When I was planning my trip to London, I created a list of experiences I was hoping to have. However, I was unaware of the amount of places I would see or the things I was going to witness or of their great magnitudes. Navigating London was not always easy and sometimes ambiguous. I not only mean finding my way around the city, but harvesting the ability to immerse myself in a culture with customs I did not know. When with others, open-mindedness and being a productive team player was required to see as much as possible and maximize the experience for the group as a whole.
This leads into cultural adaptability. I have had experiences from touring old castles to attending an early morning church service different from my own religion to not knowing the procedure for placing my order at a pub. London is a city extremely rich in history, and it is important to understand and be sensitive to the fact that perceptions change overtime, and this shapes a culture. London was a great introductory abroad experience because there was no real language barrier. However, I did learn some British vernacular and found it interesting how the same word can have two different meanings in two different countries. Public health is a field that definitely requires one to have knowledge of international affairs and global issues, because many of which directly impact health status of populations around the world. As an aspiring lawyer, these topics are naturally interests of mine, and traveling to London provided hands-on opportunities to enhance my understanding of them. Traveling changes a person, and concluding my undergraduate career in London presented avenues to me that I never before considered, such as studying Environmental Health for a graduate degree. I actually felt very comfortable in London, and I surprised myself with how willing I was to go out in a gigantic city on my own and explore things I have only previously dreamed of seeing. As I have previously mentioned, traveling and finding your way in a foreign place demonstrates bravery, independence, responsibility, and self-starter tendencies, all of which are desirable characteristics in an increasingly global marketplace. Employers and higher education institutions want to recruit people who have the ability to motivate themselves and effectively lead others, which are inclinations that are evident by choosing to study abroad, and also amplified through the experience. Currently, I am applying and interviewing for full-time jobs. I graduate this upcoming Saturday, and interview practice could not be more useful at this point. If an employer were to ask me the following questions, this is how I would respond: Q: We are proud to have a very diverse team here in the office. What experience do you have working with people from backgrounds different than your own, and how do you think those experiences relate to the workplace? A: Through my undergraduate years as a Public Health student, I have gotten involved in various causes that serve and work with diverse populations, such as tutoring refugee students and fundraising for Children’s Miracle Network, a group of pediatric hospitals that turns no child away. When I decided to conclude my college career by studying abroad in London, I sought to enhance my passion for working with people from backgrounds different than my own, and through this, I learned about the distinct cultural perspectives of the British. I developed an appreciation for their view on aspects such as smaller food portion sizes and a much greater simplicity when it comes to material possessions than we are familiar with in America. London is a city rich in history, and this history has shaped their culture and perceptions overtime. In terms of a workplace, it is extremely pertinent to be understanding and sensitive to the fact that other cultural perspectives and backgrounds influence how people function and perform in the office, as well as how people behave on the client side when they are receiving the services your workplace offers. Q: We understand that you have just graduated from college and thus do not have as many years of work experience as other applicants. What skills can you bring to the table as a recent graduate? A: Throughout my undergraduate career, I have submerged myself in opportunities that allow me to place myself outside of the comfort zone I am familiar with. This includes drawing my undergraduate experience to a close by studying abroad in London. Making the decision to fly halfway across the globe on your own to study shows bravery, independence, and willingness to learn. Having the ability to dive in and navigate a busy public transportation system, find your way around a bustling city while being punctual, and immerse yourself in a foreign culture demonstrates initiative, ambition, leadership, and self-starting tendencies. From previous work experience, I have found all of these to be transferable skills that I finally had the perfect opportunity to polish. One thing’s for sure, I can promise London that I will be back one day, with people I love, to show them my favorite, most iconic city in the world. Until next time, London. Cheers!
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I have always had a profound passion for the environment. I am insistent on recycling and protecting nature and wildlife. Because of this, the Introduction to Epidemiology course tours in London sparked my interest in the environmental aspect of public health and epidemiology, paving the way for a potential career path. I was intrigued by the Thames’s many uses in London, and the significance of its accessibility and usability as discussed on the Cholera and Casanova tour, as well as the importance of GIS in epidemiology.
