Archive Page 87

Tricky business

I made a quick trip to Washington to facilitate a one day event where reproductive health professionals came together to explore some very tricky business. How does one raise awareness about sexual and reproductive health among young people living in urban slums, in poverty, orphaned or near orphaned with none of the kind of support systems that are associated with resilience.

Researchers shared their findings that showed that the catchall term of urban youth is not that helpful as it hides significant differences. Another reported on attempts to quantify girls’ vulnerability so that we can come up with baselines and endlines, evaluating whether this or that project actually reduced this vulnerability; and then we listened to people working with urban youth groups in Baltimore, DC, Nigeria, Mozambique, Kenya, Malawi and a multitude of other places.

We had structured the design so that my facilitation job was rather easy. An associate of Sita provided the scribing that she usually does – she was engaged someplace else – and wowed the participants with his translation into images of what was discussed. I am now so used to having a scribe in the room that I cannot imagine doing such a forum without one.

Tasks and pleasures

More than a week has passed; a week that was too full for taking time out to write. I am losing my habit of writing but something has to give. I intend to make this a rare occasion.

The free sidewalk chair has been stripped from its upholstery, each and every one of the 1000s of staples removed, ironed, measured and the copied on the new fabric that we bought yesterday. A soft easy-drape red-brick material that is perfect for beginners – no patterns or lines to match up. I am putting the chair back together and only occasionally can be seen staring at a piece of fabric and muttering ‘how the heck…?”

I have been chugging away at two major tasks. One was producing the ‘good-enough-for-now’ organizational assessment tool that is part of a larger assessment a Johns Hopkins colleague and I will be using with a local reproductive health group in Pakistan next week. We will cover organizational functions (my part of the job) and health communication/behavior change communication practices. We will spend five days with our Pakistani colleagues, helping them introspect and figure out how to serve their clients better. I have been contemplating to study a bit of Urdu, imagining that I will recognize a bit from Dari and will be able to read the script.

The second big task is completing the requirements for my coaching certification, plus an additional certification for one the central tools that my coaching school uses. I had been a little discouraged by that second certification as it added about 17 more hours to the more than 200 hours I have nearly completed. But as it turns out it has been very interesting and it no longer looks like a hurdle. I think I have about another 20 hours or so to go – some of which can be taken care of during my long trip to Pakistan.

In the meantime Axel has received his sleep apnea machine. Sleep apnea has been identified as the culprit for many of his ailments. It is quite complicated to put all the pieces in the right place. For the first week it includes something that looks like a muzzle to keep his mouth closed. I couldn’t quite stand to watch it. Luckily I fall asleep easily and didn’t have to witness the whole thing. One night we met on the way to and from the bathroom and it looked as if an alien had invaded our house – the contraption, the tubing hanging from his nose – or one of those horror movies where government officials in white suits with masks on tell you that you have been invaded and everything you own is now available for ransacking.

The highlights of our time together – times when we recover from all the work and medical hooplala – is watching series together that we missed out on when it was shown on TV. We completed the five seasons of Mad Men which I found encouraging since it showed we have evolved as a species in only 50 years. Now we are watching Brideshead Revisited, the series from the 80s. It makes us happy that we did not grow up in a rich British family and, once again, it made us realize we have evolved, at least some of us.

That brings me to the US government crisis which shows, to the contrary, that in some places there has been no evolution at all.

Forever together

On Saturday we picked up a recliner that was sitting on the sidewalk with a sign that said ‘free.’ We made a U-turn and loaded the chair in the car. At soon as we got home I started to remove the dog-haired upholstery – a major job that gave me blisters and a sore shoulder from pulling thousands of staples pounded into crappy wood. I dismantled the recliner mechanism to get at the tucked away corners. I took a course at least 2 decades ago and re-upholstered a couch and an armchair under the watchful eye of an upholstery master at a local vocational school. I had forgotten that the biggest part of re-upholstery is removing the old stuff. I have no idea whether I will be able to actually do the upholstery and put the chair back to together – it would need to be ready in 6 weeks.

