The gap between the ‘here’ and ‘there’
There is a phrase in Hebrew, my native tongue, which can be roughly translated as “What can be seen from here, cannot be seen from over there.” It can be used in many contexts but when it comes to my work in Burundi, I see it as pertaining to the dividing gap between the “office” and the “field,” the “here” and “there.” I spent my last stint in Burundi as an intern for a rural economic development program in Bururi, one of Burundi’s southern provinces. During the 4 months I spent there, I lived in a compound located in the midst of the community served by the program. I never had to use my imagination to envision the local conditions; I never had to wait a week for survey results to come back for analysis. I never had to make assumptions or conjectures about the project’s progress or challenges. I could simply walk over and see things with my own eyes without having to rely on second-hand reports or distant recollections.
As part of my work with LifeNet International’s management training program I’m responsible for developing training materials and management tools to assist our network of partner clinics become more efficient, financially sustainable and provide higher quality services to the members of their communities. One of the main challenges I regularly encounter in this work is the need to create guidelines and best practices for health centers that are not just extremely varied but are spread throughout the country. I do this, most of the time, from LifeNet’s office in the Burundi’s capital, Bujumbura.
I should mention that it’s not strictly a work of the imagination as I have visited a fair selection of our partner clinics over the past 3 months since my return. I also have the privilege to consult with staff members who visit our clinics far more often in order to provide clinical training. Having said that, It is still a far cry from being able to personally observe on a regular basis the processes I’m trying to improve. I became particularly aware of this sense of lacking physical presence on my way back from a recent site visit which followed a fairly long period of absence. These short couple of days, while technically being of little productivity and filled with frustration due to long drives and multiple cancellations, appeared much more fruitful as we were making our way back to the office. I realized that while we did not see all the people we intended or carried out all the activities we had planned, merely visiting the sites of our clinics, often at the end of long, winding dirt road helped me to recontextualize the work I was doing.
It is all too easy to get lost in protocols and procedures while losing a tangible sense of the surroundings in which they are meant to be implemented. It is this escalating process of detachment that often leads to unfeasible and misguided development policies and the notorious record of failed initiatives. Equally important is the matter of motivation as peering over balance sheets and monthly reports can cause you to lose sight of the potential benefits of your work. No amount of re-reading of the mission statement or the strategic plan can replace a visit to a clinic where people wait patiently for hours to be treated and no report or performance indicators can replace a single personal story of a life that was saved. In a few weeks I will start taking part in piloting the new management training curriculum, and while I’m prepared to go back to the drawing board as needed, I still hope our work was based on more reality than fiction.