Archive for the 'On the road' Category



Tourists

On Saturday morning Cabul and I set as out as tourists. ADRA had made driver Charles and an ADRA car available to us in exchange for expenses, a very generous deal. We drove to Fort St. George at the end of the bumpy road into El Mina.

The Portuguese arrived here in 1482 attracted by vision of gold. They built a fort with a church inside it, as they did in many other places along the West African coast. The Dutch, their arch-rivals at the time, showed up in 1637 and kicked them out. They enlarged the fort with two moats and a drawbridge Drawbridge at St. George Fort in El Minathat has a distinct Dutch flavor. They turned the Portuguese church into storage space and made a more austere church in the main building of the fort, right above the female slave quarters, dark and filthy places where the women and men were held, separately, waiting for the ships to take them across the Atlantic.

The old church now holds an exhibit about culture, kings and the customs of the land. The list of kings goes back to 1300; the first 350 years seem more stable with kings chosen along the maternal line; the second 300 years favor the paternal line but there is much interference from the Portuguese, then the Dutch, and then the British. Kings sit on stools rather than thrones, and thus kings are stooled or destooled as the case may be.

As the guide told us delicately, the Dutch men, and the Portuguese before them, were without wives in these dangerous tropical lands and so they needed ladies. Thus, from time to time the miserable group of women was let out of their dank and dark dungeons into the courtyard. Standing in that very place I could picture how the governor, leaning out over a balcony two stories higher, would scan the crowd for his enjoyment. While he was doing this the blinds on the church windows across from him would be ordered closed. Clearly he did not want God to see him as he was preoccupied with his baser instincts.

If the governor could not make up his mind the guards used a Dutch rhyme that I learned when I was little (iene, miene, mutte). Our guide Richard recited it with the right intonation; the words were a little off, but may be it is because it was old Dutch, a language I never learned.

The ‘lucky lady’ was cleaned up by soldiers and given some food and sent up through a set of backstairs and a trapdoor to the governor’s private quarters, to be used as he wished. After he was done she’d go back down the trapdoor and held for a while on the floor below to entertain the officers who lived there before being discarded back into the mass of misery down below. Her only hope was that she conceived. Pregnant women were released. They could go home, a walk of some 1000 miles, or stay in town and become the mothers of a new group of notables. Their children had Portuguese or Dutch last names and were of light skin, which meant better in the social pecking order. They became the new elite. They are still very visible to this day al along the Southern coasts of West Africa. The Maternity Home has been restored and stands as a symbol of new life, in more than one sense.

The Dutch were driven out by the British in 1872. With the abolishment of slavery the place started to decline as a commercial center. Now, with the help of the EU and the Dutch government an ambitious restoration project is underway. Pictures of Dutch Crown Prince and his Maxima show the launch of the project.

After the fort we visited a similar imposing building but there the restoration and ‘touristification’ had not yet taken place. We were the only people there and had to wake up the ticket seller, sleeping on a bench in a stark naked room with only a transistor radio for company. We paid 2 dollars for a self guided tour as per the fee schedule posted on the wall but there was nothing to guide us; the place was in disarray with debris and construction material strewn along, bats and birds nesting in the turrets. They did not like our intrusion. It was a very short tour.

After lunch at the restored Bridge House, now a hotel and restaurant, we left for Kakum National Park. The park is about 35 kilometers inland, and has the only canopy walk in Africa, according to our forest ranger guide. We started our walk with buses full of Ghanaian adolescents, mostly church groups, and a sprinkling of foreigners. The walk up was tricky for me, uneven rocks and quite steep at first. But even I was in better shape than many of the young Ghanaians, so I understand the health minister’s preoccupation with ‘Mens Sana in Corpore Sana.’ Cabul and I were number 2 and 3 on the walk which consisted of 7 spans of 40 to 60 meters long that were constructed from aluminum ladders laying flat on the bottom of nets tied to ropes and with a plank over the ladder to facilitate the walking. Canopy walk in Kakum National ParkThe walks were between 11 and 40 meters above the ground. It was breathtaking to be so high up with the sounds of the forest canopy, mostly insects and birds. We were sufficiently ahead of the teenagers to not hear their shrieks of laughter and terror. We watched them later as they stepped on the first walk, the boys teasing the girls, the girls playing their damsel in distress role to the hilt.

