Sylvia's Journal

I have a different role now in this kind of ‘technical’ work as we call it at MSH. In the past I would be busy 15 hours a day, thinking, planning, goading, negotiating, giving feedback, preparing. But now all this is done by others. I have handed over the baton and it has been carried around the block several times, without me lifting a finger or a foot.

I had not thought a lot about this but this is of course how it should be: working oneself out of a job. What I also had not realized that moving further away from the action (on the balcony as Ron Heifetz would say) allows one to reflect while taking in a much bigger landscape.

And reflecting I do. I have time to read and reflect and connect. I have time for slow conversations with people, driven by curiosity rather than some force outside me that wants answers. I love it.

In short succession I wrote 3 blogs for my own page on our intranet. I have no idea who will read it, I have a just a handful of followers, but it doesn’t matter. It’s like a storage place for ‘aha’s or ‘déclics’ as the French call it. I will post some here as well. Stay tuned.

Monday morning we had a brief meeting with the project director who just returned from his vacation, about our adventures in western Cote d’Ivoire. I produced a slide show with the main observations, mostly good. I congratulated him and his team on what they have created in that part of Cote d’Ivoire that is often peripheral to where the action is.

My colleague R. treated us to a wonderful lunch: grilled fish, a paste made from plantains and Atieke, two local starches. The paste looks a bit like playdoh but tastes better. The sauce was made from the peanuts we bought on Sunday. It is a little spicy, like the Indonesian satay sauce, and very filling. Because of that it is usually eaten at home,  at lunch or breakfast time but not at night.

And then we took to the road again, this time closer by, to a town called Adzope, just 100 km north of Abidjan. It took us a small two hours. We arrived at the ‘luxe’ hotel where we launched the very first workshop of the leadership development program in May 2014. This is why am I am here: to observe our leadership development program that has been cascaded down. Now third and fourth generations of trainers are preparing the next generation to take the lessons even closer to the base. I kind of lost track of the many generations and branches that emerged from that first leadership development program all those years ago.

Once again, probably because of my white hair, I got the royal suite. It is called the ‘Suite Merveille’ (wonder or marvel suite), where I stayed last time as well. It has a bath with the same faucet arrangement I marveled (indeed) about when I was here last: the faucet doesn’t extend all the way inside the edge of the tub and thus, when the water is turned on, it splashes in all directions except into the tub. No one seems to have bothered to change the arrangement. This is Africa, improvisation in the face of adversity to the Nth degree, even when this adversity seems to me such an easy thing to change. “Ahh, c’est la vie!”

We are in the same heavily draped room with an enormous, un-moveable boardroom table that looks like a race track – an elongated oval with a space in the middle. It occupies a good part of the room. It sits about 35 to 40 people around. But we are 50. Away from the table is a second row, consisting of well-worn auditorium chairs with small writing tablets hidden in the arm rests.

I remember the panic when I saw this room three years ago. It is so completely contrary to what I then thought we needed (and could not do without). Now, 3 years later I don’t panic anymore. I know the process carries itself even if the space is unsuitable. It is no longer my problem (ah the joys of ageing!) and the facilitators can draw on their own experience to make the space work, as we did last time. They remembered, placing extra chairs on the inside of the oval, making small group work possible.

We observed the first day of the three day workshop that is the second in a series of four. We met in the same meeting hall that had been re-arranged, to my great delight, with a circle of chairs in the middle. I had introduced this notion to others some time ago, as a much better way to meet (one cannot work on a computer or check a cellphone when sitting in a circle without tables). The idea had trickled down to the next generation of facilitators. It was a new combination of faciclitators and participants, and so a bit stiff for the first part. But eventually thaw set in and the conversations became more animated and the learning began.

Having a workshop that is held, quite literally, in the middle of the hospital, is challenging as participants can be called out at any time for an emergency. The facilitators were scratching their heads on what to do about it. I suggested they stop scratching and give the job to the participants. That is after all the team that is supposed to learn about leadership.

The facilitators create a village and the group selects the name of the village, appoints the chief and notables, a ‘conscience horaire’ (time keeper), a treasurer for the fines that late comers have to pay, etc. The norm setting is a well-worn ritual all over Africa and has little to do with the behavior of people. This version, which I have only seen in Cote d’Ivoire, with its village and chief was at least Africanized. But it did have an entire enforcement system that I thought was too much like the way things are here with the emphasis on extrinsic motivation.

And then, like all the other norms I have seen over my career, immediately ignored. The only part that was respected was the role of the village chief, both as arbiter of divergent opinions and to open and close the day.

The leadership work that we do, and which few recognize, is about awareness. I believe that if you are not aware you cannot make choices. And so I pointed out that they had created a new norm, by ignoring the norms they created, and that was that norms don’t matter and that there are no consequences for breaking the norms. And now that they were aware of this they could either throw out the norms or find ways to stick to them.

