Sylvia's Journal

All morning we discussed the support functions of our common operations management unit, things like procurement, HR, finance, security, transport, housing, etc. Two people have come from HQ to see what is going well and what needs to be improved. It was a chance for them to hear directly from those being served and those serving. We are after Management Sciences, so this is a matter of pride, of good stewardship and of security, among others.

The afternoon program was a visit and meeting to the children’s hospital. We were early and had a chance to check out how the triage is working. The changes in three short weeks were phenomenal. The resuscitation room is now working so well that the dreaded assignment to the emergency ward (‘too much work’) has now become a desirable assignment (‘a place where much can be learned’). The various chiefs told stories about kids now saved because of the quick action and the functional resuscitation room.

On the down side, every up appears to come with a down, we are having a hard time getting some of those who ought to be doing the monitoring and checking to do so in our stead. It is the same old problem, encountered in nearly all our counterpart offices that are thinly staffed and with not enough of the technical skills that are needed, to avoid having the blind (or one-eyed) leading the blind.

There are other problems that have to do with the private practices most doctors have in the afternoon – to supplement their meager government salaries. This makes it hard to get people to travel along to the provinces.

While we were in the emergency ward I watched one bloodied and screaming kid after another enter the place, carried by an anxious parent. When we saw one of the guards leading the kid to the resuscitation room we knew that the training had taken; a victory. The guards at the entrance of the hospital have learned who should go straight to the emergency ward (and where) and who can stay in queue. The queue was the place where, until their training, everyone went, even those whose lives were in jeopardy.

Most kids brought in were victims of traffic accidents. In my year and a half here I haven’t witnessed any kid getting hurt in a traffic accident but being at the emergency ward for half an hour made me realize they do happen all the time which is actually not a surprise.

Back at the office, after an uncomfortably hot car ride back, I put the finishing touches on our proposal for a one year extension for review by Boston where the day had just started.

And now I am working on a slide show of 40 years of MSH in Afghanistan. I have solicited pictures from people who were here at different periods during those 40 years. I received many positive responses to my request – getting pictures with people on them who I don’t know. It is both fun and a lot of work.