Full Pledged Immersion at Work

12-June-2011, 0917 AM

It has been a little more than two weeks since my last blog entry.  Throughout this time, there had been quite a few noteworthy events, some of which even caused a stir and mild anxiety.  Really, the nervous person that I am worries just a tad bit too much I admit, but considering the most recent events and the status quo in PNG concerning personal security and safety, I do strongly believe that my perceived need for a mild anxiolytic, albeit low-dose, is really warranted.  Somehow, I feel that Dr. Dabdoub will readily agree to prescribe a short-acting benzodiazepine should I present my case to him right now. 

Raw and descriptive statistics from previous Global Health Fellows indicate that isolation, loneliness, and homesickness rise and peak through the entire first month of the assignment.  Anecdotal accounts also dictate that it should gradually dissipate from partial to complete situational adjustment and internalization of the normalcy of these emotions and feelings during the second and subsequent months.   Colleagues, and most especially family members, will agree that this was the case for me during the entire first month (May).  At the onset of the second month (June), my full pledged immersion at work, now that the final version of the Scope of Work (SOW) has been created, revised, and submitted multiple times for quite some time, caused a bit of distraction in my mind and helped to temporarily forget about home and family.  I’m not completely out of the woods yet, but it seems that I am slowly adjusting somehow.  My daily work routine generally goes like this: 

1. Wake up at 0630, snooze alarm clock twice.
2. Coffee, eat breakfast, and prepare work lunch, which is usually egg and cheese sandwich on a buttered hoagie roll.  Hopefully, there will be no need for me to re-start a cholesterol and lipid lowering agent and the Fish Oil I am taking currently will be good enough. 
3. Shower and everything else that goes on with morning hygiene, get dressed, and take AM meds. 
4. Wait for my hired driver who picks me up usually between 0745 – 0815 (notice the long variability on wait time). 
1. On Mondays and Tuesdays, he drops me off at Lawes Road Clinic. 
2. On Wednesdays and Thursday, he drops me off at Nine Mile Urban Clinic. 
5. FHI driver picks me up at the clinic around 1300 then lunch at the office from 1315 to 1415, though last Friday, I did not get picked up until 2pm.  I had lunch at 230 pm due to road traffic.  Back at the office, I also use the extra minutes of lunch time to check my personal e-mail, Pfizer e-mail, update blog, check and update FB status, and respond to queries and tweets at Twitter. 
6. I summarize the day’s events and make plans for the next day from 1430 until 1700.  My hired driver then picks me up at FHI country office late in the afternoon and brings me back home around 1715. 
7. Fridays are my personal administrative time.  This is my planned time to develop in-service trainings and powerpoint presentations for clinic staff.  At the moment, I am planning on doing the following in-service and training:
1. Pharmacology of Anti-retroviral Therapy and Newer Classes of drugs
2. Occupational Health and Safety
3. Standard Precautions and Transmission Based Precautions
4. Bloodborne Pathogens
5. Personal Protective Equipments
6. History of Present Illness, Medical History, Art of Interviewing, and the 7 Dimensions of a Chief Complaint

The first full week of being at the clinic was initially nerve racking because I did not know what to expect.  Talks and reminders were given for me to be fully alert at all times, knowing where my belongings are, especially my wallet and laptop computer.  I just remember the mantra to “kill them with kindness”.  So I waved, smiled, and greeted everyone I met and thanked them for their time in their language – “Tenkyu Tru!” (Thank You Very Much!) like I am some kind of a politician running for government office.  At the same time, the clinic staff inadvertently introduced me to clients by saying that I am an “English doctor from America”.  Time and again, I find myself gently correcting these folks and saying that I am actually a nurse.  It made no difference either way, as I later find out that both nurses and doctors are authoritative figures who are equally regarded and treated with high degree of respect.  This is all the more magnified when the clients find out that I am from America as they wanted me to be in during the consultation and sometimes cast a quick glance to see if I have some input regarding their conditions.  Outward appearance definitely plays a role, even though my daily work attire are a little less than business casual, but they can see that I am well cleaned and properly groomed, from head to toe, with shirt, shoes, and socks.  Needless to say, as soon as my patient interactions began, I felt a little bit better knowing that they genuinely want me to be at the clinics all the time.  Therefore, applying myself to work and keeping busy is what I have been doing in order to get distracted and not feel homesick.  It goes without saying that at work, I feel good because I am in the company of my new colleagues, knowing that the small inputs and recommendations I make can provide small changes, if not potential profound improvements.  The loneliness and homesickness still haunts me though as soon as I get home, most especially during the weekends, like today.  Sometimes, I walk around inside the house compound and see if I can find any critters, insects, animals, flowers, or fruits that I have never seen yet, but even that I have not done because it’s been raining like the dickens today. 

