My first 79 days

My first 79 days

Background:

My name is Michael, 30 years of age who moved 79 days ago to Tanzania, Africa from my comfortable life in the US, to work as a Leadership Development Coach (Lean consultant) for not for profit healthcare provider CCBRT on a 2 year contract.  I will attempt to summarize my experiences & thoughts on what has been the most challenging change in my life. 

Work related Summary:

I have got an engaged senior leadership team at CCBRT, what more can I ask for - this is every consultants dream. For a lean transformation to happen it must begin with the leaders - the one-one's with the CEO and his deputy and the 3 day workshop I co-facilitated with the entire senior management team has convinced me that they have the capacity to make the changes needed in their own thinking. A lean transformation to my knowledge has never been done in healthcare in Africa. For those folks that don't know what a lean transformation is my best and latest definition is that we are trying to create a continuous improvement culture with the organization focused on patient value. It's a journey that never ends, it will be new way of thinking, it will be tough, it will be difficult, it is necessary and it will be worth it. They will make history here.

Members of the CCBRT Senior Leadership Team 

Non-work related summary:

My priorities when I arrived. Find a house, find friends, find a football team and find a church (I'm not sure in what order that is). The house I live in - in honesty is ridiculous. I live in luxury. I share guilt when saying this but also honesty, I am content with the choice I made. I live in a western style compound of 8 houses with a swimming pool and high rise fence and 24-hour security. I am neighbours with UNESCO and the Russian, Swiss and French Embassy. I feel safe here. The house is a 4 bedroom castle and a good place for me to escape from the intensity of the city. I’ve travelled outside of the city to the island of Zanzibar and 2 local cities. I want to develop the routine of once per month escaping the city. I have now opportunities to play football (soccer) 4 times a week if I choose, swimming and playing football are my means of physical exercise so I'm relieved to have both easy accessible. There has been many (too many?) party weekends. 

High Point (work):

Senior Leaders beginning to Change their thinking: I got to teach a 3 day problem solving class to 16 Senior Public Maternal Health Administrators and workers. I co facilitated the class with my hero Dr. Brenda.

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Helping Healthcare Leaders think differently about the root causes of their problems

I will struggle to give you data to measure the impact this had on them but I saw enough evidence to say that this could be the greatest teaching moment I've ever had - they were so determined to changing their own ways. The goal of the 3 days was for them to reflect on the flaws of their current thinking so they stop blaming and start going to the maternal hospitals, observing the work and talking to the people who do the work. To be managers that supports their front line workers by being with them and deeply understanding the problems. 

Working with Team members on reflecting on how we do continuous improvement

Dr. Brenda has been in the maternal wards with them since and has in her own words observed a transformational shift in their thinking. The exciting part is that it is only the beginning of the journey for these managers as we (Dr. Brenda & I) have committed to give them more follow up mentoring and training. With all my heart I believe that this investment will make a difference in the maternal and infant death rates.

Teaching a 3 day Problem Solving Class to Public Health Workers

Low Point (work):

Tragedy at Temake: Temake Maternal hospital has statistics the no hospital in the world would envy (For the first 3 months of 2013: 4896 births; 13 maternal deaths; 169 stillbirths and 80 neonatal deaths). It was time for me to go see with my own eyes. The day will live with me for the rest of my life. To see a still birth being delivered and then two premature twin babies being left to the side to die was truly heart-breaking. When I looked at the patient records with Dr. Brenda & Dr. Yoni it revealed the greatest tragedy of all - the loss of life was preventable. As for me the images of blood on the floor, the unsanitary conditions, 3 women per bed, women lying on a floor, women screaming in pain, women in agony in silence, over worked staff, the broken management system they were working in and the image of the dead and dying infants has pierced my heart to the core. It's the greatest inspiration I have had in my life to continue with the work here. The human need is so great the suffering so needless. We can do something about it.

High Point (Personal)

Community: there are so many good people here, I have had the pleasure of meeting so many heroes’, so many people to be inspired by. I really feel lucky with both the house I live in and the people I share it with, we've become a family of sorts - cooking for each other, socializing together and being a community. I feel that too with the church I started to go to, it is so important to have people you can begin to call friends or at least begin the journey to friendship. I have been fortunate to meet fellow ex-pats willing to share their experience and knowledge with me so to better equip me to adapting to life here.

With my friend and Swahili teacher Fulgence

Low Point (Personal)

Loneliness. I must be honest here, however my pride would prefer to hide it. There have been many moments and days in a city of 5 million people I have never felt so disconnect from people. There is a disconnect with ex-pats and locals that is hard to explain but is a reality. Within the ex-pat community deep meaningful relations seem hard to find. I'm not saying it is impossible but it really is challenging. It has yet been a great lesson for me - that I have tested myself and know myself better. I am now spending more time in meditation and prayer reconnecting with myself and my creator, the solutions to my own personal struggles are not my external environment but lie within me. My personal pain is getting better but I feel it important to recognize it, appreciate it and grow from it. That's what I choose to do. 

In the community observing peoples struggles of a life in poverty

Mob Violence. Tanzania is one of the most beautiful places in the word with people that can no doubt teach westerns about the real meaning of life. However it would be naive of me to exclude an ugly side. I could tell you about how much widespread dishonesty is in the population as so many people including police and government officials are every day I feel out to rip me off. It can piss you off at times but with patience and experience I can see myself managing this with a smile. Witnessing Mob justice sickened me to the core. The thief (or should I say what looked like a 12 year old boy) along with the mob that were holding him only passed me by for a few seconds. What I learned was that he was caught trying to steal a mobile phone. When I asked what were they going to do with him, I almost got sick. They were going to beat him to the brink of death and then burn him alive. This punishment was the mobs way of dealing with crime in the absence of effective policing. How can this happen to this child. I am not here to analysis all these problems but I share this with you the reader. There is no simple solution. Wherever there is poverty there is injustice. The choice for the west is to act or not act.

What you can do:

Part of me wishes I could give you a very specific action that would make a meaningful contribution to this cause. Signing up to become a mentor in the Mentors for Africa program for example is one way to involve people who can't necessarily travel and be on the ground and is one of many ways you can help. Another part of me wants to give you a powerful quote that will inspire you. But instead ask yourself why are you reading this? What are you hoping to get from this, information, entertainment, inspiration? What change you want to make in your life? Decide to do nothing or do something. Whatever you do - do not procrastinate, you’re wasting your own time. 

Personal Message

Passion is the pain you are willing to endure to follow through on something that you believe in. Even though these first 79 days have not been without their challenges I believe that my purpose here is 100% intact. As I write this I fly home to be with my family in Ireland for 2weeks. It's the break I needed, however I can't wait to return to Tanzania fully charged to continue my work here. I alone am not a saviour of the issues here, my approach has got its flaws and I mess up and sometimes do more bad than good. Many more are serving far more effectively.  The human need is overwhelming and we don't have enough people, I will commit to making the best with the limited resources we have,  I will continually seek to improve, I want to get better, the better I can be as a person the better I can serve the women and children. They are my ultimate inspiration.