October 14

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The road less traveled –

It has almost been a month since my last blog. Whilst I am based in Abuja my assignment has me auditing for the Malaria Consortium and I have been traveling around the country.  Just as when I was in Mozambique and traveled there – here in Nigeria I have done the same and that is part of the reason you haven’t heard from me.  This latest blog is to provide perspective of the sites seen, the projects reviewed, and the people I continue to meet along the way.  It is by watching and listening to the rhythm of the interactions that I bring my perspective as a secondary character as I tell the story of the people here.

I was in Abuja for a few weeks prior to the start of ‘fieldwork’ giving me time to learn about Nigeria and more about myself; this has been covered in some of my other blogs and will provide other updates as I move forward in PULSE, but having time before this country audit allowed me to make connections with the staff and watch and listen. I admire the Dalia Lama and his one quote sums up PULSE, my position in GSK Audit and life in general – when you talk you are only repeating what you already know – but if you watch and listen you may learn something new…..D.L.

I have seen first-hand how hard it is to work in some of the countries where the Malaria Consortium has operations. It’s the distance that the staff need to cover to make a project a success. It’s seeing the hard work that comes together from a team of Operations, Finance, and Technical staff; like a dance; where each partner has a part to play to deliver on the strategy.  I am always trying to make the connection between GSK and what I see in the Malaria Consortium.  You only need to leave the confines of GSK to really admire how Emma took time when she was named the CEO designate in 2016 to deepen her knowledge of all areas of GSK’s business and how during these visits had listening sessions with us to focus on three key areas: what would like to keep, change and do to make our job easier on the ground.  I found that is some ways I am having similar listening sessions just by making the connections on the ground – someone who by being an outsider on a PULSE journey who can spare some time to listen and maybe could take the message with me’.

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The position here has me training staff on Anti-Bribery and Corruption and building capacity for the team. And whilst the countries are always interested where they land on the corruption index, they find it amusing that even some of the Western Countries (like the US) don’t rank as high as one would at first perceive.

Auditing here has also taken me on a trip to Lagos where I checked on work that third-party performs for the Consortium. Lagos is wild. The Nigerian Capital was located here till in moved to Abuja (officially) back in the early 1990s.  The flight was interesting and I guarantee that the lady sitting behind me had live chickens in her hand luggage which was under my seat.  I didn’t want to ask but it was either that or someone doing a great impression of chickens at the back of the plane.  There are many new airlines in the country and some with less than stellar western ways of operating, so I would not put it pass someone to bring ‘dinner’ along for the ride.   The airport in Lagos was chaotic and walking out the door just brought more chaos to the experience.  My driver finally arrived and along the way into the city (Victoria Island) we got a flat tire whilst raining and sitting on the side road – I guess I was happy I wasn’t on the train which was either stalled or passing underneath the overpass in a distance.

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As I had mentioned to my family when I chatted with them – I guess when life gives you lemons you make lemonade, and not being on the train at that moment made sitting on the side of the road in the rain not look too bad.

Lagos is a city of 21 million (under-estimated) souls that stretches from the Gulf of Guinea (look it up I didn’t know where that was either) to the inland and each person is trying to sell you something! The traffic is 24/7 and it is the only place I’ve ever been where you can do your grocery shopping whilst sitting/crawling through the traffic on the highways or side streets. Coffee, bread, fruits, veg and yes – even packaged meat ready for your drive home but if you prefer – it has some great street food!

I reviewed many projects and having a research background, it has been the most interesting part of the audit experience. Talking with the project managers, the communication team, and learning about the projects in-depth took me on the ‘road less traveled’ to the north – to Niger.

First the trip by car. No one in the West should ever complain about the shape of their roads. There has been construction to widen this road for years and maybe one day in the future it will be finished but till then…..you either drive on the side of the road or just travel wherever you can to pass the trucks or other cars.  It’s where 2 lanes of road become 5 lanes of traffic traveling in opposing directions *look closely and you’ll see the car coming towards us* and all at about 80km/hour, and no – there wasn’t an accident that caused this backup (in the photos)…it was just normal traffic flow.  Even if I wanted to rest in the car, I could not help but find myself darting beneath the sun visor to avoid the vehicle in front of me.

