I'm a 70yo doctor from Iowa who hasn't taken a salary for 16 years in one of the poorest countries in the world. I have treated undocumented farm workers in California, was a rural doctor in Mozambique and even became a UN election monitor. I am a...

I know that medical supplies, and having staff can be expensive. Even though you live modestly, how does the clinic financially support itself?

The clinic runs entirely off donations. We used to get money from the East Timor ministry of health but we havent for a few years.

It costs around USD$70,000 a month to keep the clinic, our mobile clinic, inpatients and everything else running.

We get donations from around the world world. If you can help us by giving 2 bucks a month it would really help us out. just head to www.bairopiteclinic.org/guardians-international/ to help us out.

Because of our experience in ET we are in a great position to develop a health care approach at the village level. All we lack is resources.

I'm happy to give you $2 a month for what you're doing. Is there another organization I'm a different country that you'd recommend donating money to?

Fantastic - THANK YOU. We have an international link www.bairopiteclinic.org/guardians-international/

Please edit your post to include the donation link!

www.bairopiteclinic.org/guardians-international

Hi Dr. Dan- I met you when I came with an Australian group to Bairo Pite on Sunday, and I walked away incredibly inspired. What advice would you have to someone who'd like to volunteer at the clinic in the future, as a med student or doctor? And what has been your scariest moment or experience from being in Timor? Cheers

It really nice to hear back from you. Our website and our facebook page have all the information needed for volunteers. bairopiteclinic.org.

1999 was a very scary time because of the extreme gratuitous violence everywhere. Somebody had their hands around my neck squeezing, and then there were 10 timorese clinging to my legs as they were also being attacked by militiamen. I guess you could call that scary.

More on the volunteering would be a great, but what would even be better is for someone like you to find your own East Timor. Find something, dedicate yourself and put everything on the line. There so many places around the world that need help. Just go anywhere in th middle east. There is an immense about of work to be done.

Just imagine if you were part of helping people resolve conflinct non-violently.

Hi doctor Murphy

Since I originally grew up in a 3rd world country (Vietnam), services like yours are a blessing for the local people. So my sincere thanks and respect for what you do.

I have a few curious questions.

1. What were you doing before you decided to take care of those less fortunate in poverty? And what was the reason that made you change your scenery?

2. what is/are some diseases you find very common in 3rd world countries that are easily preventable?

3. What are your goals for the future?

1. I can tell you that as soon as I finished my medical training I was drafted into the millitary and thats when I changed my entire life. I decided to plead guilty to a felony rather than go and fight in vietnam. This was during the 60s when everything is coming into question. It wasn't just womens lib, everything was up in the air and people were looking for an alternative way to live a life. And that's when Cesear Chavez (advocate for undocumented farm workers in the USA)popped up.

2. I live die, dream and breathe tuberculosis. It can be prevented if everyone has their own room to sleep in and their own air to breath. For instance when someone gets a fever our thoughts go to: malaria, denque, typhoid, TB in that order.

3. Capacity build as many people as I can in east timor and maybe provide a role model for people around the world to make the world a better place to live in.

1. That definitely was a good choice, I've heard many terrible stories from those times from my relatives.

2. I would imagine personal space is limited in developing nations (i can definitely see that as a problem in high density 3rd world countries).

Would some kind of personal air regulator/face mask be affective for containing someone infected with TB?

1. That's an admirable feat. Do you know any good programs for those wanting to volunteer in developing countries?

we have face masks and a TB patient can just wear a normal face mask to stop the particles going out. BUt to stop TB getting in you need a special personally fitted n95 mask that will not allow air to get into the mouth without going through the mask and filtereing out all bacteria. And these are very effecctive.

But TV really spreads in the house when grandpa is coughing and the little baby is sleeping next to him, often even in the same bed.

YOu have to remember that up to a third of all humanity have TB, in 3rd world countries its up to 50%.

A lot is latent but not if you have HIV or you are malnourished.

