Category Archives: MED

U.S. Embassy Bolivia: A Post Far From Heaven, Read the Fine Details in the Classified OIG Annex!

– Domani Spero

 

Which regional bureau recalled one post’s top two officials prior to the arrival of the OIG inspectors?
Burn Bag, March 23, 2014

 

According to the OIG report on the US Embassy in La Paz, Bolivia released on July 17, just before the OIG inspection conducted in February and March 2014, the State Department “recalled the chargé and the political/economic section chief who served as acting DCM from August 2012 to September 2013 and took steps to mitigate some of the embassy’s leadership problems.”

How do you recall the embassy’s top two officials? Very quietly, presumably.  There were no public announcements or statements.  There have been some pretty awful embassies with leadership problems but we have seldom heard the recall of both the number #1 and #2 at the same time. So, what happened?

This OIG report has a classified annex which includes supplemental narrative and recommendations.  This is not the first time that a report has a classified annex but this is one of the few we can recall since the OIG stopped issuing the Inspector’s Evaluation Reports for senior embassy officials.  So now, all the bad stuff is just dumped in the classified annex of the report where the OIG says that “Portions of context, leadership, resource management, Equal Employment Opportunity, and quality of life in the annex should be read in conjunction with this report.” We have no access to the annex and of course, only State Department insiders who theoretically, have a “need to know” can access the classified material.

via US Embassy La Paz/FB

via US Embassy La Paz/FB

Here is what the publicly available, sanitized report on US Embassy Bolivia says on Leadership:

The former chargé interacted with senior government officials more often and more effectively than the hostile environment might have suggested. He expanded his personal engagement with the local media. He negotiated an unexpected $2.4-million reimbursement of value-added taxes. Also, he initiated development of an updated mission vision that called for expanded outreach to the Bolivian people and greater focus on cultural programs and English-language training.

Despite these and other successes, nearly all American staff members told the OIG team that they did not understand mission priorities or their part in achieving goals. The OIG team frequently heard staff tell of instructions given one day only to have the former front office forget or reverse them the next. Skepticism about public diplomacy programming one month could be replaced by front office enthusiasm for a cultural project the next. Reporting officers, already in a difficult environment for contact development and reporting, stated that the front office did little to direct reporting or provide training and mentoring. Embassy staff members told the OIG team they wanted clear and steady guidance from the front office but did not receive it.

Is that not enough to get two senior officials recalled?

On Resource Management:

Although the 2013 annual chief of mission statement of assurances identified no significant management control deficiencies, many of the vulnerabilities discussed in this report would have been apparent if embassy leadership had conducted a thorough review of management controls prior to submitting the chief of mission statement.

On Equal Employment Opportunity:

Within the past year, the EEO counselors handled more than 10 inquiries, many involving gender bias or sexual harassment.

On Quality of Life:

The Health Unit  ” handled eight medical evacuations of U.S. personnel within the past year and provides ongoing support to mission personnel for altitude-related ailments.”

 

Well, what do you think?  The report’s key judgments, are pretty well, bland; no one ran off to a new job in Tripoli or Sana’a. And man, whose fault was it that La Paz was assigned a cadre of inexperienced officers?

  • Embassy La Paz lacked the strong, consistent leadership and the sustained attention from Washington that it needed to manage a complicated bilateral relationship and had a relatively inexperienced officer cadre and a locally employed staff emerging from a reduction in force.
  • The embassy registered several impressive successes despite a drastic reduction in programs and work force in response to the Bolivian Government’s expulsion of the U.S. Agency for International Development and the Department of State’s decision to end all U.S. counternarcotics programs.
  • The embassy needs a clearly defined mission strategy.
  • The management section has a number of potential management control vulnerabilities related to record keeping and funds control. It is still coping with 2013’s major reduction in force of locally employed staff and an almost 50-percent reduction in the embassy’s services budget.

According to the OIG report, as of January 2014, the embassy had a total staff of 310, slightly more than one-third of 2008 numbers. The U.S. Embassy in La Paz has not been a typical embassy operation since 2008. In September that year, Bolivia expelled Ambassador Philip S. Goldberg (now ambassador to the Philippines). Shortly thereafter, the Drug Enforcement Administration and the Peace Corps suspended their operations in the country. In May 2013, Bolivia expelled USAID and the USG subsequently also shut down all International Narcotics and Law Enforcement (INL) programs in the country.   The OIG inspectors conclude that the US-Bolivia relationship is “unlikely to normalize soon.” Below are some additional details extracted from the publicly available report:

La Paz, A Post Far From Heaven

  • The Bureau of Western Hemisphere Affairs (WHA) paid sporadic attention to embassy operations.
  • Since 2008, WHA used a series of deputy chiefs of mission (DCM) as chargé d’affaires and after July 2012 detailed section heads (first from the political/economic section, then from public affairs, and just before the inspection from the management section) to serve as acting DCM for extended periods. The Department also decided not to assign a permanent office management specialist for the chief of mission, and the front office relied on office management specialists from other sections for months at a time. [...] The effects of these stopgap measures were threefold. First, they required officers to serve as acting DCM for extended periods without appropriate training. Second, they took seasoned leaders out of embassy sections, leaving those sections in the hands of usually capable—but inexperienced—deputies. The deputies rose to the challenge, but they did not receive adequate guidance or leadership from their former supervisors. Productivity and morale suffered.

