Sylvia's Journal

More calls, more negotiations, explorations of options, but all separate conversations, one-on-one phone calls, small meetings with key actors missing, not sitting around a table together. This is hardly possible as centrifugal forces pull everyone into parallel or intersecting orbits, never the same. If you’d try to map these orbits it might look like a drawing from an angry child; Separates that do not make a complete wardrobe; stuff not adding up. How anyone can concentrate on doing anything well seems like a miracle. Still, stuff does get done.

I have made a new proposal, just one event, to dip the toes into the water and try this new thing that’s not called a training program. I use the word conversation. It would be actually a series of structured conversations over three days or so with all the key actors of one program together. It would have to be the family planning program because of the funding source but it really doesn’t matter – it could have been any program. And all of the conversations would concentrate on where the rubber hits the road – where the services are delivered in whatever way they are or should be.

I remember from watching a video of Parker Palmer talking about medical education where he insists that the whole patient sits in the middle of the conversation – all the time; something like that. The way to get the – in this case provider-client interaction – in the middle of the conversation I would ask them to spend an entire day either shadowing a community or outreach worker on visits or working side by side with service providers in a health facility (health post, clinic or hospital). It will not be easy to actually organize this, but that is also a matter of finding the right people (it always is), who understand the concept and are excited by the idea.

I wrote a long email to the chief of the Health Services and his HR Director and ended it with a quote from Scharmer’s Theory U book: “On the one hand it is the experience of shaping something: that’s a source of empowerment. On the other hand, it is to see the context in which you and your colleagues work. That changes your view of the larger system. You learn to see the meaning of your work in the context of the whole (region, program). Seeing that larger whole and how you relate to it is empowering. Through your better knowledge about how the system works, how the region (or program works), and by getting to know [all these] people you end up having a different access to making things work – things tend to flow more effortlessly.” (Since I read him on a Kindle I don’t have the page number, one Kindle flaw for people like me who are always looking for quotes.)

Although I am not entirely sure how this will come together I know for certain that this idea will produce the desired outcome: a small group of people who see the potential of such conversations and want more of them, with more people. I dare to stake my reputation on that – if only given the chance. I have done something like this before, nearly 10 years ago in South Africa’s Eastern Cape with the entire top team, led by its energetic chief. Not much came of it I believe because soon after the outing the chief died at the young age of 51. In the midst of paying attention to everything and everyone else he was not paying attention to himself. He died of a heart attack. Since then, when asked “what is the most important thing for leading at the top?’ I always say, “stay alive.’ After all, no matter how good you are as a leader, as a dead leader you are no good at all.

And now, onwards home after a brief catching of breath and buying of cheese in Amsterdam.