A<\/span>t the same time, in the opposite direction, a visa was organized for me at the Burkina Faso Permanent Mission to the UN in New York City, and I travelled to Ouagadougou. There, we organized an artistic workshop for ten local health professionals who work with vaccines.Everyone found a space to lie down on their backs on the floor. Then, each participant was given a brick-sized piece of fresh clay. Lying on our backs, the weight of clay on our bellies, the only rules for the next 30 minutes were to not look at the clay, just feel it with our hands, and so give it a form, all while staying concentrated and trying not to talk or observe each other. Of course, this was a bit of a surprise as an exercise, coming from a \u201cconsultant,\u201d but everyone obliged me, and at the end of the 30 minutes\u2014a very long time for such a strange activity\u2014I asked them to set the clay aside, still without looking at it, and then to join me again at the meeting table.<\/p>\n

The next instruction was return to the clay, see it for the first time, and after looking at it for two minutes, give it a title. The title could be a sentence, one word\u2014anything. We wrote the titles down by the clay and then returned to the meeting table. Next, we looked at each other\u2019s pieces of clay, giving each work an additional title of our own. We continued like this until everyone had given titles to all the pieces of clay, and then we met again at the table. The final, and perhaps most challenging, task was to return to our own clay, read all the titles, and then use them to compose a poem. Everyone took this job quite seriously, sitting individually and putting their texts together in less than an hour.<\/p>\n

After lunch, having gotten into the rhythm of what must have seemed to be a strange kind of work, everyone was curious about the next step. This was when I brought out my video camera and asked each person to perform their poem before the group and then read the poem to camera. Although everyone had agreed to be filmed in advance, doing it in this way surprised and delighted many of the participants. Indeed, if I\u2019d explained all the steps beforehand, the exercises would not only have lost a lot of their spontaneity, but also would probably have brought up a lot of resistance. Feeling our way forward, with hands and then eyes and then brains and voices, created a very different outcome.<\/p>\n

Improvising Scenarios<\/h2>\n

O<\/span>n the next day, we engaged in a more advanced exercise. In sessions of 40 minutes each, we created imaginary situations that targeted issues and challenges relating to the operation of the cold chain. In the first ten minutes, two participants sat in front of the group. One explained a specific challenge relating to the cold chain, simple or complex, while the other person tried to understand the issue and ask questions about it. Then, after ten minutes, the listener led the speaker in a 20-minute imaginary scenario. The only rules of this exercise were that they not directly mention the issue they\u2019d just been discussing (while somehow still dealing with the topic at hand) and that they both remain in the imaginary scenario for the whole 20 minutes.<\/p>\n

For example, one might ask the other, \u201cIs it OK that I walk with you?\u201d \u201cYes, come along,\u201d the other might reply. \u201cWhere are we heading?\u201d the first might ask, and the reply might be that they are going back to the village. It was the listener\u2019s job to keep the speaker challenged and engaged, so if the latter had trouble imagining what came next, the listener might say, \u201cLook, there is an animal coming this way. It seems to be carrying something! Look, it has a letter around the neck. Let me see\u2026Oh, I forgot my glasses, can you please read it? What does it say?\u201d And so the other would thus be invited to take up the challenge, reading, \u201cGo across the river and take the smaller path to the village. We are having other guests, so wait and watch from the hill until you get more information.\u201d<\/p>\n

Twenty minutes can seem a long time in such a situation. At the end, each participant took a moment to talk about the scenario, and then one person in the audience provided an aesthetic response, not clapping but offering some other gesture or some more elaborate reiteration of one of the elements we had all just observed. These sessions continued the whole day. Filming them allowed for another kind of insight\u2014more imaginative than analytic\u2014into the challenges of cold chains and into the people who operate and maintain them. Spending time and communicating in this manner with the end users of cold chains is uncommon; as I detail further in the next section, it is a way of recognizing their local competencies and their dignity as human beings.<\/p>\n

