Heidi - Public Health Preparedness Summit

Please click the tag "Heidi" or my name as author to view all other posts.

Home (Kaleigh)

Hello... I apologize for not writing more, but one of the less fabulous things about Micronesia is that internet is pay-by-the-megabyte. Needless to say, I spent a lot of money on internet and wasn't able to access 'fancy' websites often.

So.... I will just give a brief synopsis. My research with Island Food Community of Pohnpei was fine. I did a qualitative project, which left me to fend for myself, basically. More help on logistics (transportation, etc) would have been appreciated (and probably granted had my project been quantitative). Oh well. My village was an hour away and had to be reached by a 4-wheel-drive vehicle. I only made it out there 4 times, unfortunately. (And it was a struggle to get those 4 times.) I completed the project, but I do not think it is thesis-quality, so I will write up a report but not plan on using it for a thesis. Conducting the interviews in a different language was too much for my first time carrying out a qualitative project. However, I learned A LOT and am so grateful for the opportunity.

Some of the great parts about the trip... I got to swim with manta rays. Awesome. We did a lot of snorkeling. The boat trips to outer atolls were really, really enjoyable. We spent a night on one of them and it was so neat. Hikes to waterfalls were slippery and trying experiences. :) Rewarding, too, of course. The place was just beautiful, but it took getting into a boat and seeing the island from the water to realize the incredible nature we were living in.

Michael Jackson died while we were in Pohnpei and I was actually sick that weekend, so while the other researchers were out exploring, I watched Michael Jackson tributes on TV all day laying in bed. That was special...

Leaving was much more difficult than I had expected. Because it is such a small island, going to the airport is a big deal. A plane comes and leaves once a day (Continental Micronesia). Entire families and friends will go to the airport to see people off. I wasn't prepared for it to be an emotional experience and couldn't look back when walking to the plane. Met some pretty special people.

Well, I guess that is all for now. More to come at the GFE presentation. Ha.
Hope everyone had good experiences - enjoyed your posts. What an amazing group of people you are. Look forward to seeing you back in Atlanta and wishing everyone a safe trip back.

Love,
Kaleigh

Meryl is return

Heidi and I picked her up at the airport.

http://www.youtube.com/watch?v=_L4fltWl9-A

Heidi said leaving a bag unattended in an airport in Israel is a good way of having it exploded by security.

Jeff

Home

Hello,
I left JoBurg Thursday evening and arrive in the US Friday evening . It took about 27 hours. I watched a lot of television and movies and the food was pretty good. I flew Virgin from JoBurg to London. Richard Branson was on the flight and went around greeting his customers.

I'll keep blogging to cover some experiences and thoughts I didn't get to while abroad. Such as, the most disgusting thing I ever ate, almost, two days ago.

A nice woman at work makes a corn porridge for breakfast and brings it to work. She would make an extra portion for me sometimes so I could have an authentic SA breakfast. It was good with lots of sugar and milk. By coicindence on my last day of work (I think! I hope it wasn't a treat for my last day) she had brought in another authentic SA food. It some kind of insect or grub. I don't even know.




I'm pretty into food and you have to eat weird things to have street cred as a food enthusiast. There were a few African people at the table in the break room and they were sampling the fried insect. Here I am contemplating one. It's pretty big. And disgusting.



Here I am nomming on a grub. I didn't want to eat that whole thing so I bit off a third. Then I held it in my mouth for thirty seconds. The outside was kind of flaky and crunchy and the inside seemed goey. I couldn't chew it. I wanted to, but I couldn't get past the thought, if I start chewing on this, I'm going to be chewing on bug guts.


So I spit it in the trash and moved on with my life. (center below the napkin)

Kruger

I went on safari in Kruger National Park with Waverly and her friend from the US, Miranda. On Wednesday we went to Nelspruit, a major town near to the park. Thursday morning we awoke at 5am to get to Kruger for a morning drive. The driving is done in safari vehicles, a cab in front for the driver and 3 or 4 raised bench seats that are open except for a canvas roof. It was very cold and windy most of the time in the vehicles and especially in the morning. The driver for our first game drive in Kruger is the driver for the hostel/safari company and the rest of the game drives were by safari guides.

