By Kirstin Grace-Simons (Madigan Army Medical Center)January 22, 2018
Those in uniform are used to having a new challenge come their way every few years. For civilians, opportunities require more pursuit, but they are out there.
Typically it is physicians or psychologists who are wanted from Army Medicine. But, when Frank Bannister, group practice manager for the Puyallup Community Medical Home, was ready for a change of pace, he found a healthcare administrator was needed in the country of Georgia to develop their Wounded and Injured Warrior Department (WAIWD).
"I have a lot of background working with wounded warriors," Bannister explained. "I actually started the first deployed warrior medical management center in 1992 back in Landstuhl. This was when we had the Kosovo/Bosnia war and then the first Afghan war. So, we introduced the concept of case management."
After an initial eight weeks of training in advisor roles and duties, effective communication, especially in volatile situations, and diplomatic awareness, Bannister expected his days to be busy immediately. But, he said, "Even though we had culture and language training, you really have to take time to absorb Georgia."
Nestled in the mountainous Caucasus region, Georgia is bounded by the Black Sea to the west, Russia to the north, Turkey and Armenia to the south, and Azerbaijan to the country's southeast corner.
At the crossroads of cultures and kingdoms, Georgia has been conquered frequently over the years. Emerging from its most recent occupation by the Soviet Union in 1991, Georgia is a developing democracy that has allied itself with Europe and the United States, providing troops and support for recent combat missions to include Iraq and Afghanistan.
Currently, the country has 198 wounded warriors, 43 of whom are amputees. A total of 23 of these Service Members injured in Iraq and Afghanistan received care in other countries, including the United States. Georgia wants to care for its wounded warriors at home and is working to develop a comprehensive, multidisciplinary program akin to that found in the U.S.
Stepping into the role of senior medical advisor for the Georgian Ministry of Defense in February, Bannister is nearing completion of a year-long deployment. His focus has been on strategic organization, developing the staff's understanding of team-based care, integrating mental health into rehabilitation services, and working to encourage employment opportunities.
Bannister took over a program that was a mere two years old. The original program had a very narrow scope that established the basic capabilities to care for soldiers with single and double amputations.
From that small start with 7 staff members, Bannister grew the operation to 38 people with combined social services, psychology and rehab staff. He put his health care management experience to good use to get them organized, align their resources, and start talking about marketing and branding.
"It seems slow at the time, but when you look back over a year, or three years to when the program started, it's like, 'Wow, we've come a long way'," said Bannister.
Bannister deems the Georgian sitting volleyball team's gold medal win at the Invictus Games in Toronto, Ontario, Canada in September to be the biggest accomplishment of the year. He clearly relishes sharing the details of the team's win and its return to Georgia.
"They just started playing volleyball two years ago," said Bannister. The team of nine wounded warriors with various amputations beat the U.S. team, the two-time standing champion.
"We got back to Tbilisi and the entire Ministry of Defense was there; the entire general staff was there," said Bannister. "You would have thought they won the Super Bowl." They are now leveraging that win to inspire others and grow the program even more.
Bannister and the local Georgian program leaders have also mentored talented people who have proven they can lead and make a difference. He has developed programs, peer support groups, resiliency training and techniques that can help with post-traumatic stress disorder and traumatic brain injury with a young clinical psychologist named Tata Onaini who has quickly become a leader in wounded warrior care herself.
Bannister understands that the program manager took a risk in promoting a young, untested woman for a leadership role in a traditional culture like Georgia's. But, the country's culture is changing. It is starting to shed the stigma surrounding mental health and to embrace people with disabilities. Folding these changes into the strong points of its traditions -- family, social structure and spirituality -- is helping to move its wounded warrior program forward.
"The goal is to develop their own capacity based on their own culture and their own values. We're trying to improve upon what they have," offered Bannister.
Of all the things he will bring back to his clinic from this experience when he returns home in February, Bannister suspects his biggest challenge in Georgia will be the greatest realization -- tactical patience. At home, he is so focused on execution and results. "But sometimes," he said, "you've got to let things develop."