I am most curious about how the built environment impacts the epidemiology of chronic conditions and injuries. The tour of the Paddington Station was fascinating in how it made a solid connection between public health and public transportation. My future profession could possibly entail working on construction projects facilitating public transportation that are ultimately geared toward improving the public’s health. There are also opportunities to incorporate methods of primordial prevention into public transportation, such as installing an extra set of closed plexiglass doors that align with the subway’s doors when the train pulls into the station. When the train doors open, the plexiglass doors open simultaneously. This prevents people from falling onto the tracks on crowded platforms and getting hit by a train, which actually happened to someone a few stops before ours when we planned to take the Tube to our excursion in Camden Town. After contemplation, I have decided to take this upcoming year after graduation as a gap year to gain work experience that will show professional intent when I apply for advanced studies and higher level jobs. The academic skills and interests that I acquired in Introduction to Epidemiology are most definitely transferrable for employment, as well traveling skills. The ability to navigate a public transportation system and a large, congested city is empowering. It not only shows that you know where you are in the world, but it demonstrates self-starter tendencies, independence, and responsibility to employers and academic admissions boards. These are always coveted traits because motivated and courageous employees and students are always desired. During this gap year, I plan to take one or two graduate level nighttime or online classes as a non-degree seeking student to evaluate my likes and dislikes of certain graduate degree paths. The Introduction to Epidemiology course in London helped inspired me to make these decisions and take the next steps into this new chapter of my life. For that, I am forever grateful. Fortunately, during this trip, I have not had to use the National Health Service. However, I have seen the NHS symbol in many places around London, and I hope to learn more about it while on this trip. I do have prior knowledge of it, and I know that British residents and international visitors can utilize primary and emergency care services at no cost. There is a tradeoff: the cost of living in London is insanely expensive. If you buy a car or house, you are nearly paying for it twice in taxes, and that tax money greatly contributes to the NHS. Patients also require referrals to see specialists. For instance, if somebody injures their knee, they cannot go straight to an orthopedic surgeon. Their primary physician is the gateway to be able to see the necessary specialist. All doctors are government employees and paid equally, and their competitive incentive is to keep their patients the healthiest. Also, the vast majority of prescriptions cost 8 pounds. Only 8 pounds.
I find paramedic services interesting, though. Sometimes I see ambulances that are hatchback vehicles that could not possibly fit a patient in the back. Are those supplementary paramedics, maybe when less intense treatment can be delivered on the site and a ride to the hospital is not needed? The other day, I was walking along the large platform parallel to the Thames, and a young boy was having medical issues. I could not tell exactly what was wrong with him, but I saw his family on the phone with paramedics. He was sitting upright, but seemed to be going in and out of consciousness. The paramedics arrived quickly, but they talked with the family for a long time while not seeming to provide much treatment to the patient. In terms of public health policy, I have seen many implemented as measures of primordial and primary prevention. For example, the extra set of plexiglass doors covering the Tube doors in certain stations, to protect riders from the gap. Every station should make it a point to install those. As I was about to get on the Tube to go to Camden Town, a young woman had fallen onto the tracks a few stops before ours, and got hit by the train and died. I felt honored to be able to witness the site on which John Snow removed the handle of the Broad Street pump, saving Soho from a rapid cholera outbreak. The John Snow Pub we went to after our walking tour was on the site of the home of the first cholera case of the epidemic. It was incredible to learn the history of John Snow’s heroic actions, as well as the epidemiologic transition that has occurred. Previously, the epidemiological focus was on acute, infectious diseases. Now, developed countries in particular struggle with chronic diseases. We have the medications and resources to resolve infections and injuries. The prevalent chronic conditions we see trending are often a result of lifestyle choices. On my trip to Germany last year, I also noticed this: smoking is a large problem in Europe. In London, I feel that the focus is on not littering with used cigarettes rather than halting smoking altogether. I have seen very few social marketing campaigns encouraging Londoners to quit smoking, but I have seen bizarre efforts to get them to be more cleanly about their cigarette disposal. For instance, on the walk to class, there is a neon yellow cigarette disposal bin attached to the iron fence, telling people to drop their cigarette butts on one side if they prefer tea and the other if they prefer coffee. Driving is another problem I see. In America, pedestrians have the right of way. In London, drivers are anxious to get to their destination and are not usually willing to let pedestrians safely cross. I have seen social marketing surrounding other health campaigns, but smoking and driving would be a great place to start. This Introductory to Epidemiology course was a wonderful kickoff to London, and I could not have asked for a better way to fulfill my final degree requirement. It is hard to believe we are already halfway through this trip. I am determined to finish my last class of undergraduate strongly! Westminster Abbey is one of the most iconic churches on earth, and thousands and thousands of people from all over the world visit it everyday to experience its magic. I do not understand how one could go to London and not at least go up to the Abbey. Even if you are not religious, the history of the church is captivating regardless. It dates back nearly 1,000 years, and some of the most important events in Britain have taken place there, such as William and Kate’s wedding, Princess Diana’s funeral, and every coronation since 1308. Moreover, around 3,000 tombs lie in the church – those of royalty, scientists, and authors. When I toured the church, I felt strange walking over Isaac Newton, Charles Dickens, and Charles Darwin, as are predominant figures in primary education worldwide.
