Tag Archives: medical

IST Recap

Happy 2016, everyone!

I’m glad December’s over. It was a weird and kind of rocky month, and I’m ready to start fresh.

I spent the bulk of last month in the capital city, Ulaanbaatar, for a series of Peace Corps trainings. Because I’m a fly site (Peace Corps buys me plane tickets for official events), because the Bayan-Ulgii flight schedule is a tad bit haphazard, and because my meetings were pretty scattered, I had training for seven days but stayed in the capital for two and a half weeks.

At the beginning of the month I had subwarden training. Every aimag has two safety officers — a subwarden and an alternate — chosen from among its PCVs. In the event of an emergency, the subwarden is responsible for communication between Peace Corps staff in the capital and other PCVs in the aimag; making sure aimag-mates are safe; keeping track of emergency supplies; and generally making sure no one loses their head and runs into a fire. If the subwarden is out of town, the alternate is supposed to take charge.

That training was only a day long, but gave me a whole week to hang out. It was pretty cool, because I got to see people I wouldn’t otherwise have met for months, if ever: Community Youth Development and Health volunteers, who had IST the week before; our M25 TEFL IST trainers; and M25s who’d come in for VAC (Volunteer Advisory Council) meetings, which happened that week as well. Toward the end of the week TEFL M26s began to filter in — the last two nights before IST, most of my PST sitemates stayed at the same guesthouse as me.

The following week was IST — In-Service Training. Five days of sessions about how to work well at site, specifically tailored to TEFL volunteers. IST is interesting, because everyone brings a Mongolian (or, in my case, Kazakh) counterpart, and the sessions are designed so that you work both with your own counterpart and with other people’s. I found the Experience Sharing session really useful, because it demonstrated for me that (while my school is atypical in a few ways) some of my difficulties at work are shared by many PCVs. We also had a cross-culture session that my counterpart says she found enlightening, but it didn’t benefit me as much. There are some rather pointed differences between Kazakh and Mongolian culture (holidays and drinking culture being major ones), and because of the way our groups were divided, there were no Kazakh CPs in my session.

I walked away from the seminar with some new ideas, but it was also absolutely exhausting. When you put into one hotel 40 Americans who know each other embarrassingly well and have interacted with only a few native English speakers in the last three months…well, I’ll let you imagine the kind of shenanigans that go down. I think we were pretty evenly split between people who threw parties nightly and people who hid in their rooms because the population of the hotel was overwhelming. (I was among the latter, but I did spent a LOT of time making sure I got to see my close friends.)

I’d been having problems with the pollution at site — I’d start to cough whenever I spent more than a few minutes outside without a mask. I had intended to talk to the doctor about it anyway, but the week before IST I stayed in a guesthouse that kept ALL of its windows open. (Central heating in Mongolia is controlled by the government, and some buildings are randomly set to ‘sweltering’.) I’d developed a pretty deep cough, so on Tuesday I booked a few minutes with one of our doctors.

“I cough whenever I go outside,” I said.

“Okay. You should take Vitamin C for your weak immune system.”

Confused, I said, “It’s not a cold. I’m not sick. It’s the pollution.”

“Ah. Then you should exercise to make your lungs stronger.”

It’s a half hour walk from my home to my school, and I spend about an hour a night practicing karate. It was a bit of a sore point that morning, actually, because the night before I’d tried to work out with some other PCVs and started wheezing within fifteen minutes. Biting my tongue on a sharp retort, I said civilly, “I do exercise. Should I exercise when I’m coughing?”

“No. Maybe you are allergic to coal dust. I will also give you Benadryl so you can sleep at night.”

“I don’t have problems sleeping at night,” I said, and gave up, frustrated. In any case, I’d figured out some healthy practices on my own: wear a mask when you go outside and keep the windows closed.

By Wednesday night, however, it got to the point where I couldn’t take a deep breath without coughing. I couldn’t focus in sessions because my chest hurt. I staked out the hotel’s temporary medical office Thursday morning and pounced on the other doctor as soon as he got in. Upon realizing that he couldn’t actually listen to my lungs because I wasn’t capable of taking a deep breath, he brought me into the Peace Corps office proper for a breathing treatment. Afterwards he informed me that my lungs had been spasming and that I was probably developing pre-asthma triggered by the pollution. I received an inhaler, cough syrup, and several extra face masks, and returned to IST much happier and more functional.

The Monday after IST I was invited to the TEFL Project Advisory Committee meeting. The PAC is assembled annually (?) to review how Peace Corps is doing in Mongolia and how the program can improve. I attended with three other M26s, three M25s, two counterparts, the president of the English Language Teacher’s Association of Mongolia, and the Peace Corps staff associated with the TEFL program. In a way I feel like this was the most valuable part of my time in UB — I got to share my experiences as a TEFL volunteer and make suggestions for how the program might be bettered for incoming PCVs. I was also put on committees to compile resource handbooks for PCVs and to help the national education department revise their new textbooks (!!!!!).

