Archive for the 'On the road' Category



A toe in the water

More calls, more negotiations, explorations of options, but all separate conversations, one-on-one phone calls, small meetings with key actors missing, not sitting around a table together. This is hardly possible as centrifugal forces pull everyone into parallel or intersecting orbits, never the same. If you’d try to map these orbits it might look like a drawing from an angry child; Separates that do not make a complete wardrobe; stuff not adding up. How anyone can concentrate on doing anything well seems like a miracle. Still, stuff does get done.

I have made a new proposal, just one event, to dip the toes into the water and try this new thing that’s not called a training program. I use the word conversation. It would be actually a series of structured conversations over three days or so with all the key actors of one program together. It would have to be the family planning program because of the funding source but it really doesn’t matter – it could have been any program. And all of the conversations would concentrate on where the rubber hits the road – where the services are delivered in whatever way they are or should be.

I remember from watching a video of Parker Palmer talking about medical education where he insists that the whole patient sits in the middle of the conversation – all the time; something like that. The way to get the – in this case provider-client interaction – in the middle of the conversation I would ask them to spend an entire day either shadowing a community or outreach worker on visits or working side by side with service providers in a health facility (health post, clinic or hospital). It will not be easy to actually organize this, but that is also a matter of finding the right people (it always is), who understand the concept and are excited by the idea.

I wrote a long email to the chief of the Health Services and his HR Director and ended it with a quote from Scharmer’s Theory U book: “On the one hand it is the experience of shaping something: that’s a source of empowerment. On the other hand, it is to see the context in which you and your colleagues work. That changes your view of the larger system. You learn to see the meaning of your work in the context of the whole (region, program). Seeing that larger whole and how you relate to it is empowering. Through your better knowledge about how the system works, how the region (or program works), and by getting to know [all these] people you end up having a different access to making things work – things tend to flow more effortlessly.” (Since I read him on a Kindle I don’t have the page number, one Kindle flaw for people like me who are always looking for quotes.)

Although I am not entirely sure how this will come together I know for certain that this idea will produce the desired outcome: a small group of people who see the potential of such conversations and want more of them, with more people. I dare to stake my reputation on that – if only given the chance. I have done something like this before, nearly 10 years ago in South Africa’s Eastern Cape with the entire top team, led by its energetic chief. Not much came of it I believe because soon after the outing the chief died at the young age of 51. In the midst of paying attention to everything and everyone else he was not paying attention to himself. He died of a heart attack. Since then, when asked “what is the most important thing for leading at the top?’ I always say, “stay alive.’ After all, no matter how good you are as a leader, as a dead leader you are no good at all.

And now, onwards home after a brief catching of breath and buying of cheese in Amsterdam.

Squirreling

Although I didn’t feel so positive as I headed into town to speak with the HR director, road signs tried to cheer me up that good things were afoot. “French begins with you & it is possible” exclaimed a small hand painted sign tacked to a gnarled tree near the city-central cemetery.

A huge bill board from one of the main cell phone companies promised that the world would be one in 2010 and that it (the company) couldn’t wait. The small soccer ball in the corner indicated that this was only true for soccer lovers. The company operates in many countries so the odds are that ‘it’ will win. And then there was the giant national monument promising Freedom and Justice, the national motto, presumably for all; a lofty ideal that still has a way to go.

All over town there are two sets of political signs, one with the candidate who won, and his running mate, sometimes depicted as very dark skinned and on other signs as very light skinned. I wonder whether that is a printing error or intentional to appeal to all shades of Ghanaians; the party that lost also still has its giant signs up saying that their man is the best. May be he was but he did not win.

We had a long and frank conversation about this senior leadership program that I am trying to get started. There appears to be a reluctance to say no to the donors and their particular agendas. I am not hearing the ‘no thank you’ although I have suggested it as an option. Maybe I will hear it today.

Of course there is also the option of looking at the funding, with all its strings attached, as an opportunity to also get something else done or to re-negotiate the strings (possible, I am told by the donor). Once again, it appears to be a conversation that is not happening – instead I witness meetings in which people don’t really say what they mean, or, to paraphrase Martin Buber, don’t mean what they say. No wonder we are all in trouble.

So I have shifted my framing of what we can offer: a series of conversations rather than a training program, in which we can slowly rebuild the feedback loops that have been severed or missing, and hear the stories from the heart rather than the intellect. I think I can do that and today I will find out whether I’ll get that chance. Or I’ll finally hear the no, and I’ll have peace with that too as it means the timing was not right.