Love Letters Written, Never Sent

  • The political/economic section staff is frustrated and discouraged, primarily because of lack of front office policy direction, as well as poor communication, organization, and training within the section. Given the deteriorating political environment and unclear policy guidance from both the front office and the Department, the section had an opportunity to devise and drive a revised policy and action agenda, but did not do so. [...] The OIG team reviewed a number of substantive and useful report drafts prepared by officers and local employees that were never sent, usually because the former section chief dismissed them without working with the drafter to improve the texts. This wasted effort caused significant staff frustration.

Tearing Your Hair, Learning on the Job

  • The public affairs section does not have enough experienced grants officers. Only one person in the section, a FAST officer, had a grants warrant as of February 2014. From June through August 2013, in the absence of any public affairs section grants officer, two political/economic FAST officers signed about 100 public diplomacy grants, about which they knew little.

Not Leading By Example – Managing From Desk Via Email

  • The consular section is a small operation, processing fewer than 20,000 nonimmigrant visas, approximately 800 immigrant visas, and about 1,600 passport applications in 2013. The section chief manages from her desk and via email. This remote management style is not appropriate for the size of the operation and has a negative impact on section morale and operations.
  • The consular section chief only adjudicates high-profile or referral visa cases. Recent guidance in 13 STATE 153746 reminded consular managers that they are expected to do some interviewing themselves. The section chief’s lack of hands-on participation contributes to longer hours that the more junior employees have to spend interviewing, and remoteness from actual processing undermines her credibility as an expert. It also reduces the opportunities for management to train new personnel and to identify potential interview technique and workflow efficiencies.
  • Neither the former chargé d’affaires nor the former acting DCM reviewed the 65 cases that the consular chief handled in the past year. Failure to review the required 10 percent of visa approvals and 20 percent of refusals, per 9 FAM 41.113 PN 17 and 9 FAM 41.121 N2.3-7, leads to lack of consistency in visa issuance and refusal. Adjudication reviews are also a vital management control to prevent malfeasance.

FSN Evaluations and Health Plans

  • The human resources office memo also listed 11 locally employed staff whose performance evaluations were between 21 and 242 days late. Locally employed staff members cannot qualify for in-grade salary increases if their performance reviews are not current.
  • Although the embassy participates in the local social security retirement plan, it does not participate in the local social security health program. Instead, the embassy provides a private health plan for locally employed staff. When locally employed staff members retire, most of the social security health plans are unwilling to accept them because they have not been longstanding contributors. The retirees are left with diminished health insurance coverage for their retirement years.

Allowances Paid on Outdated Info

  • The Department of State Standardized Regulation 072.12 requires that the hardship differential report, consumables allowance report, and cost-of-living survey be submitted every 2 years. All these reports are late. The embassy is paying allowances based on outdated information.

Power Outages with No Fully Functional UPS. For 3 Years!

  • The embassy’s centralized uninterruptible power system is in disrepair and has not been fully functional for the past 3 years. As a result, the chancery building experiences frequent power outages caused by the instability of the local power infrastructure. The power outages have caused permanent damage to the server room and disrupted the network infrastructure.

 

Just before the inspection, the WHA bureau and the Bureau of Human Resources apparently agreed that, because a permanent ambassador is not likely in the foreseeable future, the Department would assign a permanent chargé d’affaires and a permanent DCM in La Paz. It only took them about five years to make up their minds.

Peter Brennan was appointed chargé d’affaires of the U.S. Embassy in La Paz in June 2014. Prior to his appointment in Bolivia, he was Minister-Counselor for Communications and Public Affairs at the U.S. Embassy in Islamabad, Pakistan.  It does not look like post now has a permanent DCM as Public Affairs Officer, Aruna Amirthanayagam, who was acting chargé is now Acting DCM.

The inspection took place in Washington, DC, between January 6 and February 4, 2014, and in La Paz, Bolivia, between March 5 and 20, 2014. Ambassador Gene Christy (team leader), Thomas Allsbury, Laurent Charbonnet, Eric Chavera, Leo Hession, Tracey Keiter, Keith Powell, Ashea Riley, Richard Sypher, Alexandra Vega, Roman Zawada, and Barbara Zigli conducted the inspection.

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Related item:

-07/31/14   Inspection of Embassy La Paz, Bolivia (ISP-I-14-16A)  [595 Kb]  Posted on July 17, 2014

 

 

 

 

 

 

 

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Burn Bag: One RMO/P’s ‘just need a man’ prescription

Via Burn Bag:

“When I finally saw the Regional Medical Officer/Psychiatrist (RMO/P) for help, I was told I just needed a man to make me happy.”

Via reactiongifs

Via reactiongifs

 

 

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Former FSO Candace Faber on Coming Home With the Maladies of War

– Domani Spero

Candace Faber joined the Foreign Service when she was twenty-four. She learned Dari, Polish, and Russian. At twenty-eight, she was off to Afghanistan where she spent a year at a “a tiny, crowded, dysfunctional world—one we could not leave.”  She wrote that she “often fantasized about walking off compound, just like Sergeant Bowe Bergdahl did in Paktika. In my imagination, even the Taliban seemed kinder than my colleagues.”

