Archive for January, 2015

Ups and downs

Before heading to the airport I had a most inspiring coffee chat with an Ethiopian (woman) friend I worked with 7 years ago. At the time she worked with a government institution mandated to train senior government officials. What we proposed somehow unnerved them as it was out of the ordinary. We had hoped we could partner but they didn’t bite. The meeting with them was mostly memorable because of the excellent macchiato they served during our meeting; imagine that, at a government agency. But then again, this was Ethiopia.

My friend is busy teaching life skills to young Ethiopians and empowering women of any age. I learned about the Digital Opportunities Trust, a social enterprise that focuses on young people all over Africa. Her stories were both inspiring and sobering. She has moved away from senior leadership training because of the unwillingness of those at the top to examine their own behavior. This sounded familiar.

And as if to emphasize this point I learned that Robert Mugabe was elected to be the new Chairman of the African Union. My friend and colleague PT in Lesotho wrote in response to this news, “[I] am so disappointed. Something is terribly wrong with African leaders, their decisions and choices. Unfortunately no one will save us but ourselves. They know he will promote and protect corruption, and promote culture of impunity. It will take ages for Africa to be emancipated politically and economically. The continent is desperately in need of fresh ideas in order to progress at a desired pace.”

Further illustrations of the big egos and bellies of African officialdom accompanied me on the plane from Addis to Nairobi (in front of course). They kept their AU delegate badges around their necks even though the conference is over.  I looked at their big bellies and watched the young female handler – carrying the boss’ hand luggage which was a large carry-on which she carefully repacked with the many boxes of tax free whiskies,  champagnes and Dunhill cigarettes. They were treated to a special van and a security person who took them to the transit lounge. Once there they had to mix with the likes me.

Symptoms and roots

At breakfast this morning I watched how hotel clients puzzled over the three large hot liquid dispensers that were not labeled. We all knew there was one with hot water, one with hot coffee and one with hot milk. But they were not labeled. One risked completing the tea with coffee or the coffee with hot water or the hot water with milk. It was a bit like those shows where you have to pick a door that hides a prize, two you don’t want and one you do want.

One gentleman stood there for a long time, looking for a staff member to help him with his choice but none was in sight. He was clearly not one of the trial-by-error types.

Eventually he spotted one of the wait staff. Recognizing the helplessness of the customer, and without exchanging a word, she resolutely put his cup under the right spout and he walked away relieved. She had solved the problem but it will recur again and again. I was surprised that it didn’t occur to her to put labels near each of the containers – I knew they had them as they were there yesterday. But clearly someone had forgotten to put the labels and this was obviously not her job.

It was such a perfect illustration of a phenomenon I observe over and over in the places I work.  There is something missing in their customer service training and that is root cause thinking, something we include in all our programs so that root causes rather than symptoms are dealt with and some of these easy-to-solve problems don’t keep recurring.

French-french

We have arrived at the end of my three assignments, the last completed yesterday and celebrated at a cupcakes place in Addis with spicy chicken sandwiches and macchiato. The participants in our senior leadership program, conducted jointly with Yale University’s School of Public Health, have quickly become our new French and Swiss ICRC friends. Two we met last November when I was in Addis as well. They manage ICRC’s assistance to rehabilitation programs in Madagascar, Niger, Tchad, the DRC and Burundi.

On Thursday morning they presented the current landscape of physical rehabilitation in their respective countries. All of them are pretty bleak, with Tchad and Niger at the top of the list. These managers are not shying away from difficult places and most have lived a good part of their professional lives in hardship posts: Iraq, Pakistan, North Korea, Somalia, Afghanistan, etc.  They are after all the kind of clinicians and technicians that help civilians who have stepped on mines or are otherwise physically injured in such places of conflict. It is a remarkable group of professionals who care deeply about the people who have become or were born disabled yet work in places where such people are shunned, put away and generally neglected. And if there are any services at all, these are poorly staffed, poorly equipped or entirely non-functioning. Their tolerance for frustration is tested every day.

For two days we sat around a table and talked about the senior leadership program we are about to embark on over the next 11 months. We will meet again in April when they return with a team of, hopefully influential or motivated, peopl, feom their countries to advance the agenda and implementation of the United Nations Convention on the Rights of persons with disabilities (UNCRPD).

Although all are English speakers and some of the sessions were done in English, their default language is French. And not African French, which is what I have been exposed to for the last 30+ years but French French, spoken rapidly and with all the wonderful gestures and facial expressions that the French use when they speak.  When we next meet the language will be French only, the singsongy French from Madagascar, the staccato-ed French from West African and Congolese French. It will be a French linguistic feast.

