Setting the bar

I had been struck by the cleanliness of the hospital grounds – it is rare to find the little plastic bags that are filled with water, and when finished, dropped on the ground. You see them everywhere, but not here.  As soon as you pass the gates of the hospital all the usual detritus is gone. According to one of my colleagues, this feat was accomplished by the director, irately, going from place to place and shaming people into cleaning up. Apparently it is an approach that works (enlightened dictatorship it is called – It works in Rwanda, so why not here). But it is an approach that makes me cringe.

I am still struggling to figure out what makes sense here given the many (and complicated) moving parts of the project created in Geneva. For example, what to do with the participatory management systems assessment that is supposed to be filled in by a cross section of the organization’s personnel? Should we do it even with two or three persons because I said so or because it is on the to do list? I realize the futility of doing the assessment as it would violate most of the basic principles of the tool. But then again, this has also happened with the leadership program in Madagascar, and yet, I was pleasantly surprised by its effects. As an alternative I propose to introduce it to the hospital manager, may be it is of interest to him?

We worked this morning on preparing the second of the ten modules of the leadership development program. It will be taught by one person I observed in Niamey and the chef here who is part of the Essential Management Package (EMP) team of Niger (two in Niamey, two here and two from ICRC). One of the members of the team here in Zinder prefers to be a participant.

At breakfast I asked my ICRC colleague what he hoped to achieve during this visit. We are setting the bar low to make sure we succeed. Some of those things we discussed at breakfast we achieved before noon: a formulation of what the team will achieve as a result of the program: to ensure a full multi-disciplinary package of services for all patients who enter the rehab center. Right now services are incomplete as there is no guarantee that a physical therapist is at hand to help patients learn to function with their new artificial limb.

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October 2017
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