At 4 PM the session was over and we drove to the next town and a new hotel. This one also had no power and also no water. It may be hard to imagine this, from one’s comfortable vantage point in the US (or Europe, or fancy hotels everywhere) that a hotel could run without water and electricity. It reminded me of my first month in Beirut, in 1976, after the fighting had stopped. We stayed in the Mayflower hotel and ate our peas and rice in the dark.

I was given the royal suite. A comfortable suite of rooms with an enormous bed, and several amenities that were useless because there was no electricity (two aircos, two TVs and a refrigerator). The bathroom was nice but without running water not usable. All would come back in due time we were told.  Insha’llah, I murmured. But water and electricity did indeed return and I slept comfortably and took a hot shower in the morning. The latter had to happen before 6AM because after 6 the water would be gone again until 10PM. One learns to adapt.

We ate with our colleagues on the side of the road, grilled carp, an onion tomato salad and hot salsa and atieke, the local starch, washed away with a cold beer. Life is good.

We met for the morning in the city hospital after making a courtesy visit to the hospital director. He is not a medical doctor but someone trained as an administrator. There are not many places I have visited, especially not in Africa, where non-doctors are considered competent to head a hospital. My Ivorian colleague told me that those hospitals headed by an administrator are generally doing better than those that are not. I am not surprised. After all, hospital administrators are trained for the job. Doctors are not.

I once had a fierce conversation with one of the aged notables of public health in West Africa who could not imagine that someone who is not trained as a medical doctor could possibly direct a hospital. It is funny how the same premises (having been trained professionally) can lead to opposite conclusions. Only if you take a closer look at the premise can you see the false reasoning.

In the morning the entire zone was without electricity. Our hotel had a ‘groupe’ (a back up generator) but it was without gas and ‘la direction’ had not responded to the frantic calls from his un-empowered staff. And so we were without electricity until we checked out. We had some fantasy about a small cup of Nespresso. Many hotels now have the little Nespresso machine and for an extra 3 dollars (a Nescafe stick costs 1 dollar) you can have cup of espresso, if, and this is a big if, the electricity works and/or they have the little Nespresso cups to put into the machine.

Although the electricity had not come back, two small cups suddenly appeared and the waitress beamed with pride, happy to bring us what we had asked for. I noticed the absence of foam and tasted the coffee.  It was hot and brown but it was not an espresso. They had simply opened a Nespresso capsule (and went back to the kitchen to show the used capsule to prove that they had not just used powdered coffee), and poured hot water over the content. The result had little to do with what I had hoped to get and tasted pretty much the same as the Nescafe powder that comes in the sticks.  I suppose both kinds of coffee have ‘Nes’ in common. I negotiated the cost down a bit but congratulated them with their inventiveness. With unhappy clients like us and management that is impervious to customer requests or complaints, they are the ones who will ultimately suffer.

On Monday morning there was a further split among the three of us; two heading west to Guiglo, an all-day ride, and the other staying for a few more days before heading out to Niger, on another assignment.

I do dread the long drives, but with someone to talk with in the back it wasn’t that bad. The roads are good except for a long stretch with holes in the asphalt that require a slalom approach. This is fine as long as there are no cars coming from the opposite direction. I avoid looking ahead. I look sideways to my companion or down and read.

We had lunch in a ‘maquis’ (small semi-open air restaurants with limited menus). I had a piece of boiled oily fish in a bitter eggplant sauce, not so great but tying me over until the evening meal.

At hotel Tam-Tam in Guiglo we settled into our rooms, having to step over centipedes that were crawling all over the place. I learned that when they sense danger they roll up in a tight coil that feel and look like a button. I know this because I stepped on one such coil with my bare feet and thought I had lost a button. I had not paid attention to where I put my feet.

The omnipresence of these centipedes explained why the sides of the bedcover were flipped over onto the bed, preventing my bed from crawling with these 2 inch long creatures the size and shape of garden variety worms.

Other than that the room was comfortable, with an airco that worked as long as there was electricity, which was there about half the time, and a comfortable centipede-free bed.

We had a brief meeting with the team of facilitators of the leadership program – some people I had accompanied as they embarked on their new roles, nervous, and confused at times 15 months ago, and others that they themselves had trained or who had been coached by my Ivoirian colleagues. My terms of reference included a ‘refresher’ and then observing the trainings at various hospitals, given feedback, advice and suggestions where needed.

I asked for the men’s input (there is not much of a gender balance here) and realized that I had made some wrong assumptions about the timing and modalities of this training. I revamped the agenda accordingly that night, taking advantage of the electricity being on, and carefully stepping between the bathroom and my bed to avoid the centipedes that came in in droves from the hallway.