A glimpse of the Philippines from Negros.

In early March, I had the opportunity to visit Negros Occidental province in the Philippines, thanks to Dr. Yasuhiko Kamiya at Nagasaki University and the Japan Association for International Health's Student Division (JAIH-S). I was based at Bago Health Center in Bago City, about a 30-minute drive south of Bacolod City, the capital of the province. The kind staff at the health center allowed me to stay at one of their houses, and I stayed with Joseph Aunzo, who is a nurse at the office, and his family. Every morning, it's not the alarm clock that wakes you up but the chickens that start crying no later than 6AM. I headed off to the office with Joseph every morning by 8AM and had days full of observing the many activities not only of the health center, but of schools, local villages, non-profit organizations, etc.

Due to the fact that I only had a week in the region, my primary goal for the visit was know the daily lives of the people who live in the area, and get a glimpse of the social aspects, such as the cultural, economical, political background of the community that they belong to. And from there, with a health-oriented perspective, I wanted to see what the problems, or the weaknesses, of the communities are, how the people themselves are feeling, and what they are actually doing to tackle these issues. I also had the opportunity to meet some local politicians, and wanted to know how the government sees the communities and what they are doing.

One day, I was with Dr. Kamiya, and we made a home-visit to a nearby village. This house was the home of a child with cerebral palsy, one of many disabled children Dr. Kamiya had been personally supporting for many years. He not only donates older wheelchairs and fixes those that are broken and reuses them, but listens to the child, the family, and discusses with them what can be done. The house was an ordinary house that you find anywhere in the rural areas in this part of the country, and though not affluent, the family had been taking care of the child for well over 10 years, ever since he became handicapped. However, the family didn't have enough money to buy medicine. There are established non-profit organizations, such as Negros Occidental Rehabilitation Foundation Inc (NORFI) and Volunteers for the Rehabilitation of the Handicapped and the Disabled (VRHD), both based in Bacolod, but they obviously cannot be permanent solutions. On another day, when we visited another village, the people there had listed the five major issues in the community, and the lack of money to purchase medicine and the insufficient number of health-care professionals made up two of them.

In the Philippines, the population is still growing at a fast rate. Families make many children so as to have them work and increase the household income. Catholic being the major religion, ever since the Spanish colonization days, may not be helping as they discourage contraception. Many people who worked in the health center also came from big families, some of them having seven siblings. When I visited a local elementary (primary) school, there were children full of smiles playing around, but some were saying to me "I don't have money to pay for lunch", "my house doesn't have a shower", "... because we're poor". Or were they seeing me as a donor? Comprised of six years, about 10 to 15% don't make it through the curriculum due to financial reasons, according to the teachers. The schools is trying to find scholarships, but obviously, there aren't enough. Yes, poverty, in terms of lack of cash, is an important issue and lies at the root of many problems, however, it was unfortunate that I wasn't able to feel the local people's will to do something creative to help the situation.

I asked the staff at the health center and the hospital. Here, the local government needs to find budget to lure health-care professionals to this area. Because there isn't enough cash, there isn't a sufficient number of them, especially physicians. For example, Bago Municipal Hospital, the only public general hospital in the area, had 50 beds and an emergency room (ER), but there were only five physicians. There were, however, plenty of nurses. However, many of them are working without pay, and there's a background story to this. In the Philippines, about 40,000 new nurses pass the license exam (out of 100,000 total), but that is more than the demand. And even if you are in a relatively high position, such as a chief nurse, you still only earn about US$400 per month. So, what is happening is many are moving out to work in Europe, the U.S., and more recently the Middle East, especially Saudi Arabia and United Arab Emirates. From there, they send part of their income back to their families still living in the Philippines. The nurses who are working without pay are those trying to keep up with their nursing skills while preparing to work abroad. In Ma-ao, the village I visited, there was one physician, which is rather rare, because there are many public clinics that don't have a physician nor a nurse, and a midwife is carrying out all the diagnosis and treatment.

So, what's the government doing? Ever since the Philippines became independent from the U.S., politics have never been stable, effectively slowing down the issue of bringing affordable, if not universal, health care. Staff at the health center do say that "the government is putting at least some effort and its gradually starting to improve", but its certainly far from catching up. When I visited, it was near general elections so lawmakers had once again pretty much halted lawmaking and shifted to election projects. And every time an election happens, vote buyouts are very common, and the locals use the money to help pay for their daily expenses, including health care. The people say they don't have money. The government says they don't have money either. So who does? Of course, there are the huge multi-national corporations and related politicians, who have a hold of much of the country's wealth. Some Filipinos sarcastically put it this way: the Pareto principle (80% of wealth is in the hands of 20% of the population) is more like 95% to 5% for the Philippines.

