Sylvia's Journal

We spent three and a half hours in a strategy and teambuilding meeting with the entire team minus one. He had to deal with passport and visa issues, something I have great sympathy for as I am still not sure how to get my Bangladesh visa in time for takeoff, just over a week from now over Thanksgiving week.

We reviewed the last two weeks and all the events that happened. They appeared disparate and unconnected from one another but not to those of us who were involved in all four; we moved from central level NGOs, to provincial level mixed teams, to the DG team and finally the entire collection in one room. It was a perfect assignment for me – two weeks of nothing but designing and watching the design come to life.

We ended the team meeting with an exercise around learning styles that resonated much with everyone as they guessed, mostly right, who had what kind of learning style; there were many aha’s and much laughing but also, I think, some recognition that all styles produce important contributions to the team’s task. I am not sure that the idea that they have a team task has taken root yet – last time I was fooled they had but now I am more realistic. It’s a novel concept and there are few role models.

I was sent out of the room at the end because they were collecting contributions for a present which was bought by the secretary and Ali and offered with much photo taking, after work hours in an empty office. One of the gifts was a porcelain ring box with Egyptian motif made in China, bought in Afghanistan which will be transported to Holland and then the US. The world is indeed flat.

Pia, who used to work at MSH and set up our office some 5 or 6 years ago, came to say hello to old friends. She has her own company now and spends much time in Jalalabad and other places that are much less secure than Kabul. Like me (and Axel and Joan) she is an unlikely survivor of a horrendous (car)crash and bears a long scar on her head, horizontal, as opposed to Axel’s vertical one. We went to the guesthouse and had a real social event in our salon, which looks like an antechamber to a carpet store with all those rugs from Steve. For food and drink we did not have much to offer other than toot and tea (or water, diet coke or fanta). This did not matter because the company was entertaining enough, with Steve, Maria, then Brad and Maureen joining us later.

Pia and I took off for my first night out (which she found unbelievable so it was a rescue mission of sorts). I finally had my long awaited coronas and two tacos thrown in for good measure but not until after a wild ride all over Kabul searching first for Pia’s hotel and then the restaurant. It was a little unnerving because the driver kept saying he knew where these two places were when he did not but could not say so and of course our Dari and his English were no good for serious talk about such matters. At night the streets are fairly empty except for a few trucks and cars and of course the ubiquitous large SUVs scurrying foreigners around who have to escape their confining quarters. Being lost was particularly nerve wrecking when the driver stopped in front of a heavily guarded building with floodlights and suspicious guards coming out of the dark with large guns. After that the coronas were especially wonderful.

We met John and SueAnn from another NGO who are used to go out at night and manage to get their daily rations of alcohol, so unlike us in hotel zero. John worked for Hillary’s campaign but is nevertheless happy with our new president. John is a temporary visitor like me (TDYers we are called); his colleague works in Kabul. For Pia Kabul was a haven of peace even though she was busy on her cell phone arranging for armored cars for their staff doing reconstruction in the East and South. The freedom and normalcy of Kabul made her giddy. Everything is a matter of perspective. I was reminded of Beirut again. John had lived in Beirut and studied at AUB. I rarely meet anyone who has lived in Beirut. Of course neither one of us knew the Beirut the other described, given there was about 30 years in between.

At 10 PM the driver arrived and this time, unlike 7 months ago, I immediately recognized the car and got in without a hitch because I knew the license plate, color and make. Last time I had no idea which car to pick from the line up of large SUVs with turbaned and bearded drivers and security guards. How was I to tell the difference between those with good and bad intentions?

And then it was time to pack. I took the decorations down – the pictures from the Khulm bazar that I bought on my second day in Kabul which seems ages ago. I rolled up the new Maliki rug and put it in the canvas bag that brought the rolls of paper and posters on my way in, a perfect fit.

My sleep was restless and full of dreams about plane and orthopedic disasters, two things that are on my plate now and that fill me with considerable anxiety: getting out of Kabul by air and having appointments to figure out what to do with my ankle next week.

