Archive Page 46

All in a name

Published June 10, 2016 On the road Leave a Comment
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In parts of Anglophone Africa, a generation ago, there were many parents who liked English so much that they picked interesting or random English words to name their babies. I have come across a lady named Address in Rwanda. When asked how she got that name she told me her father picked the word from a piece of paper written in English. Not knowing English and understanding what Address means, he thought it sounded nice and it became his daughter’s name.

There are many men with the first name of Kennedy in East Africa (I haven’t met a Nixon yet), among those born in the 60s. I am sure there are a few little Obamas in east African primary schools right now and someday there may be a lot of Hillaries.

One of our trainees has a last name on her badge that required explanation. If I remember well it was spelled ‘Magnififayi.’ I asked her where that came from, and once again, it was a parent (dad) who loved the English language so much that he called his daughters Magnify, Modify, Specify and Glorify. The man at the place of birth and deaths registration was probably as perplexed as I was. In an attempt to Africanize the name he added the ‘fayi’ part.

I love to ask people when I start a training to explain where their names come from as it helps me to remember them. These stories are so interesting and wonderful because in most cultures first names have a meaning. They could be the names of prophets or characters from the bible, names of Gods or Goddesses, names of the days of the week the child was born on, or names of saints on the calendar. I was told there are children in Francophone Africa who are called Fetnat – which was picked from a French calendar that indicated that the birthday had taken place on the day of a Fete Nationale, abbreviated on the calendar as Fetnat. But the ‘fy’ sisters are the best ones yet.

Testing – round 2

Published June 9, 2016 On the road Leave a Comment
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I joined the rest of my team in sunny Stellenbosch on Sunday morning and reviewed the materials for the second pilot of the training of trainers of the WHO Wheelchair Service Training packages.  Participants began to trickle in from Tanzania, Kenya, Zimbabwe, Malawi, Burkina, Jordan, Canada and the US; twelve participants to learn how to train managers of rehabilitation services to either start, improve and/or expand wheelchair services.  Another group of nine learned to become trainers of intermediate wheelchair services (those that are for people whose bodies need to be supported in a wheelchair).

I joined my co-observer, the same as in Nairobi a few months ago, to see whether the improvements we had made after the first pilot, some months ago, were indeed improvements. We had two new trainers to deliver the package as per our instructions and it was them we were observing; one trainer from South Africa and another from Zimbabwe. It was a fabulous team of trainers and, by and large, of participants.

The training took place at the Western Cape Rehabilitation Centre, requiring a daily 45 minute shuttle between Stellenbosch and the center. Since it is located at the edge of Capetown in an area where one should not drive after dark, we were under considerable pressure to end the packed days in time so that we could debrief with the trainers and observers and share our learnings. We never managed to get out before dark.

As a result our days were very long, often arriving back at the hotel at 8PM or sometimes even later, having left the hotel in the morning at 7AM . After the two days of core training participants were given assignments to try out sessions from the management training to get a taste for the material and demonstrate the concepts taught the first two days.

They were quite anxious about the practice sessions. We offered to be available after hours, which sometimes meant till 10:30PM. Then there was the requirement, for us observers, to write our daily observation notes about each of the sessions every evening. I was always too tired, pushing the task ahead of me. And so the intense and long days from the previous week continued. When I filled in my timesheet for the two weeks (New York and Capetown) I had clocked 170 hours in a two week period that demands only 80 hours.

Characters and principles

Published June 5, 2016 On the road Leave a Comment
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It was a quick turnaround. The time between trips (originating in the US) has never been this short. I had only a few hours to take care of corporate requirements that relate to the annual performance review process, login glitches, emails waiting to be responded to and packing.

The packing was a little more complicated than usual because in South Africa it is winter, in Madagascar it is a little warmer though still cool in the morning and evening and in Holland it should be nice summer weather if it is not raining. I decided to travel with a suitcase rather than hand luggage, to spare shoulder and wrists joints.

The plane to Amsterdam was full but not full enough to push me forward for free. I had a good seat and decided to medicate myself for a short night sleep, and did so.

In Amsterdam I found out that there was a business class seat available on my connecting flight, requiring a payment of 150 euro and 35000 miles. It was a great investment for an 11 hour flight. Aside from catching up on Dutch movies, KLM has a new food service with an on-demand menu of wonderful small dishes after the initial meal. That meal included a delicious ‘rijsttafel’ option. There was even a supply of licorice, available at all times.

