Zimbabwe: Things I didn't expect to find...

• Graffiti on walls criticising Mugabe and asking him to step down; graffiti no one appeared to be making any effort to remove. Apparently the latest solution to Zimbabwe’s woes, tabled by a former Tory Foreign Office Minister, is to give Mugabe a 'safe, comfortable and well looked after home in Britain'. Not sure how happy people in Britain would be with that, how long it would take before protestors lined up outside his gate calling for him to be held to account, or how enthusiastic Mugabe would be to live with his former colonial antagonists!

• A sign on someone’s gate warning burglars that explosives were laid across the garden. This is definitely a new approach to deterrence! When dogs are not enough to scare burglars away, why not resort to land mines?

• A range of newspapers that did include stories critical of Mugabe, the coalition government and Zanu PF. That said, the police have this month arrested a journalist working for The Standard who wrote a story concerning the police force, and two freelance journalists who were charged with ‘criminal nuisance’. The Zimbabwean government have also issued an arrest warrant for the editor of The Zimbabwean, who is been in exile in Britain for years, for a story published online in 2008. There’s speculation this is a crack down in preparation for the 2011 elections...

• Most expatriates I spoke to felt it was relatively secure and that crime was low, and lower than Malawi, which seemed strange. Perhaps the power-sharing agreement and dollarization has improved life. Perhaps everyone is fearful of the State. Perhaps the conditions in the prisons is acting as a deterrent – the prisons have apparently ran out of money to pay for fuel to transport inmates to their court hearings, food to feed inmates, even salaries for executioners to execute the prisoners on death row. Yes, Zimbabwe still executes people, legally, that's something else I didn't expect.

• Economic revitalisation, with new shops, restaurants and businesses opening up everywhere. The dollarization of the economy following the collapse of the Zimbabwean dollar appears to have given investors the confidence that even if there is political instability, the economy will not suffer in the way it did during 2008.

• On one of the bypasses through Harare there’s an enormous, American style, Pentecostal church that seats thousands of people. And funded by Zimbabweans, not Americans. Also along the bypasses you frequently see the highly conservative and secretive Apostolic sects, dressed in their white gowns, worshipping and praying in groups. The Apostolic sects believe in polygamy and more often than not the marriages occur between adult men and underage girls. The police reportedly rarely intervene because many sect leaders have powerful contacts in the police and government. The Pentecostal and Apostolic are apparently the fastest growing religious movements in Zimbabwe.

What didn’t surprise me was that the UN’s latest Human Development Index report shows that Zimbabwe (along with Zambia and Congo) has a lower HDI than they had in 1970. The newspapers were reporting that this was attributed to ‘lousy leadership and failed economic policies’...

Zimbabwe: The old currency

Everything from this:

to this:

That's right - one hundred trillion dollars! I've run out of fingers to count the noughts on!

Malawi: Insights into commercial sex work

I spent the morning at a clinic for trucker drivers and commercial sex workers at a border post between Malawi and Mozambique. Here are a select few insights:

• Hip Booster: The phrase women use to describe the Depo 3 month injectable contraceptive, because it gives the women more curves which makes them more attractive
• Hit and Run: The phrase women use to describe their casual encounters with truck drivers when they present themselves at the clinic for STI and HIV services and they're asked how they came to contract the STI / HIV.
• 1,000 MWK (£4): The average charge for a 'short stay' - a one off. This doubles for an overnight stay.
• Risk: It's common practice among commercial sex worker to charge customers a higher rate if the customer doesn't want to use a condom. However, usually this is intended to deter customers from unprotected sex, thereby reducing the risk for the woman. But here money wasn't an issue for the truck drivers and women appeared to be accepting risk in order to have a more lucrative encounter.
• Smell: Our brand of condoms are chocolate flavoured and studded. These attributes are marketed as 'for her pleasure'. They sell well, but we know from research that the vast majority of men aren't in the least bit concerned about 'her pleasure', leaving us questioning why these condoms sell so well. It's a complex issue, but I think I uncovered one reason today: according to truck drivers the aroma of the chocolate flavoured condom 'disguises the smell of sex' and the other condoms on the market don't.
• 100%: The percentage of women testing postive for HIV at this clinic. The HIV incidence rate among the little microcosms that exist at border crossing points and ports across the world is often 2 or 3 times higher than the incidence rate among the general population.

