As you might expect, that all depends on what disease we happen to be talking about.  A new report by Moran et al. which was published online by PLoS Medicine on February 2nd, 2009 (found here)(1) shows that while some diseases, such as AIDS and Malaria are well-funded in relation to their disease burden, while others, such as parasitic worms and bacterial pneumonia and meningitis, are chronically underfunded in relation to the burden of disease.  Note that I'm not trying to say that money should be diverted from AIDS or malaria research to parasitic worms - just that it might be time to redefine what we mean by "neglected diseases."  It seems kind of disingenuous to call a disease "neglected" when there are hundreds labs across the world trying to find a cure or vaccine (AIDS, malaria), when tropical diseases like African Sleeping Sickness and Chagas get relatively little attention, even though their impact on public health is huge.

Tying in nicely with the post from yesterday, the study also compared the per capita donations from major Western countries.  Ireland leads the way with $5.37 per person, followed by the USA with $4.09.  Russia and Brazil round out the list with $0.12 each, and Germany didn't even make the list.

As a side note, the PLoS (Public Library of Science) Journals are great - they're completely open-source, which means that you don't have to pay any sort of fee to read them, nor do you have to register, and in addition they are excellent journals.  They contain a wide variety of articles, like this one about the effect of de-worming children on school performance (2). Needless to say, I've killed a lot of time scrolling through the PLoS Journals, and should you find yourself with some time, I reccomend that you do the same. 

1.  Moran M, Guzman J, Ropars AL, McDonald A, Jameson N, et al. (2009) Neglected Disease Research and Development: How Much Are We Really Spending? PLoS Med 6(2): e1000030 doi:10.1371/journal.pmed.1000030
2.  Taylor-Robinson D, Jones A, Garner P (2009) Does Deworming Improve Growth and School Performance in Children? PLoS Negl Trop Dis 3(1): e358. doi:10.1371/journal.pntd.0000358

So after two weeks of waiting for the Maltesers to call me back regarding volunteering, I went to go see them again.  The good news:  they'd love to have me and think it's great that I'm trying to get involved in the community.  Now for the bad news:  it requires five months of training (which of course take place as 2 hours every other week) starting in April - so due to time constraints I had to rule it out.  Not wanting to give up hope, I left them my name and phone number in case they thought of something (which I was not awaiting with bated breath) and headed down to the train station to the AIDS info-center.

At first the AIDS info-center looked promising:  They were looking for people to work 4 hours a week, but they would prefer a commitment of 10 months.  It seemed that I would be able to work around this problem, but then a bigger one arose:  it's not possible to volunteer there, I would have to do a practicum, which is almost the same thing (either way, I wouldn't be getting paid, but they reserve practicum for a part of formal education, and since I'm not studying to be a social worker I can't enroll as a practicum student...).  Rather dissapointed, I was about to give up.

Then my phone rang.  The Maltesers had indeed passed my name on to someone else (this time a retirement home/hospice center) and this new person seemed excited to have me as a volunteer.  So I hauled myself out of bed this morning and took the bus across town, expecting the worst.  To my surprise, everything worked - and I get to do my training in one three-hour chunk next week.  This whole process brought to light an uncomfortable aspect of Germany - community engagement is not as high as it is in the USA.  Sure, you see advertisements to donate money to Charity A and Charity B, and on this front, the Germans don't do much better - per capita worse than the South Africans, Irish, and Turks (but better than the French) and actually going out and helping in the community is also something that does not seem to be very common over here.  However, all male students (somehow the females skip this requirement) are required to perform 10 months of military service or one year of community service upon high school graduation, and most students choose the community service.  So it's not as bad as you might think.

Over the weekend we got to experience the German version of pre-Lent celebrations in one of the great Carnival strongholds in the Rhineland:  Mainz.  Like most other Carnival traditions, these celebrations were originally somehow (mostly tangentially) related to the church, and provided the last excuse to celebrate before giving up everything fun for lent.  More reasonably, the church co-opted a pagan tradition and put a Christian spin on it (as was done with most every major pagan holiday...).  But back to the main story. 

