PT

Every person in the US Armed Forces has an obligation to PT. According to Navy Regulation it should be done at least 3 times a week. PT is good for the body and certainly gives the mind a chance to process things as well. For those who may not be familiar with the abbreviation PT, it stands for Physical Training. A more common term is exercise.

When I am back at home I do a little exercise. I usually ride my bike to work two or three times a week. I will get out and run about once a week. In the summertime I play in the pool with the kids almost daily and that certainly counts as exercise if you have ever witnessed the event. But my exercise plan at home has been more about maintaining.

Here it is different. I work out a lot here at Spann. I started out with just a little every other day while at Ft Riley, but here I have become, well ......dependant on it. I will spend between 1 to 2 hours a day exercising these days. It is not only physical but mental health that pushes me to exercise more here. For one thing it fills the many hours I would normally spend with my family, sigh. The other is that it counters the rich foods that KBR serves in abundance here.

We have two small gyms. One is a tent and the other is a B-hut. Both have some cardio machines and weights. Running around our camp is not necessarily recommended for numerous reasons, not the least of which are the fist sized round rocks "ankle-breakers" which loosely serve as the surface for most of the camp. The gyms are rumored to be merging in another building soon. Thankfully the gyms are also open 24 hours. You can also usually find a cold bottle of water in them as well. Since the TV programming is not to my tastes 9 times out of 10, I have really enjoyed the ipod Tricia bought me. It has been a real blessing.

My big thing is the cardio machines. I like the elipticals. I have learned how to not fall or hurt myself on the treadmills after much effort. We have a nice rowing machine, which I enjoy. The stair steppers I only use when all of the other machines are full. My knees don't agree with them. The bike is fine as well. I don't really do weights either. I am not so far gone that I am ready to do races or marathons. Every time I have an appointment with a patient who is preparing for a marathon I always ask them 'How far is a marathon?' When they tell me 26.2 miles I respond- Really I thought it was the distance required to kill a Greek soldier- since that is what happened to the first Marathon runner.

I enjoy exercise here while I am deployed, but not that much.

Let Them Eat Cake

On this date, 234 years ago the US Navy was founded. Since those humble beginnings it has evolved into the most powerful maritime force the world has ever seen. Although there is no ocean for hundreds of miles, a stalwart crew of sailors met together in the chow hall to commemorate the occasion with a few words, a rousing chorus of Anchors Aweigh, and finally the cutting of the cake.

Thankfully one of the KBR employees in the chow hall, John, is a retired Navy Senior Chief. He arranged for the cake and all the decorations. Our Navy Augmentees here at Camp Spann work in over 8 different units and staff sections to support the US and NATO mission. The cake was very good as well.

On Mentoring

Todays discussion is on and about mentoring.

The original Mentor was an older friend of Odysseus. He watched over his family and household while Oddyseus was off fighting the Trojan war and eventually finding his way back home. But mentoring today has little to do with deceased greek guys.

The most common definition of mentorship is a relationship between an experienced person and a less experienced person in order to help, assist, or groom the less experienced person for future success.

It sounds a lot like the same skill set used in parenting. You cannot do everything for your mentee. That just makes them dependent on you to accomplish their job. The main thing they learn is that you will do the job if they do not. Mentees, however, are older and smart enough to know when they are being manipulated. The language barrier doesn't make it any easy either.

You can make recommendations or suggestions, but these work best if you bring them into a conversation and ultimately make them seem like your mentees idea. You have to allow them to come up with their own ideas and occasionally, although not catastrophically fail. That is the biggest hurdle I have seen here. It is difficult for us as Americans to allow anything to fail at any level. There are many 'mentors' here who simply will not allow their mentees to fail at all. I still remember in training at Ft Riley they stressed time and again that even a mediocre Afghan plan is still better than the best American plan.

That sounds very noble and laudable. The bottom line is that like our children, mentees also count on us to bail them out when their plans don't work. That is what I spent today doing. Our team was due to get out and look at some more facilities around the region today. Instead we got a frantic call last night and spent the better part of the day trying to fix a problem which will probably take several more days to properly sort out. What's more is that we knew early in the process that their plan would probably fail and advised them to choose a different path! Patience is a virtue. I do believe that we have increased our mentees trust and level of rapport since we are standing by them despite it all.

I guess like parenting there doesn't seem like there is a whole lot of glory in cleaning up 'messes'. But if your mentee learns from the experience, and can eventually operate on his own then that is the measure of success.

The Clinic to Nowhere

If this is what it feels like to win against bureaucracy I like it.

I wrote several weeks ago about a very large Police clinic which was to be constructed in our Region. It will really be a poly-clinic with xray, laboratory, and a small Emergency/Triage area. I am sure my Afghan friends will call it a 'shafa khona', or hospital, instead of a clinic.