Malawi: What Do You Do?

It's the most common question I get asked. And one I ask myself sometimes too. Particularly at the end of a long day.

The comedy line, according to friends in the sector, is: I'm a sex worker. I don't use this much, although I do find myself talking about sex a lot more than I ever used to.

The official line though is: I manage ten functions: family planning and general medicine clinics (31); outreach activities (300+ sites where we have mobile clinics every month); clinical quality; clinical training; procurement; warehouse; fleet; property; repair and maintenance; and security.

What this actually entails on a day to day basis is:

• Signing things
• Not signing things, usually allowance requests and ridiculously over-priced purchase orders
• Listening to my boss let off steam
• Fabricating my timesheet which says I can only work 8 hours a day
• Feeling out of my depth
• Wondering whether anyone has realised this
• Adding to my To Do List
• Writing new policies
• Discovering yet more rooms piled high with a decade of rubbish and documents
• Searching for fuel
• ‘Coordinating’
• Eating comfort food
• Telling myself I need to stop eating comfort food
• Providing a sounding board for my boss
• Wondering what will be next
• Trying to remember what I did last
• Reminding myself what amazing work the organisation does
• Pondering what the organisation could achieve if only we improved that, addressed this...
• Anticipating how change could be misinterpreted
• Sweating
• ‘Multi-tasking’
• Cursing the falling tree fruit which kept me awake half the night as they clattered onto the metal roof
• Speculating whether or not the latest clinic burglary was an inside job
• Reading the riot act to private security companies when their guards don't turn up, their alarms don't go off...
• Wondering how concerned you should be about allegations in a newspaper that only has 20,000 circulation
• Trying to second-guess the conspirators
• Watching the next episode of whatever American TV series I'm watching that month
• Telling myself I won’t resort to alcohol and cigarettes like much of the expat community
• Sitting in traffic
• Sitting in a cafe watching the huge red sun set over Blantyre’s hills whilst trying to catch up on work
• Wandering around the warehouse trying to create a culture of attention to detail
• Poking around the latest grounded vehicle of our delapidated fleet in our service bay
• Trying to make sense of the forced ordering system
• Reminding myself not to use the word ‘abortion’ in public
• Fire-fighting
• Asking questions and receiving responses which only lead to more questions
• Reminding myself of the progress we’re making
• Wondering what it’ll take to persuade my boss in London to let me stay a little longer so I can make more progress

And occasionally I get to stay somewhere like this whilst I'm visiting clinics:

Global: Are good intentions enough?

An article in the New York Times last week stirred up a long-running and fascinating debate about the role of volunterism and approaches to development. Here are excerpts from the article that started it, which provide accounts of how individuals from the West have tried to make a difference. It's followed by excerpts from the most comprehensive response to the article, which argues that this approach is simplistic and potentially does more harm than good. Click on the articles titles to read them in full.

D.I.Y. Foreign-Aid Revolution -  (New York Times)

...And so Scharpf joined a revolution, so far unnamed because it is just beginning. It’s all about what might be called Do-It-Yourself Foreign Aid, because it starts with the proposition that it’s not only presidents and United Nations officials who chip away at global challenges. Passionate individuals with great ideas can do the same, especially in the age of the Internet and social media....

...Are these young idealists unsophisticated about what it takes to change the world? Yes, often. At first, they don’t always appreciate the importance of listening to local people and bringing them into the management of projects, and they usually overestimate the odds of success. They also sometimes think it will be romantic to tackle social problems, a view that may fade when they’ve caught malaria...

...It’s fair to object that activists like Doyne are accomplishing results that, however noble, are minuscule. Something like 101 million children aren’t attending primary school around the world, so 220 kids in Doyne’s school constitute the teensiest drop in the bucket. The larger problem can be solved only if governments make education a top priority (which they haven’t), just as ending the wars in Congo may require the concerted action of states. Well-meaning individuals like Doyne help at the edges but don’t fundamentally change the nature of the challenge; indeed, charitable construction of schools and hospitals may sometimes free up governments in poor countries to use their money to buy weapons instead. All that is true — but it’s equally true that if you happen to be that drop in the bucket, Doyne is transforming your life...