Addis

The driver who took me to the airport early in the morning has a son who is a 3rd year neuro sciences student at Harvard. The aspiring neuro-scientist has a younger brother who is also trying to get a free ride at Harvard.  My driver wants to go to the graduation in 2016 but for that he claimed a miracle would have to occur. Going to Boston at graduation time is a little out of his league, money wise. He is praying hard. It must work here as I assumed he also prayed for a Harvard scholarship, but his son’s talents must have been a factor as well, a God-given talent no doubt.

He told me his son was invited to spend Christmas in California with his ticket paid, both ways, he added, by a woman who turned out to be a friend of mine. Small world!

I was once again at the airport with plenty of time to spare. As a result I was able to enjoy the brand-new Kenya Airways lounge (the Pride Lounge) for hours. Having left too early from the hotel to partake in its breakfast, the lounge made up for this serving a full breakfast: eggs Florentine, cappuccino, a fruit platter and freshly squeezed juice.

I arrived in the middle of the day at an empty airport; a quiet time before the arrival of 100s of diplomats to attend what is the African equivalent of the UN General Assembly this week. Traffic is already tied up but with VIPs moving around the capital it will be even more so. The road out of the airport was already closed and we had to find side roads to get to the hotel.

I procured myself a simcard which means I can connect with friends and colleagues a little easier to use the little time I have here to get together. That started last night when former and current MSH colleagues, most of them having lived in Afghanistan, met for dinner and caught up. As usual, the conversation turned to flying, frequent flyer schemes, upgrades (or rather non-upgrades) and close calls. After all that is the one things we in common.

I was slated to have yet another call in the evening but the internet was too fickle to sustain a connection even though half an hour earlier Axel managed to show me on Skype what the snow accumulation looked like.

Memory lanes and bumble bees

My short stop-over in Nairobi went fast. On Saturday I joined my friend/supervisor at the lovely Fairview hotel (a country hotel in the city – indeed!).

A few hours later I experienced the infamous Nairobi traffic (even on Saturday) driving out one and a half hour with a friend of a friend and her 8 month old son in the back to the Nairobi exurb of Karen.  When baby Karl started to scream I moved to the backseat and rubbed the little fellow who was looking for a breast full of milk. Disappointed in my ability to deliver the goods he kept crying until  we arrived at our destination, a lovely country inn called the Talisman. The “gastrolounge’ claims to have a wide variety of food and drink for every pallet” (sic).There I found my friend Ida  who left Boston nearly 2 decades ago and settled in Mombasa. While her husband kept her 4 year old engaged we were able to catch up on 20 years of missed and shared history.  The way back was a little faster but not much and baby Karl slept.

Back at the hotel I handed the baton of my function as Global Technical Lead (GTL) for Leadership and Management to my successor JP who flew in from Dubai and who will join us shortly in Medford.  She had moved her family to Boston in the meantime where they arrived just in time for the mega blizzard that is raging today on the East Coast. I feel sorry for them, coming from steamy Dubai. Her mom who is looking after the kids is probably less than pleased but I am sure the little ones are thrilled. Imagine that, living in a freezer suddenly and seeing your own breath while inside the warm and cozy Hyatt they have a pool and all sorts of goodies at breakfast. It would have been my dream.

My colleague and I downloaded about 50 years of stories onto our new team mate while she was busy scribbling notes on a large legal pad. She already showed she is a good listener and eager to contribute whatever new and fresh she has to offer.

In the evening I made another trip to memory lane, house number 2, visiting one of my 1951 cohort. After we celebrated turning 40 (a milestone which the women loved and the men were not that keen about), he left MSH and returned to live in his childhood home on the outskirts of Nairobi amidst what used to be coffee plantations. At that time the estate was far away from the city but now is more or less annexed.  Still, it looked to me like a country club, charming and beautiful. He lives there with his wife, three high school children, a bunch of dogs, and then some motor cycles. We looked each other over, exclaiming ‘you have not changed at all.’ Once again we reminisced while walking the estate and preparing for dinner which we ate family style outside sitting around an enormous roughhewn table with a clay chiminea ablaze to take the chill (a relative concept) at bay. If it wasn’t for the traffic, Nairobi would be a dream place to live. His house is, even with the traffic.

I listened to the story behind the Elizabeth Glaser Pediatric Aids Foundation (EGPAF) where he works. It is both a sad and a moving tale that proves Margaret Mead’s famous quote ‘Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.’ EGPAF has contributed much to decrease the suffering of families affected by the virus. It is a mission-driven organization like MSH, but much more focused.

