Friday, January 11, 2013

Travel with Aunts and Uncles

Jan. 11th-14th

  Kathy and Ken, Susan and Tom have arrived on the South Island, and I was able to travel with them for a few days.
  Friday: shared a fabulous meal at Maharaja restaurant in Christchurch (North Indian food).
  Saturday: had coffee and perused the Riccarton farmer's market and Dean's Bush.  On the way out of town we dropped by the Re:Start Mall.  We went to Oamaru on the coast- a surprisingly charming town with many beautiful old buildings.  The main attraction for me: penguins!  Both yellow-eyed penguins and blue penguins.


There is a lot of Scottish influence in the areas we traveled through- and here was another St. Andrews along the way!


Evening- around 730 or 8pm, it was time for the yellow-eyed penguins to come to shore.  The beach is closed to the public after about 3pm so as not to disturb the penguins (which is great).  This is at Bushy Beach near Oamaru.  We were very lucky, we saw several come to shore (and then climb way up into the hills!).
  These penguins are quite rare.


This was my camera (above).
The next two are Ken's photos- just awesome.



Around 9pm we headed to the blue penguin colony observation site (they come to shore as it is getting dark- since we are so far south, it gets dark closer to 10pm).  The first penguins started coming to shore around 9:15pm.

We were not allowed to take any pictures of the blue penguins.  Here is a picture of me and Kathy near the penguin colony area.



At this conservation area, there are a bunch of nesting boxes that the penguins like to use at night.

It was really cool to see- the penguins would fish individually during the day, then meet up maybe 1000m off-shore and "raft up".  They would then come to shore together as a group.  What this looked like was a rippling black area on the ocean, and then about 20-30 penguins would be thrown by the waves onto the shore, and they would walk up the beach.  There was an open area that they had to cross to get the grass/woodlands and nest boxes, and again they would wait for each other, then as a group scurry across the area.  Pretty fun to see their quick waddle.

Amazing: to see about 6 rafts- almost 200 blue penguins.
Not so amazing: the set up of this viewing area.  It is bleacher seating at about a 45 degree angle from the beach.  If you do this activity, I would recommend getting there really early to get a seat in the last row on the side closest to the ocean.  We were not early, but had paid extra for the "premium" seating.  As the first raft of penguins arrived and landed on the beach (the commentator was giving a play-by-play)- we couldn't see anything at all!  It was a very frustrating experience (since you were hearing about what you were missing!  Penguins!).  It was made clear as well that standing up to see was against the rules.  Luckily the docent on our side let us stand behind the last row, and then we could see the rafts approaching the shore, and the penguins.

This company has a monopoly on blue penguin colony viewing.  The regular seating bleachers are simply further away from where the penguins make their crossing.  There is also a pier that goes out into the water, and people gathered there for free to see the penguins come to shore (again, not as close, but not a bad option).  The folks at the company are aware that the seating is angled in such a way that you can't see the penguins land from most of the seats.

Apparently there is a 2nd blue penguin colony near Oamaru, studied by this same group, but it is not open to the public (but may be more fun to view coming to shore from a distance if you knew where it was).

Despite the viewing constraints, it was neat to see so many penguins.  And I think my favorite part was all the noise they made!  A full on racket and ruckus all around once many of them were at their nest boxes.

Sunday:
Morning- we had a delicious brunch at Riverstone (my supervisor's recommendation)- amazing food!  So good.

Then we wandered the Oamaru old buildings and farmer's market.



We were originally headed to the Otago peninsula and possibly the Catlins, but the weather seemed like it was going to worsen, so we headed south to the Moeraki Boulders and then inland to Central Otago wine country.

Highlight: Moeraki Boulders
  These round rocks are concretions formed in mudstone (Paleocene mudstone); as the mudstone is worn away by the sea, the boulders pop out from the land.
  Maori legends say the boulders are washed up eel baskets, calabashes (gourds) and kumara (sweet potatoes) that washed up on shore after a sailing canoe wreck (and the rocks that extend from Shag Point are the remains of the wreck per legend).
  The rocks were also described by the colonists in the 1850s.
  Similar rocks/concretions are found in other places in New Z (like in my post on Kaikoura), and other places in the world; but this is a cool site due to concentration of the boulders- and they look awesome.