I spent a couple of hours touring the church; it is very crowed during visitor hours and there are A LOT of smaller chapels and rooms to explore within it. While exiting, I learned that daily worship services are conducted in the Abbey, and all are welcome to attend. Personally, I am very spiritual, and I knew I had to come back, as this was a once in a lifetime opportunity and would be unforgettable. Faith, to me, is about never hesitating to open my heart and mind to the complete (and I mean COMPLETE) love and acceptance of those around me. One of the main purposes of traveling is to immerse oneself in another culture, and this includes understanding religious history. I typically attend a Baptist church, so I wanted to step out of my comfort zone and experience faith from a new perspective, at one of the world’s most famous houses of worship. Westminster Abbey is an Anglican church, which is a Christian denomination within the Church of England, where The Queen and Royal Family are essentially also worshipped. The service moved me to tears, and a positive vortex of energy encapsulated everyone there. The angelic singing of the choir was chilling in the best way, as it lightly echoed around the intricate church. The first and last hymns were sung in Latin, and the lessons within the service consisted of reading two Bible verses verbatim. A decent amount of the choir consisted of young boys with incredible vocal ranges and control. The service lasted no longer than an hour, and it was very procedural and simple to follow. ‘Knowing what to do’ when stepping into another faith’s service can be intimidating, but they extend a warm welcome for everybody who wanted to attend. Religion and faith often binds the people of a nation together, and there is no better way to understand this than firsthand experiencing it. Developing the ability to understand and accept a population’s way of life provides great insight into why they do what they do, and why they are the way they are. This is not only a capacity needed to excel in Public Health, but in life. Never be afraid to act on curiosities out of the fear of not fitting in or being comfortable. The best growth happens when we step outside of our comfort zones, in faith and in life. It has been a longtime dream to explore Kensington Palace, and last Sunday, it finally happened. As soon as I entered Kensington Gardens, I knew this would be my favorite area in London. The glistening waters of the fountains, the purple flowers, and the overall joy traveling through the park immediately let me know that I was in my ‘happy place’. I expected the palace to be more similar to Buckingham Palace, but I was enamored with the relative simplicity and antiquity of the external architecture.
