Sylvia's Journal

I am now walking around without crutches, or sticks as the Afghans say, a literal translation from Dari where crutches are called ‘sticks of wood,’ which is what they usually are, if that.

In the morning when I get up my ankle feels great. I can even walk without my orthopedic boot on, nearly normal two-legged again. But by the time I come home from a day of facilitation my ankle is sore. My improvised icing device is a small bottle of water that I put in the freezer in the morning and bind around my ankle when I come home.

The nerves are still in disarray – touching some part of my ankle produces small electric shocks while other parts remain without sensation. I am beginning to suspect that some of the three deck screws damaged the nervous system – hopefully not permanently but I know that nerve damage heals very slowly, if at all. For now both of my feet have compromised nerves – a daily reminder of the crash.

At night I prop my foot up on a pillow next to the ice bottle and that is how I fall asleep. The sore ankle urges me to go to bed early, sometimes as early as 7:30 PM. This means I am making very long nights, 9 hours sometimes. I follow my body’s instructions, assuming it knows best.

At the guesthouse the cast of characters changes nearly daily – some Johns Hopkins professors arrived to teach hospital administrators while our TB team is on its way out; the DHS reconnoitering team will leave after the weekend and a batch of pharmacists will take their rooms. I am the constant, at least for another week when my 5 weeks are up. A week from now I should be making my way to Dubai, incha’allah.

We completed the section of the workshop focused on getting people familiar with the content of the new and improved leadership development program. It was a hard nut to crack, to cover 491 pages in 3 days. The best I could do was to reduce the sense of intimidation people may have felt when they were given a bound copy of the thick facilitator guide. I wanted them to make friends with the hefty tome. Some got too intimate and the poorly bound document fell apart – a sign of things to come?

All of today consisted of practica – twelve pairs of accomplished or would-be facilitators selected a 45 session each and then, in three simultaneous sessions going on in three different parts of the conference floor, facilitated their peers. The last 15 minutes were spent on feedback.

Again, much was done in Pashto and Dari but I got the general gist of the feedback and it was good. One set of session instructions (on priority setting) suggested to ask the women in the group to list the desirable qualities of a husband. The teaching notes says “ask the men to sit on the side and observe.” The two rookie facilitators were puzzled about this exercise (the lone woman left after lunch) and it took a bit of back and forth to change the exercise and ask the men what qualities make for a good wife. The group brainstormed the qualities and I was pleasantly surprised that education came first, then religion, then beauty and lastly wealth.

My Afghan colleagues pretty much run the show now, with the most senior (and my former direct report) taking the lead. I want the team to be able to run this workshop again (and they can) at a later time as repeats are needed: someone’s cousin died and he dropped out; another was sent to Iran on a moment’s notice and left after day 1; another had to wait three days for a plane to take off from Herat because of heavy snow fall (it was exactly 9 years ago that three of my young colleagues perished as the plane they travelled in from Herat to Kabul should have stayed on the ground).

These dropouts (and some drop in again) challenge our certificate rules. Our facilitation team agreed yesterday that the cutoff line to receive a certificate of attendance would be a minimum of 3 days of attendance; a very senior doctor is pleading with each of the facilitators to make an exception for him as he missed the first three days through no fault of his own. But we simply cannot grant a certificate of attendance when there was no attendance. Our compromise is to create a special certificate for him that indicates attendance at the two days that he will have been with us. We will sign it ourselves since it’s too late to go through the government circuit of signatures of a higher order. I am not sure whether this will be acceptable to him but it will have to do.

Just like yesterday day we continued to spend more time today than budgeted for each and every session. Yet no one but me seems to care, at least not now. However, I know that at the end when filling in their evaluation people will say (a) we needed more time (true, we always do) and (b) the facilitators didn’t stick to the agenda.

In small groups the participants simulated sessions they are to conduct in the future with the authorities in the provinces and those who have to oversee the technical quality and serve as coaches – a new concept. I circulate muttering to myself ‘trust fall, trust fall,’ and summonned my Afghan co-facilitators to pay attention to the conversations in the small groups to make sure people are learning the right things from their practice. But my co-facilitators are a little like mercury, rolling off in this and that direction to attend to various other things that come up – some urgencies that popped up without warning as well as those that were not urgent months ago when we discussed the program by email.

I introduced the concept of getting out of one’s comfort zone and today they did. There was great unease about having to discover things for themselves rather than have everything spoonfed via powerpoint presentations. I told them we do that with babies but they are not babies – a metaphor some understood and liked (they grinned and nodded their heads – these are the people I have worked with for years); others may have been insulted by this simile but I will never know.

There is a degree of learned helplessness that we, the providers of technical assistance, have created ourselves. If you are told often enough that you don’t know things then, surprise, you don’t think you know things and need to be fed with a spoon.