Can you tell us a little about the HIV situation in the 3rd world today?

Well, East Timor now has about 300 cases of HIV. Brazil has 600,000 cases. But sub saharan Africa has 29 million cases of HIV. So HIV is alive and well.

Near East Timor, Indonesia has skyrocketing cases including Bali West Java and Atambua right near the border with East Timor.

Luckily East Timor doesn't have IV drug abuse which really makes the problem unstoppable. We dont have the resources to do it. Not to mention that HIV increases the risk of active TB by 90%.

We are lucky enough to have the Global Fund support us with medicines , but all their finding is in question so we don't know if they will be here tomorrow.

Can you imagine how the soaring number of refugees around the world has drained the resources of aid organisations around the world.

Half of Syria is now refugees, and now they are going to countries without resources.

How do you get by without a salary?

As I previously mentioned in another response I just dont need a lot. I get a small amount from US government social security and savings, but mostly I just work seeing 200 or so patients a day along with rounds and other duties.

200 a day!?

How? Are you able to avoid some of the documentation problems?

A lot of the people I see are the worried well. I have two East Timorese health care workers sitting with me following instructions. Every hour - I find someone who really need our help and we admit them.

Hi Dr Dan! I am a former volunteer to Bairo Pite Clinic - I was there 4 years ago (Cypriot medical student from Oxford). You were an inspiration for me, thank you for letting us work with you. Your book is also sensational.

My questions to you are: 1) I remember you are an avid reader. What books would you recommend to a young doctor who wants to keep her enthusiasm with her job?

2) How has the clinic and health care in East Timor changed in the last 4 years? Especially with regards to TB. Has any progress been made?

Thanks (for the AMA and generally for being awesome!)

1) The pen is mightyer than the sword, the story of Norman McCune from Canada who marched accross china with

Jose Rizal - a phillipino ophthalmologist who is widely considered the godfather of the Phillipines. He was executed for his views. "The more they oppress us, the more they are pouring gasoline on our hearts."

Joseph Conrad for the way his books talk about the haves and the have nots.

Lastly Paul Farmers books about drug resistant TB and HIV.

The other group of books that's important is Paulo Freire Where there is no doctrine books. Pedagogy of the Opressed is a great one to start with.

2) Well our clinic has done something dramatic. We now have a program of giving prophelactic treatment to every child under 5 who is in contact with an adult with a positive sputum result.

With the help of a couple of grants and the dedication of our staff to contact people continually we are making great inroads, especially for the next generation of Timorese, the early results are very promising.

Favorite basketball teams? College and Pro?

College university of Iowa, pro would have to be Celtics

Thoughts on Aaron White? Think he can make it at the next level?

ahh - it going to be tricky - he is not big enough and not quick enough on the outside - so unless he develops some special talent - he is going to have trouble. Even Greg McDermott is having trouble.

Would you rather heal 1 horse sized duck or 100 duck sized horses?

If you could change leadership at a primal level then the world would have no problems. Its better to go down and work with the people. Lets go with the duck sized horses.

I'm a PGY1 FM resident. I'm recently realizing, or starting to feel like, I don't have the passion for medicine my colleagues have. I hate being in the hospital. I despise my long hours. I hate seeing family and friends in the same age bracket as me living life and enjoying it.

I feel like this is causing me to feel depressed, even though I have a great support system, fiancé, family and friends. Any advice for me? You seem like the type of person I need to hear from.

Also, ball if life. Basketball is my first love.

Come to the clinic, you would be perfect and I think your life would be transformed.

So many people have come and have said this has changed their perspective. People say hey, i realise now that you can work hard for the good human beings, not just money.

If you can tie it in with a broader struggle that you think is noble then its perfect.

How do you feel about telemedicine ? I heard from some doctors that they love medicine but they don't like the clinic a lot so they work from home and see patients over video. Might be a good alternative for you

We do use telemedicine and we consult with specialists. There is something caled Swinfin network and they have the best specialist around the world who can answer questions in less than 24 hours.

