Monday Morning

Monday morning rolls around. I wake up with two cups of coffee and head into the office. What to do this week? I have made my annual plan, my monthly plans, and each week I come up with a list of things to do. These plans help to keep me heading in one direction, but they are by no means day-to-day plans. You can’t force things here. It is a game of patience and diligence to accomplish anything. To know the right people, to approach them in the right way, to do so at the right time, and it often seems, to have a bit of luck; this is what it takes to check off each item on the list.

In a resource-starved environment often with under qualified though thoroughly networked staff, round about ways of accomplishing tasks develop that while being foreign to an outsider get the job done. When I get locked out of my office, there is not one person to go to. Instead I ask around until I find someone who happens to have the spare key to the room where the spare key to my office is located. When I am trying to obtain a copy of the reporting forms for health centers, I visit the health centers that refer me to the District Health Office then to the Zonal Health Office then to the central ministry and pick up an additional form or two at each place I visit.

Complicating things, at every step of the way there are three additional tasks that could be taken on. I am working to improve the coordination of the HIV/AIDS response in Zomba City by creating a monitoring and evaluation system that will collect key pieces of information from health providers in the city, which will be later used to make informed health programming decisions. However, right now we are not able to properly administer our bursary funds for orphan and vulnerable children meaning that there are children out there who could be in school but aren’t. We are not providing food supplements to city employees living with HIV which help them take their medications and retain their jobs. And sadly, I have just been informed that one of our secretaries, who has been cooking lunch for me since I arrived, has died from rabies after being bit by a dog this weekend. Apparently we need to revisit our rabies vaccination efforts as well.

In the face of it all, it is easy to understand how people can become demoralized. Some blows can take away your breath while others seem to deprive you of the air around you. However, day by day we make incremental steps towards a healthier Zomba City: by teaching an environmental health office how to use a GPS unit; by encouraging our data entry clerk to submit timely reports even to government agencies that are not cooperative with us; by incorporating rabies control efforts into our M&E system. Though they often do not appear in work plans and are difficult to measure and appreciate, they may be the most lasting efforts we make. They quite literally are the blood, sweat and tears of development.