The site was going to be at a small training camp about 5 miles out of town in the desert. Today I was able to meet with some Engineers who control the building plans and projects from Kabul. With very little persuasion, I was able to plead the case for moving construction closer to the city, where the population to be served is located. While 5 miles doesn't sound like very far to us it might as well be the other side of the moon to most Afghans. The main mode of transportation is by foot, or if you are lucky by taxi or donkey cart. We have two prospective sites and there is still a lot of contracting work to go through, but we are one step closer to having the right clinic in the right location. As an added bonus we were able to convince the team that our Regional medical logistics officer needs a small warehouse. This will be added to the construction project as well. While it did take a little time and patience (what doesn't in Afghanistan) these changes will fulfill the original intent of these gifts from our country to the people of Afghanistan.

I think this may have been the reason I am here in this country; to modify this one project. It could have easily slipped through to completion and been essentially worthless. But with some good old fashioned detective work and persistence positive change has occured.

I feel a little rebellious. Perhaps now that I have stopped the "Clinic to Nowhere" I'll run for Governor.

View from the Front

Just pictures today. Steve was TC for a recent patrol and got these neat pictures. Mud bricks drying in the sun and some of the mud brick buildings.

The vendors in the downtown area sell oranges and many watermellons.

It seems that every roundabout in Mazar e Shariff has a different and bizarre motiff. The next one past the globe(above) is one that looks like a birthday cake with large plastic candles. There are others with large bronze statues or space age structures in the middle. At times you may see people napping in the grass or even a herd of goats eating the well watered grass.

The return trip gave a great view of the desert area south of town heading towards the mountains(lower left). The center picture points out the size difference of the road, an MRAP and your average donkey cart. The far right picture is a naan vendor.

The Afghan have many needs and lack many things we would list as necessities, but overall they are still happy and friendly.

Downtown Public Hospital

Yesterday was another 'get out and see the city' day. Actually we have been trying to coordinate a visit with the Regional Mazar e Shariff hospital since our arrival here. Finally we were able to track down a point of contact at the hospital and arrange for a patrol to take us there. It was quite a production as we had folks from our Police medical mentoring team, the Afghan Army regional hospital mentoring team, The CO of the Afghan army hospital and several others with us. After an uneventful drive down to the area we parked the MRAPs and our 'away team' went into the complex.

We were met by the Regional Medical Director. For those who may not know, Afghanistan has three medical systems. The Afghan Army under the Ministry of Defense, The Afghan Police under the Ministry of the Interior, and the Ministry of Public Health(MoPH). So the Regional Director reports to the Minister of Public Health in Kabul and supervises all MoPH facilities in the 9 northern provinces of Afghanistan which includes at least nine hospitals and 85 clinics. We were ushered into his office for chai. I must say it was the most opulent office I have seen in this country. There was a marble desk, ten leather couches, and a large plasma screen TV. The Director, who actually spoke and understood English excedingly well, told us through an interpreter how the old regional hospital had burned down several years ago. So currently they occupy about 10 buildings in a complex until the new German sponsored four story building can be completed. They also get support from our State Department via the USAID organization and some help from Johns Hopkins University.

After chai and conversation time we took a tour of the facilities. There were two sections to the womens and maternity ward. There was a pediatric building complete with an entire ward for malnourishment and a Neonatal Intensive Care Unit with several tiny premature babies in serviceable incubators. The Director told us of their difficulty trying to get new mothers to breastfeed their children since it is tradition not to breastfeed until their third day of life. Dangerous cultural practices such as this have earned Afghanistan a 50% mortality rate for children under 5 years of age. With the help of education, vaccines and material support from Donors this concerning downward spiral is now turning around. We also took a tour of their Emergency Department and ICU/Surgical recovery area. It was perhaps the most troubling of the wards to observe. Unfortunately we only had time to visit 6 of the buildings before our time to press onwards arrived.

Of course most Americans who have never seen a struggling hospital in a third world country would probably have a very difficult time processing what we saw. But after a day to reflect on everything my partner Steve and I, who are sort of conneisseurs of third world hospitals, concluded that we have seen worse. Me in some parts of Asia, he in Africa. But for a country that is in the midst of a war and in temporary buildings for the most part it seems to be operating very well. It was depressing seeing the disparity between the Directors Office and the peeling paint and bare wires in most of the buildings. There is still a lot to do in this country.

One more word about the Afghan Health system. It is easy to be critical and see all that needs improvement here. But there are caring doctors and nurses who daily treat both insurgents and soldiers alike. They see them all as countrymen. In their consitution, free health care is a right of all citizens. So there is no cost to be seen or treated in any MoPH hospital. I find it odd that we are dictating how the Afghans set up and run their health system- "first remove the log from your own eye, then you will be better able to see the speck in your brothers eye"- a famous quote comes to mind. Perhaps there are things we can learn from Afghanistan.