We entered Kruger and the first thing we saw was impalas. There are lots and lots of impalas in Kruger. The driver even told us, we don’t need to stop long, you will see many impala. The way game drives are done is to drive around in the safari vehicle trying to spot animals. There aren’t viewing areas you can go and see a wildebeast or whatever, you just drive around and hope you see something. Watering holes are likely to have animals like waterbucks or impala, but we saw the more “exciting” animals in the bush. If you see something you tell the driver to stop and if he sees something, he will stop. The drivers are really good at spotting animals. It was always exciting when the driver stopped because we knew there was something to see we hadn’t spotted. When the vehicle would stop we would crane our necks from side to side and I would ask Waverly “what is it? What is it?” Sometimes the guide would just look off into the distance intently for a bit but most of the time there was an animal we hadn’t spotted. Twice he spotted giraffes, once in dense brush off the road and once in a tree line over a mile away that we would have missed.

After the first impala’s we saw we drove more and I spotted a lone impala off in the distance framed by foliage. I was proud of my animal spotting skills but this would end up seeming kind of silly compared to what we saw in two and half days. At that time, we didn’t know what to expect and it can vary a great deal. People at work had told me about going and not seeing any cats, so I knew that was a possibility.
Then, we passed another vehicle headed towards us and they said they had been following a lion. The animals walk on the road a lot so that is an easy way to spot them. Later we saw an incredible picture of that lion sitting in the road.

The first exciting animal sighting was two rhinos, a parent and smaller rhino. The guide told us that white rhinos have the babies walk in front and black rhinos have the babies walk in back of the herd. Then he said “where do white people hold their baby?” “And, where do black people hold their baby?” That is how you can tell whether you are seeing black or white rhinos. We never saw rhino herds and there are mostly white rhinos in Kruger, so it was not the most useful explanation.

Then we went to camp to have breakfast. We were staying in tents in Pretoriuskop, in the southern part of Kruger. I invented a sandwich at breakfast, toast with peanut butter and jelly and cheddar (It was to have lots of calories and protein. Of the pbj family, it was better than peanut butter and banana, not as good as pbj and bacon). Then we went on another game drive. On safari, you mostly are either eating or on a game drive. We saw more impalas including two males that were fighting. They were rubbing their horns together but not very vigorously, so it looked more like they were flirting. Impala’s look delicate and soft, even the guys. Then we saw our first zebras. I really like zebras. They are like funny horses. Their neck fringe stands straight up so they look punk. There were some impalas and zebras and wildebeests hanging out in a field by the road. Later the guide told us that animals like to hang out with animals tougher than them, so they don’t have to worry about predators as much. For those animals wildebeat>zebra>impala. Sometimes there is low grass near the road, which is good for sightings. Tall grass and trees are worse. The most exciting part of the mid-day game drive was seeing elephants. There were three elephants way off in a grassy depression leading away form the road. At the time, we didn’t know if those would be the only elephants we saw, so it was great.

Then we broke for lunch at one of the rest areas. A guy from Europe was with us and he warned us about trouble monkeys. Those are monkeys that hang around the rest areas and try to take loose items or food from vehicles. I thought that was a fun concept to bring back to the US. “I can’t find my keys, maybe a trouble monkey took them.” Every meal we had on safari was great. Breakfast was pastries, the aforementioned sandwich, yogurt, fruit salad, cereal, etc. Lunches were sandwiches, salad, and very delicious curry potato salad or macaroni salad. Dinners were cooked over a camp fire. Marinated chicken the first night and beef stew the second night, with pap and rice, respectively. Pap is a South African dish made of corn flour. There was a lake near the rest area and we saw our first hippo there. Hippos bob up and down in the water, from fully submerged to sticking their nose out, so you don’t see very much hippo.

It sounds super exciting when condensed, but on safari there are long stretches of driving when you don’t see any animals. Sometimes, we went an hour or two at a time only seeing impalas or something way off in the bush.

