As I settle into the various routines of a new career at the State Department and Embassy-Dhaka, friends and family have wondered just what it is I do at work each week. There are a wide variety of duties that keep the job challenging and interesting. While specific disclosures about internal workings of a U.S. Embassy are not able to be discussed, here is a general idea of what has been keeping me busy…
First, I serve as the primary care physician for the American employees at the Embassy, along with their families. I staff a small clinic located near the Embassy along with several nurses, a receptionist and lab technician. Available lab tests are similar to a family medicine clinic in the States. I am responsible for the health care of approximately 250 individuals, much fewer than the typical patient panel of a busy family physician in America (who cover 1600-2400 patients in a busy practice). Thus, the pace of clinical practice is comfortable, relaxing and fun. I can see patients whenever they find it convenient or necessary to come to the health unit. I can spend the time I wish with the patient to meet all of his/her needs, do good quality health screening and provide patient education. These are aspects of medical practice I’ve always enjoyed, but haven’t always had the time to do with the ongoing heavy patient demand for appointments in a busy private practice. I have no billing to worry about and no HMO’s or insurance companies to hassle with. I am pleased to be able to do office surgery and provide fairly comprehensive office care similar to practice in rural Minnesota. My patients range from two-month old babies to 65 year-olds just prior to retirement. I do prenatal care, but we arrange for transfer of pregnant women back to the States for their deliveries.
A typical day may include from 5 – 12 patients. We have a small pharmacy and often prescribe medication from the clinic for self-limited illnesses. Other meds are available on the local market as Asia-produced generics and other prescriptions are filled from U.S. mail-order pharmacies. We must be careful to help patients avoid some of the counterfeit meds that find their way into some small local pharmacies.
Patient care comprises only about one-third of the Regional Medical Officer duties. Another important duty is to meet local physicians, dentists, and hospital personnel in the Dhaka area to assess which advanced health services can be used in-country. I make regular visits to several local hospitals and interview a number of local physicians each month. Fortunately, advanced Western-trained physicians and Western model hospitals are on the increase in Dhaka. I often attend consultations with my patients to assess the patient care experience and the quality of the consultant. If special needs cannot be met here, I arrange for medical evacuation of patients to world-wide regional locations or the U.S. That comprises yet another important aspect of the job.
I am also responsible for health education of the Embassy community and this is accomplished in a variety of ways. The health unit staff produces an extensive health manual specific to our geographic area and special health challenges we face here. I meet with all new arrivals to post to review health risks and ways to stay healthy and safe. We submit regular education articles to the Embassy newsletter. We hold occasional lunch-time seminars and present at Town Hall Meetings, which are periodic open gatherings for all American living and working in Dhaka to keep in touch and informed.
Training local emergency responders, teaching CPR classes and doing disaster response training is yet another set of duties that I tend to. As in many large companies and government organizations, there are meetings, briefings, and committees to be involved with. There are manuals, provider listings and quality reports to be updated or written. All of these tasks blend together to give me a good variety of daily and weekly tasks when not working with patients.
Regional Medical Officers also oversee the health care in other embassies and consulates that are smaller and staffed by nurse practitioners, physician assistants or nurses. From Dhaka I travel to Kathmandu, Nepal each quarter to support the health unit and Embassy community. Some other Regional Medical Officers have very little direct patient care, but travel up to 70% of the time supervising many smaller health units, while others work at the world-wide medical evacuation centers coordinating the more complex care needs of patients that are transferred.
That, in a nutshell, is what I am doing while working. I have a great staff and a hard-working and enthusiastic embassy community to care for. It has been great fun to take on new challenges and to be appreciated for the service I bring to the community. So far, I have enjoyed this new career very much.
Wednesday, January 14, 2009
Saturday, January 10, 2009
Christmas – celebration and transition
January 10, 2009
I had not expected to travel home for Christmas vacation this year given that Laura was due to arrive in Dhaka on January 7 and because I had been home briefly in October for a medical meeting. Nonetheless, I was able to find a good airfare home, the Embassy gets pretty quiet as so many families travel during the school holidays, and I had already built up a number of days of “comp time” from work while tending to after-hours emergencies. I was in Minnesota from December 16 until January 2. It was great to get home to “relax” a little….
