Sylvia's Journal

Archive Page 119

Goods delivered

Published January 12, 2012 On the road Leave a Comment
Tags: Kenya

We completed the vision for the Kenya Institute for Health Systems Management. It is as practical and complete as it could be given who was in the room. The final activity consisted of public commitments from key stakeholder groups on how they can and will support the fledgling new institute as it takes its first steps.

Several of the participants, in a series of self-revelatory statements, mentioned that Kenyans are very good about making big plans, conceptualizing stuff and then dropping the ball when it comes to implementation. I assured them this was not a unique Kenya quality and that it had something to do with either not owning the vision or plans, being too ambitious in scope, or finding the complexity of implementation, while none of their other work had disappeared, simply too much.

We’ll see in a few months. The group certainly had reached some momentum by the time we finished. The original ending time was 4:30 PM but we were done before lunch. The closing act took another 45 minutes and included a special African clap that is rather involved, a lengthy vote of thanks leaving no one out, an exhortation about change management that appeared to inspire everyone much like a minister inspires his or her flock on Sunday, and more claps.

Everyone left with a button, immediately pinned on. It should have been a lapel pin, stating that the wearer was a founding member of this new institute. The pin idea got sunk because there were too many logos that needed to be included. Since the elections some years ago that left Kenya in flames and with two dueling presidents there have been two ministries of health. Add to that MSH as the midwife of this institute and USAID as the financier, it was simply too much to squeeze on a lapel pin. No one seemed to think any less of a button.
It gave the wearers a special status. These buttons are of a limited edition, only for those who helped to build the vision from scratch. Maybe one day they will be collectors’ items on E-bay.

And then we drove back through the dense traffic that streams relentlessly in and out of Nairobi, all day long and into the evening. I was deposited at the hotel I left two days ago for my last night in Nairobi.

For dinner I took a taxi out to the house of a colleague. It still feels a bit funny that I can walk out of the hotel – I had to suppress a reflex to pull my scarf over my head – and take a taxi from the taxi stand, walking unaccompanied.

At the house I found dear old friends I had not seen in years, all of them having become moms (of boys) over the last four years. It was an evening of countless stories about everything, including about much reviled facebook which, nevertheless got us talking for at least an hour, engaging those who loathe facebook, those who love it, and those who claim they don’t ‘do’ facebook.

And now I have checked in for tomorrow’s flight and am preparing for the final deliverables.

Electronic portholes

Published January 10, 2012 On the road Leave a Comment
Tags: Kenya

The Africa I first visited, some 32 years ago, is different now in ways no one could have imagined. Of the 40 people or so in the room today, all are computer savvy, several have iPads or Samsung tablets, notebooks; many have two cellphones of which one a smart phone.

Wireless availability in the conference room requires my utmost effort to compete with the distractions of the entire world that can enter at any time through electronic portholes.

Many things didn’t quite go as indicated on the agenda which we used to our advantage. We skipped ahead to sessions planned for tomorrow. One speaker didn’t show up and another was shorter and more engaging than we had expected.

Although we haven’t quite gotten the partners that we wanted in the room, the ones who did show up are 200% engaged and fully supportive of what the Kenyan government is trying to do – the creation of an institute to ensure that, in the future, anyone graduating from medical school, or seeking a refresher course, will know how to manage a health facility or service – thus avoiding at least some of the costly mistakes and most of the painfully acquired lessons about good management.

Less than 10 years ago we did much of that preaching but now we are preaching to the choir. There is much energy for the task at hand, even right after lunch and deep into the afternoon. We got all the work done before it was time to leave, and more.

With a medical engineer, principal of one of the technical schools, I retraced the 5 km jogging trail around the golf course. With company the track seemed shorter but we walked one hour nevertheless. The monkeys had moved to another place. We spotted them grooming each other on the far end of the gold course, small moving black dots on pristine greens. The ants had completed their crossing and I didn’t see them again.

For dinner I avoided the formal and empty dining room downstairs. Instead I had a pizza, beer and lemon grass ice cream by the pool. I sat at the bar, the only place with enough light to read from my portable library on my Kindle-equipped smart phone. I am halfway through The Thousand Autumns of Jacob de Zoet, a historical page turner novel about my (our) next destination, Nagasaki.

