Archive for June, 2015

Cuffs all around

On Monday I visited the shoulder doctor for the 3 months checkup. I had planned to ignore the summons as I find these check-up visits not a good use of time or money, but this time I went. While in Kampala my ‘good’ rotator cuff slipped a little out of its socket and left me with no strength at all in my right arm. This was a problem because I am not supposed to carry anything heavier than a coffee cup with my left arm. Luckily I was travelling with a colleague who carried the stuff I could no longer carry.

Eventually things got better. The rotator cuff must have slipped back in place and slowly my strength, what little I have in my right arm, returned. I started to worry about having to have yet another operation. My physical therapist had a name for what happen, a sub lux, and taught me how to push the rotator cuff back. The doctor told me there was a solution to this problem (in all likelihood created by the overuse of my right arm while the left is recovering); it is a reverse shoulder replacement. I am hoping that this will never be necessary, what with the left arm starting strength training in a few weeks. I am kind of tired of surgeries and the long recovery process of healing tendons and bones.

In the meantime I touched down for two days at work where things are a little bit in limbo because we are changing our organizational structure. I presume that by the time I come back from my next trip, later this month, the dust will have settled a bit more.

Imbalancing acts

During our long drive home yesterday from DC we talked about the weeks I was busy, what I had learned and facilitation assignments ahead. One Big Thing I learned (the same question I asked the conference participants during the wrap up session on Friday) has something to do with balance and imbalance.

In the middle of last week there was a moment where I had completely lost my balance. I was able to look back at that moment and my reaction to the event and realized that imbalance is actually a good thing, even though it may not feel that way at the moment. It was as if I had fallen into a hedge and came out the other end. Behind the edge, in a Secret Garden sort of way, was a whole new field full of interesting vistas promising things I had not thought about before and raising new questions I had not pondered before.

We tend to look for balance in our lives, convinced that balance is a good thing; thousands of books have been written about it. But maybe balance is boring. Falling and getting up, stumbling over things may seem a bad way to move, but if I would be given a choice now, I think I’d continue with the stumbling. All these moments of imbalance in my past, recent and long ago, have made life so much more interesting and have contributed so much to my learning, that I wouldn’t have wanted it any other way.

Back home for a bit

A whole week has passed since I left Kampala. This means I can temporarily halt the taking of anti-malaria medicine.

My next assignment, hardly leaving me a chance to recover from the week in Uganda, was the facilitation of a worldwide technical summit organized by my pharmacists’ colleagues. We looked at the work that has been done over the last 4 years to improve pharmaceutical systems so that medicines are available in health facilities for those who need it. Colleagues from 17 countries joined headquarter staff to extract lessons learned and find out what they need to focus on in the last project year. I had been part of the organizing committee since the beginning of the year and getting the program designed had not been an easy task, but in the end everything came together nicely, the energy was right, we got the outcomes we had hoped for and we had fun in the process.

Axel had driven down to DC, stopping along the way to visit friends and family. He arrived in DC just when I landed from Kampala via Amsterdam and Boston and picked me up to deliver me to my DC hotel. It was like a brief spousal visit before I dove into the conference and he continued his visits with friends.

On Saturday morning we set out for our long drive north, after a good breakfast at the Red Fox deli on Connecticut. The whole day we drove in the rain; it was rather cold given that we are now officially in summer and it is nearly July. We interrupted our trip at Sita and Jim’s for tea before continuing to Manchester (still in the rain). They had just returned from a vacation on Lake Champlain with friends.

We arrived some 14 hours after we left DC to a wet and wild Lobster Cove, which continued to be wet and wild throughout Sunday – perfect for staying indoors and getting ourselves organized for next week which includes Tessa turning 30, the 4th of July and my return to Africa for another 3 week assignment, partially in Madagascar and partially in Togo.

Truth to power

We finished the four day Coaching & Communication workshop for managers, supervisors and coaches who are responsible for reproductive health or other health services. Eighteen participants joined us, coming from the Ukraine, Ghana, Kenya, Tanzania, the DRC and Uganda. We had revamped an older curriculum that was based on a modular approach spread out over a long period of time. It was a test and an opportunity for us to try something new.

As usual I kept exploring and reading until I landed in Kampala to see if there was something newer, something potential more impactful that we could add to the mix of inherited sessions. I revisited and re-read Kegan and Lahey’s book about competing commitments which I sensed was just the antidote for the usual New Year’s Resolutions that we see at the end of workshops (I will work on my listening skills, I will be a better human being, etc.)

We had reserved the last session for exploring of competing commitments and the concept of immunity to change because it required some level of trust and intimacy in the group. We felt we had reached that stage because of the constant practice sessions in trios. By Friday everyone was quite familiar with the daily life struggles and challenges of each other, and recognized how universal they were.

