A rejuvenated (vaccinated they call it here) Liz joined us as we set out to the town of Nazareth (or Adama as it is called as well) to a zonal health office. Although it was not a long trip (from 7 AM till 1 PM), it did take the wind out of us and after our return to Addis we could have done with a nap, but we had more meetings and did not get back to our hotel until 5PM. The nap was inevitable then, a full hour long pre-dinner snooze.
Our visit with an expert in the Family Health Department revealed to us some of the headaches that form part of his daily life. We had to coax it out of him as he told us at first we had the wrong man and he could not provide us with answers. Since he was the only one around he had to be our man and we ended up getting a flavor of what he is up against, further informing our design.
The work environment of many offices looks rather chaotic to us outsiders, with piles of file folders, boxes, large computer sets stacked on or between multiple desks. Outside, a department that used to share the premises had moved out and left behind several large cannibalized generators, rubber tires and an assortment of rusted tools and bits of machinery that made the courtyard look more like a junkyard than a health office. Our host noticed me taking a picture of the mission and vision statement that was written on a board amidst the junk and old tires. He was quick to explain who owned the stuff and absolved himself from any responsibility. We left it at that.
There is a certain fatalism that accepts such disorder and chaos as inevitable and irreparable; the powerlessness weighted on me with the kind of force that causes an instant depression. Although not everyone is busy, I did feel sorry for the people who are. The people we met all seem to be working on their own, fighting their battles in a despondent and unquestioned isolation. Many obstacles appear impossible to overcome as they involve resources and thus require dealing with issues and practices that are either political or unethical or both. When allusions are made to this there are always shrugs or some nervous laughter but never the indignation that could fuel action for change. People may write letters to show they have tried to unclog channels but I don’t think they do it with any expectation of a resolution; it is more of a going-through-the-motions response, you have to do it. All this creates new crises as people give up and leave for better jobs elsewhere. This is called brain drain – another intractable problem that is portrayed as unsolvable by many.
Next on the agenda was a search for data on which to base the selection of our target zones. It was an informative wild goose chase that had us referred from one office to the next, seeing a total of 8 government officials and some retracting of steps before we got something that wasn’t quite what we wanted but the best we could get. The latter came not even from government workers, but from a duo of expert-coordinators seconded by a private agency like MSH.
Our final meeting was with our MSH colleagues, who work on different projects, to make sure that what we propose will enhance rather than detract from what they are doing. We are supposed to be ‘One MSH’ even though we do very different things. But then again, management and leadership is relevant to all and we believe that it will solidify our ‘One MSH’ here in Ethiopia.
After an Italian dinner downstairs with food that was too rich for our own good, we dragged our tired bodies upstairs and finished the powerpoint we will deliver tomorrow to our funder. Good enough for now was the operative word that ended our 13-hour workday.
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