The best reward

Allow me to paraphrase an old Taoist saying: " The best leaders are those the people hardly know exist. The mark of a successful leader is when the team says WE DID IT!"

I have always believed a leader is only as strong as his/ her team. My work has consistently given the opportunity to build the capacity of my team and others involved in my work. The effort you put in to building a team's capacity is directly proportional to the quality output. Now, what is all this talk about leadership, you may ask? Strengthening health systems has a lot to do with leadership. Building the capacity of workforce and the system requires leadership qualities. That is why I sought a doctorate in public health leadership after my medical degree. I am firm believer that leadership is essential to build and strengthen health systems.

So, what is the exact relationship between leadership and health systems strengthening (HSS)? Allow me to give an example. HSS requires a commitment and buy-in from various stake holders, government and non-government players included. Anyone heard of "From silos to systems"? Strong leadership qualities are an absolute necessity in securing these commitments and buy-in. A successful leader will engage all the players and bring them together to build a strong health system. That is what I have always done in my line of work...engage, secure commitments, and obtain buy-in. It is the first and crucial step towards building/ strengthening a health system.

My work in Liberia is a testament to successful leadership. I can proudly say I was responsible for conceptualizing, operationalizing, and initiating the first and only comprehensive HSS/ capacity building framework for a post-conflict country. It would not be possible without the commitment and support from various stakeholders and my staff. Starting from the Liberian Ministry of Health to international donors like USAID and various NGOs, everyone played a role. I am proud to have created and implemented a framework that facilitated the stakeholders to come together and rebuild Liberia.

Besides stakeholder buy-in, a successful leader is also appreciated by his/ her team. It has been almost six months since I left Liberia and I continue to receive messages from my staff and colleagues about the impact I made in their career. The best message is one I received from an ex-staffer which read "Thank you for all that you have done. WE are now able to work towards rebuilding and strengthening our health system". I capitalized the word "we" to emphasize the mark of a successful leader. The message brought a tear to my eye. I am glad the ex-staffer said "we". I never want things to fall apart after I leave, and I am glad my ex-team is following up and making things happen after my departure. I take pride in them and I am blessed to have had the opportunity to build their capacity, which enables them to continue with the work I started.

A latest message from an ex-colleague in Liberia made me think about leadership today. She wrote "good to know that you are working in Kenya. I know you will help people in Kenya like you helped my career". Am I a successful leader? I may not fit the stereotype of a traditional leader, but I possess some leadership qualities. I will, however, say with certainty that I will continue to build the capacity of people and health systems in order to prove myself as a successful leader in my line of work.

While I appreciate every opportunity I have been given, I am particularly appreciative of the fact that my teams always say "WE DID IT!". The sense of camaraderie among the team members and the stakeholder buy-in will continue to be the best reward of my career.

Onwards and upwards!

Building stakeholder participation and the challenges of being an outsider

This week began with a frenzy of meetings and trips to the counties. One of the key steps in building capacity is seeking stakeholder buy-in. The recipients have to buy in to the principles before we begin building capacity and strengthen the health system. Stakeholder participation is key!

In my efforts to strengthen the Liberian health system, I am committed to build capacity at both central ministry and the county health department level. I have already made the rounds at the ministry, having met with the key deputy ministers, assistant ministers, and senior management. I presented my strategy and won them over. I have also convinced non-ministry stakeholders - USAID, NGOs, and EU - to support and participate in my efforts. This week I am focusing on county heath departments. I just returned from a trip to Bong and Nimba counties where I met with the County Health Officers and their teams.

The two counties were polar opposites. While the county health team (CHT) at Bong was unresponsive, aloof, and nonchalant, the team at Nimba was active, participatory, and invested. A sea of change. Our project (RBHS) is well entrenched in to the Nimba county health system. See picture below. Our County Coordinator and the County Health Department Director (CHDD) share the same office space. That shows how well we work with the ministry at county level. Perhaps Bong could use the same level of involvement in order to become more invested in our efforts. It's on my to-do list.

Integration between the County Health Department (CHD) and our project (RBHS)

It is always challenging for an outsider to get local stakeholder buy-in, especially when you are someone like me. But I like the challenge. It allows me to prove myself and gain the trust of stakeholders in the process. I am sure I am not the only one who experiences this phenomenon. The new person is always tested, especially if s/he is an expat. It is part of the game, and I like a good game. The situation gets worse when the new guy is promoted within less than two months on the job. While it is frustrating to deal with such petty drama, it also makes me stronger and more invested in doing what I came here for.

I am going to visit the remaining county (Lofa) this week. I am traveling with my staff to a town called Voinjama, which is less than an hour away from Guinea. Too bad I cannot cross in to Guinea... I need a visa. I do not have enough time to get a Guinean visa before leaving on this trip. Next time!!

I ate at a Bangladeshi restaurant during my trip to Bong and Nimba counties. We stopped in a town called Gbarnga (pronounced - banga) to eat at this restaurant called Mama Zone's. The name struck me as strange, especially for a restaurant run by a Bangladeshi man, but I guess they are trying to blend in to the Liberian society. I came to know the restaurant exists in Gbarnga because there is a big Bangla UN military contingent nearby. Word on the street is that there are around 2000 Bangladeshi military personnel as part of the massive UN military presence in Liberia. You cannot just walk in to Mama Zone's and order Bangladeshi food, you have to order it an hour in advance. They prepare according to demand. The Liberian food, however, is readily available. We called ahead and had chicken curry. It was quite mediocre, even a disappointment.  As wonderful as it is to see non-Liberian food in the middle of the country, it is disappointing when the food is not good. Lesson learned! Next time I will stick to potato greens and fish.

More to come later this week...my trip to Lofa, other happenings at work, and more importantly, food!!