Posts Tagged 'Cote d’Ivoire'

Almond-shapes

I spent three days with malaria experts from Africa and one team from Nepal, our own MSH advisors who brought along their government counterparts.  It was truly a united nations. United about the goal of eradicating malaria and about 20 different nations represented. In addition there were a few representatives from our competitors who, in this case, are also our collaborators. They will be taking the baton when our project that has provided the funding so far, ends in September. This is to make sure the transition doesn’t hurt the women and children who need to be treated or protected from malaria. It is an act of synergy and collaboration that is not all that frequent (outside partnering on a bid) in an otherwise very competitive field.

For three days we did not talk about malaria, or very little, but rather focused on the human harmony or disharmony that helps or hinders the work that needs to be done. This is of course entirely in line with the original founding philosophy of MSH, which was all about the unnecessary suffering and death as a result of poor management and leadership (and governance which was added later).

Our doctor experts, and their counterparts, are both causing and suffering the consequences of not understanding human dynamics. They know the theory and focus all of their attention on what others are doing wrong. It is a familiar refrain: the politicians, the senior leaders, the donors, the villagers, the healthcare providers…one or the other or all are doing things entirely wrong and so they need to be put on the right track. There is a lot of preaching and wagging fingers and doing it harder and louder when the hoped for result stay out.

For three days, in this coaching and communication workshop, I exposed them to everything I have learned over the past 7 months about the neuroscience of getting people to work better together, share, expand, appreciate, create a climate of trust, develop, celebrate and include. The term is to ‘up regulate’ those and down regulate the criticizing, the excluding, the judging, the withholding, limiting and dictating.

Although most of the people are doctors, they know little about the brain (little of the little we know about the brain), and so for a change I was the expert. Since the workshop was in English and French, with simultaneous translation, I switched between French and English in order to give one group and then other a break from the very uncomfortable headsets. On the third day I noticed some confused expressions on the faces of the French speakers. We had talked a lot about the limbic system and the amygdala. As I discovered, the word amygdala comes from the Greek word for almond, as the amygdala are almond shaped. But there is another part of the body that is also almond shaped, the tonsils which, in Dutch, German and French uses the same Greek derivative: amandelen, Mandeln and yes, indeed, amygdales.  And so, all the time I had been talking about the amygdala, they were wondering about tonsils. In my coaching course I have learned that ‘words means worlds.’ So very true. I was glad we had cleared that confusion up before everyone went home.

Sixty-ish

The last afternoon in Abidjan I checked out a new ‘residence,’ because all the previous places we stayed were not good value for money. But this one was. I had a ‘studio americain’  which was more than good value for money. The place is near the office. There is an American dinner (the O’burger) and a patisserie around the corner. It also has things I never use such as a swimming pool, workout room. The best feature is the terrace on the 7th floor from where one can observe traffic jams in all directions, while sipping a dark rum or a ‘sex on the beach’ cocktail, underneath an artificial cherry tree which has blossoms that light up once the sun goes down (it does require electricity).

I finished my reports and packed up for our return trip to Paris first. The driver had called an hour before our agreed upon departure time that he was already waiting for us below. What he did not say is that he was waiting for us at the Ibis hotel that is on the other side of town. This we discovered when we were ready to go and he was not there. The mix up had us arrive at the airport a little later than we had planned, just about exactly the same time that all the other 1000 passengers arrived to fly to points north and east.

The plane was full again with babies; maybe they were the same babies as on the way out. Some slept, some cried and some did a bit of both. We left late which made for a mad dash to catch my flight to Amsterdam, requiring endless long walkways, a shuttle, check points and other obstacles.

I did not want to miss the flight since I had paid 140 Euro for a B-class upgrade, seduced by the words “offre spécial.” I thought it was special indeed; imagine that, an upgrade from Abidjan to Amsterdam for only 140 Euro! It was early in the morning, my brain not fully awake and my ignoring my intuition saying “too good to be true!”

It was of course. The upgrade I had just purchased was only for the 50 minute flight to Amsterdam. I got to the gate just when it was closing, the last person on board. I collapsed in my chair, a regular economy seat but with a guaranteed empty seat between me and the person at the window. The economy row in back of me also had only two people with one empty seat between them. And so there was nothing else to do then to enjoy my 140 Euro breakfast: a sliver of salmon, two pieces of (nice) cheese, a croissant with “fresh Brittany butter” and raspberry jam in its own little jar, a few spoonful’s of something in between yogurt and crème fraiche and a cup of coffee. I enjoyed every little bite and licked my fingers to not miss anything of my most expensive breakfast ever (the Meridien hotel in Dubai comes in second with a 75 dollar breakfast but it had a lot more going for it).

And then I was in Holland again. I took the train to my brother’s house, just in time to see him spent his last two days as someone who can still say he is in his sixties.

