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Retrofit

The blogposts are retrofitted, I am writing them while relying on my memory. It is not as good as writing daily but it will have to do. I was too exhausted every night to write. I made 14 to 16 hour days and this time period I clocked an all-time high of 184 hours (92 per week), which is more than double MSH’s normal 40 hour workweek.

There also was no respite. We worked all day on Saturday (since I had left on Saturday this was now a 7 day workweek) because the Directorate we were working with was being re-organized and my pharmaceutical colleagues decided that having everyone in one place was a good opportunity to finalize some of the restructuring tasks.

Originally I wasn’t supposed to be part of this but since I had re-designed the event to be more participatory, I was given the task to also facilitate the day. My Kenyan colleague worked with the TOTs to do more facilitation practice, and rehearsing upcoming sessions. The design was, after all, to have all of them conduct the leadership program to their colleagues, including a new batch of pharmacists who came from the districts. Our roles shifted to coaches and organizers of feedback and support sessions.

Sunday was supposed to be off but many tasks came in over email that needed attention, unrelated to the Sierra Leone assignments. And so Sunday turned out not a day of relaxation as I had hoped  (and wanted and needed). I put in another 8 hours of work taking care of things I could not postpone, such as  tasks related to the closing of the Madagascar program which starts happening next Tuesday. I owed it to my Malagasy colleagues to provided them with as much support as I could muster from a distance. And then there was my vacation, just days off, that I did not want to spoil with urgent tasks I could take care of now. Sigh!

Trust fall

I found my co-facilitator at breakfast the next morning, as well as my colleague who was responsible for getting me there, after a chance encounter at the airport in Brussels, both coming and going, when he went to Sierra Leone and I went to Liberia – the plane touches down in both countries.

My co-facilitator used to run the MSH leadership program in Kenya and turned out to be the best thing that happened to me. I had never worked with her in those days but knew of her reputation, which is why I had recommended her. She is a first rate coach and facilitator, besides being great company. She is a consultant now, since her MSH project ended, which is such a shame – all that talent not being used, whether in Kenya or elsewhere in the world. I am intent on finding her more assignments, preferably with myself.

The first week of our assignment was to create a pool of leadership developers. We had three days to turn some 17 lecturers into facilitators. We sometimes scratched our heads those first 24 hours. On the last day of the TOT all the participants, in pairs, had to do a session. Many of them lectured their way through the practice session or improvised and tied themselves up into knots. Lecturers are supposed to have all the answers – it was both funny and sad to see them trying to be more knowledgeable than they were. We knew they had a ways to go.

When people are used to giving lectures and presentations they tend not to do any of the things that our Leadership Development Program (LDP) facilitators have to do: prepare, follow the instructions in the guide , arrive early, have all their materials, flipcharts and resources ready (no PowerPoints allowed), read the room, pay attention to the energy in the room, do something when half the room is on Facebook, watching a soccer match, are texting or looking at pictures of full-breasted women, etc.

We selected the best 4 (2 women and 2 men) of the TOTs as we called them (for training of trainers) and spent some intense prep time with them because we wanted them, rather than us, facilitate the stakeholder alignment meeting that was planned for the Tuesday in the following week.  The purpose of this was not only to provide them with an immediate opportunity to put their news skills to the test, but also to show our audience that they now had a new resource in the country that could help implement the renewed attention to leadership and governance. It was a trust fall.

Chinese outing

My Ethiopian colleagues (both from HQ) had been talking about the Chinese restaurant nearby and took me there on my second night. It was a lovely walk along the beach where people were enjoying themselves with food, swimming and listening to good music.

The Chinese restaurant is located in a complex that includes a hotel, a casino and a restaurant, all decorated with bright neon lights that light up the neighborhood. The restaurant entrance takes one into a kind of alleyway, past the kitchen and a bunch of tables with people just sitting there; the smell is not encouraging. Large vats with liquid (water?) line this alleyway. It is clear we are not yet in the restaurant. This is hidden behind a simple door which lets one into a bright white and very cold room with more bright lights in pink and orange that flicker on and off. Another section is closed behind sliding doors. This is where the important Chinese hang out we assume. We see people going in with platters but never see anyone come out.

The place is frequented by Chinese who are drinking a white liquid in green bottles (when we asked the waiter what that was he told us ‘milk’  but we don’t believe him) and endless cups of green tea poured from an elegant copper tea pot with a long spout that makes you think you are in the Middle East.

The menu is provided in print form and on an iPad. We discovered Bull Penis with Old  Chicken Soup and other dishes that I remembered from our trip in China. We stuck to more acceptable dishes such as Chicken with Cashew, Spicy Beef and such and order too much. We had the leftover wrapped up and give it to the guard who lets us in the back door of the hotel grounds.

