Great Expectations

Breathe in; the dusty air fills my lungs. It stings and burns a little, like inhaling deeply from a freshly lit cigar. Carried with it comes a cocktail of scents that I am momentarily lost within while trying to disseminate the origins. Diesel fuel, loose mud, recently slaughtered animals, onions and meat sizzling in fat, and excrement. (I’m not sure if this is from the stray dogs, cattle, or goats that dot the street. I finally conclude with a concoction of all three.) Its 5:30 am on day two and I am out for another early morning run.  I think this will become a habit.  I’m able to run much farther than yesterday but the smog presents its own difficulties.  I am looking forward to leaving the city tomorrow, settling into my new role, and enjoying some fresh air.

Today I will meet the leading members of CARE Nepal, the country director and the program manager. They all have different ideas as to how I may best be utilized, but I can finally see some semblance of a plan coming together. Trying to make it clear that I am not here to step on any toes or get in the way I suggest spending the first month or so joining field visits and community meetings in districts where the SAMMAN project is currently established. Talking with local leaders, workers and volunteers will help me acquire a personal grasp on the scope of this mission. They also suggest attending community meetings and trainings in my home district (Kavre) so I can compare and contrast the differences with this new phase.  I am finally able to tease out that in addition to helping develop a concrete communication strategy between GSK & CARE they are also looking toward future projects currently in planning stages.  They need me to help identify and document key lessons and learnings from the SAMMAN project so they can then apply those to a much larger country wide Maternal and Neonatal health program.

Over dinner (a delicious lamb dish, Bhuna Gosht) I reflect on the day’s events.  Humbled by the potentially far reaching impact works of such a comparatively small team can have on a whole country’s maternal health; I raise my glass of Local Nepalese Beer in a silent personal toast.  Here is to big ideas and grand expectations. I just hope I can deliver.


  1. We know you can deliver Paul! Looking forward to hearing about all your progress along the way. Keep up the great ideas and remember the ripple effect.

  2. Hey Paul! Zack and I are following you and are WOWED by this opportunity and the great scope of it. In navigating the challenges you will do great things!! This program is very lucky to have you. Thanks for the pictures. They help us all get a better grasp of things. Our prayers are with you………looking forward to each new post.

  3. I love the pictures! I also love that you are taking the time to ‘Gemba’…wonderful!! You will learn so much by observing and listening. I can’t wait to hear how you will make a difference, Paul. And I’m pretty certain you’ll be able to deliver 🙂

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