PS letters, scandals, and strikes

As soon as I arrived in Zambia, people on our team were talking about how we needed “PS letters” to get various things: access to data, approval for funds, permission to share information, etc. I had no idea what a “PS” was, but I soon learned it was the Permanent Secretary of health, and that she would become a major figure in my life. Whenever we’re meeting with officials to ask for something, it’s critical to get whatever we need before they decide to utter the fateful phrase “Maybe we should get a PS letter for this” or “I think we should put something in writing.” As soon as the phrase is uttered, we know we have to give up entirely, because to get a PS letter for whatever we were asking for would jeopardize the other dozen PS letters we have pending for more important things. To get a PS letter, the process goes something like this: We write the letter of request for the letter, trying to sound as casual about our request as possible and as though it’s really for the good of Zambia, not the Harvard research team. Then we try to find someone at XXXX to print it for us, preferably one of the assistants we’ve gotten a gift for in the past week. Then we get two different XXXX officials to sign it, which usually requires several days of phoning to set up a meeting. Then the letter is sent up to the Ministry, where it sits in no-man’s-land for an unspecified length of time, before the PS eventually signs the letter without reading it, because who are we kidding, she can’t read every letter from every poor sap in the Ministry requesting permission to brush their teeth. Then, the letter is sent back to us, and possibly lost in transit, in which case we have to start all over again—all of which we’re told takes “no more than three days” but has actually never taken less than three weeks.

Things would only get worse when, in my second week here, news broke of a $10 billion Kwatcha corruption scandal at the Ministry of Health. Apparently, a Swedish donor discovered their aid was not being used for medical treatment for the poor, but rather perks and business deals for bureaucrats. The then-Permanent Secretary was placed on permanent leave, and we had a new Permanent (semi-permanent?) Secretary to deal with. Hilariously, the former PS wrote an open letter to the president not defending his innocence, but rather pleading that he stole the money (well, he never admitted this, but it was heavily implied) because he had a tough year and had so many “orphans” to care for because his siblings had passed away. Now whenever we need something from the PS, we consider including the sentence “It’s for the orphans” in our letter.

Another week later, all the nurses at public health facilities go on strike, followed by the doctors. I’m very concerned—both because I’m unsure how people are expected to get medical treatment in the meantime, and because “nurses” apparently includes the people who cook at the cafeteria. No shima lunches until fair pay for nursing is agreed on. Now, in addition to police searching the Ministry of Health, there are picket lines to further delay any actual progress. Oh my, I’m glad I arrived just in time for the country to fall apart.

An additional anecdote about how things here work: When the head of XXXX goes out of town for a week, I meet with her second in command to discuss strategic planning. During the meeting, at least ten people come in with things for him to sign. Not important, official documents—payroll slips. He tells me “With Dr. X gone, I have to take care of all these things.” What? The head of the XXXX spends a quarter of her day signing off on people’s hours? No wonder she never has time to meet with us!

PS. (Not that kind of PS, thank goodness) By the way, I’m really happy at Phyllis’s place. Somehow, however nice Richard and Andrea were, I always felt like it was their house. But here, now that my rent is paid fair and square, I feel really comfortable. I can cook in the kitchen, sit and work at the table, hang out with the girls, etc. The fact that I’m comfortable despite having to heat the water for my bath on the stove and observe an increasingly diverse array of wildlife in my room tells you that it must be pretty nice.