more about the pre-testing techniques-- it was interesting to see the differences between what the IRB in the US looks at, and what the Brazilian CEP looks at. I found myself surprised at the number of questions that were posed about the methodology, which is something that is critical to the actual development of a solid science project, but not integral to the ethical components of an experiment, survey, etc. Many of the questions focused not so much on the ethics, but rather on whether we had prepared properly for the pre-test.

The biggest problem that I am now facing is gaining university clearance from each of the universities I will be surveying at. The CEP wants to know if the universities are OK with me surveying within their campuses.

It's a slow process, and it's not the most fun, but I hope that everything will get cleared away by the end of January.

happy new year...

2011, the start of the Golden Decade (as Brazilians have been calling it) has begun.

Did you know... it's common tradition for Brazilians to eat yellow lentils on the first day of the New Year. Apparently it's a sort-of good luck act. The idea is that by eating the lentils, you will gain luck and become rich (the lentils are similar to the gold coins that used to be used as currency in the country).