Archive for April, 2017


I have been reading Nora Bateson’s Small Arcs of Larger Cycles. It is a collection of short essays she has written over the last 5 years or so. She also made a film about her father, the scientist Gregory Bateson, which I promptly ordered. It should be waiting for me at my return.

The essays are of the kind that make you think and that change you. Much like the tree book (The Hidden Life of Trees), I am changed by this one again. I am changing my vocabulary. I have become suspicious of words like ‘solutions.’  We ought to know by now that the problems that catapult poverty in our living room are not solvable from the mindset we have. It was Einstein who observed that problems cannot be solved from the same mindset that produced them. This quote is often cited but the deep meaning of it seems to be lost.

The mechanical, engineering mindset (every problem has a solution) is deeply anchored in our culture and it is easy to be sucked into its promises of engineering a better world. Yet I know that a better world cannot be created using an engineering framework simply because we are not made of steel and bolts.

Our world can only change when the relationships change, which is exactly what we found when touring this far flung area and visiting the teams that participated in the leadership program. Here is what Nora Bateson has to say about this:

“Within the great whirl of life there is culture; in culture there is language; in language there is conversation; in conversation there are two beings; in the beings there are frames of perception and, in their communication, a kaleidoscope of unpredictable repatterning.”

Although our challenge model, a kind of logical model, is a tad too mechanistic for me, it has served as a vehicle for people to establish, renew or fix relationships that make trust possible where mistrust was rampant. It is the only thing, in my mind, that can save us.


I am back in the capital and enjoy the comfort of the nice boutique hotel Tamboho. No more zebu body parts. Instead there are luxury items such as Cesar salads, red wine, omelets, internet. But the coffee is worse and the pollution is worse – my throat is hurting again. Too me this proves that I am allergic to ‘Tana toxics.’

Across from the hotel is a small shopping center with a Shoprite, a homeopathic shop (homeopathy and plant-based beauty and healing is big in Madagascar), a few salons, a pharmacy, some clothes and shoes stores and a spice store that sells Malagasy soaps, oils and spices in attractive little containers for double the price at the market, even the tourist market.

On the second floor is a food court which provided a nice alternative to the hotel’s small menu which changes only once every year (it actually just did). I eat at the hotel when I have a great need for foie gras and crème brulee. The food court is for oysters, sushi, quiches, salads or Lebanese food, sandwiches and smoothies.

Further down there is the cute baby clothes store where I go each time to buy yet another set of French fashion dresses for Saffi. Although she has more dresses than she will be able to wear I can’t help myself. They are the kind of dresses for show, not for playing in the mud.

I was dropped off at noon on Wednesday at the hotel, after the 1200 or so kilometers on the road. I spent the afternoon doing body maintenance: a pedicure, a haircut, a nice lunch, a nap and a massage. I caught up on my emails, on writing and on digesting the many impressions from the amazing trip I just made.

On Thursday the team came back together at the MSH office to plan our next moves, after I leave Madagascar. There are many moving parts and much at stake. My team is reaching high and wants to include the First Lady. She is the patron of  CARMMA which stands for the Campaign for the Accelerated Reduction of Maternal Mortality in Africa. The campaign was launched by the African Union in May 2009. Our leadership program is supposed to further accelerate the campaign here in Madagascar. It would be a great honor for the teams selected to present, but the protocol to make this happen is daunting.



The Norwegians were here

Tonight we are sleeping in Antsirabe. We could have pushed on to the capital but I had called a break. [In hindsight we could not have, as it was another 4 hours on the road. We would have driven after dark which is not allowed aside from not being advisable on paved roads]. It allowed me to hang out with an ICRC colleague and catch up on emails after having been off the grid for a few days.

Antsirabe is the second largest city in Madagascar. In the 19th century the Norwegians were here. They imported milk cows and fruit trees. Now this region is known for its dairy products and fruit.

My colleagues were looking for the artisanal cheese place. There only reference point was a large green house where the turn off would be, but we couldn’t find it. Bringing cheese home from here is worth the detour. I hope they managed during their first free afternoon to find it. [They did].

The white and black spots so familiar from Dutch cows are visible in the zebus which, I suppose, crossbred with the milk cows. I can’t think why else some of the zebus look like skinny Dutch cows, except for the bobbly bumps behind their heads.

There is not much else to show for the Norwegians, except maybe for the –son extension of names. Maybe there are Axelsons here.