But the actual treatments for diseases like Cancer need to be done on the ground and cant be done with Telemedicine.

one thing that would really improve our work would be a digital xray machine. If we go digital it can be sent anywhere in the world with modern IT and that would be so helpful with all the TB that we see.

Do you ever catch flak from people for helping undocumented immigrants?

Yeah - we cop Flack - my building was dynamited,our tires were slashed, we were shot at. I myself was harassed by everyone possible - it was a life of harassment.

Wow! What's Iowa like?

Its where the tall corn grows but I havent even stepped foot in the place for 2 years. I go back to my hometown in September for the first time in 8 years.

Its going to be great.

Where is your home town?

Life-long Iowan asking.

Alton in Sioux county, just over 1000 people

What motivates you to go around doing humanitarian work? You obviously could have done well for yourself working in a first world country. Do you regret any of the decisions you've made concerning your work?

The vietnam war changed my life and put me on an alternate track to fighting for those who are looking to achieve self determination. Fighting for those who don't have a chance.

63 year old doctor here. Specialty? What are you going to miss most about medicine?

I was used to think I was only truly alive when I was playing basketball. Now I only feel I am alive when I am busy with consultations. I think i will still be taped to the chair even after I am dead.

I just wanted to say thanks for everything that you do. As a student applying to medical school now, you are the kind of physician that I look up to! What advice would you have for me as I (hopefully) enter med school?

Also, go Celtics! Thoughts on Marcus Smart?

Find more and more time to do rotations in third world settings. Make a decision right now that you life is dedicated to helping those less fortunate that you. Marcus Smart is good but he is not going to be a game changer.

Damnnnn.... Do you happen to know any good burn units in Boston?

I can't tell you which ones are the best but I would say that every major hospital in Boston has a more than adequate burns centre.

How do you make ends meet?

I have no expenses all I do is work.I get by on social security from the US government and savings.

Some people will say here is a donation, this one is for you Dr Dan, you have needs too. But really I just dont need a lot of money when I am working all day and all night.

Most memorable case?

Well in recent memory. Yesterday a woman came into my consultation carrying a baby, screaming out, and I can see immediately is in deep trouble. This baby had no pulse, no respirations, and the pupils were fixed and dilated. She had come 15 minutes after finding her kid at the bottom of her water tank at her house. 2 years old, dead.. That's been in my memory right now.

We see miracles come through our clinic every day. People who have no chance to recover, but yet when we do our best they somehow come back.

We had a little baby that hand't gained weight since birth, 5 months old, and turning blue because blood wasn't going to the lungs by searching everywhere and using our network we managed to find a hospital in Tel Aviv that would help us.

Now little baby Lisa is back in Timor after one of our volunteers flew with her around the world to get fixed. One of our young Timorese workers found herself travelling through Istanbul, Turkey, who would have thought!

What countries have the best foods?

I still like mexican food. Timorese is good, but nothing compares to mexican.

How did you became a UN election monitor? Did they asked you, or did you made the first step? In which country did you served? Whas it a remarkable experience? Thank you for the AMA!

I was asked to be a monitor because I had worked in Mozam and they were having their first democratic election. I went right back to the part of MB that i had worked in for years. It was such a great experience and I could go on and on about what happened in that two week time.

I was down in this isolated village that only i know how to get to. Suddenly out of the trees comes this big green snake to the election table. Nobody else saw it but i did and pointed it out. They got up and ran away and got into a chair right where the chairmain of the election was.

It was seen as an omen and someone got up an whacked it. It took me about an hour to talk people into moving to the other side of the village and start the election process.

I am not sure why that happened, maybe there is more to it than we know. The opposition was kind of like a snake.

Why East-Timor?

Because no other group in th 20th century has sufered such as they have suffered. Worst of that most of it at the hands of the western world. Worst than that my country (US) being the main supporter of the Indonesian aggression, financially, militarily.