Why? Because I have finally taken the step to schedule surgery (6 weeks from now) and have chosen for fusion over total ankle replacement. What got me off the fence were phone calls with three people who had considered both options and decided for fusion. All three said they wished they’d decided this earlier. They could walk again without pain. That clinched the deal for me. November 20 is the day that my talus and tibia bones will be fused together, forever. I feel as if a weight has lifted off my shoulder. When every step up or down the stairs or even down the driveway is painful I now know it is not forever. Light at the end of the tunnel – assuming the surgery goes well.

Faro and his parents came over for the weekend. When Faro is at our house our living room turns into a playpen – all the furniture is moved to barricade something he is not allowed to get into or touch. Plastic containers are strewn across the kitchen. We have started to teach him that he can only open two drawers in the kitchen and not the one with the measuring cups, the wooden spoons and definitely not the knives (he can just stretch that far up). He walks up to the drawer and lightly touches the forbidden ones while looking at us, waiting for the ‘nee.’ That is one word in Dutch he knows well and copies. He shakes his head and says, nay, nay, nay. Other Dutch words he knows are ‘vliegtuig’ (plane), ‘appel’ and ‘auto.’

At Faro’s toddler school they have a ramp. He has discovered ramps and cars zooming down them. Axel’s wedge, which is supposed to help him sleep without getting acid reflux, turns out to be a great ramp, as does Axel’s Achilles tendon stretcher, a smaller version but still a ramp. It is amazing that toy manufacturers manage to sell us all these kids toys when our houses are already full of things that can be repurposed without much effort into the most amazing playthings.

Fall, moves and celebrations

I am getting up in the dark again, and most of my morning commute is in the dark again. It’s fall and getting colder in the morning and evening. I have used the remote starter already once. But during the day it is Indian Summer time – one of my favorite times of the year.

I missed the staff outing to check out our new offices, a place further north, where we will move in January. I have heard mostly complaints about the move as it is inconvenient for many of my colleagues who live in Boston or in the southern and western suburbs. But for me it means I won’t have to put up with the Tobin Bridge, its traffic jams and its tolls. Since I joined MSH in 1986, the office has been slowly moving in my direction.

Today we are celebrating Steve’s 30th birthday. He is entering a decade that is about settling down and moving into middle age – ha, he doesn’t like to think about that I am sure. I think it was Jung who declared that this is the decade that bridges the first half of life with the second; a decade of shifting priorities and developing other parts of oneself. That certainly was true for me.

Steve’s favorite food is pierogies; it is convenient that he lives in Dorchester’s polish triangle. The place is awash in sausages, pickles and pierogies. It is not quite our WeightWatcher’s fare but we’ll join in on the fun anyways.

Next

Sometimes it feels as if I am in one of those road race machines that you find at malls – as soon as you have maneuvered past one set of difficult sections of the road, new and challenging road sections appear on the horizon. The road glides underneath the car and new horizons appear, until the quarter is used up. Such fun!

My quarter is not up for a long while, at least that is the plan. I feel good about the work done in Uganda and South Africa. I worked with two different colleagues, both insightful and very competent individuals, a pleasure to work with. We did well – developed a robust design and then implemented it as planned and produced the outcomes we had intended. While completing the writing tasks for this assignment, I am already looking ahead and designing the next event, and the next, and the next.

The first ‘next’ is a forum about urban youth and reproductive health in developing countries. It is put up by Johns Hopkins and I get to work with one of Sita’s partners. This will be a domestic trip, to Washington D.C. The next ‘next’ is Pakistan, barely three weeks from now. This trip has been postponed more times than I care to remember. When I turned on the news this morning and the earthquake in Pakistan was announced I wondered for a brief moment whether a trip to Pakistan was simply not in the stars. And there are two nexts queuing up after that: Uganda again, maybe, and then Afghanistan in the new year.

I am experiencing my last very frustrating minutes in this country trying to connect on the internet. My attempts are in vain, messing up my schedule for the third time today. Oh the things we take for granted, being ‘on’ all the time. I have much sympathy for my colleagues in various parts of Africa who deal with this every day.

On my way to the airport I will visit an old friend with whom I worked now nearly 20 years ago in what was then a newly free South Africa. We did a lot of reminiscing last week and will continue some more but this time in her new home in the hilly suburbs of Pretoria. And then it is off to Sietske in Aalsmeer and then home. 