That night we had a night drive. We went out at about five as the sun was setting. Right outside of camp we saw our first baboons. They were crossing the road in front of us. There was a baby baboon riding on it’s mothers back which delighted Waverly and Miranda but I missed it. On night safari, there are bright flashlights in the vehicle and you shine them out to the sides and use the lights and headlights to try to spot eyes in the dark. I think we mostly spotted animals in the lights without actually seeing their eyes. Night drives are good for seeing cats and we hadn’t seen any cats yet. The night guides were different from our day drivers and they were incredible at spotting animals. As the sun was still going down they saw a rock antelope on a rock face way off in the distance. The drivers also spotted a chameleon on a tree (while we were doing about 20 mph and in the dark!) and we saw a bush rabbit. We also saw a few owls. Mostly I am using correct names but if I don’t know the right name, I just append “bush.” Bush rabbit, bush squirrel, etc.
I have a bunch of black pictures from the night drive from trying to take pictures at night of animals in dense bush. The first cat we saw was a leopard. It was walking towards us on the road and then it turned away and walking away about level with the vehicle. I have a picture of its butt. I think the second exciting animal we saw was a hyena. It was about 20 feet away and not moving. It was gazing at the ground and didn’t seem to care that we shining a light on it and talking. I really like hyena faces and I’m glad I got to see a hyena. Then we saw two lions. One was a girl lion and they both might have been, I’m not sure. They were very close to the road. I think when we first stopped they were only 15 feet away. It felt a little bit dangerous. They moved away from us but stopped about 25 feet away for a bit. I think lions are a bit overrated, because you usually only seem them briefly and at night. It’s also fun to see elephants playing or impalas bouncing up and down over brush, but when you go to Kruger people are really concerned with seeing the big five (lion, elephant, rhino, leopard, water buffalo). The big five comes from hunting and if you are sightseeing, then zebras or giraffes might be more fun than water buffalo but not as good for bragging if you are a hunter. A bit later we saw a third lion walking parallel to the road and roaring. The Euro guy had done an impression of the lion he saw and it was like that. Low and short and not very loud, Ruuur, Ruuur, Ruuur. The guide thought he was looking for his lion ladyfriends.

It was pretty cold our first night in Kruger. We had hot water bottles to snuggle with and we used them for the morning drive the next day too. I think of day two as elephant day. First we went and looked at a watering hole that was empty except for a few hippos. Two young hippos were playing, sticking their jaws out of the water and on each other. Then we saw a few waterbucks. Waterbucks have a white behind. The guide explained that waterbucks sat on a toilet seat that had been painted so they have a white U shape on their butt. Then as we were cruising along the road a pack of wild dogs approached in the opposite direction. Wild dogs are very rare, I think only cheetah’s have fewer numbers in Krueger. They are splotchy black and tan and white and about the size of a coyote. There were about seven of them and they didn’t seem fierce at all. Some went by on the road, close to the vehicle and some veered off into the bush. Wild dogs are thought of as intense predators because they will bring animals down in a pack and start eating while the animal is still alive.

Then we went and saw the watering hole where the battle at Kruger took place. It’s on youtube, but I can’t get the link from my work computer. There were lots of Waterbucks there and I was hoping there would be a lion-croc fight over one of the young ones but it didn’t happen. Then we saw about three zebras. I asked the guide how many zebras he would see at a time since we hadn’t seen more than four and on tv I have seen large herds of zebras. He said nine or ten was the most zebras he would see in Kruger. Then we drove for another hour or so, seeing a bush lizard, before we saw about fifteen zebras right by the road! There was a kid zebra and a teenage zebra dude and a bunch of adults. That was one of my favorite sightings.

Then we saw an elephant pretty close to the road eating a bush. After that we saw water buffola completing the Big Five. ***old dudes*** Next we went and looked at a creek bed. In one direction there was a rhino off in the distance. In the other direction there was a giraffe way off in the distance. I have a picture that looks like a loch ness monster picture because the giraffe is so far away and it has the same head shape. Nevertheless, we crossed off giraffe from our list of animals to see.

Then we stopped for lunch. There were lots of trouble monkeys at lunch. When the group next to us finished eating trouble monkeys came and scavenged their leftovers. Then the trouble monkeys went to our vehicle. I had to shoo five monkeys off our vehicle trying to get into our bags. As we were pulling out of the parking lot I saw that there was a minivan with an open window and monkey was going into it.

We saw a lot of elephants after lunch. We were driving thought high bushes and I saw some dark shapes behind bushes. Just as I thought I should say “stop” to check if they were animals we got a clear view of another elephant between two bushes. There were three or four elephants eating leaves as they wandered away from us. The guides had told us to stay low in our seats and not lean out because animals will react to a human shape and not to talk too loudly. One of the elephants shook his head at us and the guide told us that he was irritatied with us. We moved on and saw a lone elephant pretty fast. That elephant shook his head even more angrily. He wanted to kill our safari vehicle. Our guide told us elephants had charged him but he didn’t get give details about what happened. Shortly after that we saw two groups of elephants. One groups was next to a concrete cylinder with water in it. One of the elephants was sticking it’s trunk in and then spraying water on a child elephant. One of the smaller elephants was trying to get his trunk in the water but he couldn’t reach.