Can you imagine Gerald Ford, the president of the United States is in Jakarta with Henry Kissenger the day before the invasion of Indonesia in 1975.

Would you be opposed to a mini-documentary filmed by a media student? Also, what media exposure have you received in the past and do you feel it made a difference, for better or worse?

If its well done it would be very valuable.

We have been featured on ABC (Australia) TV's Foreign Correspondent,, which was also picked up by Al Jazeera. You can view it here: http://bairopiteclinic.org/clinic-foreign-correspondent/

We actually got a great boost from that and it helped us out for over year with more donations. But as more time has passed its slowed down a bit. But we are always looking for better ways to tell our story.

Thoughts on how the Hawkeyes will do this season with White gone? Went to UofI and just moved after living in Iowa City for 5 years.

I think they will remain at the upper level, but I dont see how they are going to make it into the elite teams. There is just too much talent around now days. They are good but not great.

What is this about a book?

Glad you asked its been compared to a mix between Henry Miller and Fifty Shades of grey.

Its an autobiagraphical but in the same way Moby Dick is about a whale, my book is about basketball. From the two handed set shot to modern basketball.

But mostly its about amateur pickup games and small town teams struggling to become heroes. Also all the important events of those times and plenty of medicine, politics, travel around the world and adventure. It's all there.

how do you feel about lebron? have you seen Trainwreck?? What did you specialize in (in terms of medical school)?

Lebron is getting a little more tolerable but he is still very arrogant. I am a specialist in third world misery which usually means TB, malnutrition and other diseases caused by poverty and I haven't seen trainwreck.

Yesterday, u/TalesOf1994 posted in r/CasualConversation that s/he wants to treat mental illness in Africa. https://www.reddit.com/r/CasualConversation/comments/3dy2tx/what_is_your_dream_job/

Can you help out u/TalesOf1994?

I would say go to the village level somewhere and try to focus on the fundamental rights of women in society. If you can improve that situation of women on the ground then you have gone a long way to set an example of how mental health can be treated in Africa.

African

How was it working with Cesar Chavez? How did you meet?

I did my internship in NYC and the city is a very political arena. At the time CS was making an impact. Many people were interested in his work. I heard about it and it fit perfectly with what I wanted to do.

We had poor people who needed access to healthcare and I was like I am in. So I called him up and we started working providing health care to the undocumented workers.

The first thing I did when I got there was start remodeling chicken coops into a medical clinic! It was a very fulfilling experience.

I also read all about it in my self published book Breakaway which is available on Amazon. http://www.amazon.com/Breakaway-Autobiography-Dan-Murphy-ebook/dp/B00V3R3ZUG/ref=sr_1_1?s=books&ie=UTF8&qid=1437520012&sr=1-1&keywords=breakaway+dan+murphy All profrom the book go directly to the clinic. (After amazon takes its cut)

What are your political views?

I would say I would start with the poorest of the poor, start helping the most marginalised and try to reduce their suffering and let them live with a minimal amount of diginity.

I dont belive in a lifestyle of consumption of non-renewable resources at an ever increasing level.

I think a philosophy that involves always reaching out to others will make the world a better place to live in.

Do you believe the kind of help we send right now to Africa or Asia is the good way to go? What could we improve?

There is a problem in creating dependence rather than empowering people to deal with their own problems. Many time we inhibit initiative by putting aid in hands of people who don't have a plan on how it will stimulate them to become independent.

What is the most common medical problem you run into?

TB would have to be up there. followed closely by malnutrition and then problems in childbirth.

How do you protect yourself from contracting TB from your patients? How easily communicable is it?

I am pretty good at denying all symptoms and just go to work - so far it has worked.

Being around sick people gets me down alot, does that happen to you too?

No, just the opposite. The sicker they are the more it gets my attention and makes me want to do everything possible to help the situation.

