Thursday, April 26, 2012

Probably the last one..

It's hard to believe, but I have not written a blog since last July and it is now April.  I have missed writing the blog and feeling a connection with all those who followed my adventures thru the blog.  I have spent most of my time since returning, traveling around the country and Mexico, visiting family and friends and thinking about what else I might do besides just living.  Although I have some ideas, I have made no definitive decisions and thought I should somehow at least finalize my Sri Lankan experience.  I recently received the formal evaluation of my job performance and thought it would be fun and concluding to share it with you:

State your relationship with the volunteer, length of time known and frequency of contact : 

Nancy Shamban was a VSO volunteer in Sri Lanka from December 2009 to June 2011. I have known Nancy in my capacity of a VSO Programme Officer for 4 months and as a Programme Manager for 14 months. During this time, there were many occasions where I made contact with Nancy in a professional and social setting. The professional contact was the result of VSO’s project implementation, which ensured that I interacted with Nancy in a professional capacity while also giving me insights into her professional skills & abilities.  During the length of her placement in Sri Lanka, I got to know Nancy as a professional and flexible person, sensitive to the needs of the different communities, and committed to learning and helping others learn.

This has been completed in consultation with the mental health team of the Provincial General Hospital (PGH), Badulla including the Consultant Psychiatrist, Dr. Pubudu Pandithasekara, Medical officer Mental Health Dr. Sisira Bandara, Psychiatric Nurses Ms. Lakshmi and Ms. Samanthi, Development Assistant Mr. Nilantha Ratnayake and Support staff member Mr. Sunni. Nancy Shamban was known to most of them for her entire duration of service as a Mental Health Development Worker to PGH, Badulla. Especially the Nursing Officers had the opportunity of working very closely with Nancy.

Describe the main duties undertaken by the volunteer, the level and breadth of responsibility and the specific skills and experience required for the job:
The main duties undertaken by the volunteer included the training and support of Psychiatric Ward PGH-Badulla staff. She also supported doing some trainings in Moneragala which comes under the same partnership and VSO partner, Regional Department of Health Services, Hambantota. 

During Nancy’s  placement at PGH, Badulla, her duties included:

  • Support in capacity building, training coaching and mentoring staff in providing clients centered mental health care to service users and their families. 
                 e.g (a) Mentor Consultant Psychiatrist and MOMH two times a week and as needed especially on    the need for counseling for distressed, suicidal, depressed, anxious patients in addition to or instead of medication.
                  (b) Mental Health training program established and ongoing for all Psychiatric staff PGH, Badulla every Friday 

  • Supervision and mentoring 
e.g (a) Given to psychiatric nurses on an ongoing basis
     (b) Informal supervision given to support staff 
                 (c) Given to Psychiatric Social Worker in general and specifically around counseling patients and their carers. 
                   (d) Mentor and supervise Occupational Therapist around group activities for patients.
              (e) Supervise and mentor all staff going into the community to visit patients and carers and all    staff on the need to focus more on community care and involvement.

  • Supervision of the booster training on prevention & management of aggression & violence conducted by nurse/support staff to all staff.

To accomplish above tasks, one needs professional training in management with at least 5 years of experience. Planning and organising skills together with good leadership qualities, communication, with motivation and adaptability would be essential.  

