It's a beautiful Summer evening in Kigali. There is neither even a whiff of a breeze nor a cloud in the sky as the Sun heads swiftly for the Horizon, glowing bright red as it does the closer you are to the Equator. Being as close to the Equator as Kigali is (2 degrees south) the days don't vary enormously in length from Summer to Winter. At their longest, as they are now, the Sun sets at around 6.20pm. In Winter closer to 5.30pm. Which means no long, sunny evenings to sit on a terrace having a beer during the Summer (as I recently enjoyed back in New York, London and Toronto) nor does it mean mood-destroyingly short days during the Winter. At the other end of the day, the Sun is always up by 6am and the Rwandan people on the move not long after. This is still a country that walks to work even in Kigali. Only the elite and the taxi drivers have cars. Some can afford to take the little mutatus ("bus" in Swahili lingo, exactly the same little vans were in use in Lima and were called "micros"). Otherwise as you drive to work in the morning or home in the evening you see lines of people walking along the sides of the roads, which are frequently lacking in pavements / sidewalks. The reason that activity starts so early here is that everyone is in bed very early. After darkness descends only 28% of urban residences and a very low 2% of rural ones have electricity to make use of. What else is one to do but sleep? Or that other activity which the Rwandan government is actively discouraging in order to bring down the 5.5 fertility rate amongst Rwandan women.
In case anyone happens to be interested in further stats on Rwanda, mostly related to health, check out the newly released Interim Demographic and Health Survey (http://www.measuredhs.com/pubs/pub_details.cfm?id=936&srchTp=home). If you're a geek like me, it makes for fascinating reading. It has its drawbacks as a survey (much of the data is self-reported and impervious to verification and there is little comparison to previous years for trend analysis) however it's still for the most part pretty good as an indication.
As for work it never sits still. When I arrived three new people had been hired all starting the same day as me who would form the team I would manage. Two of those have now left, one to do a masters in Belgium and the other on loan to our sister organisation Partners in Health. What's more we're on the verge of hiring nine or ten additional people who will all have the misfortune to be managed by yours truly. It's exciting. I'm engaged in three broad areas: advising the Ministry of Health in Kigali on policy and planning; working in one of the 30 districts of Rwanda to help them manage their health system, consisting of a district hospital and thirteen health centres; perhaps most interestingly of all developing a large-scale data collection, storage and analysis tool/engine which will collect several hundred data points on every health facility in the country (450 and rising) every six months and allow every level of the health system (from rural, isolated health centres to the Ministry of Health in Kigali) to manage their investment and operational decision-making. This last piece of work is all the more fun because it's probably one of the first to be developed on the continent and is being built with one eye on other countries where we could deploy it. Right now we're going through a certain lull as most CHAI (Clinton HIV/AIDS Initiative, just one of several initiatives run by the Clinton Foundation) staff are out on vacation. However the storm clouds are clearly visible and due to arrive in the first couple weeks of August. From then until Christmas, and beyond, work is going to be wild. Our donors and the Ministry expect.
Thursday 23 July 2009
Wednesday 1 April 2009
A New(ish) Beginning
Four and a half months into my life in Rwanda and I’ve managed to say virtually nothing about my life here so far! My intention was to round out my experience working on the Obama campaign with one further entry detailing the micro-managed, super-focused, hugely rewarding and in the end massively successful two months that I spent in Las Vegas but the task of writing that piece has seemed so overwhelming that all I have to show for it is two months of silence. So I’ve decided to skip that and move on to the present.
Where to start? Let’s begin with the personal. That large house I referred to a few posts ago which was one of two options I was considering to move into is now my home. My bedroom, whence I’m writing this, is large enough for a huge bed and could comfortably accommodate a table tennis table and a pool table besides. I’ve no doubt this is the largest bedroom I will ever inhabit and would probably compare favourably in size to the entire flat I lived in before leaving London. It’s ridiculous. I share the house with three people, all girls and all Canadian. That they are all girls is entirely unsurprising; the NGO crowd here is overwhelmingly female (clearly not a problem, at least not for the minority gender). That they are all Canadian is much more so albeit that they’re an interesting mix: one Scottish-Canadian; one Eritrean-Canadian; and one US-Dutch-Canadian. In Kigali though one mostly comes across Americans, Belgians, Germans and Brits. And virtually no French. For those who don’t know the history, these last have not entirely covered themselves in glory in their dealings with this country and continue to shoot themselves in the foot diplomatically by pursuing government officials for war crimes and generally being on the wrong side of the argument. However I’m teetering into the political sphere about which I will unfortunately have to be less talkative than I was in Peru. (Incidentally the trial of Alberto Fujimori which I discussed a fair amount over a year ago is due to come to a close very shortly. A conviction is likely assuming the trial doesn’t collapse on the technicality that he’s in ill health and his absence from the courtroom for 12 days would entail starting all over again.)