 We stayed the night in Cromwell.  Weird vibe because everything in the town was built in the last 20 years (more or less)- the river was dammed in the early 1990s, forming Lake Dunstan (and flooding the old town center).  This area has a history of gold being discovered around 1862.

As Ken said, "welcome to Lake Chelan!"; the temperature and the surroundings felt a lot like Chelan.  One bonus- we could swim from our deck!

We had a very tasty dinner of steak, potatoes, and a huge salad- all from the Oamaru market.  Really good.


Next day (Monday), I needed to head back to Christchurch.  Got in a visit to Wanaka, though, and a short hike up Iron Mountain with Kathy and Ken.  Short and steep!  Well-utilized trail- we saw a lot of families and dogs on this trail, and were rewarded with lovely views at the top.

Here we are at the top- looking over towards Wanaka, the lake and mountains.


Kathy and I in front of manuka shrubs/trees (native to NZ with small white flowers).


We took the scenic highway from Wanaka towards Queenstown, and it was an awesome drive- very dramatic scenery.  At a view point we pulled over and walked up the hill and took this picture.  Queenstown is nestled in the hills by a river curve in the distance.  The green patch seen on the opposite hillside to the left of Kathy is a winery.  Really cool area.

As we were a little early for meeting up with Susan and Tom, Kathy had the idea to drop into Arrowtown- a small town along a river that was also part of the gold rush.  It turned out to be very cute- great main street, several good-looking restaurants, and a great vibe to it.  I found an Icebreaker shirt (merino wool) that was 50% off, and Ken got to get some beta on the local wineries at the wine shop.  I was surprised how much there was to see in Arrowtown (and we didn't even make it to the historic Chinese worker part of town).

After a late lunch that was tasty but slow (!), I hit the road back to Christchurch.
I was very excited to see the top of Mt. Cook on my drive back!


Thursday, January 10, 2013

DHB Showcase

One of the best parts about my time in New Zealand is that I have had the opportunity to learn about the healthcare system here, and efforts in Canterbury to deliver good-quality, affordable, integrated healthcare.  The DHB (District Health Board) is working with different primary care groups in the region to establish "Integrated Family Health Centers" (much like our Patient-centered Medical Home in the U.S.).

Here in Canterbury region (including Christchurch); most GPs own their own practice- either solo or a small group of GPs (maybe up to 6-10 doctors).  Other healthcare services also act independently- for example, privately-owned pharmacy practices, physical therapy (physiotherapy), etc.

The reimbursement model is mixed- capitation makes up about 50% of the GPs revenue, and ACC (accident coverage from the government), AD (acute demand- coverage from the government for more serious work-ups and treatment) and co-pays make up the other 50%.

For example, for capitation, the GP may receive $108 per year for one person enrolled in his or her panel (actual amount varies based on age and gender), and the average panel size is 1200-1500.  Co-pays to see a GP are about $40-50.

The Canterbury region has about 450 GPs and 600 Practice Nurses.

GPs here work hard- seeing patients about every 10-15 minutes usually.  They do not have much time built in for preventive care or outreach.

Most practices seem to have EHRs (MedTech).

Challenges: an aging workforce (average age of a GP here is 52)
  work-life balance
  worrying about passing on the practice when ready to retire (having a good replacement).

I was invited to tour the "DHB Showcase"- a warehouse that displays some of the challenges in providing healthcare in the Canterbury region, and some mock-ups in planning a new regional hospital.

These pictures may look familiar to some of you- very similar to our cardboard mock-ups in the warehouse in Burien when Group Health was working on designing new primary care clinics!

It was disappointing, though, that primary care groups have not been able to go through this process yet for the new clinics they are designing.