My seat mate came from Vancouver for her bi-annual artificial insemination treatment. It seemed a long trip for something that could be done in the US or Canada but she insisted that there was something about the quality of the donors and, besides, her wife was from Capetown and had connections. It was also an expensive trip as she had bought a business class ticket for about 6500 dollars. When I told her that, without using miles my upgrade would have cost 800 euros she thought that was cheap. I suppose it was, compared to 6500 dollars.

Across the aisle were two (older?) ladies from California, one of them drinking one Heineken after another, stating loudly to the steward how light Dutch beer was compared to what she was used to back home. Just before we landed one of the crew remarked to her she was not a frequently flyer and would she like to join? She declined saying she could not be bothered by that. The world is so full of characters whose stories I would love to know.

While transiting in Amsterdam I learned that Mohammed Ali had died at the age of 74. I had traveled to Kabul in 2002 on the UNHAS flight and he was on it too, visiting Afghanistan as a kind of peace ambassador. One of the NYTimes articles includes a picture of him with a small school girl in Karte Sei.  It was a small plane and we all got to shake hands and have our picture taken with him. He was already in a far advanced state of Parkinsons. I had not realized that at that time he was only 60. He looked old and needed several handlers to take care of him. Parkinsons is a horrible disease.

Reading the statements from Obama and Trump about his death, I am amazed how united people with such radically different outlooks are about what made this man so great. Who could have imagined that back in the 60s and 70s? It seems that, in the final tally, we all do value people whose behavior is guided by principles, even if we don’t agree with them or with each other.

The things that count

Published June 4, 2016 Uncategorized Leave a Comment

Once in a while you get news that puts everything in perspective. Sita and Jim’s brandnew niece, hardly 7 weeks old, has been diagnosed with a terrible birth defect and is undergoing her first operation today at Boston’s Children’s Hospital. It’s a condition that is more common in Asia than in the US, rare here, a chance in thousands, a case of really bad luck. She is undergoing a procedure that was developed in Asia. It is probably one of many surgeries she will need in her life. It is both scary and very sad.

The baby would not have lived long had she be born in a developing country, so we should count ourselves lucky, but we don’t know what’s in store. I am thinking about the pain and worry of her parents and grandparents, two sets of which we share with Faro and Saffi.  It is rearranging all the things that I thought important and worth fretting about.

Distilling actions

Published June 3, 2016 On the road Leave a Comment
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The months and weeks leading up to the NY consultation included many skype calls and iterations of the agenda – we were retrofitting activities into a solid design. It was just-in-time, with the finally pieces falling in place just hours before the end.

We nearly always called each other from different continents – often late at night or early morning for at least one of us. Some of these late night skype calls took place during my vacation in Thailand and Vietnam. There were times I regretted to have accepted the assignment.

It’s hard to join a design team in midstream, especially with people whose comfort zone is with the traditional format of individual presenting alone or on panels followed by Q and A’s or when the organizers feel not entirely in charge.

The traditional format (powerpoints followed by individual questions and then answers from the presenter), especially with 80 people in the room can be deadly. Individual agendas can easily hijack the usually few remaining minutes in a session. Everyone has experienced this more than once. And yet, unfamiliar with alternatives, most public health experts I know repeat the pattern of the old format over and over. It is what they known and what keeps them in their comfort zone, even though such a format is hardly engaging. When I ask about such experiences they sigh, as if this is an inevitable course to follow.

I love to show alternatives, what is possible, and how to get to the action – which is what people always say they want. But unreflected action is worse than no action. There has to be a process for meaning making and culling and vetting. This is why we need structures for meaningful interaction. And just as with physical structures, conversation structures also needs architects.When we select speakers and let their activities design the event we are putting the cart before the horse. And when we attach ourselves too much to narrowly described pre-set outcomes that may not be shared by all those invited, we are also unlikely to get value for money.

I am always struck about how much fear there is that ‘things will get out of control, that dominant people will hijack the meeting or minorities don’t feel safe to voice their opinions.’ The irony is that without structure, this is eactly what will happen.

