Well, I hope things can change back in a postive direction so you feel happier - it's more than abundantly clear how much you love the job (in spite of the negatives) - or at least the positives must outweigh the negatives. Could you see yourself doing the same or similar role in a different country and/or culture though? Perhaps in a country whose government actually gives a damn about medical care, that is? Lord knows you must have a few good contacts by now ;)