Please rate the volunteer in the following areas, in each case using the space below the boxes to provide evidence and/or examples:
Level of professional /        
technical competence
Nancy’s experience and skills in psychiatric nursing helped work with the staff and clients of PGH Badulla  and to develop and strengthen a more multi disciplinary approach to working among staff and greater role clarity for the psychiatric nurses at the psychiatry ward.  
eg. She helped the multi disciplinarily teams in the ward rounds and shared experiences at the counselling sessions.  
Ability to work as part of a team  
Nancy’s role involved interacting with various stakeholders within PGH Badulla. This ranged from Psychiatrist, Medical officers, Development Assistants, Psychiatric nurses and support staff with varied educational background, training and experience. Her sensitivity and maturity enabled Nancy to work with all of these groups and ensure that they were able to work together to achieve objectives.  Nancy understood the context in which she worked by gradually building an understanding over the 18 months she worked on her placement. 
e.g. During the community visits to give medications, she worked with the team. She also actively engaged in mental health day celebrations and supervisions with the other team members.  
Ability to adjust to new tasks, situations and challenges
Nancy has coped well, adjusting quickly to living and working in a completely new culture. 
e.g Nancy wanted to start staff training on psychiatric illnesses.  It was difficult due to the nurses’ duty roster. However finally she could start Friday training and activity programme. 
Ability to accept personal responsibility and work on own initiative
Nancy was good on working on her own initiative and sets her agenda and structures to suit the partner organisation. For example, planning the training around the nurses and other staff shifts.
Nancy took a great initiative in networking with other stakeholders. E.g She explored the possibilities of getting people from Alcohol Anonymous (AA) to do some alcohol prevention programmes in Badulla. VSO Shared the contacts made by Nancy with the Director, Mental Health Services, and Ministry of Health at a planning meeting of an Alcohol prevention programme. 
Ability to lead and motivate others
Nancy has always supported all initiatives taken by the PGH staff and encouraged them in all their activities. Nancy was always ensuring that all levels of staff were represented in decision- making using participatory methods and always spoke up with the management to include staff and patients where possible. She did motivate the Development Assistant all the time saying ‘You can’ and pushing for that. 
Ability to communicate effectively
Communication in Sri Lanka is different to communication in other developed countries. It has been quite challenging for Nancy to communicate with her Sri Lankan colleagues especially when people are not very open and direct and don’t say what they really mean. For instance, people in Sri Lanka will never tell if they can’t do something. They will say yes to everything and after that nothing will happen. Nancy has learnt how to cope with these situations by understanding the differences in communication. 
Using the combination of good communication skills and a great sense of humour Nancy, in communicating with a wide range of people including medical staff, nurses, administrators, support staff, residents, families and colleagues with minimal English knowledge.
Ability to negotiate and persuade
Nancy is good at negotiating and persuading others. I have experienced this skill of her at one of the volunteer quarterly sector group meeting. She played a big role in bring some volunteers from negative attitude to a positive attitude. 
Commitment, enthusiasm and positive attitude
Nancy always thinks about the patient’s rights. It is a challenge that we face because we are a developing country. But she tried very hard to achieve that. Nancy had a very positive approach to work, was culturally sensitive and committed to equality and equal opportunities for everyone.  
Resilience and determination
She adapted well to a new cultural setup and work environment and handled disruptions to work with a positive frame of mind. E.g Most of the time she did home visits with the staff. She walked with the staff members to those houses. 
Nancy has not only been reliable in her tasks and meeting targets but has also helped the staff become more reliable and accountable team members.
Please use this box to highlight the volunteer’s key strengths and achievements in and beyond the placement including, for example, notable areas of personal and professional development, significant changes brought about by the volunteer and areas of real impact. This will help a prospective employer gain a clear sense of who the volunteer is and why they should consider employing him/her.
Life of a volunteer worker in a developing country is rife with challenges. These range from the professional, such as challenges of working in a foreign language and cultural differences within a work setting, to the personal, such as social isolation.  Nancy had to deal with the entire gamut of these challenges and she did so with a unique willingness to stand back and critically view her own role within this environment. Nancy’s key achievements in this context include, supervising and coaching the mental health staff members on a regular basis, trainings for staff,  networking with other organisations etc., 
Nancy has impressive personal qualities; she is resourceful, highly motivated, shows considerable perseverance in difficult circumstances and is an effective and supportive volunteer. She adapted quickly and effectively to the considerable personal and professional demands of working in Sri Lanka and I believe she is very capable of adapting to any future local or overseas role.
I recommend Nancy for any future employment.

