The beautiful Summit Hotel in Kathmandu overlooks the bustling city below, nestled between sloping hills which sit comfortably in the shadow of regal snow-capped mountains. It is also full of International aid workers, because naturally, everyone wants to work in Nepal. The government estimates in fact that there are over 15,000 individual organizations working in the country throughout all sectors. As you can imagine, I was a little hesitant to dive in and start navigating the waters of partnership building in such a highly saturated ecosystem, but my fears were quickly assuaged as we jumped right in and got to work (shout out to Joon and Ravi at UNICEF Nepal for being such wonderful guides during our first hazy 48 hours!).
Mark and I spent several days in Kathmandu meeting with various stakeholders from our partners (UNICEF and WHO/CDC), to key people from the national ministry of health, and various consultants and experts from the immunization, technology, and health system strengthening space. It was an exciting, informative, and exhausting first week to say the least!
If we thought we might get a nice relaxing weekend, we were mistaken. Instead, we worked with WHO to organize a site visit to Nawalparasi in the terai region, one of two districts in which we will be implementing in early 2015. As someone so aptly explained to us, Nepal is laid out like a sidewise strip of bacon: the top golden brown layer is the mountains, the stripy red/yellow middle part is the hills, and the deep red piece that runs along the bottom is the terai. As it turns out, we will be working along the delicious bottom strip of the country that shares a border with India. Much like fresh bacon, Nawalparasi is sizzling hot.
Despite the steamy temps, we had an incredible couple of days with our colleagues from WHO, CDC, and the US Fund for UNICEF (have to insert another shout out here to Susanna, Keiko, and Michelle for being such great travel partners!). Not only were we all graciously welcomed by the District Health Office staff, we were able to gather almost all of the information necessary for our initial project planning after visiting several different types of health facilities and speaking directly with facility managers and community health workers. We saw that Nawalparasi has a very well structured vaccine delivery system and can even boast that it is a fully immunized district! Like any project, this one will not be without its challenges, but it’s always a huge advantage to have such support from a local level and we certainly found that in Nawalparasi. As a small cherry on top, we were able to find a few hours in our busy schedule to visit Lumbini, the sacred birthplace of Buddha. Even in the rain, there’s no denying that this is a beautiful place that compels one to pause, and self-reflect. It was a wonderful way to mark the midway point in our busy trip.
Our second week found us back in the smoky hustle and bustle of Kathmandu, meeting with some inspiring and impressive NGOs and attending an eHealth strategy workshop organized by the Ministry of Health and UNICEF, showcasing both local eHealth projects and organizations as well as those from around the world. It was so cool to see so much capacity around using technology to improve health outcomes. We left the workshop feeling more motivated than ever to get to work and find our place in this rapidly developing and innovative health system.
All in all, the trip was a huge success. It’s near impossible to sum up all of the things we did and saw and what a different experience it was for me to see this part of the world. We owe a great deal to our amazing friends and colleagues both in Nepal and in the US for making it all happen. There’s certainly another trip in our near future to visit our second district (Dadeldhura in the Far West) and I’m excited to share this beautiful country with the rest of our team. For now, I’ll leave you with some Buzzfeed worthy trip highlights. Namaste!!
5 Things to Never Do Around Monkeys
8 Things to Buy in Nepal
VaxTrac proudly announces its new project, Vial to Child, launching in Nepal, September 2014. The pilot project is in partnership with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), with the dedicated collaboration of the Ministry of Health and Population (MoHP) Nepal and key health stakeholders on the ground.
VaxTrac works to provide developing countries with the technologies and support they need to maximize the effectiveness of their vaccination programs. Vial to Child is currently VaxTrac’s second international project, and first in the Southeast Asia region.
VaxTrac’s first and ongoing project in Benin, West Africa, will serve as a model for the Nepal project. It employs a vaccine management system comprised of two parts: a fingerprint scanner plus an android based tablet or smartphone loaded with VaxTrac software customized for local needs. The VaxTrac system enables health centers to digitize their vaccination management process with the goal of: improved record keeping practices, maximized efficiency of frontline health workers and streamlined delivery of health services, particularly for children under the age of five.
Most Nepalese live in rural, often remote locations, where access to quality healthcare services can be limited. One of the main causes of death among infants and young children involve diseases, like pneumonia and measles, which are often vaccine-preventable, but in areas where record keeping is often precarious, it can be a challenge to provide all children with these life-saving vaccines in a timely and efficient manner. A tablet based system like VaxTrac can help take clinic level vaccine management out to these isolated areas where children are most in need.
