Tag Archives: ireland

Priorities

12 Tuesday May 2015

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I can’t find the piece of paper where I noted the two news items from this morning that I wanted to refer to. And I don’t feel like looking it up on the internet now. I’m trying to remember.

imagesThe first was that Ireland is now the most expensive country in the world (I think) for childcare. Young families are spending apparently more than 30% of their income on childcare. Not, not because it was more expensive, but because it is not subsidised.

The second one was that the Government is thinking about increasing salaries in the public sector and to cut all the cuts in public sector salaries introduced following the bank bailouts.

I’m working in the public sector and my take-home salary was cut, in total, by about 1/3 following 2008.

But in a country where families cannot afford childcare, where thousands are waiting years for an appointment with specialist consultants, where 100s spent nights on trolleys in Accident and Emergency Departments, where people have to leave the country to find appropriate medical treatment,… what is it, a responsible government should do first?

The sad fact is, they will go out and buy votes by handing out money to the people who’ll then elect them. Nothing has changed and probably won’t ever. It seems to be part of the DNA.

Or will the voters tell them otherwise?

An afternoon with Pádraig which was really good: hair washing, massage, standing bed stuff. All good.

Oh, a few short points:

images(1) I found out yesterday that the salary of an OT is, roughly, 1,800 euro a month in Germany. Consider that you can pay 80 euro an hour in Ireland for therapy out of your own pocket. Now, 5 hours a week (or one a day, Mon-Fri) over 48 weeks (a working year) would roughly cost you in Ireland what a therapist employed full-time in Germany would earn. – Made me think and sounded like a perfect case for An Saol.

(2) There is a real need for a book(let) for people confronted with the tragedy of a catastrophic brain injury. From treatment, to drugs, to devices, to therapy, to food, to … We’re finding out about all this very slowly and with a lot of effort.

(3) Would you help me to put together a new CD for Pádraig with the songs he would have picked up himself over the past year or two? New songs that came out while he had to listen to music stations I picked for him?

That’s all. Good night. And stay tuned:)

Otherness

12 Friday Dec 2014

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Totally confused.

It was obvious when I came to Ireland in the eighties. I was German and this was a different country with different customs, people had a different way to deal with each other, and they didn’t stop asking me whether I liked it in Ireland (sometimes, people still ask me, and how do you like it here?:). And back then, when I told my Irish family that in Germany police was wearing pistols and everybody had an ID that they had to carry with them all the time by law, they looked at each other and said something that sounded like ‘police state’. But I was in a new country and I was still learning English and didn’t stop wondering about my new country.

It was a bit less obvious when we brought Pádraig to Germany and (re-)discovered what it means, in Germany, to rent an apartment, to buy a mobile phone contract, to make sure that there is no condensation on the windows (‘lüften, lüften, lüften’). I thought I was German, but looked at what was going on with my Irish eyes (often smiling at the German way of doing things).

It was completely messed up, durcheinander,  when I was in Ireland this week. What is the ‘other’ and what is ‘mine’? I kept taking pictures: at the airport where Connect Ireland in an attempt to lure new foreign investment to the country was trying to connect JFK, Enda Kenny, and Martin Sheen; then, when I got to my Aer Lingus flight, it all felt and looked like as if it was Ryanair in the old days: every bag was measured and checked for the maximum 10kg weight; and on a German magazine they were making fun of Germany’s most treasured seasonal symbol, Oh Tannenbaum, the christmas tree…. Is it me who is durcheinander or is someone, some dark force, trying to mess with me. All of a sudden, all was foreign, all was the ‘other’.

 

To be back with Pádraig was good. And then: he finished a huge portion of pureed apple with chocolate yoghurt, no bother. It was so good that we’ll try some ‘normal’ pureed food at noon, and the pureed apple in the afternoon tomorrow. It would be brilliant to get him back eating more regularly and, eventually, to get rid of the tube feed, the PEG.

And, Pádraig managed to get into the wheelchair for the first time after his operation. For just for a bit more than two hours. It was great. He must have felt really good. And now, after the operation, he doesn’t need a helmet anymore either. A whole new feeling.

Today’s German Music Tip
O Tannenbaum without and O Tannenbaum with, subtitles
What’s hot
‘Otherness’
What’s cold
Confusion about the ‘otherness’
The German word/phrase/verse of the day
O Tannenbaum

Median

02 Thursday Oct 2014

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Before I forget it, here are some interesting statistics I came across recently: the first is about the median age in the countries of the world, the second is about life expectancy at birth.

The median age is the age that “divides a population into two numerically equal groups; that is, half the people are younger than this age and half are older. It is a single index that summarizes the age distribution of a population.” According to a reliable source, none other than the CIA, the median age ranges from “a low of about 15 in Uganda and Gaza Strip to 40 or more in several European countries and Japan”. Ireland’s median age is 35.7

Life expectancy at birth (2012)

Life expectancy at birth (2012)

Another interesting figure which I took from Index Mundi (also quoting the CIA), is that of life expectancy at birth. In other words, how many years can a baby born today expect to live? Here again: an incredible range. From 49 years in South Africa, 60 in Senegal, 70 in Iran, to 80 in Ireland, and 90 in Monaco. There are a few interesting differences I didn’t expect: you can expect to live longer in Syria (75) than in The Bahamas (71), and longer in Tonga (75) than in than in Russia (66).