Back at the park entrance I visited the exhibit which was nicely done. It was the first time I saw the Adinkra symbols used in ways I like to use them. Many are stylized representations from nature and it is graphic design at its best: the fern stands for endurance and defiance; the snake climbing up a palm tree stands for doing the impossible and 4 crocodiles pulling outward stands for unity. It gave me some more ideas for next week.

Breakfast with a View

cgbhview_sm.jpgI am sitting at a breakfast table in an open air restaurant that looks out over the ocean. I have a front row seat and watch hotel staff wash the Harmattan dust off the warped ping-pong table. Behind him, not allowed on the hotel premises but as close as is possible are young men in their Rasta outfits trying to sell trinkets to holiday makers. In back of them, just along the water’s edge, a few women walk in a line in and out of view with enormous piles of firewood and bowls on their heads. They walk fast, bare feet. And far off on the horizon I see the fishing pirogues, some with sails others with paddles or motors.

Yesterday morning we left Accra early. We arrived in Cape Coast and went straight to the Ghana Health Services regional office to make a courtesy visit and see the workplace of one of our teams next week. After that it was time for a little holiday as the Brits call it. One of the regional Office staff had booked us in a delightful beach resort, the Coconut Beach Hotel for Friday and Saturday night. Sunday we move to the venue for the workshop which is right behind the regional health office in the town of Cape Coast.

To get to our temporary quarters we drove through the old slave port El Mina, which reminded me of Zanzibar and other slave ports I have seen along the coast of Africa. The place was teeming with people. They are dwarfed by the two imposing buildings that we will visit today. One is probably the old governor’s castle, the Dutch were here in the 17th century, the other I am not sure about. We are going to visit the town today.

The resort is a few kilometers outside El Mina, at the end of a bumpy road that leads through a small fishing village. Small fish are drying on racks everywhere.

We bought access to the hotel’s hotspot access network. I had not expected it and later wished it hasn’t been there. Connecting to it became an exercise in patience and I gave up quickly and ended up sitting by the ocean and reading for hours. Against doctor’s orders I ordered a Pina Colada. It is the kind of drink you are supposed to have in places like this. It was heavenly. Cabul was more task-oriented than I and fiddled with his budget spreadsheets until the numbers came out right. Today he too is going to relax and we will be tourists.

Hillary

My dream about Hillary started with us passing in a parking lot. Hillary was on her way to her caravan (a large family car, the epitome of suburban achievement in the US in the 90s) and I was on my way somewhere.. As we passed she looked me deep in the eye, the way spies would do when they pass each other at a cocktail party and communicate through their eyes without talking. But then she spoke and it was something very personal that surprised me. It had something to do with a choice I had to make. I remember being surprised about the personal attention, as I assumed she was dealing in millions, not single, votes.

Later I found myself in a house decorated in sixties style with kelly green open weave curtains. Hillary, instead of leaving in her caravan, had returned. She was with her son, a pesky little mini version of Bill but with a darker complexion and slightly overweight. He was a real pill and Axel, or was it Joe Sterling, thought he needed to be taught a lesson. I think it was Joe who knocked the kid to the ground. He scrambled up with a bloody lip but he stopped being a pill. Hillary ignored him throughout.

I was surprised her cellphone wasn’t ringing off the hook. She talked about her husband always using his first and last name. Chelsea was there also, but again, a Hispanic version, slightly overweight. She mentioned that Bill had worked with Chemonics. Now things started to move faster. Hillary began to hold court in the (my?) living room and she was on the phone all the time. I was upstairs with Axel and some other people and everyone seemed to be encouraging me to make a move but I felt immobilized. Then suddenly there were lots of babies and the way Hillary interacted with them was very compelling. I remember thinking, if I had a small child I would vote for her. She then left with Chelsea and once again she looked me deep into the eyes. And then I woke up.