I met with S from ICRC for dinner in the hotel. After days of eating rice with broth and rice tea (the dregs of the rice kettle mixed with water to serve the dual purpose of cleaning the pan and providing extra nutrients to the drinker), I splurged on duck, ice cream and wine. The total bill, very reasonable to me (15 dollars pp) would have shocked my Malagasy colleagues. I didn’t spend as much in the entire three days we have been on the road on all my meals combined.

Tomorrow we are heading to Tana and conclude the first of the two sweeps through the regions where our leadership program was implemented. We will rest tomorrow and then get back to work to summarize what we learned into a format that others can do something with.


Rice is everything here. There are the bright green or yellow rice stalks on the terraces; there is rice in the paste wrapped in banana leaves we had for breakfast; there is rice in the mortars where the grains are pounded into flour; there is rice in the bellies of the little children. The donuts, offered to us steaming hot at a roadside stand somewhere in the region on a beautiful crisp morning were also made of rice.

Rice is also in my cells now after 5 days of travelling like a local. We are eating rice for breakfast, lunch and dinner at tiny grimy little places which are called ‘hotely,’  or sometimes not even that. Sometimes it is just a lean-to with a few planks that serve as seats and tables. The word does not mean you can sleep there. It is a local eatery where the food is ready and made fresh constantly as there are always people eating. It is cheap and fast. Our meals rarely last more than 15 minutes or cost more than a dollar.

The other thing served with our roadside breakfasts was fresh coffee. Not Nescafe. During our entire trip I did not see one Nescafe advertisement, not one of the little strips with a few grams of the instant coffee. The coffee we have been drinking out in the region is grown locally, not for export. People grow it for themselves. It is roasted, ground and then put in a sock over which boiling water is poured. It is delicious, bitter black or sweetened black.

Miraculously my GI problems that have been dragging on for years and required expensive but fruitless modern medicine diagnostics are gone.  My rice diet seems to have fixed the problem. Rice: wonder drug?


All the houses in the villages in the area we visited are built according to the same pattern – I see Christopher Alexander’s pattern language everywhere. The houses face west, there were people can catch the late evening sun after a day of hard work on the land. The windows are tiny, no glass, just wood shutters. They are no bigger than a square foot. People sleep on the upper story, with the livestock on the ground floor. You get to the living part, a single room with reed mats for sleeping, by climbing onto a small ladder which can be pulled up in case of raids by bandits.

In the US we associate bandits with the Wild West. Here the wild west is very much alive, with cattle raids to pay for bride price, so one can marry and start a new family.

I was wondering about people like me with sore joints and not very good at climbing skimpy ladders to get to bed. But here the old and the young are good at that. They are used to hard labor, walking up steep hills, bare feet. Younger people do the same but with 250 kg of rice in large bags on their backs. No one needs a gym, the gym work is part of everyday life.

What about the disabled I wondered? My colleagues tell me there are no disabled – but WHO tells me that is not true. When labor is obstructed and emergency interventions are not available, if the child survives it would have cerebral palsy. Where are these kids?

My ICRC colleague tells me they are there, hidden on the top floor, never leaving the house – growing up in the dark, and probably not getting very old.

We see the disabled in the cities where they beg on corners. Some of them are organized in DPOs (Disabled People’s Organizations), who advocate for a life that doesn’t require begging, showing that physical disability doesn’t mean intellectual disability.

White wonder – deep ruts

I was told by the regional health director that foreigners rarely go where I went. He said the gesture was very much appreciated. It had touched him that we’d made the effort. He assured me it would have touched the staff of the three health centers we had visited even more.

I had noticed that older kids gaped at me in wonder and younger kids were scared to death seeing me, this strange white creature. In the capital or even regional capital of Fianarantsoa white folks are not given any special attention, but in Ikalamavony, Fitampito and Mangid I was a rarity.

Development projects refuse to go to these ‘zones enclavees’ as they are called. Visits would take days and supervision or control would be nearly impossible. The place we visited had not been supervised even by people from the regional office in two years before we had started out leadership program.

It took us 9 hours to cover about 90 kilometers on the impressive sounding Route Nationale nr 42. Along the road were faded signs that the World Bank was working on infrastructure. What infrastructure I wondered? Where did all that money go? We are always being pushed to show the result of donor investments, but here the accountability appeared to be missing. Nothing to show except for a few paved meters here and there. What if I took a picture of the sign, and then the road, and then send it to the World Bank in Washington, with a note that would say, Messieurs….?

