Sylvia's Journal

We completed the first of the two leadership development launches this week. A small group of members of the national association of pharmacists of Benin was initiated into the not-so-secrets of leadership, good management and good governance. They embarked on this path with great enthusiasm, concentration and perseverance.

We talked a lot about getting out of one’s comfort zone, about listening, about knowing where one is heading (if you don’t want to end up elsewhere) and separating facts from fictions.

This morning we dipped down into the hard labor of figuring out what a good result would look like, what data we can use for monitoring and which indicators will tell us whether we are bound for success or trying to do something undoable. There were groans, aha’s and there was much solidarity as four teams banded together to tackle some of Benin’s persistent and complex pharmaceutical challenges.

They experienced a trip through the kind of mud, something I am quite familiar with. I have learned over the years that mud is full of nutrients and serves us well, despite being hard to wade through. I have made this mud trip with people in many different countries and know to expect it. But for people new to our approach (an alternative to simple and one-sided solutions that treat symptoms only) it was frustrating. They greeted my assurances of normalcy with relief.

Our local team will continue the process during the next 8 months, now that the train has moved out of the station. I have no doubts about their ability to do so enthusiastically and competently.

At the breakfast restaurant there is a small Nespresso machine, prominently displayed, the one that makes one cup at a time and that you can get at drugstores in the US. It can be activated by buying the small capsules for 3.50 dollars apiece – it is an alternative to the Nescafe powder which is available as part of the breakfast buffet. I have chosen to be a tea drinker this week as that is the only thing that is brewed.

The main dining hall is actually an enormous terrace. It overlooks the lake, part of the city, the bridge and, across from the sandbar, the Bay of Benin. Hovering in the distance are towering oil tankers, menacing silhouettes, against a dark sky. It’s hard to imagine that the skinny Somalis frighten these behemoths on the other side of the continent.

Tonight the terrace was off limits for us guests. It was reserved for Iftar, Ramadan’s breaking of the fast, for the Lebanese who make Cotonou their home. It made for good entertainment as I ate my lonely dinner, watching from an adjacent section where guests were allowed.

A stream of men made its way to the terrace, kissing and hugging and handshaking a welcoming committee. The Lebanese appear to fare well here, judging from the protruding bellies and double chins. They are the business men of West Africa, much like the Indians play that role on the other coast.

We are not quite halfway through the four events for which I was summoned. I am biting my way through the challenges that come from sorting out a hybrid process for leadership development. We are using the parts that are very robust and can stand on their own – sorting out the right French translations from the not so right phrases that transmit a different message than the one intended. But it works in a context where andragogy is a novelty. Leadership made palpable.

More challenges have already appeared on next week’s horizon when we are working with the ministry. An important event has been called in the capital that will certainly draw attendance down but there is not much we can do. I look at it from the positive side, less people, more depth.

Those who were new to the methodology only two days ago are now treated as knowledgeable coaches and showing increased confidence. It’s a bit of a contrast with the very intensive coaching training I am in, which required being on the phone from 1:30 till 3:00 AM very early this morning, and again after midnight tomorrow at the same time. I have alarms set on my smartphone for at least 4 coaching related activities this week, all at odd hours, all outside the regular 12 our workday – a side show.

Except for my very short trip to Ivory Coast earlier this year, I haven’t been much in French West Africa for nearly a decade. The arrival at Cotonou airport reminded me of arriving in Mali decades ago, or in Haiti before the new terminal was built.

The French have many great words to describe the chaos: pagaille, anarchie, brouillamini, cafouillage, désordre, gâchis. Maybe it is the poet it in me that likes these words that are so full of the noises they describe. You can practical hear the luggage carts bumping into each other, grinding to a massive gridlocked halt; the enormous boxes wrapped in plastic film containing luxuries from France, dwarfing the men in dusters below them; the big mamas with their oversized boubous and large gauzy scarves; the babies, finally asleep and the husbands busy greetings friends and relatives.

There was no way I could see, let alone extract, my suitcase from the fast moving baggage belt through the throngs of people and carts that separated me from my case. Being tired and resigned rather than assertive I was slowly but steadily pushed into the walls of the tiny arrival hall. I think the hall was designed a long time ago when planes were DC6s and small boys carried one’s possessions past sleepy douaniers.  

Some people, maybe those from the diaspora, dressed in western clothes rolled their eyes at me as if to distantiate themselves from the disorder of their homeland.  

I thanked my lucky stars I had only one suitcase and nothing else.  I had offered to bring a Xerox box full of books – but that offer was made to late, for which I was most grateful. I surrendered until the suitcase would appear, and settled in for a long wait. Eventually it did appear and all was well.

This is what surprises me about this part of the world: the total acceptance, or maybe tolerance, of what seems such an easy problem to solve. Why not get rid of these bulky baggage carts and engage more of the skinny porters?

My sparring partner here, who hails from another part of West Africa, has a pair of glasses with one of the sides of the frame entirely bent out of shape. He doesn’t seem to notice or mind. Last time I saw him he still had the small sticker with the strength of the lenses (2+) attached to them. I wonder whether it is the same frame, now without the sticker. I think that frame was bent too.

I carry with me a small notebook and write down the things that I see that I find inexplicable. Sometimes these things make me smile, sometimes they make me wonder and once in a while they get me very irritated. I ponder all this while stuck in traffic and occasionally I have a brilliant thought, like this one: It occurred to me that the people here live very much in the present, unlike us in the US who live either in the past or in the future.