The venue of the workshop is one of the specialized hospitals in the city. This is a Russian heritage – specialized hospitals. Kabul is full of them.

When you cannot come in through the side door (arriving before 8 AM) you have to go to the backdoor. There doesn’t seem to be a front door. The back door leads you into the hospital, up the stairs where some of the wards are. Men and women mill around, surprisingly, but I assume the wards are segregated.

The place is dark and dungy, not a place I’d associated with healing. The floors are dirty, there are hundreds of cartons stacked against a wall and it is hard to distinguish between hospital staff, patients and visitors; a few white robed figures are, presumably part of the staff but I cannot tell whether they are aids, nurses, doctors or technicians.

To get to the conference room and the offices of our staff a locked gate has to be opened. Behind the gate the paint is new, there is a carpeted runner and a large very warm conference room which is my home for this week.

There is a bathroom on the hospital side of the gate that is is also used as a kitchen. On our side of the gate there is a very clean woman’s bathroom but not one for the men, surprisingly. Maybe, when the gate was installed one of the bathrooms became all purpose.

Our women’s bathroom has three stalls – on the inside of each stall someone wrote in black permanent marker, and in English, ‘woman’s bathroom’ with the number of the stall (1, 2 or 3). It is not clear why it is on the inside rather than the outside; the latter may have discouraged men to go to the women’s bathroom and look for their own. Once they are inside the stall the message comes too late.

I went to bed at 7:30 PM after a quick meal and after re-adjusting the program of day 2 to accommodate the reality of everything taking about twice as long as I had expected; a time budget that I thought was already amply padded. I now see that I had forgotten about what one can realistically do in 6 hours with a group of about 25 people.

Before collapsing into bed I needed a Faro fix and was able to talk on Facetime with Sita and Faro who were on their way to buy a new car after the old one collapsed on the Mass Turnpike. Faro wasn’t too excited about the new car expedition, reminding his mom he wanted to get out of his car seat and play. I agree, playtime should trump everything when you are 20 months old.

To my great surprise the large conference room at one of the Emergency Hospitals where we are holding this week’s workshop was set up with a circle of 30 chairs in the middle and around the outer edges doubled-up desks to accommodate group work. I had sketched it out but because it is not your ordinary room set up but this usual makes no difference. And so I was prepared for a set up that was more formal and traditional; hence my surprise to find something even better than what I had proposed.

Around the perimeter the superfluous small desks were piled on top of each other, blocking the row of windows on one side of the room. When the power went off and I needed the drawn curtains to be opened to get some light into the room, my room helper quickly jumped on top of them and walked from one desk to another as there was no other way to get to the window.

Although I dress for winter (my winter experiences from 2002, and even 2010 included frigid rooms full of people clad in heavy winter coats, hats and even gloves), this time I am perpetually overdressed – the meeting halls now have central heating. Today the radiators (whether open or closed) maintain a tropical temperature of 32 degrees (Celsius). Unfortunately I cannot take off my cardigan as my short sleeved dress underneath would expose a good part of my arms.

Several of the basic assumptions for my design, despite having been assured they were correct months ago, turned out to be incorrect requiring a series of on-the-fly adjustments. For one, half the people have had no experience facilitating the leadership program design we have upgraded, so rather than building on existing experience, for some I am building on nothing.

In addition, English was a prerequisite for passing the initial selection and I was told it would be no problem for me to run the workshop in English. I have heard this before – there is embarassment, or even shame, to admit one cannot follow English and so you think you are teaching but you are only talking in a language that is poorly udnerstood. I had been prepared for this and have a team of Afghans around me who are able and willing to run the show in a mix of Pashtu and Dari. With the Pashtu I am lost but the Dari I can more or less follow.

Only one woman is among the 22 men. I knew other qualified women from her organization and asked her why they were not with us. Apparently they didn’t make it through the selection process which is showing more and more of its flaws as I get more involved. That process was supposed to be transparent. My questioning led to a blame game to help explain the poor execution of this process. Men with no relevant experience passed or were invited to the workshop while experienced women did not. If there is a rationale for this I could not extract it from anyone today.

I took the liberty of inviting the missing woman to tomorrow’s session as nearly a quarter of the selected individuals did not show up. I proposed an After Action Review of the selection process. The Division chief under whose responsibility this activity falls also didn’t show up – no one seemed to question that but it is possible the reason is so obvious the others forgot to tell me.

Despite having heavily padded the morning session with its opening protocol, baseline setting, expectations and the like, we found ourselves significantly behind on the schedule by lunch time, so I am dropping bits and pieces here and there. I am sure when I read the evaluations a week from now they will say ‘we needed more time.’ We will do our best is all I can promise, as we swim, sometimes, upstream.