Don't Try This Abroad (Foreign Policy)

...The stories sound lovely. I admit to feeling a little warm and fuzzy inside reading them. After all, this is what drives me to do development work: to make the world just a little better... We all want to tell ourselves the story about fighting through hardship -- each of these women made personal sacrifices for their work -- to make the world a better place...

...Unfortunately, such stories don't reflect reality. Spend a little time in any community in the world, and you'll see people from that community finding ways to improve it -- not outsiders. Yet these sort of people -- local community members helping their neighbors and themselves -- are absent from Kristof's stories. Instead, he gives the reader an American heroine (his stories are mostly about women) who comes to save the day. Local individuals exist as needy targets of the protagonist's benevolence. If they act on their own behalf or the behalf of their community, it's only after the American has prompted them to do so. Developing country governments and domestic civil society are barely mentioned...

...Such implicit arrogance aside, a more fundamental problem is that Kristof's narratives make development seem simple. In his stories, the hero sees a problem and fixes it. Women are suffering from war and rape in Congo? Raise some money, build some homes, and regulate conflict minerals. Lack of affordable sanitary pads keeps women from work and girls out of school? Develop a cheaper pad. Orphaned children in Nepal? Build an orphanage. He even implies that the established foreign aid organizations "look the other way" when it comes to these problems. How could they miss such obvious opportunities for improving lives...

...What Kristof misses is that even seemingly obvious solutions are more complicated than they appear. Development means change, and change is always complicated -- and often political...

...But in this field, amateurs don't just hurt themselves. A project that misunderstands the community or mismanages that crucial relationship can undermine local leaders, ultimately doing harm to the very people it was meant to help...

...The world of aid has spent the last 50 years grappling with these questions. The development industry is by no means perfect, but it has made progress and learned valuable lessons. The lessons are often ignored by newcomers, and the same mistakes are made over and over again...

...We all start as amateurs. The difference is whether we seek to learn more or assume that we can just start doing something, muddling through as we go...

Malawi: Unsafe abortion - the testimony of health workers

Bonus Makanani, head of the Department of Obstetrics and Gynaecology at University of Malawi's College of Medicine, says QECH commonly sees women who have sought abortions from health care workers - clinical officers, nurses, medical assistants, occasionally medical doctors. "A lot of them think they've got the theory, but I am not certain that they have the practical experience to undertake such procedures," Makanani says. Such workers may begin the process and then send the woman to QECH once complications arise. Other women seek to induce an abortion by ingesting detergent powder, consuming drugs or herbal concoctions, or inserting sharp objects vaginally. Such methods can rupture the uterus or bowel and lead to infection, bleeding and in some cases infertility or death.

Read on: http://allafrica.com/stories/201010221086.html

Malawi: The case for safe abortion services

It's an emotive subject, but here are some facts:

• Section 149 of the Penal Code outlaws abortion. It says any person who administers abortion shall be liable to imprisonment for 14 years, while Section 150 indicates that any woman who solicits abortion is liable to seven years imprisonment.
• 112,008 women procured abortions in Malawi in 2009 and a large percentage of this number feared to seek medical services for the fear of stigma, discrimination and legal repercussions. (Strategic Assessment, Magnitude and Consequences on Unsafe Abortion in Malawi - Malawi MOH, 2010).
• 32,094 women were treated for induced abortion complications in Malawi's health facilities in 2009 (ibid).
• Many of these women have approached traditional healers and herbalists who commonly insert a stick of chigwada (casava) into the vagina to induce an abortion, or provide a chilambe concoction (herbal mixture). Other women resort to drinking deterrgents and other household chemicals and poisons. Some approach private clinics who often do not have the adequate knowledge, suitable equipment or an appropriate operating environment. (Unwanted Pregnancy and Abortion: Experiences of Women in Malawi - ICW, 2009)
• 33% of girls aged 15-19 years old are married (Malawi Basic Indicators - UNICEF, 2010)
• There is growing evidence of sexual and gender-based violence as communities become increasingly aware of that health facilities now stock Post Exposure Prophylaxis. In one hospital in Malawi, Kamuzu Central, the number of patients reporting an assault increased from 78 for the year 2006-2007 to 134 patients for 2007-2008. (Malawi Ministry of Health, 2010)
• Malawi's HIV prevalence rate among adults aged between 15 and 49 years is 11.9%. This equates to an estimated 930,000 Malawians living with HIV, of whom 490,000 women and girls.
• Nearly 5.5 million African women have unsafe abortions each year. As many as 36,000 of these women die from the procedure, while several millions experience short or long term disability. (World Health Organisation)
• Criminalising pregnancy termination is not associated with a low incidence of abortion; quite the contrary in fact. Most unsafe aboritons occur where aboriton is highly restricted. (Global and Regional Estimates of the Incidence of  Unsafe Abortion - World Health Organisation, 2007)