Tuning

Published January 9, 2012 On the road Leave a Comment
Tags: Kenya

We spent the morning finetuning the design of the workshop and meeting with counterparts. I ask about expectations, about challenges, traps and pitfalls I can expect. This is not just for me but an occasion to help people be realistic, let go of wishful thinking. “We don’t want to have politics interfere,” says one. But politics are always there.

I now have a co-facilitator and a flexible plan. I use the time to get my co-facilitator on board as an educational intervention. I explain my thinking and assumptions and test them. Heads are nodding when I describe situations we want to avoid: dominant people inserting agendas, hijackings, people not daring to speak out. More nodding, they have all be there and look relieved when I tell them there are ways that make all this more difficult for the hijackers or the monologuers or the grandstanders.

The first day of a workshop is always full of unknowns. I have padded activity times with extra half hours here and there in case we start late (likely) and speeches are longer than predicted.Padding the time allocations has the benefit that things can go faster. Sending people home early is never a problem.

In the four years since I was last here the case for better management and leadership training of health professionals has been made abundantly. I don’t have to advocate for it as I used to. I am surrounded by advocates –that baton has been successfully handed over and progress is visible.

I am moving out of my nice hotel to the place further out where the workshop will take place. I am taking advantage of my last few hours here by doing work that requires the internet, not knowing what awaits me.I traveled light so packing and unpacking twice on this trip is no problem.

It is warm and lush here. I had forgotten that it is not winter as I understand winter to be. it is hot and dry. It suits me fine.

I keep thinking I have to put a scarf on, that walking out of the hotel’s gate is not allowed, and marvel at the thinly clad women with their exposed legs and arms – Kabul routines are still deeply embedded in my head – I have to tell myself, I am in Kenya, not Afghanistan.

People say there are threats and attacks, from the Somalis. They consider security tight but to me it is not tight at all and probably rightly so – how can one preserve safety in a large city, teeming with people and cars? Life is risky, here too.

Later: I was driven to the Windsor Golf and Country Club – a fancy resort with, depending on one’s room, has a view over green with the city of Nairobi in the background or Mount Kenya and the Aberdare ranges on the other side. I have seen neither so far.

The magnificent 18 hole golf course has a 5 km path that meanders around it, through woods and open lands with an abundance of tropical trees and bougainvilleas in bright colors, their faded blossoms like a carpet on the ground. There are signs of wildlife. I spotted some Sykes monkeys overhead, paying no attention to me, and a column of ants, one inch wide, without beginning and end, that cut right across the path. I watched them for awhile and film them with my smart phone.

Thirtytwoyearsago

Published January 8, 2012 On the road Leave a Comment
Tags: Kenya

Two and a half years have passed since my last visit to Africa, a continent that I visited so often and for so long before I moved to Kabul.

I am starting my re-entry with Kenya, a more or less normal place after Afghanistan. I wrote to my old friends, colleagues, students in Kenya who I haven’t been in contact with for years. Not surprisingly many of the emails bounced, but some wrote back right away. I told them that my schedule was tight and my visit short but hoped we could at least talk on the phone, re-acquaint.

Some of the people I hope to see or will see weren’t parents, or not even married when I last saw them. Now they are parents to more than one child. There is much to catch up. Others were AIDS activists. I am not sure they are still alive. Some of those emails bounced.

I am going to do what I like to do: facilitating the conversations between key stakeholders that need to happen to establish buy in, create a shared vision, for an institution that is supposed to teach Kenyan health professionals how to be good managers and leaders in moving the health agenda forward.

I am only part of this during this one step. There have been many steps before and there will be more in the future. Accompanying such a process over time was the attraction of going to Kabul (an attraction few people understood). A structure with a similar mission (improve management and leadership skills of health professionals) now exists within the ministry of public health in Kabul; it is staffed and has a space, two enormous accomplishments that happened after I left. I helped with the planting and the watering, but am not sure I will ever get to see the harvest with my own eyes – of my four planned trips to Kabul not even one has been scheduled.

Arriving in Kenya was full of old and new; the smell of Africa, stepping out of the airplane, the airport (no change), the road into the city (just more businesses, more buildings) and the hotel (upgraded). I remembered my very first trip to Nairobi in 1979. When Axel and I left to return to Dakar, Sita, the size of a pinhead, traveled back with us. Much has changed, in the world, in airline travel, in Kenya and in our family, since then.