I surprised daughter Mary with my arrival by picking her up unexpectedly at St. Olaf College on December 17. Two days later we celebrated Laura’s graduation from St.Cloud State University where she just completed her Master’s Degree in Government and Non-profit Institutions. Then it was time to roll up our sleeves and get down to the task of moving out of our home of 18 years in Willmar. We signed a purchase agreement on the house while I was home, and have lined up a renter for the winter months. But sorting through the accumulated possessions of a busy family with three children kept us very busy. There were many trips to Goodwill and the recycling center and two to the county landfill. There was careful sorting of items to go to Bangladesh on a second State Department shipment, items to go into long-term storage in Washington, D.C. and items to go to the townhouse we have purchased in Minneapolis that our son, Paul, is renting for the next few years. Two moving companies, a week apart, with Christmas in the middle of that week made for a quick holiday season. But we got through it as a team with laughs, sighs, occasional frustrations, and lots of wonderful memories of our years in Willmar. A moment of happy relief was selling our pick-up truck to a neighbor just before leaving Willmar.
We did make time for the traditional Norwegian Christmas service at our home church on December 23, and went on to celebrate a wonderful Christmas holiday with Laura’s family and my family during the 24-26th. All the unique items I had stuffed into my suitcase from the gift bazaar several weeks earlier were a fun part of holiday sharing.
After a few short days of relaxing after resettling in to our allotted space in the Minneapolis townhouse, it was time for me to head back to Dhaka. I took off on my trip hours before daughter Mary headed west on Amtrak to a retreat center in the Rockies were she will spend a “January term” in a religion course from her college. Laura headed to Bangladesh on January 5 after a final weekend visiting her parents and sister. The boys, Paul and Mark, remain settled in Minneapolis and Madison, WI, respectively, where they are working. Our hope is to spend next Christmas all together in Bangladesh with a side trip to Nepal together. I was glad to have this holiday time together, but I suspect we’ll never have a holiday season as hectic as this one has been.
You’ll see some changes in the blog as well, as Laura begins some contributions. She is anxious to have me write about what I actually DO at work, so that will be coming shortly.
I had not expected to travel home for Christmas vacation this year given that Laura was due to arrive in Dhaka on January 7 and because I had been home briefly in October for a medical meeting. Nonetheless, I was able to find a good airfare home, the Embassy gets pretty quiet as so many families travel during the school holidays, and I had already built up a number of days of “comp time” from work while tending to after-hours emergencies. I was in Minnesota from December 16 until January 2. It was great to get home to “relax” a little….
I surprised daughter Mary with my arrival by picking her up unexpectedly at St. Olaf College on December 17. Two days later we celebrated Laura’s graduation from St.Cloud State University where she just completed her Master’s Degree in Government and Non-profit Institutions. Then it was time to roll up our sleeves and get down to the task of moving out of our home of 18 years in Willmar. We signed a purchase agreement on the house while I was home, and have lined up a renter for the winter months. But sorting through the accumulated possessions of a busy family with three children kept us very busy. There were many trips to Goodwill and the recycling center and two to the county landfill. There was careful sorting of items to go to Bangladesh on a second State Department shipment, items to go into long-term storage in Washington, D.C. and items to go to the townhouse we have purchased in Minneapolis that our son, Paul, is renting for the next few years. Two moving companies, a week apart, with Christmas in the middle of that week made for a quick holiday season. But we got through it as a team with laughs, sighs, occasional frustrations, and lots of wonderful memories of our years in Willmar. A moment of happy relief was selling our pick-up truck to a neighbor just before leaving Willmar.
We did make time for the traditional Norwegian Christmas service at our home church on December 23, and went on to celebrate a wonderful Christmas holiday with Laura’s family and my family during the 24-26th. All the unique items I had stuffed into my suitcase from the gift bazaar several weeks earlier were a fun part of holiday sharing.
After a few short days of relaxing after resettling in to our allotted space in the Minneapolis townhouse, it was time for me to head back to Dhaka. I took off on my trip hours before daughter Mary headed west on Amtrak to a retreat center in the Rockies were she will spend a “January term” in a religion course from her college. Laura headed to Bangladesh on January 5 after a final weekend visiting her parents and sister. The boys, Paul and Mark, remain settled in Minneapolis and Madison, WI, respectively, where they are working. Our hope is to spend next Christmas all together in Bangladesh with a side trip to Nepal together. I was glad to have this holiday time together, but I suspect we’ll never have a holiday season as hectic as this one has been.
You’ll see some changes in the blog as well, as Laura begins some contributions. She is anxious to have me write about what I actually DO at work, so that will be coming shortly.
