A certain tolerance of (gross) imperfection
on Ashtin Doorgakant (Malawi), 17/Oct/2011 11:18, 34 days ago
There is an anecdote recently from work that encompassed so many aspects of this feature so Malawian that I really have to elevate it to the status of case study. It is about a phenomenon that us foreigners find so hard to understand and accept. It drives us up the wall, it’s probably responsible for the majority of instances where we lose it with Malawians (and then repent shamefully for weeks!) and it certainly provides an incredible insight into the Malawian psyche, let alone socio-economic reality. It is the wayimperfectresults, systems, jobs you name it, are so coolly tolerated here. This will without a doubt sound like a litany of criticisms of the Malawian way of doing things. Indeed I was first to have this reaction when I landed here. But really I’ve moved from that stance to be closer to understanding what it really tells us. It tells us a lot about Malawi, the country and the people for sure, but it also tells us about ourselves quite a deal. For if tolerance of imperfection makes us flinch so much, then it somewhat suggests that we aremore inclined to the opposite... and in that I readintolerance!The story is that of a box! A box I tried to get the hospital maintenance department to make in order to enable us to run a nurse-less clinic. Indeed the situation in terms of nurse staffing is so dire at Queen’s that we run all our clinics ourselves as clinicians. Also our orthopaedic ward staffing has recently been culled such that there is now a single nurse for up to 70 patients on nights. So I devised a compartmentalised box which would contain all the materials (gloves, dressing, slings etc) we need in clinic and all the ward nurses would have to do is to keep it stocked up in between clinics. So I drew up a model of the box in the question and handed over to the maintenance big guy as I would have done in Ntcheu. To my surprise he directed me to the main guy for the specific section: carpenter. I automatically assumed that this must be a big enough unit to deal with quite a volume of work. So I gave the model to the chief carpenter and got the assurance that this is a very simple job indeed which shouldn’t take more than a couple of days to complete. So 2 days later, I drop in onmy way to the clinic and can’t find the box. I find the subordinate carpenter instead who informs me the chief carpenter is on a bigger job and has delegated this job to him. But he had decided not to make a start on it until he got a chance to check on specifics with me. Fair enough! So I went through the very basic features of this simple box and got told to come back at the start of the following week. It turns out I was very busy that next week, so I gave the carpenter ample time to do the job well. Come Thursday, clinic day, I stumble by the department again and find no signs of my boxyet. The subordinate, it turns out has gone off sick. Can’t help it, so I ask the chief carpenter to reassume responsibility of the job if the other doesn’t come back soon. Next week I go there to enquire and still find no progress on the box. The chief carpenter is not around, he’s gone off on another more important job again. Fair enough, the corridor connecting the surgical annexe to the main hospital has caved in! It started as a crack in the wall and before we knew it, the wall was on the ground with a big chunk of floor attached to it! So that’s another week at least before chiefcarpenter gets back to ‘little jobs’ again. As for his subordinate, he’s not back yet. I’ve seen it so often here and it saddens me. Young perfectly able-bodied men and women, look smilingly at you one day full of life and the next day they’re in the throes of a terminal illness, out of which many don’t make it. There’s a lot of serious infections that go round but I don’t agree that they should claim such a big death toll. Poverty among low grade health staff is really heartbreaking and results in life being, to put it bluntly, devalued. So I gave my carpenter man, now working all by himself, another 2 weeks instead of one to get back to the task. So the next time I go there, I have an OMG moment when I see him actually displaying the work he’s done. He’s come up with a list of materials that he will need to make the box and is waiting for me to provide the cash. And I find out about this 4weeks from handing the job in! So I ask why is this not covered by the departmental budget and he tells me he assumed I wanted it done quicker to save going through the procurement process. That’s when I find out that this guy is working without tools essentially. Every new job has to go through an inconvenient approval process, including the very nails he needs. Thankfully the list of things we need for my box are internally stocked and can be procured within a week. So next week, I drop in, you know the next bit... to check on the progress with the box. We now havethe wood cut up in the component pieces and enough nails to connect them, but something else is missing. A hammer! If I had one I assure you I would have hit my own head with it! The carpenter shows me the one he’s using, which is the equivalent of a fork without prongs essentially. There’s a handle attached to a headless hammer that’s only got the nail-pulling end still on. He must have had this for years without being replaced and he still uses it to hit big things. But nailing I’m afraid can’t be done lest we want a fingerless carpenter to stick to the theme! I’m assured thoughthat there is one that been ordered a while ago and which has been approved for external