The feeling you get when someone improves and smiles is something you can't compare with anything else.

[deleted]

Come to us for a year or two then go seek your fortune in the country of your choosing

How concerned are you about antibiotic resistance, and what (if anything) do you think we should be doing about it?

I think that its so important and we have to be very careful when using antibiotics.

In ET people can get it over the counter. They also buy steriods and they are treating everything with that. This combination has huge ill effects on peoples health.

We have to be very careful on how we deal with the pharma industry. They effectively run the world, they are very influential. They will do anything they can to keep making more profits but its never enough. Lobbying and marketing to doctors with free gifts with out any strings attached. Drugs that are needed for TB etc are not developed because its more profitable to make a new Valium.

I would love to see a neutral non-profit organisation developing new drugs. Most of it is funded by the pharma industry at the moment and their motivation is profit, not people.

Hi! What is done (traditionally or other) for women with bacterial UTIs in the places you've worked?

Every common illness and every significant event in a persons life in a village level has rituals and traditional therapy which could involve everything from visiting a local healer to application of roots or leaves. Sometimes it works and sometimes it doesnt.

But if someone presents to us, we just give them antibiotics. But in the Indonesian time people didnt go to the clinic because they were the people committing genocide against you. So a lot of my work has been about building trust with the community.

which medical technology do you think has done the greatest amount of good at the least cost?

I like the book 'where there is no doctor' by David Warner. I like empowering women at the community level - this is the way to improving the world.

Dr Dan I visited your clinic a few times in 2005-2007 while working also as a Doctor for the Cuban Medical Team. (Clinica Centro & Atauro). What's your opinion of the work done by us over there and your views on the new generation of local MDs?

I think intentions are very good - however my approach to health care goes done to the grass roots level. In a country like East Timor we need to go down to the village women level and get them involved in a process. Decentralisation of resources will help get East Timorese improve its over all general health.

Whats your love life like? Married?

I am doing well, I don't have any complaints and she is also helping with the cause. I dont want to say much more though, I'm a guy and I never really know what the right thing to say it.

What position do you play?

I need the ball. Give me the ball. I dont care, anywhere on the court and I will take it. You guys help out.

Designated gunner.

How many languages do you speak? Have you practiced medicine in America for any extended period of time?

I speak many languages ,mostly regarding medical things.

I am fluent in English, Spanish, Portugese and Tetun (Timorese language) but I can by as a doctor in something like 30 languages.

I lived in the US for 17 years in Cedar Falls, Iowa doing family practice, running a methadone clinic and also as the team doctor for the University of Northern Iowa Basketball team and helping out with a lot of other sports.

Do you consider access to health-care to be a human right? Is it something the government should provide?

Health care is a fundamental human right. It should not ever be a privilege for those with resources or the rich. The increasing gap between those who have and have not is causing a lot of the problems in the world.

Do you feel you've achieved any social-scale change from your years of influencing lives only at an individual scale?

Yeah. Here was a country that is being oppressed by the fourth largest nation in the world backed by superpowers.

Now it is free and independent, and I was there participating in that for the last two years. Especially the media work. But not only that I gave them an alternative for health care which they didnt have.

Hi, thank you for doing this ama. In terms of medical help/need, what is the biggest difference between what you do in Timor-Leste and what you did in Mozambique? Also, what do you think is the single most important thing that richer countries can do to help the once that are poorer?

Odd as it may seem when I worked in Mozambique i was criticised by some on the left asking why did I wait until the revolution was over when I went to help. Therefore in East Timor, still occupied by Indonesia I showed up in the heart of the struggle.

So that means your strategy even as a doctor is much different. In the first two years in East Timor, media work was just as important as the medical.

Genocide is not good for your health it turns out. I did interviews every day because as I say, where there is blood, there will be media.

Where I was in Mozambique they had never even heard of the capital city so the focus was much more on medicine. I was given responsibility for 200,000 people by myself with no medicines or materials to work with. One of the first thing I had to learn there was how to walk away from critically ill people to go train community health workers.