Faith & Practice

This morning I woke up from a very vivid dream about Hillary Clinton. It is a novel way of getting votes, appearing in people’s dreams like that. I frantically penned down the dream, still half asleep in order to record all the details. And while I was writing I noticed that the carpel tunnel symptoms of numb middle fingers had re-appeared. I also discovered that since my cortisone shot (Depo-Medrol and Lidocaine) in my shoulder, one week ago, I have not woken up one single morning with numb hands and that my shoulder problems have all but disappeared.

And now I am completely awake and even though it is only 6 AM it makes little sense to go back to sleep. The alarm will go off in 30 minutes and I have to pack since we are moving out to drive to Cape Coast, a two hour drive westwards along the coast. This is where we will be for the workshop and stay till next Thursday.

I will post the dream about Hillary as a separate entry so that this one does not get too long. There was much to reflect on from yesterday’s senior alignment meeting.

I have been thinking about the words faith and practice ever since we ended our meeting yesterday. Faith is something that we, in our facilitator team, had to have in each other as we leaped into this senior alignment event together. Our practice yesterday, and hopefully in the week to come, is about congruence and being true to what we teach. Faith and Practice also happens to be the name of the Friends (Quakers) book of discipline which contains descriptions of the Quaker faith understandings and accepted practices. The book includes a set of queries, which are questions designed to help individuals and groups reflect on their faith and faithfulness. The book also contains a set of guides and statements of what is normative, rather than rules.

There are several Faith And Practice books in the Quaker community so it is not like a bible. These books often start with a quote from a Letter from Meeting of Elders at Balby, in Yorkshire, England, 1656: “Dearly beloved Friends, these things we do not lay upon you as a rule or form to walk by, but that all, with a measure of light which is pure and holy, may be guided: and so in the light walking and abiding, these things may be fulfilled in the Spirit, not in the letter; for the letter killeth, but the Spirit giveth life.” Although the old English is a bit cumbersome and tedious to read I found it interesting to glimpse into another lifetime, centuries ago, and read about killing letters and a spirit giving life.

I think we all felt some sort of spirit moving in and around us yesterday in the Ghana health Services conference room. We were all moved by it in a way that seemed nearly choreographed. Our time estimates were right on, we started early and were able to add something that we had left out fearing we’d run over. Each facilitator did a piece and handed flawlessly over to the next. Everyone was engaged and excited and you’d think that the facilitator team had been doing this sort of work for years and that it was their own.

In my line of work there is much agonizing about ownership and how to get others to own something you care greatly about. Operationally ownership means that the new owner (of a program, a new initiative) starts paying for it instead of the old owner. Sometimes the illusion of ownership is bought by giving people goodies or money to show up and participate. It seems our leadership program is already fully owned before it has even started. I am trying to figure out how that happened, so quickly; I still feel like we have just arrived.

Cabul and I had dinner at the house of our colleague Adama Kone. Adama and I started at MSH in the same year, 1986 and so we both have a Hitchcock chair with a plaque thanking us for 20 years of service. Adama’s chair was shipped to him in Accra from Boston in a huge DHL box. Mine is in my office in Cambridge. If you come for a visit you might sit in it.

This was another French immersion evening for Cabul. Adama had invited some Senegalese physicians who are off to Niger with him next week on a consultancy.  

 It is unavoidable, when you put a bunch of francophones together, even though they could manage English quite well, that they speak French. So Cabul got busy figuring out what we were talking about based on our hand gestures. French speakers use their hands and arms a lot more than English speakers do. With an occasional translation he managed to follow the rough outline of our all-over-the-map conversations. By simply observing he had a Francophone West Africa experience thrown in for free with his anglophone West Africa trip; a bonus that included great food (cieboudien) and 1 centimeter (in my case) of an excellent Chateau Neuf du Pape from 1995.

A Leap of Faith

Today is our big event for this week. We call it the Senior Alignment Meeting. The purpose is to bring senior government officials on board with our leadership initiative by exploring links between the things that keep them awake at night and the promises of this program. When we did this program in Nepal a couple of years ago only 7 people showed up of the 35 invited and we did not quite get the alignment we had hoped (we got it later). Here it looks like we’ll have the opposite. We would have been happy with 10 people but the latest tally is nearing 40. Whether numbers correlate with degree of alignment remains to be seen.

