January 10, 2009

On Work

My God, people sure are lazy around here!

Alright, so that was just to grab your attention. No one can watch how hard people work here just for daily survival and believe they are lazy. But… the other day I went to the hospital where we get our mail and saw a big pile of post-holiday mail waiting to be sorted. I left and came back later in the day to check again. Still, the pile was just waiting there. I came back just before the day ended and the gigantic pile of mail was just sitting there. Frustrated, I asked the two employees why the mail wasn’t sorted. “We are busy,” replied one. As he spoke, he was staring off into the distance, his chair pushed back from his desk, and doing absolutely nothing productive, except, I imagine, counting down the minutes until he could go home. His co-worker was reading a sales flyer. I wanted my mail so I sat down and began sorting through the pile. I think in the U.S., I either a) wouldn’t have been allowed to do that or b) would have generated enough embarrassment in the employees, they would have sprung into action. Here, the employees just ignored me and thought to themselves (I assumed), “thank goodness he is doing it for me.” Later, a new employee showed up and asked to borrow a pen. I said she could have one when the mail was sorted. That didn’t make me very popular but I got my Christmas cards and was on my way.

I see this approach to work in virtually every day around town. Sometimes when I interact with the nurses who are the prime movers in the health system here, I am stunned by what I see as a lackadaisical approach to their jobs. After all, if there’s anything that has ever made me believe in Martin Luther King’s great phrase “the fierce urgency of now,” it’s waiting in a hospital with a sick and dying person. There’s millions of dying people all over the country but it seems to me at times that there’s no urgency in confronting the issue.

One explanation is simply cultural. I’ve been told before here “you hurry everywhere” and that is certainly true compared to the pace of life here.

Another possible explanation is general work weariness. After all, I only see a handful of the patients that the nurse who runs the ARV clinic sees and I’m sure she is more than a little bit overworked by the burden of the people who come to see her. This is fair and might even be a useful corrective to my sometimes charge-ahead attitude to patient care.

I think there’s another kind of weariness, though. Life can be exhausting here. It is likely that a nurse - or any employee I encounter in my day-to-day work - has several people at home to support. Maybe a sibling has died so she is raising her own children and her nieces and nephews. Perhaps one of her children has already had a child so she is now both a mother and a grandmother. Because jobs are relatively scarce when someone gets one he or she likely ends up supporting a tremendous amount of people. (In Itipini, I sometimes think the most effective thing we do is pay salaries to our dozen employees. That money supports a huge contingent of people and I always marvel at how far our employees can make it go.) In addition, the work of daily survival is harder here. Washing machines, running water, and stoves that turn on at the flip of a dial are not as readily accessible here as they are in the rich world.

In this context, showing up to work might be a bit of a relief from all the pressures of life at home. If the daily battle for your own survival and that of your family is so exhausting, perhaps when you get to work you don’t have the energy to charge full-speed ahead every moment of the day. Several times when I was a volunteer EMT and had a few calls in the middle of the night that significantly cut into my sleep, I would show up to work the next morning and pray for a quiet day in which I could spend a chunk of it staring off into the middle distance and doing nothing in particular. Is there a similar dynamic at work here?

The trouble is the scale of the social problems in this country require an “all hands on deck” approach virtually all the time. There’s not a lot of time for middle-distance staring. There are people dying in the hallways of the hospitals before they can be seen. And it’s not just nurses who confront this challenge - government bureaucrats, teachers, and so many others need to pay concerted attention to their jobs.

I’ve been working up the justification I’ve just presented for virtually my entire time here and I think it is a sound one. And yet… sometimes I just can’t get past the belief that people here are complete slackers. If “African problems demand African solutions,” as I have come to believe, how do we arrive at those solutions with a bunch of people whose work ethic is something less than what I think is required?