It was clear that my unconscious was not done with the events and insights of the day after I went to sleep. One dream put me in a winter landscape, on slippery ground where my guide plunged a long way down into a stream. He could have been killed but he survived. A wild fox that looked suspiciously like Alison’s corky Abby jumped from tree branch to tree branch overhead like a flying squirrel, it colors brilliant against the white winter landscape. I know that in Native American medicine the squirrel tells something about squirreling away nuts for later; busy now with collecting, safe later during the bleak days of winter. I certainly have been busy collecting impressions this week and have stored them (on this blog and in my mind) for later.

I wrote a message in the guestbook for my friend Susan from Alaska who has just been diagnosed with pancreatic cancer. It is odd to be on the guestbook side of Caringbridge, a site so familiar to me as an author during our first 5 months of recovery. I am glad to know how important these messages are and that we are all given the chance this way to follow her in her journey and cheer her and her family on. This journey will take her to Boston repeatedly I suspect and I hope to see her in person at some point. It does put things in perspective.

Disconnections

With my system recovered from the flushing activity of Tuesday, I was ready for a full day of work. It turned out not all that full as we had only been able to secure one appointment in the morning. A dinner meeting was added later in the day, unplanned but welcomed, with a team of consultants assessing the health system’s health.

I found myself less certain of the good outcome of this trip after meeting with one of the regional directors who challenged me, indirectly, and politely, on bringing in yet another training program. She listed training programs done by other organizations – some of which I know – that all came with promises that weren’t realized.

Organizations and projects often put training workshops in their plans because it is something that you can do no matter what and then tick off as accomplishments. Of course they are not accomplishments unless the participants go back and change their ways but that requires intensive support and coaching over a long period of time. That rarely happens. How can I explain that what we bring is different?

I like that we were being challenged because it actually shows that someone is not happy with this state of affairs. No one should be, but people have a love-hate relationship with the donors: they like the treats and the trips but they don’t like to be bossed around.

In the afternoon I got a surprise call from a (Dutch) compatriot who is in country with a multi-donor team that is here to validate self assessments from various parts of the health system in preparation for the Health Summit that happens next month. It’s a lofty idea but only works if people actually do their self assessments which they had not. So the team went fact finding on its own.

What they are finding is not a surprise and could be found in any country that receives mega donor funds. Every part that plays a role in the larger health system is disconnected from every other part, from the community down at the bottom of the societal pyramid all the way up to the donor community with their earmarked funds. Everyone knows this, but it is mostly an abstraction as long as the fingers of blame point away to others.

One of the team’s conclusions is weak leadership at the top. That too is not new – but then what? Sending people to Harvard or Oxford, or bringing in a big consulting firm to teach these leaders about management and leadership has been tried before and not produced any of the hoped for systemic changes, even though individuals changed.

Here, like in most other places I visit, the work is embedded in a culture that does not let criticism rise to the top. As a result higher ups are not benefitting from any meaningful and actionable feedback about their own contributions to bottlenecks and miscommunications. Thus it is not surprising that people are looking for causes and solutions that do not include them. What’s bad and hurtful about this state of affairs is that the criticism is voiced to others, outsiders or peers, and so it does enter into the organizational bloodstream after all. And yet it cannot be acted upon in a direct way because of the way it is voiced, softly and behind people’s backs. No one will ever be successful this way.

All this makes my mission very timely and at the same time difficult because everyone wants other people to be trained in leadership, yet there is no open communication about any of this. I am making these visits and notice that the dots are not connected, and no one wants to be fixed unless the training is seen as a nice vacation from work and some extra income.

How all this is playing out in my psyche was obvious from a frightening dream I had during my afternoon nap in which my brain was disconnecting from my limbs and senses, or more correctly, the place that the sensory nerves went to was disconnected from the command center that told the motor nerves what to do. I wanted one thing but my body did something else, my eyes weren’t registering what was in front of me and I had no control over where I was going. It was a perfect representation of the team’s findings that were communicated to me many hours after I had the dream. On a cellular level I knew.

Distractions

My first Ghanaian lunch (manioc leaves with ground melon seed, fish and fried plantain), consumed on Monday, contained something that did not agree with me. This became clear yesterday when I could no longer pretend that all was well and blew my lunch out of the car door, opened (mostly but not entirely) just in time. I did manage to have a fairly productive meeting with the dean of a public serve school just before this; but towards the end I knew that I better start looking for a quick exit, so as not to embarrass myself and my colleague.