We moved on from the elephant area and drove for a bit before seeing some cars stopped on a bridge. The bridge was a bit narrow so cars were backed up and the first person we asked didn’t know what there was to see. When we pulled forward more someone told us there was a leapord in the dry creak bed. That was the only cat we saw during the day time. It was lying in the shade of a tree and didn’t move during the time we were looking at it. That was it for day 2 and we went back to the camp.
This was the giraffe day. The guide had an incredible sighting of a giraffe and zebras way off in a tree line. Then we saw giraffes not too far away in trees and bushes. There were two. The way the head sways as they walk is fun and I like the horns. The giraffes looked at us, which was nice. A lot of animals either ignore us or move away.



Jeff

Sapa (Ron)

After the two posts my Jeff and Heidi I tried to think about an event here that had a similar bearing on my humanity and I can honestly say I have not had that experience (thankfully). My experience here is that Vietnam is a very peaceful country with wonderful people. The closest I had was a political discussion about a progressive citizen who was imprisoned for speaking out against corruption of the current government. It was not even a debate as my co-worker was agreeing with me that this man's imprisonment was improper.


On a more happier note, I have found one of my favorite places on this earth. Sapa, Vietnam. Sapa is a little town northwest of hanoi in the nothern mountains of vietnam that is surrounded by ethnic minorities who live their very traditional lives in small villages scattered amongst the rice paddies.

I booked a tour with handspan tours which was the best investment for this trip. The guide we had was wonderful. He grew up in Sapa so he was very knowledgeable of the area and the people. The hotel was simply amazing. Here is the view we had.


The group of people I had most contact with were called Black Hmong. Others in the region are Red Dau, Day, Tay, Flower Hmong, and Lu. At times it's very difficult to tell the difference as an outsider but each group has slightly distinctive clothing.

Here is a Black Hmong mother and her baby. They hike EVERYWHERE so all young children are carried on their back.


This is Cat Cat Village (Black Hmong). As you can see the village consists of small houses usually in a valley scattered around rice paddies.

This is from the second day hike to Lau Chai village. As you can see from the pictures it rained. In fact it rained the entire time I was in Sapa and I still left feeling like it was one of the most magical places I have ever been to.

One of the main reasons why I felt Sapa to be so wonderful is the people I met there. Everyone is trying to sell you something as the town and surrounding area is a tourist attraction. It is a mixture of hilarity and anger as you continually say "no" to someone who continues to ask "you buy from me?"

But the younger children speak very good English and are eager to practice. They are very outgoing and sometimes just want to get to know you. Here is a picture of a couple girls my group and I spent time talking to.

These two girls were hilarious when together. Just simply amazing people.

If anyone travels to nothern Vietnam you absolutely must take a trip to Sapa. The small town is beautiful in itself, hiking along the villages is a great way to spend the day, and the people are utteraly unforgettable.

Highlight of my trip so far.

Because Jeff brought it up...

My 'worst thing I've seen' isn't what I saw, but rather what I heard.

A couple weeks ago Adi and I were waiting outside her apartment building waiting for her roommate so we could all walk to a Shabbat dinner. With open windows we heard this really loud cracking and clanking in her neighbor's second floor unit followed by screaming. We soon realized the dad was whipping a child with his belt in the room right above us. It was horrifying how long it went on for. We waited several minutes for her roommate and, with the beating still going on, left for our dinner.

I asked if we should call the police, and Adi was hesitant. She knew that the neighbors were Lebanese and because they helped Israel during the Lebanon War (2006), they were allowed to live in the country. Apparently abuse is common among this group - a stereotype, I know. While she wanted to help, she said that it can be dangerous for her to report them if they were to find out it was her, and decided that for her safety it would be best to ignore it. I should say too, Adi is a nurse, and incredibly compassionate... to me it spoke volumes about the complexity of this situation when she was reluctant to get involved. The neighborhood is a little rough, but clearly there are social, political, and cultural dynamics here that I don't understand.

This was by far my worst experience, the kind that challenges your being and leaves a knot in your stomach, and ironically it's something that I could just as easily experienced in Atlanta. It was a terrible feeling to know that a child was being relentlessly beaten, hearing the foreign shouting and piercing cries, and to not have the ability to do anything about it. I guess I'd like to think that if I were confronted with a similar situation in the US, I would feel safe enough to intervene... hopefully I'll never have to find out.

