We're back home!

We've arrived in Singapore as of last Friday!

Our holiday in Munich, Berlin & Prague had been extremely enjoyable.... ...! Despite the feeling of being lost and slightly overwhelmed by the catching up of work we missed in the first week of school, it was more than worth it!

I know our blog has described activities only up to Week 3 in Groningen! Haha! That's because we're always lagging by one week in blogging and after we left UMCG after 4 weeks, we didn't have free internet access to blog anymore, so we didn't.

But it will be up, soon! I will not forget why I set up the blog in the first place ... ... To share our experiences but more importantly get people interested in SEP! So, late we are but finish it we must!

And of course, we would like to share very much with people like Nicole, Gwylim, Bao Mu, Tessa & everyone else we had met over there what we did then & a little bit on what we're up to now.

So... ... ... patience! It will be up :D

Third week of attachment - Production

University Medical Centre of Groningen has its own production department, which produces medications for their patients under certain circumstances:

1. When the drug or formulation needed is not available in The Netherlands and Europe

2. Orphan drugs - too few patients need the medication and there are no pharma companies

producing it

3. Pediatric medication - no commerical products with the desirable dosing

4. Cytostatic drugs which are unsafe to produce in the wards

5. Diagnostics - tracers e.g. isotopes

6. Drugs for trials - pharma companies may not want to produce the drug and the placebo

Ok enough of the facts. Presenting to you the production area of the hospital!

On the left is the big tank that produces water for injection (WFI), which is monitored 24 hours to control quality of the water. On the right are some bottles used for different products.

The production area follows Good Manufacturing Practice (GMP) rules closely. The sign shows BLACK ZONE in Dutch, where labcoat must be worn.

See, I wore my coat!

And Mandy pretends that she hasnt got hers on :)

Tank for washing of bottles before they are filled. WFI is used for the washing and the water is filtered. Notice the filter housing which is connected to the tube.

Still in the Black zone... autoclave for terminally sterilzed products!

Some equipment are sterilized here too. The autoclave operates uni-directionally, things go in here and come out from the door on the opposite side of the autoclave, to avoid contamination.

And the pharmacy assistant really opened the autoclave like this! Of course he was much more professional :)

Mad-ny at the control panel of the filling line. Don't push the button!

Ok let's get to work. Personnel have to gown up in a GREY zone to enter the clean room or sterile production area. A Grey zone is also used to transport materials from the black zone into the white zone:

Here is one of the platforms used to transport materials. GRIJZE ZONE is of course, GREY ZONE in Dutch.

And we enter into the WHITE ZONE...

Where a pharmacy assistant is at work! Notice her overall suit, hairnet and mask. Plant shoes are also worn in the sterile preparation area. The fume hood has laminar air flow which constantly blow air out (towards the technician) so as not to contaminate the product.

The white infusion fluid on the right is total parenteral nutrition that is produced here. The white colour is brought about by the lipids present in the infusion.

This shows the sterile production area, where infusions and eyedrops are produced.

By the way, the clocks in the production area are always one hour late in summer as the staff have not adjusted them after daylight saving last October. It should be 9.46am already!

Compounding tank in the sterile production area, where large volumes of solutions are mixed for filling into bottles or ampoules.

The ampoule man :)

He fine tuned the ampoule machine according to their sizes, fill volume, positions, etc. The ampoules are supplied sealed, the machine melts the mouth to open it, fill, and seal is by twisting like what we did at the lab. Of course many times faster, hence the product is exposed for only seconds and chance of contamination is very low!

The galenicals are produced here! Products include tablets, capsules, suppositories, solutions, syrups, ointments, creams, i.e. everything that's non-sterile.

The tablet coating machines

Visual inspection station, where products and labels are checked before release.

There are large scale production and production for individual patients. Large scale production is not so large, maybe 20 to thousand bottles, but some products have been in production for many years in the hospital and the hospital would not function like how it does now without the medications produced here.

Groningen - Part Three, The Tourist-y Stuff

Northen Groningen

Tessa took us on a nice, long drive to the northern part of Groningen! We first drove to a seal sanctuary at Pieterburen. Baby seals are SOOOOOOOO cute.... Their eyes are just like those of Puss in Shrek 3 when he acts cute!

(We were really in a relaxed & holidaying mood then & didn't feel like taking any pictures...... so no pictures here)

And then we drove further up north to a harbour where we COULD take a boat to the Schiermonnikoog, an island off the Netherlands. (we didn't go there tho)

To the right of the harbour

To the left of the harbour

The part I enjoyed most was the long drive in the province! It was what I'd been expecting of the Netherlands countryside.... Just green & flat with lots of cows ('Dutch Lady Condensed Milk' is really popular in Singapore) .

Sunshine Tessa!

Just a random shot from the car

Maggie's companion for the trip, Miffy!