The food at the hotel is mediocre. A two week stay at the hotel would pretty much exhaust the choices and I tried most. Heavy on animal protein and starch, it was getting a bit tiresome, but two escapades to the Chinese were enough. I am craving the fresh vegetables that must be starting to arrive in the markets in Massachusetts.

 

 

Car, boat, bus, plane

I had used one of my ‘thank you’ rewards from Delta for my loyalty and countless trips. It is good for a one way upgrade to business class. It is supposed to get you all the way to your destination but the award program of KLM is not aligned with that of Delta, so when I connect in Amsterdam for the KLM flight the business class deal was over.

I was glad that I got the B-class seat as I was feeling increasingly lousy as I boarded the plane. As soon as we were airborne I put my seat into sleeping position and didn’t wake up until we arrived in Amsterdam. I kind of sleepwalked to the lounge in Amsterdam and slept there as well until it was time to board for Sierra Leone and then I slept some more.

I arrived around 10PM at the hotel in Freetown. The trip from the airport to the city is quite an adventure. I had heard about it (it involves a bus and a boat) but never experienced it. My Sierra Leone colleagues had given me detailed instructions and everything was exactly as described: someone with my name on a sign handed me a boat ticket and took me to the bus stop. I boarded the bus and gave my suitcase to an attendant. The bus drove for a while and then dropped us off at the beach where a simple concrete structure with plastic chairs served as our way station. We hang around until the boat returned from the other side of the lagoon and we filed on board, all 40 or 50 of us.

We squeezed into seats around tables as you expect on a yacht and the 45 minute trip started. It was all very congenial – for a brief moment we were a community with a shared goal: getting to the other shore and either to home or to our place of assignment. Total strangers started sharing why they were on the boat. It was really quite nice, and not the pain in the neck I had expected. It is true that the bus and boat trip added another good hour and a half to arrival time (and thus also to departure time), but if you are not in a hurry (and I had slept a lot) then it is OK.

The Radisson Blue in Freetown is, as it claims, an iconic hotel; I have been in other so-called ‘iconic’ hotels that didn’t seem very iconic to me (maybe they used the same advertising agency). The hotel has carpeted floors which I think is insane in a climate with 80% humidity. Everything was musty, a smell I stopped noticing after a couple of days. My clothes were also always damp.

Touchdown week

During my brief touchdown in the US I was kept quite busy on the preparation of the material for the next assignment, a just-in-time affair that would not have been possible if one of my young colleagues had not stepped in. I am very lucky to have all this young talent around me.

There is a proposal that needed attention and there was the tying up of loose ends from the Madagascar trip. But through all of this I was nevertheless able to enjoy the changed landscape around me: the trees are green again (they were bare when I left), the asparagus are out (eating asparagus for dinner several times a week), the peas are visible, the berry bushes are looking healthy and the apple and beach plum are gorgeous with their delicate blossoms.

I wrote my annual remembrance letter to B whose daughter, Sita’s best friend, died 16 years ago of an overdose. We planted the beach plum in her memory and called it Jennee’s tree.  The tree has shown staying power. It was uprooted when the new septic system went in; it was invaded several times by a destructive colony of tiny creatures, eating its leaves, and some of its limbs died. But it is thriving again and so we think about resilient Jennee in her second life as a tree.

We attended a lecture about ‘The House at Lobster Cove.’ A wonderful book that I could not put away. Although the title suggests the story of a house, it is actually the story of a very interesting man, George Nixon Black, who lived through some of America’s big upheavals at the turn of the 19/20th century. If anyone thinks we live in a time of great upheaval now, read some history books, especially of the 19th century. Americans burned Catholic churches, feathered and tarred people of the ‘wrong’ religion (priests) and agitated against the influx of Italians and Irish. This current preoccupation with foreigners and their religion is nothing new in America.

George Nixon Black commissioned his friend, the later famous architect Peabody, to design and build the house on Lobster Cove, named Kragsyde. Olmsted designed the landscape around the house. Axel’s grandfather, after whom he is named, was the gardener and is mentioned in the book. This is where Axel sr met Axel’s grandmother, who worked at the estate as a maid.

The house was an architectural masterpiece. Unfortunately it was taken down after Black died. There is no trace of it here at Lobster Cove anymore. But the speaker and her husband, as a young couple at the time, built an exact replica using the original plans on an island off the coast of Maine. It took them 20 years. We hope to visit it one day.kragsyde

And now the day of departure has arrived again. I am switching between playing with grandchildren and packing my suitcase, favoring the former. Sita had to work in Boston and brought the family to stay with us, a wonderful advance treat for Mother’s Day.

