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ONE of Bahrain's most respected doctors and health service executives today spoke of the challenges of running a 21st Century medical service in the kingdom.
Dr Paul Armerding is retiring from his position of chief medical officer and chief executive officer of the American Mission Hospital after serving the nation for 22 years.
When he arrived the AMH was a small outfit comprised of a handful of medics trying to provide primary care to the population, which has now grown to more than a million people.
Instead of tackling communicable diseases such as measles, today's doctors and nurses are more concerned with cracking the chronic self-inflicted conditions of the 21st Century such as heart disease and obesity.
"Things were certainly a lot different when I started here," said Dr Armerding, 62, "but the mission of this hospital has remained the same and I am very proud to have played a part in its incredible journey.
"In this part of the world, certainly among the local population _- and to some degree it is true of the expatriates also - the majority of people are relatively young. It is a population that has a higher need for outpatient services, birthing services, and day-care surgery rather than admitting to hospital.
"We are trying to encourage healthier lifestyles nowadays. We are trying to get people into programmes to prevent or manage chronic illnesses.
"The big issues of today are diabetes, cardio vascular disease, high blood pressure and chest diseases. We encourage people to come into organised programmes so that we can minimise the complications and the loss of good years in people's lives by handling these problems well."
When Dr Armerding, joined the private, not-for-profit hospital team in the late 1980s one of his first tasks was to help instigate the provision of 24-hour healthcare.
He proudly said, looking back at the success of his stint at the AMH, that the hospital now reaches out into the community through its satellite clinics and mobile services and prescribes medical care to more than 200,000 patients a year and has one of the busiest outpatient departments in the kingdom.
It has gained international recognition and praise for the quality of its services and standards of care.
But despite its achievements, the hospital continues to face many challenges like continuing to fund its operations and development. Dr Armerding said: "We say in our mission statement that we want to deliver high quality care at the most affordable prices and we struggle to maintain that balance.
"We are facing rising costs as our employees have to deal with the inflation of the economy and we need salary ranges to be competitive. We are trying to be efficient and watch our processes and operations carefully.
"As the island gets more crowded and the traffic situation gets worse, we are having more and more difficulty with access and parking issues. I would like to see the hospital grow into multiple sites across Bahrain.
"The other great need in this hospital is capital and our biggest problem is that we have to go out to the community to raise it. But, there is only so much that we can raise that way. So when it comes to having to rebuild this hospital it is a huge challenge. To be honest I have not come up with a solution to that ... I hope my successor does!"
Dr George Cheriyan, who grew up in Kuwait and India and studied medicine in Europe, will be stepping into Dr Armerding's shoes. He moves from his position of head neonatologist at oil giant Saudi Aramco in Saudi Arabia.
Dr Armerding added: "In general terms we have been very successful in promoting a positive work environment. I hope my successor will take it to even higher levels. I picked up this job as a 40-year-old surgeon. He has considerably more experience and that is now needed as the hospital is a much bigger concern."
Dr Armerding, who has two children, Charlotte and John, and two grandchildren, Audrey and Helaena, will shortly be moving to Missoula Montana in the US with his wife Rebecca. From there he will continue to serve the Gulf region as a consultant with Arabian Gulf Connection and Medical Compass.
He said: "I have enjoyed living here. I have enjoyed the experience and I have enjoyed being with all the people I call friends here. In general terms I want to promote this region and assist people coming to here.
"My second goal is to provide consulting services for faith based non-profit medical activities in the developing world because what I have come to realise is that while there is a great deal of medical expertise found in these places, often there are real struggles to provide adequate management services."
