Working at the Ivorian Ministry of Health

Notes from my first week of work at the Ministry of Health:

• I arrived at work on Tuesday morning and the electricity was out.  They didn’t really know what to do with me, but one of the women in the office was about to leave for a week-long conference, so they sent me with her.  The conference was in Agboville, 90 minutes north of Abidjan.  I was told to go home and pack my bags and Noelle would pick me up in two hours. 
• The conference was about how to improve human resources in the Ivorian health system.  There were officials there from several different branches of the Ministry of Health, as well as from the WHO and Abt Associates, who sponsored the meeting. 
• The meetings were a bit stressful at first, as my French comprehension is still not totally up to par, and I had trouble following some of the more technical conversations.  Also, I’m the only non-African here.  It’s an odd feeling; I attract a lot of attention whenever I walk into a room.  Everyone is polite enough to pretend like it’s nothing out of the ordinary, but it’s interesting to feel the vibe of the room change when I enter.  It’s a bit of a lonely feeling and I imagine it will increase my empathy for outsiders when I return to the U.S. 
• It’s worth noting that Abidjan doesn’t feel like this.  White people are noticed, but there they are common enough that you usually don’t get more than a brief second glance.  This is supposedly rare for Africa.  Sheila says that even in Accra she attracted significantly more attention. 
• By the end of the week, everyone had become much more comfortable with me.  I got invited out to dinner in town on our last night, and I had some nice conversations on Thursday and Friday. 
• There was a refreshing and admirable level of honesty at these meetings  -- it is common for government officials at an official meeting to say something like “our system of financial motivation for health workers is completely worthless,” and everyone will nod in agreement.  U.S. government would function better if public officials were so honest.  
• On Wednesday morning, we had a presentation on “Results-Based Management” (“Le Gestion Axée sur les Resultats”).  The presenter attributed the concept to Peter Drucker and his 1964 book “Managing for Results.”  The presentation cited the fact that the Canadian government adopted this concept in the early 1990s. 
•  We seem to be writing the official 3-year plan for how to improve human resources in the health sector. 
• In French, to make a text comprehensible to the population is to "vulgarize" it, which says everything.  
• At lunch, I found a hair on my plate.  I spent a moment trying to decide if it was mine before realizing that I was the only person within 25 miles with hair like that.