On Monday we spent the day at the office, meeting new and old colleagues and talking about public health leadership, management and governance. I repeated a webinar I did some months ago that most of my Kenyan colleagues had not been able to attend. When people asked about my new role now that I was no longer the GTL for leadership and management, I invented one on the spot: my new title will be bumble bee, the queen of cross pollination. I will travel from project to project and serve as a connector. My first cross-pollinations are between our Rwanda and Kenya projects as they have much in common.

And now off to Addis for my last assignment.

Back and forth

Our presentation before USAID of the work plan for year one was so much better than the rehearsal, as it should be. The meeting had been shortened by 30 minutes but we managed to stay within those boundaries and even leave some time for comments. We digested the experience over lunch and then everyone went their way. I stayed for a brief orientation of a few diehards to make sure they know what kinds of resources we have in the wider MSH family and how to access them.

Upon the return to my hotel  I rewarded myself for the successful completion of my first assignment with a 90 minute hot stone massage – something I had been looking forward to. Managing short openings between calls with Boston I managed to enjoy a short dinner and sat by the poolside. It was ‘African night’ and the buffet offered only African food (at least for the main course). It turned out to be the only African food I have eaten here (if you exclude the lunch dishes at the office).  It included an astonishing array of starches, any kind of meat and a few veggies – delicious but filling. It was also music night with the same band as last week singing the same mournful songs.

The driver, who besides being the top driver and an ‘arranger of everything,’ showed up on the dot at the appointed time. He had told me I had to be at the airport 3 hours before my departure at 9:10. That turned out to be way more time than was needed to make one’s way through the various check-in steps. As a result I was the first and one and only passenger and made for a very quick check-in process. The only delay was caused by a search in my baggage for ‘a radio with antenna,’ which the security staff claimed I had in my duffel bag. It turned out to be an electric toothbrush.

By now my Arlington colleagues have arrived in Amsterdam and are waiting for their plane to DC.  One of them was part of the team I joined 28 years ago at MSH when we started a 30 year run of management capacity building and laid the foundations for MSH’s later reputation in management, leadership and governance for health. We did not work much together after 1990, moving in different directions. And so we did a lot of reminiscing about the memories we have in common. I remember when I was young I found listening to old people reminisce boring. Now it is my turn.

Showtime

Today all the team leaders and their teams put the final touches on the year one work plan. It is now one day to ‘lift off’ – the first official presentation of the work plan to USAID  Getting ready for this was a massive undertaking which required great attention to detail and alertness to version control, while working on the less than user friendly interface of Excel. Excel focuses attention on detail, the trees, making it hard to see the forest. One can get lost.

This afternoon we rehearsed the presentation to USAID. It was a real feat to get all the pieces come together into the required formats and have everyone in the room to rehearse. I am glad we did – everyone learned something and we will all be the better for it tomorrow when it is show time.

We have tried to work on Google Drive – something MSH is pushing and for which I have advocated. But the experience here, at a distance from the more or less guaranteed and fast internet and power we have in the US, is less than ideal and the experience frustrating.  It’s a good reminder of the conditions that make the work of our colleagues in the field so challenging – at headquarters we sometimes forget that.

At headquarters we also sometimes forget that changing the time of calls is inconvenient for people many time zones removed.  For us travelers between field projects and headquarters, with initiatives or work with other field projects that don’t take a break while we are away, this makes for long work days.  When our work day in Rwanda ends the work day starts in Boston and DC.  On Tuesday I rushed back to the hotel to be seated at my computer, connected, headphones on – foregoing the 6PM cocktail hour to decompress – only to find out at the last minute that the meeting has been cancelled and another one, following a bit later, was delayed.  It makes for frequent room service dinners and few occasions to disconnect from the computer and work.  But then again, this is the reality of our work, and for us travelers always a temporary condition.

On Friday night my other two colleagues return home to DC and I will be by myself. I have made an appointment with Hanna who is reputed to be the best hot stone massage therapist in town. I reserved 90 minutes for this; afterwards I will treat myself to a nice dinner, a glass of wine and go to bed early to get up before dawn for my early morning flight to Nairobi.

On track

We are now fully immersed in the work planning exercise. It is disciplined, collegial and as rigorous as these things go. I think this is probably the most engaging and inclusive exercise I have ever been involved in. By Friday everything needs to be ready to present to our funder for a before-final sign off . And then the project staff will meet with their government counterparts for final approval. By then I will be in Addis and on to my third assignment of this trip.

Axel is busy planning his trip to Angkor Wat and then a boat ride do join me in Phnom Penh. It will be the second time I am in ‘striking distance’ of the famous temple complex and missing it again. I will visit it vicariously through Axel’s pictures, much like I did when we were in Japan and Axel told me about his fabulous trip to Kyoto. We have reserved a few days at the tail end of the Bangkok conference, to have a vacation together before heading home and preparing for surgery.