I went out with a longtime friend last night who I had not seen since I last worked in Ghana in 2004. I had my first not starchy meal (Tigerprawns and haricots verts, or, as they used to be called when we lived in Senegal, Harry Couverts). We caught up and compared experiences of getting close to our sixties; we who always thought only other people got old. I received a good overview of the lay of the land, at least one person’s perspective and received some advice that may prevent surprises. Much of this has to do with expectations and people taking things so for granted that they fail to articulate them. This is what sometimes gets foreigners in trouble. We assume, but we don’t check. So last night I checked. It is all part of the leadership practice we call scanning

During the day we designed and prepared for this important meeting with four members of our newly built facilitator team. To get us in the right frame of mind, we started the day with a wonderful internet slide show called an Irish prayer that was sent to me the night before by one of my colleagues whose mother just passed away. It is about wishing people not smooth sailing and beds of roses but the things that help you through rough times. It was about all the things that we experienced over the last six months.http://www.e-water.net/irishblessing_en.html

We had a very productive day. The resulting design of the meeting today is better than the draft I did on my own the night before. I had used some of the Ghanaian Adinkra symbols that mean something I felt was relevant for this program and us as a team: Two Heads are Better than One; Doing the Unusual or the Impossible, and Unity.

Doing the ImpossibleUnityTwo Heads are Better than One

The leap of faith part is that I have not yet seen any one of the team members facilitate. Some people might say that it is risky to do this with such high level folks but for me it is a calculated risk. It will test my belief that facilitation is easier and less likely to go off the tracks if the design is robust. Most of the failures I have seen in meetings were a direct result of not having a design at all.

I discovered that several of the people I met with during the nutrition meeting At UNICEF in New York a month ago are actually meeting again across town, right here in Accra. There is a lot of traveling and meeting going on in the world I live in and I wonder when some of these people are ever home. But maybe people also wonder that way about me.

While I am preparing for the immediate future, as in today, I am also, on the side, preparing for other trips over the next few months, Ethiopia, Tanzania, and Afghanistan. I am catching up with my old lifestyle and it makes me happy. The assignments are exactly the kinds of things I like to do.

Up and Running

Up and running was far from my mind for months. Actual running is still not in the stars. My regular walking has greatly improved. I am rarely limping. I can get myself into ADRA’s large SUVs without too much effort. I don’t think people here can tell that I was in a wheelchair four months ago. But still, the nerve endings in the ball of my right foot and in my toes are not back to their old state. Sometimes it feels as if I walk on a wad of cotton balls. There has been no significant change in months now and sometimes I wonder whether this is the way it is going to be. I have discovered there are many people with neuropathies in their feet or toes. People usually don’t talk about them unless you ask. I am learning that this condition simply becomes part of who you are, like a scar. You learn to live with the odd sensation(s). If this is the only lasting damage from our fall from the sky, I have no reason to complain.

I am starting to get sloppy about my exercises-in-the-shower routine. Part of the reason is that the shower is actually a narrow bathtub and the angles and surfaces I need are not right. Once I am out of the shower the tasks of the day call me and the exercises are forgotten. There is also no one else around to remind me.

Yesterday was a day of up and running in the figurative sense. At a little past 9 o’clock we had 10 potential leadership development facilitators seated around ADRA’s conference room table, half of them from the ministry, and over half of them women. Nearly all of them were informed at the last minute, some just an hour before. This was not because of bad planning or anything like that; I considered it in a more positive light: a spontaneous response to the seeds we had dropped about the program and scattered into the wind during the last 24 hours.. The group was enthusiastic and diverse, representing various sectors, organizations and professional interests.

I had planned a full day orientation and team building workshop during which people experienced some of the exercises they are expected to facilitate next week in Cape Coast. That way I would be able to observe them in a group. I saw what they are passionate about and gleaned insights from their long and deep experience in Ghana. We shared our personal philosophies about learning, leading and managing and we reviewed some of the challenges that the teams they will be working with will be up against. I asked one of them to facilitate our own visioning exercise which led to a great conversation about inductive and deductive planning approaches.

