civil society

I had the absolute honor of listening to Dr Brudtland speak to the WHO staff this afternoon.  Prior DG herself and prior prime minister of Norway, she was a woman leader who was comfortable with being a woman and a leader. And she left me with much to think about US society…

A WHO staff member said she was from Kirgizstan and was with election observers from Kirgizstan when they were in Norway. They noticed election booths were not guarded, the electricity went out once, but no one cheated.  Norway couldn’t understand the questions or concerns the observers from Kirgizstan had.

Then she said, health concerns and corruption go together in many countries- “what is it we can do in Kirgizstan so one day, the first thing you don’t think of is how to cheat if no one is looking in your voting booth?”

This is what Dr. Brundtland said:  “Norwegian voters are used to behaving themselves, and a democracy where there is transparency, and they know that they can only deliver one envelop with one list.  Many people would not even think of trying to fool the system.  Norway is an inclusive society and has been for the last 100 years, building stone by stone, a solidarity base.  A welfare community where people are responsible for each other, where they are willing to pay taxes, where we have UHC and a good education system.  People feel they have a society that works for them.”

“The elections in the US and maybe also Brexit are an example that people are very frustrated, they didn’t like what has happened in their lives in the last 20 years or so, so the candidate that told them lies, they went for him because things had not gone on so well.  Increased taxes, with the middle class falling behind, and the middle class thinking their children couldn’t have a better life then they did.  It’s an example of how democracies can be set back if people are not taken care of.”


So much to think about there….


I need to pull away from life sometimes.  I don’t think it is distracting myself from life as much as escaping.  It could be a long wandering walk in the woods, or laying on the beach with a book and ending up letting the sun and wind put me to sleep, or walking in circles in a distant city,

My life has been moving rather fast lately.  Moving out of my little apartment, moving to Geneva, visiting Paris, now the World Health Assembly, next weekend Barcelona.  I am meeting such amazing people.  When that happens I start to wonder, what do I have to offer?  I don’t really have a tribe here.  I suppose I don’t really have a tribe anywhere.  I wander partly because I have nothing to tie me down.  I need to find a community here, even if it is just for a little bit.

How does one create community? Most the time I think I am so much in my head, I cant keep up with the world around me.  I suppose that’s a habit we must all avoid.  So here is my plan- get up, go to work, come home via the lake and walk and talk to someone.  Then come home and plan to rent a bike next week to explore more. Its hard to get a routine when things are so busy, but Ill find a yoga around here and perhaps run or ride and get out of this interior place I seem to have created by default,



70th annually WHO World Health Assembly has begun.  Sitting on the edges of this amazing organization is an interesting view.  The people I have met are some of the most intellegent and committed people I have ever known.  I love being with them, discussing health for the world.  Struggling with issues of  gender inequality, research quality, health disparities, nutrition, humanitarian responses, epidemics, violence, environment, health work force, policy, and effective education, implementation and evaluation.  And now the world’s delegates have arrived.

To have the world gathered, all treated formally, calmly and with a ritual of significance.  They create recommendations, guidelines, policies, strategies, white papers, reports, initiative and evaluations- all without any legal ramifications if not followed.  Yet presented with such presence, there is almost a sense of shame if you don’t consider them significant.

At the opening, a speaker from Ukraine objected to Russia’s participation in the life affirming activities of WHA, and requested their statement- including a reporting of Russia’s violence- to be formally placed in the record.  And then the event continued.

I know I hear others complain of the slowness of response, the bureaucracy of WHO, but it is hard to imagine it responding faster.  This past year they responded to over 600 “health emergencies”, I received an email alert about rising levels of malnutrition and starvation in Africa, the bulge in population of adolescence and their unique health needs, and it goes on.  In just over a week since I have been here, I have heard of many new initiative just starting, while others are trying to get finished, and fires are dealt with- all of that while being understaffed.

I suppose it’s obvious I enjoy the Public Health more than I ever imagined.