Well, I guess that's all folks!!  From my heart, thank you all!  xx Nancy

Tuesday, July 26, 2011

Bad Nancy

     So it's like I was never in Sri Lanka and I have easily fallen into disgrace.  Yesterday I was with my cousin Helene and we were listening to Vince Gill a Country Western singer who is singing with James Taylor at Tanglewood on Monday along with Amy Grant;  I commented that I thought Country Western singers have ugly names.  I also commented that not only did Conway Twitty have an ugly name but he was ugly.  I also had  commented earlier in the day that Omar Kadafi was ugly.  Helene could not stop commenting on what a superficial being I was, talking about people's looks and names rather then the music they sang.  To make matters worse, later in the day I asked to borrow a soap dish to carry in my beautiful pink plaid utility bag and she took out a bright YELLOW soap dish and of course I said something like that would look ugly with my pink case!  The shame I now have to true superficiality has come out.  It didn't bother me squatting to pee or having no toilet paper or only cold water showers or people who couldn't buy the smallest item, like a soap dish, due to poverty..
     On the other hand,  I am hugely bothered by the ease of waste here and the lack of thought about it.  I was bothered in India but we know better here.  People's comfort seem so much more important than the future of the species.  I too get into it, I forget to turn off lights, I take long, hot showers, I have quickly forgotten how part of my daily routine was to boil water and then pour it thru a filter before I could drink it.  It is so easy to forget.
      I find I am not laughing as much.  I more quickly get into being a bit annoyed at this or that  infraction of life's minor trials especially interpersonal ones.  I am ashamed of that.  Life is soooo easy, it's crazy to not just be in the moment and joyous..I really have no problems.
     As a matter of fact I am feeling that having no problems isn't enough, I need to be planning something.  I am thinking of  running a contest for what is Nancy's future.  I certainly can't sit around forever just having fun and filling my days with going on trips and lunches, dinners, lunches, brunches..firstly, I am putting on weight, secondly although I am not a person who get's bored and can always occupy my time even living in someone else's house, there eventually needs to be a purpose.  I am not feeling a lack of structure per say.  I think it will feel good to be in my own home and after unpacking the 2 huge boxes which, after 4 months, have finally arrived from Sri Lanka, I see it will take me weeks to find places to put all the stuff I didn't realize I bought over the time I was there and will need to be put somewhere; anyway even with all that, a purpose must be found..TBC
     I have been forced to purchased an adorable car, a Honda Fit in white and I love her, her name is Baby.  My GPS is named Sadie.  Speaking of Sadie my great niece, I have also learned a new word from her which, since I have returned home, I find I have used a lot..the word coined by her is FLUFFING as in "Oh daddy, stop fluffing!"

Thursday, June 16, 2011

Too Easy!!

     What a  royal welcome home!  My sister Roberta and my cousins Helene and Lyn were at Logan airport with a bright pink boa, a welcome home poster with all things i missed like bagels, western toilet, cheeses, pizza, breads and a washing machine on it; and to top it all off, a diamond tiara to wear on my head. I wore it all evening.  I really felt like a queen.  
      I have been back a little over a week and it feels like a month.  I slipped right in and it is disturbing as if Sri Lanka never happened.  I am missing my life there, my friends, the staff, the patients, the routineness of day to day life in a rural town where there were so many hellos as I walked thru the streets, my routine in general; yet I am totally comfortable here and easily slipped into American life.  I have been very busy with fixing cameras, computers, getting glasses, shopping for a car, spending money in general seems very, very easy!  Supermarket shopping was really overwhelming.  There are soooo many products and choices.  It is too easy to get everything here.
     The weekend was spent at my stepson Scott's 50th birthday party, the reason I came back when I did.  I loved seeing the kids, family, Mari..that was so sad, so sad. What felt great was seeing all the grandkids and being welcomed and wanted and playing and laughing and making fun of their aging parents!
     It feels too easy to slip back into running water right out of the tap, no boiling, no filtering.  It is too easy to step into a hot shower that is actually hot and runs as long as you like.  There is also always toilet paper when you use a toilet, I don't have to remember to carry packets of tissues everywhere and I never have to squat, it's too easy to throw my clothes in a tub and they magically get washed; and I don't have to get carsick driving on unpaved roads that go to where you want them to eventually like 7 hours later.  
     Of course I have neglected to mention my final adventure in Sri Lanka which happened on my last night there.  My wonderful priest friend invited me to spend my last evening with him (truth is I invited me).  He lives near the airport so VSO drove me from Badulla to his house and he graciously took me to the airport at 2:30 AM.  We had a lovely evening and then I laid down for a few hours.  It was very hot so I laid down on my tummy with little on.  When I arrived in London, I became vaguely aware of feeling itchy and by the time I got home, I was very itchy on my front torso morning I diagnosed myself with bedbug bites!  Fortunately, I had put nothing but myself on the bed so I didn't transport any and I had a reminder of Sri Lanka for days to come!
     It took several days to unpack my 2 suitcases filled with stuff.  I had forgotten that I had filled my cousin Helene's closet and drawers with other stuff..what is all this stuff????  Probably half of it is a waste.  What is frightening is that I shipped two boxes of stuff that has yet to come..oy veh or ai ow...what will I do with that!!!  
     So the questions:  am I retired, when am I going back to NY, am I going to work, when am I going out West or South, what is my next trip, am I going to volunteer again, what am i doing with my life, how will I pay my bills????????????  Most important question, what should I do with my blog..I am open to suggestions....

