Thursday, October 4th, 2007
My new hospital is dominated by RSCI graduates and Canadian trained consultants. The medical protocols are mostly American. The UK appears to be off the radar screen of most people. Its frustrating and takes more hard work to be in the same ball game as everyone else. There is a little bit of chaos too: people turn up on the ward not having been admitted via the usual entry routs into the hospital (A&E and outpatient). They kind of just speak to someone in charge and show up for admission - which I have experienced before in the UK but to a much lesser extent.
The patients are a joy to look after. I have not yet come across a local patient who did not say a prayer before leaving the room. They tend to make a mess of their health though by picking and choosing services. They would come to us for a consultation, ask for a report, speak to private doctors, go to the next door government hospital, visit Thailand or India or where ever, have something done there, come back to us and ask for something else that we did not recommend in the first place. We are often left to pick up the pieces here and there.
On a personal level, its a little bit of a challenging time. I am trying to distract myself with hobbies and interests but its not an easy job. Inshalla things will work out for the best.
Thursday, September 27th, 2007
As planned, I started working on Tuesday. The first day was pretty much occupied with admin and HR stuff. I had originally intended to work in A&E as I have not had a chance to do that in UK but was advised to do few weeks in Medicine to get to know the various departments before going to A&E. This is not really a proper rotation but a transit period before my training starts.
Its a little bit different walking in the hospital; doctors still wear white coats, most activities are senior led and nursing staff do far more than what I am used to in the NHS. I recognised few people as class mates from school or university and my first impression is that of a friendly place with colleagues who are trying really hard to make you feel welcomed. The consultant who meets all the new doctors makes a fantastic first impression and does a good job of encouraging people to turn a deaf ear to all the whining and negativity that is floating in the air. The work load is much less than RBH and you do, at times, feel the need to really make an effort to find an activity. On the management side, there are few draconian practices like finger print attendance record and HR approval of short 2 hour breaks and sick leaves.
Not bad so far.
Thursday, September 20th, 2007
Work starts next Tuesday. I hope my medical knowledge has not faded away completely by then.
I attended my grandmother’s ERCP the other day. It was unplanned as I thought the procedure was already done when I made it into the hospital. I was allowed in the endoscopy room and looked very comical in traditional attire, a surgical mask and an xray shield. No wonder Kandourah is not part of the formal doctor’s wear in this country. I was surprised to learn that they perform around 4000 endoscopies including 1200 ERCP’s every year in Mafraq hospital (that’s a large number) and that they have one of the most advanced endoscopy units in the region and receive referrals from all over the GCC and occasionally Europe.
“If I ran a hospital, I would have the same standard that Disney has. You never pass another individual in the hallways without greeting that person with a smile. I would expect every manager to role model that behaviour and require it of everyone in the department. Avoidance must be considered a violation of the organization’s culture, because with each avoidance we have a missed opportunity for the little courtesies that add up to an overall perception of a cheerful, friendly place”
My favourite book for the moment is: “If Disney Ran Your Hospital” which perhaps should be an essential pre-requisite read for every hospital administrator anywhere in the world. In fact, the concepts outlined in it are broad enough to work for any organization. Its elegantly divided into 10 chapters:
If Disney ran your hospital, you will:
- 1.Redefine your competition and focus on what can’t be measured
- 2.Make courtesy more important that efficiency
- 3.Regard patients satisfaction as Fool’s Gold
- 4.Measure to improve, not to impress
- 5.Decentralize the authority to say yes
- 6.Change the concept of work from service to theatre
- 7.Harness the motivating power of imagination
- 8.Create a climate of dissatisfaction
- 9.Cease using competitive monetary reward to motivate people
- 10.Close the gap between knowing and doing.
Saturday, September 15th, 2007
Its Ramadan, may all your sins be washed away and all your good deed doubly rewarded. There is much spiritual catching uo to do. I have never been one to sleep Ramadan off and always got annoyed in the past with people who claim to fast by sleeping all day and waking up just before Maghreb to do all their prayers before spending the rest of the day eating like pigs. But then, I have not spent Ramadan at home for many years and was not for a long time touched by the cruel effect of the desert sun while fasting.
