August 26, 2014 One Golden Truth

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

Thibo, a Technician, contributes to a team session editing the Scorecard, in Benin

Thibo, a Technician, contributes to a team session editing the Scorecard, in Benin

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


Get the red pen out!  A national team member records his recommended changes

Get the red pen out! A national team member records his recommended changes

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.

Pascal, our Field Supervisor, tests out the tool in a clinic

Pascal, our Field Supervisor, tests out the tool in a clinic

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.

August 21, 2014 Visit to VaxTrac Headquarters in the US: An extraordinary experience of cultural exchange (VOYAGE AU SIEGE US DE VaxTrac, UNE EXTRAORDINAIRE EXPERIENCE D’ECHANGES INTERCULTURELS)

Fidèle Marc outside of the White House

Fidèle Marc outside of the White House

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.

DC Team enjoying the World Cup final

DC Team enjoying the World Cup final


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.

June 11, 2014 Introducing our Summer Associates: Mary Michael


Hi! My name is Mary Michael McDuff, and I will be working as a program associate for VaxTrac this summer in VaxTrac’s new Atlanta office. I am a rising senior at the University of North Carolina at Chapel Hill. I am majoring in Health Policy and Management in the UNC Gillings School of Global Public Health, with a minor in medical anthropology. I am so excited about being a program associate at VaxTrac this summer because I believe it will allow me to see firsthand what healthcare delivery looks like in a underserved population, and more importantly, how we can apply technological solutions to make this delivery more efficient and effective.

It has been an incredible whirlwind of a first week! After a few days of orientation at the VaxTrac office in Washington, D.C., the other program associate this summer, Anita, and I moved into our new office in Atlanta on Monday. We settled right in and began drafting our Scopes of Work, which detail the projects we will be working on together, and individually, over the course of the summer. For many of my projects, I will be working closely with VaxTrac’s Monitoring and Evaluation Manager, Jessi Hanson, to revise our baseline tools. One of my favorite projects I will be working on this summer is researching the role of fathers in the immunization process in Benin and how to get mothers who do not come to the clinics to want to bring their children in for immunizations. Later this week, I will be traveling to Benin with Jessi in order to complete our research in the field and to help implement the revised baseline tools. I cannot wait to visit the clinics in Benin and to see VaxTrac’s project sites firsthand.


As a team, Anita and I will work with Jessi to fully research the paper vaccination records currently used in Benin in order to make our technological record even more comprehensive. Anita and I will also be tackling the creation of project management tools and needs assessment tools to be used in VaxTrac’s upcoming projects as VaxTrac expands into new countries. I am grateful to be working for VaxTrac at such an exciting time because the organization is set to start new projects this summer in the countries of Indonesia and Nepal.

It will be a summer of collaborative research and of rethinking current strategies, and I couldn’t be more thrilled to be a part of this dynamic, globally minded team!

June 9, 2014 Introducing our Summer Associates: Anita


Greetings from VaxTrac’s new office in Atlanta! My name is Anita Narayanan and I am one of VaxTrac’s program associates.  As you will probably be seeing Mary Michael McDuff (the other program associate) and I post/tweet/Facebook over the next few months, it seems only fair that you know a little bit about me.

I was born and raised in Atlanta and moved to D.C. for my undergraduate degree where I majored in anthropology (specifically cultural and medical anthropology) at Georgetown University.  During this time, I interned at a non-profit working on HIV/AIDS awareness in India, a small consulting firm whose primary client was the CDC, and in the private wealth management arm of a bank (I obviously took the “explore your options” advice to heart).  After graduating, I moved to New York and began working full time with the same bank.  For several years I enjoyed/survived the unique, high-stress environment, especially working in the industry during the financial crisis.  After five years of working there, I started to feel the pull back my initial intellectual interest in healthcare.  This led me to decide to head back to my hometown to get my MBA/MPH at Emory University.

I’ve just finished my first year in the program and knew I wanted to spend my summer working at an organization that focused on global health.  I was lucky enough to hear about VaxTrac and very excited when I was hired as a program associate for the summer. We spent our first week training in D.C. where we learned about the organization, the projects we would be involved in, and got to know our awesome coworkers (through very entertaining team building exercises). It’s only my second week on the job, but I have already learned so much about healthcare delivery, vaccines, and fingerprint technology.


This summer, some of the projects I will be working on are to create a standardized needs assessment tool for planning future projects, analyze health worker practices to increase efficiency and identify best practices, and create a process map to streamline and consolidate record keeping techniques.  All of these projects directly appeal to my interest in processes and systems management within the healthcare industry.  This summer will give me the opportunity to learn about the inner workings of global health along with the new experience of working at a startup non-profit and traveling abroad to visit the health clinics first hand.   I am excited to be working here and feel very lucky to work with such a great team! P.S.-Sadly, the dog in the picture is not mine, but I seem to have very few pictures of myself without a random dog with me (until I get a dog, I just make friends with people who have dogs and then spend more time with the dogs than my friends).

February 19, 2014 Fun times in Cambridge: ID Hack 2014

Last weekend I had the singular pleasure of spending a night with some of the best and brightest young minds in the country. I’m talking about ID Hack, a 24 hour hackathon put on by  the Harvard Developers for Development and the MIT Global Poverty Initiative.  Unlike some other hackathons the aim wasn’t to create the next Facebook based platform to allow users to rate attractiveness of their friends cousins or something equally vapid and zeitgeisty, it was to put young developers in touch with globally focused NGOs with real technical needs. [Also to stay up all night and eat pizza] We all showed up with a project or problem, pitched to the more than 100 young brains and they formed teams to tackle them.


Our pitch wasn’t quite as straight forward as some, we weren’t looking for a new website, we wanted deeper analytic measures. Our pitch was this: VaxTrac has piles of data, our stakeholders are used to asking for the typical metrics and we provide them. However, we collect more data than a typical immunization program, what metrics can we create from our piles of data that can inform and empower local decision makers? Once we find a metric, how can we visualize it in an interesting way?

     I spent the night working with two students; Michael a freshman in CS at MIT, and Wanli, a masters student in Psychology at Brandeis. We wanted a simple analog (probably over-simple) for the efficacy of any particular clinic. We chose the average schedule adherence and vaccination rates for two vaccines with a single dose in the first year , BCG and Yellow Fever. BCG is given at birth and Yellow Fever at 9 months. We looked at the number of doses of each for each clinic and also the average age at which each child who got the vaccine received it. Based on this we built a map showing which clinics most closely adhered to the set schedule. You could clearly between the two maps, which clinics were retaining the most children from the birth dose to the nine month dose. Not bad for a night’s work!

[Note: We mapped real clinics to random cities, this map isn't representative of actual regional performance. Also we were working with meta-data, not patient records.]

Again, I’d like to thank my team. They chose one of the more abstract problems available and I think they did a fantastic job.

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