This was my first quarterly presentation. I was given a copy of the power point
presentation of quarter 2 as an example of what to be expected for the
presentation. No one told me the objectives of this exercise but I gathered
that it is a forum for updating the quarterly data but more importantly it
should also be a place where constructive action plans should be put forth for
the fourth quarter although already one month late since the report was
scheduled a month into the fourth quarter.
Even before the meeting, MSF staff was busy preparing the
data for the presentation. The MSF data
persons made several trips to the East Bank to gather the final bits of
data. I worked on my mentorship part
with my mentors and learned that in the past MSF prepared the presentation and
the Ministry of Health (MOH) staff presented because this was supposed to be a collaborative
effort. Already this was sounding all
wrong to me. The preparation should be a
joint effort but that I was told this could never be accomplished because the
MOH staff has generally not be able to rely upon to appear to work on a project. So eventually the following scenario
develops: the MSF staff succumbs to time pressure and analyzes the data, makes
them into pretty slides, outlines the challenges, the accomplishments and the
action plans all without the input of the MOH.
Is this really a collaboration?
For this third quarter, a day or a few days before the
presentation after numerous phone-calls, text messages and e-mails, you asked
nicely, cajoled, reminded the MOH presenters they needed to go over the slides
with you before the day of presentation.
Even after all that the HIV coordinator warned me that he might not be able
to come to present, he might have to ask the ART coordinator whether he could
kindly do it. I often wonder why you
need a HIV and an ART coordinator, why can’t this position be held by one
person?
What are the reasons behind this MOH staff’s inertia? Is it
because through experience over the last few years that MOH staff has learned
MSF will follow through and not fail to present a finished product even if they
themselves (MOH) don’t lift a finger? Is
it because of a lack of commitment? Is it a leadership issue? Or the universal issue of ALLOWANCES? Would
they come and knock on our door to help prepare the presentation if we said we
would offer a handsome allowance? In my long discussion with my staff, it is
all the above and perhaps some other unknown reasons.
MSF has always taken the leadership role in this supposedly
collaborative effort. My observation of
the mentorship program in my first couple of months here gave me the distinct
impression that MOH mentors are just as content to let MSF lead and they themselves
take the back seats. The mentorship program started in 2011 and I came in at
the end of quarter 2, 2013. Initially MSH and MOH were supposed to jointly come
up with a monthly work plan but now it has become an MSF originated work plan,
waiting for MOH staff to work together to formulate one did not succeed. They either did not show up or assumed that
someone would. Days, weeks and even
months would pass and nothing concrete would come about so by default MSF
filled in the GAP. Even now the HIV coordinator has not been able to assemble
his mentors and he himself has been known not to show up for meetings that he
arranges. There is a lack of commitment
on the parts of the MOH mentors and a lack of leadership on the part of the MOH
Mentor of Mentors (MOH MOM), their hearts are not in this program.
When MSF still provided an allowance which ended at the end
of September MOH staff clamored at the door of the mentors’ office for a copy
of the work plan which they did not work on and so had no clue what MSF
mentors’ objectives were for the month.
When allowance ended MSF mentors now in turn have to ask if the mentors
are coming with them to the health care centers to mentor and inform them when
they are being scheduled. There are
often excuses for not being able to come: too busy, sick and not feeling well
today, just back from Blantyre
and now in the middle of doing her laundry.
These are all true excuses that we have heard so far. MSF mentors have even asked point-blank why
they are not coming. One answered, “I’d
come when there is money.”
In November, we start a series of training through lecture
presentations in the health centers, again the preparation materials were all done by MSF
mentors. MOH mentors are slotted in the
training but everyday we have to ask them whether they would come to review the
slides with us and whether they would be coming to jointly do the training, the
answer is, you guessed it. So at the
training we dutifully remind the health centers personnel that this is an MSF/MOH effort
but where is the MOH representation?
And so I digress.
Back to the third quarter District Health Officer (DHO) presentation, as is often the case the
meeting started almost an hour late. All
MSF staff was present and MOH mentors except one whom I later learned that the
HIV coordinator forgot to invite her. He
even has trouble remembering all his mentors. The DHO came in to give the
opening remarks but did not stay for any of the presentation! District Nurse Officer (DNO) excused himself around ten am because of
a previous engagement in Blantyre
and he was quite apologetic. The (District Medical Officer) DMO did
not come until close to the end and asked a few questions and then made the
closing remarks. The main persons from
MOH who needed to hear the presentation could not make themselves available.
Was this a useful exercise?
Have we accomplished what we wanted?
What did we want to accomplish anyway? The collaboration here was a good
show but not a real one. We still are
trudging along as the bulwark of this mentorship. The handover for this part of the MOH-collaborated
mentorship is at the end of this year, the MOH portion is still taking small
tentative baby steps, not ready to walk let alone run on its own.
As we finished lunch at a restaurant, the HIV coordinator
said to me, “Next time, don’t arrange for lunch just give me money.”
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