For our session yesterday Ali had mobilized eleven facilitators, most were his own colleagues from our project, a few from the ministry and some from another donor. Their job was to help the small group conversations stay focused on the end result: clarity on issues that they could resolve themselves and those that had to be tackled by higher level authorities in the ministry or even beyond.

After a set of predictable but unpredicted delays our session got started rather late. As planned it did get the system connected to itself with provincial, central and NGO participants talking with each other about things that held them back. It unfolded more or less as we had hoped until the previously mentioned international organization ran interference again. A two person delegation showed up to present something that was not on the program but deemed important (everything here is deemed important). Everyone argued their case (of why or why not this presentation should be inserted in the middle of our group process that was in full swing). We were like lawyers of opposing parties walk up to the bench and whisper something to the judge while the audience waits for the process to continue. In the end we prevailed and our carefully designed and agreed upon process continued; the invading delegation left with a vague promise that they would be on the program later. I know they came back in the afternoon but I don’t think their presentation ever happened.

The small groups went through a filtering process that produced a summary of the major bottlenecks (or issues, or recommendations – the language was a little unclear and I suspect stuff was lost in translation). It’s not my favorite approach, to start with problems rather than a vision, but that had been a given. Post-It notes with issues that did not fit in the current health and nutrition strategy, that did not need to be tackled right now or that could not be tackled by the people in the room were put in envelopes labeled ‘not strategic,’ ‘not now,’ and ‘further up.’ The latter was handed over to two of the 6 DGs for putting on the agenda of minister and his deputies. At least that was the plan. That too did not quite happen in the way we had designed it.

Just when we were ready for the lunch break and the system looked engaged and connected to its self, the said international organization showed up once more, this time its top leadership and a delegation from their regional and world headquarters. They took place at the high table and were invited to address the participants. Then came a goodbye ceremony of one of their staff members, presents, certificates, more speeches. It felt as if we had tumbled into a parallel universe. The impromptu event overpowered what was left of the design of the day and from then on everything defaulted back to familiar patterns of large public events. The energy that had filled the large ballroom only hours earlier had all but dissipated and everyone went back to telling (top) and asking (bottom).

There were some feeble attempts made to refocus the event but it was out of our hands. At 5 PM Steve and I quietly walked out and headed into another dust-filled traffic jam across town. We did not get home till 6 PM. One of our colleagues called at 9 PM that he was just home. The event he had put so much effort in to organize had droned on hours past its formal ending time. May be it was a big success, or good enough but I don’t think it did much for encouraging leadership in the provinces, despite the exhortations to lead.

I dreamed of a simple dress that contained vaccine. Somehow, it was able to slowly pass from the fabric into your body and deliver sufficient protection to save you from one or another vaccine-preventable illness. I heard enough the last few days about unnecessary deaths that could be prevented through vaccinations that my mind set to work during the night and came up with this idea. If I had an iota of entrepreneurial gutsiness in me I would further explore this farfetched idea. But I don’t. I am in a different business which is the one of thinking and talking together in productive ways. That will be our challenge this morning. It was originally on yesterday’s program but various forces conspired against it.

Yesterday had some activities inserted that were not on the program. A high powered UN team from outside the country arrived just in time for lunch – funny how so many people show up just before lunch. The delegation shamelessly hijacked the morning program under the guise of ‘a nice opportunity to exchange views with you.’ I could see the organizers biting their tongue. But the interference is sanctioned by the highest levels, so what can you do?

Although I agree that it was an opportunity, the ‘exchange’ part did not work. The exchanges were nothing more than a series of requests for help from the audience, reducing participants to the role of victims, or worse, beggars for this or that, rather than agents of change. It is a role many are familiar with when in the presence of higher authority and, like a well worn coat, they wear that role with ease. While some of us try to strengthen leadership and management, much of the design of public discourse produces behavior and attitudes that are antithetical to leadership and instead reinforce helplessness and dependency.