In the making

Published January 6, 2012 Uncategorized Leave a Comment

I had just started on a rather girly looking sweater for a new born when word (and jpeg) reached us that it is a boy that is in the making, a baby boy Bliss. And so I unraveled the second sweater in as many days.

Sita and Jim will have a baby boy on May 28 if everything goes according to plan. This little boy is lucky to have three sets of eager grandparents awaiting him, a teeny cousin, Nora, a wonderful set of aunties and uncles in close proximity and then of course the best parents he could wish for. Yesterday there were many exclamations all around Massachusetts: “It’s a boy!”

And so we are settling in for the seemingly long wait of four more months. I am trying to arrange my travel schedule so that late May/early June is stay-at-home time. That may turn out to be a big challenge.

Today I am starting an intense period of travel with a trip to Kenya. In the next three months I will be visiting 8 countries, all in Africa except Japan later this month. It temporarily solves my billing problem, finding enough billing codes to fill 8 hour days.

When on a mission like this I have the luxury of having a code for the entire period plus some spillover for after I am back. And then of course I won’t have to get up at 4:30 to get quickly to Cambridge, ahead of thousands of fellow commuters (although some people would think that is still better than commuting by plane to Africa).

Unraveled

Published January 4, 2012 Uncategorized Leave a Comment

I unraveled the sweater I had nearly completed, only one and a half sleeve left. I decided I didn’t like the product and was probably never going to wear it. This is as incomprehensible to Axel as folding up the 1000 piece jigsaw puzzle and putting it back in the box. But the pleasure of these activities is in the making, not the product itself.

Yesterday we went to see 102 year old uncle Charles who still lives by himself in a trailer park in back of a shopping center. It doesn’t sound very good but he is happy there and has a good support system, and he can walk to McDonalds for a cup of coffee if no one brings one to him.

His trailer is sparsely but sufficiently furnished. There is no clutter. There is just enough of everything for him and for a guest if one were to show up. We returned with the bag of Christmas gifts (a jar of mustard, a bar of chocolate and some tangerines) because such a bag is clutter and not needed. We can re-use it, he could not.

We drove to each of Wareham’s beaches and sat in the car looking at the afternoon sun and the changing colors of impending dusk while Charles was telling us stories – me knitting on the back seat (the knitting undone today).

The Wareham and Onset beaches are stunningly beautiful. We ended our tour with tea and coffee at Dunkin Donuts (we should have gone to McD) and a chocolate donut for Charles. He doesn’t have to worry about gaining weight or cholesterol.

On the way in we drove via New Bedford. We had a plan to go to the Whaling Museum but we left the house too late. All we had time for was lunch. On the way back, too late to come home and prepare dinner, we stopped at Ikea and had a very inexpensive dinner before dragging ourselves through the entire upstairs showroom looking for an elusive cabinet that Axel had set his eyes on.

The last time we were there was a few months after our accident and the image of dragging ourselves on our injured limbs stayed. Once again my limbs are painful and once again I felt unable to complete the circuit, much to Axel’s dismay. I told him he can go as often as he wants by himself when I am travelling – there will be many opportunities in the next few months.

The news from Afghanistan continues to be dismal. On the heels of orphan abuses, reported in the NYT, and today’s deadly explosions in Kandahar came the Sahar Gul story reported by Jon Boone in the Guardian UK. The wicked mother and sister in law have been arrested. It is an archetypal story worthy of the Grimm brothers – though I am not sure there will be a Cinderella ending to this one. And I know that for this and other similar headline grabbing stories countless untold ones remain in dark basements.

The unraveling of the sweater felt a little cathartic.

Piping in the New Year

Published January 2, 2012 Uncategorized Leave a Comment

We welcomed the New Year with a bagpipe serenade. Our friend Steven plays many instruments. He brought two to our house, the sitar and his bagpipe.

The sitar he played indoors, the bagpipe was pulled out at midnight to play Auld Lang Syne. Standing under a crystal clear sky he sent the bagpipe’s haunting tones across Lobster Cove from where they bounced back to where we were standing. A dog barked next door and then fireworks (of the teenage boy variety) started someplace else. We rushed inside as it was very cold.

That was the end of a lovely evening with our musician friends from down the street – wine made by a Manchesterite in Italy, fish soup, Dutch apple pie. Around these delicacies we wove stories about cross cultural music, Quakers and Buddhists and the persistence of religious images that we bring with us from our childhood.