sourcing finally. Another week I say, that’s okay I’m busy anyway. So next week, (...), and I finally find a hammer next to the nails and cut up wood blocks and can only express my puzzledness to the carpenter as to why the hammer hasn’t driven the nails into the wooden blocks yet! And I’m told that he wanted to check everything with me first before ‘committing’. This isn’t amputation surgery, but I guess that when he’s handling material that’s so difficult to acquire as in this case, hewants to treat it as if it was. And indeed, upon checking, I find out my cursory initial explanation had been misunderstood, but there was no need for him to ask for clarifications then as he would have forgotten it anyway by now. This happens a lot here, for that precise reason: predictable unforeseen reasons! So one more week I delay and go back to find my man. Hallelujah, I see a box! But is has no lid. Why? He didn’t realise I wanted it so I could keep the box locked when not in use, even though it was on the drawing. So another week goes by and predictably, there’s a finished box with lid and even a lock , which I haven’t had to wait another week for. I reach out for it and realise it’s not ready yet. No! It’s yet to have the final touch applied. Polishing and lacquer. But hey, a large piece of sandpaper only cost about 25Kwacha (10p) and he can’t get it procured fast-track. So this time, I fish for the cash from my pocket and say get it when he’s in town. Next week, I find the box in the same state it was the week before. I’m told there is no sandpaper in town! I can’t believe it. But I just remembered I had some at home. This I bring to him the next day, but it’s not the right one and not big enough. So next week when I find him, no progress still! I’m baffled, not sure what the next move is. So I just leave things to move at the default pace of external procurement. Luck has it though that I had to go to town that week and in the shop where I wanted to buy paint, I find sand paper also on sale. Can you believe it? So I race back to Mr Carpenter and hand him by new found treasure. Why he couldn’t find it is a slight mystery but the following reasons are likely to be contributory. Currently a lot of shops are out of some stock or other because of the acute fuel shortage and his shop, probably the only one he’s allowed to procure from for the hospital doesn’t have it. Because initiative is not rewarded and he doesn’t dare to bypass the authority of the hospital even though I gave him the money (read job insecurity despite pathetic wages), he simply assumes the same situation applies across town. He’s probably been told that by the shop guys anyway. The frequency of stock shortage and malfunction (of equipment/ system) has over the years slowly eaten away at that vital human attribute called initiative. It is (sometimes rightfully) perceived as a waste of time, which could be better spent elsewhere. It is used by some to get on with personal errands that they would otherwise not have time to get done. Do you know that most Malawians I’ve worked with hardly ever take any holiday? They are entitled to it but becauseof their pathetic wages, often prefer working them so they can earn some locum money- and don’t be fooled into believing this is the same overinflated locum wages as replacement staff get in UK. This locum is a fraction of their normal wages. Each time I hear expats call Malawians lazy, I feel like suggesting to them to drop their wages to a measly £200 a month and do away with holidays for an indefinite period! Circumstances force a different work ethic within which opportunities are created to avoid burn out simply, e.g. a looser adherence to punctuality, extended lunch hours, time off for training and the all-notorious allowance culture. I’m under no urge to adopt these ‘mental-state-sustainability’ measures for I, like most expats, am only here for a couple of years and can work myself to the limit in this time. If I were told to continue at this rate for longer, I would certainly burn out.So even as we speak (10 weeks on), the box case ain’t closed yet, as the final stage of lacquering is still underway. But the shift of perspective it has engendered is quite apt, since I’ve literally had to think outside the box to even begin to comprehend the complexity of issues at hand here. Is there a part of it even I’m responsible for? Ifor all I stand: the Mauritian- African, Indian and muzungu all at once, the aid worker, the idealist, the perfectionist, each aspect coming with its own threat of interference. When so many external influences as we see in Africa more than anywhere else in the world come in conflict, one can see progress might be hampered rather than enhanced in the end. To simply bandy concepts like Dead Aid, neo-colonialism, slave trade legacy, economic and cultural invasion, global village, China in Africa and the state of international trade rules in one line is exceedingly inadequate. But for sake of illustration, it does the trick, that is to start thinking that all might not be due to the Malawian personality, including that of its leaders. Very importantly too, there’s a lesson, we, from the West, can learn from here- to be more patient, relaxed and tolerant of human imperfection. The rightway is always somewhere in between.The world is like the human body, where each part is linked and crucial to the functioning of the whole. It has been so since the beginning of times, way before anyone coined the term global village. The little toe going black is often not due to the toe having done anything wrong itself- it was dependent on blood flow to it being adequate...