My colleague went to the handicraft center and asked if I wanted to come along. I said no, as I am not interested anymore in buying local souvenirs. I have distributed those I accumulated over the last 30 years among my colleagues and our house is already full of knickknacks (inside and outside boxes) from around the world. I could be easily seduced into buying more fabrics but I already have trunks full of them.

My work days are long. I leave for the office at 7:30 and when I get home at 6PM I order room service and have my phone calls with various teams and individuals at the home office. The massage place closes too early  (last call at 7:30PM) – I wished they’d be available at 11PM. It would make for a good start of the night.

With my job in Rwanda winding down I am casting my eyes to assignment 2 in Kenya which will be a nice combination of play and work for my short stay there.

A good stay

A weekend at the Serena Kigali is pretty nice. I had my second massage after a visit to one of my colleagues in both his current house on one side of the city and the house he is building on the other side of the city.  His one and a half year son accompanied us which made me miss Faro.

I had all sorts of plans to write a short paper I have to produce by Monday, and tinkered a little with the outline, but the writing will have to wait until tomorrow when, once again I have great intentions and many distractions.

I am getting to know a new colleague and there is much to talk about. She is excited about landing in Rwanda; I would be too. The climate is beautiful, the vistas from every part of the city are breath taking and there are basically no traffic jams. And if there happens to be one there are many ways to descend or climb the various ‘collines’ as they used to be called in the old Rwanda.

I have stopped watching TV as it is all about terrorists. The media appear to be as active as the terrorists themselves in seeding terror in our hearts. Instead I listen to the chickflick equivalent in audiobooks and do electronic jigsaw puzzles, interrupted by nice long meals in great company, sitting outdoors in a cool breeze: not too warm, not too cold. When people pity me about my long trips packed in economy they forget there are these nice stays in between – not always of course but certainly this time.

My shoulder is a little better these days even though there is no reason for that. Last week the nights were painful, bringing me sometimes to tears but now I have a large king size bed with 6 fluffy pillows with which I build a nest; it seems to work.

The internet connection is good enough to allow chats with Axel who, thanks to the wonders of technology, can call me, or  I can call him, as if I am in the office in Medford. He is busy planning his trip, accompanying me to Cambodia and Thailand mid February. Nearly 10 years ago he was doing the same when I was going to Nepal, planning to come along on a business trip but the Maoists spoiled our plans. We keep our fingers crossed that this will not happen this time. As far as we know there are no Maoists operating in Cambodia and Thailand; tsunamis and typhoons are more likely; those too we hope to avoid.

Convergence

While listening to the final chapters of an audiobook on my iPad (to avoid the library removing it from my device),  I let the amazing Rwandan landscape slide by as we drove the 100 or so kilometers to Lake Kivu on the border with the DRC. Some people call Rwanda the Switzerland of Africa, with Switzerland a symbol that stands for mountainous beauty.  In contrast to most other African countries I know, the towns and villages we passed through looked pristine, well cared for and organized. One of my colleagues who has lived here for 8 years, and made this country his own, told me the orderliness and cared-for look is not just an appearance.

We arrived around 6 PM on Tuesday evening at our Serena Lake Kivu hotel. After we placed our baggage in our rooms we assembled for our opening session, an early start to gain some extra time on day one of the retreat.

We have now passed the halfway point of the retreat and starting to converge towards the intended results: a detailed work plan for Year 1 that can be used to fulfill our first 90 day deliverable, to create a budget for year 1 and present shortly to the ministry leadership and counterparts to make sure it is fully aligned with their priorities.

It has been a fun assignment as I am getting to know a new set of colleagues and also partner organizations I had never heard of or only by name: Jembi Health Systems from South Africa, Banyan Global from DC, Tulane University and the (Rwandan) School of Public Health.

I am also in my element because I get to observe people and their interactions with others. This is giving me some raw data to help inform interventions that I may propose to help them work as effectively as is possible given the mix of personalities, cultures, styles and levels of experience and expertise. Creating a new team out of this  is no easy task.

The hotel looks out over Lake Kivu. In the far distance is the DRC. In the middle of the foggy lake is a tall structure that captures the methane gas that escapes through the water from pockets deep down formed by the volcanoes that are ubiquitous here.  If you manage to think away the signs of civilization (people, structures) you can imagine what this place looked like when the earth created itself: a red hot bubbly mass of fireballs, gasses, minerals, flowing here and there, leaving the Rwandans the most deep dark and most fertile layers of soil. It is such a contrast with the sun-baked soil in the countries in the Sahel where, when you drop a seed on the ground, it will wither and die quickly; here it produces something green in no time.


January 2015
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