That put an early end to the day. It was a good thing we had not been able to get any appointments. I spent the rest of the day in recovery mode, sleeping and replenishing lost fluids. I could have been in a worse place to do that. Still, it was boring when not asleep. I could not stand to watch the barrage of doom and gloom stories on CNN – and with few other interesting channels, I turned the TV off. I was too weak for reading or computering. Nurse Cary gave me an email consultation from Cambridge and I ordered her prescription: rice, ripe bananas and toast – the kitchen only had rice

La Rue delivered the 45 page application for research permission to the Review Board after dropping me off at the hotel since I was no fun having around. She later reported that the phone call from the chief helped although the Board will not be considering our application today – we missed that slot, but two weeks from now, in a specially callled session. That will still work.

And, now, after these distractions of the proposal scramble and food poisoning, it is back to work – there are only two and a half days left.

Architecting a better place

After our first day of work in Ghana I can say that we made progress on one front and were set back on another. The senior leadership program is beginning to take shape. We got something I have wanted to get for months: a determination of which teams shall participate. We also have a rough idea on when this program might start and who will facilitate. I am testing the model that we constructed only a week ago in Cambridge on what sets senior leaders apart from the district teams we have been working with here in Ghana – that got a good response too.

The next hurdle will be to get attention from the very (very) busy senior leaders and their subordinates so that we can explore what they are up against, collectively and individually. We are calling and trying to get appointments but so far no luck. I have used up one of my 4.5 days here, so this will be an exciting race against the clock.

The setback is that the submission of our research proposal to the authorities, which we had thought had been duly submitted as required three weeks ago turned out to have been lost in between offices. This led to a frantic scramble to get official letters from collaborating institutions here and in the US, and a new document, written according to guidelines that have only now been revealed to us, a literature review, consent letters, etc. People and organizations like ADRA and GIMPA are coming to our rescue.

The document has to be delivered, in 13 bound copies, at the Ministry’s Research Unit early this morning – with no guarantee that the review board will get to it, or consider our handiwork of last night sufficient. The next meeting is in 2 months, too late for us to piggy back the low budget research project to the leadership development program that starts in one month. This delay would effectively nix the research project.

La Rue, bless her soul, is doing the re-writing as she knows about research and the requirements of Institutional Review Boards. I would have been totally flummoxed. My contribution was to deliver the connections and a cell phone with enough minutes to produce at least some of the letters and endorsements, including a phone call from the highest authority. Whether this will help remains to be seen and we are keeping our fingers crossed behind our backs. One step forwards, one (or two) backwards.

In the meantime a surge of energy is coming in through the internet from Sita who has set out, with her Value Web colleagues and graphic facilitator buddies to connect the dots around the world. The dots are all the people who are working for social justice and eradicating all sorts of bad stuff from the globe – not for profit but out of a deep sense of obligation, or simply the excitement of trying out something new. She is bringing idealist fervor to the table that is in sync with what our new president is trying to hold on to in the midst of public outcries and self-righteous and simplistic demands.

Sita wants me to connect her to other people who are experimenting at the edges, innovators, creative geniuses, social experimenters. It makes me search my mind for people in my network who love this sort of ambiguity, open-endedness, and would embrace the idealism of such an outrageous idea (what? work together, hook up with people around the globe, across disciplines to make the world a better place?).

It has been tried before and it can be tried again, each time a little different. The codeword I am learning, as I follow her quest, is re.co.de which stands for repetition (as in iteration), collaboration and design. I made a subfolder in my inbox to hold all this energy tightly together. I named the folder ‘Sita CTW’ – the last letters stand for Change The World.

But when I go through my network I find very few of the kind she is looking for and more of the kind who, I think, would ask me: what’s this all about ?(answer: an idea as in idealism); what’s the result ? (answer: we don’t know); what’s the outcome? (answer: something good); how would we measure that? (answer: beats me); who would benefit? (answer: everyone except the really bad people); who’s funding this? (answer: no one in particular moneywise, and everyone who joins, energy wise).

At a closer look of her last email last night I noticed that her signature stamp said, Sita Magnuson – Vice President, US – The Value Web. Imagine that, we have a VP in the family. I am so proud of her, not so much of the VP title, although that is certainly cool, but because of the energy she is applying to this connecting people to one another around the world for a greater good. It’s a long way from the moody adolescent who said she wanted to be a garbage collector in New York City because someone had convinced her they made so much money, and that’s what she wanted.