It was a short stay for me, but I was able to meet a variety of people. However, as I mentioned earlier, the lack of money is at the root of many problems, but many people have stopped their thinking there. Yes, financial support is important, but that's an issue that will be around all of the time. What's important is how creative the people in the community together as a whole can become to overcome hurdles, including money, to make their daily lives happier. Yes, it's not easy, and it's not accomplished in just days or weeks. Some staff said that foreign visitors coming and praising the work the villagers do helps them gain confidence and move on. I guess that is important as well, but eventually, the people should be doing the things because they together feel the need to do so, not because somebody from another country is saying they're doing a 'good job'. When a people together become able to address its own issues, and creatively use their strengths and resources to tackle them, that is when a village starts to become truly independent, and it is what leads to empowerment and social development.

However, I want to make sure I am not saying the people have lost vitality. Yes, there are many who have fled overseas, but, there are many who have chosen to stay, even though their salaries are only a fraction of their counterparts in Europe or the U.S. They love their hometown, they don't want to be far from their families, or they have a strong passion for the work they do. Conversations with Nona Obando, the chief nurse at the health center, and Dr. Ramon were memorable, especially because I felt how much passion and pride they have not only for their responsibilities, but their home city. These altogether are invaluable assets to the local community and what helps it keep going. And then again, even for the people who have fled overseas, their feelings for their families and hometowns are the same. I have seen people in Japan and the U.S. who have lived for over 10 years without returning, but still continues to send money back to their families.

Immigrants are there all over the world, and ever more so with globalization. Whether documented or not, they all come because they want to make their daily lives better, because they want to support their families. And their longing to live in their hometown does not change. I would like to express my appreciation for Dr. Kamiya, JAIH-S, Nona, Joseph, Dr. Ramon, Dr. Pilar, and all the staff at the Bago City Health Center for their kindness and letting me have this opportunity.

What do airline alliances and consolidation lead to?

Having earned almost 80,000 miles on a SkyTeam member airline, the addition of Romanian national carrier TAROM and especially fast-growing Vietnam Airlines to the alliance in June is welcome news. At the same time, SkyTeam renewed its membership program, eliminating the 'associate member' status and thus upgrading Air Europa (Spain) and Kenya Airways to full members. Smaller airlines wishing to join no longer need to adopt a current member's frequent flyer program (FFP) if they already have their own. So June saw the number of member airlines grow to 13, serving 898 destinations in 169 countries and carrying 384 million passengers annually. Further, China Eastern is joining in 2011, and Air Algérie (Algeria), China Airlines (Taiwan), Garuda Indonesia, MEA Middle East Airlines (Lebanon), and Uzbekistan Airways have also shown official interest in joining, and are in various stages to apply for membership.

However, by size, the undisputed leader of the three major airline alliances is Star Alliance, which is also the oldest, having been founded in 1997 by Air Canada, Lufthansa, SAS Scandinavian Airlines, Thai Airways International, and United Airlines. Now boasting 28 members encompassing 1,077 destinations in 181 countries, they transport almost 624 million passengers annually. They recently added TAM Airlines of Brasil giving its presence a boost in South America, a continent without a partner ever since VARIG Brasil went bankrupt. On the other hand, the alliance with what some say is the most balanced network is Oneworld, with a member airline in every continent of the globe except for Africa (and Antarctica, of course). LAN of Chile (with subsidiaries in Argentina, Ecuador, Peru), Qantas of Australia, and Royal Jordanian in the Middle East help the group stand out. By size, they are third, with 11 members serving 819 destinations in 142 countries carrying 308 million passengers annually.

The battle to lure the leading carriers into their alliances is only getting fierce, especially in India, Latin America, and Africa. In China, the 'big three' have already decided on their future partners, with Air China in Star Alliance, China Southern in SkyTeam, and China Eastern also joining SkyTeam in 2011, which left Oneworld without a partner in the world's fastest growing market, though they do have Hong Kong-based Cathay Pacific. For the 'big three' in India, Kingfisher has already announced their intention to join Oneworld and Air India is preparing to enter Star Alliance, leaving SkyTeam to do whatever they can to persuade Jet Airways to join. The airline is reportedly most interested in Star. In Latin America, the recently-merged Avianca-TACA group is being fiercely fought for by Star and SkyTeam, though the airline says they are so far leaning towards the former.