Friday, June 3, 2011


It's happening way to fast.  I am leaving here Sunday, probably never to return.  6 months ago it felt right, now it is too fast, too soon, I am too ambivalent.  I now know what true ambivalence is.  Each time I am with Lakshmi, Samantha or Roshani, the nurses I am close to, I tear up.  On the other hand, Baby is not ambivalent at all.  She was taken to Roshani's house 2 weeks ago and when I was invited for dinner on Wednesday eve. and saw her she wasn't exactly unfriendly but she clearly loved them more!  The 2 children abuse her but she doesn't run away.  She hung out with them, she snuggled..I still think she is here, seeing her in shadows as I go from room to room.
Today is my last work day and it is the culmination of the 6 month mental health course started in December for all staff.  Everyone is getting a certificate.  Certificates are big here, people love them even if it is just for attending a half day of something.  I had really nice ones printed on beautiful paper with the logos of the EU and VSO on them.  They were signed by Dr. P. and me.  Before the last 2 weeks I was sort of wrapping things up, writing reports, making sure today would be ready, separating myself from things.  Then I went on my last weekend vacation to the beach.  I had a very busy few days in Colombo at meetings but also saying goodbyes to the staff and Volunteers.  They had a Thank You cake at the office and Anne, another volunteer had a party at her house to which a lot of volunteers AND staff came to.  I had been advised not to expect staff, they never come to these things, so I was quite flattered and happy.  On Sunday, I came back to Badulla and I have had no time!  Each evening I have been invited out to dinner to the homes of the various nurses and last night, Dr. P and the doctors took me to a restaurant where we could actually bring wine and drink with our dinner!  Ancy and I were the only women drinkers. We got into talking about the culture here. We talked about calling whoever is in charge Sir and standing up when those people walk by.  I am so embarrassed when patients' families sometimes stand up when I walk by.  I started thinking about the US in the 50s and thinking about when I was coming of age in the 60s and life felt like it was changing and growing and modernizing..there was great hope and I remember thinking naively how once things go forward they don't go backward because there is too much information and how it would never be the 50s again with McCarthyism and narrow mindedness, how the country had moved beyond that; and now it is happening again, the ethics and moral of our country are regressing and I feel so sad and afraid to come home.  
 Anyway, the days are totally filled with finishing final notes for the Psychiatrist, the Nurse Master, VSO, any case, as I said it is Friday morning and guess what?  I have not packed yet..but I am very organized as you can see from my final list.
Today I am somewhat anxious.  I am going to be dressed in a Sari by Lakshmi and we are having a ceremony.  We were supposed to end the program with  lunch  but all of the money we budgeted for it ended up going to decorating lanterns for Vesak for the competition at the hospital (we came in 3rd).  So we used the food money.  I was going to offer to get food anyway and then decided I needed to let everyone live by their decisions, we spent the money as they chose.  I have a feeling people will bring stuff anyway.  To be continued....

I am so overcome after this morning, I can barely pull it together. Lakshmi dressed me in a Sari.  The staff made a party and a member of each group said some beautiful things and I gave out the certificates and then they presented me with this amazing plaque for my work with them.  That's when I lost it.  Then I cried and as the rest of my time there went on other staff got teary eyed and one of the nurses who has hardly every talked to me and never showed any interest, came to the ward and had tears and thanked me and cried.  I was really shocked.  I have never felt so useful, appreciated or valued as I have felt this last year and a half.  I have also figured out how to ensure I keep feeling it; I just have to keep having good bye parties.  I just had good bye parties from New York and Boston and now Colombo and Badulla, I could just go to new places and after getting to know people and being sweet for a while, I leave and they throw me a good bye party and say nice things about me!!!!