The worst thing I saw today

In the HIV section of a case report form “mom refused testing.” The child was one year old.

Most of the CRFs don’t have any extraneous writing, it is just boxes checked or lines filled in. Still, a lot is apparent about HIV testing in South Africa. People definitely are not testing when they should be. Stigma and denial must be huge factors, as well as worrying about having access to treatment if diagnosed.

I am only seeing cases with invasive pneumococcal disease, which is itself a warning sign about HIV status. Sometimes, a patient will have wasting and candidiasis or TB and candidiasis and the box is checked that they refused testing. Sometimes there is a CD4 count, which indicates the doc thought there was HIV and is going to try to treat the patient without acknowledging that they have HIV.

Sometimes I see a narrative through CRFs. Someone has the box checked for suspected HIV and they have AIDS defining illnesses but they refused testing. Then, three months later, there is another set of CRFs and they are positive.

Jeff

Bara

I like my women like I like my hospitals. The largest in the Southern Hemisphere.

On Thursday I visited Chris Hani Baragwanath Hospital. Bara is the main hospital serving Soweto, a black area that abuts the southwest of JoBurg. It was a separate municipality until 2002 but now Soweto is considered part of JoBurg. There are clinics in Soweto, but if you need a hospital for something serious, or you can't pay very much (or at all) you go to Bara. The hospital gets 150 000 inpatients and 500 000 outpatients per year and 160 gunshot wounds a month (1).

Aside from being really really big, Bara is unlike any hospital I have ever seen. I have only seen hospitals in America, where they are usually squareish buildings with a lot of concrete. Bara has lots and lots of one-story buildings as well as two larger buildings and a variety of sizes in between. The largest building is about 11 stories. The wards are mostly 1 story and they are scattered around the middle area of the grounds. There are brick buildings, concrete, tin roofs, and a variety of colors. There are small buildings scattered around between the wards. Some of them are restrooms, some have doctor’s office, some sell halal food.

I was at Bara to learn about the GERMS-SA surveillance and burden of disease. The Group for Enteric, Respiratory and Meningeal Disease Surveillance-South Africa (GERMS-SA) does surveillance for a variety of disease that are associated with HIV positive individuals. HIV is one of the risk factors for invasive pneumocococcal disease generally, as well as for serotype 19A specifically, which I am working on. Bara has about six surveillance officers for adults and 1 for pediatrics, all women. In SA, nurses are called nursing sisters. Sadly, male nurses are not nursing brothers. When diseases under surveillance by GERMS-SA are identified in the hospital laboratory the surveillance officers go to the patient to ask for consent to have that person be a part of the surveillance.

The sisters told us that finding patients and consenting them can be tricky. Older patients may be illiterate. Sometimes it is hard to locate patients in such a large hospital. Patients with cryptococcus are often experiencing cognitive difficulties. People may abscond. We couldn’t locate a patient and the sisters thought he might have absconded. People may be transferred to the step-down hospital before the sisters have time to see them. People may be unclear about what they are consenting to because they want to be treated and so want to approve everything. This happens with HIV testing as well. GERMS-SA wants to identify HIV positive individuals. Sometimes patients “consent” to HIV testing. Then when asked if they want to receive the results, they don’t.

The first patient we saw was a child. The mother was there and so the surveillance officers were collecting information from the chart and from talking to the mother. They want to know things like vaccination record, temperature on the day the CSF isolate was collected, does the child live with siblings under 18, has the child been hospitalized recently, etc. If the patient is a child, surveillance officers will check when family members visit so they can talk to someone.

While walking to the next patient we had a fascinating discussion about HIV treatment. People will often see a traditional healer, either instead of seeking treatment or in conjunction. This occurs especially in HIV positive individuals with Cryptococcus as the mental effects may seem to be a curse from someone else or spirits and also may affect judgement. The doctors try to incorporate the traditional healers into the health plan and people will come with their healer to the doctor. Also, we learned that people sell anti retroviral drugs to drug dealers. ARVs can cause hallucination even if taken correctly so people will grind them up and smoke them for fun (2). About this time we passed a condom lying in the gutter. Oh JoBurg.