Following the visit to Ouagadougou, I returned to Norway, where I met up with Dr.\u00a0Mboane. Over the next few days, Dr.\u00a0Mboane worked with me to edit the first version of Upstream the Cold Chain<\/em>, based on footage taken in Ouagadougou.<\/p>\n

Some months later, I myself arrived in Niassa Province in the north of Mozambique after a one-day stopover in Maputo. Dr.\u00a0Mboane picked me up, and as a member of his staff and another fellow doctor happened to be on the same plane, we all rode together. I was introduced to the director of the hospital, given a room in a nearby hotel, and then given a tour to meet some of the cold-chain operators and see their facilities, cold rooms, storage space, vehicles, and the like. The next morning, I was introduced to the whole staff, and I explained to them, through a translator, what I was working on and what I planned to do. The day before, I had gone to fetch the clay, with the help of the translator, in a village outside town. Two young girls dug the fresh clay straight out of a nearby creek.<\/p>\n

The workshop went much as it did in Burkina Faso. This time, we did the first part outdoors. Having a tight schedule, I returned after less than a week, editing the video at a local video-editing office in Maputo, which we located with the help of a taxi driver. We worked overnight to edit the video with subtitles.<\/p>\n

A few days later, I travelled to Geneva to install and premiere the full video at the UNAIDS building and meet up, once again, with not only my colleagues on the project but also with Ms.\u00a0Sinare\u0301. After introducing her to the team, I screened the current version of Upstream the Cold Chain<\/em> for her, which included her, her colleagues, and the group in Mozambique, in order to give her the chance to veto any content or suggest any changes before the work was installed in the exhibition.<\/p>\n

Happy with the final version, Ms.\u00a0Sinare\u0301 and I discussed how we might introduce the work the next day at the special preview of the exhibition for dignitaries and heads of state. We decided to use the poem she had composed during the first workshop; she read the text in French, while I read an English translation:<\/p>\n

La main<\/em><\/p>\n

The Hand<\/p>\n

Toi, qui m\u2019aide dans tout ce que je fais,<\/em><\/p>\n

You, who help me with all things<\/p>\n

\u00e0 porter le masque sur la t\u00eate<\/em><\/p>\n

To carry the mask on my head<\/p>\n

Pourquoi es-tu toujours cinq, mais pas plus et pas moins?<\/em><\/p>\n

Why are you always five, but not more, or less?<\/p>\n

Parce que la main forme un ensemble indispensable<\/em>
\nDans tous les gestes.<\/em><\/p>\n

Because the hand constitutes an ensemble, indispensable
\nin all gestures.<\/p>\n

La main, toi qui ressemble \u00e0 la paume des pieds<\/em>
\net conserve tout, comme une caisse conserve l\u2019argent,<\/em>
\ntu es formidable. Je te dis merci, merci,<\/em><\/p>\n

The hand, you who look like the sole of the feet
\nand conserve everything, like a cash register keeps money,
\nyou\u2019re amazing. I thank you; thank you.<\/p>\n

car sans toi, les mains, ma m\u00e8re ne pourrait pas me porter au dos et ne m\u2019emmenerait pas \u00e0 la<\/em>
\nvaccination, pour que je recoive mes doses de vaccins.<\/em><\/p>\n

Because without you, hands, my mother could not carry me on her back and would not bring me for vaccination, so I could receive my doses of vaccine.<\/p>\n

Oh, la main, je t\u2019 adore.<\/em><\/p>\n

Oh, my hands, I adore you.<\/p>\n

Proud and without hesitation, she read the poem aloud with the full attention of the many attendees at the opening. Speaking in French, a black woman from a third-world country, not a formal dignitary but a low-paid, hard-working public health employee, a single mother dressed in Burkina Faso finery for the occasion, she represented her community, her country, and the poetic and practical hardships of motherhood and vaccination. It was an important moment, rewarding us all with a sense of integrity and of meaningful work well done.<\/p>\n