The aviation industry is one that is fragile and constantly changing, yet often requiring airlines to make company-risking decisions. Consolidation is happening everywhere in the industry, where the strong are merging to get an even stronger hold of the market, the weaker are being gobbled up or wiped out, whether a legacy flag carrier or not, while a constant threat of low-fare low-cost carriers force the incumbents to make radical changes to keep up in the competition. Alliances are also a tool for consolidation, with airlines in the same alliances merging or taking over one another or forming joint ventures and making joint purchases of aircraft. Air France/Alitalia/Delta/KLM, Air Canada/Continental/Lufthansa/United, and the recent American/British Airways/Iberia are the most notable examples.

Recently, in the U.S., Northwest just completed merging with Delta, and now Continental is proceeding with a merger with United (retaining the latter's name), pending government antitrust approval. United belongs to Star Alliance, Delta belongs to SkyTeam, and American belongs to Oneworld. Then there are the now well-established low-fare airlines such as Southwest (the mother of them all), AirTran, and JetBlue, while not doing bad are Frontier, Spirit, and Virgin America. While across the pond in Europe, airlines are starting to get consolidated around three major airlines: Air France (SkyTeam), British Airways (Oneworld), and Lufthansa (Star). Then there are the well-known (or rather notorious) low-cost carriers such as Ryanair and EasyJet, among others like Air Berlin, Norwegian, and Wizz Air.

In Asia, consolidation has been rather slow, however, with the recent surge of successful low-cost carriers such as Air Asia (Malaysia, Thailand, Indonesia), JetStar (Australia, Singapore, Vietnam), Tiger Airways (Singapore, Thailand), and a handful of Indian start-ups, the legacy airlines are being forced to change. An airline like Air Asia X, which is the first low-cost low-fare model for long-haul operations, could change the entire picture, especially if they team up with the local low-cost low-fare carriers and connect their respective networks. It would have the potential to effectively create a low-cost low-fare network that spans worldwide. Plagued by mismanagement, political instability, economic turmoil, or other factors, once great airlines such as Japan Airlines, Philippine Airlines, and Garuda Indonesia (finally improving) need to act much faster. Malaysia Airlines, which is one of only five five-star rated airlines by Skytrax (others being Asiana, Cathay Pacific, Qatar Airways, Singapore Airlines), has been changing their 'long-term' plans too often and seem to have settled down on going solo, for the time being, after having had talks with SkyTeam for years.

In 2000, former TWA chief Bill Compton said that in 10 to 20 years, there would only be about 10 legacy carriers in the world plus a couple of successful low-cost low-fare carriers for each continent. Now, that doesn't seem to be an exaggeration. However, this brings us to another question. Deregulation of the airline industry was aimed at bringing the best value for the fare-paying customers, however, now it seems like they could have less choice in the not-too-distant future, if the industry does actually get dominated by just a couple of huge airline groups, thus raising the potential for higher fares. Hmm... but then maybe there will be the next surge of new airlines challenging the big ones. However, that is not as easy as said, and more so if the challenged are much bigger than they are today; countless start-ups have fallen to predatory pricing tactics of the incumbents.

A visit to Quneitra.

Located at the southern end of the Anti-Lebanon Mountains lies the Golan Heights, an area surrounded by four countries: Syria, Lebanon, Jordan, and Israel. With its fertile soil and abundance of water, the rocky plateau has been a scene of battles between regional powers for several centuries over who controls the land.

Originally part of Syria, the land was lost to Israel on June 10th, 1967, the last day of the June War (for Arabs) or the Six-Day War (for Israelis). It was briefly recaptured in 1973 during the Ramadan War/October War (for Arabs), or the Yom Kippur War (for Israelis), when Egypt and Syria launched simultaneous attacks on Israeli-controlled Sinai and Golan Heights, but Israel regained control in its subsequent counter-offensive. It was only in the negotiations following a ceasefire that Syria was able to regain some 450 square kilometers, a demilitarized United Nations Disengagement Observer Force (UNDOF) zone a couple of kilometers from the 'de facto' border between the two countries. At the eastern edge of the zone lies Quneitra, a city which was completely destroyed when Israeli troops withdrew in 1974. For many reasons, Syria has left the city almost exactly as the Israelis left it.