She was thirty years old when she resigned from the the FS.

Via Candace Faber on Medium – The Other Veterans:

[S]eeing them take this woman’s very real suffering so lightly, dismissing both her service and her fears as a woman, did more than hurt. It invalidated my own experience.

If a military veteran on a PRT had no right to struggle with readjustment, then by comparison, my year at the U.S. embassy compound in Kabul was a joke. My closest brush with terrorism was a distribution of children’s books I attended in Logar Province, pulling schoolchildren, government officials, and journalists together in a single building. The next day, that building was attacked by a vehicle-borne IED, and two of my colleagues were injured. I was shaken, but I wasn’t there. I also wasn’t there during the September 10 attacks, a fact that only seemed to invalidate my experience further.

In my mind and that of my colleagues, neither that woman nor I had the right to struggle with our transition. There was no excuse save PTSD, and I didn’t have that. I couldn’t have it. I wasn’t a veteran.
[...]
It has been a hard journey, as everyone close to me can attest. Resignation has also had financial consequences. But money matters very little compared to having my mental health back. As of today, I have not had an anxiety attack in months. I credit psychotherapy for my recovery. The only question in my mind is why it took so long for me to get help—and why no one in the Department of State, not even when I announced my intention to resign, suggested the option. Instead, I suffered alone for a year and a half, convinced that I was simply a broken person who could never be put back together again. All of that could have been avoided.

 

Ms. Faber notes that “the paper-based screening” given to her in Kabul was very limited.   “This seems like more of a way to shield the Foreign Service from liability than a good faith effort to support its corps.” She suggested that this should be replaced with in-person screening at appropriate intervals.

Once more, we’re hearing about the security clearance process; she writes, “the federal security clearance process must get rid of its prejudice against mental health treatment, which deters people from seeking the care they need. There is a double standard here: If you are physically wounded in action, you are a hero. But if you come back from a theater of war psychologically broken, wired to treat everyone as a threat, and angry at the world, you cannot seek help without risking your security clearance—and with it, your job.”

Read in full here.

Below are some of our previous blog posts on mental health, PTSD, security clearance and the State Department’s programs:

 

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US Embassy Conakry Issues Security Message on Ebola Outbreak in Guinea

– Domani Spero

On March 24, the US Embassy in Conakry, Guinea issued the following message to U.S. citizens in the country:

The Government of Guinea has confirmed the presence of the Ebola virus in the Nzérékoré  (Guinee Forestiere) region, mostly in the administrative district of Gueckedou and in the town of Macenta.  Symptoms include diarrhea, vomiting, a high fever and heavy bleeding.  To date over 80 cases have been recorded with 59 recorded fatalities.
The U.S. mission in Conakry strongly recommends that U.S. citizens avoid contact with individuals exhibiting the symptoms described above until further information becomes available.

Ebola Hemorrhagic Fever (HF) is a deadly disease but is preventable.  It can be spread through DIRECT, unprotected contact with the blood or secretions of an infected person; or through exposure to objects (such as needles) that have been contaminated with infected secretions.  The viruses that cause Ebola HF are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.  Ebola HF has a high mortality rate and early evidence suggests that the Guinea strain of Ebola is related to the Zaire Ebola strain that carries a mortality rate of 90%. Some who become sick with Ebola HF are able to recover, while others do not.  The reasons behind this are not yet fully understood. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.
During outbreaks of Ebola HF, the disease can spread quickly within health care settings (such as a clinic or hospital).  Exposure to Ebola viruses can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola virus though 8-10 days is most common.  A person suffering from Ebola presents with a sudden onset of high fever with any of the following: headache, vomits blood, has joint or muscle pains, bleeds through the body openings (eyes, nose, gums, ears, anus) and has reduced urine.

Since the virus spreads through direct contact with blood and other body secretions of an infected person those at highest risk include health care workers and the family and friends of an infected individual.

For more information on Ebola hemorrhagic fever, please visit the CDC website at http://www.cdc.gov/vhf/ebola

CDC map

CDC map

On 25 March 2014, the World Health Organization provided a status update of the outbreak:

The Ministry of Health (MoH) of Guinea has notified WHO of a rapidly evolving outbreak of Ebola haemorrhagic fever in forested areas south eastern Guinea. The cases have been reported in Guekedou, Macenta, and Kissidougou districts. As of 25 March 2014, a total of 86 suspected cases including 60 deaths (case fatality ratio: 69.7%) had been reported. Four health care workers are among the victims. Reports of suspected cases in border areas of Liberia and Sierra Leone are being investigated.

Thirteen of the cases have tested positive for Ebola virus by PCR (six at the Centre International de Recherche en Infectiologie (CIRI) in Lyon, France, and seven at the Institut Pasteur Dakar, Senegal), confirming the first Ebola haemorrhagic fever outbreak in Guinea. Results from sequencing done by CIRI Lyon showed strongest homology of 98% with Zaire Ebolavirus last reported in 2009 in Kasai-Occidental Province of DR Congo. This Ebolavirus species has been associated with high mortality rates during previous outbreaks.

