Immigration/ Language Class

Immigration and assimilation into Germany is a finely tuned and outlined process. Upon arrival foreigners are required to report to the immigration office in their town. During my visit last year I received and signed a document outlining the requirements and timeline I had to complete classes and tests to be eligible for a resident permit. 

Train Station

With the influx of people from all over the world into Germany, it's interesting to see how guidelines have changed since the last time I lived here. Today, potential permanent residents are required to reach certain language proficiency levels and learn about German history, government and culture.

Bremen

With my list of requirements tucked under my arm I headed to the local community school to register for classes and tests.

Outside the registration office and in class I had the opportunity to meet people from every corner of the world.  I met people from Syria, Indonesia, Japan, Eritrea, Russia, Greece, Poland, Afghanistan, Bulgaria,..... Some of the conversations are unforgettable and inspiring as I heard first hand stories about life in other countries and what various peoples plans and hopes for their future were. War, love, adventure, career opportunities, education and family were frequent reasons for many people deciding to move to Germany.

Apartments in Hannover

German class was a highlight of my assimilation experience into Germany. We had a great time in class. Language classes are so much fun because you get to read, talk and are encouraged to exchange ideas and information while practicing various grammar topics and expanding your vocabulary.

German class

We learned about each others native culture and adaptation to German culture. We celebrated birthdays, achievements, holidays and offered encouragement and advise on rough days. One thing we did a lot of was laugh. We laughed with and at each other. The class was educational as well as therapeutic. A good laugh and insight to other ways of thinking does wonders for the soul. 

Talented Classmate

Celebration #7 (I don't remember the reason)

A Bubbly Bike Tour

Ohhhh! There are some traditions in Germany that I just love, love, love!

Today I joined some friends for a German style bike tour in the country. To start the fun we had a little pink bubbly :) Delish!

Pomegranate Sparkling Wine

With some pink inspiration to sip on we strategically outlined our goals of the day, to see the country, ride some off beaten roads, refresh ourselves at the destination with some Kaffee and Kuchen and have a grand old time :) Sounds like the perfect bike tour!

We set off and saw a lot of this

Lake or pond

and this

Farm House

and this

Mooooo!

What a workout! Our Rectus Femorises, Glutes and Hamstrings needed some sucrose replacement, stat! The perfect antidote for our physical exhaustion was a little German style Kaffee and Kuchen.

Beautiful Kuchen
http://outandaboutingermany.blogspot.de/2016/09/kaffee-und-kuchen-yummmm.html

We all felt much better :) The solution to just about anything is a cup of coffee/tea and cake with pals (Evidence Grade Level A). I highly recommend it ;)

Apple cake

Rhubarb cake and strawberry cake

Afterwards we had plenty of energy to enjoy the sights and find our way back home.

Off the beaten path

Are chains part of the future?

Pharmacy and healthcare are an ever evolving field influenced by the development of society, medicine, law and business. Lately I have been reading about changes and developments in pharmacy ownership.

Earlier in Germany, ownership was determined by 3 different routes:

"Privileg"-
A land owner or a commune/ parish could award a pharmacy to a pharmacist who could later choose to sell it or pass it on in an inheritance.

 "Realkonzession"
The state could grant authority to an individual to own a pharmacy. The owner could later choose their successor and present their replacement to the state.

"Personalkonzession"
The state lends a pharmacy to an individual. The pharmacy could not be sold or inherited further. When the owner decided to leave the pharmacy, it would be returned to the state and the state could then lend it to someone else.

Medications sold only in a pharmacy behind the counter

Today, current laws allow only a pharmacist to receive an operating permit for a pharmacy. The pharmacist may receive a permit for up to 3 additional pharmacies. The intention of this law is to place the responsibility, ownership and liability on the licensed operating pharmacist and prevent corporate enterprises from entering the market. 

Mometasone Nasal Spray

Many believe the independence of the pharmacist and their ownership is imperative for the pharmacy to be able to act, adjust and provide healthcare with the best interests of its patients as a core focus. In return by providing reliable, high quality healthcare the owning pharmacist ensures the longevity and success of their own investment and maintains their pharmacist license.

Health Center

There is political discussion now in Germany reviewing pharmacy ownership laws and what changes would occur if corporations and chains were granted the right to own and operate pharmacies. Some of the key questions are:

Would granting corporations and chains the rights to own pharmacies impact the supply of medications?  How?
Would this shift healthcare focus from patients to shareholders?
Would there be benefits or disadvantages to communities or the public healthcare system? 

Hmmmm, What are your thoughts?

Cough and Cold Meds

City of Peace, Osnabrück!

Osnabrück founded around 780 AD is a hip, fun, multifaceted, beautiful town with so much to offer! If you like old buildings and lots of history dating back to before your great, great, great, great, great grandparents were born, then this is the place for you :)

Old city tower

 It's a town rich in history, culture, great restaurants, pubs, beautiful architecture, friendly people......

Cafes

If you like churches or just want to experience some unforgettable acoustics visit this place.

St. John's Church (Johanniskirsche) estab. 1256

If you want to walk around some old streets and imagine you live in the 1600's there are plenty of romantic, old alleys to explore.

Charming windy street in the Old Town area

Also known as the "City of Peace", Osnabrück played a pivotal role during the Thirty Years' War.  The city co-hosted negotiations to end the war. With the signing of the Treaty of Westphalia in the Osnabrück town hall the war came to an end in 1648.

Osnabrück Town Hall

There's a local joke, "How long was the Thirty Years' War?" ............ 30 Years!  Tricky, huh?