When I visited Syria at the end of February, Quneitra was the first place I visited. Although situated only 60 kilometers southwest of Damascus, I hired a driver because public transportation to the area doesn't come with frequency and would have required changing microbuses at Garage Sumariyah in Damascus and then a change to a service taxi (shared taxi) from the town of Khan Arnabeh, plus I had also heard recent rumors that you couldn't enter the U.N.-supervised zone unless you have your own transport. The road that heads down to Quneitra is picturesque, going through fields and farms, many of them producing vegetables, especially the olive, which is a specialty of Syria. When the snow-covered Mount Hermon of the Anti-Lebanon Mountains started appearing on the right, it was a sign that we were getting near, and soon we could start seeing some vehicles with 'U.N.' stickers.

Since Quneitra is part of the UNDOF zone, there was a gate, where Syrian officials stopped our car to check my passport and permit, which I had arranged in advance at the Ministry of Interior in downtown Damascus. It was a mere five minutes until they gave me back my passport and a Syrian officer hopped on the car to guide us around the demolished city. As we went on, houses with roofs lying on the ground and walls completely knocked or torn down started to appear on both sides of the street. We went through sites where there used to be shops, a mosque, a church, a school, and also a hospital, but obviously, all were vacated. The government does not encourage former residents to come back, and the few who still remain in town cater for the U.N. troops and visitors.

At the western edge of the battered city were barbed wires, which mark the 'de facto' border, beyond which is effectively Israeli-occupied land. There is an unofficial border crossing that primarily allows Syrian Druze from the Golan Heights to cross one way through the passage to study, work and live in the rest of Syria. Only those who receive special permission are allowed to cross the border and come back for the Habil pilgrimage. More recently, apples produced in the Golan have been shipped across the border into Syria. However, no way is the crossing open to anybody else, obviously, as the two nations are officially still at war.

It truly was a ghost town with an eerie atmosphere, but it's not as simple as that. We were able to get off the car and walk around in some places, but could hear nothing. Just voices of us and the sound of our footsteps, plus the occasional wind. On the walls of some buildings, we could see Arabic inscriptions as well as those written in Hebrew, probably left by the Israeli soldiers. The Arab-Israeli conflict is one that is extremely delicate and has been complicated by the powers influencing the nations in a tangled web of relations. Israel was heavily criticized by the United Nations for the city's destruction, while Israel has criticized Syria for leaving the city as it is and claimed the Syrians added further damage to exaggerate. However, we have to remember that it's the locals who are the most affected. Their houses were burnt down by the Israelis, and now Syria is telling them they can't go home. The entire population is now scattered around the country.

On the way out of the area, we saw two groups, probably families, picnicking on grassland near the crushed buildings. Syrians like picnicking, and perhaps those were just some people longing for their peaceful return to their motherland.

Returning to good old Philly.

Philadelphia. It's like my second home, or the first. It's where I spent my young days, my middle school years, and where I made many friends. I don't remember too much of the days when my family lived down near Washington D.C. before we moved up to the Keystone State, and though I spent no more than four years up there out of a total of ten I spent in the U.S., Philly means more to me than any other place in the country.

Looking back at the days, it's where I grew up most while living overseas. It is where environmental studies caught on me, while simultaneously being drawn into participating in activities that do social good for the communities, locally or globally. I still clearly remember the days when I did volunteer work every other week with the Whosoever Gospel Mission, a homeless shelter in Germantown, helping the homeless to empower themselves and become independent, or helping fundraisers for the UNICEF and the Kobe earthquake. Come to think of it, how many middle schools in other parts of the country or in Japan have volunteering with the homeless as part of the curriculum? Maybe some in the U.S., but I've never seen nor heard of in Japan. Looking back now, it helps to make you feel that they're not too different from us, but maybe just born in socially handicapped families, and together with unfortunate circumstances and some mistakes, have become 'homeless'. Well, this leads to a different topic so I'll stop here...

I revisited Philly in March, as part of our 'graduation trip' I went along with five other friends at my university. In my words, Philly is like a countryside city of charm sleeping or rather 'hidden' between the economic powerhouse of New York and the capital Washington D.C. However, it's not any other mega city nor just a countryside city. Having been the first capital of the nation, the historic Old City area or the many cobblestone streets accompanied by well-preserved homes, churches, and various other monuments help to keep the rich history alive, while Center City has blossomed into a world-class downtown with towering skyscrapers, five-star restaurants, theaters, and galleries.