Security

I have been in Pretoria for just about 2 days now. It is cool, overcast and windy. It is supposed to be spring and the Jacaranda trees ought to be filling the streets of Pretoria with their purple flowers. But instead they are dry and leafless. The fields between Jo’burg and Pretoria are brown and yellow. Everything screams for rain. This is not the always-blue-skied-and-warm Pretoria I remember.

I have been tying up loose ends, still picking through the mailbox that overflowed during my week off the grid, now nearly a month ago. I am also getting organized for my coaching exam that I hope to do within the next 2 months, in between getting ready for my next assignment that starts on Wednesday.

This morning I watched the news about Kenya. I have stayed many times in the section of Nairobi that is called Westlands. I remember that mall being built. It is exactly the kind of place to go for some distraction after a week of hard work. The scenes, panic and pronouncements by officials make me think about the illusion of security.

Life is not safe. It never was. In the past people succumbed to marauders, pirates, natural disasters, honor and revenge killings, scurvy, microbes, reproductive hazards, arbitrary laws, landlords, and fundamentalists, just to name a few. Now all these things are still happening; they may be called by a different name. Thanks to ‘development’ these may happen to smaller proportions of the population but since there are more of us, the numbers are higher. And in their accounts the media scare us to death.

Experts talk about the lax security at malls and how predictable this was; any place where people gather in great numbers make good targets for spreading mayhem and terror. So we put security guards at entrances – low paid people, with no authority or power, not the kind that could protect me, take on people armed with AK-47s, or fight back. I don’t think I have ever seen a well-fed and muscular security guard on my travels.

At any rate, I don’t think it makes any difference. Security, whether lax, as it is in most places I visit, or strict as I imagined it to have been at the Navy Yard, seems to do little to stave off attacks by individuals determined to cause mayhem and terror. The hotel in Uganda had two bored people sitting by a metal detector. I’d put my stuff into a plastic tub and walked through the detector which would always go off yet no one paid attention. The staff would not even look in my purse and simply move the plastic tub across the little table next to the metal gate. Sometimes they waved me through and I didn’t even have to put anything in the bin or even walk through the metal detector. And so we can go through life scared all the time or live and be lucky enough not to be at the wrong place when disaster strikes.

One down, one to go

My co-facilitator has left after a day of debriefs, next steps and new assignments, two actually, falling into my lap which may require another trip to Uganda later this year. I am settling on the last trips for 2013: Pakistan and then Uganda.

We completed the retreat that produced a solid first draft of a strategic plan, with choices made and focus areas clarified. We looked for things that cost money and where the money could come from and things that can be attached to activities already funded. It was hard work, three days of hard work indeed.

We ended the retreat with everyone plastering everyone else with colored sticky notes indicating what everyone had appreciated about everyone else. We were quite a sight and parted on a high note.

Susan and I celebrated the completion of our assignment with our last Indian meal at the terrace looking out over Lake Victoria in the cool evening air, cleared by monsoon like rains during the day. We have been eating superb Indian food all week long and had pretty much exhausted the choices on the menu.

Today we finally made it out of the resort hotel and headed into Kampala proper. We had lunch with our client and then headed out to the MSH office to meet colleagues known only via Skype or email, shook hands with some of the 200+ office staff we have here in Kampala, met the chief and a colleague I have known for decades who is now one of the four project directors.

I packed my suitcase watching Ugandan TV and was surprised to see a special on vasectomy. That would not have been possible a decade ago I believe. A banner ran at the bottom of the screen stating that ‘experts target men as population spirals.’ I have been wondering ever since what that means.

Victoria views

We are lodged at the Speke Commonwealth Munyanyo Resort. It is a vast conference complex on the shore of Lake Victoria. “It is the biggest lake in Africa,” said the young man who was showing me my room, proudly.

My room looks out at the man-made Marina where a few fancy pleasure boats are moored plus a few canoes, upgraded versions of the traditional hollowed out tree trunks. We hired one yesterday for a spin around the section of the vast lake where the resort is located. There are birds everywhere: grebes, egrets, marabout vultures, kingfishers, and many I cannot name.