All in all, it was a productive, emotional, and ultimately exhausting month, and while it was pretty interesting, I’m glad it’s over. Here’s to everything 2016 will bring.

Backstory: Paperwork

Peace Corps Volunteers are issued a special passport for business-related travel. There are two ways to apply for this: either mail in your current passport, if you have one, with the DS-82 (passport renewal) form; or fill out the DS-11 (new passport application) at a post office or other passport agency. If you complete the DS-82, the Peace Corps retains your passport and returns it when you arrive at Staging. Since I was planning to travel out of the country on one last family vacation, I decided to fill out the DS-11.

Now, government employees undergo a different process from other applicants — the mailing instructions are slightly altered, and they aren’t expected to pay the $110 passport fee. I checked online for a passport agency that would be open on a Saturday, since I had work, and found a nearby post office. I arrived at the post office around 9:30 to be informed that the passport office was closed on Saturdays (the mailwoman pointed to a closed door, beside which the hours “Saturday 9-11am” were clearly printed), and furthermore I had to have an appointment.

On Monday I started calling around to the nearby post offices. It turns out that government passports are not commonly issued: the first three offices I called had never heard of them, announced that they were not qualified to issue them, and were mightily suspicious by the phrase “no-fee” despite that I was quite literally quoting the DS-11. I attempted to call the Buffalo passport office, but got an automated line, a lot of being-on-hold, and the spectre of a $65 service fee independent of the passport fee itself.

Finally, I got hold of a very helpful passport agent, who said that she’d never done a no-fee passport, but she’d heard of them, and she was pretty sure it was in the manual — why didn’t we meet the Tuesday after Christmas, in about a week? She would do her research, and I could bring my instructions, and if for some reason she couldn’t do it she would give me a call. I thanked her slavishly before I hung up.

The actual application process was neither difficult nor especially different from the ordinary application, although it was terrifically awkward to tell a USPS employee that a U.S. government bureau does not allow its employee candidates to use USPS to mail their employment-related documents. (Something about a radioactive screening process that melts photo paper; I’m not sure why UPS and FedEx don’t have the same problem).

“I don’t know why the other offices said they couldn’t do it,” the agent told me cheerfully. “It’s all in the manual.”

Neither do I, I thought, and smiled at her.

In the beginning of December, my medical portal updated with the documentation required for clearance.

I am tremendously fortunate in that, being under 25, I’m still covered by my father’s insurance. (I could also have been insured through my document control job, but the coverage wasn’t as complete.) My medical expenses were minimal, though I know of people who had to shell out several thousand. I’ve seen a dentist and an optometrist regularly since early childhood and didn’t have to get much work done. I did, however, have to go through the intake process for an adult physician, since my pediatrician had politely and discreetly slipped me a transfer-of-care slip at my only visit as a college graduate.

My complete medical experience:

  • Personal Migraine History: I get migraine headaches and had to write a personal statement about how I’d deal with them abroad. Not a problem — migraines only rarely interfere with my day-to-day.
  • Dental: I’ve always had pretty good teeth and was due for a checkup around the time I received the forms. No problems.
  • Optometric: the Peace Corps replaces your glasses if they break during service, but doesn’t support the use of contacts. I dropped off the prescription form when I stopped by to pick up my last six months of contacts; this month, when the insurance turned over, I bought a backup pair of glasses.
  • Physical Part 1: I had to do an intake appointment with a new physician to establish my medical history and get my records transferred from the pediatrician. She issued me a script to get my bloodwork done.
  • Immunizations Part 1: I was up-to-date with everything except my TDaP and an adult polio. When I had my intake appointment, my new physician informed me that they could to the TDaP but that she would have to write me a prescription for the polio, since it’s no longer part of the routine for U.S. adults. “They’ll give you a vial,” she told me, “just keep it in the fridge until you come for your next appointment.” It turns out that regular pharmacies aren’t licensed to distribute vaccines (shocker, right?) so I had no way to get the prescription filled.
  • Bloodwork: I’d never gotten my blood drawn before and babbled inanely at the technician to hide my nerves. (It probably didn’t help that it was 6 a.m. and I hadn’t eaten.) Turns out six tubes of blood is significantly less than, say, the Red Cross asks for in a donation.
  • Physical Part 2: My new physician was both thorough and brisk, though she flatly refused to examine (and therefore would not check off) the sections that fell under the gynecologist’s purview, and she forgot about the TDaP. My bloodwork was clean.
  • Immunizations Part 2: I booked an appointment with a travel health organization to get my polio vaccine, and decided to do the TDaP while I was there. This cost me around $250, since the organization didn’t take my insurance.
  • Pap Smear/Physical Part 3: I had to do intake with a gynecologist as well, but that was a much quicker process — just a few forms at the same appointment. The gynecologist was happy to fill out the sections of the physical my primary had left blank.

All said and done, I had submitted all medical documents by February 7th and received my medical clearance on February 9th.