We were mostly going in 1st gear in our landcruiser, and this while (a) we had a dependable landcruiser, (b) we each had our own seat (local bush taxis would have 20 people squished into the same space) and (c) it was not raining. Still, even under these great conditions, it took us all day to get just to the district capital. We had to get out multiple times when the car had to tackle steep hills covered with large rocks, or traverse mudflats. In the US we would have called the road not navigable.

Occasionally there would be short stretches of ‘goudron’ (asphalt),  50 or 100 meters, and I would quietly rejoice, but it never lasted and I learned to ignore these as signs of better times to come. Even the people we met, the overflowng bush taxis (it was not until 4 hours into the trip we met the first car) and trucks that went the opposite direction, would say, ‘oh yes, asphalt is near.’ Sometimes it wasn’t until an hour later that we saw the short stretch. What is considered near here is quite different from my ‘near.’

I marveled at the small ‘charrettes’ basically wooden platforms loaded with bags or tires or vegetation. They have small wooden wheels, rarely rubber tires, and are pushed up and down the ruts. Now there is what I would call a challenge. We buy a very fresh pineapple from a man pushing such a charrette that is on its way to the big city market. When we bite into it, later that evening, at a Chinese restaurant, I taste the labor that went into this piece of fruit.

I learned we had traveled through a ‘zone rouge’ a place where bandits attack cars. We would have been full of bounty with our computers, camera, printers and other gadgets, and me with my dollars, but we were left alone. Other cars would drive in convoi. the first car would have written on its windshield that it was the first in a convoi – we would huddle on the side of the road, waiting for the car with the sign that said ‘last.’ In the first and last car were gendarmes with guns. Such a contrast, this lovely land with its bright green rice paddies and smiling and waving people in their colorful clothes, men-height wild lupines and lantennas, the houses that come right out of children books, and then these men with guns.

This is the same road that people are transported over when there is a medical emergency, as there is no facility other than in the regional capital where emergency operations can be done. I tried to imagine what that would be like – even under the best of circumstances (no rain), if you had an acute appendicitis or the need for an emergency cesarean. It would be hell on earth. Many people don’t survive it, if they go at all, dying a horrible death.

Our driver and the the men I had hired over a year ago as consultants would scout the road ahead for fresh tracks, as if we were following wildlife, to see which way to take when we arrived at a fork. Sometimes we took a wrong turn. There are no signposts. You’d have to ask people, but sometimes there are no people in sight. You take the wrong turn, you have to retrace your steps – such a waste. What a metaphor for life!

We arrived in the mid afternoon in the district capital, which has a name that I could only remember because it kind of rhymes with Kalamazoo (Ikalamavoony, with the ‘I’ and ‘ny’ not really pronounced). The name means: beautiful yellow girl. I wondered about that. On the coast the Asian influence is clear and maybe one Chinese or Malay merchant came through and settled here either with his beautiful yellow daughter, or he made one. The Chinese/Malay, unlike the Indians, have completely merged with the local population, creating quite stunningly beautiful people.

We had another 3 hours to go to the remote health center we had promised to visit. We calculated that we would have to return in the dark. This is not advised, but what to do – we had come so far. And so we decided to push on. Our local guide had disappeared but luckily the district health chief and his wife offered to come along and guide us, sitting in the back of our cruiser after we removed our luggage.

This was more than generous. Would I offer to go for a 3 hours out and 3 back over a dirt track on my Sunday off? And so we went, another interminable ride, a track less exacting than the one we took previously, but still with lots of obstacles and crossing of inundated bridges where (I was told) caimans hid on the banks. The sun was starting to go down. The wide prairie was beautiful, with soft mountains at the edges. It looked a lot like parts of South Africa.

We arrived at the furthest point of our travels and were received by the chef of the health post, his wife and baby (screaming at the sight of me). He was ‘seul au poste’ which means he is the only doctor wide and far. Most of the doctors in such faraway places are young, in their late twenties or early thirties – often the first real post out of school. He is not supposed to, nor equipped to do surgical interventions and has to sent people on to the regional capital we had come from. People rather go home and die.

My colleagues had asked the doctor to arrange for a meal for us as we are way beyonf hotels and restaurants. We ate in the house of the Commune President. His women prepared the meal. We paid for it, as we had invited ourselves. People are dirt poor and can use the little extra our presence provided. We sat at the family dining table and had our usual mountains of rice. I am eating rice two or three times a day now. Usually the rice is served with a bowl of watery bouillon with a small piece of a chicken floating in it. One pours the bouillon over the rice, making it soggy.