I really enjoyed the trip... Just a lazy Sunday spent on the roads, thanks to Tessa for driving us all around :)

The Martini Tower

Nice photo, yeah? From the internet of course :)

We climbed the Martini Tower! That was about 300+ steps worth of a vertical hike! Very tiring. The Martini Tower is the tallest thing there is Groningen & it's protected by law to be that way! We were introduced to the term 'horizon pollution' by Erwin and that's when tall buildings obstruct the view of the horizon.

The climb up itself was almost treacherous as the steps were spiral and steep at some points.

Check out the spiral steps!

We didn't bother taking any pictures from the top of the tower because the whole viewing area has been fenced up to prevent suicidal people from jumping off the tower (it has happened before) . Any pictures taken would have those metal mesh grilles in it too.

The best part of the whole tower climbing experience was the bells! There was this guy in charge of the tower and he let us try something very fun! Basically, to sound the church bells he would have to pull on this thick rope really hard so that the bell swung and struck something in order to chime.

Because the bell was really heavy, if you hung on to the rope & not let go when it swings back in the opposite direction, it could lift you up as well!

That's what I mean! (Check out Maggie's hair)

Me me me!!! I managed to fly to about my own height off the ground but Maggie couldn't capture it :(

Banishing Maggie to a corner of the tower for that!

Martinikerk

I.e. Martini Church! Maggie & I kind of stumbled into this church while roaming around in the city. A pleasant surprise I must say!

The organ

The pulpit and stairs leading to it

The organ & the main hall

The choir room's ceiling

Groningen canal tour


The canal tour was a must because we're in the Netherlands!!!! Plenty of canals here.

Maggie with her new cap from H&M

View from the boat

The bridge opening to let boats pass!

Blonde baby girl at the edge of the canal

My new brown cap from H&M!

Boat passing us by on the canal!

Such boats are a common sight in the canals of the Netherlands! I don't think it's very uncommon for a family to own a boat and to go off sailing somewhere... Sounds nice..... :)

Groningen City - Part Two, It's all about PANCAKES!!!!

WHO LOVES PANCAKES SAY "AYE"!!!

And if you've said 'Aye!' , welcome aboard the Pancake Ship!

The Pancake Ship!

The Pancake Ship's actually a restaurant on the canal that serves pancakes! Kids obviously love the pancakes and I've never ever seen that many blonde children within a restaurant in my life before, it was almost surreal.

Tessa with a bacon & cheese pancake!




A close-up view of the pancake!

Absolutely delicious and SINFUL. Imagine a pancake glistening with maple syrup (not on yet) with melted cheese & streaky bacon!

The healthier Apple & Banana alternative!

(If you can see the frosted sugar & imagine the maple syrup on, then you know it's not that healthy either.... ... )

After this enormous meal (ONE PANCAKE EACH!) , we went home to catch HOUSE on TV &.... ... ... we bought a box (of 3's , which means one each for me, Mag & Tessa!) of MAGNUM! Not just any Magnum but Magnum Ecuador Dark (62% cocoa!) !

(when you see Maggie & I 2 sizes larger back in Singapore, remind us to lose some weight though you'll know that the damage was well worth it )

And no, we won't stop there in our quest for good food :) Check the next picture out! (This was taken on a separate day, of course!)

Poffertjes with beer!!!

Poffertjes is really typical Dutch & something that I REALLY like!! (though I can't decide which I prefer, stroopwafels or poffertjes) It's a bite-size pancake coated with lots butter (!!!) & frosted sugar. It's warm, so the butter melts (!!!) & it's SUPER nice to have on a cold day! (Not forgetting the beer, of course :) )

So there we have it, hollers on pancakes from Holland!!!!! Thanks Tessa for bringing us to these awesome places at the city centre for some awesome pancakes :)

Groningen City - Part One, Random Shots

Part ONE! Just random photos of Groningen... No stories to tell, just photos taken when we're doing our daily activites!

A river/lake close to Tessa's house with many ducks & geese around

Just one (bird?) here

Maggie on the bridge over the stream

Told you there were plenty of them!

Me everyday in the morning having breakfaston the way to work!

One of our dinners at a restaurant in the City Center

The pot that's elevated contains beef in some brown gravy. To the left of it is red cabbage, which I didn't really like because the flavour is really strong. Well, potatoes is typical staple food here and you can't see it, but there's chicken sate on my plate!

The ceiling of that restaurant! Notice all the things hanging!

People waiting at one of the many bridges across a canal

The bridges 'open' at intervals to allow boats to pass through. Pedestrians & motorists just have to wait, of course :) This particular bridge is special because instead of opening upwards, it swivels to one side of the canal to let boats pass on the other side.

A church close to the hospital that we work at

Random photo taken on the bus on the way home

The Martini Tower in the background with some parts of the city centre captured

A cafe/restaurant that looks nice behind Maggie

Background - something like the city building of Groningen where people can get married and do other official stuff

Yoghurt Drink we had at La'Place, which is really similar to Marché in Singapore!