Work at the Clinton Foundation is fantastically fun and extremely rewarding. And constantly in flux. Amusingly in some ways it’s very similar to what I was doing at Goldman Sachs, i.e. sitting in an office working with Excel all day. In important ways though it’s very different. Whereas my work at GS for six years was almost entirely inward facing, here I am daily in meetings with Ministry officials and every couple of weeks am out in the field meeting with regional health managers. At GS it was always difficult to explain to people what I did, particularly to those who didn’t work in finance, which led some to think I really worked for the intelligence services, but here it’s essentially very simple. We are here to help the Rwandans build up their capacity to successfully manage their own affairs and to do ourselves out of a job.
Unfortunately success isn’t going to come rapidly and someone will likely still be doing what I’m doing by the time I’m considering retirement but you would go mad in this line of work if you didn’t consider and accept the long view. And in Rwanda things happen. I’m constantly hearing from my NGO colleagues who work across African countries that there’s a level of thought, coordination and direction here that isn’t to be found anywhere else on the continent. From the Big Man on down there’s a will to pull this country up and to do so in a systematic, government-driven and clean way. It’s impressive to behold even for someone as inexperienced as me who has nothing with which to compare it. Of course the Rwandans have no resources. There’s very little to drive tax revenue so the country is massively dependent on foreign funding. And as previously said, this will not change anytime soon. But there is the will and there is the understanding of how to do it even if with other people’s money. It’s extremely exciting to be a part of. Over time I want to talk more about the challenges and the opportunities, the hopes of this tiny little over-populated country, the expectations of the international community and the tensions that result when the two rub each other the wrong way. There are endless anecdotes that constantly have us thinking about how to improve and make more effective our work to help Rwanda. The goal is nothing short of colossal.
Where to start? Let’s begin with the personal. That large house I referred to a few posts ago which was one of two options I was considering to move into is now my home. My bedroom, whence I’m writing this, is large enough for a huge bed and could comfortably accommodate a table tennis table and a pool table besides. I’ve no doubt this is the largest bedroom I will ever inhabit and would probably compare favourably in size to the entire flat I lived in before leaving London. It’s ridiculous. I share the house with three people, all girls and all Canadian. That they are all girls is entirely unsurprising; the NGO crowd here is overwhelmingly female (clearly not a problem, at least not for the minority gender). That they are all Canadian is much more so albeit that they’re an interesting mix: one Scottish-Canadian; one Eritrean-Canadian; and one US-Dutch-Canadian. In Kigali though one mostly comes across Americans, Belgians, Germans and Brits. And virtually no French. For those who don’t know the history, these last have not entirely covered themselves in glory in their dealings with this country and continue to shoot themselves in the foot diplomatically by pursuing government officials for war crimes and generally being on the wrong side of the argument. However I’m teetering into the political sphere about which I will unfortunately have to be less talkative than I was in Peru. (Incidentally the trial of Alberto Fujimori which I discussed a fair amount over a year ago is due to come to a close very shortly. A conviction is likely assuming the trial doesn’t collapse on the technicality that he’s in ill health and his absence from the courtroom for 12 days would entail starting all over again.)
Work at the Clinton Foundation is fantastically fun and extremely rewarding. And constantly in flux. Amusingly in some ways it’s very similar to what I was doing at Goldman Sachs, i.e. sitting in an office working with Excel all day. In important ways though it’s very different. Whereas my work at GS for six years was almost entirely inward facing, here I am daily in meetings with Ministry officials and every couple of weeks am out in the field meeting with regional health managers. At GS it was always difficult to explain to people what I did, particularly to those who didn’t work in finance, which led some to think I really worked for the intelligence services, but here it’s essentially very simple. We are here to help the Rwandans build up their capacity to successfully manage their own affairs and to do ourselves out of a job.