Brutes and tender(er)s

I was given the luxury family suite in the not very attractive looking hotel right in the center of the town of Moramanga, some 100 kilometers from Tana. It was very Chinesy looking and I am sure all the hotel decorations had been trucked in on one of those tractor trailers years ago. The Chinese and the Malgache have intermingled for a long time – they may have been the Chinese from Malaysia or further northeast. Some go back to the 1800s.

Some Malgache look decidedly Chinese. Unlike the Indiens and Pakistanis who some fear are now in a more stealth way taking over the country, the Chinese were and are rather quite open about their infiltration. There are major construction projects all over the place. They would do poor families a favor if they could fix route national 42!

I noticed how development here (and probably elsewhere) is both brute and tender at the same time. The brutish part is the Cartesian, mechanical, engineering-dependent exploitation of primary resources with a focus on gain and short term profit. And then there are the people who we met who sacrifice much (so much more than we would ever agree to sacrifice, we wimps); the young idealists from here and abroad who study trees and plants, the ecology, to ‘unexploit’ it, to reforest, replant, make healthy again all life, human and other; those are the people with the long horizon, who focus on the other bottom line, who are driven by care.

But, people will say, we cannot abandon the trucks and the containers because the goods provide livelihoods for so many people who come to Tana, and initiate the detail commerce from there on, fanning out to the next level capitals where commercants of an even more petite entreprise continue further down, all the way to the tiny wooden shacks in the villages that sell the fake plastic Barbie dolls (pink with yellow hair), the soccer shirts, the leggings and the cheap tools that came in from (probably) China.

And while all this driving to and fro is done, the trucks gouge what remains of the secondary roads so that the people who have the bad luck of living far from a health center choose dying at home over dying a horrible death on the road (there are no painkillers!)

The trucks also do terrible things to the lungs of the more vulnerable members of the population who live and toddle along the road, breathing in the fumes all the time, if they don’t get run over. Brutes and tender(er)s.

Sacrifices

I somewhat dreaded the long way back to our next interview which would be along Route National 2 that connects Tana to Tamatave. It would be first the ferry, 30 minutes this time because we went with the current, then another hour of the undulating sand piste, then another 3 hours to the main road and then another two hours west. We would arrive at sundown. And we did, also in the rain, at the next, and our last, health center.

The path to the health center was up a slippery red clay road. The doctor was running around, her white coat flying, as she was trying to induce an abortion of a woman who had walked 2 days while in labor. The baby had died inside her before she arrived at the health center and needed to be aborted to save the life of the mother. If only Trump and his prolife supporters would see this, I wished. I suspect Trump has probably never heard of Madagascar and couldn’t point to it on a map if his life depended on it.

While she was putting the traumatized woman on the abortion-inducing drip we talked with another woman who was waiting to see the doctor, 6 months old baby on her hip. She looked healthy as did the baby who smiled at us. It was her 11th child (she was 38 and had her first child at 16). The baby was called Sunday the 11th. She was here because the baby had diarrhea.  We asked about family planning. A woman behind her whispered in her ear ‘we don’t like it.’ ‘Husbands don’t like,’ corrected the doctor. They are not making good inroads on family planning yet. For now she concentrates on prenatal visits, especially the last one and delivery in the health center. She had reached the target she had set for her team. This was illustrated when we finally sat down in her office after she had seen the baby with diarrhea. By now it was pitch dark and we took notes with the help of our smart phones’ light.

The doctor had done what her higher ups only write (and dream) about:

  1. She mobilized community and local health personnel to contribute to the purchase of delivery kits – when women come to a health center and don’t have two bottles of water, a piece of clean linen, a clean shaving blade and more they are sometimes sent away. The kits are to keep this from happening – but some kits are accumulating where they are not needed and not available where they are, like here.
  2. She bought a blood pressure cuff (about 125 dollars) from her own pocket as the one at the center was no good anymore. She could not wait for a new one that might never come and couldn’t work without one. She does not expect reimbursement (things don’t work like that here).
  3. She mobilized the Commune to raise money and build four ‘cases d’herbegement’ places where the pregnant woman who is about to deliver can wait the last few days with her family so that she doesn’t have to walk for days while in labor like her unhappy sister on the drip in the room next door. We visited the two cases that were occupied with expectant families. Three cases are already completed and a fourth one is being built.

We asked what else was different since she completed the leadership program. She told us that she had never had an experience that gave meaning to the word ‘objectif’ (goal) until this program. She liked what it did to the team and is now also setting herself a goal to buy a piece of land and construct a house in Mahajuna on the west coast before the end of 2018. This will bring her closer to her vision of a happy family life. Currently her husband lives in the far southwest corner of Madagascar, about two days of travel (with a good car); her baby is with relatives in the capital. This means she is alone and on duty 24/7. She loves her work (which would explain the sacrifices). She  cares deeply about the women in her community.


June 2017
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