The celebrations took on extra meaning in the Rhineland (main cities being Cologne, Mainz, and Düsseldorf, in that order) as the celebrations let the residents make fun of the French and Prussian occupiers.  As time went on, the political satire became an important part of the whole show (which starts at 11:11 on the 11th of November, takes a quick break for Christmas and New Year's, and really starts up the Thursday before Ash Wednesday).  Main themes this year were the German version of the bailout (roundly mocked) and the US elections (mostly positive, surprsingly).  Of course, the roots of the celebrations show themselves with the ridiculous faux-military garb of the "Prince's Guards" and the Prince and Princess themselves. 

In Mainz the celebrations reach their high point on the monday before Ash Wednesday (Rosenmontag) with a huge parade (public drinking is encouraged) where they throw small gifts and candy to the crowd.  After the parade there was a giant open-air disco on the Cathedral Square, where it looked like half of Mainz turned out (and most of the students from any city close enough to reach by train).  Most of the crowd dresses up too, so it's very much like a German Halloween.  All in all, it's a pretty good time - one of the few times of the year where Germans are nice to strangers.  On Saturday we saw the Kid's Parade, which draws in schoolchildren from all over the region and is the largest Children's Parade in Europe (go figure).  As you would expect, it was much more tame than the Rosenmontag parade, but still, it's nice to get free candy and see Germans going all out for celebrations.  More photos in the gallery. 

On Sunday we went to go see a parade out in a village near Mainz.  I liked this parade much more than the Kid's Parade in Mainz - it felt more comfortable, we got to hang out with locals afterwards, and, most importantly, the wine and drinks were free, thanks to a very generous owner of a winery where the inofficial after-party took place (with a population of 3,548, it was more like an after-meet-up).  Interesting German cultural difference of the day - in the wine region of Germany, a popular drink is half red wine, half coke.  At first, I was skeptical, but it's actually pretty good.  

We were supposed to go to London this weekend, but the weather did not cooperate - Stansted Airport was closed to all traffic, so our flight from Germany was canceled, and the earliest we could have made it to London was Saturday evening - giving us a total of 14 hours in London.  Instead we decided to try again for another weekend and go visit some of the area around Mainz.  On Friday we took a trip to the Natural History Museum of Mainz, which had a lot of stuffed animals, displays about the geological and biological history of the region, and quite a few skeletons of mammals from the ice age.  For a small museum, it was well put together and we enjoyed ourselves there.  Surprisingly, the square just outside the museum contains the world's largest hourglass - who knew!

On Saturday we branched out a bit and since the weather was nice we decided to travel to the Rheingau, the major wine-producing region on the Rhine.  After looking through the guidebooks (and the map of where we could take the trains for free) we decided on Rüdesheim am Rhein, a town of about 3000.  From the guidebooks we knew that it was heavily touristed, so we came expecting the worst, but to our surprise, the town was empty and we had the surrounding hills to ourselves.  We took a nice short hike to the ruins of Burg Ehrenfels (pictured), which looks exactly like I think a castle ruin should.  It was built by the Archbishops of Mainz and used in conjuction with the Mäuseturm across the river on a island to levy tolls on medieval shipping.  Sadly we couldn't go inside, as falcons had built a nest there and the castle was closed for the forseeable future to avoid disturbing them. 

After the quick walk it was back into the town, which was about the kitschiest thing I've ever seen - street after empty street of stores hawking beer steins and restaurants proudly offering "Authentic German Food - with English Menues!" which were actually just Bavarian dishes.  The whole village had a very touristy feel, and I wouldn't reccommend going there except to the see the castle ruins and the Niederwald Monument, built to commemerate the fouding of the German nation in 1871 and complete with an ominous statue of Germania raising her sword against the French.  We were unsure if people actually lived there - since we went during the off-season the streets were empty and we heard more Dutch, French, and Spanish than German.  So after a short (but still too long) stop in the village proper it back to Mainz.

Back in Mainz we went to an Indian restaurant with Erica's roommate and her boyfriend.  I made the mistake of ordering something spicy ("spicy" in Germany usually means that it might contain something like bell peppers, so I thought that I was safe) and while it was good, I'm not sure that my mouth will ever be the same.  The rest of the weekend was fairly usual, but next week is Karneval, so I'm sure that next weekend will be just a bit more exciting. 