Philly is a city that has also given birth to a handful of favorite local foods that are now known throughout the country: cheesesteak, soft pretzel, and water ice. So I definitely made sure we didn't miss out on having a taste of those, especially the cheesesteak. Some say that "a proper cheesesteak consists of provolone or Cheez Whiz slathered on an Amoroso roll (definitely a must!) and stuffed with thinly shaved grilled meat", however, it's pretty much up to personal preference. Some like the rolls toasted and crispy (that's me), while others like them soft and chewy. Some would dip it in grease, while others would complain that too much grease makes the roll soggy (me). Some prefer the meat to be diced as thinly as possible (yup, me), while others prefer larger chunks. Some love the artificial Cheez Whiz (me too), while others prefer American or provolone cheese. Where to get the best? Again, up to you, but my favorite is Jim's Steaks. Although Pat's and Geno's both claim to be the first cheesesteak, Jim's produces better. Jim's has four shops, with the original one still located in West Philly, but the one that attracts most is the one down on South Street. It was 15 years ago when I went there the first time.

South Street is one of many shopping districts in the city. Offering an eclectic mix of over 300 mostly independently-owned shops, including diners to ice cream parlors, head shops to tattoo parlors, hip-hop clothing stores to jewelry shops, records stores to home and gift shops, and add to that lingerie and sex goods shops, South Street offers a unique selection of shopping opportunities; no wonder Jim's at South Streets gets a waiting line every weekend. Another shopping district I like, despite with a totally different atmosphere, is Chestnut Hill in Northwest Philly. The only business district in a largely residential area (big homes too), Germantown Avenue, with cobblestone and trolley tracks, is like the Main Street in a small old town with quaint storefronts, Victorian lampposts, and shoppers who stop to chat with one another. It has a modest selection of antique shops, upscale home goods shops and clothing shops, and several independent art galleries. It's a nice place to stroll on a weekend afternoon.

Oh boy, am I missing Philly. :)

Savoring Polish cuisine and Żywiec.

When my Polish friend's family took me around the country, I had the opportunity to savor a variety of Polish cuisine, both at their home in Żywiec and at restaurants around the country. Polish cuisine contains much that is distinctive, but little that is truly unique to the country, with most of it representing a blend of culinary styles that run across countries in east-central Europe, such as Belarus, Lithuania, and Ukraine. Meat and potatoes are the mainstay of the national diet, while north European vegetables including carrots, cabbage, and beetroot provide good accompaniment.

When I visited, it was in February, still the winter season, though at the end of it, so there was plenty of snow that had yet to melt. During this time of year, vegetables become harder to come by, excluding those imported, and together with the long cold season, the people consume more meat and cheese. Every morning, together with the family I had bread with many kinds of cheese and ham. It was simple, but the bread bought at a nearby bakery was certainly not something I find everywhere, and it was the first time I felt I could eat cheese without eating it with something else. Simple, but depending on the combination of bread, ham, and cheese, you could enjoy a variety of tastes. A good choice of sweet pastries goes along well too.

What I also enjoyed much was the soup. It plays an important role in any Polish menu, serving as an introduction to a multi-course meal or just a mid-day stomach-filler. The most famous of them, and what I found to be my favorite as well, is barszcz (borscht), a reddish beetroot-flavored broth with a mild yet perfect balance of sweet and sour tastes. If you visit in the summer, you would find a refreshing variation on these theme called chłodnik, which is cold borscht served with lashings of sour cream and a side order of boiled potatoes. Another soup I remember is the fasolka, a solid, almost stew-like combination of beans and smoked sausage.

As I previously mentioned, meat is often the main part of Polish cooking, but it is pork that takes up top billing. You can reveal for yourself how important the pig is to the Polish society if you look over the delicatessen counter and see the sheer size of the repertoire of sausages and smoked cuts of pork. Although the generic name for sausage is kiełbasa, there are plenty of varieties to choose from: the thin, smoked kabanos, the garlic-rich wiejska, and the pink, mildly-spicy krakowska. A pork dish that I remember well is golonka, a deliciously tender roasted pork knuckle, traditionally served with chrzan, which is horseradish sauce. Dairy products, especially the cheese, is also central to the Polish diet. The oscypek, which is a bun-shaped sheep milk cheese sold everywhere in the town of Zakopane (though available in other places as well), was delicious, especially the smoked ones.

