blurgh

I've become an unreliable blogger. I know it. It isn't out of neglect - I think about posting nearly everyday. Its more that I've fallen too deeply inside my own head to pull out anything worth posting. I've been feeling pretty disconnected lately, and rather overwhelmed with work issues, and its been hard to reach out even so much as to put a few words up here. Not that there hasn't been a lot going on.

So I decided tonight that rather than try to compose a post, I'm just going to dump. Everything thats been stored up for the past month and a half, in stream of consciousness form. So apologies if its at times incoherent. This is the only way I think I can get any of it out, and onto the page, as it were.

I came back in early Jan, and spent two weeks getting back up to speed, and working on year end donor reports, which were due for most programs on the last day of January. I spend too much of my life writing reports. We hired an Administrative Manger to help with the reporting load, but low and behold, she founds so many other things that needed doing, that she didn't have any time to help with reports. And the offers of help I had from the US evaporated, so its back to me. It takes a ridiculous amount of time to solicit, review, and compile components from various staff members and local partners, format and insert photos, appendices, graphs, charts, etc. check the data, make sure it has been properly presented and interpreted, all put together, cleaned up, made sure it meets the requirements of that particular donor, given the unifying brush strokes, submitted, and then all follow up questions and requests fielded. I sometimes feel like a full time reporter.

I also had to make sure all of the staff had action plans for the next few weeks, as I was about to leave for 2 1/2. About half of the programs were doing supply orders, and almost all were preparing for trainings. A very busy time.

So just two weeks after getting home, I got back on the nightbus to return to Bangkok for CCSDPT. We love acronyms here. The NGO world, and the development world are already full of them, but I think the Thai/Burma border takes it to a whole new level. Acronyms are often six or seven letters long. No one remembers what they stand for. CCSDPT is the coordinating body for all of the INGOs working in the nine refugee camps on the Thai/Burma border. Everyone in the camps are from Burma, but everyone at the meeting is expat or Thai. No CBOs (community based organizations) attend (or are invited to attend). Few cross border groups attend, though the IDP, migrant, and refugee populations are very fluid. Over the course of one year, one person could very easily be counted in each of those groups at different times. I have started attending as a way of coordinating our work with what is happening in the camps. (i.e., using the TB lab in Mae La camp as a way to do QC for our partner's TB program across the border, discussing standardization of treatment protocols, data, etc.). It's an interesting window into the aid world. My org is in an odd place - we are an INGO, but we don't act like one. Mostly because we are small, and because we are some embedded with our partners. So we kind of teeter on this windowsill between two worlds, not really in either. My org has also developed a rep for being data people, in that we produce a lot of it, and its good quality. So many orgs like having us there, because we can answer questions, and because the data is very good for advocacy (i.e., when they ask for more money). In December I presented about the report Diagnosis: Critical, which I think I mentioned previously. In January, they wanted to know about the PHR report on the India border, which GHAP was minorly involved with. PHR is coming to Mae Sot to do a similar report with the Karen, which is great because I like PHR and am happy to work with them (my grad school advisor/mentor is their co-founder), and because they are hiring a friend of mine from Hopkins to coordinate the project, so it will be great to have him out here. At the next meeting, I will be presenting a reproductive health advocacy report, and perhaps our own report on the India border. The day before the meeting I went to the health subcommittee meeting. The night after the meeting, CCSDPT had its annual holiday party. Its the first I have been to. Its was rather funny, to see all of the INGO big wigs boozing it up, and letting it all hang out. I met someone at the party who I had dinner with and many come to visit Mae Sot.

The next day I met up with a field medic and a trauma surgeon and drove to the border for a trauma management training. We stayed in a small village in the middle of the jungle. In fact part of the road washed out in the last rainy season, so we had to walk the last bit (about 2 hours, though we left the training equipment to get picked up by a huge 4x4 later). Pigs and flocks geese, ducks, turkeys, chickens, and peacocks wandered freely. Everyone bathed on platforms over the stream behind the houses (basically, you 'shower' while wearing a surong). We went to bed at 9, and got up before 5. There was a generator to provide power when it was needed. It was a very pleasant week in many ways. I'll post photos from my week there soon.

The training involved teaching community health workers how to handle trauma injuries, including falls, gunshot wounds, and landmine injuries. The medics are from villages in the Mergui-Tavoy area of south eastern Burma. There is not as much active conflict as northern Karen state, but there are still flare-ups. The majority of trauma injuries are accidental landmine injuries (villager steps on old landmine) and hunting accidents (gunshot wounds). The same training was conducted farther northern a week later, where medics treat many more landmine and gunshot wounds, and there are many more conflict injuries. They are taught primary and secondary survey, reductions, splinting and casting, suture, surgical airways, chest tubes, fasciotomy, debridement, and amputation. Not bad for a one week training.... Most of the trainees have come before, so it was more of a refresher, but its still gives a little pause to think that they are the primary or only source of treatment available to many people. The last day includes a pig lab to practice techniques, followed by a pork feast.

