Posts Tagged 'Philippines'

Home and hospitals

I have returned to beautiful Lobster Cove. I got the requested business class upgrade for the 18 hours in the air from Manila via Tokyo to Detroit.  In Detroit I found out that both Axel and my granddaughter were in the hospital. Both were being examined to determine why they weren’t well. Axel had a spell of something (but heart attack was ruled out) and Saffi was listless and had had diarrhea for several days. Sita and Jim were back again at the hospital they so detest but what else to do?

Axel was dismissed before I landed in Boston but Saffi is still a patient. The hospital won’t let newborns go home until they have gone through an entire list of tests, including spinal taps –as per lawyers’ instructions we suspect. So far, none of the test has been positive and she is looking better.

Tessa was summoned to Logan to pick me up – it’s good to have children look after their aging parents – and take me home. Axel rode along, dismissed from the hospital just about when I took off from Detroit.

We had a Chipotle take out meal. Axel made a margarita took accompany the meal, which I drank too quickly. Going to bed was a good thing to do anyways. I had gone through a 36 hour day compressed into one day: I got up at 4 AM in Manila, arrived at 4 PM in Tokyo and then again at 4 PM in Detroit. I tumbled into bed at 9:30 PM and slept until deep into the morning. It is wonderful to be home.

Old

I observed the first day of the management training that is provided as part of the WHO wheelchair service training package from the sidelines. My Filipina colleagues ran the day in a mixture of Tagalog and English. Not everyone of the participants actually manages a rehab center, some are in charge of developing national policies. This makes it challenging to cater to everyone’s needs. But the trainers are doing a great job.

Not having slept well the last few days I resolved to go to bed early, and treat myself to a facial to get sufficiently relaxed beforehand. I was suckered into getting the anti-aging treatment, which is double the price of a regular treatment.  I am sure my 26 year old colleague was not given that suggestion. Have I now entered that category of old and credulous people who pay extra for the silly promise of looking younger? My brain told me this was poppycock but I bought the package anyways. When it was time to pay, as if to convince me I had chosen well, the beautician pushed a mirror in front of me. Frankly, I thought I looked old and tired.

On the way back to the hotel I stopped at the supermarket to stock up on dried mango for the return trip. There was one line dedicated to retired people. I decided I looked sufficiently old (and tired, though not re-tired) to be allowed in that line which was also populated by a string of young girls. When the cashier saw me she told the girls to step aside and let me through. Old indeed!

Birth of a society

The second wheelchair stakeholder alignment or consultative meeting is over – it was the primary reason for me being here.  Although my task is not done, the hard work is over. Tomorrow we start the managers training meeting for rehab center directors and other people in managerial positions from the government, the national health insurance program, private sector and charities. I will get to serve mostly as a supportive coach to the Filipina trainers; they left me just one session to conduct, on Planning for Financial Sustainability no less!

This afternoon I served as a midwife to the birth of the Philippines Society of Wheelchair Professionals. The first part of the day was hard labor, but then in the afternoon the baby slipped easily into this world. The birthing process was participative and exciting and left spirits very high, swept even higher by a group photo accompanied by Queen’s “We Are The Champions.”

I had asked for nominations for candidates to form a transition committee that would help shepherd the Society into its postnatal period, until such a time that it is strong enough for formal election of its officers. Ten people were nominated or nominated themselves; two of them declined, seven of them did a less than one minute stump speech and eight were on the ballot. Everyone voted for five candidates, a somewhat arbitrary limit informed mostly by practical considerations and my experience that teams of 5 are often more effective than larger teams.

While Maggie counted the votes, the 60 or so participants and soon to be members of the Society created three drafts statements built up from the ideas of each and every individual in the room. After the election results came through, the five members of the democratically elected received their applause and set down to their first task as Transition Committee and fashioned the mission statement out of the key words that the group had identified from three drafted statements. Transition_committee-PSWP

And while the Society’s mission was being created, the rest of the participants brainstormed possible objectives and settled on four, an easy process of convergence as the glue among the participants had already set, in spite of quite divergent individual agendas and concerns.

Maggie gave me a brief refresher on hash tags and @ signs and supervised my first Instagram postings on this newly born society and its first pilots.

A research team from JHPIEGO, a Johns Hopkins affiliate, invited everyone to dinner to share the results of a consultation they conducted on Monday morning – a nice example of synergy between organizations who sometimes compete and sometimes work together, as we did here – both of our programs funded by USAID.

I ended this great day deeply tired but very happy and treated myself to a massage in the hotel spa. Unlike the sketchy spa in our previous, much more upscale hotel, this spa was great and open till midnight.  My massage was splendidly done by Nellie, who I might visit one more time before it is time to return home.