Walking back in time

Spaces offer too much time for reflection

Of times past

When edges were clear

And cut to the core

A home, no longer a home

Now childhood near

Fathers gone

Husbands a mirage

phones rang on holiday’s past

With tears and cries

Trying to forget
Losses and trials

Offering  growth and grace

Or so we tell ourselves

I tell myself

What’s he best choice

For what we do not choose
Now here we wander

No plan or place

Homeless, childless, jobless

All identity stripped away

And you ask what I want-
To be loved and cherished

Wanted and desired

Ah, but that is not

What you are asking

Today, this moment

I want memories here

To wash away pasts

And create a new one
To find myself in my past

Running away

But always finding myself back

Trying to work out

Losses and trials

I never chose


There is part of me that whenever I find myself in a new space like last year at school or now at WHO, surrounded by these amazing people, I feel like a fake. My confidence falters and I wonder if I have anything to offer. I’m stubborn enough that I open my mouth, and still I wonder- did they all know this already? Clearly I’m so naive, I’m just stating the obvious. And I continue to feel foolish.

This time I’ve been blessed by amazing midwives. And like an amazing midwife, they encourage my birth. Supporting my tentative questions with generous statements like, “those were good questions”. So often I wonder what did I do to deserve such kind and amazing people and opportunities in my life? How blessed I feel. 

I wonder at times if it’s a female thing, this imposter syndrome. But I’m reminded this week that everyone faces power inequities in life and struggle for significance- to themselves and those around them. 

global health

What a wonderful day.  First, I have been so blessed with this amazing weather the last few days.  Second, I have been so lucky with all the amazing people I have met!  Yesterday I met Kathleen Hill (of the RMC Landscape report) and Peter Johnson from Jhpiego (of the Effective Inservice Training report) .  There are so many amazing people here.  Last night Fran and Peter and I had dinner and after I spoke at length with Peter about capacity building.  What insights.  He spoke of technique, timing, location and media as being important for interventions and monitoring and assessment being key to capacity building.  It was brilliant.  Kathleen and I had a coffee today and she spoke about not getting to lost in gender inequality- yes, there is a gender inequality gap, but there is also poverty, education etc.  I agree with her. men need to be addressed as well, all of humanity has a right to respectful and compassionate care, but I guess my heart will always be with women and the inequality they experience.  If there is poverty- they feel it deeper, if there is lack of education, they experience it to a greater degree.

I haven’t had a chance to do much writing yet- just a short note for the WHO newsletter about ICM and a flyer for ICM, but I am trying to get myself prepared- thinking about, vocabulary, style, organization and presentation.

I miss being able to talk to my family, but the enforced quiet nights are also very liberating.  Although I am looking forward to Paris this weekend.  🙂


My first full day in Geneva and I am smitten.  There is a sense of thinking about others when you are surrounded by organizations such as the UN, the HCRC, and WHO.  Part of it is the culture in Europe.  Even trash is dealt with in a way that take effort- separate out everything, recycle and compost.  Working for the greater good takes some effort, but no one says a word, it is just what you do.  Oh I know everything is not perfect, it never is, but its prioritizing things that take effort that impress me.

I am working on a few large projects: A survey of evidence for midwifery education around the globe (with a rapid systematic review of current evidence.  Preparing for the research meeting prior to the ICM- prioritizing research for midwifery.  And the Essential Childbirth Care Course- haven’t heard much about that one yet.  I love working with so many people who really take their job seriously.

Looking forward to tomorrow!

An uncomfortable mother

I have always believed there is a value in making oneself feel a bit uncomfortable.  I find I learn so much about myself and life when I am not afraid to be a bit uncomfortable.  As a child, fresh out of the pool, heading home in my mom’s 1979 VW bug, the seats were so hot we had to sit on our towels.  But the air, the air in the closed car was like a wall of heat.  I remember sitting and slowly breathing it into my lungs, feeling the air molecules as they. went deeper into my body.  It was an amazing experience feeling the air so clearly because of its heat.  Other kids would complain, but I sort of relished it.