Everyone came with five challenges they had to deal with, related to relationships with peers, with bosses, with recalcitrant or non-performing staff. All of these they considered obstacles to both the quality and quantity of service delivery. This link to services was important because both our funders and their employers had agreed that this workshop would ultimately benefit the users or would-be users of those services. This was an assumption that we had to prove. We engaged everyone in this collective challenge by creating our theory of change which then informed the development of our monitoring and evaluation plan.

We had created several opportunities each day, usually in trios, to apply and practice the various concepts we covered: giving or receiving feedback, coaching, listening, inquiring versus advocating, facilitating learning, repairing relationships, exploring why we often cannot be honest when we have to have the hard talks, and re-writing the scripts of failed conversations.

One recurrent theme throughout the process was the inability to speak truth to power. We could see how, for them, as it is for us on the other side of the Atlantic, not being able to speak truth to power is the cause of many initiatives failing to deliver on promises (at best) or terribly gone awry (at worst) with sometimes catastrophic consequences for individuals or whole populations.

We used aIgnorance is bliss Calvin and Hobbes cartoon as teaching material. Despite Hobbes’ warning that they (Calvin and Hobbes) are heading for a cliff in their red radio flyer, the wild ride continues. Why worry about later when you are having fun now?. Hobbes is speaking truth to power (we are heading for the cliff), but is unable to stop the inevitable and unpleasant conclusion of the ride from happening.

We can all come up with examples of this in real life. The US’ misguided actions after 9/11, the arms race, dictatorial regimes, and, at a micro level, the sons of powerful persons who are never held accountable for raping or impregnating school girls.

Except for a few very brave souls (many of whom either stand to lose their freedom or live(lihood)), most of us reluctantly accept what happens so that we don’t have to fight with our demons or confront our deepest fears. In the immunity to change session some people did get a whiff of those fears. Although they could be real (when the stakes are high) in ordinary life many of our fears are imagined and never put to a test. If we did, and found out that they are unfounded, lots of things would stop to be problems, and many a ride towards a cliff would be diverted in time.

Back to work

I managed to stay away from my computer during most of my vacation week. This worked because there are some very capable people in the office who took over. I had no sleepless nights over this. In fact, I have slept better than ever in the last 6 months because my shoulder is no longer bothering me.

I continue to get high marks from my physical therapist for my progress. I have to watch out not to progress too much because the ‘no weight bearing’ remains in effect until July 27.

On Friday night I was back on a plane to Holland. This time with Tessa and Steve who joined me for my brother’s wedding – a second marriage for both – but celebrated as if it was a first. The only things that gave this away is that there were, between husband and wife, 9 (grown-up) children and no one was in white. We celebrated the melding of two families, or may be even four as the parents of one ex and one deceased spouse were also there. It was a joyous and warm celebration despite the nippy not-quite-summer-night weather. Tessa got to hang out with her cousins, a rare opportunity, and schemed to have everyone come to her wedding next year.

I left the party early to catch up on sleep and prepare for the next assignment, in Uganda, while Tessa and Steve partied on and left for the east of Holland with another brother and his wife, to explore lesser known parts of Holland by bike.

I got up when some had just gone to bed and most of Holland was still asleep to catch a train to Schiphol airport, boarded the plane to Kigali and Entebbe, and arrived at my hotel in Kampala at midnight. The quiet of the night allowed for a swift ride covering the 40 km from Entebbe to Kampala in less than an hour. Apart from the few drunken young men riding on giant Easy Rider type motorbikes, helmless, there was little traffic, a good thing. We let them pass and hoped to not see them again later by the side of the road. We didn’t.

Trying for summer

I have been back for more than a week. It was a rather frantic week with long days and early rises so that I could relax this week which is a vacation week.  So far I have managed to ignore emails for one whole day, Monday!

In the meantime Faro turned 3, last Saturday, a joyous day spent in the Nonotuck park in Easthampton amidst a bunch of 0-3 years old, family and friends and an abundance of food. Faro, who has not been exposed much to sugar discovered cupcakes, and in particular frosting. We are indulgent with birthday kids and so he was able to lick the frosting off at least a few cupcakes before we drew a line.

Sunday we worked in the garden, a good workout after a mostly sedentary life of months, no years. The asparagus are popping up, the leeks and onions are thriving in this wet spring, the potatoes foliage is looking healthy, the spinach not quite discovered by the rabbits and the garlic looks vigorous. The more delicate plants were a little perturbed by all that rain, which followed me from Holland back to the US.

Axel and Tessa returned from their mission to Palm Springs experiencing everything that is wrong with air travel, spending about 24 hours to get back home. Tessa negotiated that half the miles used for the trip got re-deposited, plus some extras, as the delays messed up her work week that is now even more frantic. She too has to clear her desk before she heads out with me to Holland for a more fun occasion, the wedding party of my youngest brother where she has a chance to re-connect with her uncles, aunts, nieces and nephews. She negotiated with me about Steve coming along (he is). She should have been a lawyer!

My big sister Ankie arrived with her husband yesterday afternoon. We celebrated their arrival with Lobster and corn on the cob, strawberries and cream. Except for the weather it is summer!


June 2015
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