Sylvia's Journal

We ended the managers’ meeting with some wonderful comments from participants who told us they got a lot out of it even though we were rather critical of the design. If a doctor tells you that he realizes there is a whole service delivery system that needs to be in place for other caretakers and technical folks outside his consultation with the patient, then you know you have scored.

Filipinos are big into social media, especially facebook, and picture taking. Something it took a long time to get from one side of the room to the other or even to the bathroom because at every step there was someone with a camera and people lined up for a picture. The handing out of certificates required pictures to document handshakes and smiles from multiple angles.

We had earlier said goodbye to our lead trainer who was heading off to Vietnam where M will join her so I got a promotion to lead trainer and was in charge of the speechifying and certificates and thus subjected to the picture taking. But that was only fair since M played that role last week.

M and I celebrated the completion of our assignment and claimed our just rewards in the form of a pedicure, followed by a Korean dinner, followed by one of the exquisite and artful pastries we had been eyeing in the hotel lobby since we arrived. Of course we should have had one but we couldn’t make up our mind which to choose and took two which we only half ate. As with many of these pastries, they look nicer than they taste and they are much too big. I had the second half at the airport, all 2000 calories I believe, and am full for the ride home.

It was a short night; the taxi picked me up a little before 4 AM. I had expected a swift ride to the airport through an empty city but was mistaken. Although the ride was fairly swift, the city was all but empty. Our hotel is located on the edge of what looks like a popular entertainment district with many side walk eateries, hawkers, karaoke bars, 24 hour massage places and ladies of the night. The place was hopping with sidewalk cafes full to overflowing and neon lights blinking to entice passersby inside.

At the airport there were long lines to get in, long lines to get checked in and checked out. I had once again asked for a wheelchair (now I now it is a transport wheelchair, not for daily living use) and was wheeled swiftly past the lines by my handler Erwin. I was upgraded for the two short flights that bookend the long one from Japan to Detroit – for that one I return to a middle seat in the back. You get one you lose one.

The stakeholder workshop, where I was given pretty much free rein, is over and now I am piloting a managers workshop design where the reins are quite taut. I found myself procrastinating, balking at having to read a script. I kept postponing the preparation for the sessions assigned to me until early this morning when time was up. And even though I had prepared my 50 minutes, once I stood in front of the class I forgot my lines and improvised in a way that made sense to me. Even though I did engage with the participants, more than my lines suggested, it didn’t feel right.

Our lead trainer is now quite familiar with the approach and design; not only has she been immersed in using the manuals that we have to work from for some time now, and completed a five day workshop on basic wheelchair training just last week, as a PT she also know the technical and clinical side of things really well. This in stark contrast with M and I who are learning as hard as the participants. I still have to prepare for my last session on monitoring and evaluation (I know something about that). Once again, I am procrastinating, preparation postponed to sunrise.

I am quite tired and full from our 2nd Shabu-Shabu/hotpot meal. The menu consists of 95 items displayed in alternating white and yellow lines, like an excell spreadsheet. I was given a pencil and make our selection, like on a sushi sheet. The wait staff didn’t really speak English and so we were on our own. We were both intrigued and put off by things like black fungus, chix leg mushroom, tao pao, Taiwan pechay, polonchay, sotanghon, mini ngoh hiang, fried fish skin, squid balls, pork intestine, pork vein, pork kidney, pork liver and beef tripe

We felt very brave to order the fish lips, crab roe balls, and bamboo pith. M is one of those rare Americans who likes eel so we had one fished out of a tank sitting on the sidewalk and presented to us for approval, slithering through the fish catchers hand. Five minutes later it appeared elegantly dressed (but still raw) on our table before it was dumped, head and all, into the hot pot. There was local lettuce (a disappointing pile iceberg leaves), leathery bean curd sticks, rice noodles, small sweet local scallops, wontons, dumplings and thinly sliced beef. It was a little much for three people but not filling in the way an Italian overdose would be.

Time flies when you are having fun. We started the stakeholder alignment meeting yesterday and now it is already over. We had expected about 50 people but had many more. Some had not answered M’s emails and so we assumed they weren’t coming. And then they did show up and brought others along.

