Sylvia's Journal

I had my last morning of leisure before the work started with a visit to the ministry of health in the afternoon. Government officials have Thursday afternoon and Friday off while our MSH colleagues have Friday and Saturday off. Dr. Ali picked me up at the guesthouse after Steve, Maureen and I went for a quick visit to Chicken Street which was off limits last time I was here. Steve took us to his carpet man Mr. Smiley who smiled indeed when he saw us come in, knowing that Steve cannot leave without buy adding something to his collection. I went there naively not planning to buy anything and then got seduced into getting a rug, a large shawl and some embroidered belts – which left me in debt to Steve and with just a little of the American cash that has to see me through my two week stay. But I suspected it might well be my only free time and I did not want to have any regrets.

I met my various counterparts and clients at the ministry. We came in through back door because the main entrance is now off limits after the Ministry of Culture was invaded by armed men with sinister plans, who wrecked much havoc some time ago. In 2006 the main entrance hall was newly painted and looked as nice as a cavernous entrance hall of a government building can look. The back entrance was not pretty and as a believer in pattern language, had all the wrong patterns: those that suck energy out of you when you enter rather than inspire one to do the difficult work that needs to be done.

Much of the conversations took place in Dari. As a result my interactions are sometimes like one big trust fall. I wished I spoke the language but I am never here long enough to engage in serious study. I know I miss a lot as a result and when I speak in English I also know that much is missed. But somehow, something gets across and we get on with the work.

That work consists of three events that have to produce lasting outcomes, measured as engagement and implementable plans to roll out the leadership program in ways that will maintain quality and an emphasis on measurable results such as safe deliveries, family planning, vaccinations, TB detections, etc.

The DG of Health Services sketched out the enormous task before him and the pressures he is under. He asked for help getting his team in gear to support him in pulling something off that seems rather impossible at the moment. He knows what he is up against. Over the last few years he crisscrossed the country and reported on the enormous gaps between policies made at the top and the daily realities way out in the countryside; the grocery store owner who only had a bag of 7 kilos of sugar which had been untouched for over half a year because no one could afford to buy; the empty orchards; the curative health professionals who looked down on anyone engaged in preventive public health, essentially an exercise in producing non-event; a hard sell in any part of the world, but especially here.

The city was busy by the time we left, with everyone else trying to get home. Our driver followed a convoy of VIPs which got us swiftly through a jam packed square until we told him that we preferred being stuck rather than being in the wake of a potential target. Once never knows here and so we melded back into the crowd of honking cars and undisciplined pedestrians. Despite the threats and the occasional real scares, life here goes on as it does in any other chaotic and conflict ridden place. People have to earn a living and buy their food. We remember that from Beirut.