Sylvia's Journal

The national health coordination warrekshp (this is how the word is spelled and pronounced in Dari) is held at the glitzy Safi Landmark Hotel in downtown Kabul that stands in sharp contrast to its surroundings. It is considered a pretty safe place even though important people congregate there. It has the kinds of glass elevators that ride up and down the sides of a 7 story atrium, just like the big chain hotels in the capitals of the world. It also has a mosque on the 7th floor so prayer breaks can be short. At the bottom of the atrium is a real coffee bar and sparkly stores with expensive toys for grownups. Some of our colleagues who work on another project stay there. I am glad I am not. I much prefer our homey guesthouse and its interesting inhabitants.

I was glad I was not responsible for the conference that started yesterday. It had all the usual glitches that happen when you invite high level government officials who do not show up at the appointed time because something else pulls them away. I was sitting next to someone who was responsible, a half Greek, half Italian, French speaking and Afghan looking woman who represented one of the three major donors who had paid for this gathering. We had a good time together, me providing perspective while she sailed with clasped hands and a good sense of humor through the ups and downs of the conference’s beginning. In the end everything worked out, as things often do that we obsess about.

The high official eventually arrived and exhorted everyone to do their best. He also paid homage to fallen comrades, some 45 doctors, both female and male, who had been slain in the line of their medical duty over the last year, mostly in the areas to the South and the East of Kabul. Four had their portraits displayed. They all looked sad, as if they knew what was in store for them when the pictures were taken.

One of the director generals showed a video of a trip in winter in Heart province (it should really say Herat Province but the built-in spell checker always changes it to Heart). It is amazing how snow covers all that is not pretty. The video footage of SUVs driving (and being stuck) in snow could have been taken in Massachusetts, except for the part where doctors treat patients right from the back of the truck or the passenger seat with crowds of mothers standing in the snow and holding their babies up for examination. There is much writing of prescriptions going on which is, I am now learning, the essence of medical practice here. I am learning so much each night around the dinner table that I think we should be sending anyone working in public health to one of the guesthouses for a thorough induction into the profession and learn about the difference between theory and the real world.

Steve and I did not stay the whole day for the conference. It is expected and good form, as foreigners, to show up at openings even if a conference is in the local language. When the opening takes place in the middle you end up attending most of the day. By the time the conference was officially opened it was nearly lunchtime and so we stayed to partake in the very classy meal that was offered to us by the World Bank, the EU and the American People. It was a few notches up from our guesthouse food; given the cost, it should have been indeed.

The first part of our session is today. The session had no name other than ‘organize for group work.’ I think that is because people know that is what I will do. I proposed a more appealing name (Towards aligned and concerted action for better health). It is placed at the low energy hour of the event, after the mid afternoon tea break. Whether it will actually start then assumes that everything else will go more or less according to plan. Dr. Ali is mobilizing all his colleagues to help facilitate the break out groups while he will lead the session. I will hover on the side, may be occasionally mouthing the words ‘focus.’ The session is so designed that it should hold the conversations and create the container in which ‘us versus them’ can become a ‘we.’