Doctors Without Borders/Médecins Sans Frontières (MSF) has worked in Guinea since 2001. Its March 25 update indicates that the group is reinforcing its teams in Guéckédou and Macenta, two towns in the south of the country where the virus has spread. Thirty staff members are reportedly on the ground and more doctors, nurses, and sanitation specialists will be joining them in the coming days. According to DWB/MSF, thirteen samples to-date have tested positive for the Ebola virus, an extremely deadly viral hemorrhagic fever. Other samples are currently being analyzed. Suspected cases have been identified in neighboring Liberia and Sierra Leone, but none of these have yet been confirmed by laboratory tests.

The CDC has updated its outbreak page with information from WHO and says that it is in regular communication with its international partners WHO and MSF regarding the outbreak, to identify areas where CDC subject matter experts can contribute to the response.

As of March 25, 2014, WHO has not recommended any travel or trade restrictions to Guinea in connection with this outbreak.

U.S. Embassy Conakry is an extreme hardship post receiving 25% COLA and 30% post hardship differential. Post is headed by Ambassador Alexander Laskaris who was sworn in as the 20th U.S. Ambassador to the Republic of Guinea on September 10, 2012.

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US Embassy Ottawa: Canadian Court Sets Aside FSN Sandra McDonald’s $240K Default Judgment For Now

– Domani Spero

Via Ottawa Citizen, a wrongful dismissal case filed by Sandra McDonald, a former Foreign Service National (local employee) of the U.S. Embassy in Ottawa.

Sandra McDonald, now in her early 60s, worked at the embassy for nearly 30 years as one of its locally engaged staff. She sued for wrongful dismissal after she was fired in early 2011 while on long-term disability with complex regional pain syndrome.

McDonald’s lawyer, Bijon Roy, said she was “very disappointed” with the judge’s decision and that it might force her to fight the case all over again.

In July 2012, Ontario Superior Court Justice Heidi Polowin issued a default judgment in McDonald’s favour after U.S. officials failed to file a statement of defence or contest the case in court. The embassy had been served notice of the case through Canada’s Department of Foreign Affairs and International Trade, and was kept informed of the matter on a regular basis. McDonald’s story also received high-profile coverage from Ottawa media, including the Citizen.

In court this week, embassy officials, seeking to overturn the default judgment, said they had “explicable and plausible” reasons for not having responded to McDonald’s lawsuit, and a “good defence” to be made against it. According to court documents, the Americans claimed that they’d “lost the documentation”, “could not open the email attachment”, that the documentation was “inadvertently directed to the wrong office at the State Department”, and that it was “not indexed correctly”.

Superior Court Justice Timothy Ray questioned how U.S. State Department officials could claim not to have been aware of McDonald’s default judgment. “Its embassy apparently failed to see the front page of the Ottawa Citizen (on) Sept. 11, 2012,” the judge commented.
[...]
Ray said he would set aside Polowin’s default judgment on conditions the embassy pay McDonald’s legal costs and put the $240,000 award in a court trust within the next 60 days.

Read in full: U.S. Embassy wins bid to set aside wrongful dismissal judgment.

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Former Foreign Service Kid Writes About Dad With Severe PTSD

– Domani Spero

In 2012, we blogged about a retired FS employee, William “Tony” Gooch who was sentenced to 12 years in prison – the maximum he faced under a plea agreement in a Nov. 7, 2010 episode, in which he reportedly rammed a Jeep into his estranged wife’s home before setting it ablaze. (See Former FSO William Anthony Gooch: No Mercy for Broken Men?).  Colorado Spring’s The Gazette covered the hearing in 2012.

We recently received a note from his son, Andy Gooch (he was referencing our blogpost below):

I came across this article the other day while searching to see if there was anything out there on my father, William Gooch (Tony). He is currently incarcerated and subjected to the brutality of prison life. He was in fact diagnosed with severe PTSD, depression, and substance dependence after serving State Department which the court system neglected to take into consideration. This whole situation frustrates me everyday. In fact, I clearly remember like it was yesterday after I told the judge my little amount of overseas experience. “This sounds like something out of a Jason Bourne movie,” stated the judge. It was as though he was calling not only my statement, but my fathers career a fabricated story.

Anyway, since then, my father and I have published a book on Amazon about his life. It’s called “My Mind, A Different Place.” If you are interested in his story, please look into it. Below is the hyperlink.

http://www.amazon.com/My-Mind-Different-Place-familys-ebook/dp/B00IHOCAC2/ref=sr_1_1?ie=UTF8&qid=1392741948&sr=8-1&keywords=my+mind%2C+a+different+place

It’s unfortunate how the path of one’s career is often times vulnerable to acquiring PTSD, yet others don’t see/understand the reality.

Thanks,
William Gooch (Andy)

News report said that Tony Gooch’s career with the State Department ended with a medical discharge after he suffered a breakdown during an assignment in Kingston, Jamaica. On the prologue of the book, Andy Gooch writes that he moved to Centennial, Colorado in 2004 to live with his father  who was then retired from the State Department.  “It took me all these years to understand him, and to see what he was going through. At that time, my ignorance was bliss. Had I known then what I know now, I would have done a lot more to help my dad, ” he writes.

According to Andy , his father is not getting the mental health treatment he should be getting and his physical condition is deteriorating.  Due to this, he said his family is “currently filing action against the state.”  Andy also said that his father is allowed to accept some items like books and magazine through the mail writing,  “He is so isolated from the outside world I’m sure anything from anybody would be great.”

