I can’t believe six months has already gone by, half way through the fellowship already. Cliché as it sounds time really is flying by.  We just finished our mid-year retreat for Global Health Corps here in Rwanda and it was great to see the GHC staff and fellows from Tanzania and Malawi. One of the really cool things we were able to do was cross site learning; discussing our work’s challenges and successes.

This year many of us are working on supply chain issues and one re-occurring theme that will impact my work for the next six month is supply chain data capture. This data capture is essential forecasting pharmaceutical and consumable needs, as well as tracking stock management improvements.  In many in country supply chains in the developing world, the management of supply chain information is insufficient impacting everything from the central medical stores to the patient.  Without adequate information the health centers, district pharmacies, and central medical stores are unable to manage the supply chain efficiently.

In light of these problems, my main project for the next six months is data collection and forecasting for the district of Burera. I’ll be supporting the district pharmacy in supervising the health facilities in the district (health centers and health posts). This supervision tracks consumption, as well as stock management data, thus improving supply data capture and assessing stock management. The hope is with regular data capture, the district pharmacy will have a better idea of the supply chain reality within the district, be able to track stock management improvements, and enhance supply chain data to improve forecasting of pharmaceutical and consumable needs.

As the Burera pharmacy manager and I often say ‘petit a petit’ or little by little. It sometimes feels daunting when you see all the of the challenges that in county supply chains are facing but hopefully in the next six months we can really make an impact little by little on the supply chain here in Burera.

I just read a great article sent to me from my GHC mentor about product design and wanted to share: When Technology Flops: 6 Common Pitfalls for Product Design for Social Good

Pitfall #2 hit home for my project.

Pitfall #2: Using technology to solve a culture-based problem. Sometimes, the most fundamental issue isn’t tech-related. For instance, female infant mortality in many countries is largely the result of cultural value systems rather than lack of sufficient healthcare (although the latter is necessary as well). In these cases, well-designed medical devices aren’t going to solve the underlying problem of gender-based discrimination. Other forms of intervention are necessary for changing people’s mindsets.

Though there are many technologies that can and will help the health system in Tanzania, so much more work needs to be done that isn’t based just in developing a technological platform or tool. Unfortunately, solving culture based problems requires changing cultures which is often a much more difficult challenge to tackle with a more nebulous path towards a solution; especially when you don’t know the culture you’re trying to change that well in the first place.

Fortunately the GHC system for pairing local and American fellows has been incredibly helpful for navigating cultural issues and Goodluck and I are starting to see some real seeds of change.

Check out Paul Farmer, co-founder of GHC partner Partners In Health’s, recent congressional testimony on the opportunity that the horrific tragedy in Haiti represents to rebuild a stronger, more stable and more prosperous Haiti.  His remarks focus on the need to work with the Haitian government in rebuilding efforts and prioritize job creation as a means of not just rescuing Haiti from this current crisis, but investing in long-term development:

“In other words, if we focus the reconstruction efforts appropriately, we can achieve long-term benefits for Haiti. The UNDP is helping to organize programs of this kind, which should be supported and extended around the country. Putting Haitians back to work and offering them the dignity that comes with having a job and its basic protections is exactly what brought our country out of the Great Depression.

This was always the right thing to do, and aid programs persistently fail to get it right. So here is our chance: if even half of the pledges made in Montreal or other such meetings are linked tightly to local job creation, it is possible to imagine a Haiti building back better with fewer of the social tensions that inevitably arise as half a million homeless people are integrated into new communities.”

Check out this link on the importance of good management and leadership for improving health outcomes in the recent issue of Global Health magazine.

http://www.globalhealthmagazine.com/cover_stories/leadership_and_management

If 6 months ago you had told me I’d be posting articles about management on this blog, I probably would have politely nodded and internally thought you were nuts.  Management has never been my strength.  But this year I have become increasingly convinced of not just the importance of good management, but the centrality of it, for producing effective results.  Good management can look different in different countries, different organizations and with different personal styles, but whatever it looks like, I think strong management and leadership is essential for motivating a team, driving a vision forward, and making change happen.

As you’ve seen from the fellows’ blogs over the last week, we just finished our mid-year retreat in Rwanda. It was absolutely amazing. Fellows came together to share stories of challenges and successes, we discussed great new paths for GHC, and we all left feeling regenerated and excited to return to work.

That’s why I’m embarrassed to admit that we had several conversations in the office about whether or not we were going to do the retreat at all. Finances are tight, and we badly want to offer more fellowships next year. While we’re proud that so many people applied, and that our fellows represent the top 2% of applicants, we so badly want to offer this opportunity to more people.