I was given another bowl with some unrecognizable piece of meat in it, in addition to my chicken piece. My colleague explained that this was a special piece of meat to honor the white-haired white lady from afar. I asked what it was. There was much laughter when they explained that this was the ‘derriere’ of the zebu – which I took to be the anus. My colleague assured me that it was very well cleaned and that I could not refuse it.

Earlier I had already eaten zebu hooves, or at least the cartilage of the hooves which were plopped in the noodles that came from a package. It is good for you, said my team mates – it contains collagen and it very good for old people. I bit into the not very attractive pieces of thick material, with a few hairs still attached. It was better not to look as the texture left enough to the imagination. Good for my ankle arthritis I thought, complementing the cortisone shots, the PT and acupuncture, and cleaned my bowl.

We’d eat in the kind of road side eateries I would never have gone to had I been by myself or a group of tourists. Although my daily allowance is several tens of dollars, I am spending an average of 20 cents for breakfasts and just about a dollar for lunch and dinner. Here you can still live easily for under 5 dollars a day, which is of course a fortune for the locals.

After we returned over the prairie back to the district capital we had been on the road for 14 hours in first gear. We slept at the convent as there was no other place in town to stay. The cost of our lodging, simple cells, was 4 dollars and 31 cents for the night. I got to have my own cell, with two beds. The bed was hard and consisted of a bunch of slats covered with a thin foam mattress, a mosquito net, a pillow stuffed with tiny pieces of foam, a small towel and electricity till 10PM. The toilet was outside and didn’t flush. The communal shower I didn’t even try. The sisters are not used to put up travelers. Our MSH accountants at HQ insist we ask for a bill, there was none to be had. The place is for novitiates. I tried to imagine what it would be like to live there forever. I supposed one can get used to it. Compared to the usual family lodging, altogether on a mat on the 2nd floor of the house, this would be the most luxurious a girl would have ever lived.


The part I like most about travelling in faraway places is the delight of seeing things out my ordinary. Like a fish shop that also doubles as a patisserie, or the primary school that is called ‘arc towards the future.’ This name resonates particularly with me because of the book I am reading, Small Arcs of Larger Circles, recommended by Sita. It is a collection of essays written by Nora Bateson, the daughter and granddaughter of, respectively, Gregory and William Bateson. All essays look at context from a variety of perspectives. And it is exactly context I am taking in here.

My laryngitis, which started nearly as soon as I stepped off the plane, just like during my visit some years ago, has been well managed with a corticoid pill which I put under my tongue every morning and evening. It was only on my first day of visits and interviews that I croaked. One of my colleagues told me that I night be allergic to the enormous amounts of Sulphur in the air. Since Saturday I have been in the healthy plein air of rural Madagascar where the only pollution that exists is of the psychological kind. There are no abandoned plastic bags, broken flipflops (nearly everyone is barefoot), derelict cars or empty water bottles littering the side of the roads. Everything is used until it disintegrates. Even the water with which the rice pan is cleaned is served as a kind of tea with our meals. It is called ranavola which means water money. I supposed because it is rich in vitamins and minerals.

The good and healthy part of being here is like the nostalgia to good old times that actually weren’t all that good. It masks the countless dangers people here face: there are the diseases (pest, leprosy, malaria, TB, diarrhea) that incapacitate and/or kill many of the babies and a good number of the adults. There are the caimans hidden in the rivers which, when overflowing their borders, come close to human habitation where small children toddling around are an easy target. There are the road accidents – we saw a few car wrecks where the driver surely could not have survived. And then there are the brush fires that one can see at night on the prairie and that can suddenly cut you off with nowhere to go. I used to use brush fires as a metaphor for starting change but here it is not a positive thing.

Everything requires an view of the context before judging – this is my big learning from this trip. I knew it in my head but now I also know it in my ‘tripes’ (=insides) as the French would say. The same tripes that got exposed to all these new foods and so shaken up along the road!

April 2017
« Mar   May »


Blog Stats

  • 119,734 hits

Recent Comments

Judy Wang on Endings and transitions
svriesendorp on The end of a long run
svriesendorp on The end of a long run
Carol Sawyer on The end of a long run
Judy on The end of a long run

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 63 other followers