With the Vial to Child project, VaxTrac will be primarily responsible for customizing and implementing the tablet based vaccine management system in the selected districts, supporting project management, ongoing supervision, and in country training and clinic support. The VaxTrac system will be tailored to mirror the paper based national vaccine record system, will appear in the Nepali language, and use the Nepali calendar.
The project will be implemented in January 2015 in two rural/semi-rural districts. WHO will support the project in the district of Nawalparasi in the Western region (Terai), while UNICEF will lend support to Dadeldhura in the Far West (Hills). The Centers for Disease Control (CDC) will provide additional support to Vial to Child by helping guide the evaluation process across both districts and work closely with the Ministry of Health and Population and all other key stakeholders.
We look forward to collaborating with all of our partners on this momentous project to improve child health in Nepal.
Reflecting on the last ten weeks of my time as a summer program associate VaxTrac and trying to put it into words has proven to be immensely difficult. You’ve read about our first impressions at the beginning of the summer along with our trips to Benin, but trying to encapsulate the entire experience into a blog post is nearly impossible.
When I started this summer, I had no idea what to expect. My previous work experience was limited to large corporate financial institutions and I worried about successfully transitioning to a non-profit start-up work environment. Ten weeks later, I can confirm that not only was this summer the most fulfilling work experience I have ever had, but it made me realize that this sector of healthcare is where I see my future.
Mary Michael and I started in June with a wonderful week of orientation in Washington, D.C. This gave us a chance to meet the rest of the team in D.C. along with learning about the different project opportunities for us to work on. Meredith, Jessi, and Mark each took turns writing different general ideas or goals they had on a white board and then the most surprising thing happened-they took a step back and told Mary Michael and I to pick what projects we were most interested in. They stressed that they only wanted us to work on projects that we found personally and intellectually stimulating. Never have I been in a job environment where my interests took priority in determining my work scope. Once we had determined what areas we were most interested in, it was time for our work to begin!
We headed back to Atlanta and set up our Atlanta office. While Mary Michael and I had initially thought we would work on our projects separately, we quickly realized that collaborating on our ideas would provide a more efficient and overall better work product. We bounced ideas of each other, playing to our own strengths, and were able to come up with three main goals for the summer: create a process map for the vaccine record keeping system in Benin, analyze the timeliness of vaccine delivery using the data that the VaxTrac system captures and use a combination of observation and interview-based data to track health worker efficiency in the field (for more details on this, read Mary Michael’s final blog post-she does a great job of explaining all) . In addition to these projects, we also got to help work on the monitoring and evaluating tools along with being in charge of social media of the organization. I was most apprehensive about the social media portion of the summer but it ended up being one of my favorite things to do. Mary Michael was kind enough to get me up to speed on terms like “re-tweet” and soon our mornings started off with brainstorming ideas for updating VaxTrac’s many different forms of social media including Facebook, Twitter, and Instagram. The highlight of this project was when we were re-tweeted by The Gates Foundation (yes-we are still bragging about this).
Here I am, a page into this blog post and I’ve barely gotten through week two of the internship-see what I mean about how difficult this summer is to encapsulate? In order to avoid writing an entire novel, I’ll go over the rest of the summer with major highlights. Mary Michael and I spent most of the time in the Atlanta office with Mark working on our projects. The World Cup could probably be considered a VaxTrac employee this summer as it became a focal point-and a source of contention when we created a VaxTrac bracket (congratulations again Duncan-I promise I’m not still bitter…). We each took separate trips to Benin (read about it in our travel blog posts!) which provided invaluable research and insights to our projects. Near the end of the summer, Mark informed us that we would be presenting our research and findings to the VaxTrac team along with two leaders in global immunization. Mary Michael and I were very nervous but also excited to share what we had found and accomplished. We presented on our second to last day of work and were overwhelmed by the positive responses from everyone in the audience. To have a leader from the CDC come and ask insightful questions and provide us with great feedback was humbling, to say the least.
We ended our summer with a final day of feedback and exit interviews. Mark, Meredith, and Jessi not only wanted to give us their feedback on our performance this summer, but also to hear about our own reflections and recommendations for future summer program associates. The day concluded with us receiving our awesome certificates and headed out to have a celebratory glass of champagne before Meredith and Jessi went back to D.C. It might sound strange to say, but I was incredibly sad that the internship was ending. It felt like we had just started our work and there was so much left to do! This was sincerely the best summer and work experience I’ve ever had and it definitely ended too soon. If you want to hear the full story of the summer, just let me know (and make sure to set aside about 5 hours)!