If you want to help, you may send cards, books or magazines to William “Tony” Gooch’s address below:

William Gooch #157833
AVCF Unit 4-B
12750 HWY 96
Ordway, CO 81034

Andy Gooch graduated from Virginia Commonwealth University in 2012 and is a second lieutenant in a Field Artillery Battery with the Army National Guard.

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Drowning in Smoggy Delhi: There’s No Blue Sky, So Where’s Blueair? (Updated)

|| >We’re running our crowdfunding project from January 1 to February 15, 2014. If you want to keep us around, see Help Diplopundit Continue the Chase—Crowdfunding for 2014 via RocketHub <||

– Domani Spero

In December last year, Hindustan Times reported on how air and water pollution plagued Indian cities:

One in three people in India live in critically-polluted areas that have noxious levels of nitrogen dioxide (NO2), sulphur dioxide (SO2) and lung-clogging particulate matter larger than 10 micron (PM10) in size. Of the 180 cities monitored by India’s Central Pollution Control Board in 2012, only two — Malapuram and Pathanamthitta in Kerala — meet the criteria of low air pollution (50% below the standard).

The NYT also reported in February last year  that “The thick haze of outdoor air pollution common in India today is the nation’s fifth-largest killer.”

NASA image courtesy Jeff Schmaltz, LANCE MODIS Rapid Response

NASA image courtesy Jeff Schmaltz, LANCE MODIS Rapid Response
Photo from January 11, 2013
(click on image to read more)

The State/OIG report from 2011 says that the health environment for US Embassy employees in India is “challenging, punctuated by frequent respiratory and gastrointestinal illnesses.”  That’s putting it mildly.  Reports about the air pollution in India is nothing new but has not been as widely reported as the “fog” in China. That’s probably because we have @BeijingAir monitoring crazy bad air in China and no @DelhiAir to report on India’s bad air.  NYT reported this week that “The United States does not release similar readings from its New Delhi Embassy, saying the Indian government releases its own figures.” Click here to see NYT’s follow-up report why.

The Times of India notes that “Lately, a very bad air day in Beijing is about an average one in New Delhi” and cites disturbing comparative numbers between the two cities:

Clean Air Asia, an advocacy group, found that another common measure of pollution known as PM10, for particulate matter less than 10 micrometers in diameter, averaged 117 in Beijing in a six-month period in 2011. In New Delhi, the Center for Science and Environment used government data and found that an average measure of PM10 in 2011 was 281, nearly two-and-a-half times higher.

Of course, FS folks have been living and hearing about this for years.  Haven’t you heard — “If you have asthma or other breathing issues, think long and hard before committing to New Delhi?”  Last year, an FS member said, “Very unhealthy, especially for young children, during winter when dung, garbage, and everything else is burnt for warmth, and smog traps it within Delhi.”  In 2010, somebody assigned to New Delhi warned that “Asthma and skin disorders are on the rise.

We understand that you don’t get to see the blue sky for a couple of months. In 2011, somebody called it, “the worst in the world.”

This past weekend, Yale Center for Environmental Law & Policy and Columbia University’s Center for International Earth Science Information Network released its 2014 Environmental Performance Index (EPI) at the World Economic Forum Annual Meeting in Davos, Switzerland.   The Environmental Performance Index (EPI) ranks how well countries perform on high-priority environmental issues in two broad policy areas: protection of human health from environmental harm and protection of ecosystems.

The announcement made special mention of improvement in India’s overall performance but cites dramatic declines on air quality. The announcement notes that “India’s air quality is among the worst in the world, tying China in terms of the proportion of the population exposed to average air pollution levels exceeding World Health Organization thresholds.

India ranks 155th out of 178 countries in its efforts to address environmental challenges, according to the 2014 Environmental Performance Index (EPI). India performs the worst among other emerging economies including, China, which ranks 118th, Brazil, at 77th, Russia, at 73rd, and South Africa at 72nd.
[…]
In particular, India’s air quality is among the worst in the world, tying China in terms of the proportion of the population exposed to average air pollution levels exceeding World Health Organization thresholds.

“Although India is an ‘emerging market’ alongside China, Brazil, Russia, and South Africa, its environment severely lags behind these others,” said Angel Hsu of the Yale Center for Environmental Law and Policy and lead author of the report.“ Very low GDP per capita coupled with the second highest population in the world means India’s environmental challenge is more formidable than that faced by other emerging economies.”

This is not a health hazard that just showed up yesterday. So we were surprised to hear that at a town hall meeting at Embassy New Delhi, a medical professional reportedly said that none of the government issued embassy purifiers at the mission do the fine particles.

Wait, the US Embassy in New Delhi issued air purifiers that do not work for the  finest particles — the particles that do the most damage?

How did that happen?

Some folks apparently are now buying their own air purifiers. A mission member reportedly spent $1600 for purifiers to allow a breath of clean air inside the house.

Dear US Embassy India, we would have liked an official comment, but your public affairs ninja ignores email inquiries.  Call me, maybe — we’d like to know which smart dolt spent all that money for decorative air purifiers.