Something not to miss, and what has become more or less an icon of Polish cuisine is the pierogi. They are boiled dumplings of scallop shell shape and size, and are stuffed with a variety of savory or sweet ingredients, from minced meat, cabbage, potatoes, mushrooms, and cheese, to strawberries, cherries, or other fruit. The food is consumed well in this part of Europe, where the people speak language of the Slav origin. Belarus, Russia, Ukraine, Slovakia, Estonia, Latvia, Lithuania, Germany, Czech are all among them, although sometimes they are under different names such as kalduny in Belarus, and koldūnai in Lithuania. There is a similarity to the Italian ravioli and tortellini, or the manti, khinkali, or chuchvara in the trans-Caucasus region, including Turkey, while not too similar but still sharing some aspects are the Afghani mantu, Mongolian buuz, Nepalese-Tibetan momo, Chinese wonton, Japanese gyoza, and the Korean mandu.

Oh, yes, and I didn't leave out beer! Situated in the southeastern corner of Silesia province in Poland, Żywiec is a peaceful countryside town with a population of just over 30,000, and it is known for the beer that is named after the town. Although now under the Dutch Heineken empire, the Żywiec Brewery was originally founded by the Habsburg family in 1852 and has been producing ever since. Competing brewers include Tyskie and Lech, and though I could not recognize too much of a difference between the three, it was certainly nice to visit the history-rich bar located adjacent to the brewery and sip on a glass of Żywiec, naturally the most popular of the three in this part of Poland, enjoying the atmosphere of a Polish countryside bar.

A visit to Auschwitz, Oświęcim.

70 kilometers west of Kraków lies the town of Oświęcim. Although a quiet, countryside town with a population of just over 40,000, this place is recognized widely as, and is still indissolubly linked with the name the Nazis gave it when they occupied Poland: Auschwitz.

I had the opportunity to visit this notorious camp in February, right after I had my license examination. I actually hopped over to Europe the very next day. My trip to Poland, and the first one to a country in eastern Europe, was made possible by Krzysztof Sanetra, a Polish friend I got to know well through a program at the University of Edinburgh, and his family. Although it was not his best time, as he was busy writing reports and preparing for exams, we were finally able to meet up once again, and he and his family were kind enough to plan out a sightseeing trip for me. I truly don't know how to thank them for driving me around the southern half of the country, sometimes on five-hour legs, arranging English-speaking guides for me everywhere, letting me stay at theirs, and taking care of me.

Following the Nazi invasion of Poland in September 1939, Oświęcim and its surrounding region were incorporated into the domains of the Third Reich, and the town's name was changed to Auschwitz. Establishing new concentration camps in this newly conquered territory was a German priority from the beginning, as camps in their homeland were already getting overcrowded, and the occupation of Poland dramatically increased the number of potential 'undesirables' who would need to be interned. The site of Oświęcim was perfect for many reasons. It already had a Polish-built camp for migrant workers (which could easily be converted to prisons), it was remotely located between the Soła and Vistula rivers, and it was strategically situated at the 'center of Europe'.

Designed by Rudolf Höss, the camp was opened on June 14, 1940, initially with 728 Polish prisoners. The camp originally comprised 20 buildings, of which six had a second floor. However as the number of inmates grew, an extra story was added to all one-floor buildings and another eight buildings were built by 1942, using the prisoners as workforce. As time passed, the Nazis started to deport to the camp people from all over Europe, including Soviet prisoners-of-war (POWs), Gypsies, Czechs, Yugoslavs, French, Austrians, and Germans as well, though many of them were Jews. The number of prisoners kept on increasing, and a second camp, which is much larger than the original, was opened in 1941 three kilometers away in Brzezinka. It became known as Auschwitz II - Birkenau. A third site was constructed in Monowice near Oświęcim and became Auschwitz III. At peak, the camps accommodated no less than 20,000 people

When you enter the Auschwitz Museum, which is located at the original Auschwitz I site, you will see above what the prisoners passed under each day: a gate with the cynical inscription 'ARBEIT MACHT FREI', which translates to 'work brings freedom'. It was a bitter cold day when I visited, with temperatures only reaching a high of five degrees below zero Celsius and snow still frozen, but back when the monstrous facility was still in operation, prisoners being forced to hard labor (sometimes exceeding 12 hours) in this harsh environment was the norm. Prison cellars now display various objects, including numerous photos, empty cans of Zyklon B (the substance thrown into the 'shower room' and could kill 2,000 in 30 minutes), the actual belongings of the people such as shoes and suitcases with the name of the deportees, and cloth and carpets made from human hair.