By Jessi Hanson, M&E Manager
In the last decade of working in international development, I have learnt one golden truth: Trust your staff on the ground to know best! The international
development world is made up of usually two groups working together (hopefully in harmony) on a variety of projects in sectors that combat poverty, empower marginalized people, and aim to improve their quality of life. These two groups typically include: international consultants or international staff, and national staff. The first group consists of people from countries like the United States, Canada, England, or Japan, who often started out doing small volunteer stints abroad, maybe even worked in Peace Corps or the VSO. Most later got a degree in a sector like education or public health, or studied international development and international relations. They might have lived a few years abroad and authentically contributed to a few projects in the field, but a great majority work out of the main offices in cities like: Washington, D.C., London, or New York, and travel from time to time to advise or oversee projects in country. We (and I humbly include myself as one) often get endearingly referred to as the gringos, muzungus, the weepoos.
The second group of development workers, the national staff, typically are from the country or region in which they are working, spend long days each week in field, speak the local language, and have a better understanding of the people that organization labels its ‘beneficiaries.’ They are the knowledge on the ground, the insight to the cultural contextual reality, and more often than not, have double the experience level and management expertise than us international
It was a wonderful moment to see on one of my first trips to Benin, how much every international staff member recognized this ‘golden truth’ without ever specifically stating it. It was demonstrated in their actions, the way they collaborated on decisions, and the thoughtful manner they spoke about our Benin teammates. We, at VaxTrac, work hard on a variety of project initiatives to ensure our International Office and National Office have equitable inputs and decision making power. It is also something we are working to instill in our monitoring and evaluation practices.
One example was on our last trip to Benin, in June. We worked to develop a new monitoring tool, which we named the ‘VaxTrac Digital System Scorecard’, which assessed the use and capacity development of the health workers who we trained to use the VaxTrac digital system in clinics on a frequent basis. For most of our health workers, the VaxTrac system is the first time that they ever turned on a computer or entered data using a keyboard; so it is pretty important that we track their progress with using this system, and in a way, that we can give feedback to them and measure over all our clinics where trainees are succeeding or need more guidance.
Developing a good monitoring tool can take many months if done right, and this time was no different. As far back as January, we worked collaboratively with our Africa Regional Manager, Fidele, to draft the concept of a scorecard that would work in the local environment. Next, our team in the USA researched and drafted a first version of the Scorecard. It went back and forth several times via email to our different teams before we felt we almost had it. On the June trip, we got the entire Benin team together in a room, projected the Scorecard on the screen, and watched sat back as Fidele led his national team to dissect the tool to perfection. It took over two long hours, and then even more. They picked it apart, reshaped boxes, scraped bits we in the US thought made sense. And in the end, after several days of further pilot testing in the field and running the drafted tool by the health workers themselves to see their thoughts about the tool, we had a set product.
It takes a concerted level of humility, trust, and respect for your teammates to let a favorite pet product go for collaborative editing. But follow the ‘Gold Rule’. As an international staff member, I try to remind myself everyday to trust the expertise, vision and understanding that my national team members have for something we will apply in what is ‘their world’. In the end, when we work alongside the best national team, we can do that, and know in the end, the vision is even brighter and will yield just not a better product but promote a sense of community even across oceans.
I was very excited when I got my entry visa to the United States, though on the flight, I was greatly disillusioned. After being on the plane the whole evening, we finally landed in the country of Aile Selasie (Ethiopia), twice as far from America than Benin. The journey was long and very stressful for both my courage and patience. We even had a stopover in Rome, the land of the Pope. Finally, we reached the land of Uncle Sam which was impressive and had a natural greatness. After an interminable wait for customs, I was received by my colleagues Shawn and Meredith. We drove to the VaxTrac office and then had a welcome lunch at a nearby restaurant. Surprise surprise, I was staying next door to the US Benin Embassy. Without wasting time, I visited the Embassy in honor of the homeland, and as we say in our country, a « yi kan xwé bi o ».
The welcome at the Embassy was very warm. My team and I had the honor of being received by His Excellency Mr. Omar AROUNA, the Ambassador. The following day, I had to try walking from the hotel to the office, as there are no “Zémidjan” in Washington. Walking is a culture here, and the most amazing part is that it takes the same time on a taxi or bus as it does to walk most places, so we must adapt because it is good for our health; “What a trip, that allows us to prevent so many heart diseases!”
On the streets of Washington, the people I met were very hospitable and interested in my African outfits; I had to take advantage of the opportunity to brag about my culture. It’s summer and it is warmer here than at home; so I could put my “baubas” made in Africa. But beware, the bazins did not do me any favors in the heat, I almost suffocated!