Just in case you are loving the town and the person you are with, you might want to make time to get hitched in Osnabrück!  Just walk through the romantic, blue doors to the city marriage registrar office :) 

Maybe you will hear these church bells after the ceremony ;)

As numerous other towns in Germany, Osnabrück suffered many losses during World War II. As a way of commemorating and remembering the lost lives of their Jewish residents, engraved gold cobblestones dot the streets marking where they used to live.

Family Stern deported in 1941 and murdered in Riga

Ms. Grünberg deported in 1942 and murdered in Auschwitz

The golden cobblestones are stunning and caused me to stop mid-stride.  You can't help but reflect on the person listed, standing in front of their home and what that time in history meant to them. It's sobering. 

Half-timbered house (Fachwerk)

The Christmas Market (Weihnachtsmarkt) is also an unforgettable event. Rain, Snow or nose-numbing-sub-freezing temperatures the party continues at the Weihnachtsmarkt. 

After a marveling and reflective walking tour of the town a beer at one of the local pubs is the perfect way to cap off the day and enjoy all Osnabrück has to offer!

Biergarten photo compliments of another Portland transplant :)

Cheers!

References:
http://www.historytoday.com/richard-cavendish/treaty-westphalia
http://www.historicgermany.travel/historic-cities/
https://issuu.com/omt_osnabrueck/docs/welcome_to_osnabru__ck_englisch_201

Get your fresh local...

Get your fresh local fruit, veggies, cheese, meat, bread, flowers and amazing baked goods!

The Saturday (or whichever weekday) markets are great to peruse and purchase fresh groceries. As you walk through aisles of vendors the color of the produce and products are mesmerizing. Did you know carrots come in so many colors!

Mushrooms also come in a myriad of shapes and sizes.

To build a beautiful salad be sure to shop the rainbow on display.

The cheese, olive, wine corner is also fun to see and sample. Cheers! 

 And what German market would be complete without a few tantilizing wurst and sausage stands :)

Rain, shine, sleet or snow, the open Saturday market is always there with fresh, locally made/grown products.  

 Some of the bakery vendors even bake onsite in a wooden oven.

I'd like to pick up some of those and a few of those and some of that and ....... :)

Don't you love your local market? 

First Pharmacy Highlights

To prepare for the German pharmacy board exam I began volunteering at a local pharmacy. The experience has been fascinating and I look forward to learning more and seeing new ways of accomplishing similar goals. Some fun factoids that I think may be of particular interest to my US colleagues are listed below. 

German pharmacies are easy to recognize with this standardized symbol 

Fun Pharmacy Factoids and Observations

• No refills on all Rx's
• No electronic, telephone or faxed prescriptions accepted, just hardcopies
• I haven't seen a pharmacy with a drive thru 
• Herbal remedies are prescribed and used more commonly
• Pharmacies are closed on Sundays. If you need a medication you can look online to see which pharmacy close to you has been assigned the Sunday shift. Sundays and nights shifts are rotated among the pharmacies in the region.
• There are no large chain pharmacies
• Changes to Rx in regards to dose, quantities, adding/removing DAW1, medication form i.e. tablets to liquid, require a date and additional signature from the prescriber documented on original Rx hardcopy
• The average store hours for a community pharmacy are from 8/9 AM to 6:30/7:30PM

Opioids and Stimulant Scripts 

• Rx's valid for 8 days (this includes the date written)
• Rx's are printed on a required standardized yellow triplicate form with a serial number

This pharmacy established in 1620 found its permanent residence here in 1767 

Privately insured patients (11.3 % of population in 2011)

• Patients pay the entire cost of the Rx upfront and then submit the Rx to the insurance company for reimbursement
• Prescriptions are printed on a standardized blue form
• Blue Rx's are valid for 3 months (excluding opioids and stimulants)

State Funded Health Insurance Covered Patients

• Rx's are valid for 1 month. The Rx must be dispensed within the timeframe. Most copays are 5-10 Euros (approx. $5.40- $10.80) or less per Rx for up to 100 days (exceptions apply i.e. patient brand/ manufacture preference...).
• Rx's are printed on a standardized red form

Rx with Braille visible and sticker with dosing directions

Medication Packaging

• Medications are sold in original packaging in blister packs. No counting trays are needed. 
• Doctors prescribe in the boxed quantities available on the market (some exceptions apply)
• Medication packages also have the medication name printed in braille 

Fascinating isn't it?

Pizza ala Germany!

This was my favorite post to research for! Ohhhhh the research was strenuous but I enjoyed every piece of it! Who knew pizza could be so different and light and delicious :) In Germany pizza comes with a variety of toppings not common in the US. Would you like some pizza with white asparagus?! 

Pizza with asparagus and pickled peppers

Or a pizza with ham, olives and mushrooms on a handmade, asymmetrical, thin, crispy crust? Delish!

Remember to add a little vino and Pellegrino to the menu :)

 For the artichoke fans there is an option for you too!

In case you need some extra spinach in your diet here is a delicious alternative :)

Spinach Pizza 

There's another form of pizza made with Flammkuchen. Its a super thin crust that has a light brushed layer of sour cream (Schmand) instead of tomato sauce and often uses cheeses other than mozzarella like gouda or feta. The toppings compliment each other synergistically and are delicious :)
Here are some Flammkuchens with topping combinations of feta and olives, a chicken curry mix or a simple mushroom, oregano, fresh chive and gouda combo .  Double Yummmmm :)

Now for some close ups! Ohhhhh Yeah!  

I wish you a blissful, adventurous pizza eating session!