Le kilo

The 500-page French-language instruction manual for our leadership program is called ‘le kilo’ here in Cote d’Ivoire. It was a comment I believe I made three years ago when we started and I apologized for the hefty tome that we handed out to the would-be facilitators. We laughed about it. Now it has become simply a reference to the instruction guide; people use it with a straight face, no longer a joke, just a word for a thing. I had to laugh when, during the practicum, someone said, they didn’t use their ‘kilo.’ An outsider would not  understand what this referred  to.  One of the slogans in my current coaching course is ‘Words mean worlds.’ Indeed.

We had a full day of practicum sessions yesterday. Because the group is so large we have split in two. I am observing one region in one room and my counterpart is observing the other region in the room with the race track table.

The two regions are represented by, respectively, 8 and 6 district teams. The plan is that these district representatives, who are themselves participants in regional leadership training that is far advanced, take the program one level down. After this training each district team will conduct the leadership development program in their districts, much like the ones we observed last week in western Cote d’Ivoire.

The practice sessions I observed took place in a small room with four air conditioners that did not work very well. It was hot and humid, and in the afternoon, when the hot sun tried to get through the curtains and everyone was busy digesting a heavy lunch, the teams struggled. But this is the reality they will be operating in when they go back: seeing the participants in the program they will lead after lunch in rooms that won’t be as fancy as this one, which by the way is not all that fancy.

Harvest time

I have a different role now in this kind of ‘technical’ work as we call it at MSH. In the past I would be busy 15 hours a day, thinking, planning, goading, negotiating, giving feedback, preparing. But now all this is done by others. I have handed over the baton and it has been carried around the block several times, without me lifting a finger or a foot.

I had not thought a lot about this but this is of course how it should be: working oneself out of a job. What I also had not realized that moving further away from the action (on the balcony as Ron Heifetz would say) allows one to reflect while taking in a much bigger landscape.

And reflecting I do. I have time to read and reflect and connect. I have time for slow conversations with people, driven by curiosity rather than some force outside me that wants answers. I love it.

In short succession I wrote 3 blogs for my own page on our intranet. I have no idea who will read it, I have a just a handful of followers, but it doesn’t matter. It’s like a storage place for ‘aha’s or ‘déclics’ as the French call it. I will post some here as well. Stay tuned.

Marvel

Monday morning we had a brief meeting with the project director who just returned from his vacation, about our adventures in western Cote d’Ivoire. I produced a slide show with the main observations, mostly good. I congratulated him and his team on what they have created in that part of Cote d’Ivoire that is often peripheral to where the action is.

My colleague R. treated us to a wonderful lunch: grilled fish, a paste made from plantains and Atieke, two local starches. The paste looks a bit like playdoh but tastes better. The sauce was made from the peanuts we bought on Sunday. It is a little spicy, like the Indonesian satay sauce, and very filling. Because of that it is usually eaten at home,  at lunch or breakfast time but not at night.

And then we took to the road again, this time closer by, to a town called Adzope, just 100 km north of Abidjan. It took us a small two hours. We arrived at the ‘luxe’ hotel where we launched the very first workshop of the leadership development program in May 2014. This is why am I am here: to observe our leadership development program that has been cascaded down. Now third and fourth generations of trainers are preparing the next generation to take the lessons even closer to the base. I kind of lost track of the many generations and branches that emerged from that first leadership development program all those years ago.

Once again, probably because of my white hair, I got the royal suite. It is called the ‘Suite Merveille’ (wonder or marvel suite), where I stayed last time as well. It has a bath with the same faucet arrangement I marveled (indeed) about when I was here last: the faucet doesn’t extend all the way inside the edge of the tub and thus, when the water is turned on, it splashes in all directions except into the tub. No one seems to have bothered to change the arrangement. This is Africa, improvisation in the face of adversity to the Nth degree, even when this adversity seems to me such an easy thing to change. “Ahh, c’est la vie!”

We are in the same heavily draped room with an enormous, un-moveable boardroom table that looks like a race track – an elongated oval with a space in the middle. It occupies a good part of the room. It sits about 35 to 40 people around. But we are 50. Away from the table is a second row, consisting of well-worn auditorium chairs with small writing tablets hidden in the arm rests.

I remember the panic when I saw this room three years ago. It is so completely contrary to what I then thought we needed (and could not do without). Now, 3 years later I don’t panic anymore. I know the process carries itself even if the space is unsuitable. It is no longer my problem (ah the joys of ageing!) and the facilitators can draw on their own experience to make the space work, as we did last time. They remembered, placing extra chairs on the inside of the oval, making small group work possible.

Containment

Yesterday we completed our sweep through one of the regions in the western part of Cote d’Ivoire. We sat in on the last session of this round of the workshops in the leadership program at the hospital of Bangolo. We were seated on brightly colored plastic chairs in a small standalone meeting room on the hospital grounds. Here too there were no tables, though some people used another chair for that purpose. This team, which included two women (unlike the previous group), was made up of the hospital director, someone from the ministry of sports and youth, an NGO leader, a midwife and a couple more hospital staff.