There is always wisdom in the room but that this wisdom is either unrecognized or unfiltered. The process of coming to shared insights is a distillation process, with lots of impure stuff being heated (talked about with passion), then run through a cold water pipe (the realities, conditions on the ground) until the really good stuff comes out in small drops. And that is finally what we did. I was really happy after all to help make that happen.

We celebrated the end of the event at a small tapas place next to Central Station after which we all went our ways. I walked to Penn Station which was way too frantic for me and must be very intimidating for innocent tourists. I couldn’t wait to get into the train, have my dinner and a beer. Four and a half hours later I tumbled exhausted into bed.

Community and presence

Published June 2, 2016 On the road , Uncategorized Leave a Comment
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I enjoy working with people who don’t know that you can get a lot done with 80 people in two days. One woman from Uganda said, after we collectively defined what integration meant in about 20 minutes, that this exercise would have taken them days or maybe even weeks back home.

When people express wonder, amazement and appreciation for the facilitation, they don’t realize that they are commenting on the design. Facilitation is very easy if the design is solid, even for newbie facilitators (maybe not easy but doable). Facilitation is very difficult if there is no design, even for experienced facilitators.

I believe the appreciation comes from having one’s voice heard or seeing that space is created for the quiet voices.  Those whose voices are always heard, and often too much, don’t usually express such appreciation. They sometimes bristle at the structure that I impose.

“Everyone participated!” say the ones who want to hear everyone’s voice, as if they can’t quite believe it.

For me this is simple and never a surprise; people participate because there is no way not to participate. The only people not participating are those who are doing something else on their phone, tablet or computer, or are taking calls outside the room. To reduce these absences, I periodically sweep through the room and close computers or turn over smartphones that are being used for some other purpose than the meeting. I do this with a smile. Some people thank me for it, some get defensive (“I was looking something up!”) and some get a bit prickly. people learn fast. When they see me coming they put their phone down so I don’t have to do it for them. I am acting like an old fashioned teacher, people recognize that quickly. It works.

In the development world I work in, I often hear people say ‘value for money.’ It is also one of MSH’s strategic priorities. Yet we are surprisingly tolerant of meetings where half the people are not present, even though the limited development resources that we always complain about, have been paid to physically bring them in. I think I know why we tolerate this kind of behavior: we are uncomfortable confronting people, especially those higher in the pecking order. Under the guise of being polite, we actually collude with people who are not polite. If we are saying we want to do something together, then shouldn’t we all be present together? I sent those who cannot be present out of the room.

Despite all the kudos and raves, I didn’t even feel that this meeting was as good as it could have been – there were a few disconnects, speakers who came in for their session, unaware of what the group has already discussed and defined; the schedule was rather full leaving little time, too little time, for serious discussions and reporting back.  Because of that, running late from the get go, unrealistic expectations were not examined and thus, there were disappointments at the end. Some critical voices were missing and there were too many wishes and wants resting on different agendas that had not been sufficiently confronted. Hierarchy and seniority always gets in the way, here and everywhere else.

Still, I was pleased with the productivity, the expansion of the community of activists and the good energy in the room. Things could have been improved with more time for dialogue, more focus, scribing and music. I hope there is a follow up where we can do this.

A brief trip to NYC

Published June 1, 2016 On the road Leave a Comment
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Some months ago I had agreed to facilitate a consultative meeting in New York City, just days before my planned trip to South Africa. It would mean arriving back home at midnight the day before my departure to South Africa. I accepted because I love such assignments, even though it was a bit of a sacrifice and there were moments I regretted my ‘yes.’

It was a consultation about getting childhood tuberculosis considered as part of a broader package of maternal and child health interventions as the local level. This may sound simple but it is far from simple. Local level ultimately means the community level. This is the level where, in many developing countries, the usually unpaid community health workers are fulfilling the most basic tasks of prevention, diagnosis and treatment of illness. These people often have little education and sometimes aren’t even literate.

They are trained to fulfill their various tasks through vertical programs: the malaria people provide materials, pictorial algorithms and instructions, training sessions and reporting forms. And so do the health education people, the maternal and child health experts, the HIV people, the TB people, the nutrition people, the vaccination people, and so forth. A participant from Uganda told us that she has seen community health volunteers who have to fill in 11 registers to show their task masters what they did each day or week or month or quarter.