We took a break that took twice as long as I had planned because we went to a popular lunch restaurant, another maquis, which required a car. Despite our efforts to be organized and order ahead of time it took an hour before all of us had received our meals. The manager of the restaurant was trying to instill an attitude of customer service in her wait staff but it was a lost cause as all of them, including the kitchen staff, struggled to keep up with demand. It was a seller’s market and thus bad luck for us. But the food was great and so was the company and there was lots to see.

Next to us a large number of Maggi sales people (‘Maggi and Me, the Secret of Goodness’). They were celebrating something. They were all dressed in the same bright red and yellow shirts. I regret I did not take a picture of them; it was such a festive sight. I asked the two white managers, older gentlemen, who did not look half as smart in their shirts as their young Ghanaian salesforce, how one could get a shirt like that and their answer was ‘you work very very hard.’ They emphasized every word in a way that made it seem an unattainable dream and look at the proud wearers of the shirts with some envy. Cabul thought it would be nice to have a uniform like that. It does create an instant and clean sense of belonging. In search of the missed picture I went on the Maggi (=Nestle) website of Ghana and found all sorts of useless but interesting information. There actually was a Mr. Maggi (Julius) julius_maggi.jpgwho founded the famous cubes over 100 years ago. I did also learn that there is a coveted “MAGGI Homowo Kpopoi Manye” title at the grand final event of the Homowo Festival, a harvest celebration in the Ga community around greater Accra. Maggi sponsors cookouts where, I presume, much Maggi is used. This competition has evolved, according to the site, to become not only a key brand-building event for MAGGI, but also for the ethnic group called the ‘Ga.’ Imagine that, brandbuilding for ethnic groups. I am struggling with the concept.

Ready-Set-Go

Today is my Irish-twin brother Willem’s birthday. For one month each year we have the same age. That month just ended today. Happy Birthday, gefeliciteerd!

Yesterday was like the Tetris computer game, where different shapes fall from the top of the screen to be stacked right at the bottom of the screen. Good hand-eye coordination and fast reflexes are needed to guide the shapes into the right spot so that they create a smooth surface for the next series of shapes. If you stack them wrong you quickly get into trouble and to the game is over before you scored any points at all. The more progress you make, the faster the pieces come ‘raining’ down. When a layer is completed it disappears and you get bonus points or are promoted to the next level in the game.

We have been playing this game for awhile. At first, back in October, the Tetris pieces came down slowly but they have been speeding up lately. Yesterday the pieces came down fast and furiously as we had to nail down dates, times, venues, participants, hotel reservations, facilitators, meals, materials and more. We also had to throw ourselves into thick traffic to visit most of the key players in this leadership development adventure. I am pleased with the results, the most important of all is that we were received warmly everywhere with more than pledges of support; we got everyone’s full cooperation, their confidence and enthusiasm.

Our partner, the Adventists Development and Relief Agency (ADRA/Ghana) was particularly helpful and became our graceful host, making their office and conference room available as well as a driver and car. We criss-crossed Accra several times, often searching for our destination. Streetnames are absent or hidden and places are referred to as ‘in the neighborhood of this or that landmark.’ For newbies like us this is a big challenge. Even our Ghanaian driver was stumped a few times.

Halfway through the day I discovered that it was Cabul’s 27th birthday. It was too late for a decorated birthday chair at breakfast but not too late for a celebratory meal in the evening that included a Margarita à la Tante Marie in a little maquis (open air) restaurant that served a variety of African foods from the region. The margarita did not quite fit the local food theme but it did go, belatedly, with the Chimichangas Cabul had for lunch at the US embassy. The embassy also houses USAID and is brand new; a fortress-like structure that sends out one signal that says ‘America is under attack’ and another that says ‘don’t even try.’ It is discouraging to see our tax dollars at work in such a costly, and in my view unproductive and reactive way. I could see ways in which all that money could be used creatively and productively to create more attractive futures for those who willingly blow themselves up in or near our embassies. Cabul and I are on the other extreme of our our tax-dollars-at-work continuum. I’d like to think of us and this leadership program as good and more creative value for money.