Upon entering, you immediately learn that the palace is much larger than it appears from the outside. I was fortunate enough to be in London at just the right time to be able to see The Fashion of Princess Diana exhibit. A lot of her most famous dresses were on display – including the dress she wore to dance with John Travolta in the White House, and a dress she wore on the same trip when she consciously removed her gloves for that groundbreaking handshake with an AIDS patient. It was incredible to see the evolution of her style over time, and to learn of her involvement in her wardrobe. She would sit on the floor with the designer for hours and compare fabric samples after fabric samples, giving her own valuable feedback. She knew that her presentation was her first point of contact with the rest of the world, what would define how she defines herself. I have always idolized Princess Diana, as she was a woman of humility, charity, philanthropy, and equality. She brought undivided attention and awareness to causes that were continuously swept under the rug, by never being afraid to extend a helping hand, and by being open and relatable with her audience when it came to eating disorders and mental health issues. She also advocated for children and adults performing hard labor in landmines that often results in severe disability or death, showing the world what an impact that a schoolteacher who initially preferred wearing a simple t-shirt and blue jeans could make. Princess Diana just happened to be royalty. Her death in 1997 sent the world into a downward spiral of deep sadness. In fact, it still does. Her memorial fountain in Hyde Park commemorates her well, as it is always filled with laughter, diversity, and liveliness. My beloved field of public health has improved due to her contributions, and her humanitarianism inspires me in my personal and professional lives. Walking in her footsteps, and seeing what her life was like in Kensington Palace for just a glimpse was absolutely remarkable and a day I will vividly remember forever. Thank you, Lady Diana Spencer. Like they say, not all heroes wear capes. On the morning of July 5th, 2017, we met at my favorite place in all of London – Kensington Gardens – to begin our Pox and Penicillin walking tour. The garden contains a bronze statue of Edward Jenner, the scientist who is credited with ultimately eradicating smallpox. Queen Mary died from smallpox at Kensington Palace, so the statue has been erected in her honor. Smallpox is the only disease that has been eliminated worldwide, so it is wonderful to see the city where Jenner lived, studied, and conducted the experiments that would later save countless lives. It is the most groundbreaking discovery early on in epidemiology, and it has paved the way for more cures.
This tour largely discussed transportation in London, and the efficiency of public transportation in London is something everyone everywhere should aspire to have. Between the Tube the Overground railroad, double-decker buses, and taxis (and walking), private vehicles are rarely necessary or owned. The Paddington Station is the heart of transportation in England, because it was the first underground railway built in the country. Before trains, the British tried transportation interventions such as horse carriages that could fit two dozen people. But nothing is more effective, or iconic, than their trains. Obviously, conditions are different in different places. So, we could not build an underground railroad in Florida because we are already at sea level. However, we can advocate for stronger bus systems and for a monorail. Access to public transportation increases public health – pollution that would be present through the usage of private vehicles is reduced, and the public has reliable transportation to get to healthy grocery stores, exercise facilities, and healthcare centers. We saw another significant church on this excursion, St. James. This is the church where Oscar Wilde got married, and also the church where the foundation of the Boy Scouts is commemorated, an organization that provided structure and discipline in the lives of young boys to keep them off the streets and out of trouble. Last but not least, we got to see the outside of the hospital (St. Mary's) where the Royal Family gives birth to their children, and right across the street, the laboratory in which Alexander Fleming discovered Penicillin [by accident]. The existence of Penicillin has made a gigantic impact on epidemiology and public health, and can now treat infections in a short amount of time that previously mass killed people. In Florida, Penicillin and other common antibiotics are free at certain pharmacies, providing access to treatment for large volumes of people. Prior to the synthesized medications we have today, herbs were the source of pain and illness alleviation. On Monday, July 3rd, we got to see herbal gardens that have been producing health remedies for hundreds of years, and how those herbs are transformed to be applied to the body once picked. We got to hold and examine the plant from which heroin is derived, evening primrose, and lungwort. Evening primrose was used as defense against asthma and whopping cough, and today women consume its oil in soft gels to help gain weight if needed, cease hormonal acne, and even regulate their menstrual cycles. Lungwort is considered to be a holy plant because it is believed to have been spotted by Mary’s breast milk, but now it is not used anymore internally to treat respiratory diseases as it was found to be poisonous to the body.