Now that I have been here for more than a month more things are becoming apparent. Social commitments are one of the biggest wastes of time and I can see why it is difficult to be dedicated to your work or be creative as there is always some social thing to interrupt you: a death to be mourned, a birth to be celebrated, an illness to be nursed, wedding parties, a formal majles gathering, etc. Getting the balance between personal/professional priorities and and these social things is tricky. That’s not to say that its easy to do without them though because that’s where a great deal of networking happens. I suppose they are like cocktail parties, except there is no cocktail and not much of a business cads exchange.
I did not start working yet. I was kind of hoping to go to Omra with some friends but all weekend flights seem to be full and having driven once to Mekka, I am not keen on doing the same road trip again.
At the moment, there are just too many variables in my life.
Sunday, September 9th, 2007
No word regarding work yet.
Someone seems to have pressed the break pedals in my life since I did my shoulder. I have been sleeping more, close to 8 hours a day, and I haven’t done many sport activities for fear of exacerbating my injury. I am also slowly beginning to feel the weight of double standards of this society. People talk about morals and ideals like we are in Camelot. When it comes to actions though, many (trying very hard to avoid the word “most”) stink of self-centredness, materialism and plain old abuse of everything and everyone in their reach.
Three days ago, I drove to Al-Ain via the less known rout of Nahel-Hili carriageway. Its an unlit stretch of the network through desert quite far from all the new settlements. The stars appeared most glamorous on a very dark background untainted by artificial lights. Al-Ain itself remains as I remember from my school days; cosy, friendly and spacious. Everyone has their own space but remains strongly bound and connected to the rest of society around them. Its people, I think, has been shielded from the free-wheeling capitalism that is over taking other big cities in UAE.
I am stuck reading “Lord Of The Flies”, one of the most boring books I ever touched. If it was not for my habbit of finishing all books that I start, I would have burnt it long time ago so that no one is ever forced to live through the same mistake again.
Thursday, September 6th, 2007
I managed to dislocate my shoulder in a skiing accident few days ago. I felt it pop out of its socket and could see the new bulge on the left side under the jacket and felt nothing but excruciating pain in my left arm. Too proud to call out for help, I struggled to undo the straps of the board with the other hand and walked all the way down where a doctor friend pulled it back into place. Next day, I had an xray done which shows everything is currently in place. The pain is now subsiding, but my shoulder rotates with a click every time I pray which suggests I may have torn a ligament (which basically sucks, especially with training coming up soon)
Monday, September 3rd, 2007
Holiday still continues. I had an amazing time in Jissah Resort in Muscat. The sight of mountains on either sides of the Grand Canyon of Arabia fading into deep blue sea was something of a dream. We did not have time to explore the famous Wahiba desert of Oman. Perhaps on my next visit.
Diving was good too. We did three adventure dives; night, deep and navigation which brought us closer to our next Advanced licence. For some bizarre reason, the sea in Muscat is not as salty as the Arabian gulf or the stretch of the Indian ocean opposite Khour Fakkan so it was easier to cope with when the inevitable happened and sea water made its way to our eyes and throats.
I never expected customer services in Muscat to be better than those at home but I was truly surprised. The hotel, the restaurants, the dive centre - I can remember only very few places in UAE where I had similar experience. In Muscat it was like: Here, take my money - You guys make me feel great!
In fact over the last few days, I had a friend visiting from Qatar and I took him around both Abu Dhabi and Dubai and although the speed of development and the new shiny buildings left their mark on him, he was less impressed by the quality of the services provided. There is for example an exhibition in the Emirates Palace Hotel whose subject is the Saadiyat island. Amazing stuff. The guide was a nice chap too but he was obviously regurgitating the written material on the wall opposite the models. When we had questions to ask he quickly shrugged his shoulders saying that he doesn’t know and went back to his speech, not offering to look up the material or apologising for being ignorant of some of the facts.
