For example, our upcoming trip to Russia has been cut short by three days because our return flight was cancelled- we need to squeeze 5 days of surgery into 4. Just yesterday we learned that there is no money available for our food and lodging because the banks in Vladivostok have closed due to a financial crisis. A small group goes out on a search trip to the country, meeting the people, checking out the OR and looking over the lodging. In the meantime team members are chosen, supplies are packed and visas obtained. For many of the people we meet, we are the first Americans they have ever seen.
Local customs are strong on many of our visits.
It is easy to offend, but most locals are very tolerant of Americans. We try to dress conservatively, especially the women on the team. In Pakistan this meant wearing long, loosely fitting dresses with long sleeves. Ankle length pants are worn under the dress, and a head scarf is always worn indoors and outside. We arrive at our destination exhausted after a cramped, long flight.