After being here for four days I am content with my present circumstances. Djibouti is certainly a desirable place to be deployed to relative to other places in the Middle East, and despite missing my friends and family at home, I feel blessed.

I was able to obtain private quarters on Tuesday and am slowly getting acclimated to the heat, time zone, and schedule. I technically do not start work until next week, but I am spending a couple of hours in the clinic talking to staff about how things are run. I will be one of four providers--there is also an internist, a physician's assistant, and an IDC (independent duty corpsman). The four of us will see patients and share call, the latter being about once a week, which I can take from 'home' via cell and beeper. I will also be the Outpatient coordinator, making sure that all of the outpatient volume has appropriate access to care. We are using AHLTA (drag), but apparently it is a theater version that also documents our ER and inpatients, unlike our domestic brand. In addition, it is handled at a local server, so I won't have to worry about intercontinental bandwidth slowing me down, though I am sure it has its own medley of problems. The rest of the clinic is run similar to Kings Bay, so I should not have a problem with most of my workflow. Medevacs are an exception to this, and with marginal radiololgy and specialty care, it may become a more common process than I (or you as a taxpayer) desire. Interesting, because I hear that Djibouti will become a permanent duty station, with the first wave in October of this year.

I met the senior medical officer here yesterday, a surgeon. In speaking with him, I may go over to the French hospital to participate in c-sections and other minor procedures...so pray for that opportunity. It would be a good one, though reports from my nursing friends who have already seen the OR there are, well, what you might expect from an OR in an underdeveloped country (like swatting mosquitos during the procedures--ha!)

As I mentioned, we are slowly acclimating to routine. I am working out about 2 hours a day and eating less--certainly less junk food, although it is free and everywhere (oreos and milk at 3am? you got it!). Unlike all other deployment sites, we are allowed to wear civilian clothes when not on duty (awesome), go into town (awesome), and drink up to 3 beers a day at the cantina (awesome). I have been going to our hangout spot called '11 degrees North' and playing pool with these Philipino cooks I befriended (they have been here for 3-5 years!) who have had a lot more practice than me. After a beer or two though, I give 'em a run for their money..or at least I think I do! haha. There is something to do every night if you want and/or have time, from guitar hero tournaments to go kart outings, to kareoke, though so far I have not participated in any of these. I am going to the baby orphanage this weekend to volunteer and take pictures. Next weekend I may be going to this place called Moucha Island where we can snorkel and SCUBA...apparently the diving there is fantabulous. I am sure all of this will become mundane after a few months, but for now, it is distracting me from the comforts of home.