Sunday, May 15, 2011

I'm over it!

    Okay, I am over it.  I got so much feedback basically reminding me that I am taking this PERSONALLY. It is totally true.  I fell into this subjective place where I made myself the center and got so disappointed and angry as if the future of this place is good or bad because of me!  I lost perspective.  One volunteer sent me this and I think it is so wonderful as a reminder to everyone:
  "There once was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day he was walking along the shore, as he looked down the beach, he saw a human figure moving like a dancer. He smiled to himself to think of someone who would dance to the day and he began to walk faster to catch up.
As he got closer, he saw that it was a young man, and the young man wasn’t dancing, but instead he was reaching down to the shore, picking up something, and very gently throwing it into the ocean.
He called out, “Good morning, what are you doing?”
The young man paused, looked up and replied, “Throwing starfish into the ocean.”
“I guess I should have asked: WHY are you throwing starfish in the ocean?”
“The sun is up and the tide is going out. And if I don’t throw them then they’ll die.”
“But, young man, don’t you realize that there are miles and miles of beach and starfish all along it. There must be thousands of them on this beach alone. You can’t possibly hope to make a difference!”
The young man listened politely, then bent down, picked up another starfish and threw it into the sea, past the breaking waves and said, “To THAT one, it made a difference.” "
     Actually, even hoping my presence made a difference to one starfish is still personalizing it but it is a wonderful story!  I can look back over this time, which I have done little of yet, but looking back over the times that I got a bit blue or angry or teary and I think it was when I got off center of what I was here to do.  I personalized.  Such a good lesson to hold onto. I asked 8 or 9 of the staff to evaluate me, VSO sent reference forms.  I asked some nurses, doctors, MSW, support staff to write them. 2 of the staff said my resilienceh was good rather then excellent because of my behavior around the bars being put up.  It was so unSri Lankan to have an emotional reaction and to talk about it for 2 days!  I have a list of things I still hoped to talk to the Consultant Psychiatrist and the new Master about.  I am not sure I shall talk to them now.  None of it is new, hasn't been said, it is stuff more to remind them..I am going to redo the posters that I had done in the beginning for  all the staff and hope they will put them up where they will see them but that is up to them.  The posters said:
     I am getting ready to go in the same organized way that I got ready to come.  I already shipped over 50 pounds of "stuff" so I really don't have that much to organize.  I have reports to write and things to complete and a bit of sorting so I am doing something each day to move forward.
     One of the nurses asked me if I had seen the lanterns one of the patients was making on his own.  She said as soon as he started making them he became normal.  Having an activity made such a difference!  Maybe one starfish?

Friday, May 6, 2011


     Well a few days ago I said in my blog that I was ambivalent about leaving, now, a few days later, I am not. I am ready to go.  In the last 3 days, literally, the nurses have had constructed, essentially, a prison for the women patients and they had a patient who was due to go home tied to the bed because she was wandering (wanting to go home).  It feels like my work here was a waste if the basic lesson of kindness and empathy for patients has not penetrated.  I have failed in the one way I thought I was successful, and it couldn't be more blatant.    The new Master is a tyrant, half the staff is talking about leaving, our wonderful doctor S. is hoping to transfer to be able to do more community work, our new Community Psychiatric Nurse who was especially selected (basically by me) is not being able to do her work and has asked to leave; she is up at night, not eating, worrying, feels unsupported by the other nurses, she needs to leave. Even our Consultant Psychiatrist, Dr. P, was describing the childish behavior of the other consultants, really like squabbling children and of course that leaves patients without care as passively fight over who is responsible for seeing them.  Little discussion happens between anybody to try to come to a more neutral place, people don't talk about things here, they just act out.  Maybe it is this way everywhere and I am very naive, it is possible I suppose.  I thought I was a realist but maybe I am a hidden idealist so I get so disappointed or maybe I don't understand the culture still, enough, or resistance to change or....
     I can learn new things however.  I have always watched people brushing their teeth and been amazed that they can walk around and not get wet, foamy toothpaste all over the place.  I finally figured out what I do wrong; when I put the toothpaste on the brush, I run it under the water before moving it to my's so automatic that now I have to be very conscious not to do it. I am now much neater at brushing and almost as a reward I get fewer ants in my sink if I forget to clean up the toothpaste because there is less of it!
     One of the staff, a guy who politically I am the most connected to, asked me if I wanted a party to celebrate Osama Bin Laden's death.  I was horrified.  In my mind his death can lead to more death as a reaction to his death, I can't celebrate that.  I have recently read this wonderful article about Paul Chappell in my favorite magazine, THE SUN.  He wages peace.  When I get home, I am going to study more about this. This doesn't mean I am against killing when necessary or being strategic to get the bad guys.  It does seem that money, power and greed are behind most bad stuff, for the leaders I really doubt it is religious or political idealism underneath the underneath.
     I finally understand the behavior of one person I work with that for all this time didn't quite make sense to me.  I now understand that without really admitting it or even being conciously aware of it, this person, an Asian, is racist towards whites.  I really am naive.  My landlord this morning asked me about my camera and I was telling him about a shop in town that had cameras for sale, he said no, not there, you can't trust the moslems!  It never ends (the isms).

