Joensuu and the North Karelia Project

Joensuu
The city of Joensuu (pronounced "youn-soo") is a modest town of 75,000 people in the region of North Karelia.

The Non-Communicable Disease Seminar participants, Seth, and I traveled by train for five hours (440 km) north through large pines forests and fresh white snow to North Karelia. One could easily confuse this place for a town in northern Minnesota and I suppose that's why the Finns and Swedes settled in Minnesota - they were good lumberjacks, they could survive the cold winters, and they love to ski!
The first day in Joensuu, we visited the headquarters of the newspaper, Karjalainen. They are the largest daily newspaper and reach over 80% of the population in the area everyday. "How can that be?" you might ask, well the Finns not only consume the most coffee per capita, but they read print newspapers the most too - 34 minutes daily per person! They have 32 daily newspapers and 166 non-daily in a country of only 5.4 million people. They told us about the partnership that they have with the North Karelia Center for Health to promote healthy behaviors and develop a "reality" show of 8 people trying to be healthier - quitting smoking, exercising more, and eating more fruits and veggies. They use journalistic flavor to appeal to the readers and promote healthy lifestyles.

(Katie standing outside the Joensuu City Hall where our international crowd met the Mayor and Regional Council members.)

Hospital visit
Next we visited a primary health center which was very nice but only had 10 clinicians for 150 beds and none who worked the night shift. Not sure I'd ever want to get seen there but alas, they assured us that nurses take on a lot more responsibility here and manage most of the chronic disease management and screening visits and that most of the beds are long-term beds, aka nursing home type, and have six-month waiting lists. A doctor is available by phone and all emergencies are transfered to the Central Hospital in the next town where specialists were covering 24/7. Nurses and doctors are civil servants here, like teachers and politicians, and are not compensated well. Most doctors in this area work in private practice.

Taxes
The Finns spend 46% of their income on taxes! However, they spend half as much as we do ($2331 vs. $5401 per capita) on healthcare per capita. Nearly 100% of babies are born in hospitals and their infant mortality rate is the second lowest in the world to Norway. Healthcare is mostly free in Finland ($12 per visit and minor medication fees). The school system is amazing! They are one of the most literate countries in the world and their schools include a free home-made balanced lunch for all students up to grade 9, free transportation if you live over 3 miles away, and free university tuition. All of their teachers must have a Masters in Education.

Folk singing
That night, the Finnish Heart Association invited us to a special meeting in the next town over. While we were on the bus, I got a phone call from my Dad who had attended my Match Day Ceremony where I found out that I matched at the University of Washington - Seattle for Internal Medicine. I was giddy waiting for the call and nearly in tears when we found out because we were so happy!! When we arrived at the meeting, we were greeted by a choir and soloist who sang "songs about the heart" they said. There were speeches in Finnish by the president of the association, our hero in cardiovascular disease prevention, Pekka Puska, and the town leaders. Then, we had to stand in front of everyone and introduce ourselves and afterwards a few people came up to us but did not speak any English so we had to pull over one of the Finnish participants to translate. It was a great evening and Seth and I celebrated with our new Australian, Nigerian, Bahranian, and Finnish friends over dinner and wine in the hotel afterwards!

(Photos will be posted later)

Back in Helsinki

Helsinki is the northernmost urban area of a population over 1 million, and there is much to do and see in terms of it's design business and history, starting with the centrally located Senate Square and Lutheran Cathedral. The master of the Finnish Art Nouveau was Eliel Saarinen (1873–1950), whose architectural masterpiece was the Helsinki central railway station and the city hall in Joensuu (photo from above).

If it's too cold, you could always spend a day getting lost while shopping in the eight-floor department store, Stockmann's!

St. Petersburg

Seth did not mention how wonderful the styles of the women is here - furs, furs, black tights and boots! Men are dressed in less stylish but still warm fur hats and wool coats, and some even carry leather purses. It's wonderful and cracks me up every time we leave the hotel. More blogs to follow about the Hermitage who's director once said "We can't say we are the #1 art museum in the world, but we aren't #2." We plan on spending all day there tomorrow. Thanks for reading!