When my kids were little I ffirst heard of mom’s not believing in vaccination.  At first I was appalled and enjoyed that sense of self righteousness that goes along with little like life experience.  Then a few months later I came across an article about vaccines, this was back in the days of the original DPT shot, before they revised it.  IT spoke of the very rare, but nevertheless serious side efffects.  At first I quickly turned passed the page, but then later found myself drawn to the feeling of being uncomfortable with something and knowing it meant I had something more to learn.  SO I read it.  Through the years I have thought a lot about that day.  It opened my mind to so much.  In the end I didnt change my mind much when it came to vaccines, but I did discover integrative medicine, organic (back in the late 80’s and early 90s) and, my passion, herbal medicine,

And now, I am back in school.  Racking up a healthy student loan debit, and pushing my tired brain, so comfortable with its way of life that it often fights me and the changes I am imposing on it.  And to be honest, I am afraid.  I am afraid I dont know enough, I am not thin enough, I wont speak well enough or write clearly enough.  ANd of course I am stubborn and am very passionate and way too earnest- all of which can cause problems when you are trying to come off as a professional who is calm, controlled and competent.

SO I am heading to make myself more uncomfortable.  As I held my baby girl in my arms, her baby bulging, straining to make it presence here in just 6 wks, I almost cried.  I wanted to cry because I am scared, because I want to hold her as she pushes this baby out and because I want to push myself out.  We are all in the process of creating ourselves, yet this feels significant.  I feel. So uncomfortable, so out of my comepetency zone, so alone in the end, that I must push myself for out.

Dear Leo, be kind, gentle and quick.  Sweet lovely little girl/mamma, forgive your mother’s wandering ways. My heart aches to be with you and to find where my path is leading.  They bath matter so very much to me.  Please know how desperately difficult this was and how I left part of myself with you.

I’m not sure where this path is taking me…

I’m not sure where this path goes. Actually I suppose we really never know. But it felt like I knew what path I was in before. Is that because I was following the approved path for me?  I feel like everything has become a possibility for me. Wandering off the standard path, my children grown, suddenly free, renting my home, selling my car, quitting my job- and now, done with my first year of doctoral school. It can be rather dizzying actually.

This summer I am heading to Geneva to do my summer practicum with WHO. I m so excited and have so many questions- what do they do? Will I have anything to offer?  What will the General Health Assembly be like?  What about ICM?  Can I offer any impact for birth centers and midwives? At that start of grad school there were moments I wondered what I was doing.  Yes, I love catching babies and I know what I am going and I felt confident.  Suddenly I was like a freshman in college, doe eyed, a bit lost and knowing absolutely nothing.  My classmates, although clearly very much younger then I was, seemed to know so very much.  There was a new language- M&E, outcomes, behavioral change objectives, cohorts, causality, linear regression, vectors…I found it fascinating and at the same time felt I was nevver going to grasp this new world.  I was so used to being competent and suddenly I was a novice, but a really old one.  What had I done?

I knew for certian, I wasnt going back.  I didn’t want to go bac to that life.  It was a good life.  I really loved it while I believed in that path.  But suddenly the world was possible, and I wanted to expolore it all…so, here I go.

Grad school blues

Attempting to figure out what I can actually do, and what I do really terribly, seems to be the point of grad school.

I have this problem. First, I am curious and get excited and passionate about learning. Learning anything. And I somehow have this crazy belief that most of the things we do in life are intuitive.  Or if not, I just follow the recipe or directions. I can bake a cake, so I can put in a new electrical panel. I can make a fancy cake, so I can take intermediate epidemiology. Um, no.

Then life in grad school becomes a series of days I am just disappointing myself over and over until I am no longer sure why I am here or if I am good at anything at all.

And it feels very lonely. I came here because my life was turned upside down, because I was devastated, and I wanted a new life I was in charge of. Because I thought my heart was broken, but instead I found out my expectations were let down and my heart was free to live and love and be who I am.  Because I want to do global work. Because I love working on respect and compassion and with midwives.

But I’ve always felt like an outsider- and now I’m a 49yo woman going to college. So I list what I am good at:
Explaining things, being passionate, seeing connections between things, the larger concepts at the core of someone’s argument, and education. Oh yea, and catching babies 🙂

Will that be enough?