Catching up
Saturday, January 10, 2009
The past two months have flown by at an amazing pace and some important changes have taken place to my life here in Dhaka. The most important, of course, is the arrival of my wife, Laura, in Bangladesh. She arrived four days ago and is now getting through that first challenging jet lag of flying to the opposite side of the globe in a 24-26 hour trip. It is really great to have her here and begin our true adventure of the next 12 years – together.
After the last blog entry I became very busy at work. Increased traffic in the clinic was noted as the cold and flu season arrives in Dhaka, as in the U.S. Administering flu shots to the American Embassy community and many of the locally employed Bangladeshi staff of the Embassy was a worthwhile project that kept my staff and me busy in October and November. Another trip to Kathmandu, Nepal was set up and taken. During this trip I was able to tour a number of the local clinics and small hospitals to assess our ability to use these facilities for American Embassy staff and families should specific needs arise.
Ambassador and Mrs. Moriarty hosted a friendly and inclusive Thanksgiving dinner at their home for all of us at the Embassy who are here in Dhaka without our families. Somehow they had managed to find all the ingredients for a fully traditional turkey dinner with “all the fixings” to make a bountiful feast. We surrounded our tables in a large ring, holding hands, while prayers of thanks were offered for the bountiful blessings we enjoy. I was grateful to be included in this family-like atmosphere, and am so thankful for the blessings of comfort, safety, freedom and love from others that God has granted me. Early on Friday morning, I could share Thanksgiving once again with my family as they had Skype audio and video set up with a laptop right in the dining room in Willmar, where Laura and the kids were hosting Laura’s family. It was a great Thanksgiving.
One thing not present in Bangladesh is all the commercial hustle and bustle of the pre-Christmas shopping season. But Christmas celebration still occurs – even in this largely Muslim country. Early December brought several concerts at the local American International School. There were also some nice fellowship events at the Dhaka International Christian Church that I attend. A particular fun afternoon was the Arts and Crafts Bazaar at the local school. A local charity sets up the bazaar where over a hundred local artists and craft producers assemble their wares in time for Christmas gift-buying. Although I had mailed gifts home to the family in November, I found some unique items I decided to bring back to the States, having decided on a trip home for Christmas several days earlier. More about that trip in the next entry…
The past two months have flown by at an amazing pace and some important changes have taken place to my life here in Dhaka. The most important, of course, is the arrival of my wife, Laura, in Bangladesh. She arrived four days ago and is now getting through that first challenging jet lag of flying to the opposite side of the globe in a 24-26 hour trip. It is really great to have her here and begin our true adventure of the next 12 years – together.
After the last blog entry I became very busy at work. Increased traffic in the clinic was noted as the cold and flu season arrives in Dhaka, as in the U.S. Administering flu shots to the American Embassy community and many of the locally employed Bangladeshi staff of the Embassy was a worthwhile project that kept my staff and me busy in October and November. Another trip to Kathmandu, Nepal was set up and taken. During this trip I was able to tour a number of the local clinics and small hospitals to assess our ability to use these facilities for American Embassy staff and families should specific needs arise.
Ambassador and Mrs. Moriarty hosted a friendly and inclusive Thanksgiving dinner at their home for all of us at the Embassy who are here in Dhaka without our families. Somehow they had managed to find all the ingredients for a fully traditional turkey dinner with “all the fixings” to make a bountiful feast. We surrounded our tables in a large ring, holding hands, while prayers of thanks were offered for the bountiful blessings we enjoy. I was grateful to be included in this family-like atmosphere, and am so thankful for the blessings of comfort, safety, freedom and love from others that God has granted me. Early on Friday morning, I could share Thanksgiving once again with my family as they had Skype audio and video set up with a laptop right in the dining room in Willmar, where Laura and the kids were hosting Laura’s family. It was a great Thanksgiving.
One thing not present in Bangladesh is all the commercial hustle and bustle of the pre-Christmas shopping season. But Christmas celebration still occurs – even in this largely Muslim country. Early December brought several concerts at the local American International School. There were also some nice fellowship events at the Dhaka International Christian Church that I attend. A particular fun afternoon was the Arts and Crafts Bazaar at the local school. A local charity sets up the bazaar where over a hundred local artists and craft producers assemble their wares in time for Christmas gift-buying. Although I had mailed gifts home to the family in November, I found some unique items I decided to bring back to the States, having decided on a trip home for Christmas several days earlier. More about that trip in the next entry…
Subscribe to:
Posts (Atom)