When the traffic would let up, you could see the women drying beans on the road and afterwards gathering them up for delivery to the markets in the city, pounded yam or palm oil for sale – small bottles to petrol size containers ready to take delivery and carried on a young girl’s head as she went back to her village. Humbling is the word that comes to mind.   You could also see the women and children gathered to wash their clothes in the river and drying them either on the ground or the bushes that were along the river banks.  Wash day takes on a whole new meaning.

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You take so many things for granted and hot water and a real shower are 2 things I never gave much thought. There is nothing quite like taking a ‘warm’ shower out of a bucket standing in the middle of a room with a drain in the center of the floor.  I am sure that my fellow pulse volunteers that are in the more remote areas of their PULSE assignment can relate, but I guess I never thought much about it and if you would be staying in a hotel in a city of 300,000 people this would be the norm?

And I’ve had my fair share of chicken since arriving in Nigeria: the rooster that wakes me up in the morning, to the chickens in the street, the ‘live chickens under my seat on the flight’, and the chicken that seems to be part of every meal. I’ve asked for no chicken when I take my trip back to the States in a few weeks for my mid-assignment break, and am considering asking for a steak for the US Thanksgiving holiday instead of another fowl (turkey). I’m cool with the stuffing and side veg but would enjoy something that has been grilled. So speaking of chicken; Do you want? Sure I respond.  Then please choose the chicken from the hens sir and I will have it ready for you within an hour – there is nothing quite like farm fresh to table side service that exists in the smaller cities in Nigeria.  This was one of the best chicken meals I had.

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The projects – they had me checking on the delivery with visits to Government Warehouse, visiting with staff in Local Government Areas (LGA), discussions with Community Healthcare Extension Workers (CHEW), Research Assistants and the Community-Oriented Resources Persons (CORPs) who are the people on the ground in the village. Although there has been a reduction in the under-five and infant mortality rates in Nigeria, the burden of under-five mortality in Nigeria remains high. Whilst I could talk about all the projects the one that has really interested me was the Rapid Access Expansion Programme (RAcE) project. The aim of the programme is to deliver integrated Community Case Management services in rural communities in hard-to-reach areas. When I say hard to reach areas this really is an understatement.

I was joined by project staff and we were on road one morning – to drive through the Nigerian savannah to the LGA of Lapai .   The goal of the RAcE project is to increase coverage of diagnostic, treatment and referral services for the treatment of malaria, pneumonia and diarrhea.  As noted these LGAs are spread out and in the rural and hard-to-reach areas of Niger.  How do you get there, you may ask?  You travel the same dirt/paved roads with pretty scenery and the only traffic jam is the occasional Sheppard boy and his cows that haven’t cleared before you come around the next bend in the road.  But this is also the harder to reach areas – one that after heavy rains, which occur quite frequently (and did the morning of our drive) get flooded.  The roads/bridges wash away and leave these villages even more difficult to reach.

You could see the water was high in the fields from morning storms and after driving for more than an hour you just couldn’t go any further. It is the dedication of the volunteers and the programme staff that this project has been a success. As was mentioned to me, if I had not been with them they would have crossed the river and hired someone out of their own pocket to take them the rest of the way on a motorbike.  They are the change they want to see in the world.

On the return trip, we visited another LGA, Paikoro, where I got to spend time with the CORPs firsthand and hear about his training and what a typical day is like for him in the village. You could see he is a proud man as he was selected by his village elders to this position and for once this village has a ‘doctor’ – someone on the ground looking for the symptoms, treating and referring elsewhere when necessary. It was through a conversation in their local language that he stated he is hoping to be a change for his community – They are the change they want to see in the world.

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Left to Right…. Ibrahim Abubakar (MC), Mrs. Zuweira Abubakar (CHEW), Sani Muhammad (CORP), Ms. Debora Sillas (Research Assistant) and Yahya Hamzat (MC).

I once read that there are three sides to every story – your side, my side and the truth. I feel that I have given some justice to two of the three in my blogs, it is coming to grips with what is truth? That is something I’m still trying to learn on this PULSE journey. I think it’s difficult to define because as soon as you think you have it mastered, some case or counterexample will show deficiencies with your definition. Maybe in the end it isn’t about truth as much as it is about being authentic, being true to one’s own personality, spirit and character despite the external pressures encountered.  I have seen truth in action by the people on the ground here – both within and outside the Malaria Consortium.  Hoping to take some of that truth back with me when this assignment is over.

Till next time when I will share experiences of Abuja – stay authentic!