My Guinean ex-colleague and good friend Namoudou Keita, who is based in Togo, happened to be in Accra on leave and joined us for dinner. Namoudou is learning English and since Cabul does not speak French, this seemed like a perfect occasion for Namoudou to practice. That was the theory. In practice there was a lot more French than Cabul could handle. It left him eager to learn French.

Back at the hotel we parted from Namoudou and retired to prepare ourselves for our next set of tasks. I tried to catch the occasional wireless signal that wafts in and out of my room. While waiting for the signal to return I prepared for today’s first encounter of the Ghanaian facilitator team; a mishmash of people from public and private organizations who are interested or have been nominated to be part of the core team that will carry the leadership program forward after Cabul and I return to Boston. Back home we will cheer them on and support them using whatever technology is available, Internet, Skype, cellphones and, if necessary, carrier pigeons.

It was a good start of our trip and I kept thinking, “Something must go wrong now; this is too good to be true.” But nothing did. I have never quite gotten off to such a great and fast start elsewhere. There is something unassailable about having the support from the top leadership of all the groups we are working with: the ministry, USAID, ADRA and the Ghana Institute of Management and Public Administration. It proves the old saying that where there is a will, there’s a way, especially if the will comes from the top. The way forward is right in front of us and wide open.

Calm in Ghana

I woke up from a dream about a nursing conference where I was in charge of a session that had a clever name and was about emotions. I remember walking to the session and leafing through the booklet that went with it. It was very fancy with glossy pages but I did not recognize it and it had nothing to do with what I had planned to do during my session. The booklet I had in my hand seemed prepared for a lecture whereas I had planned a series of conversations in pairs and small groups. I had counted on these conversations to produce the content of the session.

The dream was probably triggered by my reading an article last night about introducing participatory community planning events in Indonesia that, according to the author, went quickly off the tracks. It also represents the reality I usually have to deal with when we first launch a leadership development program. Often people expect the expert to lecture people into changing. Gently bending such expectations into a different direction is what I usually need to do in the beginning. There is sometimes resistance to this because the activity of bending, both for the bender and the bendee is not without effort. Lecturers, especially if they have been lecturing for a long time, require little effort or preparation; listeners to such lectures require little effort or preparation, only the presence of their bodies in the room. What I am proposing requires lots of work, from beginning to end.

Yesterday I slept in and found Cabul had indeed arrived as planned. Mamadou had picked him up and dropped himoff at the hotel. We had our cornflakes together in an otherwise empty dining room. Susan Wright from USAID stopped by the hotel to welcome us and painted us a more detailed picture of the context and cast of characters we will be meeting soon. Later, Moussa and Cire, Mamadou’s sons, who look like they are in their late twenties but are actually still in school, one under 20, picked us up in their father’s SUV and drove us through empty streets (it’s Sunday) to Mamadou’s house. Mamadou and his wife Zahara live in a sort of palace. The two crowns on the big black gate prove this. It is owned by a Northern Nigerian Chief who lives next door in a 15-room palace with the same crowns on the gate. Inside the house is majestic. Another couple, Ivorian/Senegalese joined us for an enormous lunch spread, including meshwi (a recognizable lamb) and chickens, looking puny next to the lamb, a large salad and atieke, a couscous-like substance made from manioc. Lunch was completed by fresh paw-paw, mango and pineapple, a real treat for us coming from a northern winter. Cabul got a large dose of French which was the primary language of all present, except the two of us. Sometimes we switched to English and Cabul could participate for a while, then back to French.

On our way home we drove around looking for a simcard for Cabul’s cellphone. The preferred place for this and a carton full of water bottles is the Shell station. The little stores at gas stations are common here too and have become the local convenience stores. Not much in terms of staples but lots for people craving sweet or salty snacks. Apparently, these bad eating habits are on the minister of health’s screen: a retired military by the (first) name of Courage (names are destiny). He believes in wholesome living, good eating habits and much exercise. He reminds me of Dr. Kellogg and his movement in the New York mountains at the turn of the (previous) century. There are some other priorities here that have to do with more basic health problems such as women and children dying during or right after delivery and the scorch of malaria, killing small children in droves.

