Believe it or not...

In 1 hour, SP's plane is supposed to land. As we haven't heard anything to the contrary, we believe that she might...actually...be on board.

Yesterday, I didn't get a chance to finish my blog about our visits, but am realizing that we're just seeing too much to write about (and also process into something interesting to read). I guess the thing I'd like to get across is that we're seeing some unique things here, getting to see sides of Budapest that many of the Hungarians don't even seem to know about.

After our morning visit to the private rehab house on the outskirts of the city, we come back to visit a foundation run by a old pastor and his wife. It served up to 100 young men, all of them with drug or alcohol addictions. They lived in the facilities for a year (3 months of orientation, and if they did well, 9 months of rehabilitation) and then, if they continued in the program, they had the opportunity to learn skills such as carpentry or baking. We had the opportunity to visit the baker, which produced several tons of baked products daily, and were invited to sample several of their fresh-from the oven pastries (We LOVE our research project!) Afterwards we toured the humbly furnished but clean and sunny facilities.

The next morning, we went to one of the "worse" neighborhoods of Budapest (District 8), which looked quite normal to our eyes, but was apparently, the place where most of the addicts and alcoholics could be found. There we visited another foundation, this one serving all of their patients on an outpatient basis. We met a dedicated staff of several women (psychiatrists and psychologists) and one man (social worker). This program served probably some of the sickest patients in Hungary -- men and women who had been addicted for so long that they had to relearn basic survival skills. The program taught them how to dress, how to learn to wake up every morning for their jobs, how to speak at an interview, how to use a computer, etc. The director and chief psychiatrist explained to us that one "uniquely Hungarian" aspect to their program (which also probabaly explained the high success rates -60% of the patients remained sober and employed) was that they didn't let their patients fail. "It is very important for us to have a male social worker, so that when a patient relapses and we find them in the pub, our social worker goes and pulls them out of the pub and brings them here."

We've had many impressions from our last week, both from the discussions we've had with the psychiatrists and from our visits to these different rehabilitation homes. Sometimes, SB and I draw different conclusions, but in general there have been many common things we've seen that we've been surprised by or impressed with.

Alcoholism is huge problem in Hungary, as it is in many places around the world. Here, 50% of the population (that includes everyone) drinks every day. 10% have a problem with alcohol (dependence or abuse), 1% have the physical conditions associated with chronic alcohol consumption. In a country of 10 million people, it is both overwhelming and somehow completely unaddressed. Many doctors we have spoken to understand how big the problem is, but then go on to say that fortunately, in their practice, they do not have any alcoholics. Those with alcohol problems who seek out treatment are usually treated by psychiatrists and psychologists, and unlike in the US, would not consider going to their doctors as a starting point for care. The medical system usually only encounters patients with alcohol problems when thier chronic consumption leads to physically apparent disease (cirrhosis and cancer) or when their intoxicated state causes an injury. There is no system set up to refer the alcoholic patient from the hospital to a rehabilitation program.

The rehabilitation programs we have seen seem remarkably successful compared to US statistics, but none seem overburdened by patients, as we would have expected. They are almost always a product of grassroots initative (an pastor and his wife, a group of psychiatrists that see the need, etc), rather than government initiative. The people we've met have supreme dedication to their work and use the most current and progressive systems and models for rehabilitation, yet they seem to have little (or government support) in public awareness campaigns (both about the dangers/warning signs of alcohol abuse or the services that they offer). One place we visited had the capacity for 24 patients and only had 3. They had a staff or 6. They charged a sliding-scale fee, but in Hungary, where many health services are free (though people almost always tip their doctors heavily), the fee may be disuasive to all but the most motivated patients.

So, these are some of the impressions we're making. Obviously, they are impressions and we really can't draw any objective conclusions. But we are learning new things, and it's been very interesting.