Both of these figures proof, if proof was needed, that, in general, people live longer in richer parts of the world than in poorer parts of the world; and the population of a poor country is generally younger than that of a rich country. Health systems cost money. If you are poor, you die younger.

imagesPádraig today ‘lost’ his tracheostomy tube. We were with him this evening when he had a big cough, he moved his head and neck to the side, and all of a sudden, the tube was not stuck in his neck but beside it. I went out to call his nurse who came in with two of her colleagues, one of whom stuck his finger into Pádraig’s neck to keep the hole open. Within a few minutes they had fitted a new tube.

It sounds all a bit more dramatic than it was, but demonstrated what can happen – although, coughing out your tube doesn’t happen that frequently. Because Pádraig has had this tube for more than a year now, there was no danger of the hole closing up immediately. There was also no danger of him suffocating because he can breath ok, even when the tube gets closed completely so that he has to breath in and out through his mouth and nose (unless his head is bent back into his neck). Nonetheless, there was a bit of drama this evening – before we left the doctor on call came in and checked him out. When we left, all seemed to be back to ‘normal’, and Pádraig seemed to be ok again.

Earlier on, his senior doctor came in to see us and to explain in a bit more detail what had happened last Friday. Pádraig’s cramps had gone on for an hour and a half, and only after they had given him the third drug trying to control what was going on, did he respond. Had he not responded they would have put him ‘to sleep’ and on a respirator. – On Sunday, they will try out a different drug, kind of a ‘cousin’ of the one that apparently caused the cramps, not as ‘potent’, hoping he will respond better.

We’ll wait and see. – Not in a kinda relaxed way, though. There are things in life I never knew about. Imagine. After so many years. And there are things in life, I’ll never get used to. No matter how long I’ll live.

 

 

Need

01 Wednesday Oct 2014

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images2Someone asked the question – what are the figures for Acquired Brain Injury (ABI) and  Traumatic Brain Injury (TBI) in Ireland?

Whatever about the answer – it’s the right question to ask.

In 2011, the government published the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland 2011-2015. Surprisingly, it did not include what business people would call a market study, and what medical people call an epidemiological study. In other words, the Government did not establish the need for neuro-rehabilitation in the country which seems to be surprising.

A CEO of one of the major interest groups and service providers said to me that this study does not exist, because the Government is afraid for the public to have access to those figures. Would he be right?

Again, looking at Germany and transferring the figures to Ireland – which is not, strictly speaking, valid but should give us an idea. Remember, this is just for TBIs, not for ABI, and not for rehab in general – in this case the figure would be much higher.

Description Germany Ireland
Pop in m 80 5
Acute TBI p.a. 267,000 15,353
ICU admissions 30,000 1,725
Beds in early NeuroRehab required 1,600 92
Admissions in Rehab Clinics 10,000 575
Costs per year in € 2,500,000,000 143,750,000
Source: Schädel-Hirn-Trauma. Epidemiologie, Versorgungsverläufe und Patientenbewertung. Paul Wenzlaff. Zentrum für Qualität und Management im Gesundheitswesen. Supported by ZNS Hannelore Kohl Stiftung. 2005.

 

Without going into too much detail: Ireland’s only National Rehabilitation Hospital has 3 beds for early neuro rehab for severe TBIs, and 110 beds in total for any kind of rehabilitation (source: Quick Facts about NRH) – when there is a likely demand for 92 beds in early neuro rehab and 575 beds for rehab just for TBI patients.

Pádraig is ok these days, not terribly awake or aware, but he continues to communicate with his tongue (although slowly), he eats (although little and very slowly), and all his vital parameters are ok. We asked for a meeting with his doctor to find out about his current medication and plans for further treatment. Today, there was a special nurse examining the skin on his shoulders which needs some attention – maybe it’s just regular cleaning, but there are a few small wounds, though nothing serious. A very nice nurse helped me today to transfer Pádraig into his wheelchair and back into bed, and all in very good humour:) We went out onto the roof terrace, the temperatures are still quite high here and we’re taken advantage of the good weather, as long as it lasts.

Check out Donal’s fundraising page for the Marathon, just in case you haven’t done so already.

UntitledWe have to organise ourselves – I know there will be a few people running this year, in addition to Donal. There was Ciara, there’s Cian, Fergal, and myself (though I’m still recovering from the half marathon which is not a good sign). Anybody else?

Keep watching out for the Dreamboat – it’s getting closer and closer to our shores!