On a related note, early this month, China Daily reported that in December last year, the US Embassy in Beijing ordered 2,000 air purifiers  for its employees in the country from Blueair, a Swedish manufacturer:

The cheapest model from Blueair, the Blueair 203, costs 3,590 yuan ($591) from Torana Clean Air, Blueair’s official seller in Beijing, while it sells for $329 on the Best Buy and Amazon websites in the US.  The order placed for air purifiers by the US embassy was handled by the Swedish company’s American supplier, and the unit price was not disclosed.

We don’t know what types of purifiers were issued at US Embassy India.  Popular brands like Blueair, Panasonic, Daikin, Sharp, Yadu, Honeywell are compared here as used in China via myhealthbeijing.  There is also a review of air purifiers by the Consumer Report that should be worth looking into; the report is only available to subscribers.  Or check with MED which should have this information available.

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State Dept Regional Psychiatrist William Callahan, 53, Dies in Cape Town

– Domani Spero

We previously posted about the December 12 death of a U.S. Embassy Accra employee while visiting Cape Town, South Africa. (See US Embassy Accra Employee Falls to Death on South Africa’s Table Mountain). We subsequently learned the identity of the employee but decided not to publish his name as we could not confirm independently that the family back in California has been notified.  His hometown newspaper had since identified him in a news article as William E. Callahan Jr., 53, a prominent psychiatrist in Aliso Viejo, California.  He was the State Department’s Regional Psychiatrist covering West Africa. Below is an excerpt from OCRegister:

Callahan had left his private psychiatry practice in California last year to join the U.S. State Department as a Regional Medical Officer and Psychiatrist based out of the U.S. Embassy in Accra, Ghana, said Kenneth Dekleva, Director of Mental Health Services at the U.S. Department of State in Washington, D.C.

Dekleva said the news came as a shock to him and his department last Friday when he found out Callahan’s body had been recovered by South African authorities near the Table Mountain Range.

“His death has touched many people: my phone hasn’t stopped ringing since Friday…we lost one of our own,” Dekleva said. “It’s a huge loss for our organization. He represented the best in psychiatry in my opinion. We’re very proud to have known him and to have had him as part of our team.”

Dekleva said that the investigation surrounding the circumstances of Callahan’s death is ongoing in South Africa.

Memorial services are planned in Accra on Wednesday. Services in Greenfield, Mass. and Laguna Beach will occur in early 2014, the State Department said.

 

Dr. Callahan joined the State Department in July 2012.  Our source told us that “he was an avid outdoorsman and in great shape.  He was well-liked in Accra and at the other embassies he covered in West Africa.”

According to his online bio, he was a Special Forces flight surgeon turned psychiatrist.  “With the constant deployments in my military unit on clandestine missions, I observed how stress in a family member can jump from person to person and lead to physical illness as well.  After 5 years of active duty and 9 of total service, I left the military to get the training to become a board certified psychiatrist.”

He was previously the president of the Orange County Psychiatric Society.  For 15 years prior to joining the State Department, he  provided a two hour a week, free, open-to-the-public group for families dealing with a mental illness called Interactive Solutions.

Dr. Callahan’s service in the military included a general surgery internship at David Grant Medical Center at Travis AFB, CA followed by assignment to the 8th Special Operations Squadron as a flight surgeon, at Hurlburt Field, FL.  He served in both the First Gulf War and Panama Wars,  and received two Meritorious Service Medals. He was the 1988 Flight Surgeon of the Year within the First Special Operations Wing.

He graduated from Deerfield Academy (1978), Tufts University (1982), Tufts Medical School (1986) and did General Surgery Internship at Travis AFB, CA (1987), and his Residency in Psychiatry at UC Irvine (1994).

R.I.P.

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State Dept’s Bureau of Neglected Disease – Dengue+Encephalitis, What Help Is There?

– By Domani Spero

She joined the Foreign Service over 20 years ago.  Among her overseas postings were New Delhi, Damascus, Alexandria, Northern Iraq, and Beirut.  In 2009, she opened the new Consulate’s PD shop in Hyderabad.  In 2010, she contracted dengue fever. And encephalitis. She was medevaced to Singapore and spent 10 days at a hospital there.  That was not her only hospital confinement.

In the November 2013 issue of Foreign Service Journal, FSO Juliet Wurr writes:

“Over the next year, first in Hyderabad and then in Washington, D.C., I discovered and then struggled to cope with the repercussions of my illness. My doctor concluded that my now-unreliable memory, constant drowsiness and cognitive impairment were all the result of my encephalitis. I knew that my Foreign Service career had come to an end.”

The CDS describes Dengue (pronounced den’ gee) as a disease caused by any one of four closely related dengue viruses (DENV 1, DENV 2, DENV 3, or DENV 4). The viruses are transmitted to humans by the bite of an infected mosquito. The CDS says that with more than one-third of the world’s population living in areas at risk for transmission, dengue infection is a leading cause of illness and death in the tropics and subtropics. There are reportedly as many as 100 million people infected yearly.   In September this year, the NYT reported about India’s dengue problem.  In October, the Raw Story called it New Delhi’s “mysterious dengue fever epidemic.

Click on image to see an interactive Dengue map of the word.

Click on image to see an interactive Dengue map of the word.