The purpose of the consultation, led by UNICEF and the TB Alliance, was to learn from other experiences of integration and consider the upstream implications of integration at the base: the health system functions, the financing, the evidence and identify the research agenda that would give guidance on how to proceed and avoid mistakes of the past

I took the train to NYC, having calculated that plane or Acela train would take about the same time and cost about the same as well. Sometimes we hear about Amtrak trains derailing because some system was poorly maintained or the conductor was driving too fast. These things happen and make a big splash, but they are rare. I boarded the train hoping all systems were maintained and the conductor had had a good night sleep and followed the rules. I arrived safely at Penn Station, though the trip took a bit longer due to a few glitches that were annoying rather than deadly.

I arrived at UNICEF just when the place emptied out for the day. I finally got to meet my team mates in the flesh (though one I had met nearly 20 years ago in South Africa). We did the finishing touches on the design and flow of day 1 and identified what still needed work for day 2. Since all my team mates were lodging in places far apart I was on my own for dinner and too tired to visit anyone. I consulted Trip Advisor and found an authentic Japanese/Korean restaurant across the street. It was full of Japanese and Koreans, which confirmed the rave review, and I was greeted by all staff the way I remember from Japan. I also discovered a Japanese convenience store a few blocks away and stocked up on some delicacies to nibble on later, while watching TV in my tiny ‘central location’ hotel room.

I watched an amazing PBS program in which Stephen Hawkins turns theoretical constructs into a series of ingenuous experiential exercises for teams of three young scientists. The take away message: we are infinitesimal small in the greater scheme of things. It was another reminder about keeping perspective.

Rituals

Published May 30, 2016 Uncategorized Leave a Comment

Today was Memorial Day, and it rained. This rarely happens. We showed up when the seaside ceremony was already in full swing. This is for the navy, I imagine. A wreath is thrown into the water from the back of a motor boat by a uniformed man. The wreath is attached to a thin white string. I guess this is to fish it out of the water afterwards when everyone is gone, and, hopefully, give it to someone to hang on their door. I am sure in the past the wreath was simply tossed into the water and then left to drift wherever the current took it. But the environmental police must have put a stop to that. It is still a ritual and it is the ritual that counts, but I liked that there was an unscripted part to the ritual.

Every year I sit (with occasional standing) through the ceremony which after the seaside part is done at the cemetery, where Axel’s ancestors lie as well. We had spiffed up the graves of his grandparents, parents, aunts and uncles and now also one niece, with geraniums.

This is our personal (pre-)memorial day ritual. When we are done with the planting we take a little rest on Grampy, Grammy and Ester’s’s grave and drink a toast to all. We thank Penny and Herman for life given to us and then we dribble a little bit of vodka over the grave stones. Axel’s grandparents were teetotalers but their offspring were decidedly not and so we hope the elders don’t mind this little bit of vodka.

This year’s ceremony was held at the legion with major parts left out because of the inclement weather. The master of ceremony told us to imagine the parts of the program that couldn’t be done indoors, like the salvos, the marching, the school band and the taps. As a result everything was done in no time. We shook hands with some folks and I had to ask Axel, who’s that and who’s that? I got introduced, as I am always on this day, to the same people again. I can never remember their names or their faces.

And then I get to vent to Axel, also a ritual because I do it every year, about the glorification of war and the death of our men (and now women) in uniform. I do understand the rituals and the commemoration – thinking of people who died in uniform, and I like the small town community feel, but I could do without the military flavor and the presence of all these uniforms.

What bothers me in particular is the idea that they died for an ideal. This may have been true for WWII but I can’t find the noble goals in all the other war that came afterwards.  I hear people say that those who died, died for the ‘American flag and everything it stands for.’

To me, all those who died (this includes the enemy as well who were alegedly just as patriotic and fighting for their own noble goal) did so because of the psychodynamics of their leadership, the ones who waged the wars; those few men at the top, all driven, in one way or another by childhood traumas, egos under assault, hurt pride and having a surfeit of testosterone.