Then we looked for a patient in one of the adult wards. He wasn’t where they expected so they did a bit of investigating. They knew where he had been admitted and so they could check the night counts and what the computer system said about transfers. They weren’t sure if he was transferred to a different ward and it wasn’t noted or if he absconded. The wards are segregated by gender. This seemed strange to me because I don’t think of US hospitals as segregating by gender but I guess they do. We do it by room but their wards are one giant hall so it’s the same idea. It just felt different because it isn’t stated in the US, only one gender but room, but I guess that’s the policy. I asked a sister about it and she said privacy is important and “you wouldn’t put a lion in a room with a lamb.”

The next patient we saw was an HIV positive individual with Cryptococcus. The patient (TP) was experiencing cognitive effects so TP had been admitted to the hospital. TP had ARV medication but hadn’t been compliant with the treatment. Both interviews by the surveillance officers were in languages I don’t speak so they would have to explain what was happening. TP wasn’t clear on the importance of taking medication and possibly TP’s counseling when TP was diagnosed with HIV was not adequate. TP wanted to know about buying ARVs but that would be very expensive and they would be free at the hospital. Sometimes people that are HIV postive are in denial or don’t want to talk about their status because of the stigma so the sisters will talk to them about treatment without talking about their status. It was sad to see TP because TP was very nice and the sisters were trying to impress upon TP to take TP’s medicine and TP didn’t seem to be getting it. One of the doctors told us if TP wasn’t complying with his treatment he would be sent to the step-down hospital and then discharged because they need the bed available. One of the people with me on the site visit was an MD from London and she said TP would probably relapse and die from crypto if TP didn’t take the medicine for that.

Then we went to the morgue where the sisters sometimes go to check about paperwork. There was music playing a bit loudly in the morgue. The sisters told us that is to keep the spirits cheerful.

There is a building at Bara for prisoners that require medical treatment. Also you see people with orange jumpsuits and wrist and ankle chains being escorted around the grounds. We went to an HIV clinic next and it was pretty crowded. The waiting room had about 30 people in it including a prisoner. It is an obstacle to testing and treatment that the HIV care is pretty centralized in Soweto. It can be hard for people to get the Bara.

The sisters were very friendly and worked hard. It was great to see where my dataset has come from and what data they have trouble collecting. I asked one how long she has worked at Bara and she had been there 4 years. She said she enjoyed her job and it is interesting but it is hard because so many people have HIV. She said ARV treatment wasn’t helping very much because people get sick before they are started on ARV. I think the CD4 count has to get below a certain number before ARV is started. In the 80’s mortality at Bara was similar to a hospital in the US but now it is much higher. It can make treating patients seem futile. I was a little concerned with some aspects of the data quality after seeing the sisters. For example, they mentioned that they round age up. If I have a date of birth, I use that. If not, I go with the indicated age.

Then I went on pediatric rounds. I have been on rounds once before, at the ICU at SF General. That tine, there were a few people dying, a lot of people with trache tubes that couldn’t talk and seemed pretty miserable, etc. Although yesterday we were seeing sick kids, it was still kind of cheerful, compared to SF. In one room, there was a dad laughing as his kid held a Gatorade bottle for his dad like a bottle. The rooms were painted brightly with lots of images on the walls. There were usually parents with the kids and sometimes there were siblings too. The kids all had infections of some kind and antibiotic resistance is often a problem.

In one of the wards I vaguely noticed something on the ground but it didn’t register because hospitals often have miscellaneous equipment scattered around. The doc mentioned how it is hard to do infection control and pointed. I realized it was a sink on the ground that was ripped out of the wall. Everything was a bit grubby and the doctors talked at times about having trouble getting certain (expensive) medicines, but they seemed very competent and able to treat the kids.

Jeff

1. http://www.chrishanibaragwanathhospital.co.za/bara/article.jsp?id=161

2. http://www.aidshealth.org/news/in-the-media/no-turning-back-teens.html

p.s. I retracted my earlier post about hearing gunfire (in the comments), but I should say it on the front page too. It was just a loud noise. Although a friend of a friend was shot in an attempted carjacking near to where I live. She survived.

Happy 4th of July!

We have upon us what is arguably the best holiday ever -- the 4th of July!

So, what's everyone doing to celebrate this weekend?? Are you celebrating with other Americans, hosting a BBQ, or bringing yard games and fireworks to the locals? Whatever it is, take plenty of pictures and we'll have a story and picture posting blitz on the 5th! Pictures with American flags get extra props!

Happy 4th!