Archive Page 29

Southern fare

It seemed so far away last July when I planned this trip to new Orleans with our compensation tickets from American Airlines – compensation for having given up our seats after a windstorm upset air traffic along the entire northeastern sea board. In exchange for a 500 dollar travel voucher each we agreed to take a later flight, requiring a four hour wait in a crowded gate area with lots of angry people. We simply put on our headphones, pulled up a nice book on our iPads and waited patiently. It was a small price to pay for a free trip to New Orleans with change to spare. To make for the perfect vacation where all money is spent on food, we got our friends’ unused timeshare exchange place for a week for around 100 dollars in fees and that was it.

And now we are on our way to join Tessa and Steve who are already there – having taken a much more direct route (a three and a half hour flight on Spirit Airlines versus our whole day adventure with stops); but we can’t be picky.

The first time I was in New Orleans was in 1973, with Peter – it was a different America then, and the south was particularly different, mostly segregated except for New Orleans if I remember. Was it because the white tourists came to listen to music that was played by Black Americans? I am sorry I can no longer remember which musicians we listened to. I did not know much about jazz.

Tessa thought NO felt very European, whatever that means – French maybe? And that may also be the reason why, on that grand tour of North American- at 5 dollars a day all these years ago, NO was one of our favorite cities. These also included San Francisco, Boston and Montreal.  On the other hand, Detroit, Denver, LA, Houston, Miami, DC and New York were so utterly new and alien, so very American in their expansiveness and bigness that we walked around in awe, though not always in admiration. The bigness related to houses, skyscrapers, parks, cars and people. Obesity was already visible then, the tip of the iceberg, though not openly recognized for what it was, ominous, by public health experts and the public at large. The companies that sold (and still sell) ingredients that produce obesity were having free reign. It took more than 40 years and we are not there yet, to rein them in.

Smart animals

The first snow has just started to fall, on the wintry December 10 day. I was just in time planting 20 tiny Winter Aconaite (Eranthis) bulbs. They look like nothing, little shriveled up dark things that blend in with the debris from frantic squirrel activity over the last few months. As I was digging small holes in different parts of the yard I always found nuts from this or that tree that had already claimed the space. It is rather amazing how the squirrels remember where they put stuff. We would call that smarts, but I am not sure what it means for animals.

I am listening to a book about cephalopods, among them octopus, giant squid and tiny squid. It is a philosophical treatise about consciousness and what the amazing behavior of cephalopods teaches us about consciousness. As with most books I am reading or listening to these days, it is about the brain. But the brain and nervous system of the octopus is, I learn, not in the head but all over the body. In my coaching course the word ‘embodiment’ is often used and I am trying to figure out what that means for us humans – but for the octopus it is clear. The body and brain are one. And maybe we are like that too, as there are neurons (some 500 million) in our gut and (less) in our heart. And neural activity takes of course also place in our small toe.

 

Body and mind

At work things are quiet – which is always true just before the holidays – but I also have little project work to do and charge much time to overhead. This I don’t like, and I am sure my superiors don’t either, since I am relatively costly. I am using the time for self-care related to my arthritic ankle: cupping, a massage technique that separates the fibers in my traumatized ankle with all its scar tissue, massages and physical therapy. On Fridays this can take up half a day.

I also use my down time to read up on professional literature that I have put aside. As always I am amazed about the knowledge and experience that is constantly being accumulated – but I am also heartened that by the fact that the so-called soft stuff of development is now being acknowledged as important (above and beyond what is usually referred to as ‘technical skills’). I even saw the word ‘co-create’ surface here and there. Now I am in my element – it’s time for me to write about how one can do this. I have some ideas.

Another year

On Sunday I passed from 65 to 66. I told Axel we should have taken a ride on Route 66 but it is a bit far from here. Instead he took me on a surprise birthday trip to Portland (Maine) where he had created a feast that went from fabulous lunch to fabulous dinner to fabulous hotel to fabulous breakfast to fabulous lunch before we headed home via Tessa and Steve.

They whipped up a fresh pasta meal for us with leftover sauces from their annual friends dinner where some 18 people come together to enjoy each other and great food. It’s a wonderful ritual that reminds me a bit of our periodic taco nights when we lived in Georgetown (MA) and the guys vied with each other for who could eat the hottest taco – sweat drops running down their foreheads as they pushed beyond limits. Was it fun? For us not engaged in this contest it was great fun to watch the men in their self-imposed suffering.

 

Experiments

Back in July I started an experiment related to an auto-immune disease called Hashimoto’s that I inherited from my mother. The disease is common among light skinned and blond haired women of European descent. Mothers pass it on. It was diagnosed rather late in life and rather surprised – I had never heard of the disease and had none of the associated symptoms. I didn’t notice any difference before and after the diagnosis was made and after taking the pills to up the performance of my thyroid.