There is a way of applauding, all across Francophone West Africa, that starts with a shout ‘clap one,’ at which command people clap once, followed by a ‘clap two,’ and then ‘triplet’ (pronounced the French way). People clap three times in unison and with their hands send the last clap to the person who merits the applause. This person then accepts the clap by bringing his or her hands, full of the clap energy, to his or her heart. In the first group we attended on Wednesday, they even had assigned a focal point for these ‘triplets,’ who periodically shouted out the commands. The second group we observed had little of this and the third group did a triplet just about every five minutes. It can get a little bit stale after hearing dozens of triplets, but no one seems to mind.

I was quite pleased with what I observed the last three days. The facilitators were trained by the people I trained back in 2014, and most had entirely internalized the concepts and tools they were sharing. The three teams are working on the containment of infectious diseases outbreaks to keep them from becoming epidemics; it is small scale and small victory work right now but that is because they are practicing new ways of managing and leading as they go along. The hope is that after we are gone, they will have changed the way they lead and manage and can tackle larger problems.

The team in Guiglo focused on bringing deaths due to meningitis down to zero; the team in Duékoué was looking at neonatal tetanus and the team in Bangolo focused on rabies. I remembered a district in Afghanistan that had followed the same leadership development approach and also focused on rabies. They were able to bring the number of people coming into the hospital with rabies to zero by getting rid of the dogs that carried the virus. They did this by engaging multiple stakeholders to work together on this public health threat. I am sharing their Challenge Model with the group here – as they are not focusing on the dogs themselves, which they probably should. In Afghanistan it was the lack of environmental hygiene in the market and around slaughter houses that had led to the rabies outbreak

We had our last meal at the same place we have eaten every night – grilled carp and atieke and a salad with, every day, less and less tomatoes and more and more onions. We are now buddy-buddy with the waitress, Estelle, who was dressed in long white and gold trimmed gown, an outfit fit for the Oscars. Maybe because it was Friday night and payday just happened a few days ago? In her gown she dragged small tables and plastic chairs to accommodate our wish of not being too close to the disco that we assumed employed her. The playlist was fabulous but better at some distance. She served us our drinks with a smile and entertaining conversations. When we made moves to leave she kneeled before me and extended her arms, a respectful way of saying goodbye to an elder, which I am in this part of the world . She called me  ‘mamie’  (grandma), which I am also.

Amenities

We observed the first day of the three day workshop that is the second in a series of four. We met in the same meeting hall that had been re-arranged, to my great delight, with a circle of chairs in the middle. I had introduced this notion to others some time ago, as a much better way to meet (one cannot work on a computer or check a cellphone when sitting in a circle without tables). The idea had trickled down to the next generation of facilitators. It was a new combination of faciclitators and participants, and so a bit stiff for the first part. But eventually thaw set in and the conversations became more animated and the learning began.

Having a workshop that is held, quite literally, in the middle of the hospital, is challenging as participants can be called out at any time for an emergency. The facilitators were scratching their heads on what to do about it. I suggested they stop scratching and give the job to the participants. That is after all the team that is supposed to learn about leadership.

The facilitators create a village and the group selects the name of the village, appoints the chief and notables, a ‘conscience horaire’ (time keeper), a treasurer for the fines that late comers have to pay, etc. The norm setting is a well-worn ritual all over Africa and has little to do with the behavior of people. This version, which I have only seen in Cote d’Ivoire, with its village and chief was at least Africanized. But it did have an entire enforcement system that I thought was too much like the way things are here with the emphasis on extrinsic motivation.

And then, like all the other norms I have seen over my career, immediately ignored. The only part that was respected was the role of the village chief, both as arbiter of divergent opinions and to open and close the day.

The leadership work that we do, and which few recognize, is about awareness. I believe that if you are not aware you cannot make choices. And so I pointed out that they had created a new norm, by ignoring the norms they created, and that was that norms don’t matter and that there are no consequences for breaking the norms. And now that they were aware of this they could either throw out the norms or find ways to stick to them.

At 4 PM the session was over and we drove to the next town and a new hotel. This one also had no power and also no water. It may be hard to imagine this, from one’s comfortable vantage point in the US (or Europe, or fancy hotels everywhere) that a hotel could run without water and electricity. It reminded me of my first month in Beirut, in 1976, after the fighting had stopped. We stayed in the Mayflower hotel and ate our peas and rice in the dark.

I was given the royal suite. A comfortable suite of rooms with an enormous bed, and several amenities that were useless because there was no electricity (two aircos, two TVs and a refrigerator). The bathroom was nice but without running water not usable. All would come back in due time we were told.  Insha’llah, I murmured. But water and electricity did indeed return and I slept comfortably and took a hot shower in the morning. The latter had to happen before 6AM because after 6 the water would be gone again until 10PM. One learns to adapt.

We ate with our colleagues on the side of the road, grilled carp, an onion tomato salad and hot salsa and atieke, the local starch, washed away with a cold beer. Life is good.


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