Conformance

29 Monday Sep 2014

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imagesSystems work best if they are standardised, processes are predictable and can be planned, if there is nothing out of the ordinary. Henry Ford said that his customers could have their car in the colour of their choice, as long as that was black. Take it or leave it. Most systems don’t tolerate divergence very well – whatever doesn’t fit in is rejected and disposed of. This is true for industrial systems like conveyor belts, it’s also true for many social systems.

Today, the Financial Times reports that Apple will be accused of prospering from illegal tax deals with the Irish government for more than two decades when Brussels this week unveils details of a probe that could leave the iPhone maker with a record fine of as much as several billions of euros.

Preliminary findings from the European Commission’s investigation into Apple’s tax affairs in Ireland, where it has had a rate of less than 2 per cent, claim the Silicon Valley company benefited from illicit state aid after striking backroom deals with Ireland’s authorities, according to people involved in the case.

I wonder – will there be a fine imposed on the Irish Government too who allowed the world’s richest company to pay less than 2 per cent tax, when, at the same time, the health services budget was cut by hundreds of millions of euro to a point where some essential services could not be delivered anymore? When health officials justify non-delivery of essential services, like neuro-rehabiliation, by saying it offered a bad “return-on-investment”?

photoToday, a prime example of non-conformance arrived in the post. It came with a recommendation. Pádraig would love it. Stuff about his city. Dublin. Real, true Dublin. It also came with a health warning. There would be the occasional non-printable word. The CD, the letter, both nicely wrapped in a padded envelope wasn’t the first package that arrived from this friend of Pádraig’s who is making sure that he won’t get bored but will be able to listen to first-class music, and now stories from his town, his country.

Back on the ward. It’s strange to feel almost ‘at home’ in a hospital room. Though – the ‘almost’ is important here and it makes a big difference. I learnt a lot about what the concept of being institutionalised means in practice and I know that it’s not something to aspire too. It’s probably easy to agree to this but one thing is to think about it or to imagine it, the other is to experience it. Institutions have this tendency to suck up anything that has got to do with the individual, digest it, and spit out conformant and standardised people, attitudes, and practices. ‘Take it or leave it’ is another aspect of institutions, because, although you hope at times, you will never be able to change them (easily).

Pádraig is still receiving high doses of medication to prevent a re-occurrence of what the doctors called seizures from last Friday. He also seems to have the symptoms of a light cold. So today, we didn’t go out onto the roof terrace, though it was a lovely day. Tomorrow, I hope to hear from his doctor what his strategy in relation to the medication is. Pádraig never took any medication, apart from Lemsip Max. The stuff he’s getting now is ok to deal with what happened, but, I imagine, wouldn’t be anything one would like to consider over a prolonged period of time.

At the fair on Saturday, I made a lot of contacts with companies who said they’d be delighted to send a rep along to check whether their stuff fits Pádraig. Some of them were almost as interested as we are to find out whether a 2.04m person can use their things. Hopefully, they’ll start making contact later in the week, and we’ll be able to arrange something for the coming week. Even if we won’t be able to buy some of the aids straight away, to have it all tried here is a great opportunity.

Today’s German Music Tip
Desiree Klaeukens, Kompliziert.
Der Mond glüht
als würde er gleich explodieren…
Ich sag dir was falsch ist
sag mir
ob es stimmt.
What’s hot
Yourself
What’s cold
Conformance
The German word/phrase/verse of the day
Schlawiner

We have arrived

11 Monday Nov 2013

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Pádraig and I have arrived in Hamburg, Germany. The staff at Beaumont Hospital had got up in the middle of the night today to prepare Pádraig for his second big trip in four months. An ambulance picked us up at the hospital and we arrived safely at Dublin Airport a few minutes later. We had to wait 45 minutes for airport police to complete some paperwork, and then they escorted us to the air ambulance waiting for us on the tarmac. The flight was relatively uneventful and took less than two hours. Out of the plane, into the German ambulance, and off to Hamburg-Eilbek’s Schön-Klinik (no paperwork this time).
Pádraig was brought to the neuro ICU, located in a 2-year old building. Upon arrival, there were about eight hospital staff who checked him in and made him comfortable. I had a 30-minute ‘welcome-talk’ with an ‘Oberarzt’ (senior doctor). She explained to me that they will test Pádraig for multi-resistant bacteria and that his room will an ‘isolation’ room until the swabs will come back. This means, you can only get into this room with a special disposable apron and a face mask for the next three days or so. Once Pádraig has settled in, she is planning to run a number of tests and scans to get a better picture of Pádraig’s condition.
Following a very long day for both of us, I had to leave Pádraig to look for a hostel. It took a while, but with the help of hospital staff who let me use their computer and internet, I found one.
So here we are, Pádraig in his new bed in the Schön-Klinik, me in a hostel not too far away from Hamburg’s main train station – both of us absolutely exhausted. I am writing the first entry into our hospi-tales, something I intend to do every day from now on. I hope these tales from the hospital will help us to stay connected with Ireland, and the town Pádraig and I loved so well. This is a new beginning, with new hope. It’s a new beginning but with a heavy heart.