Have a Guinness…

I celebrated my safe arrival in Ghana with a Guinness, a beer that is very popular here, while watching CNN report on two plane crashes. I am drawn in a morbid sort of way to plane crashes. I watched a series of specials on famous plane crashes on the National Geographic Channel in my Ethiopian hotel last year. I could not help myself.

The possibility of planes crashing is never far from my conscious mind. I do feel safe on the long-haul flights that take me to Europe and then onwards. But occasionally, while I am dozing off, I register subtle changes in engine sounds and imagine we are falling out of the sky – in my semi-conscious state I surrender, after a brief moment of panic, just like I did in the real crash; maybe it is because it served me well that time.

La Rue and I finally met up in the plane when I heard someone looking for her glasses in back of me. I recognized the voice. We somehow missed each other in Amsterdam.

The flight to Accra was full, unlike the one to Ethiopia last month. Maybe the world’s financial crisis is not hitting Ghana yet. I shared a ride to the hotel with a gentleman who is trying to sell TV-on-demand to the Ghanaians. His company must think so too or maybe the expectation is that unemployed Ghanaians would like to be watching TV-on-demand while waiting for the economy to recover.

I got more breathless reports from Axel about his adventures in Costa Rica and a vehement denial of my statement yesterday (‘He’s so busy having fun that he won’t even notice that I am gone.”). Diane also corrected me. I knew, I knew.

This morning we are having an early meeting with the chief of the country’s health services (before people start to interrupt him and exact his attention). This is no small feat. I am grateful that I can start my assignment by getting my marching orders directly from him. And after that everything is rather loose and the week’s calendar needs to be filled quickly, before it is over.

Peace

Saturdays are nearly always dedicated to flying, weather permitting. I woke up to a glorious bright blue sky, no winds, a perfect day for taking off. Bill and I were going to practice yesterday morning, among them some IFR procedures that would be new to me. But it was too beautiful a day for staying close to Beverly. So we changed our minds. I flew to Biddeford in Maine and then over a winter landscape and many frozen lakes west to Laconia in New Hampshire. The last time I landed there was with Axel on one of those $100 hamburger trips in the early summer of 2007. Bill flew us back to Beverly.

When we landed in Laconia a couple, in their late 60s, with a huge dog and a Mooney (a fast little plane), were preparing their flight back to Virginia. It would take them about three hours. I watched them with some envy. That is what I had in mind, starting to fly late in life: going on trips with Axel – maybe not as far as Virginia, but surely all over New England. We are not quite there yet. Axel has mentioned that he may be ready to fly this summer. His first trip will probably be him sitting in the back with Bill and me in the front. We are not in a hurry to do this though.

My (ex) sister in law Judith was cremated yesterday. I am sorry I could not be at the service, in Holland. If if only I had left one day earlier. But such things cannot be known, even when there was no surprise. Still, I was there in spirit. She’s traded in a life that held no promises for something else unknoweable – undoubtedly more peaceful. She is in a better place now than she has been in a long time. “It was good” wrote my brother. And with that, a chapter is closed.

I caught him on his cellphone, only minutes after I landed in Amsterdam. He was sitting on a sunny terrace, after a bike ride through the dunes, looking out over the North Sea. A good place for reflecting, contemplating and sorting through the avalanche of feelings and the social, familial and private labels attached to each of them. If mine are already mixed, I can’t even begin to imagine his.

Axel is having a good time in Costs Rica. He sent me a picture with his and Chuck’s catch of the day – a trout I believe. He’s so busy having fun that he won’t even notice that I am gone.fishy_axelchuck

Scrambled with salt

My friends Joellen and Carol, both ex colleagues, showed up in my dream last night; independently. I remember at some point that I was to tell each one that the other was also going to Haiti. The dream happened someplace else and consisted of different chapters with entirely different stories; one before waking up in the middle of the night and the other after. The last phase took place on a gorgeous estate someplace near the ocean. Except for Axel I did not know the people who showed up in my dream. We all shared the immense place peacefully; maybe because we were all trespassing as it was not ours.

The daffodils were out, the vistas spectacular. To (or from) this place I rode in some form of public transport and had kicked my shoes off and put my possessions on the dusty and dirty ground where they had rolled around during the trip. At some point I had to get off and had to scramble to find everything. People were helpful but it was still a scramble. I reluctantly went down on all fours to scout under the seats for my things. I never found out wether I ever got off the train or tram or whatever it was.