We also walked to the 'Death Block', which was a prison within a prison, completely isolated from the rest of the camp. The ground floor and the basement 'torture' cellars are still preserved in their original form. The courtyard between Blocks 10 and 11 is enclosed on two sides by a high wall. The wooden blinds on the windows of Block 10 were installed to prevent the inmates from observing the executions taking place here, though they could still hear the bullets being fired. At this 'wall of death', the Nazis shot thousands of prisoners, mostly Poles. In the yard in front of Block 11, the Nazis carried out punishments in the form of hanging prisoners to a special stake by their arms, which were bent behind their backs. An endless number of visitors leave behind flowers and candles at this place.

The more I walked though the Auschwitz facilities, the more it gave me an eerie feel. It is so-to-speak a 'factory of death'. When prisoners arrived, children, the elderly, the handicapped, the pregnant, were immediately sent to the 'shower rooms' and mass-executed in a mere 30 minutes with Zyklon B (Cyclon B). Their belongings would be collected and reused or sold, their hair would be 'reused' to weave cloth, and there were experiments to collect fat from the corpses and produce soap. And, not surprisingly, all of this was carried out by the prisoners as well. Those who were young and of the working generation were kept alive longer, though forced to hard labor in temperatures of sometimes -20 degrees Celsius, given only one meal per day, allowed to visit the toilet only twice, and lived in bunks with poor hygiene. Cleaning the toilets was said to be the 'best tasks' among the prisoners, as they were always working inside, and could visit the toilet anytime they wanted to. There were tortures all the time, however, the harsh environment was often enough to take the toll. Whenever someone died, it was the norm for the inmates to keep it a secret, so that they can receive one more meal.

I found myself at a loss of words. With the even more massive Auschwitz II facility, the complex gives you the impression that it is truly a 'human-processing' factory, and one that is carefully planned and cleverly laid out. Yes, it was politics. But, how can humans become so inhumane? Was it not possible to direct all that intelligence and effort towards something else? We learn history so that we do not make the same mistakes and we can build on top of the past. However, though in different situations, genocides have been repeated, and more than once. Oświęcim will remain a place everyone should visit at least once in their lives...

Taking a break in Cairns.

In December, I traveled to Cairns, in the northeastern corner of Australia, with my family. It was certainly a nice and long-needed break from the daily rigorous studying. My October was full of exams, and the beginning of December saw the last, yet the biggest exam of the six years: the graduation exam. Not until we pass that do we become eligible to take the national license board. In Japan, graduation from a faculty of medicine requires you to pass this graduation exam, instead of submitting a thesis. So, we do go through a period of 'torturous studying', however, we are never required to learn how to write a paper.

Named after William Wellington Cairns, then Governor of Queensland, this city was originally founded in 1876 to serve miners heading for the Hodgkinson River goldfield. However, the region has been inhabited by the aboriginal Walubarra Yidinji people, who called and still calls the area Gimuy, since long before the Europeans came. Later on, the city developed into a railroad hub and a major port for exporting sugar cane, which still remains the biggest local industry after tourism, and metals, minerals, and other agricultural products from the surrounding coastal areas.

Cairns gives you the impression of a peaceful countryside city. It doesn't have skyscrapers, nor does it have multi-story shopping complexes. It's not about the hustling and bustling one has to endure in Sydney or Melbourne. The seaside boardwalk gives you a pleasant view of the port and the peninsula across the cove, which is sacred aboriginal territory, and especially picturesque at sunset. However, the nearby beaches are not a place for swimming, as it is infested with crocodiles and some stinging jellyfish, a reminder that the seashore is predominantly mangrove swamp, and that the port was built after clearing part of it.

The best and most beautiful waters for swimming nearby is certainly out at the Great Barrier Reef, which is a UNESCO-registered world heritage site, and stretches over a distance of 2,600 kilometers. It is composed of over 900 islands and 2,900 individual reefs. Cairns is naturally the hub for those who come to see what is the largest single structure made by living organisms. However, we must keep in mind that the booming tourism (generates AU$1 billion every year) together with climate change are the biggest 'enemies' for this great natural wonder.