Saturday, August 25th, 2007
Still on holiday. I have been spending a lot of time skiing in Dubai and feel quite ready for the real slopes of France which I plan to visit soon. Boarding classes were tougher than I thought and I need more time working the small muscles of my feet before feeling comfortable with it. My time on the board was reminiscent of my first day on skis where I did not really spend more than 30 seconds up right my entire day. Also two days ago, I went to Reem Al Bawadi coffee shop in Jumaira and was amused by the crowds who flock to this place from all sort of backgrounds. Customer service was not really their biggest pulse but that is hardly a surprise in Dubai. Their food is beautiful though and so is their sheisha I am told.
The rest of my time has been occupied with “The Rain Maker” and going through car catalogues.
I am off to Muscat tomorrow for an adventure dive.
Wednesday, August 22nd, 2007
Contractors have been given the green light to start building Khalifa Hospital RAK. The only other government hospital in RAK as far as I know is Saqr Hospital. There are four government hospitals in RAK currently in addition to 71 private clinics. According to 2004 statistics, these hospitals together should service 205,000 people. To put this number in prospective, in my previous job, we used to service 330,000 people but we were one of the busiest hospitals in the region. There is no indication as to who will administer the new hospital but as its outside Abu Dhabi and Dubai, I suspect MoH staff will be directly responsible for its management (compare to Khalifa hospital in the capital which is administered by Cleveland).
To say that RAK hospitals were managing would be an exaggeration. Patients used to over flow into Khalifa Hospital - Ajman and ultimately into one of the hospitals in the capital, usually SKMC. Ajman region has 158,000 people to service without this extra load and similarly the capital hospitals service 860,000 people not including people in Al-Ain and the Western region. I am getting a headache just thinking how the resources are allocated with a constant shift of patients from one place to the next and four independent bodies spending from four seperate budgets on these hospitals.
In any case, congratulations to the people of RAK (I’d expect their antinatal and paediatrics mortality rates to improve), and congratulations to the MoH as this will improve their overall service performance.
Monday, August 20th, 2007
When I was younger, there was an acacia tree behind our house. It was one of many that dotted the landscape of the village - one at about every 100 meters. I remember vaguely playing under one particular tree and making a small wooden frame into a tree house between its thorny bushes. The air was so dry it always sucked the moisture from my mouth and nose. I preferred to be in my tree house alone and not be disturbed by other kids. I would climb up my hand-made ladder, hang up side down for few minutes and contemplate the immediate change in the composition of the landscape. The blue clear sky now appears at the bottom of my field of vision like an endless sea and where the sky was, there is now sand the colour of dry blood dotted with stars of grey and white gravel of varying size. Sometimes, there might be a camel feeding of some bushes of my tree or a neighboring one but it would not notice me and would go on grazing for hours. There were occasionally some locust but only once I remember seeing them in abundance almost masking the sun. More memorable was the constant buzzing of the eurybrachyidae planthoppers signifying the presence of summer.
I fell once off my tree. I heard the cracking of the branch under my weight and before I could react, I was on my way down, head first, onto gravel. I was knocked out for a short while then when I came round, I saw that my Kandoura has now turned red with blood. There was no pain and my hands and legs seemed intact. I touched the top of my head and could feel warm blood still flowing and what felt like a crack in my skull. I ran inside the house to the shock and horror in my mother’s eyes but my grandmother who was visiting at the time quickly declared that a mixture of salt and turmeric works best for head injuries and that a pinch of garlic would make the wound heal neater. Even though the clinic was only about 3km away, she decided there was no need to see anyone and that I would be fine. She said she would watch me over the next day to make sure that I was still alive and moving and that if I started talking gibberish it will be a bad sign.
It has been nearly 20 years since my fall. It didn’t affect me except often now when looking after patients with head injuries I would remember my grandmother nursing my own skull wound and would admire the simple life they were used to with no luxuries forcing them to make do with what they had.
PS: This post is dedicated to my grandmother.
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