With full day meetings to facilitate and annual report revisions at night I am one busy bee who is taking only short breaks for food. The launch of the project is going well. Even if at times it is a bit uncomfortable because of the ambiguity that goes with any start up but with this project even more than I am used to. The guidance to not work at country level but at regional level makes it even more difficult to conceptualize what results can be expected.

The purpose of this five year effort is to guide major actors in health in Africa towards promising but unused or underutilized approaches to reduce preventable mortality and morbidity – from everything, everywhere in Africa and to have that done by Africans themselves.

The necessity of focus creates both comfort and discomfort and the newness of the team adds to the soup. I am seeing all the usual turbulences that go with such a challenge. I don’t think I have ever seen this (mandated and quick turnaround) planning process generating the fun, creativity and cohesion that people want it to be or think it should be. I think it could be but not under the time constraints we are working under.

People use the words excitement and innovation all the time but I sense they are often pushed aside by more immediate considerations about how one is seen and whether one’s selection for the job was warranted – at start ups I am sure these thoughts flash through people’s minds all the time: “will I be liked, seen as competent and effective?” This is Will Schutz stuff by the way, not my invention, but powerfully explanatory.

I have not once turned on the TV or gone to the pool or exercise center. I am told they are nice. Only twice did I manage to follow a 30 minute AM yoga teacher on a DVD I brought. That routine from Kabul is very hard to recreate here. My days aren’t as predictable and circumscribed as they were there.

The big celebration event of MSH being 40 years – of which I witnessed 25 – took place on Wednesday night and I am very sorry I missed it. Axel went and represented me and got to see all my favorite MSHers, old, new, retired and gone elsewhere.

Last night I missed another event, Sita’s 31st birthday which was celebrated with friends, dad, pizza and bowling. I got to hear the happy voices in the background and was, once more, sad I missed that too.

This is indeed a taste of what’s to come – missing a lot of events with people I like to be with. The urge/search for another overseas position has not gone away, in fact it is getting stronger as work is piling up on the horizon – work that makes for a heavy ecological footprint.

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October 2011
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