What were we fighting for in Vietnam, exactly? Having just been there and seen the particular flavor of communism that allows Vietnam to sign the biggest trade deal ever with America, one cannot help wonder what all the fuss was about, a ‘fuss’ that wreaked havoc, both here and there. Why? Because a beloved American president figured it was better to stay put in that part of the world to uphold his image of being tough on communism until after his hoped for re-election. But he didn’t live to see the day, and then everything spiraled out of control. I firmly believe that our messes are for the most part self-inflicted; this is true for individuals and the spheres they govern, whether families or whole countries. Just watch Trump.

Birthday assemblies

Published May 28, 2016 Uncategorized Leave a Comment

For the second or maybe third time in a row I am missing Faro’s birthday. Early June seems to be traveling time – though I suppose every month is traveling time these days.  We decided to spend a good part of Memorial Day weekend with Sita and Jim so I could give Faro his present. As it turned out, I also got enlisted to assemble his parents present to him.

Our present was a little nostalgic – a scooter.  Not the dinky little foldable one with the tiny wheels, but one with air tires. It looks like the scooters that were around when I was a child, except much fancier. It has handbrakes (my brakes where my feet) and a skull and crossbones on the step plate. It came in a box on Thursday and I assembled it under the watchful eye of Axel and Woody and with the help of a martini and some wrenches.

Scooters, in my youth, were called “autopeds” or a “steps” though sometimes we called them “autosteps.” They are actually neither autopeds nor steps as there is nothing auto about the propulsion. It’s actually very hard work, especially when going uphill (no uphills in my childhood), and even more so when Faro decides it is much more fun to stand on the plate and let Oma do the ‘stepping.’

We spent two very hot days in western Massachusetts, sometimes wishing we were on the eastern seaboard and cooling off in Lobster Cove – it would certainly have been several degrees cooler there. But Western Massachusetts is an attractive place to be. We (including Sita) sometimes fantasize about renting out our house on Lobster Cove for oodles of money and getting a small place in western MA. The fantasy is postponed until I don’t have to commute to work anymore – maybe within the next 5 years.

For kids Sita’s neighborhood is wonderful. There is Look Park in Florence, with its train rides, picnic areas and playgrounds. There is also the river with its perfect river beaches and swimming spots that have enough of a current to stay relatively clean, a sandy bottom and little fish to chase after.  Faro has been going to swimming lessons, a Christmas present, and I was curious to see his progress, which was not as great as I had hoped.

Faro’s parents gave him a Bucky climbing structure that needed assembly. We worked on that with sweat dripping down our brows – it was a little bit too hot to do so in full sunlight – but we persevered and had it up in less than 24 hours.  The structure is about 10 feet wide and 6 feet tall. Faro got the hang of climbing on to the lower parts in no time, still a little anxious about swinging like a monkey. I would have loved to have a climbing structure like that when I was his age. We used trees instead.

Sylvia birds

Published May 23, 2016 Uncategorized Leave a Comment

Sita had given us a walk with a bird expert for Christmas. It was one of those wonderful ‘experience’ presents that she is good at finding and giving. I had taken the day of to cash in our gift.  On this beautiful spring day we met Ben, our guide, at the Mass. Audubon Joppa Flats Education center, a structure that had not existed when we lived in that area.

After we exchanged our dinky little binoculars with two more serious ones borrowed from the center , we set out, first by car, to Plum Island, stopping along the way when he heard a warbler sound. Ben knows birds by their song. They are hard to see in the foliage and the flit from branch to branch so fast that it is hard to find them with our binoculars.

There were other birders looking for the warblers and they exchanged information and clues, using a language I hardly understood. I learned that the warblers exist in many sizes and colors, some weighing as little as 3 grams, less than a nickel, and others as much as 10. The colors vary by sex and age. It was hard to remember all these details, but that is why we have bird books.

The walk made me realize how much live is going on around us, invisible but audible. The bugs eat the juicy new leaves of the trees (warblers like to hang out in oaks), the birds eat the bugs and cross fertilize and we are all the better for it.

That night I dreamed of birds and my bilingual brain was searching for the Dutch name of warblers. I woke up thinking that I knew but when I looked it up I had been wrong; my sleepy brain had found the Dutch word for chickadees (koolmees) but not warblers, which turned out to be a ‘tuinfluiter’ in Dutch. Tuinfluiter means, literally,  ‘garden whistler.’  In the process of my research I discovered that the warbler belongs to the genus ‘Sylvia’ – this must be my bird.

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