Logo courtesy of www.gmu.edu

Malawi - A Conversation in a Cab

“So what’s the news Lawrence?” I ask as I get into the car.

“I’m getting engaged at the end of the month!”

I’m a little surprise. Only two weeks ago Lawrence had been telling me how upset he was that the father of his girlfriend had banned her from seeing him, even though she was pregnant.

“The girlfriend who is pregnant? So the father changed his mind then?”

“Nooo! This is a girl from my village.”

“Lawrence, that’s very quick!”
Assuming that engagement is as significant a thing in Malawi as it is in the UK, I ask “Are you sure it’s the right thing to do? Two weeks ago you were telling me you loved another girl!”

“Ah no, that is the past, I do not love her anymore.”

“Lawrence, are you thinking with your head or your groin?”

He bursts into laughter.

“How long will you be engaged before you marry?”

“Maybe two years.”

Lawrence tries to explain himself. “Me, I cannot be alone for long. I need a woman to look after me.”

“So do you need to be engaged to have sex and live together then?”

“Yes.”

“Why don’t you take it slower?”

“If I do not sex her, another man will sex her”

I have a hard time not laughing at the phrase ‘sex her’ but we move on.

He switches the focus of the conversation to me. “Do you want a relationship in Malawi? Do you like black women?”

“If I met the right person, yes. But for me it’s complicated. I think many women I meet in restaurants and bars look at me and see money.”

“Ah yes, you only find bitches in bars.”

“So that’s name for women looking for men with money?”

“Ah, yes. But you must buy things for all women.”

I’ve been in Africa long enough to know the answer to the question but I ask anyway, “Why?”

“Because you must!”

“So the woman gets clothes and jewellery from the man. What does the man get?” I know where this is going.

“Sex of course!!!”

“But doesn’t the woman 'get sex' too? Doesn’t she enjoy sex too?”

He’s laughing and shaking his head at me in disbelief.

I move the conversation on and immediately regret it. “So at what age do most people in Malawi start to have sex?”

“14, 15 years old. Even me, I like 14, 15 year old girls and I am 31.”

I’m a little taken back that he’s so upfront about this. In some countries in Africa it's common but the sentences for this and community outcry are so severe it’s not something you’d admit to. “But that’s illegal and exploitative Lawrence!”

Dismissive and not in the least bit phased he replies, “Noooo, many men like 14, 15 year old girls like I do!”

“That doesn’t make it right!”

Malawi - First Impressions

I expected challenges. More than that, I wanted challenges. And three weeks in, I've had everything.

Two clients undergoing a procedure at our outreach sites were subsequently admitted to hospital, prompting what's referred to as 'major complication investigations' to establish whether the admission to hospital was linked to the procedure we performed, and whether or not our clinicians performed the procedure correctly. It's inevitable that a medical providers will have some reports of major complications and our complication rates are significantly lower than other providers, but nonetheless it's not taken lightly. There have been three burglaries which have left the clinics wrecked and disrupted services. This on top of a mountain of more systematic issues across the clinics, outreach, warehouse, procurement and fleet. Issues which are completely understandable given the fact they've effectively had no Operations Director for 2 years. 