I finished another puzzle, obsessively I might say. There is no one to help, Axel is clueless about puzzles, and the puzzle doesn’t progress unless I do it. It is done now and I can put it back in the box for later, when I retire.

My other new year’s holiday project is the knitting of a sweater from the wool Sita gave me for Christmas. I had to go to the yarn shop for some technical assistance which the knitting guru gladly provided. All the while I am playing scrabble with my sister and niece over the phone. I am doing quite poorly.

I am also doing poorly with my joints and tendons which all seem to be permanently inflamed – this takes some of the fun out of our daily walks with Tessa and her dogs.

Bridging divides

Published December 29, 2011 On the road , Uncategorized Leave a Comment
Tags: Maine

We are in Maine. After a 3 hour drive it felt as if we were deep into Maine but when you look at the map we barely made a dent into this gigantic state.

We came to visit F. and his American homestay parents. He is on Christmas break from his college in New Mexico. About a year ago we said goodbye to him at SOLA in Kabul before he headed out to a high school in Maine. That is how it all started. Now he is one and a half year shy of his International Baccalaureate.

His American mom has become like a another volunteer SOLA teacher, except that she does it from Maine. Twice a day she is on video skype with SOLA, and helps F, F’s cousin, to get her English up enough to get into college in the US and follows her cousin’s footsteps.

We talked with her for about half an hour on video skype, the first time I had seen her since I left last September. What progress we noted in her English!

She is in the middle of her college application, a very challenging task for someone who never learned how to write essays in her Afghan schools. Her ‘mom’ stayed up long after we had gone to bed to help her improve her essays.

The education at SOLA, which is to help them get into schools in the US or elsewhere in the western world is incompatible with traditional Afghan education. The SOLA boys and girls have learned to ask questions and be critical thinkers, not a quality Afghan teachers like.

Several of the SOLA girls find themselves in a no (wo)man’s land where they are not up to snuff for American school but with too much snuff for Afghan schools. Not unlike many other places in the world, the kids who are pulling themselves out of the mediocre mass to create a better and different future for themselves find themselves kicked back into place. I can only hope it makes them more resilient – on top of a resiliency that everyone in Afghanistan has already developed.

We watched F’s video about building a tennis court for the girls at a Kabul school. It is a wonderful example of having a vision and then creating it. He did this is less than two months. The whole process from A to Z is shown in the video though the work of mobilizing the resources is not shown; he raised about 2000 dollars and managed a workforce part volunteer part hired. He’s the kind of person you would want on your team!

We also watched a slide show of the Christmas party, including tree and ornaments and gifts, that was organized by and for the people that either run SOLA and its household or benefit from its existence.

Seeing the laughter and smiles, watching them unwrapping gifts and decorating themselves with the bows and ribbons, seeing them enjoy the special meal made for a Christmas present all by itself.

They overcame the hesitance that usually accompanies the celebration of days that are holy in another religion. The girls learned that Christmas preceded Christianity by a long time and that good Moslems can celebrate being together and give gifts to one another just for the sake of being grateful and appreciative. Much like good Christians can celebrate the specialness and gratefulness that Eid is all about.

Phases and pink blazes

Published December 27, 2011 Uncategorized Leave a Comment

I have never quite enjoyed official holidays as I do now because they are days that I don’t have to cobble together 8 hours of work. I didn’t realize that the day after Christmas was an official holiday (Christmas being on Sunday) until this morning when I saw it listed as official MSH holiday on my Outlook calendar. Yeah!

The day after Christmas was devoted to clean up, both of Christmas paraphernalia, creating space again in our already crowded living room, and throwing more things out in the big dumpster that will leave us shortly. This included the red fake leather chair Axel’s father used to sit (and sleep) on in their TV room and on which countless squirrel mothers had given birth. We had decided that it was too gross to consider for re-upholstery. There is a matching white fake leather chair (Axel’s mom’s) and it may go the same way as it also shows remnants of squirrel afterbirths.

Included in the big throw-away was my moldy Halloween collection, built up over my 25 years at MSH and mostly for the purpose of Halloween displays that a colleague and I used to put up at work at some ungodly hour in the morning. This year I realized that that phase is over now and things could be thrown out. It included masks, rubber body parts, wigs and more. I saved only a few things that may come in handy one day and that can be washed (like the Ronald Reagan mask).