Tessa turned me on to some books written by a pharmacist who also had the disease and made the relief of her and others’ severe symptoms her life’s work. I learned that there are some foods that exacerbated her symptoms. My goal was not to alleviate symptoms, since I had none, but rather to get off the medication. I started a four-month experiment, first by removing gluten from my diet – gluten is a known inflammatory agent.  When tests were done after three months there was no difference from a year earlier – some values had gone up a bit and some down. So much for the gluten, though it has been nice to support Tessa for whom gluten is turning out to be really a bad thing.

Then I started another experiment, with the doctor’s consent, to stop taking the thyroid medicine altogether. Again, I noticed no difference. But when my bloodwork results came in today both my primary physician and endocrinologist told me to immediately get back on those pills; the values were wildly out of range, in the wrong direction.  That ended the four month experiment and I am back where I started.

Now I am starting a new experiment, also to get off medication, this time off the statin I am taking for high cholesterol. With about 17 pounds lost and on a daily exercise regime I am wondering whether I still need the medication. With the doctor’s consent I pushed the pill bottle to the back of the shelf, until early February when bloodwork will tell me whether I can continue without or need to get back.

The last experiment is to get off the Neurontin for my ankle zings and prickles. I have started a treatment of cupping – the creation of space in the mass of scar tissue in my left ankle – a dense mass that my overexcited foot nerves can’t seem to penetrate. The first treatment was encouraging – increased mobility and range of motion, less pain.

Reflecting

I have enjoyed my stay in the new and improved Novotel – the best part was the swimming pool which, once again, was hardly used by hotel guests – swimming turns out to be a good activity with much less competition than the elliptical or treadmill machines – those tend to be occupied all the time before and after work hours.

We ended the four day retreat on a high note – even if sometimes I wondered whether we could get anything done with the constant coming and going of people trying to arrange three weeks of intense activity in the regions – there are advances to be arranged, bank visits, supplies, gas allotments, drivers and more. And unfortunately the project director wasn’t there to help me interpret all this coming and going – I tried to find out whether the difficulties they were having in organizing the activities was only because of the heavy administrative procedures (as they claim) or also with their own organizational habits (no! one said indignant when I suggested this hypothesis). It’s hard for me to interpret what is really going on, as I parachute in now and then.

At times I was surprised how often we pay for things that the government considers important, yet they are not in their budgets. Sometimes I think we (and other organizations like us) are like an ATM – you go there when you need cash to pay for stuff. I challenged the notion that the government finds certain activities important yet doesn’t put them in their budget. It is something I have trouble with when it comes to development assistance – is it really development or just easy money? The perdiemitis phenomenon (prise en charge as it is called in French) is one such a thing that was created to help the donor-funded program get their planned activities done. Someone in the 1979s had an idea when people were reluctant to come to training workshops – let’s pay them! The rest is history, and irreversible I am afraid – it is like any other entitlement program, easy to create, hard to undo.

And then there is the reimbursement for transport costs. Apparently last week some of the notables were quite insulted by the (minimum I suppose) 5 dollar transport reimbursements. My Ivoirian colleagues think this should be adjusted (upward of course).  Really? When people use official cars and drive a known distance which is then multiplied by a certain fixed amount, they should get more? Did we check the numbers or is it something else – when you are higher in the pecking order you should get paid more?

I inserted many tools and concepts that I am learning in my Conversational intelligence ™ course and am having fun with it – just as our teachers suggest – experiment, they say, have fun, play with the ideas. And I did.

Hazards

My second week here in Cote d’Ivoire is with our team – some of the people I worked with last week and others who joined us.  The task before us is a creative one – with one large project over, and new solicitations before us, what should we be doing different? It is not easy to rethink a program that has, by and large, been very successful.  If it wasn’t for our office chief people would probably stay right where they are. We talk a lot about staying in one’s comfort zone, and how nice it is to dwell there.

The design of the week is emergent, I have a rough idea what the outcome should be and use for the overall design a methodology I recently learned, DRIVE, that takes people from Discovery, Re-alignment, through Innovation, Validation and Evolution. I am making some adaptations, aside from the translations, but by and large is provides a good structure.

I am inserting many elements of my neuroscience coaching program – mostly because I want to equip my colleagues with the tools to create a climate of trust, wherever they work. I have trained them over the years to shift from teaching to facilitating. They are already quite good at that; although from time I can see they wished things were less ambiguous and they could slide back in their teaching role, at which they are equally good, as long as they feel mastery of the material.

We meet in the basement of the office, a room that looks out over a narrow terrace and a small strip of dirt and grass where cars are parked. One of the cars parked there is a wreck. The front is destroyed, including the driver’s seat. The driver didn’t survive the accident. Each time I step out onto the terrace and look at that wreck I think of him. I asked why they don’t get rid of this horrible reminder of a departed colleague. It has something to do with transparency and accountability I gather; the same reasons why broken furniture cannot be discarded; why the hospital in Zinder had a pile of broken hospital beds sitting on its grounds – if they disappear it could look as if someone had stolen the beds, or the furniture, or the car. There must be other ways to account for broken things I wonder, especially this painful reminder of the occupational hazards of being a driver (and by extension, a passenger) on the roads in developing countries.