In the end, we decided we needed the retreat. Our mission is to mobilize a global community of emerging leaders to build a movement for health equity. Our mission is not to provide as many fellowships as possible. While we must scale to a much larger size to build a movement, and meet the massive demand from young leaders who want to serve, providing placements with great organizations is only the beginning of it. The real power of GHC is and will be the community.

The fellows left with new ideas about how to improve their work. Jafari and Isaac swapped ideas about procurement. Mark and Edwin taught all of us about electronic medical records. The cross-site learning was really special to watch.

But more importantly, the fellows, and us on staff, left with higher spirits, renewed determination, and an even closer group of friends. This work is hard. Maintaining a sense of purpose and a sense of optimism is so important. And, cheesy as it may sound, being able to do this work alongside great friends you love and respect is an absolutely amazing feeling. GHC is not about what we all do in this year, it’s about what we do over our lifetimes. It’s this feeling – the joy of being in this community – that gives me faith we will all continue this work in the years to come, and build a true movement.

Our very own Dave Ryan caught up with the Clinton Global Initiative University team about what the GHC organization is doing to address health issues in both the developed and developing world.

See the article here.

Here’s a sample from the article

“There is a need for skilled professionals who can provide the services necessary to build and implement effective health systems. The young leaders who participate in Global Health Corps have experience in a range of fields, including technology, supply chain management, monitoring and evaluation, and program consulting. We place them in organizations where they can implement innovative strategies to build effective health systems. We also nurture them so they can explore careers in the health care field that fit their skills.”

16th January 2010 was an important day for Global Health Corps (GHC)! This was the day GHC organized its first retreat since the organization was founded. GHC has fellows working in Africa and the USA, and it was the African retreat that was organized first since the majority of the fellows are working in Africa, i.e Rwanda (8 fellows), Tanzania (6 fellows) and Malawi (2 fellows).

It was thoughtfulness and foresightedness of the leaders of GHC to have this retreat take place! First of all, we had spent six months in our placements. A lot had taken place in terms of our adjustment and integration to the work environment and the partner organizations. How we faced the work challenges in our first months and the approaches we took to overcome those challenges was essential and had to be shared not only with other fellows but also the GHC leaders so that it would help them refocus their mission.

Cross-sites sharing came out as an important approach for the fellows to share the challenges from different societal settings and different work environments and ethics. The approaches to health problems in Rwanda are different from those in Malawi or in Tanzania and it was vital to understand the cultural, political and social setting of these problems and how home-made or borrowed solutions are used to address these health challenges.

It was quite refreshing how huge mounds of problems became very manageable after sharing ideas, approaches and solutions from other fellows who had experienced same problems or gone through same situations. Equally humbling was the fact some challenges became insignificant in respect of what the other fellows were facing!

I couldn’t come to imagine setting in motion the Expert Client project of CHAI in malawi and managing the challenges involved, understanding the health management information systems  of a remote island off the coast of Dar es Salaam, getting involved in organizing and running a new and important multi-country infectious diseases surveillance organization that would be the epitome of an africa-led rapid response to infectious disease outbreak, understanding the intricacies involved in Government-Donor supply chain of  central medical stores nor was I in position to solve issues related to cooperatives that support the important work carried out by Community Health Workers!

By sharing all the above challenges, every fellow came out of the retreat with a new focus and a new way of approaching problems. The retreat set a platform for teams (pairs) to find constructive moments to reflect on their work and how their contribution has impacted on health care delivery in their respective GHC partner organization. The same platform made it possible for the fellows to set new individual and team goals and the integration of the borrowed good practices in their refocussed vision.

And the retreat was closed with a GHC Hiking For Health of Bisoke Volcano Mountain (12175ft) of Rwanda. For, in order to  promote global health issues, one needs a health body?!

On the way up the Bisoke Volcano

On the way down Bisoke Volcano.

Things are moving along here in Newark. Just wanted to share a quick link with you all so that you can get a feel for the work that we are doing. January has been a very busy month and among other things, Richard and I have been working with some of the IT team in the library to create a Health Literacy Dashboard that will be accessible online and be a quick link as part of the clinical desktop on all computers in the hospital. This way providers will have information at their fingertips. It is still in development and will soon be populated with more information. This will include maps of the hospital, communication techniques for providers, and health information that is appropriate for those with limited health literacy.

We would love to hear your feedback so that we can improve on this basic dashboard.

Here is the link: http://mediacenter.umdnj.edu/LiteracyDB/index.html

We just had a great GHC conference in Rwanda where fellows met to share challenges, experiences, and solutions. Here’s a quick update:

Folks looking for more information about next years fellowship positions feel free to leave a comment, contact me directly, or check out the application page at http://apply.ghcorps.org/