For example, even though it may rain heavily (the weather site for Benin tells me so, and, presumably farmers know about this), no one carries an umbrella. And then, when it rains, surprise, everyone gets soaked. Maybe that is the point – it’s refreshing while it rains, but afterwards?  [And of course, there are few Senegalese here, the guys who are selling umbrellas in New York, it’s more lucrative.] I, on the other hand, even though I never actually use an umbrella, always have one handy, just in case.

The people who live here could benefit to live a little more in the future whereas we could benefit from living a little more in the here and now. In that respect my co-facilitator and I make a good pair, me fretting about things that may or may not happen, anticipating alternative scenarios, and my partner looking happily through his crooked glasses at what is right in front of his nose. We have been making good leadership workshops together since back in the previous century.

My doctor told me I should eat more garlic to counter the hot flashes, whether caused by a malfunctioning thyroid or because I am of a certain age. This requirement is more than fulfilled by the restaurant of Hotel du Lac which sprinkles all its dishes with enormous amounts of garlic that leave me gasping for fresh air.

We completed our first day preparing members of the ‘Order of Pharmacists’ of this country for their leadership role in realizing their mission of promoting ethical and independent behavior and honoring the pharmaceutical profession as a critical actor in promoting and maintaining good health.

After a hesitant start that made our careful planning of yesterday irrelevant from the start, we ended up with five people in the room, plus two of our colleagues. This will be the team of coaches, to oversee the leadership program that is for the rank and file who will join us on Wednesday.

Compared with facilitating a meeting of 120 people on my own only 2 weeks ago, this ratio is rather luxurious, 7 people with 2 facilitators and tomorrow only 3 participants per facilitator. Only on Wednesday will the ratio be more reasonable: 24 for the two of us.

We are retrofitting an approach painstakingly developed over the last 10 years to a situation that doesn’t quite fit the design – but it is robust enough that the general principles are relevant even to this small group. The challenges of the pharmacists lend themselves well to the Challenge Model, a visual image with embedded questions to get from mission to ‘what next tomorrow?’

We tackled questions of ethics as well as support for a profession that suffers from unregulated sellers of both legal and potentially ineffective, counterfeit or smuggled drugs – cheap prices for drugs of unknown origin and dubious effect. But with a sizable illiterate and superstitious population, such practices go easily unnoticed. The bonafide pharmacists are being asked to comply with ISO standards and engage in a lengthy, costly and rigorous certification exercise. The prize for such compliance is a promise of better earnings at a later time but many are not yet convinced. There are only a handful of early adopters (some in the room with us). The challenge is how to get more of them. That was one of our discussions today, to be continued tomorrow.

I had hoped by the end of the day to be mostly clear on what will happen on Monday, but I have still a ways to go and fell asleep in the middle of the day. There is always Sunday I keep telling myself.

In the meantime I have taken care of some other important things. I have a local phone number now from the Move company. When one stops anywhere along the road boys with packets of any of the major cellphone companies stream like flies to your car, as if the window was covered with honey. Compared to the lengthy control process in countries such as India, Bangladesh, South Africa, where obtaining a simcard requires a trip to a store, a passport, a letter from the hotel and many forms to fill in, here it is a transaction that takes seconds. If it takes any time at all it is because of the negotiation about the cost (in the control countries the cost is neglible, a nominal fee, like 1 Rand in South Africa).

Next stop was the pharmacy. Although I knew that malaria is a big problem here, I hadn’t put one and one together and procured myself some malaria prophylactics back at home. Now, staying in an hotel on a lake and observing the mosquitoes in my room, I realized I’d better get some medicine. My co-facilitator is a doctor and he got me the medicine (WHO prescribed he told me, 200mg artesunate and 250 mg mefloquine, 3 days in a row), good for curing me and also protecting me, even as long as 6 months into the future. Oof!

And then the bank. Luckily I had some money left over from my trip to Cote d’Ivoire, which is the same currency they use here. Going to ATMs is always a bit of a crap shoot, you never know which card will work at which bank. It took only 2 tries and now I am good for local meals and more call minutes.

After several failed attempts to get into the office to see what was prepared for Monday we gave up. In between attempts we took a break at lunch time. My co-facilitator took me to a restaurant that was clean – me remaining in good health is critical to him (and to me for that matter). And so we had lunch at Mama Benin who announced on handwritten panels on every corner of her restaurant, in two languages, that food, once ordered could not be taken back to the kitchen or altered for reasons of hygiene (“thanks for your undestanding”).

A long counter with several pans sitting side by side replaced a written menu. The waiter explained patiently what was what: fish cooked in a variety of ways: smoked, stewed, grilled, cut up, whole (we are both on a lake and at the ocean), rabbit, poulet bicyclette (sinewy skinny chicken with long bicycle legs), gizzards on a stick, mutton, leafy sauces, red sauces, rice, manioc, fries or couscous. I asked whether any of the dishes were ‘piquant.’ ‘No,’ the cooks told me, ‘food here is not piquant.’ This, I discovered later, was not true.

I ordered a salad of quail eggs, a regular sized egg decorated with finely chopped greens, the most delicious avocados and lots of onions and tomatoes as a starter and then the leafy greens with a grilled piece of fromage (paneer) and grilled fish with too many tiny little bones. We ordered baobab juice to wash the fish bones down. According to the label it was full of the whole vitamin alphabet.

And now I am waiting for my colleague who is somewhere in the ‘interior’ of Benin to call me back, waiting for something that looks like an agenda and figuring out who is going to do what when the events start. From Monday on these ‘events’ will continue non-stop, with a brief weekend pause, until I leave on the 25th.