Exhausted as I am, I'm thoroughly enjoying it. Being back in the field doing hands on work, learning about something new, leading and managing a team again. And despite the issues, I can see enormous potential now we're in a position to invest some time and energy in managing the team and putting some systems in place. Already you can see the changes as people respond to having some support, direction and monitoring. Will three months be enough though? Not for the organisation, and not for me!

Malawi - My source of therapy, the hammock

Malawi - "The darkest hour comes before dawn"

The reassuring words of a colleague full of wisdom, as we tried to navigate our way through a colourful couple of weeks...

When I take on new teams, I like to start by agreeing expectations of each other and our commitments to each other. It's a contract of sorts and a good foundation. One of the key expectations I have of my teams is that they don't play games - if they have an issue, they bring it to me, we resolve it professionally, there's no conspiring, undermining or rumour mungering.

Little did I know what was afoot.

Over the past two weeks we've been engulfed by anonymous allegations sent to the national press and threats of an organisation-wide strike. On Sunday the allegations were published on page 2 of a national paper, albeit alongside the Executive Management Team's response. And today we were greeted by yet another anonymous email reiterating the allegations.

There's one common theme running through the allegations of racism and corruption: the recruitment process for the Executive Management Team is biased towards white internationals and disadvantages black nationals; the organisation is flooded with white internationals on short-term postings doing jobs black nationals could do; and there's a huge disparity in the remuneration of white internationals and black nationals. My arrival has just aggravated pre-existing grievances.

As misinformed as the examples cited are, the allegations are thought provoking. They touch on some pertinent and perplexing issues. Over the past five years there's been a huge change within the international partnership as longstanding national Country Directors and management teams have been replaced by internationals, often following unfavourable audit findings.

International vs. national is a recurrent issue; I've written about it before when I've confronted it in other contexts. But it's perhaps more sensitive in developing contexts like this where there's a richer resource pool to recruit from. Some of the questions this issue raises I can answer with conviction, some I still wrestle with.

What determines whether a post is opened up to international recruitment and remunerated differently to a national post? What do internationals bring that nationals don't? Is trust a factor, what lies behind this and are we willing to acknowledge this? How do international experiences build capacities? How can we create more opportunities for national staff to gain those international experiences? Do we recognise the different capacities internationals and nationals bring? How do we value these, e.g. exposure to different contexts vs. innate understanding of local cultural. Should internationals be compensated for being away from their place of origin, friends and family? How relevant or significant is it that I'd earn a lot more if I employed my qualifications and expertise in another field, based back home in London? What do we need to be alert to when writing 'person specific requirements' to ensure there isn't an underlying bias.

The list goes on...

Sadly the allegations don't appear to be driven by principles, nor shared by the overwhelming majority of staff. They have instead originated from a select few aggrieved that there are stronger international candidates for posts above them.

Handling these allegations has also been perplexing. I've encountered teams with grievances before, but never teams who took it to the press. Knowing who is behind them, but unable to prove it, leaves you feeling frustrated; you can't confront them or issue a disciplinary. But it slows you down, forces you to be more subtle. I've been taking my guidance from Sun Tzu:

• Be extremely subtle, even to the point of formlessness. Be extremely mysterious, even to the point of soundlessness. Thereby you can be the director of the opponent's fate. (Sun-tzu, The Art of War. Emptiness and Fullness)
• The best victory is when the opponent surrenders of its own accord before there are any actual hostilities...It is best to win without fighting. (Sun-tzu, The Art of War. Planning a Siege)
• The skilful employer of men will employ the wise man, the brave man, the covetous man, and the stupid man. (Sun Tzu)

Malawi - Ringtone of the Month

For 8 hours I endured this ringtone whenever my driver's phone rang.

Shouted in a deep preacher voice: "You are blessed in your body, you are blessed in your finances, you are blessed in your business..."

I never got to here the rest of the sermon because he'd answer the phone.

A little different to the latest Rihanna tune or the Crazy Frog.

Ethiopia - Random Facts

1. 
   
   VW Beetles are everywhere you look, particularly in the city. I counted 23 in a half hour drive.
2. 
   