I visited many parks and public gardens with trips for wine, jazz and to meet friends of my colleagues. I even had a football game organized by Meredith and her friend Robert which was wonderful. The greenery of Washington is impressive but I was shocked that it is illegal to urinate in public here, as that is not the case at home.
The meals are very close to what we consume at home so I certainly had no trouble feeding myself.
On Sunday, I searched online for the nearest Catholic Church which was supposedly an hour away from my hotel. This was a great contrast with Germany where the cathedrals abound in the streets of cities that I visited there. I had to travel far I the US to get close to God, but then I reconsidered; God is One, so participating in a Protestant worship will not do any harm. But I was too late, the service was very short. God here is so smart that his worshipers go straight to the essentials; God here does not use too much of people’s time, or at least people in Washington use God’s time wisely.
The following Monday, I was taken by my colleagues Shawn and Meredith to Baltimore Airport for my flight to Atlanta where I was expected by Mark Thomas, Executive Director of VaxTrac. Two hours later I arrived in Atlanta, lost in a crazy world of passengers without knowing where to pick up my luggage. Everything is electronic! Suddenly, a little boy smiled and stopped at my level. He asked his parents to greet me and they helped me to navigate the big airport to retrieve my luggage. At the exit, I saw Mark Thomas with a warm sign and together we went to pick up my suitcase, then he took me to the VaxTrac Atlanta office, where I was greeted by my colleagues Mary Michael McDuff and Anita Narayanan. After a Staff Meeting via Skype with the Washington team, I was taken to the hotel, where I was enveloped by sumptuous comfort. The next day, I experienced a work day at the Atlanta office. Here, under the deafening quiet of nature, each of the professionals are in constant contact with the task at hand and each remains productive beyond expectations. Not even cell phone sounds break the calm. The few phone calls which I did hear were around break times. Five major documents were produced in eight hours of work. Great performance and lesson in work time management! That same night I had the honor of being invited to dinner at Mark’s place with his parents. Mark himself prepared delicious food that we enjoyed in a very friendly atmosphere. The reunion was very warm between the three Marks (Fidele Marc, Mark Jr. and Mark Sr.), Mark’s mom Marti and Ashely, our wonderful hostess. I will keep very fond memories of this evening.
Then came the discovery of the city of Atlanta. Mark Thomas Sr., father of Mark, drove us everywhere, from the University of Emory to CDC, and the Georgia Aquarium with edifying availability as, according to him, “to teach by example.” Each place we visited hinted at one lesson, “Dream big and pursue quality in all that you do.”
The next day I returned to Washington, DC to reunite with my colleagues Shawn and Meredith who took a very good care of me. I stayed in a top quality hotel where I had a panoramic view of the city of Washington. For the first time, I attended a baseball game in a very friendly atmosphere with my colleagues and their partners to whom I express my deep gratitude. We are a team that respects the integrity of the human being.
I finished my mission in the United States while keeping in the bottom of my heart the beautiful life lessons that I have learned.
Je fus très excité quand je reçus mon visa d’entrée aux Etats Unis. Sur le vol, ma désillusion fut grande. Après avoir volé la soirée entière, nous atterrissames au pays d’AILE SELASIE encore deux fois plus loin des Amériques que le Bénin. Le voyage fut long, nous faisant passer par la terre papale, et très éprouvant pour le courage et la patience. Finalement, nous atteignîmes le pays de l’oncle THOM avec un génie grandeur nature impressionnant. Apes une interminable attente pour les formalités douanières, je fus accueilli par mes collègues Shawn SARWAR et Meredith BAKER. Je fus conduis au siège de VaxTrac, puis après un déjeuner de bienvenue, à l’hôtel. Surprise pour surprise, je serai logé à côté de l’Ambassade du Bénin près des Etats Unis à Washington. Sans perdre de temps, je rendis visite à l’Ambassade en hommage à la terre natale, comme nous le faisons au pays : « un yi kan xwé bi o ».
L’accueil fut très chaleureux. Mon Equipe et moi avions eu l’insigne honneur d’être reçus par son Excellence M. Omar AROUNA, l’Ambassadeur. Les jours suivants, il fallait expérimenter les marches matinales et vespérales de l’hôtel au bureau à Washington. Il n’y a pas de « Zémidjan » par ici. La marche est une culture. Et le plus étonnant, tu perdrais le même temps à bord d’un taxi ou d’un bus qu’à marcher. Alors il faut s’y adapter puisque c’est bon pour la santé. « Sacré voyage qui me contraignît à prévenir les Maladies Non Transmissibles ! ».
