The Foreign Service Journal, March 2009

Availability for worldwide service is a defining characteris- tic of the Foreign Service. Of course, not all employees can be worldwide-available at all times during their career. Like every- one else, Foreign Servicemem- bers can have bad luck with accidents or disease. Nevertheless, without a large enough corps of diplomats and de- velopment professionals available for as- signment at locations with difficult climates and rudimentary medical facil- ities, our nation could not consistently staff our 267 embassies and consulates around the globe. Thus, it has always surprisedme that the State Department, through its Of- fice of Medical Services, has not done more to promote health and wellness. Let me give some examples: • Early in my career, I did a Corpo- rate Exchange Program detail assign- ment with a large U.S. manufacturer. The company had just finished a major cost-cutting exercise, but still offered its employees a comprehensive and well- publicized health and wellness pro- gram. The program included regular individualized assessments to identify health risks. It also provided health club discounts, medical Web search tools and information, and weight loss and smoking cessation programs. While MED does have some health promotion efforts, they are not comprehensive, are not well publicized, and primarily ben- efit only domestic employees. • More recently, I attended the Army War College, where students are intellectually prepared for senior leadership. Students also benefit froman executive health and fitness pro- gram aimed at ensuring that middle- aged officers are physically able to con- tinue to serve the nation. The program seeks to reduce the risk of cardiovascu- lar disease by helping participants im- provenutrition,manage stress, stopsmok- ing, lower blood pressure and increase flexibility, strength and aerobic fitness. State offers no comparable program. • It has been a decade since MED stopped the longstanding practice of requiring full medical examinations prior to all overseas transfers. While the current policy of self-certification may be appreciated by those of us who dis- like physical exams and prefer to ignore new aches and lumps, one wonders if there has been a drop in the early de- tection of medical conditions among Foreign Service members. If so, that would result in more serious illnesses and increased numbers of disruptive medical evacuations from post. • A January article in the Foreign Service Journal describing problems with Class 2 clearances (i.e., post-spe- cific assignment limitations) highlights the persistent disconnects between MED and the Bureau of Human Re- sources when it comes to assigning em- ployees with medically restricted avail- ability. AFSA frequently hears from members frustrated whenMED vetoes assignments based on criteria that members do not understand or do not agree with. President Barack Obama has pledg- ed to expand America’s diplomatic pres- ence “in difficult corners of the world.” For that to be possible, increased focus must be placed onmaking sure there are enough Foreign Service members who are physically available for such assign- ments. Toward that end, MED should in- vest in prevention, early detection and education. MED and HR should bet- ter coordinate the assignment of em- ployees with limitedmedical clearances. And State should establish fitness cen- ters at overseas posts where commercial facilities are inadequate or unsafe. I am not a health expert. However, were MED to survey the best practices from elsewhere in government and the private sector, I have no doubt that a world-class wellness program could be crafted. Such a programwould benefit not only individual employees, but would also assure that our foreign affairs agencies have sufficient numbers of worldwide-available employees tomeet the foreign policy challenges of the coming years. John K. Naland is the president of the American Foreign Service Association. P RESIDENT ’ S V IEWS To Your Health B Y J OHN K. N ALAND M A R C H 2 0 0 9 / F O R E I G N S E R V I C E J O U R N A L 5