Breakfast is served on a wide porch that the British knew so well to construct in the buildings you can find all over the commonwealth. The main impetus behind this is, I believe, the sundowner as these terraces are always facing the setting sun. It is kind of a G&T place.

On my first breakfast I was just about the only woman on the enormous porch, surrounded by at least 50 men. I didn’t recognize their language, it sounded rather unfamiliar, and their skin color didn’t give much away, a generic pale coffee color. I asked and discovered they were don Turkey. I was able to greet them in their own language, to their great surprise.

Travel reminiscences

It is that day again, departure day. There is stuff strewn across my office, an open suitcase and a nagging feeling that I have forgotten something important. Even lists can’t help. Years ago I made packing lists. I had one for every country I traveled to because each has special requirements. Like malaria prophylaxis for countries around the Bay of Benin but not for Afghanistan; winter clothes for Afghanistan but not for any of the other countries I usually travel to; electrical plug types etc.

The lists were made in the early 2000s and show how much the technology has changed our lives. On my lists featured items such as a phone-flashlight-music player- handheld (remember the Ipaq?) – camera, with different charging devices for each; now a tablet or smart phone will do all of that and so much more. We also had paper tickets which sometimes made for some exciting last minutes, waiting for a DHL or Fedex envelop with either my ticket or my passport with visa stamp, or both. Now, except for the visa part, these days are far behind us. Today I crossed off all these superfluous things; I happily crossed off theTampax as well, I am way beyond that now.

Travel was relatively simple then. There were three classes, First, Business and Economy, with Business only a few hundred dollars more than economy. Our travel policy included a rule that allowed B-class for trips longer than 14 hours. Alas, these days are long gone yet my trips are often closer to 24 hours. I am ecstatic if I get an Economy Comfort seat but by the time my ticket is purchased these are usually long gone.

I also used to travel with toys, gadgets to entertain people or give away as prizes, stacks of quotes printed on large colored papers, poems and what not. All this filled half my suitcase – I brought very few clothes and without all that stuff could have travelled with hand luggage only. I invested a huge amount of effort and energy in creating a ‘space for learning.’ It is not that I don’t think this is important but I am lacking the energy and create the learning space psychologically only.

Abun-dance

After a flurry of activities, compressed into a three day week full of meetings, inbox assaults, deadlines met and not met, I activated my out-of-the-office message for Friday and headed out to Marlborough for the third and last 30 hour face-to-face workshop in my coaching training that is nearing its end. Not counting the time spent writing reports and filling in worksheets and reading required books, this will complete 200 hours of study. It seemed daunting at the time I started back in February, and it is still a little daunting since there is an exam still to be taking, but I do feel a sense of accomplishments and feeling tremendously enriched.

We learned some new techniques today and I applied one to the question whether I wanted to be a vegetarian or a mixed animal/vegetable eater. The tool probes for pain and gain (or costs and benefits) of change versus status quo. The answer was quite clear at the end of the exercise: I will remain a combo eater, light on the animal side but not without. This turned out to be a good choice: I was invited along to dine in a Brazilian diner where, had I made the other choice, I would not have been able to eat.

Back at home Fall is approaching. Tonight Axel had a fire going again, barely three months after the last spring fire in June. Our summers are short indeed, but our apres-summer is one of the best seasons of the year.

The vegetable garden is full and ripe. I pulled up the leek and braised them as suggested by Julia Child; the last fingerlings were consumed tonight by Axel – we have been eating those for weeks now. The beans keep producing as if there is no tomorrow and the kale keeps coming back after we cut it bare. The Sungold cherrie tomatoes also keep producing but their skins are more and more fragile and burst before we can even get to them – burst or not burst, they are still delicious. We are in a state of vegetal abundance.

And in the cove there is marine abundance. With a little bit of luck we will be able to harvest oysters in the not too distant future; the mussels are indeed reproducing, and the sea urchins are coming back. We have been a bit lax with the lobster traps, leaving them baitless in the waters where they fill up with the red invasive seaweed, an abundance we are less happy about.


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