After touring the herbal garden, we got to sit down and watch a demonstrative presentation in the Oldest Operating Theatre in Europe, which had a very foreign concept to grasp. Hundreds of years ago, 150 – 175 medical students would pile into the tight, attic-like theatre and watch a surgeon perform unsanitary operations and amputations. The patients were usually poor people, and they were viewed more as a learning experiment than someone who needed healing. Infants and adults alike had operations in the theatre, with a very low survival rate. Conditions were extremely unsanitary. Doctors did not don a new jacket for each patient, and operated on new patients with previous patients’ blood and body fluids on them. They did not clean their cutting equipment or the operating tables; they just merely placed new thin sheets on the small, hard wooden tables for patients. Preparation was minimal, and involved purging of the patient’s stomach by herbs. Bandages were already used and bloody and would be applied to fresh surgical wounds on new patients. Medical students would be crammed into a small, hot room, spreading whatever germs they had to the patients on the operating floor. Complex operations that take a few hours to complete in today’s society took no more than 15 minutes back then, such as amputations. The skin and soft tissue would be cut around the extremity after a tourniquet got applied , and then the bone would be completely sawed through to remove the limb completely. The arteries and veins would be knotted together, and the remaining flaps of skin would be folded over to cover the stub. Of course, there was not only no sanitation or hygiene, but no anesthesia. Patients would often die of infection or shock. Leading causes of death at this time were acute illnesses and infections, and inadequate surgical circumstances definitely contributed to this. It is incredible to think that we have gone from this barbaric form of surgery to very intricate, complicated operations that can not only be performed by the human hand but by robots. These operations require such precision that they take hours as we know the harm the slightest mistake can inflict. Conditions are tightly regulated, and the environment and equipment is thoroughly sterilized and cleaned based on what it is and how it is used. We have made great strides in a short amount of time, and are constantly making new discoveries. The vast majority of surgeries are successful and greatly improve the patients’ health, and people are holistically treated as people rather than science experiments. Nothing is perfect, but doctors and medical students from those time periods would be astonished at how far we have come. Dr. John Snow was the predominant figure who inspired many Public Health students to embark on the lengthy journey from Tampa to London, including myself. He was ahead of the general mindset of his time regarding epidemiology. Most doctors and scientists did not believe in the germ theory. Rather, they thought that an imbalance of the body’s four humours or “miasma” (also known as ‘bad air’), caused disease. When John Snow brought it to their attention that the transmission of germs through well water were causing this rapid cholera outbreak in Soho, his discovery was originally rejected and he was seen as a madman.
On June 27th, 2017, we got to trace John Snow’s footsteps all of the way back to the John Snow Pub, which is the world famous site of the original location of the cholera-containing pump to which he removed the handle to halt the epidemic. The handle of the pump is located in the upstairs auditorium of the London School of Hygiene and Tropical Medicine – where I can only hope to get on this trip. We saw where he lived, and learned that it took him over a month to walk to London from York, where he was from. On the tour, we not only saw John Snow’s residence but Sir Isaac Newton’s as well. It is amazing how well these buildings and artifacts have been preserved. Things made back then were truly meant to last. Seeing St. James's church, what it had endured, and how it had been reconstructed amazed me as well. Dr. John Snow was also a pioneer of anesthesiology, which we are all ever grateful for! Prior to him, the most comfort patients were given during surgery was the option to bite down on a tough leather strap. I will discuss The Old Operating Theatre in detail in a subsequent post, but I could not imagine what it was like to live back then and attempt to endure such trauma. Surgeries most often only disabled a person further, and the survival rate was low. Not only was there no way to numb people, but the conditions were completely unsanitary and filthy. John Snow and his work with the germ theory heightened awareness on sanitation and hygiene, and how the lack thereof greatly facilitates the transmission of disease. This cholera outbreak occurred in the 1850s, and we have made many medical advances since, in both epidemiology and anesthesiology. We have ways to analyze epidemiological data and principles to connect the dots when an intervention is needed. John Snow's revolutionary geospatial applications laid the foundation for how we bounty hunt diseases. We have effective anesthesia, and most people survive their surgeries, due to more knowledge of anatomy and physiology and sanitation as it relates to health. We have come far in a short amount of time, and I know the future holds amazing technological advancements, treatments, and cures. The Medical Bloomsbury Tour on Monday, June 26th, 2017, was the first of many excursions that will allow us to walk in the footsteps of many greats. It was a detailed walking tour that not only incorporated medical history in this area, but more general British history as well.