Unfortunately success isn’t going to come rapidly and someone will likely still be doing what I’m doing by the time I’m considering retirement but you would go mad in this line of work if you didn’t consider and accept the long view. And in Rwanda things happen. I’m constantly hearing from my NGO colleagues who work across African countries that there’s a level of thought, coordination and direction here that isn’t to be found anywhere else on the continent. From the Big Man on down there’s a will to pull this country up and to do so in a systematic, government-driven and clean way. It’s impressive to behold even for someone as inexperienced as me who has nothing with which to compare it. Of course the Rwandans have no resources. There’s very little to drive tax revenue so the country is massively dependent on foreign funding. And as previously said, this will not change anytime soon. But there is the will and there is the understanding of how to do it even if with other people’s money. It’s extremely exciting to be a part of. Over time I want to talk more about the challenges and the opportunities, the hopes of this tiny little over-populated country, the expectations of the international community and the tensions that result when the two rub each other the wrong way. There are endless anecdotes that constantly have us thinking about how to improve and make more effective our work to help Rwanda. The goal is nothing short of colossal.
Sunday 8 February 2009
A Short Backgrounder, Part Two
Amongst the political entertainment during my time in California (New York Governor Eliot Spitzer the unwitting tangential prize of an organised prostitution-ring bust, Detroit Mayor Kwame Kilpatrick charged with eight felonies, Alaska Senator Ted Stevens charged with improperly compensating a building contractor, etc), a very serious one was continuing its eighteen month-old machinations. What had begun in the snows of Iowa had really started in February 2007 when Barack Obama declared his candidacy for President of the United States and even much before that. My memory of Barack Obama entering my consciousness is a little hazy although I recall that by the time he delivered the keynote address at the Democratic National Convention in July 2004, I had been following his progress for some time. When the Big O declared he would run for the Presidency two years after becoming the junior US Senator from Illinois this came as little surprise to any political egghead.
Around early June I slowly started to realise that a golden opportunity lay before me to engage in a political process which I had enthusiastically been following from the comfort of my armchair and the earphones of my iPod for well over a year. Being the type who respects those who walk the walk rather than talk the talk, it became clear that not only would my job-search take time, but if I were so convinced that the Big O would be a better alternative to any Republican then I ought to do some’at about it. By this stage Hillary was for practical purposes already out of the race. So in amongst travels to Europe for aforementioned family reasons and a fantastic 4th July holiday around the southern United States (I highly recommend Savannah and New Orleans) I looked for ways to become involved. One aspect of the Big O’s now famous campaign was his harnessing of the “new” technologies first employed on a large scale by Howard Dean during his not-so-successful run for the Democratic nomination in 2004. Obama’s website, being designed as it was by the guy who developed Facebook, was set up such that people could publicise events, rallies, organizational meetings and so on and allow others to get involved. I started attending various events, mostly talking up Obama to people passing in the street and at summer fairs. Obama had also decided that his policy framework (for which read high-level principles) would be decided democratically by a wide swath of his supporters rather than just those who attend the Convention. Thus I attended various policy discussions to elaborate a submission to Obama’s staff which taught me a whole lot about education and healthcare in the States. And allowed me the opportunity to educate a few people on what goes on in “Europe” (expressed by some as though it were somewhere close to the Moon).
Another event posted on the website, MyBO as it became known, was a voter registration drive in Las Vegas. One of the most impressive organizational decisions by the Obama campaign was to pair rock-solid states with geographically proximate swing states. Thus California was paired with Nevada and a large number of events were set up for Californians to travel to Nevada to help the local effort. So I drove up to Las Vegas with three other people I’d never met before, a girl who does public health work in developing countries and who was in LA between jobs, a guy who had run for local elected office in Southern California unsuccessfully and whose day-job is computer programming and an octogenarian battle-axe who provided constant hilarity. She was part Muhammad Ali, part Erin Brockovich. We spent the weekend standing outside WalMart (not generally considered Democratic-friendly terrain) and signed up large numbers of voters. It was hot. It was very, very hot. But it was also a lot of fun. The best ploy to get people to stop is to make them laugh combined with an overly strong appeal to their better sense. And never ask a question to which the answer is “yes” or “no”. “I would love to register you to vote today.” “I don’t have time.” “It will only take a few minutes to register and it will give you a voice.” “It doesn’t make any difference.” “Yes, that’s how Floridian Democrats feel too.” And so it went.