Wall outlining the demographics of Canterbury.
On the opposite wall there were iPads that connected to screens above- we did an aging activity, where you snap a picture of yourself, and a new picture is projected, making you look about 50 years older!  Not flattering for anyone...


This was an activity where we designed the different tiers of healthcare and brainstormed which services (radiology, home care, physiotherapy, pharmacy, GP, etc) needed to be close by in communities, and which ones could be shared by a larger region.


Post-its looking very "LEAN".


Mock-up of a hospital room.


Mock-up of a floor plan.

Sunday, January 6, 2013

Adrenalin Forest

Not too much to say on this one, but after the "Flying Fox" at Orana, we were inspired to visit the "Adrenalin Forest" in Christchurch.  Really fun; did most of the routes, but we may need to go back to finish the rest.  I also chickened out on one that is a tarzan rope into a rope web- the guy before me definitely couldn't hold onto the rope (there is quite a drop/fall involved), and was held by the back-up system.  Mike did it though!  I could probably do it next time.

 Basically just walk on the zig-zag line.

This is harder than it looks!

 Can't be afraid of heights for this activity.
 This is a "flying fox".
Good date!

Friday, January 4, 2013

Akaroa

Jan. 4th-6th

Akaroa- stay at Onuku Farm Hostel, Dolphin Swimming, and Banks Peninsula Hiking


Onuku Farm Hostel- recommended by Mark the warden at Mt. Cook- great place to stay!  We opted for the "stargazer huts" (seen above)- fits a double mattress, and has skylights on one end to see the stars at night.


Resident sheep at Onuku.

Now for the dolphin swim!


Hector dolphins- smallest in the world!  And quite rare.  Up to 1 meter long.


They loved to come along with us at the bow of the boat.


Mike got some great pictures underwater.  He was the first one in, and he was swarmed by them!




Here we all are in the water; there is the boat.





Wetsuit was wonderful- made the water much more comfortable---


When I was getting out of the water, a bunch of dolphins started coming right towards me!

Highly recommend the dolphin swimming trip; we went with the boat from the hostel (maximum of 6 swimmers)- awesome with such a small boat.
We saw a blue penguin as well, and had delicious tea on the boat.


Here is the common area at the hostel- really peaceful, and lots of birds.

Hiking from the hostel-



The Ridge Walk.


These fanciful trees are called Cabbage Trees.


Most of the walking trails were really sheep trails- somehow they always seemed surprised to see us!



Mike on the Lookout Rock.


View over Akaroa from the Scenic Route.

EDF

Thursday, January 3, 2013

Orana Wildlife Park (near ChCh)

Jan. 3rd

Great date- Orana Wildlife Park near Christchurch!


Lemur being fed.

This is basically a zoo, which they make as interactive as possible.  If you follow the animal feeding schedule (which is quite regimented, with a different animal being fed about every 15-20 minutes), you see pretty much the whole wildlife park, and you learn a lot about each animal.  In many cases they are rescue animals (for example the owls in the same area as the kiwi birds have wing injuries and would not survive easily in the wild), and in general seemed to have nice living areas and environments.


Mike being licked by a giraffe!


The tiger has a large piece of meat.



Baby giraffe.

Pictures below: Mike and I paid extra for a special lion feeding.  We got to be in a cage on a truck with the animal handlers, who fed the lions through the bars in the cage.
  We had lions all around- snarling at each other (!), and jumping on and off the truck, and over the truck (making the whole truck shake).  The lions on the top of the cage were even drooling onto us!
  You don't really appreciate the mass of lions until you see them fully stretched out or walking above you....




We ran into friends at Orana, who kindly took a photo for us for a different perspective.


Totally worth it.  In addition to all the animal feeding highlights, they have a great New Zealand native bird exhibit (and two Kiwi birds- they are a lot larger than I expected!  Really about the size of chickens), and they are working on a fun set up in the cheetah area where they have a rope course over a long distance and can tie things to the rope, move the rope at a fast speed and have the cheetahs chase the prize (they did it once during the feeding time, and the cheetah quickly caught the prize and broke the rope).

Great date.