Last week, I was caught in a bit of surprise and excitement when the Country Director asked if I applied for an Australian Visa and made arrangements for flight and accommodation yet.  I realize that the full 1/3 of the assignment is going to be completed soon, July 4^th to be exact.  The two month finish is heralded by a short weekend trip to Cairns since a one-time stay at PNG for a short-term multiple entry business visa is 60 days, which I have to get out of the country on or before the day, and then come back again.  It brought sheer excitement and inspiration because the short trip is scheduled to leave early morning on July 1^st and returning in the afternoon of July 3^rd.  A complete change in scenery will do me well I suppose, and I put myself on a mission to find a good burger house and pub.  What’s profoundly even better is the easy process to apply for an Australian Visa.  I did it online and got approved within a matter of 1 minute!  Remembering in retrospect the bureaucratic red tape I had to go through to apply for a PNG visa, I was ecstatic afterwards because it took me a total of only 10 minutes to get the whole process done for Australian ETA (Electronic Travel Authority, no passport stamp though).  Then I booked a hotel accommodation in the heart of the Esplanade in Cairns, where the touristy attractions are located. 

It’s not all gravy these past few weeks though.  One of FHI staff, (For privacy and confidentiality purposes, I am not going to say who or what this person does), was punched in the face, shirt ripped, and assaulted while inside the truck last week.  The FHI staff supposedly hit another parked vehicle inside our lot at the compound.  The FHI staff stopped the vehicle, was going to get out to assess damage and arrange for plans to repair, and apologize to an incoming Papua New Guinean who saw the incident, who was eventually surmised to be the owner of the vehicle.  Without any forewarning, the Papuan provocatively assaulted and punched the FHI staff in the right cheek.  I did not saw any of these but later found out something bad was happening because I saw and heard escalating voices from the FHI staff outside the truck, my driver, and the Papuan trying to talk as to what happened.  My driver was the one who later told me the whole incident because he was there waiting for me when the incident took place.  I was a bit edgy and nervous at the time knowing that the perpetrator is inside our very own lot!  But my driver assured my safety and advised me to call him at anytime I feel I am in grave or perceived danger. 

Want more?  On Friday, my driver picked me up in the morning as usual and I saw his car without the right side view mirror and the right side of his face was obviously hurt.  He had scattered bruises and his right eye was red.  He then tells me that the night before (Thursday) he was involved in a not-at-fault car accident.  The driver from the opposite oncoming traffic was going to hit him head on.  He swerved to the left; the other driver hit the right side view mirror, which then hit my driver in the eye and in the face.  I immediately asked him if he had an x-ray done, eye exam, fluorescin stain maybe, and a quick doctor’s visit, and also to press charges.  But because it involves money, he deferred going.  There is no system in place like collision coverage or insurance.  Every expense is out of pocket.  The worse thing is that my driver cannot go after the other party either because he did not stop.  So as far as the incident goes, it was a done deal already and nothing that my driver can do.  He then tells me that this is how it is usually done in PNG.  All that I kept thinking at the time was how sorry I was for him AND how thankful I was that I was not with him during the time of the accident.

Thomas, my housemate who works for AUSAID, is gone and out of the country for two weeks.  He went to Ottawa Canada for some business meetings and trainings.  There is no one in the house but me so I am just trying to keep my mind occupied and busy to help pass the time.  I did laundry and ironing yesterday.  I read two chapters in the current novel I am reading by Bryce Courtenay.  I am now making and entering this blog currently.  The TV is also one of my saving grace as far as distraction goes.  I mean thank goodness and thank heavens for this and the cable; otherwise, I probably would have gone crazy bananas without anything to do.  I discovered the timeslot for the Filipino News program called BANDILA hosted by Julius Babao, Karen Davila, and Ces OrenaDrilon.  I also now remember that today is the actual Philippine Independence Day when the flag was first hoisted and put on the pole in Kawit Cavite by the first President Emilio Aguinaldo.  I usually flip the channels between HBO and Star Cinema for some movies.  Tonight, Titanic and Avatar is going to be on.  It’s good to hear “I’ll never let go” and “I see you” (the two prominent one-liner of these movies) again after sometime. 

October is still a long far ways to go and up until right now, I still do not feel nor observe the saying that “time will go by fast and it will be soon over before you know it”.  At this point, I am only looking forward to the end of the month when Thomas comes back home and I will be going to Cairns Australia.