Sylvia's Journal

Our weekly meetings with USAID and our weekly call with Boston make Tuesdays and Wednesdays into 11 hour days. The pace is intensifying. We are gearing up for gearing down. In 13 days we will be in Dubai, on our way home via Atlanta. Before that much has to be finished or started.

The joy of today was seeing our provincial health advisors (PHAs) during their quarterly meetings at our main office. I have known some of them for some time. The first time I saw them in a meeting together was more than one a half year ago. Many are still there; one has become a provincial health director, the representative of the minister of health at the provincial level. He has taken everything he learned during his time as a PHA to heart (or Herat for that matter). His PHA tenure was like training wheels on a bicycle. He is now running a tight ship with a wonderful team, one of our model provinces.

Our job is capacity building which is hard to measure in the short time spans that evaluators give us. And so, more often than not, people count the number of workshops given. This is something that irritates people who are looking for impact and it sometimes irritates me. But what I am seeing here is the cumulative effect of many workshops given to the same people over time. This is usually something that is frowned upon: why train the same people over and over when others should also have a chance?

What I am seeing more clearly now is that by giving many workshops to many different people we dilute the impact to such an extent that there is little to show years later. The provincial management support strengthening program on the other hand is highly focused: a small group of people is trained, coached, mentored, ‘refreshed’ as they call it here, over and over. It may be a significant investment (although compared to the military bill it is small change) but the payoff is visible now.

We did after action reviews with them to see how the planning for health emergencies has paid of with the arrival of H1N1 – it looks good. We are also looking for what was there to learn from the handover of contracts from one NGO to another, not an easy task because there is money at stake, livelihoods, and reputations. Once again, given what could have gone wrong, I am deeply impressed to see how much didn’t.

But maybe the best thing is that the facilitation techniques that I and other colleagues first modeled years ago, to an audience that knew only about powerpoints, and bad ones at that (too many, too many words per bullet, bullets per page and letters flying in from left and right) are now part of their repertoire. They have become facilitators. That is probably the most rewarding thing of all. The confidence is enabling them to be at ease with soliciting opinions from the group, even when they are controversial or counter to their own views. As far as that part of my previous role as consultant is concerned I have worked myself out of a job.

My new job is very different and requires me to practice what I have been preaching for a long time. That it is all actionable knowledge I can now say with certitude as a practitioner. I have my eyes (as well as the eyes of my superiors) set on the most senior ranks in the ministry – a place that generates much fear although few people actually realize that. It’s a journey into the unknown past a set of doors that are barely open.