Les personnes rencontrées sont très hospitalières avec beaucoup d’intérêt pour mes tenues Africaines. Je devrais en profiter pour vanter ma culture. C’est l’Eté et il fait plus chaud ici qu’au pays ; alors, je pouvais mettre mes « baubas » made in Africa. Mais attention les bazins ne m’ont pas rendus service. J’avais failli suffoquer en dessous. J’ai visité beaucoup de Parks et de jardins publics sous l’accompagnement du vin, du Jazz et des amis de mes collègues. J’eu même droit à une partie de football organisée par Meredith et son ami Robert. Ce fut merveilleux. La verdure de Washington est impressionnante mais gare à vous si vous arrosez les herbes d’urine : C’est la Cour d’Assises qui tranche votre cas. Les repas sont très proches de ce que nous consommons au pays. C’est une mixture interculturelle parfaite. Je n’ai eu aucun mal à m’alimenter.
Le dimanche, je recherchai sur mon portable l’Eglise catholique la plus proche. Il faut y aller suite à 1h de voyage. Le grand contraste avec l’Allemagne. Pendant que les Cathédrales pullulent dans les toutes rues des villes Allemandes que j’avais visitées, il fallait voyager loin pour se rapprocher de Dieu. J’avais alors opté pour un plan B ; Dieu étant Unique, participer à un culte Protestant. Mais, trop tard. Dieu ici est si SMART que ses adorateurs vont à l’essentiel. Dieu ici n’use pas du temps des hommes, ou du moins les hommes à Washington utilisent judicieusement le temps de Dieu.
Le lundi suivant, je fus conduit par mes collègues Shawn et Meredith à l’Aéroport de Virginia pour mon vol sur Atlanta où m’attendait Mark THOMAS, le Directeur Exécutif de VaxTrac. Deux heures plus tard, j’arrivais à Atlanta, perdu dans un monde fou de passagers sans pour autant savoir par où aller chercher mes bagages. Tout est électronique. Soudain, un petit garçon qui accompagnait ses parents me sourit et s’arrêta à mon niveau, obligeant ses parents à me saluer et à négocier qu’il reprenne la route avec eux. J’en profitai pour m’orienter vers mes bagages. A la sortie, je vis Mark THOMAS avec une chaleureuse pancarte artistement conçue par Anita NARAYANAN notre Assistante de Programme. Ensemble, nous allâmes chercher ma valise, puis il me conduisit au bureau annexe de VaxTrac à Atlanta, où je fus accueilli par mes collègues Marie Michel MCDUFF, et Anita NARAYANAN. Après la réunion de service en ligne avec l’équipe de Washington, je fus conduit à l’Hôtel, où le somptueux confort m’étreignit.
Le jour suivant, j’expérimentai une journée de travail au siège annexe d’Atlanta. Ici, sous le calme assourdissant de la nature, chacun des professionnels dans un contact permanent avec sa source d’inspiration, reste productif au-delà des attentes. Pas de bruit de portable qui dérange. Les quelques rares coups de fils passés autour de moi, ne l’ont été qu’à la pause. Cinq grands documents conçus en huit heures de travail. Grande performance ! Et belle leçon de gestion du temps de travail. J’eu ce soir-là même l’honneur d’être convié au diner chez Mark Thomas Jr avec ses parents. Mark a lui-même préparé les délicieux mets qu’il nous a offerts dans une ambiance familiale. Les retrouvailles furent très chaleureuses entre les trois Mark, Maman Marti et la Reine des lieux. J’en ai gardé des souvenirs très filiaux.
Ensuit vinrent la découverte de la ville d’Atlanta et du diner d’au revoir. Mark THOMAS, père de Mark, nous a conduits partout, de l’Université d’EMORY à CDC en passant par la GEOGIA AQUARIUM avec une disponibilité édifiante comme pour à ses dires : « Nous instruire par l’Exemple ». Chacun de ces lieux visité ne laissait entrevoir qu’une seule leçon : « Rêver grand et rechercher la qualité dans toutes ses interventions. »
Le lendemain, je fis mon retour sur Washington avec mes Collègues Shawn et Meredith aux petits soins, logé dans un Hôtel à Cinq Etoiles où j’avais une vue panoramique sur la ville de Washington. Pour la première fois, j’assistai à une compétition de Baseball dans une ambiance de famille très conviviale avec mes collègues et leurs conjoints à qui j’exprime ma profonde reconnaissance. Nous sommes une équipe respectueuse de l’intégrité de la personne humaine.
J’achevai ma mission aux USA en gardant au plus profond de mon cœur les belles leçons de vie que j’en ai tirées.