After the cleaning we went for a very long and intense hike in the Manchester-Essex Conservation Trust area, a gem of a semi-wilderness area that we have only once visited in our many years here. Trails are marked and so we did not pay much attention to the map. If it wasn’t for the pink blazes marking the trail we might have gotten hopelessly lost. We did end up a little different from where we had expected to return so we sent Jim jogging to bring the car and pick us up.

Lately I have found walking on uneven ground difficult and very hard on my ankle. It is not the ankle that was injured in the accident but I am beginning to suspect it may have been injured after all, an injury that wasn’t detected. Such intense hikes up and down hills and across tree roots and boulders is becoming increasingly painful but I am not quite ready to acknowledge that this phase (of being active outdoors) is over as well. We are still holding on to our cross-country skis, just in case we can.

After a Dutch dinner of ‘boerenkool met worst’ (kale, potatoes and smoked sausage) we went caroling with a neighboring family that consists entirely of artists, a very uplifting experience. While the men were admiring silk-painted ties and tasting a home brew the women played music and sang carols, changing the masculine pronouns in all the songs into feminine ones; no one noticed. I slipped out early as it was a school night, but with the promise of more artistic fun on New Year’s Eve.

More spirit

Published December 25, 2011 Uncategorized Leave a Comment

This Christmas is a little different from last year’s which we celebrated in Kabul. It’s an odd experience when this special week is just an ordinary week, as it is in Kabul, where the big holiday (Eid) took place some time ago and the new year doesn’t start until Mach 21.

Being with our kids and friends is wonderful. With the serenity (oh how I love the music) that has taken the place of its franticness, time may stand still.

The day before Christmas Eve we went caroling at D’s house, an annual event we look forward to as Christmas caroling is a sure way to lift one’s spirits. And God knows we needed spirit lifting – D because her husband passed away this month and me because of my difficulty to get my feet back on the ground. And I am sure there were other sad stories among the carolers. But while we sung the missing husbands showed up in spirit and the future looked brighter again.

Christmas Eve was a time of cooking and rhyming, in preparation for our Christerklaas. In the late afternoon we joined Sita’s in-laws across town for an annual ritual that includes great company, great food and much cooing around two babies. Next year there will be three. Sita and Jim practiced holding a baby as if there was no tomorrow. They are next, five months hence.

The in-law event is also an annual ritual and includes a Yankee Swap (or Dirty Christmas as they call it below the Mason Dixon line I was told). People pull numbers from a hat and everyone put their unlabeled but wrapped gift in the middle of the room. Number one gets to pick a gift first, then number two, etc. Any number after 1 can choose to exchange the gift selected for one that someone has already gotten. Finally number 1 gets to do the final exchange, if any.

It’s great fun as one is confronted with the quickly formed attachments we develop to material things – but holding on to a few prize gifts is near impossible. The gifts that were most exchanged were coffee paraphernalia, a knife set and a ball of horse dung.

I drew the last number which is considered very lucky. I got a bottle of wine and exchanged it for the ball of dried horse manure plus some lottery tickets. It was the horse manure that will make this a gift that will keep on giving – actually really a gift for our flowerbed after having bloomed for me all summer. (The lottery tickets were losers).

Back home we all dashed into our rooms and offices to prepare for our surprise-lade Christerklaas, a variation that is beginning to develop its own character, on the traditional Dutch speaking-truth-to-each-other rhyming and teasing.

The Lobster Cove variation consist of elaborate schemes with riddles, multiple beneficiaries and collective projects, but also of hanging poems in the tree. In another decade the origins of this ritual will have been lost in the mists of time.

We usually start at midnight because no one is ready before that time. This time, since we are all a bit older, we weren’t able to finish things and by 2 AM we gave up, to be continued.

So far I have made out like a bandit and received some great poems and gifts: a composter (goes with the horse manure thing), a new pair of Dutcg clogs (the old one got eaten by Tessa’s dog while we were in Kabul), wool, a shawl and a bunch of bath liquids that include one by the name of heavenly bliss, that includes red poppy and hemp extract – will the police come and arrest me while I bathe in this naughty concoction?

One of the themes this year appears to be pigs and goats. There was a bacon cookbook, goat cheese, more bacon and a gift of a goat and a pig to be distributed according to Heifer International’s wishes. And then the other theme of course is baby-in-the-making Bliss.

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