You cant sit there with one sick person all day, thats not going to help as much as teaching people about nutrition.

What has been the most rewarding moment of your career? Was there ever a moment when you doubted yourself or what you were doing?

I am always in doubt. But I will say that it almost brought me to tears when the univeristy of Iowa of medicine decided I should get a distinguished alumnus award about four years ago.

It was a recognition of a lifetime of work, I never expected such a thing. But I just felt fulfilled, like someone saw that I was actually doing something worthwhile.

I have always been outside the mainstream, but having official recognition of that was great.

Whats up Doc.... I just have to know: what inspired you to become a doctor? By the way; thank you so much for your work, leaving it a lot better then you found it!

Well i became a doctor because I coulndt think of anything else to do at the time. BY father was a doctor and worked extremely hard. I always thought that was too much,I cant do it, but now I have even exceeded what he did.

You said you like the Celtics. What do you think we have to change in order to go deeper in the playoffs next season?

I think they have to stick with the same players long enough. You cant expect to have a new team every month and the players to just gel.

What inspired you to start the free clinic?

Immense suffering, most of which was brought upon innocent village people by western geopolitical strategic thinking.

I just had to help.

What do you see for the future of your clinic?

Well - I would like to see improvement of the quality of care at every level. Capacity building so that more and more things can be done in East Timor and not overseas. And most of all community involvement focusing on prevention all around the country.

From your perspective is basketball growing overseas? Can it replace soccer in some countries as a primary sport?

Basketball is truly international. We have had players from China, India. Thats half of the world right there. Can you imagine how the marketers are salivating.

And now kids are playing. Its a good game and I love it. I think it is growing. With these latest scandals in Soccer. FIFA has take a huge hit so maybe an opportunity for Basketball. Although with basketball you have to be big and tall but soccer you can be little and still play well.

That's a lot of experience to have under your belt, and a lot of it pertains to great moral causes.

Did it ever get tough? When you're trying to be the selfless good guy, I've heard that times can get remarkably difficult emotionally or psychologically, at the worst points. If you did find this to be the case for you, how did you push on?

I can say that towards the end of every day I am on th verge of going gaga. but I havent gone over the edge yet, but it could happen at any time.

So yeah its tough, if its easy you arent in the right place. Watching people get better and expressing gratitude makes you go on.

One day last year a old guy walked many miles in to the clinic to give me some bananas because I treated him. I didnt even remember him but that made my day and its little things like this that keep me going through the hard times.

What kind of documentations/certifications are needed in order to do your kind of work East Timor? Are there many, if any regulations, placed on the way you practice medicine there?

As the country develops regulations also develop.

When I first came you just walked in and started working. Nobody asked anything. Now they are starting to develop regulations. For a maverick like me its a little bit depressing but its a good sign of a country developing.

If bureaucracy is done well it can be very helpful, although if poorly done it can be downfall of an entire nation.

Do you think that the current court for the NBA needs to expanded? Also do you think the height of the rim should be raised?

No I think thats too much. I think we need to stick with what we have now. I really like the shot clock though.

Now you have to move, I like the fast pace.

Do you think the borg have the right idea when it comes to health care?

yeah - that is perfect - I wish I had one of those scanners and I could sweep it over the body and they would be fixed.

With all the horrid things you see, do you never feel that some of these people aren't worth saving?

I think the moment you start diminishing the value of any indivual in the world you are on a slippery slope and its a huge mistake. We have to respect every human being.

Where does Lebron rank in your best players of all time?

give me a Bill Russell, everyone else comes later.

How do you pay for malpractice insurance when working in California?

It was a long time ago but I didnt carry any when working with undocumented workers.

I never really believed in insurance and havent carried any. But if you made a single mistake in treatment it would have been a detriment to our cause, which was to organise the workers into a union for collective bargaining.