The remainder of the day Cabul tried to stay up and adjust to the new time zone and I contacted various people I knew and did not know to say I had arrived in Ghana.

We had a delicious local meal in the, once again, empty dining room and withdrew too our rooms around 9 PM for another good night sleep.

From Accra

I am sitting in the empty lobby of the Alisa hotel in Ghana, because the wireless signal is stronger here than in my room. Except for Cabul who arrived this morning from New York we seem to be the only guests and I wonder why hotels say that they are full when they are not. The place is decorated with large cloth red and green banners, Christmas lights, and, at the airport, soccer balls. The West African soccer tournament starts the 20th and it might as well have been the Olympics. A Christmas movie is showing in back of me on a very large plasma TV.

In Amsterdam I met an old MSH colleague, Mary Taylor, at the gate for the flight to Ghana. We used to work together at the beginning of our first leadership project, nearly eight years ago. She is now with the Gates Foundation. She traveled light, with hand luggage only, so I lost track of her when we arrived in Ghana. I am not yet able to participate in the mad dash for passport control. I suspect that by the time she settled into her hotel room, I was still waiting for my luggage. I thought about my easy entry into Kenya only two months ago, in a wheelchair. I am now back with the ordinary people who have to stand in line a lot, and wait. The ending of an otherwise easy and comfortable trip was thus a bit more challenging. By the time I spotted my friend and colleague Mamadou waiting for me at the arrival hall I was limping heavily. He quickly got me into his car and left his son Moussa in charge of the heavy lifting of my many pieces of luggage.

We arrived at the wrong Alisa hotel where they did not recognize my name (but also had a room if I wanted it – so much for full hotels in Accra). An employee of the hotel drove us to the right Alisa Hotel in the Cantonment section of the capital. If there is a coup we should be either at exactly the right or exactly the wrong place. But Ghana is, for now, one of the more stable countries in the region. Not that this means a lot, as we can see from Ivory Coast a couple of years ago, or Kenya now. There are elections coming up in Ghana too.

I spent hours unpacking and settling into my small room while watching a movie. I think I watched more TV in those few hours than I have over the Christmas break. My unpacking was interrupted by a Skype video call from home. It is still so amazing to me that I can see into our living room on the other side of the Atlantic, seeing Axel stoking the fire. The internet connection was too slow for me to put my webcam on so I could not give then a tour of my room.

En Route

I am in Amsterdam, in between flights. I slept a bit on the way over from Boston and feel fairly rested even though I skipped most of the night. Just before leaving I changed the header picture of my journal. Another step away from the imagery of hospitals and ill health. Unlike my previous trip to Kenya, I am traveling without my moon boot and look like all the other travelers now, except when I get up. The stiffness, after having sat down for awhile, is hard to cover up.

I said goodbye to Tessa and Steve and also to the Christmas tree, which, as Sita wrote, “decided to run out the door in your absence – we decided not to keep it up until July.” Getting the Christmas tree into the house and then decorated always seems to be Tessa’s biggest challenge. It is an important event for her and Axel, while Sita and I are lukewarm about it. With Tessa going, so goes the Christmas tree. I think it is a good thing because the clutter that comes with the tree and the holidays is beginning to get on our nerves.

I am happy that Sita and Jim are still living with us. I would have found it much harder to leave knowing that Axel would be alone. It has been wonderful to have had both girls here over the Christmas holiday and one of them staying nearby all the time, and for a bit longer

I am getting the quiet reading done that I did not find time for back home, about Ghana and its health services, its challenges and its successes. I recognize elements in some of the success stories that have to do with leadership, a positive vision of the future and the contagion of success. It is not explicitly called leadership but I recognize its manifestations. I think we have found a way to make recurrence of such episodes of success more predictable and less haphazard because of the way we are combining some key ingredients: working in teams rather than alone, creating a shared vision, coaching, holding teams accountable for moving towards a result they selected and a healthy competition between teams. Our approach fits within the large scheme of things as envisioned by the government of Ghana, according to its website and USAID/Ghana. That’s always a good thing.


May 2026
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