That weekend was so much fun that I went back with Sara (the public health girl) and a friend of hers the following weekend. And that one turned out to be so much fun again that I started talking to the regional managers about coming up full-time to volunteer. At the time I was semi-serious about it. But by the time I’d got back to LA I realized that it really was something I should do. When was I going to get the opportunity again to work on a presidential campaign? When was I going to get the chance again to work on a campaign which I had heard from at least a dozen people had not roused their passions to such an extent since 1960? So a week later I packed up my car and headed back to Vegas, this time to stay until the election. I had little idea of what was to come; 60 uninterrupted 16 hour days at the grindstone. No weekends. No days off. The hardest I’ve ever worked.
Around early June I slowly started to realise that a golden opportunity lay before me to engage in a political process which I had enthusiastically been following from the comfort of my armchair and the earphones of my iPod for well over a year. Being the type who respects those who walk the walk rather than talk the talk, it became clear that not only would my job-search take time, but if I were so convinced that the Big O would be a better alternative to any Republican then I ought to do some’at about it. By this stage Hillary was for practical purposes already out of the race. So in amongst travels to Europe for aforementioned family reasons and a fantastic 4th July holiday around the southern United States (I highly recommend Savannah and New Orleans) I looked for ways to become involved. One aspect of the Big O’s now famous campaign was his harnessing of the “new” technologies first employed on a large scale by Howard Dean during his not-so-successful run for the Democratic nomination in 2004. Obama’s website, being designed as it was by the guy who developed Facebook, was set up such that people could publicise events, rallies, organizational meetings and so on and allow others to get involved. I started attending various events, mostly talking up Obama to people passing in the street and at summer fairs. Obama had also decided that his policy framework (for which read high-level principles) would be decided democratically by a wide swath of his supporters rather than just those who attend the Convention. Thus I attended various policy discussions to elaborate a submission to Obama’s staff which taught me a whole lot about education and healthcare in the States. And allowed me the opportunity to educate a few people on what goes on in “Europe” (expressed by some as though it were somewhere close to the Moon).
Another event posted on the website, MyBO as it became known, was a voter registration drive in Las Vegas. One of the most impressive organizational decisions by the Obama campaign was to pair rock-solid states with geographically proximate swing states. Thus California was paired with Nevada and a large number of events were set up for Californians to travel to Nevada to help the local effort. So I drove up to Las Vegas with three other people I’d never met before, a girl who does public health work in developing countries and who was in LA between jobs, a guy who had run for local elected office in Southern California unsuccessfully and whose day-job is computer programming and an octogenarian battle-axe who provided constant hilarity. She was part Muhammad Ali, part Erin Brockovich. We spent the weekend standing outside WalMart (not generally considered Democratic-friendly terrain) and signed up large numbers of voters. It was hot. It was very, very hot. But it was also a lot of fun. The best ploy to get people to stop is to make them laugh combined with an overly strong appeal to their better sense. And never ask a question to which the answer is “yes” or “no”. “I would love to register you to vote today.” “I don’t have time.” “It will only take a few minutes to register and it will give you a voice.” “It doesn’t make any difference.” “Yes, that’s how Floridian Democrats feel too.” And so it went.
That weekend was so much fun that I went back with Sara (the public health girl) and a friend of hers the following weekend. And that one turned out to be so much fun again that I started talking to the regional managers about coming up full-time to volunteer. At the time I was semi-serious about it. But by the time I’d got back to LA I realized that it really was something I should do. When was I going to get the opportunity again to work on a presidential campaign? When was I going to get the chance again to work on a campaign which I had heard from at least a dozen people had not roused their passions to such an extent since 1960? So a week later I packed up my car and headed back to Vegas, this time to stay until the election. I had little idea of what was to come; 60 uninterrupted 16 hour days at the grindstone. No weekends. No days off. The hardest I’ve ever worked.