The most memorable, haunting, gratifying part of the tour was standing outside of the gates to the Foundling Museum, which we will enter as a class next week. In the early 1700s, Thomas Coram founded the Foundling Hospital as a charity and orphanage for children who were surrendered by their parents as a result of poverty. The gin craze had conquered the city. Prior to the hospital, children were abandoned in the streets, as they were not viewed or valued and given a true childhood as they are today. They were thrown into hard labor very young and deprived of almost everything. Thomas Coram essentially pioneered the idea of genuinely caring for children, but it was still the luck of the draw when it came to Foundling Hospital admission. If the family drew a certain colored ball from a bucket, the child would be accepted into the institution. If not, the child would be turned away and often estranged. Great Britain has a vastly different healthcare system than we do in America, and it was rewarding to witness one in action from the outside. Ambulances and families were taking sick children into and away from the Great Ormond Street Hospital for Children. Famous supporters of this hospital include The Queen, Princess Diana, and even Johnny Depp. Outside of the hospital stood a Peter Pan fountain and a wall of children depicting all that they wish their hospital could have. Upon entering the London School of Hygiene and Tropical Medicine, I stopped for a moment to view the last names of the public health pioneers displayed overhead on the building. Underneath them, disease-carrying insects carved into the building. In the lobby, there was an exhibit showing the history of the school. Upstairs, there is the handle that John Snow removed to halt the spread of cholera through the Broad Street Pump in the 1850s. I can only hope to see that on this trip. The British Museum is one of the most famous in the world, and we got to set foot in it to see an important exhibit in the Living and Dying unit. An extensive glass case stretched across the room, and inside of it lay a masterpiece that a doctor and artist collaborated to create. Two separate runs of mesh fabric with pills sewn into them are juxtaposed, and they are representative of how many pills both males and females take throughout their lifetime – about 14,000 each. It is wonderful that we can alleviate with many medications, but we must focus our efforts more on prevention. Tracing the footsteps of the scientists who gave rise to the field of public health is indescribable, and something I will vividly remember for the rest of my life. Historical London holds the pioneers of public health and epidemiology. In the humongous scheme of time, 200-300 years is not that long ago. We have made great strides in that time, and there are many more to come that will make the founding fathers of public health beyond proud. In America, I live an active, healthy lifestyle. I am a lover of weightlifting, dance, and spending time outdoors with my horse. When time permits, I love to experiment with cooking unique, healthy meals. This will obviously change in a few ways when I go to London. My horse will not be there, and I likely won’t have an empty dance studio to mess around in. However, I indeed plan on getting the gym membership special being offered to Education Abroad students and going to lift weights as much as I possibly can. In London, we will be walking for miles each day. This is a built-in way to get that heartrate going and keep up with my endurance. This will also burn more calories, making us more hungry more frequently. Eating out will likely be happening more in London than in America, because there is so much to experience, but there will also be a communal kitchen in our dorms. I will keep convenient, nutritious food options in my dorms to save time and money – such as protein bars, fruit, and whole grain foods. And because most of our time will be spent exploring the city, it is extremely important to carry water at all times and continuously hydrate. I will make a strong effort to significantly hydrate myself starting a few days before I depart, as flying and rushing around airports can easily dehydrate a person. Nourishing our inner bodies is important, but good external hygiene must be practiced. Our skin can take a hit from traveling and jetlag, so it is important to stay moisturized and clean, to avoid any cracking of the skin that can be a portal of entry for infection. Washing the hands often will be the number one way to prevent illness, since we will be roaming around in a large touristy city, touching things, with many people who carry all kinds of germs from all around the world. Mental health is largely what will determine how well I perform in my classes, which is my number one priority while abroad. I will be sure to get acclimated to the new time zone as efficiently as possible, and do my best to get at least 8 hours of sleep each night, which is what my body usually requires of me. If I am feeling homesick or distressed in any other way, I will be sure to confide in someone, whether it be friends I made on the trip, faculty, or reaching out to someone back home. When I tell people that I am about to study abroad in London, they almost immediately ask if I am afraid considering that England is under critical threat for terrorism, and with the terrorist incidents that have been occurring far too frequently. I say no, as the point of terrorism is to terrorize, and if they scare you from enjoying a perhaps once-in-a-lifetime experience, then hate and evil have prevailed. Of course, it is always a priority to be aware and vigilant, no matter where I am, because truth is, anything can happen anywhere, but I prefer to focus on positivity instead of fear. The top image is my own, the One Love Manchester is from Stereoboard, and the Eat Right is from The Odyssey Online. |