   The fault line running through Ethiopia towards the Red Sea has been gradually widening; this is expected to result in the Horn of Africa becoming detached from the rest of Africa, albeit in 10 million years.
3. 
   
   Ethiopian hotels have notices banning same sex couples or notifying same sex couples that they must pay a 50% premium.
4. 
   
   Ethiopians seem to be table tennis fans. From cities to villages you will see table tennis tables set up in the open air everywhere you look.
5. 
   
   US adoptions of Ethiopian children have been on an upward trend since Angelina Jolie adopted an Ethiopian child in July 2005, although this also coincided with clamp downs in Vietnam and Guatemala. In 2004 289 children were adopted. This doubled each year for the following 3 years and peaked at 2,277 in 2009; that’s more than 6 children a day. 34% are <1 year old, 39% 1-4 years old. (Source: INS Immigration Services). International adoptions of Ethiopian children cost an estimated $20,000-25,000. This lucrative ‘business’ is sparking concerns among many.
6. 
   
   Ethiopians love their fresh juice. There are juice bars everywhere. The favourite seemed to be avocado or a kaleidoscope of juices in a glass.
   

Ethiopia - Pertinent African Proverb

Tomorrow makes known to us what tomorrow will bring

Ntondo ikatondolaga (Sukuma)

Kesho hufanya ijulikane mambo yake (Swahili)

This Sukuma proverb in Tanzania has a play on words. Ntondo means “tomorrow.” Kutondola means “to reveal” and also “to shell peanuts.” The Sukuma people use this proverb in relation to shelling peanuts. When you break the shell you do not know what is inside – a ripe peanut or a rotten peanut. So to shell peanuts is to reveal something that is unknown or hidden. The meaning is that we can’t know today what will happen tomorrow. What is hidden today will be revealed tomorrow.

Ethiopia - Eye Opener

The day starts well. The breakfast menu at the local café is probably the best I’ve found in Africa; there’s no boiled cows foot soup, dry bread with salty butter, anaemic omelettes, papaya... In fact it’s so good I seize the moment and order two things. Breakfast banquet over we rush off to meet the outreach team. We wait while they finish packing the vehicle with medical equipment and then prepare to head out to the field. It’s another false start - the outreach team need to have breakfast first. We loiter and potter for an hour. We then head off to the outreach location together. My child-like excitement at seeing the programme first hand has not yet subsided. We bounce along the winding roads as we head yet further up into the highlands. Settlements become more sparse, poverty more obvious. But it’s what I’ve come to call ‘picturesque poverty’ – thatched huts, lush green surroundings and full of life, not the scenes of desolation and despair that covered our TV screens two decades ago. We reach the government health post where the outreach will be based today to provide some of the family planning services the Health Workers are unable to. I step out of the car and immediately regret not having had the foresight to bring a hat and gloves; the wind is howling over the mountainside and its freezing. Everyone is walking around wrapped in blankets, only their heads and feet showing.

The health post is typical of local buildings – it comprises three small rooms constructed with a frame of tree branches, walls of mud, straw and dung, and a roof of aluminium; there are windows but no glass. The outreach team are tasked with turning this into a sterile but welcoming environment in which to conduct consultations, medical procedures and recovery. In less than an hour the team are set up and ready for the first client.

While the first client is having a tubal ligation I cower out of the wind behind several huge stacks of dried animal fodder and corn. An Ethiopian colleague translates for me as I start a conversation with a woman who is huddled outside the health post wrapped in her blanket. She was there to provide moral support to the first client who’d come for a tubal ligation on her recommendation. A year ago she too had come to Marie Stopes on the recommendation of a Government Health Worker. A widow with three children, she decided her child bearing days were over and that a tubal ligation would simplify her life. It was a success story; she’d only felt discomfort for a couple of days, and hadn’t felt healthier or happier since. When I asked if there was anything we could do to improve the service she said only “I did not know about Marie Stopes until someone told me. Most people don’t know. You need to go out and tell more people about it”.