Sunday, May 1, 2011


     Just heard Osama Bin Laden is dead.  I am glad about that but I am not jumping for joy.  The world feels, America feels, so dangerous to me now..anyway, not what this blog is about today.  I have been putting off writing, not sure why but maybe it has something to do with the fact that all of a sudden I have hardly any time left here.  I don't feel miserable but I don't feel happy.  It is happening too fast.  When I made the decision to leave after 1 1/2 years, I was feeling like it was enough, I had done what I could do and as time went on I must admit, I had done as much as I wanted to do.  Then, I don't know, there is so much to do, I have so many reports to write and meetings to have and things to do, I am running out of time.  I have my e ticket home, I have my final meetings set up at VSO and yesterday, Anne one of the volunteers I am friendly with, offered to have a goodbye party for me at her home in Colombo before I leave and I am thinking, I just had going away parties in the States, it feels like yesterday..Staff here are really sad and I know that it is highly unlikely that I shall ever see these people again and now I am sorry I am not staying until December but I suppose it would feel the same then as it feels now.  Ironically, in the last week I have met several new volunteers who came after January and  I just had an opportunity to spend time with them.  4 of them (2 volunteers and their spouses) are Canadian..finally I felt like I was with people who spoke the same language as me, we had a great time together and well, this is life I to cope, I am dangling carrots in front of myself, I have several weeks booked to travel already when I go home as well as James Taylor tickets at Tanglewood.    Oh well, fiddle de de, I shall think about it all in November.
     What I wanted to describe to you is what happened here over the Sinhala and Tamil New Year a couple of weeks ago.  Dr. S. had described to me that in his family meaning parents, wife, siblings, cousins etc. they celebrated by having "fun and games".  He described essentially the kind of games we play with children at birthday parties:  pin the tail on the donkey, greasing poles and trying to climb, ring toss etc.  He was describing adults doing this..doctors..and I so wished I had been invited. (Actually I had been but was in the Maldives that day).  Anyway, that week on the ward I was informed that the Friday program for staff and patients was to celebrate New Years and we were going to have FUN AND GAMES!!!  It was amazing, we played 15 games:  pin the eye on the elephant, fill water bottles with water and drink it, run to balloons and blow them up until they burst, be blindfolded (staff member) and feed yogurt to a patient, potato sack have to imagine staff and patients participating together in this activity in Badulla, Sri Lanka where staff stands when the psychiatrist comes into the room and patients sit and do nothing if the doctors want to suddenly call was marvelous.  It reminded me of those old films of 1910 or so at county fairs where life wasn't so busy and complicated and people played games and had picnics.   The greatest part of it though was that even though only 4 staff members not from psychiatry were informed to come to the program, about 50 or more ended up coming because word got around the hospital; even the head Matrons of the hospital showed up.  Also stigma is always a problem in the field of psychiatry and especially at a place like ours and because of holding this activity outside, many families, patients, visitors from other departments could see us and watch how normal the patients were and how we all interacted without fear. Anyway, it was so much fun and we were all is it that in the west, these activities are only for kids' parties, we are so very sophisticated aren't we.  
     Well it is 10:30 am and I am not at work yet, getting texts asking if I am coming..I shall miss that a lot.