My job.

Some time ago I promised to describe what exactly it is I am doing out here on the border, since most of you don't actually know... So here goes.

The organization I work for provides technical assistance and capacity building for local organizations providing clinical and preventive health services inside Burma, in the conflict areas, and other border areas not accessible by the NGOs working in Burma, and where the government does not provide any services. Our organization is comprised of clinicians and public health professionals. Originally, folks came out to the border twice a year to do training for the local orgs, but it has grown, and now we have a full time presence here. Basically, we do a lot of trainings, on everything from monitoring and evaluation and health information systems, to actually teaching medics from the field how to conduct early diagnosis and treatment for malaria, or how to do trauma surgery (for example, to treat a landmine injury patient). We work with the orgs to develop their programs, help order supplies and make sure supply chains are set up and functioning, provide technical assistance on technical aspects of projects, help them monitor and report on their projects, and other assorted tasks. On the Thai border, we work with three main local partners, in addition to a handfull of others in more limited capacity, as well as Mae Tao Clinic (http://www.maetaoclinic.org/).

On an average day, I might start the day at a meeting at the office (which is downstairs from where I am currently living) at 8:30, then bike a few kilometers to a parter orgnaization's office, and interview a relief worker returning from the Irrawaddy Delta, then meet with staff to discuss an upcoming training, grab lunch at a noodle stand on the highway (for about $.50), bike farther down the highway to another partner to meet about a new program in development, stop by T-Corner to pick up a Thai Iced Tea, then return to the office for a few hours to work on program budgets, donor reports, do some reasearch on modules to include in a training, or a new intervention for a program. Around 6 I go swimming, and may stop at the bank on the way to make a few transfers. I swim from ~6 to ~7, and either shower at the pool and go to meet some folks for dinner (or trivia!), or come home and cook. Generally back on email by 8 or 9, to catch up on the horrendously voluminous flow, and look over a few documents for a couple of hours. Unless there is a training, in which case training is over about 3 or 4, and then you get to begin everything else. When there are people visiting (which there have been for the past month) there are often meeting before and after work (today, we met at 7 am before training, and at 7 pm).

I like the work, I like working with so many local partners. It's nice to move around during the day, not sit in one office all the time, even just biking between meetings is nice, to stretch out, give the eyes a rest, enjoy being outside. Well, we're kind of outside all the time, since all of the buiding are open, and some 'offices' don't even have walls. It's interesting, working on computers, under a leaf roof, when the rain is pouring down just feet away. Work hours and work space are very flexible, I can work from a cafe, or from my bedroom. We use the office as a place to meet, store shared files, equipement, etc., but it is not a place that we are required to report to everyday. Basically work where you need to, when you need to, as long as you get it done. It is very independent. There is no real organizational hierarchy. Some people have more final decision making power, but there is no staff hierarchy - it is expected that everyone will contribute, share in decisions and responsibilities, and be responsible for getting their own work done, and asking for help when they need it. A very freeing and enabling work environment.

Currently, there are a ton of us on the border, more than there have ever been. We have five staff (two that are leaving, Jade and I who are new, and one who is here half time, and in the states half time) as well as a doctoral student just here for a couple of months, and three interns (fourth arriving this weekend) who will all stay until next summer. Just a year ago, it was 4 folks, and no office. Right now is seems that we have tons of people, but come December, it will be just Jade and I. The other staff will be gone, and all of the interns are pre-med, and will be returning to the states for 6-8 weeks for med school interviews. A couple of times a year (Aug, and Jan) others come from the states to assist with trainings, such as the immunization training that just ended and the trauma training that occurs every Jan. That timing is set to line up with the return of the backpack medics, as they come back from inside twice a year to train and restock.

I hope that gives a sense of what I'm doing out here. We also work on surveys, help coordinate local groups, and help local orgs establsih relationships with donors, share their work, and advocate for cross border work and the health needs of those living in the border areas. Some of these endeavors mean spending hours fretting over question wording or translation headaches on a survey, spending days compiling a response to a report or statement from another organization, or helping to plan a press conference. Working with local partners with very varied levels of experience, language skills, and priorities means that you have to adjust your sense of how long it takes to get things done (i.e. everything takes a lot of time), and the participatory nature of the work requires staying open to constant flux and change. The security issues also mean frequent last minute changes, such as when a training will start (often pushed back as trainees can't arrive in time) or even the city in which it will occur (the TB training was moved to a city hours north of here, on very short notice, because the trainees couldn't make the last leg of the journey). Or maybe the Asia Director of USAID will announce a visit with little notice, and ask you and the local group to prepare presentations (he is coming Sunday).

Mostly, I am impressed by how hard and long the local partners work, with what dedication and compassion and earnestness. And skill, insight, and accomplishment. It is amazing what they are able to do. Most of these programs are conducted in the jungle, in areas of ongoing conflict, under a hostile government, in areas planted with landmines, and endemic drug resistant malaria. It really is impressive to be able to collect sound data to evaluate these programs, and demonstrate their tangible impact on the health of those communities. Really groundbreaking work is being done here. I'm glad to be a small part of it.