Tired from the hard work of my dream I woke up in our Best Western hotel room with a view of the parking lot and Fall River’s industrial area beyond. The parking lot is empty except for a handful of cars, a touring bus and a truck. The interior of the room is sleek and functional: an enormous TV and king size bed, a black microwave and refrigerator, a dark wood grain veneer kitchen/media center and desk, two armchairs upholstered in a silver/grey metallic check, a (fake?) leather executive swivel chair, and 5 lamps on brushed metal pedestals. If you have to work and stay here for awhile it is not a bad place. It even has wireless. The outside is designed by an architect from the ‘build-a-box’ school.

It took us 3 hours to drive to Yale’s Art Gallery for an exhibit that could be seen in about one hour. It was a delightful exhibit that spoke to Picasso’s experimentation with various printing techniques (etching, dry point, linocuts, and lithographs) and his playful illustrations of the writing from Ovid, Balzac, and his contemporary writer friends.

While I enjoyed the playfulness and/or clean lines of his illustrations (I don’t care about his cubist work) it is hard for me not to include in my appreciation of him his terrible treatment of women and his appalling home life – I have a hard time separating the two and so looked at his accomplishments different from the way Axel looked at them. Axel is taking a class on printing and sees something very different. But we both agreed that it had been worth the long drive.

With a few minutes to spare we visited one more floor of the wonderful building in which the collection is housed. Axel got all excited to find a (yellow) Josef Albers’ square. He had done a project about him for his graphic design course some years ago. Seeing the real thing is very different from seeing a picture of it. There were other surprises and gems but then we were alerted that the museum was closing and we left, reluctantly.

We drove to our hotel in Fall River via Newport over the two spectacular bridges that span Narragansett Bay. You have to pay a toll but it is worth the ride, especially after nightfall with all the lights. In Fall River we scrambled to check in, select a place to eat and then find it (in a city we don’t know) in time before it would be closing for the night.

We arrived at a full restaurant where most people were just paying their check and ended up being the last two diners. It was a delightful Portuguese restaurant,Sagres, named after the town in southern Portugal where Henri the Navigator built his school in the 1500s for other restless souls and from where he discovered the world. The restaurant’s fare is primarily fish, with several dishes based on the famous salted cod, bacalao, great vinho verde and a wide choice of porto varieties to end the meal. We followed the recommendations from our young Portuguese speaking waiter and had no regrets, although we did have to drink a lot of water during the night to recover from all the salt.

Juicy babyboomers

It was pitch black when I woke up this morning – the one hour forward is actually a setback because I am getting up and leaving home in the dark again, but not for long.

Kristen and I flew back from DC in a very full plane that was one in a series of continuous departures from the crowded USAID terminal; as if everyone wanted to get out of DC. Back home I found Tessa and Steve busy packing for their trip to Steve’s family up north in Canada; the dog restless, knowing something was afoot. Axel was chairing his town committee at the town hall, doing community preservation business. The house was empty.

The trip to DC was, except for the travel part, very enjoyable. I like traveling with my younger colleagues and hear about the courses they take and the learning they do. I also like to hear about their families. Their parents are about my age and it is interesting to hear perceptions about parents from our daughters’ cohort. We also talked a lot about group dynamics, my favorite organizational studies topic. And so the trip was more fun than I had anticipated.

The half day workshop had been advertised as a ‘Health Systems Strengthening Roundtable’ in the international health community that resides in and around Washington. One participant came all the way from Richmond. We had exactly the number of participants that could be seated around the very large conference table, representing various organizations that we sometimes compete with for government grants or contracts, and sometimes collaborate with. A few colleagues from our organization’s offices and projects in DC attended as well; people I only knew by name, or not at all.

The design for the workshop, not quite tested in that specific form, worked nicely as each part built on the previous piece and was introduced, as if scripted, by a pertinent question from our audience.

A friend of Tessa, just out of college and job-hunting in the field of international health, happened to be in DC. I had invited her to attend as it would give her a much better overview of what we do than me talking to her for an hour. I was not sure I would recognize her as I had not seen her in 15 years – from 8 to 23 makes a big difference. But I did; her face exactly as I remembered her as a bright-eyed 2nd grader.