M provided a fabulous buffer between me and the work inside the conference room and the haggling outside about this and that, per diem, requests for a room, hotel staff orders and surprises. She handled all these with grace and a smile, even if sometimes she wasn’t feeling so smiley inside. I knew nothing of this and just noticed we had a group that seemed larger than 50. Towards the very end they were all still there as no one wanted to leave unless they really had to.

The room was quite full with 8 round tables that left little maneuvering space for the many wheelchair users but everyone was graceful and patient.

By the second morning the catalytic nature (and intent) of the meeting was already clear. Connections had been made and ideas bubbled up everywhere. Someone had already posted on her facebook what was happening. I am not sure everyone understands how facebook works so I encouraged them to ‘like’ each others’ posts to expand the circle exponentially.

The design worked exactly as I had expected and surprised everyone else. Once designed the hard work for me was done and started for the participants but many never realized it was work. The atmosphere was congenial and collaborative – but what else could it be when the focus is on what everyone wants? To me that is not a surprise but to those used to powerpoint presentations by people who talk too much, who dictate or pontificate, the idea that a meeting like this could be fun and fly by in no time, was entirely novel.

Having done such events many time, a few things were quite remarkable about working in the Philippines: the ability of the participants to design and execute a report on group work in the form of a performance (including songs) in a very short time; the willingness to take on tasks and sign on to take a lead role (rather than people volunteering each other) and ignoring breaks entirely and forgetting all about time.

We are now moving into the next activity which is entirely scripted by a WHO team that is piloting the design in different parts of the world. This is hard for me, to stick to a tight sequence and line by line instructions. Part of me doesn’t want to prepare for this and I have postponed getting ready for my sessions until the last minute – not my usual modus operandi.

With a business center that doesn’t quite live up to its name we ventured out on Sunday afternoon to the biggest mall in Asia to find a copy place. A scary undertaking as the mall stretches over acres and acres and it was Sunday. But we lucked out and the copy and printing places were close together right by the main entrance and the crowds just started to thicken when we left.

While M took care of business I lounged around in a pretend French café and sampled, now fully informed, a cronut, leaving half for M who joined me when the copying and printing was done. She is learning slowly that everything – EVERYTHING – is prepared with loads of sugar. If you don’t say anything that’s what you will get – it’s the default.

While she was working I was eyeing the sushi assembly line restaurant across the walkway – it was lunch time after all. Close up the sushi on the moving small colored dishes didn’t look quite as appetizing as from a distance so we ordered a la carte: salmon sashimi, seaweed salad and a tuna temaki. I am in seventh heaven in this place with sushi and sashimi at every corner. The green tea was unsweetened when I emphasized this but (over)sweetened when I got my refill, triggering the default.

I finally, after a week, tried the workout facilities and swimming pool that is part of my view, five floors down. The gym was hot but I managed to bicycle for 15 minutes, followed by what can hardly be called a swim when you have to dodge small Japanese boys with giant tubes around them and two large Lebanese men occupying the middle ground. M set out to exercise but gave up quickly because of the heat and went, presumably, back to work.

We met up later in the day with our research colleagues and sampled the national dish, chicken and pork (always and everywhere pork) adobo. Tasty, sweet and salty. After dinner we checked out the conference room and prepared the name tags and hand-outs. We are ready for the first ever Philippines stakeholder meeting to take the agenda for mobility-challenged individuals forward. It’s ready-to-roll time.

This morning at breakfast we joined with others from our group. They had moved here from the other hotel after seeing the plane travelling participants from last week’s course off to their various destinations. A complex undertaking as they were accompanied by two large boxes with wheelchair samples.

We had some great conversations about everything and nothing. As people learned about life in Kabul from me, I learned about cronuts which are apparently popular here (and in the US). I didn’t know that I ate one yesterday. I did notice it was exceptionally rich and left my hands greasy. Who cooked this up? I wondered. As if putting more calories in a donut is a good thing. And then to think I had a real croissant as well, a triple whammy I came to regret.

