Sylvia's Journal

It was the ultimate challenge, working with a group of unknown size, representing unknown parts of the ministry of health, with a new colleague, although a seasoned facilitator, entirely new to our program, and with people I have no relationship with – and with whom it is hard to do so without a voice.

We had tried hard to get a few minutes with another high positioned individual who gave us an appointment at the exact time we were to start our afternoon meeting; somehow my colleague thought this was possible and I surrendered. I did a lot of surrendering these last few days and had very low expectations. Getting access, even if for a few minutes to a high level official can be a major victory and the highlight of one’s day. I also surrendered to being sick and without voice and to all my colleagues from the other projects, who know our methodology well and could run such a meeting on a minutes notice, not being available at all.

I had a rough night, waking up every two hours, then with this cold symptom, then that, feverish and dreading having to get up and go to the office and then do this meeting. There was no question of canceling it – it was such a victory that we were told about 30 people would attend from across the mid to senior level of the ministry. The next time we would be able to those people would be in January, when I am not able to come here.  I had to observe my colleague in action and be confident she can take this on without me. In a way she had to, since I could only whisper to her when I felt she needed some re-direction.

Given all this, the meeting went better than I could have hoped. We introduced the notion that a vision is like a dream but with wheels underneath (=action).  That’s the session they found most memorable. And I got a good idea what the fruits of better leadership and management and governance would look to them. Nothing earth shocking but something to refer to later and because of that, quite helpful.

On Thursday morning I decided to see a doctor, fearing a sinus infection was in the making (which it turned out to be). My colleague accompanied me; she is now quite used to interpreting my whispers to a third party. We were told to wait 10 minutes in a rather full waiting room, with me being the only foreigner. Although I don’t like foreigners being treated more politely and faster than the locals, being rather sick, the principle wasn’t as strong anymore.

My colleague (V) told me that 10 minutes in Madagascar could be an hour. I surrendered and settled into observation mode. After about half an hour we saw a young female doctor. I was not greatly impressed by the thoroughness of her examination and had to remind her to look into my ears, as these had been under pressure the night before. To do this she had to find a new battery.  V and the doctor talked for a while about grogs and other local remedies, pushing me to get pectos (whatever these are, pastilles probably) and soak them in whiskey, and voila, my ailments would be gone. They were really working hard on me, demonstrating how annoying it is when people give you unwanted advice. I had been listening to this and other home remedies for two days now. Everyone has had what I have and everyone has their own remedy which I should try.  I had no appetite for alcohol nor sugary pastilles – I think I am ingesting enough sweet things, now realizing that over the counter medicine for a cold are all sweetened with sugar. This means a temporary pause in my low sugar diet.

I was told to get an X-ray to see if I had a sinus infection. I didn’t know X-rays could do that, but since I am not a doctor and finding out whether I had a sinus infection was the main reason for going to the doctor in the first place, I obeyed and we moved to another waiting room. A radiology technician was working his butt off, I commended him for that. There were so many people waiting, some quite sick and disabled. The medical centre promises on various billboards to do scans, ultrasounds and other high tech things. I peeked around the corner into the ice cold scan room. Impressive.

My first X-rays had a spot on them and had to be redone; by now we had been there 2 hours. We got the results quite quickly – there is no one reading the X-ray except the doctor. She was in an emergency and so we had to wait another hour before the verdict was read: yes, had a sinus infection and received a total of 5 drugs (a spray, a syrups – oh that sugar – and antibiotics, effervescent prednisone pills and a pack of tiny blue pills). It is a complicated regimen  of 3 times per day for 5 days fo one drug and 3 times in the morning for 3 days for another, and 3 times after meals for a third, etc. It’s hard to get my head around this but I will try anything to be among the talkers again.

The whole thing cost me about 50 dollars: 9 dollars for the consultation; five and a half dollars for the X-ray and 35 dollars for the drugs. It is clear who is making the big bucks here. Pharmaceuticals is clearly a lucrative business since no one leaves the doctor’s office with just one prescription. I think my pharmacy colleagues at MSH are trying to do something about this.

By the time we were done it was also time to get to the conference room at the ministry and run our meeting.More about that later