How I see it …. bursting bubbles?

After two weeks in lockdown to prevent the spread of COVID-19, I have left my home a total of three times.

Once to pick up a prescription and once to buy vegetables and once to go for a walk. In these times, I have come closer than 2m to three people who are outside of my isolation “bubble”, and in all cases, they were wearing some form of PPE.

While the process of isolation is a change to the life I have become used to there are positive aspects, for example, I can, for the most part, work from home. My work has been less interrupted and at times, more productive. At home, there is also less traffic noise at night which means getting to sleep is easier.

Socially we have adapted, we now have virtual coffee, virtual drinks and today a virtual afternoon tea for a staff member who is leaving. A further example of adaptation is related to grocery shopping. Instead of more frequent visits to the supermarket, I find myself waiting up until midnight to get delivery slots for groceries instead of same-day order and delivery before lockdown. Even though ordering over a week in advance is a new thing for me, it is not a big problem.

Overall, I would consider myself pretty resilient, a problem solver and someone who strives to make the best of most situations and logistically isolation has not been as hard as I expected it to be. However, I did underestimate the emotional toll of loneliness, uncertainty, fear and loss of family contact.

My isolation bubble is small and consists of myself and a flatmate. My family have two other bubbles in NZ. The first is my mother and brother (who also have the same genetic respiratory condition). The second is my father, who is in a bubble of his own with Hospice staff.

Today my morals were challenged. The hospice Doctor discussed the fact that I could visit my father in his last hours which could be soon. Currently, the COVID-19 lockdown means no visitors other than compassionate at the end of life.

While it will be fantastic to spend time with Dad, the context is not the best. Over the last few weeks, I have been finding not seeing him or helping with his care very challenging, but this is with the knowledge that in breaking the rules, I could cause harm to others.

The dilemma I face is the safety of others versus my own and my father’s desire. Just how many bubbles do I burst to spend time with him versus the risk of harm?

Having low vision means that I can not drive. For travel, there are usually other means, such as rideshare, taxi, busses, friends and more but in lockdown, options are more limited by availability, cost and time.

There are a lot of things to weigh up. I really would like to see my father, just as he would like to spend time with me. However, there are other factors in play, such as cost, time, emotions, lockdown, the potential spread of disease, and putting others at risk.

As a nurse, and personally helping others is important, this includes my father and the others I may encounter. In lockdown, helping myself and my father means not assisting others, in other words, both options are mutually exclusive.

My father is in a hospice that is 35 minutes drive from my house. It would take me 3 to 4 busses and at least 1 hour 35 minutes weekdays. In taking this travel option I would potentially burst at least 5 bubbles (not including other passengers). Taxi companies have quoted around $220 for a 35 minute trip with three bubbles burst (mine, the driver, my father).

Asking my brother to take me is an option; however, his car has no warrant and registration, and the local testing station is only open for essential vehicles making this a less viable option. While there may be compassionate grounds around the warrant and registration, this is a risk my brother is not willing to take. It would also burst three bubbles.

Typically, organisations such as Hospice, Cancer Foundation and Blind and Low Vision may have volunteer drivers for visits like this. However, in lockdown, these options are not available.

What I have come to realise is that no matter what option I take here, there is a cost whether it be timing (e.g. the time it takes me to get to hospice to see Dad in his last hours), financial (the price of a taxi), emotional (not seeing Dad or putting others at risk) or risking spreading COVID-19, travelling outside of my local area (breaking the law).

What writing this post has reminded me is one of my personal and professional values is around showing compassion for those around me and myself when we are all challenged by the world that we live in.

How I see it … getting around in the UK and Hamburg

For those of you who are new to my blog, I am a nurse and academic who happens to have a vision impairment. In the last year or so my night vision has decreased and susceptibility to glare has increased. To learn more about my vision, please see my previous blog entries. I have recently started using a white cane to get around mainly when it is dark, or the glare is excessive.

This blog post primarily focuses on moving around London using public transport to get to the conferences that I have been attending along with visiting friends and family. There is a lot to cover, so I have concentrated on spatial awareness, travelling on the London tube, the pedestrian environment and crossing signals.

So far I have participated in an education conference in Bloomsbury, London for three days, visited friends in Hamburg and Oldenburg in Germany and am currently staying with family in the south of England until returning to London for a Digital Health conference next week.

Spatial awareness …

One thing that has stood out while moving around in the UK and Germany is that people appear to be more spatially aware than those in Auckland. What I mean by this statement is that so far fewer people seen to walk around staring at their cellphone or feet and more people seem to notice what is happening around them. While this is a generalisation, and there are always exceptions to the rule, I feel safer moving around in crowded areas because more people notice what is around them.

One of the challenges I have is in crowded areas where people moving around me affect my ability to judge distance, and any movement distorts my vision; this means that I tend to limit moving around and feel nauseous when others move.