This village was also the site of a big meeting planned for the end of the week to discuss the future of the people living in the Mergui-Tavoy area of southern Burma, which is in jeopardy because of a huge development project beginning nearby. The Italian-Thai company is developing a enormous industrial park, including a deep sea port, and a highway and railroad from there to Thailand. Below the park will be a beach resort development project. The project is being done in Burma because Thailand considered it unsuitable, mostly due to environmental concerns (there is a very explicit quote from the Thai foreign minister). Numerous villages will be displaced, at the site itself, and along the rout of the highway and railroad. Past large projects have also led to (documented) cases of forced labor by the Burmese regime. There is real concern about loss of land and livelihoods, and forced labor. And even besides those threats, just the challenge of maintaining their culture and way of life through the displacement and dispersal. All of this 'development' but the people in the area being 'developed' aren't benefiting from it at all.

After the training I went to Sankhlaburi, another border town farther south than Mae Sot, with a couple of our staff from the US, to visit some current, and some potential future, partners there. We were very excited because the one bakery in town has recently started making bagels. They were very good! Sankhla is such a quiet, peaceful town, it is lovely to visit. It straddles a dammed river which has formed a lake, though this year the water is so low it is more of a river again. One side is dominated by Thais, and the other by Mon (the ethnic group living in the part of Burma just across the border, although all of Sankhla is in Thailand). There has been fighting across the border ever since the election, and although you can't see the displacement from Sankhla (because the Thais won't let the people cross into Thailand), people displaced by the fighting have been amassing at a couple of sites on the other side, mostly around two clinics that our partner runs. There have been shortages of medicine and food, and no one knows how long the fighting will last. Even the currently stable places are now threatened, because the ceasefire which has kept the area quiet for the last 15 years recently dissolved. So fighting is expected to spread before it resolves. Our partner is currently conducting trauma management training for all of its medics, who haven't had to treat gunshots or landmine wounds in 15 years, but are now once again faced with these traumatic injuries. There is a lot of talk about the sustainability of health programs - what happens when the border is completely closed and support/supplies/funding can no longer get to them from Thailand (as the gov't of Burma is already preventing those things reaching from inside the country).

We drove 10 1/2 hours back to Mae Sot on Saturday in time to start our 'Field Summit' on Sunday afternoon. Several US staff, including our new Executive Director (we just merged with another NGO, and our old ED became the Medical Director) to talk about the state of the organization. It was supposed to mainly be focused on the implications of the merger, and next steps as we continue to shore up our structures/policies/staffing. It turned out to be a week of the staff venting frustrations and airing complaints, many of which were founded, but the vehemence of their expression suggested a much deeper seated frustration than I had realized, and much more of it was directed at me than I had realized (or at least that was my interpretation, though I have also received some comments to the contrary). Mostly it was aimed at 'leadership' which isn't just me, but as the Field Director, I'm the ready face of it. Our organization has been under resourced for a long time, which we have all known, but while I and others thought we were making slow progress towards addressing that, many others seem to think that nothing has been accomplished, and that its a "complete shit show". I found this very disheartening. While I have readily acknowledged, and complained about, many problems during my own tenure here, it is frustrating and depressing to think that we've been working hard for nearly 3 years to address issues, and have apparently made zero progress. To work so hard for so long and have nothing to show for it is very depressing. It is not disputed that we have continued to produce quality outputs where our partners are concerned, but internally, its just devastating to think that all of the time and effort we put into working on structure, on top of all of our other work, was a waste. I think a big part of this is that most of the people now working on the ground here have been around less than a year, and so don't see the larger trajectory. And it was good to get issues out in the open, and to begin crafting a plan for moving forward. Still, it was a very difficult week, both professionally, and personally. And it made me feel very lonely.

So now we are back to work. Trying to follow up on all of the action points from the summit. Trying to 'fix' all of the problems identified with the org. Trying to manage expectations, since they wont all be fixed at once. Still trying to get a couple of lingering reports out the door (that are now late). Trying to find my own balance again. Trying to figure out how to lead while unsure of how much trust or confidence the staff have in the organization or my bosses have in me, while trying to identify my own weaknesses and build my own skills, while trying to manage an already overcrowded plate at work, while trying to not completely loose touch with the people important to me.

Other random things before I go:
- I canceled my trip to India, so will be in Mae Sot until the end of March.
- The cool season, which was much cooler than last year, but less cool than the year before that, is already slipping away, which makes me very sad. I don't feel ready for the hot season yet. On the plus side, my office is getting AC, so at least it will be bearable to work there for the next few months.
- I just bought a plane ticket back to the US for October (well, I used miles, yay miles!) in order to attend a very special wedding. I'll be in the DC area from Oct 27 through Nov 5.
- Just found out that one of my dear friends is being deployed to Afghanistan next month.
- This week I received a package from a friend which contained a very amusing solar powered gift
- the back tire of my bike refuses to hold air, although I've taken it to the shop twice, and they can't find a leak
- Mona is a very picky eater
- I love having fresh cut flowers in the house, and love that I can go to the market and get enough flowers to arrange 3 or 4 vases for only about 4 USD.
- I've had pasta salad for dinner the past three nights
- I received a Kindle for Christmas, which was a complete surprise, and while I hadn't thought I was ready to enter the world of e-reading, it has already proven to be extremely useful and readable, and I'm very glad to have it