Dengue is an endemic illness in India, the second-most populous country in the world.  Anecdotal reports suggest that the U.S. Embassy in Delhi has about half a dozen dengue cases among mission members this year alone. We’ve requested information on current mission-wide dengue cases and medevaced cases but have not heard anything back.

A separate report in the Indian Critical Care Medicine notes that “Encephalopathy is a very common neurological complication of dengue fever. Dengue encephalopathy is usually secondary to multisystem derangement like shock, hepatitis, coagulopathy, and concurrent bacterial infection.”  Encephalitis is the irritation and swelling of the brain that can be mild and short and results in full recovery. Or it can be severe with permanent impairment or death as a possibility.  For more on encephalitis, see the National Institute of Health.

In an email to this blog, Ms. Wurr writes:

“I think there is a huge gap in what State can do statutorily and what morally they should do.  If employees and the public realized this I think they would be outraged.  I want to do all I can to publicize because there are simple changes they can do that don’t depend on legislation.  I am retiring six years earlier than expected.  State refuses to advocate for me with Department of Labor Workers Comp.  I am receiving no compensation for my $500+ medical bills each month or for wages lost.”

Ms. Wurr said that she had been to the Office of Medical Services and the Bureau of Human Resources, who “were kind and welcoming, but eventually they admitted they had nothing to offer me.” She had also been to the Office of Casualty Assistance twice, and told this blog, “They said there was nothing they could do.”

She had filed a claim at the Labor Department’s Office of Workers’ Compensation Programs last year. It was denied. She had refiled that claim, it was denied for the second time. The reason for the denials, “I could not convince Labor that my illness was caused by being in India as an employee of the Department of State.”

She’s up for a third filing, and has now hired a lawyer.

If this story sounds familiar, it’s because it happened before.

Remember Frank Pressley who was wounded in the East Africa bombing and had filed for permanent disability? The  Office of Workers’ Compensation Programs and the State Department’s Office of Casualty Assistance (OCA) both made the news:

Compensation claims examiners questioned the precise percentage of Pressley’s handicap. Two non-government doctors administered tests and said the arm was 78 percent disabled, permanently. The Office of Workers’ Compensation Programs said it was only 40 percent disabled.

Hoping to minimize runarounds, he contacted Kendall B. Montgomery, director of the State Department’s Office of Casualty Assistance, which was established in 1999 in response to the embassy bombings.

“I get no assistance, no options, no real help,” he e-mailed last summer. “I’m afraid that nothing is going to happen unless I get a lawyer. That would be very sad for me. I trust the system, my country.”

“Frank, I understand — and share — your frustration,” Montgomery told him in a December e-mail. The federal workers’ compensation program “is just not meeting its obligations to you and many others. The system is broken, but there is no will to fix it.”

After The Washington Post inquired about the status of Pressley’s disability compensation, government officials including the State Department’s Office of Casualty Assistance suddenly got their Minute Maid:

The State Department’s Kendall Montgomery vowed she would push for “speedy approval” of medical treatments for injured employees mired in the federal compensation system.

“We’re putting a very high priority on it,” she told The Post while a public affairs official monitored her words. “We’re once again trying to start a new round of discussion between ourselves and the Department of Labor. . . . We do hope they’re fruitful discussions.” 

Soon after, the Department of Labor stopped disputing Mr. Pressley’s claim to a 78 percent disability in his left arm and paid up.

But whatever “fruitful discussions” the State Department conducted with the Department of Labor back in 2002, the result is clear.  We sent email inquiries to the Office of Casualty Assistance (OCA) and the Family Liaison Office (FLO) asking what type of assistance their offices provide to cases like Ms. Wurr’s in ensuring that sick/injured employees mired in the federal compensation system are not stuck there. We also wanted to know more information about the State Department and specifically OCA’s role in advocating for cases before DOL’s Office of Workers’ Compensation Programs.

Today, we received a one-sentence response to our email and a non-response to our questions from Kirk A. Leach, the director of the State Department’s Office of Casualty Assistance.

“The Department is fully supportive of Ms. Wurr’s case and is actively engaged in advocating her position with the Department of Labor’s Office of Worker’s Compensation.”

That’s the same office, who according to Ms. Wurr, gave this response: “They said there was nothing they could do.” After learning of  OCA’s response to our inquiry, Ms. Wurr was surprised.  If they are working on her behalf, she said, “they kept it secret from me.” LOL!

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What to do when different voices start delivering multiple démarches in your head?

-- By Domani Spero

 

Below is the State Department’s High Stress Assignment Outbrief Implementation Guide – the FSI/MED Model.

Background of the High Stress Outbrief Program via fbo.gov

The High Stress Assignment Outbrief program was developed after the first groups of employees began coming back from assignments to Iraq and Afghanistan in 2002 and 2003 – posts that would have beenin evacuation status in more normal times. Returnees asserted that coming back from those posts wasn’t at all like coming back from a regular foreign affairs community assignment – that theDepartment needed to help with this particular transition in some way. Med’s Office of Mental Health Services asked the Foreign Service Institute’s Transition Center to assist in the development of a prototype training event, which was piloted in 2003. MED/Mental Health convened an Iraq Out-briefing Conference on July 29 & 30, 2004 at the Foreign Service Institute. The Outbrief program was reviewedand discussed by the full cadre of RMO/Ps, Dr. Robert Ursano and Dr. James McCarroll, from theUniformed Services University for Health Sciences, Dr. Carol North, Washington University (St. Louis),with guest presentations by (then) Director General of the Foreign Service Amb. Robert Pearson and others.

