True to the itinerant nature of my work, I passed into the New Year in Addis Ababa, Ethiopia. In this 3-week trip, I revisited 2 sites. Without betraying confidences, I’ll just say that I encounter a wide variety of challenges. Typically, the first thing I try to figure out is the cultural context in which the institution I’m serving functions. Needless to say, given the brevity of my visits, I must rely upon the experience of those who have served long-term in the given location. Also, sometimes I note similarities to other cultural contexts where I have served. However, a greater challenge is to figure out the culture of the organization itself. Who do I listen to? What am I hearing? How am I to interpret what I’m hearing? How do I account for my own cultural background as I converse with others from a different background? As always, there are more questions than answers.

February found my wife and me in Northern Macedonia. I joined 2 other physician-consultants. We had been invited by 2 official medical organizations to discuss the role and training of primary care providers for the country. It was a delight to work with the other 2 consultants, and I trust that we left our hosts with a useful set of recommendations.

For the past several years, I have participated in a continuing medical and dental education program that helps North American health care providers who serve overseas to maintain their home-country licenses and to strengthen their knowledge and skills. I usually lead a 1-day workshop that takes participants through the process of strategic planning. However, this year I was joined by 3 others — a pediatrician who is earning her MBA, an engineer with a background in project management, and a financial consultant who is already equipped with an MBA. All 3 are currently serving overseas. Together, we created a 2-day program — Strategic Planning on day 1, and Project Management on day 2. These were well received by the participants. I really enjoyed working with these colleagues, and they have expressed an interest in being part of Medical Compass as their situations allow.