I have entirely transferred responsibility for our interactive session to my counterpart, and he has successfully delegated subtasks to his peers. He organized a just-in-time orientation of facilitators from our project’s team, the EU team and some from the ministry of health. Organizing this was a challenge and a half. I admired how he pulled it off over lunch. This required not only rounding everyone up but also chasing higher level officials away from our reserved table, something no one felt comfortable to do. I offered myself as the naive foreigner and politely explained why we needed the space. I hope my outsider status made this act forgivable. All in all it was a nerve wrecking enterprise and I tightly crossed my fingers behind my back.

The hijack of the morning created such a ripple that the entire program was hours behind schedule. By the time our session was supposed to start it was too late. We scrambled to re-budget the time for the next morning, knowing that there was a hard stop at the very end of that last day and that this change, in turn, would create further ripples. Everything was off balance.

More annoying than the hijack itself was the fact that the high level delegation left after lunch and therefore never found out about the consequences of its act. I am trying to figure out how to get that feedback to them since I know it is unlikely that any Afghan would even consider doing something like that. It is safer to whisper and complain about it in private conversations (and I heard a lot of those).

It was past 5 when the day was officially closed, and it took another half hour before we had a car. The sun was setting by the time we got on the road. And although rush hour should have been over, the traffic was so thick that it looked like a slow drive home. The driver decided that was not a good idea and took us over Television Mountain to the part of Kabul where we live. I am not sure it was actually cutting anything short but there was at least a sense of movement, albeit it very bumpy, over unpaved mountain roads. It wasn’t only better than standing still in traffic; it was also exotic and different. For awhile we were high up seeing the lights of Kabul below us while around us we appeared to be in a remote mountain village – mud brick houses and hardly any lights.

Steve was delivered at the office to catch up on work and messages from Boston but I had had enough and was dropped off at ‘hotel sifr.’ I realized that I had not yet gotten the irritations of the day out of my system and unloaded on Maureen and then wrote an impulsive angry email which I later regretted, before it got far into cyberspace ( I hope). An early evening phone call with our team in Cambridge was the final work activity of the day. Altogether it was enough and made for a very long day.

In Dari the place I am staying at is called hotel sifr (zero) or hotel yak (one), That is what the drivers call on their radio when they approach the house because the guards have to open the gate so there is no idling in front of the house; a security measure. I am still not sure which of the two houses in our compound is Guesthouse Zero and which is Guesthouse One. If I stayed in hotel zero last time I must now be staying in hotel one; or it is the other way around.

My evening and morning routines in the guesthouse are now well established – it took a while to do so as I was learning how to make best use of all that was available to me. After dinner I fill the rubber bladder that I brought from home with hot water and put it inside my bed. That way it has a few hours to warm the bottom of my bed where my toes will be.

I bring a thermos from the kitchen and some bags of green tea. The Thermos bottle is made in Japan; unlike the large and often garishly decorated and colored Chinese thermos flacons that are ubiquitous in developing countries, this one is reserved and subdued in its colors and decoration. According to the label at the bottom of the thermos, the color is ‘cacao herb,’ an undefined tan color. Three messages, written in very small print and thus easily overlooked bring the user some good advice. Nobody in the house had noticed them. Two of the messages, marked by a large letter G and F say that we should enjoy working in the garden and put fresh flowers in our house. The third has a stylized picture of a flower and sums up the other two: Live beautifully together with herbs. The two kinds of thermos flacons entirely capture the national character of these two different nations, as least as I have experienced them. The adjectives I have heard the Chinese use to describe the Japanese and vice versa could also describe these insulated bottles that keep our water warm.

I drink many cups of jasmine green tea at night. According to the package, this tea ‘reduces stress, depression and headaches and stimulates metabolism and the calorie burning process.’ I am also assured that the tea has no side effects. All this is good since I am eating here more and differently from what I am I used to. I leave enough hot water in the cacao herb bottle for the morning to warm my hands while blogging and checking mail. It helps with the increasingly unpleasant task of getting up in the morning. The cold invades my room during the night when there is nothing to hold it at bay other than my 25 pounds of Chinese blankets.