Wet Sunday

Sunday the remains of the latest cyclone hovered around Manila. It was a day to stay indoors and take care of other assignments, read and take naps. I decided to take a late breakfast but that was a mistake; everyone and their brother, and especially little overweight brothers, milled around the various self-service stations in random movements. The description of the breakfast arrangement is priceless: a showcase of a live interactive kitchen and the intent to “make your gastronomic adventure more festive.” Today I am going to try breakfast at 6 and visit station 7, the kimchi and other fermented foods station.

During a few dry spells I took a walk in the neighborhood of the hotel. It was Sunday and therefore quiet for a change. We are near the UN and the University of the Philippines faculty of allied health services and the university hospital. The buildings hint at past grandeur but it is gone now. The Radium and X-Ray Therapy Institute had known better times, its function chiseled into its grand façade.

When the mall opened I checked out eyeglasses but found little reason to purchase an extra set here. The prices were only slightly lower than in the US. This is true for many of the brand name offerings at the mall which clearly caters to the well-heeled citizens of Manila. Only the nail and spa places are a bargain for us. After the pedicure a facial and massage is still on the program.

Two women who had just flown in from the US joined us for dinner. One is from Johns Hopkins University who will share the findings of a research study about wheelchairs. The other is from the US Cerebral Palsy Foundation and arranged her last minute flight, this event being too good an opportunity for her program to meet with key stakeholders to miss. We went out to the Seafood Market restaurant, recommended to us by both the concierge and the reception staff, a short walk from our hotel.

The restaurant turned out to be quite a dining experience. When entering the restaurant one receives a supermarket shopping cart and then helps oneself to fresh fish, displayed on ice, vegetables and fruits. When done the cart is wheeled into the kitchen and a short while later the contents of the cart return to the table transformed into a most wonderful meal.  For about 20 dollars each we had sweet and sour fish, scallops, jumbo prawns and a mountain of stir fried greens. For dessert we had picked mangoes and watermelons which were delivered to our table prepped for easy eating. What a concept!

Work, eat and play

It was a nice reunion at breakfast where I found both my US colleague and my Filipina co-conspirators – the same team I worked with in Cambodia earlier this year when Massachusetts was still covered under lots of snow.

I love breakfasts in Asian hotels because they serve both Asian and western breakfasts and I get to sample a lot of different foods. I started with sticky rice rolled in some sort of leaf, eaten with caramel and roasted coconut. Then I had a crepe, again with caramel and this time with banana slices, and of course lots of fresh fruit.

After breakfast we reviewed our plan, divided roles and I started to prepare for the sessions I am running. M. and I went to the mall for lunch and to hunt for flipcharts but we got sidetracked after an overdose on Japanese food – M. had a facial and I had my toenails done in a nail spa that reeked of toxic liquids but made my nails presentable again.

It is weekend here and in the rainy season, or maybe any season, it is mall time. The place was filled with Filipinos who are visibly doing well. But on the way to the mall you have to dodge the street urchins, some younger than Faro, who have already learned the rules of street life. A young mother held on to the littlest of her brood of four, five? I wondered about her story. It was a very sad and disturbing sight, just steps away from the good life.

Later I met a new member of the team,  a young Mexican physical therapist who was one of the trainers of last week’s intermediate wheelchair fitting course. She is also representing the newly founded International Society of Wheelchair Providers, supported, like all of us here, by the American taxpayer via USAID. We plan to lay the foundation this week for a local society, and possibly future affiliate of the international society.

For dinner (there is always a reason to eat here) we went back to one of our favorite places during our last visit, a shabu-shabu restaurant (akin to Mongolian hotpot). We had our Filipina colleagues do the ordering to avoid the fish lips and other weird edibles that M. and I ordered last time, not knowing what was what. For desert they had brought the fruit durian. I was amazed that the restaurant was OK with us bringing in our own dessert, and, even more amazing, something that had a rather pungent aroma that wafted through the place as soon as the Tupperware container was un wrapped. We all got to try a piece – not bad actually, until the burps set in. We also got to try malang, another tropical fruit, small white globules, a little like lychees, that made a very nice ending to the meal, and that may also have contributed to the not so great burps.Maggie-and-durian

Rewards

photo 3Manila-pedi

just_rewardsWe 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.

Fish lips, eel and bamboo pith

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.

lobster_in_bottle

black-eel_live

Black_eel2

Catalyzed

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.

Preparing to roll

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.

Cronuts, copy and creative conversations

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.


May 2024
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