Sunday, November 10, 2013

More Abidjan Thoughts

Observations from the past few weeks here in Abidjan:
  • I had strep throat last week, and possibly malaria as well.  I'm better now, but this was a barrier to blogging the past couple of weeks.  
  • Internet USB keys here are very convenient.  You can buy a USB key and insert it into your computer whenever you need internet and it provides you with a 3G connection.  I assume that this technology exists in the U.S., but I was completely unaware of it.  
  • At the ministry of health, my direction is now pushing forward a plan to introduce "performance based financing" into the Ivorian health system.  This should be an exciting project and I imagine that it will be my core project during my time here in Cote d'Ivoire.  
  • A lot of professional documents here are written collaboratively here.  In fact, at every government conference, workshop or commission that I've been to, the goal has been to produce, via group, some sort of document.  This is in stark contrast to the U.S., where documents are composed individually and circulated for editing, and where workshops and seminars are often a waste of time.  Here, the workshop is the most important work activity; everyone comes together, works hard, and produces a policy paper collaboratively.  Still, based on what I've seen so far, I'd probably choose the U.S. model for producing collaborative work.  I do like that the Ivorian model encourages such a high level of collaboration and participation.  But it does not encourage outside research.  It's a closed universe, where a group of people will sit inside a room drafting a strategic plan without bringing in outside research, thereby failing to take advantage of the wealth of easily accessible information available via internet.  It's possible that these judgments are premature.  I have only been to a handful of workshops and commission meetings so far.  
  • Abidjan is generally pretty nice.  It is green, there is not too much garbage on the streets, there are lots of nice buildings.  Still, it's not quite as well kept as, say, NW Washington DC.  The main reminder is that my fingernails and the bottoms of my feet are usually dirty here.  Lots of dust flying around always.  
  • In general, I've been positively surprised by the level of social capital here.  To get window curtains made, you go to the store, select your curtains and then come back in a week to pick them up.  They don't demand money up front, and it is quite possible that you would never return and they would be out the cost of the materials and the labor.  When we got our furniture made, we left a sizable deposit to allow the carpenter to buy supplies, and, while he wasn't a great carpenter, he did eventually deliver all of the furniture that we had ordered at the price he had quoted.  
  • That being said, I left my cheap cell phone in a taxi last week, and the finder did not make any attempt to return it, despite text messages promising a reward.  
  • There is no daylight savings time in Cote d'Ivoire.  Which makes sense, this being so close to the equator and all.  Days are always about the same length here.  Sunrise around 6am and sunset at 6pm.  
  • There is an odd competition here among ex-pats to see who can pay the least for taxi rides.  I understand the desire to be well adapted to Ivorian culture, but I still don't really understand bragging about negotiating a particularly low fare with a cab driver.  Would you brag about how little you tipped your waiter at lunch?  Is there an ethical difference between the two?  


  1. How is financing being decided now if not on performance?

    1. It's just being budgeted through the traditional budgeting process. I'm not exactly sure how that works in Cote d'Ivoire, but I assume it involves the government making calculations about what each hospital or clinic needs and the clinics probably lobbying to get as much money as possible.

      Performance-Based Financing seems to be all the rage right now because Rwanda and Haiti recently tried it and it seemed fairly successful. As far as I can tell, all the big players (World Bank, USAID) are pushing it pretty hard. I don't know enough yet to have really strong feelings about whether it's actually a significant improvement or just a development fad.