The program was endorsed by MED leadership and has run as a partnership between the FSI’sTransition Center and MED/Mental Health Services since then. All subsequent Directors General of the Foreign Service have mandated that all returnees from Iraq (and later Afghanistan) who have served for 90 days or longer be required to attend either a group or individual Outbrief upon return to CONUS.The realities of the Foreign Service assignment system brought complications – many officers had TDY-ed to Iraq or Afghanistan and were returning directly to their former posts. Others PCS-ed directly to follow-on assignments around the world. Clearly, a purely Washington-based program would not be effective in providing the service to all of our employees. Furthermore, many participants did not fit traditional Foreign Service employee profiles – special hiring authority hires (3161s), civil service employees, and third country nationals all stepped up to serve in those war zones. RMO/Ps were instructed to deliver Outbriefs at posts or during post visits, and to communicate the name of the Outbrief participant, date, and place back to the Transition Center for entry into the Department’sofficial training registration database to certify compliance.

Read more below:

 

I’ve requested help in understanding the usefulness of the Outbrief session and received a few responses below:

Comment #1: (from a twice-deployed employee)

“I have taken that half-day course twice in 2009 and 2013.  The class was almost the exact same.  They basically tell you to get sleep and try to adjust back and if needed, see someone.  The class I took in 2013 was 8 months after I returned because HR would not pay to send me to DC before home leave then I was in language training for six months.  If it was really important, HR would allow people to take it as early as possible otherwise, it must not be that important.”

Comment #2 (a State Department employee who served in Iraq and Pakistan)

“The description of the outbrief program seems reasonably accurate – although it’s been a while since I attended (in 2008 after Iraq, but not subsequently after Pakistan).  There’s a certain value to spending a bit of time (three hours?) with people that have been through similar experiences – probably including someone that you knew or at least shared acquaintances with.  It gives you a chance to talk with people who better understand your experiences.   It’s possible that some of our feedback made it back to decision makers in aggregated form.  For example, one of the themes of our discussion was that the Department (USG?) was doing itself no favors by sending warm bodies that lacked core qualifications (e.g. basic competence and a desire to be there.)  I think that the Department is now requesting 360s [360 degree feedback] for everyone that they send – although that may just be part of the general trend towards requesting 360s.  My memory is a bit hazy, but I think a key element was describing what other resources (e.g. clinical/therapeutic) might be available for those that needed them.”

Comment #3 (somebody once posted in Iraq— added at 6:48 am PST)
The high stress outbrief  is, as you noted, just an example of CYA– look, we have a program! A couple of voluntary hours with some contractor at cozy FSI with no follow-up, and especially no mandatory individual session is worthless. Many symptoms of PTSD evolve over time, and many returning-to-DC-stresses only become apparent after you have in fact returned to work and gotten the lay of the land in a new office. Speaking out in front of a group is not a core FS trait, and not something any person with real problems does easily. Imperfect as it is, the military does require formal screening and a brief one-on-one session with a counselor. Follow up care (imperfect) is available. At State, you’re told to “get help” without much help in getting it. After all, MED is not responsible for healthcare in the U.S.
 
Still not sure? Check with officers who were MEDEVACed for anything, not necessarily PTSD, and see if any of them got any follow-on from MED other than a new, career-crushing clearance status.

One of our readers commenting on mental health support suggested the following:

“While I know it wouldn’t solve everything, I think that anyone coming out of a post with danger pay should have some sort of mandatory sessions with some sort of licensed therapist. That would take away the stigma of the therapy and maybe get some people some help before they take out their PTSD on themselves or someone else.”

 

Remember the US Embassy Malta road rage meltdown that made the news? (US Embassy Malta Gets a Viral Video But — Not the Kind You Want).  We don’t know this individual nor his story, or which post he previously came from. But assignments to European posts like Malta have typically gone to employees who did tours in Iraq, Afghanistan and Pakistan.   We don’t know if this individual came from an AIP posts. Even if he did, it’s not an excuse for such a behavior, but it might help us understand his demeanor.  American diplomats normally do not go around looking for a fight.

Our concern is simple. We are sending people out to the war/danger zones.  The State Department touts its mandatory High Stress Outbrief, an educational program that only requires presentation/delivery skills from whoever delivers the program.  Less than 60 percent of returnees attend the program, and there are no consequences for non-compliance.  Who does the follow-up? Anybody?

Is it fair to say that the State Department does no follow-up beyond the Outbrief session and expects employees to simply self-report any mental health issue? And because no one fears the social stigma of seeking mental health help and nobody suffers from the fear of losing one’s security clearance over a mental health issue, everyone in the Service can be counted on to self-report if/when different voices start delivering multiple démarches in one’s head?

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Filed under Afghanistan, Diplomatic Life, Foreign Service, FSOs, Functional Bureaus, Govt Reports/Documents, Huh? News, Iraq, Leadership and Management, MED, Mental Health, Org Culture, Pakistan, State Department, War