Extremes

I had requested another hotel in the capital upon my return from the provincial capital. I had a great need to swim, after a whole week on dry land. The Novotel in Abidjan had a fairly large pool I remembered from when I last stayed there, even though that was not a good experience: the hotel staff was unresponsive and even entered into arguments with clients, the rooms were old and dirty.  I had vowed to never go back there. But this time my need to swim won out.

To my great surprise I found a transformed Novotel – friendly and accommodating staff, brand new rooms, a great fitness center and a room with a view over the Lagon.

I went from one extreme to another: instead of the little Nescafe sticks at breakfast, I now had not only access to various machines producing all sorts of real coffees in the restaurant (ristrettos, cappuccinos, espressos, machiatos), I even had a little Nespresso machine all to myself in my room, including a daily refill of the little capsules. I also went from a very limited menu (fish or fowl), to be ordered hours in advance, which was then delivered to my room to eat alone, to an abundance of choices, both a la carte and as buffet. I must add that the cost of this buffet probably exceeded the food budget of a poor family for an entire week.  This creates some discomfort at first – the contrast of rich and poor in the countries I work in hard to accept. But then again, I do like my creature comforts.

However the best was being able to swim and exercise daily – something I am now craving after a long day at work.

Progress

The people who have come to this workshop are quite diverse, as compared to the typical workshops we organize for health professionals.  We have representatives from various community organizations, managers and chief medical officers from hospitals and representatives from the local administration (the prefecture) – recognizable by their khaki uniforms.

We talk a lot about ‘engaging the community’ but when you have barely literate women sitting side by side the doctors you quickly see what the challenge is. I can now imagine what some of those COGES meetings are like. Even the body language of those concerned speaks volumes.

In the groups, 3 or 4 people sitting around the computer brought by the hospital manager or doctor – the local administration and community group representatives have no computers – one can see the dynamics just by noticing the physics: the women with their chair slightly pushed back, sometimes even in second rows, some leaning back; the men in khaki – some leaning back, some on their phones while several of the women in khaki are bent forward and appear quite engaged; and then the hospital folks at their computers, they are at the wheel – I suspect this represents reality.

Many of the hospital people, and some men in khaki, had already gone through our leadership program and knew the process, the way we work. They are by and large better educated than the community reps.

But when the district teams had selected their challenge it included nearly always ‘the problem of the women’ as it is sometimes referred to. This meant that the men had to listen to the women to understand the issues – mostly that they were appointed to the committee without any orientation or training in how to function well on a committee.

There is much implicit bias. Even those supposedly ‘enlightened’ showed this implicit bias by their words and behaviors.  You can ask ‘why?’ in two different ways, expressed by two similar sounding but entirely different words: inquisition and inquiry. Yet, even if the ideal of equality is still a faraway goal in this country, I see movement. In this workshop one in four participants is a woman. This is progress. And of those not representing women’s group, many are women in khaki, representing the power of the state at the local level. That too is progress.

Details, details

What is it with bathtub installers in the hotels in the provinces here? During a previous visit in another town, the faucet was installed in such a way that it didn’t reach all the way into the tub and splashed all over the bathroom when inadvertently turned on.

Now, in my otherwise quite pleasant and spacious room, the bathtub is installed in such a way that they had to hack an edge out of the wall to slide in the tub and the reclining side of the tub is placed right under the faucet.

I wonder when I see such things what happened prior to the installation. I imagine there was no diagram and the installers themselves may have never sat in a tub like that. So how would they know that the side that slopes down at an angle is to be on the opposite side of the faucet?

But then I wonder, wasn’t there a supervisor or a contractor who inspects the work? Again I imagine the supervisor checking the plumbers’ work. Did they not notice? Do they themselves have no familiarity with modern tubs? Did they never check or did they notice and realized that it would be too much re-work?

The puzzle for me is that some workmanship is excellent and elegant, like the rosettes on the ceiling, and others is sloppy, like the three doors of my closets that don’t close and can’t even be locked despite the keys dangling from useless locks. Again, who was checking and if so, why weren’t those things fixed? I can’t help but think that these symptoms reveal much about why Africa keeps needing help, despite the billions of dollars poured into the continent.


April 2026
M T W T F S S
 12345
6789101112
13141516171819
20212223242526
27282930  

Categories

Blog Stats

  • 140,554 hits

Recent Comments

Lucy's avatarLucy on Probabilities
Olya's avatarOlya on Cuts
Olya Duzey's avatarOlya Duzey on The surgeon’s helpers
svriesendorp's avatarsvriesendorp on Safe in my cocoon
Lucy Mize's avatarLucy Mize on Safe in my cocoon

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 78 other subscribers