After writing and checking my mail I wrap myself in a warm blanket, put my slippers on and cross the yard to take a shower in the downstairs bathroom of the other house where the water is hotter, the pressure stronger and the tank bigger.

For breakfast, unless it is his day off, our housekeeper puts everything on the table that could possible be consumed during breakfast. Every day he puts things out that nobody touches. It is all about routines. We have a choice of jams and jellies that come from Greece, Turkey and Pakistan, peanut butter from America, honey from Australia and various Kellogg’s products, Familia Muesli, leftovers from last night’s desert, cookies, yoghurt, a bowl of fruit, a bowl of hard boiled eggs, brown European bread and naan (local bread), milk and a variety of juices from Europe. The Special K box reminds us that ‘Every woman wants to be admired in that special way’ and then gives us advice on how to get the shape that would have us admired. Of course this includes eating lots of Special K. Steve has been eating the stuff for months but it doesn’t work for him. You have to be a woman.

The national health coordination warrekshp (this is how the word is spelled and pronounced in Dari) is held at the glitzy Safi Landmark Hotel in downtown Kabul that stands in sharp contrast to its surroundings. It is considered a pretty safe place even though important people congregate there. It has the kinds of glass elevators that ride up and down the sides of a 7 story atrium, just like the big chain hotels in the capitals of the world. It also has a mosque on the 7th floor so prayer breaks can be short. At the bottom of the atrium is a real coffee bar and sparkly stores with expensive toys for grownups. Some of our colleagues who work on another project stay there. I am glad I am not. I much prefer our homey guesthouse and its interesting inhabitants.

I was glad I was not responsible for the conference that started yesterday. It had all the usual glitches that happen when you invite high level government officials who do not show up at the appointed time because something else pulls them away. I was sitting next to someone who was responsible, a half Greek, half Italian, French speaking and Afghan looking woman who represented one of the three major donors who had paid for this gathering. We had a good time together, me providing perspective while she sailed with clasped hands and a good sense of humor through the ups and downs of the conference’s beginning. In the end everything worked out, as things often do that we obsess about.

The high official eventually arrived and exhorted everyone to do their best. He also paid homage to fallen comrades, some 45 doctors, both female and male, who had been slain in the line of their medical duty over the last year, mostly in the areas to the South and the East of Kabul. Four had their portraits displayed. They all looked sad, as if they knew what was in store for them when the pictures were taken.

One of the director generals showed a video of a trip in winter in Heart province (it should really say Herat Province but the built-in spell checker always changes it to Heart). It is amazing how snow covers all that is not pretty. The video footage of SUVs driving (and being stuck) in snow could have been taken in Massachusetts, except for the part where doctors treat patients right from the back of the truck or the passenger seat with crowds of mothers standing in the snow and holding their babies up for examination. There is much writing of prescriptions going on which is, I am now learning, the essence of medical practice here. I am learning so much each night around the dinner table that I think we should be sending anyone working in public health to one of the guesthouses for a thorough induction into the profession and learn about the difference between theory and the real world.

Steve and I did not stay the whole day for the conference. It is expected and good form, as foreigners, to show up at openings even if a conference is in the local language. When the opening takes place in the middle you end up attending most of the day. By the time the conference was officially opened it was nearly lunchtime and so we stayed to partake in the very classy meal that was offered to us by the World Bank, the EU and the American People. It was a few notches up from our guesthouse food; given the cost, it should have been indeed.

The first part of our session is today. The session had no name other than ‘organize for group work.’ I think that is because people know that is what I will do. I proposed a more appealing name (Towards aligned and concerted action for better health). It is placed at the low energy hour of the event, after the mid afternoon tea break. Whether it will actually start then assumes that everything else will go more or less according to plan. Dr. Ali is mobilizing all his colleagues to help facilitate the break out groups while he will lead the session. I will hover on the side, may be occasionally mouthing the words ‘focus.’ The session is so designed that it should hold the conversations and create the container in which ‘us versus them’ can become a ‘we.’