Sunday 4 January 2009
A Short Backgrounder, Part One
How did I get here? And where have I been? Questions I’ve asked myself a few times of late. After seven months in Lima, the last one and a half of which I spent separately traveling with parents and friends from London, I decided the time had come to move on. But move on to what? I had looked into a few jobs which would make some use of my combined experience in the finance and non-profit arenas. I had even had a telephonic interview between Lima and my interlocutor in Nairobi (where she was visiting on business) for a job based in Washington DC. The line was bad and my interview sharpness not much better. The outcome was as expected.
Around the same time I pursued a connection I had made shortly before leaving London. During the whirlwind few weeks between leaving Goldman Sachs and leaving on a jet plane in June 2007 I had breakfast with the lovely Cassia who I’d been put in contact with by a colleague. Cassia worked at the Clinton Foundation, regularly commuting between London and various places in Africa, working in a division of the Foundation called CHAI. It sounded like tea, it sounded like fun. We spoke for about an hour at the conclusion of which she told me to give her a call when I was done in Peru because they were always looking for “people like you”. At the time my thoughts were more focused on microfinance than health system strengthening as I felt my finance background was more suited to the former. However a few months’ reflection led me to realise that my passion lay in international development generally not microfinance specifically. So come December 2007 I did what Cassia suggested. Unfortunately she didn’t answer my emails and I had no contact number for her. I did find out through our mutual friend the Goldman Sachs colleague that Cassia had gone on maternity leave but that she didn’t know much more than that as they hadn’t been in touch for a while. As practitioners of the espionage trade would say, the lead went cold.
As my pre-planned departure date of mid February slipped to late February, I did at last book my flight out believing that my future lay in the States, leaving behind some great friends and a wonderful Peruvian family who had taken me in as their sixth (and eldest) child. My grandmother in California was in failing health and I decided to move in with my uncle there to spend some time with her, a grandmother who had been a major influence in my life. This turned out to be fortuitous timing as just eighteen days later I watched as she breathed her final breath, thankful that I’d been able to spend a couple weeks with her. Her passing was to foretell further sadness in the family as both my French grandparents succumbed to old age just three months later and within a week of each other. My French grandfather had similarly loomed large in my formative years and I was fortunate to be able to spend some time with him just prior to his passing when I visited France in June.
From early March, when I arrived in California, until exam day in early June I had been studying for the second level of the CFA, the first level of which I had passed in 2003, since when I had concertedly avoided any further participation. By this time my decision to resume the qualification resulted from the combined desires of pursuing something useful to my career as well as giving me space to contemplate my next move. It succeeded on one of those fronts at least. By early June I was back into job-searching again in full force. Applications went out to various non-profits and a further attempt at contact with Cassia was made, this time successfully. I was extremely saddened to hear from her that she and her husband had experienced a tragedy in the intervening period and despite this Cassia was as helpful to me as could be and excited that I’d contacted her. She ran me through the various possibilities available at CHAI (Clinton HIV / AIDS Initiative) and asked me to forward my curriculum vitae.
A set of interviews ensued for a position which would have involved travelling around a third of Africa on a fairly constant basis assisting countries in their procurement and internal distribution of drugs. (That would be malaria prophylaxes and HIV anti-retrovirals rather than cocaine and ecstasy tablets.) Fortunately for me some combination of the three interviewers decided I wasn’t suited to the post and immediately it was suggested that I consider a “managerial” position. The job would have been very satisfying but too restless and clearly would have upped my carbon footprint by a not insignificant number of cubic metres. The Foundation’s suggestion was well taken. There followed two interviews, one with the CHAI Country Director for Rwanda and Burundi, Pascal, and t’other with the gentleman I would be replacing, the Program Manager for Rural Health, a Kenyan by the name of Kisimbi (which, I would later learn, is his family name; apparently all six sons in the family refer to themselves by their last name which causes no end of amusement when friends call their house in Nairobi). The interviews failed to entice me to say anything controversial or stupid and a visit to Kigali was hastily arranged for a tête-à-tête. After a mammoth Las Vegas – Washington DC – Rome – Addis Ababa – Kigali country-hop I arrived in Kigali for four days to seal the deal.