After the workshop our new Washington-based colleague La Rue joined us for lunch. La Rue and I are travelling together to Ghana in 2 weeks and we have communicated so far entirely by email and phone so it was time to meet in person. I spent much of our lunchtime listening spellbound to her stories about her family which, in structure and age, matches mine: 1 older sister, 2 older brothers, 1 younger brother, and both of us born in the early 50s. We also had been in a house-on-fire early in our life. But there the resemblance ended; I grew up in a Holland that was on the rebound after the war and with university-educated parents; she grew up in the Appalachian Mountains in Southern Indiana in a small house without indoor plumbing.

Her stories could fill a book; not one she would write as it is not all that happy, especially the current chapter. It is about the kidnapping of her demented father, and a marriage that was tricked on him by a woman in her 70s who is after his assets. She has a daughter in the same business and they have gotten themselves quite wealthy over the years, with many houses signed over by husbands now dead.

La Rue and her siblings have been in court several times but the laws don’t protect them or their father as marriage is quite sacrosanct and the law, rightly so, protects women from men, not the other way around. I thought this was a good thing and suppose it mostly is, but not in this case. The children have to visit their father under police escort and at least half of his estate will go to the new wife.

Aging women as predators, I never would have thought that possible; according to la Rue, it is unfortunately quite common as they discovered during their research and days in court. And the hunting grounds are wide open and filled with a wide choice of juicy victims: wealthy baby-boomers who have lost touch with their children while they amassed their riches, sliding into dementia with no one to protect them. I am happy that this is a problem we won’t have.

Fragile poems, messes and stresses

Yesterday was a long day that ended at 9 PM at the Melrose hotel on Pennsylvania Avenue in Washington DC, in a 3 room suite. A bill that matched it in size was pushed under my doorway this morning.

When I travel I don’t get up at 4:30 AM so yesterday started slow and late. Axel cooked me breakfast, leaving me time to admire Lobster Cove, spectacular in its post snow-storm appearance. Everything was covered in frozen snow – the kind of white that looks blue in the sun. It made me want to pull out my watercolors – to catch the snow on tree trunks and branches, best painted by not painting it, as negative space. On some of the branches the wet snow had melted and then frozen again; ice crystals that sparkled in the sun like jewels. To complete it all a bright red cardinal settled down on a high branch, chirping as if there was no tomorrow. It was a fragile and tender nature poem – for now the sun was helping it come to life; soon it would kill it.

I dropped the car off at the Shell station near work to fix the slow leak in one of the tires. A little gremlin is piercing the outer wall of our tires. One month ago we replaced one tire and now this one on the opposite side has the same problem. We are puzzled by this and soon some 200 dollars poorer; but then, we know that the tires and the car are old and worn. The Korean mechanic circled the pinhole that he could do nothing about with yellow paint. He put the tire back on, it’s a slow leak after all, and did not charge me; he knows I will come back. My belief in the basic goodness of people is coming back, even if it is simply good customer service.

I travelled to Washington with Kristen on the 7 PM flight. These flights used to be full but now, like all others, they are only half full. We sat next to a discombobulated woman from the Commerce Department who panicked when she did not see her purse. When she found it (inside a larger purse) we all sighed and laughed. She was going home to DC and clearly in need of some R&R. She had taught businesses in Rhode Island about export rules and restrictions. When she discovered that we were ‘in international health,’ (in developing countries even) she blessed us for our good work and I kept my skeptic mouth shut, trying not to reveal how we are all tripping over each other in places like Afghanistan and Ethiopia, doing HIV/AIDS work. And that there is money in doing development – some people even derive a very good living from fighting poverty. That’s when shame takes over from pride. But I let her bless us nevertheless. As far as tax dollars go, I feel like I am spending them quite responsibly (we did not take an earlier flight to avoid an extra charge of 50 dollars and instead waited for 2 hours in the airport.)

We have been asked to do a 3 hour session to teach our peers about management and leadership of health programs. We have done a similar event about one year ago. Kristen will do more now and I will do less. We have no idea how many people will show up. There does not seem to be a registration process. We are prepared for one person, for 30 or anything in between. The event is part of our continuing crusade to have those who assign clinicians to run health facilities think about the management and leadership tasks that need to be done before things get messed up. It causes a lot of unnecessary stresses in people and systems. I know this first hand, as it happened in my own family. We have been doing these sorts of events for years and keep being surprised that this is not obvious to others that people need to learn how to manage and lead.


March 2026
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