We are fine-tuning the design and preparing the materials for the stakeholder meeting that starts tomorrow. This may include a trip to Copylandia at the Mall of Asia, a 30 minute ride from here. I am sure it is a favorite Sunday attraction. I expect one mega large shopping and eating frenzy if to judge from our experience of the smaller mall (still rather large) around the corner from our hotel.

We have been looking for days for a Copycat or Kinkos here to no avail. Today we learned about Copylandia. I see a business opportunity for an enterprising young person.

After the stakeholder meeting is over we are embarking on the last part of our assignment here: a management and stakeholder workshop on Wednesday and Thursday. Somewhat complementing the basic skills training course of last week, it is for those who run wheelchair service or training programs, or want to start one and who are in decision making roles. The program requires considerable technical expertise about wheelchairs and so most of the sessions will be run by our local experts. M and I will do the few sessions that are related to management of resources and change. There is nothing to design as it is a pilot; we just follow a script.

Last night we went to a Chinese/Japanese restaurant, a surprising combination I had not seen before. When we entered we were met with the welcoming shouts I remember from Japan but not the bows, illustrating that this was indeed a joint enterprise. We asked for Shabu-Shabu and got Mongolian hotpot which is basically the same, although my Shabu-Shabu experience in Japan was more elegant and refined. This one reminded me of our Mongolian hotpot meal which Axel, Tessa and I enjoyed in Bejing 11 years ago.

Yesterday was the Harvard Social Enterprise Conference in which I participated with Sita and Axel last year. I had to cancel this year but Tessa took my place, continuing the near complete family participation. Sita had organized, pro bono, a complex and creative series of sessions (Idealabs) in her role as US President of the Value Web – a worldwide network of graphic facilitators and we were her helpers. I am sorry I missed it and am waiting for the reports. I am going to try something creative here myself – not that creative but surely more creative than what the participants will be expecting; song, dance, poetry or other art forms are on the program.

Today was the final day of the basic wheelchair service training and the participants got to apply everything their learned on 6 people who were badly in need of a good wheelchair. Each of them had a condition that required a unique fitting: a young boy with TB who had a bone infection and needed his leg straight for a year; an older gentleman who had had a stroke and needed much support; two women with spinal cord injury, one of them with pressure sores, a man who had contracted polio and a double amputee.

It’s a complicated undertaking requiring good measurement, selecting the right chair and then making the adjustments. There is also the art of making the right seat cushion and foam wedges to relieve pressures that, if not corrected, create pressure sores; in warm and humid places such sores can easily get infected.

I have developed a new appreciation and much respect for these wheelchair folks. As I watch the trainers help their trainees focus on the safety and comfort of their clients I am quite moved. I suppose these people are lucky, to get this kind of service.

Just as the trainees are finishing their course I start to get to know them, hear their stories, especially of those who are wheelchair users themselves. From their personal experiences the plight of disabled people in the Philippines becomes very real – the hardship, the daily challenges, the misperceptions and misguided actions of the able-bodied.

One is a marathon wheelchair athlete whose dream it is to wheel himself to the Boston marathon finish line. To make that possible he has to be invited; and to be invited you have to be really good. He is working on that in regional marathons. We talked briefly about last year’s marathon – he watched it all, and will watch again this year, hopefully enjoying the accomplishments rather than the dramatic turn of events near the finish line.

The closing was touching. After several brief speeches, certificates, much applause and picture taking it was time to part. When everyone was gone the many supplies and wheelchairs were packed up: two sample chairs that will go to each trainee’s place of work, and the practicum supplies that will accompany the Philippina lead trainer and M who are off to Vietnam, for a similar course after we complete our events next week.

And then we piled into a bus with the exhausted but happy trainers and sat in traffic (only for an hour this time) to join a US/Canadian research team that is part of the larger USAID initiative to provide quality products and services mobility services to those who need them. They are staying in an even fancier hotel that was full of other celebrants. It is graduation in the Philippines and apparently families go out for birthday,judging from the singing and clapping that happened all around us.