A visit to Lao-China Friendship Hospital.

When we visited Laos in August, I went without any prior contact, since I knew nobody in the country, but still, I wanted to get a glimpse of what health care looks like, and listen to the actual health care workers in the country. So, one afternoon, we negotiated with a 'songthaew' driver to take us to Luang Prabang Provincial Hospital, more commonly known by locals as the 'Lao-China Friendship Hospital', or simply the 'Chinese' hospital.

Located off the main road four kilometers south of the city on a seven-hectare land, the hospital was completed in 2004 with assistance from China, as its name implies. It was already during the late hours of the afternoon, so the outpatient department had already closed and many staff gone home. Although without any contact beforehand, the staff at the counter in the deserted main hall kindly allowed us to walk around the hospital. Upon starting our 'tour', we noticed that all of the emergency exit signs and fire hydrant labels were written in Chinese and English only, and without Lao, no wonder the locals call it the 'Chinese' hospital.

While we were walking, we came into a nurse, who was apparently about to go home, and she was kind enough to let us hear about the hospital and her job. The hospital is divided into four major departments: inpatient, outpatient, labor room, and pediatrics. The outpatient clinic includes internal medicine, surgery, pediatrics, obstetrics and gynecology, family planning, otorhinolaryngology (ear-nose-throat), dentistry, and emergency. Depending on the day, the hospital sees about 25 to 100 patients per day, with Monday getting the highest number. Its medical staff comprises 97 nurses, 27 physicians, plus 10 volunteering nurses from South Korea. Some common medical problems include common cold, respiratory infections, cardiovascular disorders, gastroenteritis, and accidents. She said that an increasing number of people do not take enough exercise, something I am used to hearing in other parts of the globe as well.

After going through the examination rooms, we visited the ANC, or the antenatal care department, which they say is the busiest part of the facility. At least three staff must constantly be present here, so they are currently working on a 24-hour-work-and-24-hour-rest rotation. For vacation, they get 10 days off per year. According to them, the busiest months are February, March, May, and June, before the rainy season starts. Here we met some nursing students, who told us that they have a 2.5-year program. There were no medical students, but we found out that is because the sole faculty of medicine in Laos is in Vientiane, the capital.

For the patient, there are two often-encountered problems in the medical scene, although they do represent larger underlying issues. One is the lack of medicine matching that of international standards. In recent years, foreign aid, especially from China and Japan, has helped hospitals to update their out-dated facilities and equipment, and bring up more health care professionals, however, there still are often cases where the patient is asked to travel down to the capital of Vientiane, almost 500 kilometers away on a recently-paved mountainous road. And even at there too, the patient is often asked to cross the 'Friendship Bridge' to receive further treatment at a Thai hospital. In emergency cases, such as major traffic accidents, this clearly does not work. And, obviously the patient would have to pay for all of the transportation costs, and the fees skyrocket if you need to be transported across the border.

This leads to the second issue: money. Universal health care is still non-existent, so even in public hospitals the patient needs to pay. The same goes with ambulance, where patients pay by the kilometer, like a taxi. If she or he gets admitted, the average fee per night for a normal room is 40,000 kip (about US$4.80), but that is not easy for a country where people live on an average 10,000 kip (about US$1.20) per day, though the economic disparities are great. People who live in Vientiane, the nation's capital, are the richest, where over 50% of households have cars and 40% have air-conditioners, while next comes those living in the capitals of the provinces, like Luang Prabang, and the poorest are the farmers who live in the mountains and the countryside. According to the staff, patients who have financial difficulties paying fees may submit a request to receive aid from the government, but again, one needs to travel down to the capital to do so. It is not surprising that the 150 beds at Luang Prabang hospital are never near full.

The government seems to have started working on these issues over these few years, and is in the process of not only setting up a clinic in every village, but a primary school, and encouraging more villagers to have their children enrolled. Of course, the families would have to give up on earnings that would be made through having the child work instead and understand the long-term significance of education, so it's not easy, but at least they wouldn't have to walk hours to go to school anymore. They are also working to put more emphasis on preventive medicine, and moreover, health-building through community participation. Things have only started to change, and it will certainly take a long time, however, the interesting point about Laos is that they are going through the process at the same time their economy is developing, something other economically-developed nations went through at separate times, with economic development coming first.