Thus am I now in the employ of the Clinton Foundation providing technical assistance to the Rwandan Ministry of Health. This has prompted several observers (as though I have those) to ask what exactly in my professional experience qualifies me to provide technical assistance on health matters to an African government. Or any government for that matter. Allow me to explain.
Around the same time I pursued a connection I had made shortly before leaving London. During the whirlwind few weeks between leaving Goldman Sachs and leaving on a jet plane in June 2007 I had breakfast with the lovely Cassia who I’d been put in contact with by a colleague. Cassia worked at the Clinton Foundation, regularly commuting between London and various places in Africa, working in a division of the Foundation called CHAI. It sounded like tea, it sounded like fun. We spoke for about an hour at the conclusion of which she told me to give her a call when I was done in Peru because they were always looking for “people like you”. At the time my thoughts were more focused on microfinance than health system strengthening as I felt my finance background was more suited to the former. However a few months’ reflection led me to realise that my passion lay in international development generally not microfinance specifically. So come December 2007 I did what Cassia suggested. Unfortunately she didn’t answer my emails and I had no contact number for her. I did find out through our mutual friend the Goldman Sachs colleague that Cassia had gone on maternity leave but that she didn’t know much more than that as they hadn’t been in touch for a while. As practitioners of the espionage trade would say, the lead went cold.
As my pre-planned departure date of mid February slipped to late February, I did at last book my flight out believing that my future lay in the States, leaving behind some great friends and a wonderful Peruvian family who had taken me in as their sixth (and eldest) child. My grandmother in California was in failing health and I decided to move in with my uncle there to spend some time with her, a grandmother who had been a major influence in my life. This turned out to be fortuitous timing as just eighteen days later I watched as she breathed her final breath, thankful that I’d been able to spend a couple weeks with her. Her passing was to foretell further sadness in the family as both my French grandparents succumbed to old age just three months later and within a week of each other. My French grandfather had similarly loomed large in my formative years and I was fortunate to be able to spend some time with him just prior to his passing when I visited France in June.
From early March, when I arrived in California, until exam day in early June I had been studying for the second level of the CFA, the first level of which I had passed in 2003, since when I had concertedly avoided any further participation. By this time my decision to resume the qualification resulted from the combined desires of pursuing something useful to my career as well as giving me space to contemplate my next move. It succeeded on one of those fronts at least. By early June I was back into job-searching again in full force. Applications went out to various non-profits and a further attempt at contact with Cassia was made, this time successfully. I was extremely saddened to hear from her that she and her husband had experienced a tragedy in the intervening period and despite this Cassia was as helpful to me as could be and excited that I’d contacted her. She ran me through the various possibilities available at CHAI (Clinton HIV / AIDS Initiative) and asked me to forward my curriculum vitae.
A set of interviews ensued for a position which would have involved travelling around a third of Africa on a fairly constant basis assisting countries in their procurement and internal distribution of drugs. (That would be malaria prophylaxes and HIV anti-retrovirals rather than cocaine and ecstasy tablets.) Fortunately for me some combination of the three interviewers decided I wasn’t suited to the post and immediately it was suggested that I consider a “managerial” position. The job would have been very satisfying but too restless and clearly would have upped my carbon footprint by a not insignificant number of cubic metres. The Foundation’s suggestion was well taken. There followed two interviews, one with the CHAI Country Director for Rwanda and Burundi, Pascal, and t’other with the gentleman I would be replacing, the Program Manager for Rural Health, a Kenyan by the name of Kisimbi (which, I would later learn, is his family name; apparently all six sons in the family refer to themselves by their last name which causes no end of amusement when friends call their house in Nairobi). The interviews failed to entice me to say anything controversial or stupid and a visit to Kigali was hastily arranged for a tête-à-tête. After a mammoth Las Vegas – Washington DC – Rome – Addis Ababa – Kigali country-hop I arrived in Kigali for four days to seal the deal.
Thus am I now in the employ of the Clinton Foundation providing technical assistance to the Rwandan Ministry of Health. This has prompted several observers (as though I have those) to ask what exactly in my professional experience qualifies me to provide technical assistance on health matters to an African government. Or any government for that matter. Allow me to explain.
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