The second client was happy for me to sit in on the procedure so I sat in the corner of the cramped makeshift operating room while the three staff went about their business. Central to the organisation’s approach is a pain management technique which seeks to reduce reliance on pain relieving drugs in short procedures. As someone who is queasy and has a pathetically low pain threshold, this isn’t a concept I warmed too. But I sat there and watched a woman lie in silence as her abdomen was cut open, her fallopian tubes pulled out and tied together, and her abdomen stitched back together, with nothing more than local anaesthetic, distracting conversation, and a comforting and encouraging team. If I hadn’t seen it first hand, I would have struggled to believe it.

Disappointingly that marked the end of the services today. Clearly we really do need to go out and tell more people about the services. We packed up the vehicles, agreed we’d conduct a debriefing back at the clinic out of the cold, and headed back. We arrived ahead of the outreach team and waited. We were reassured they were “on their way”, “nearly here”, “not far”. An hour later they arrived. They’d stopped for lunch. I think the Ethiopian language must have a lot of ambiguity within it if a group of Ethiopians can’t reach a shared understanding of what’s been agreed. There’s also an intriguing habit of randomly inhaling sharply at the end of sentences, almost in a Gordon Brown style.

We lunch at 4pm, return to the clinic to look at the records and stock for a couple of hours, and then head off for what I’m told will be a “cultural experience”. We wander through a non-descript entrance into a dark bar strewn with cow hides and the skins of more exotic animals. In the corner of the bar are a musical trio – two typically beautiful Ethiopian girls and a half drunk young man. They take turns to sing, play a guitar like instrument, and drum. The girls excel at singing traditional songs with sporadic high pitch whooping noises, dancing with their shoulders and necks in a style oddly enough akin to the 1980s hit ‘Dancing like an Egyptian’ and Shakira. They have the men entranced and they respond by tucking notes into their tops. The half-drunk young man excels in working his way around the bar, spontaneously making up amusing lyrics about each individual. He has everyone in hysterics and they respond by tucking notes into his top too, if only to encourage him to move onto the next victim. It’s a great and unexpected end to a long day.

Over breakfast the following morning, as we complemented the waitress on smiling through our numerous requests for bespoke breakfasts, I learn that there’s a world record for laughing and it’s held by an Ethiopian.

Ethiopia - Going with the flow

Thanks to Ethiopian Airways’ appalling entertainment offering, an exit row seat and a couple of lightweight sleeping pills I manage to sleep through at least some of the night flight. I head straight for the head office only to find its spread out over three offices in the same neighbourhood; this gives a whole other dimension to the challenge of NGO coordination. After a round of introductions to an array of people whose names I know I will struggle to remember, I go into a ‘planning’ meeting. In my experience, planning has never been Africa’s forte; people instead favour going with the flow. This was no exception. “We will leave at 10am.” I cut short a meeting with the Finance Director to ensure I don’t hold anyone up. We leave at 1.30pm after waiting fruitlessly for a cheque to be signed (3 hours), taking lunch (1 hour) and picking up the luggage of staff (1 hour). “We should leave at 10am instead of the afternoon because we now think it’ll take 6 hours to reach Dessie”. It takes 8 hours and we arrive at 9.30pm. I’ve been away from Africa for 6 months and clearly need re-sensitising to the way things work.

The journey takes us through the Ethiopian highlands, along the rift valley and back up into the highlands. The landscapes are diverse, captivating and unexpected – vast rolling plains of grass, crops and grazing cattle, rocky mountainous terrain, lush flooded valleys. I’m struck by the amount of activity; there’s little sign of idleness or stagnation; everyone seems to be tending cattle, working in the fields, constructing new homes. Ethiopia seems to be on the up, not just in the cities. Another sign of this is the new road being constructed by the Chinese.

The journey is not without it’s hazards though - precarious mountainside roads, frequent standoffs with cattle whose horns wouldn’t have been out of place on a colonial hunter’s wall, stones hurled at the car by brazen children, herds of camel, sheep, goats and donkeys wandering across the roads oblivious or defiant, careering lorries, blankets of thick fog on the mountain tops, landslides, smoke billowing across roads as villagers simultaneously start cooking dinner... The driver smiles throughout; it seems to be an Ethiopian characteristic. I go to bed resolving to smile more and to say “So what’s the plan guys?” less.