Sylvia's Journal

Once big change from my previous work is that I am now a director. I direct others to do the work I used to be myself. There are now many Afghan facilitators implementing the Leadership Program here and in the provinces. It has been a while since I was directly involved in one or even observed one. And since it is all done in local language I have no idea how much it has drifted.

And so today I decided to accompany my Afghan colleagues for an alignment meeting with hospital directors as part of an effort to improve hospital performance in the capital city. This sector has been neglected too long and people realize that a significant proportion of the politically active or literate population lives in Kabul and other urban areas. For them hospitals represent the face of the ministry of health, or the government. And this is a face that’s not good looking at the moment.

Two hours before the meeting we heard that the general director for hospital services couldn’t come as he was called to the Salang Pass where hundreds were killed and thousands stranded because of an avalanche. The stories emerging from this catastrophe are horrendous and the response from the government came too late for too many. Emergency preparedness mostly exists on paper, as plans developed at the central level with help from consultants, but implementing them is a bit more chaotic, lethally chaotic.

One hour before our meeting the event was back on – it was after all a regular hospital directors’ meeting that happens every week or month, and life goes on, even with hospitals on standby to receive avalanche victims.

Then, as were approaching the venue for the meeting we received a call that the meeting was off again but we continued anyways, pleading with the Director for Hospital & Curative Services to not cancel the meeting even if she couldn’t be there.

Of the 30 expected people some 12 trickled in during the first 45 minutes of the meeting. Without any presence from the government we are always in a bind – should we take over their functions or drop the ball? We decided to step in and play ball. My staff conducted a shortened version of what was supposed to be a 2 hour alignment meeting and an orientation to the leadership program.

What I observed had strayed a bit from the original design. Always, when time is shorter than expected (a normal occurrence) the tendency is to shorten the experiential exercises and revert back to feeding people concepts from handouts or powerpoints. Still, the meeting had its desired effect, creating enough of a pull for the leadership program that we will go ahead with the first or five teams, later this month; one step back, two forward.