I found out on Friday that I was admitted to the University of Michigan, School of Public Health.  I was admitted to the International Health track in the Department of Epidemiology, and I'm quite excited - the school is great, the department has been exceptionally nice, and the program involves doing a practicum for a summer in a developing country.  I think that this program offers a lot, and I feel much better about my future options after getting this acceptance.  Still waiting on Columbia and financial aid offers from the University of Michigan and Emory, and then I should have all the information I need to make my final decision. 

So I took my first Klausur today, which is essentially the German version of a final exam, in "Special Topics in Infection Biology: Parasitology, Virology, and Immunology."  Just from the title alone I was a bit nervous about what would be on the Klausur, as there isn't really a whole lot of material related to those topics that was not covered.  So naturally I spent a good amount of time preparing, making sure that I knew all the patways, toxins, and symptoms.  Much to my suprise, the Klausur ended up being two-thirds multiple choice and one-third short (and I do mean short) answer which took about 45 minutes.  The questions were surprisingly tricky, but only because they were so specific.  It was a HUGE change from my exams at Pomona, which could contain a question like "Explain how AB Toxins work by using an example" whereas the exams here are more likely to ask "What class of toxin does the Diptheria toxin belong to?" 

Overall, I like the American-style exams much more - there is less of a focus on how much you know, and more of a focus on how well you understand what you know.  The German exams, on the other hand (assuming that this one example represents all of them, which I doubt), seem to just make sure that you've read the material and took the time to memorize things.

To be honest, I was kind of surprised about getting admitted here - of all the schools, it was the one I thought mostly likely to reject me, due to my complete lack of experience in the field of public health (unless you count volunteering in a hospital, which I doubt).  Regardless, I'm quite excited.  The Master's of Public Health in Epidemiology is a great degree, and the department does a lot of very interesting research.  The University of Washington School of Public Health is also right in the middle of Seattle, which doesn't hurt matters, seeing as there is diving, mountain biking, and great hiking right in the area.  Still waiting to hear from the University of Michigan and Columbia. 

So while I did not actually accomplish what the title suggests, I plan to.  Erica's roommate told us about a run/walk where the goal is make it 100km in 24 hours by foot.  You can run, walk, or use some combination of the two.  Erica and I agreed that it would be a good idea, so we have until June 5th to prepare for the madness... which means that I may actually have to start, you know, running and such.  The trail goes from the town of Bayerische Schanz to Frankfurt am Main, following some old trading routes and cutting right through the middle of the Spessart, a German natural reserve. 

Since the above picture is not so big, the technically savvy can click here to go to the trail on Google Earth (assuming, of course, that you have this program), and those savvy with the German can check out the homepage for the run here.  To put the 100km in perspective, that is 62 miles (for the metrically impaired).  The distance from Marburg to Frankfurt is  about 90km, so assuming that I can actually finish the stretch, I could in theory make it from Marburg to Frankfut by foot in one day.  Or, you know, take the train and get there in an hour. 

So I've been trying to find a place where I can volunteer here in Marburg, and after my experience at the ER near Pomona the hospital was my first choice.  The hardest part turned out to be explaining what I wanted to do, the common response being, "But you want to help?  For free?  What do we have to give you?"  After explaining that yes, this was my goal, and no, I did not want to do an internship, everyone I talked to promptly sent me to someone else.  I ended up in the social worker's office, who then told me I would have to send my CV to the head of the ER department and hope that he could provide me with something - but it would take a few weeks and there would be no guarantee. 

So after this run-around I decided to change my plans - I knew that there was a Red Cross station and a Safeway (help for addicts and alcoholics) in town, but by the time I made it into town they were both closed (German opening hours, especially for anything even semi-official, are apparently random, if not based on lunar cycles).  Rather dissapointed, I headed home, but on my way back stumbled across the Malteser - there's no real analogue in the US but they perform ambualtory hospice care, driving patients to hospitals, food delivery, that sort of thing.  They decided to take me, pending approval by the boss (which should happen tommorrow, and which they think is likely).  I'm naturally excited about this opportunity, as it will give me a chance to better my German and get more involved with the community.

On a completely different note, it looks like the Germany army is heading back to France.