The other surprise was the number of push bikes in Oldenburg; however, these travel on the road or bike lane on the footpath and both pedestrians and riders show far more respect for others sharing the space than I have encountered in Auckland. The part of navigating around Germany that was the most challenging was re-learning traffic patterns and remembering traffic approaches from the opposite side of the road. A tip for vision impaired travellers is that there are no buttons on to press at the crossing, but you need to cover the whole front of the box with your hand, and it detects this. Hidden on the bottom is a plastic indentation which moves when the light is green.

On reflection moving around as a pedestrian in both London and Germany has been less stressful than I expected. I suspect this was directly related to the spatial awareness displayed by others and the distinct lack of electric scooters on footpaths. While I have been known to ride an electric, I did not realise how much stress sharing a path with unpredictable and fast electric scooter riders in Auckland had caused me until I was in a place where they did not exist.

Travelling on the London Tube …

Navigating the tube has been an “interesting experience” the most significant difference from Auckland is the sheer volume of people who try to fit onto the one train is somewhat overwhelming. Often I have found that I am standing holding on to a rail with people crushed against me on all sides. As someone from a country where there is less crowding on public transport, I found this quite confronting. In comparison, the trains in Hamburg were very well scheduled and timed, and this meant that I always got out of one train carriage, walked about ten paces across the platform and got straight on to the other train which meant that both platforms and trains seemed less crowded.

However, in saying this, in the UK, even though the transport system is crowded, many staff members are there to assist in navigating the system and are very quick to offer assistance. For example, at Victoria station, I stood for around 30 seconds looking at a sign before I was approached by station staff asking if they could assist, he then offered to walk me to the platform I needed.

Similarly, each time that I have entered a tube station with my white cane, a staff member has approached and asked if they can help – which is fantastic. So far the assistance I have accepted has been in the form of asking the way to a particular platform and I have been given very clear directions and if I have declined further assistance staff have accepted this without question. What has stood out is that the workers in London and on the Southern UK train network never seem to make assumptions about the assistance that I need but asked if and how that they can help.

In contrast, interacting with members of the public travelling has been variable. I have had some very positive interactions and some very poor interactions. For example, in a packed tube train where I was standing surrounded by people and unable to move in any direction, the tube stopped at a station, and several people got off of the train. A woman grabbed both of my arms and pushed me into a seat saying “sit down”. A seat is excellent, but, I was somewhat overwhelmed by someone deciding that they could by physically moving me without asking is not pleasant and is also making assumptions about my needs. This treatment put me in a vulnerable position, where I felt very uncomfortable.

The Pedestrian Environment …

After travelling in New Zealand, Sydney, Brisbane and Melbourne, I was surprised that the distance between the platform and train was so variable in both height and length. Similarly, the curbs and stairs are also variable. While many people could argue that this is a part of history and charm of London, this has meant is that I have had to rely on my white cane to determine distance far more than I would at home. An advantage of this is ensuring safe travel, but as a part-time cane user, it has been an emotional step for me to increase the cane use.

wlo-bl-nbplat

Photo from: https://www.squarewheels.org.uk/rly/LUgenPhots/WLO-BL-NBplat.jpg

Some tips that may assist vision impaired travellers:

UK General:

  • Accessibility is well legislated, conferences etc. offer large print and accessible materials as a standard.
  • Audio described performances at the theatre are common and often no extra charge.
  • Attractions will often offer different and more extensive tours to those with a disability.

UK Transport and Travel:

  • Obvious one traffic drives on the left.
  • Expect more crowds.
  • Traffic signals have tactical markers under the box in the form of a cone that spins when it is safe to cross.
  • Train platforms aver variable in distance and height to and from the train.
  • Stairs in the underground are variable in markings (can be absent), shape, size and surface.  They can also be odd shaped such as curved with unexpected pedestrian tunnels crossing in older parts of the network.  London Transport offer guidance on how to avoid stairs they also offer accessible journey planning advice including planning trips without stairs.
  • Some platforms are curved and not straight.
  • Cobblestones are problematic, consider a rollerball tip for your long cane.  If you did not bring one you can order one online or buy one onsite at the RNIB in London.
  • Tube Maps are tiny to read.  You can download a PDF or order Large Print and other formats.  An audio guide to the london underground is also available.
  • You can order a badge saying “please offer me a seat” although I did not do this and can not comment on the usefulness.
  • Concessions may be available.

Germany (Hamburg and Oldenburg):

  • Obvious one is that traffic drives is on the right.
  • No buttons on the crossing boxes, apparently you cover your the front of the box with your hand to activate the crossing if this is required (some crossings are automatic) and tactile feedback is an indentation on the underside of the box.  
  • Cobblestones are problematic, consider a rollerball tip for your long cane.  If you did not bring one you can order one online or buy one onsite at the RNIB in London.
  • People seem less likely to offer assistance with less staff at stations in Hamburg.