Tag Archives: community

Building consensus and community

Over the past 7 years, since we first started MH in Kamwenge, Michael and I have learnt much about management, particularly in a Ugandan context.

Most of this learning has been through the school of hard knocks. Which is often painful. And extremely humbling.

It also can be a very effective way to learn.

It’s not quite like learning things at university. I don’t seem to forget the mistakes as much as I would if they were simply questions I marked wrong on an exam.

For the first year or so of our management experience here, I spent a lot of my time trying to prove myself.

Trying to give myself permission to lead.

Trying to remind others that I had authority

Trying to show our staff and the community that I did have the capacity to run this organisation.

There was a lot of flailing arms and big emotions and alienation from our staff and then questioning my decisions retrospectively.

I don’t mean to say I was hopeless, back then. In the interests of practicing some self-compassion, I still bought a lot of skills to the table, we set up a fantastic workplace and worked round the clock to do this – we did a pretty good job considering the circumstances, all round.

But I have realised that my management style these days looks remarkably different. And because of this, our organisation looks very different as well.

This slow-moving shift is due to two revolutionary factors.

The first thing is me. I am different. I believe in me and my gifts. I have experience. I have proved to myself that I am (mostly) resilient to setbacks in a professional capacity, and I have realised somewhere along the way that I can actually do this work – though insecurity still plagues me at times.

The second is that I have learnt, ironically, that management is not about me.

It is about everyone else. It is about building a community of equals that are authentic, free to question and critique, free to own failure and learn from it, and most importantly, sold out to the vision and values of an organisation.

The natural progression of these values is that everyone has a voice – from the cleaners and security guards, all the way up to top management. Our hope always is to foster an environment where building consensus is a priority; where everyone has space to talk, and will be listened to when they do. This is obviously counter cultural around the world, but in Africa, where the ‘big man’ syndrome is endemic, this is powerful. It stands out from a mile away.

Lately we have been reviewing our organisational policy and procedures. It’s a big job. Everything from employees coming to work on time and how much maternity leave we should offer, to big decisions on what constitutes gross misconduct and what corruption looks like at Maranatha. Even thinking about these topics can give me a headache. It would be much easier for me to sit at my desk and review the policy myself, or better yet, to bring in an outsider.

But instead, we are slogging through the 70 page policy handbook in the morning meetings, which is when all our staff on duty for that day meet for half an hour to raise concerns, discuss issues, encourage each other, tell stories… and invite God to help us in our work for the day. Some of this policy discussion has been really painful, as you can imagine. Opening up to humans the ability to make decisions about their own work benefits creates the kinds of demands that would be expected – we have had many slow discussions (where I would consider giving my first born child away to avoid facilitating) regarding why we can’t have more annual leave or longer time away from work for a burial or why sick certificates are important. But with those issues, it has been important for the staff to learn the limitations of a tight budget and choices between benefits. I have also learnt and then revised my own position many times, based on Ugandan cultural norms and our staffs’ passionate discourse.

Other meetings, we have entirely thrown out my own freshly drafted policies that departments originally identified a need for, because the staff felt it was unnecessary or problematic. That was hard. But it was the best decision for the organisation, in hindsight.

This last week, as part of this process, we have had a discussion on what constitutes corruption at MH. Uganda now rates top on the list of East African countries in corruption indices. Corruption is everywhere and health care is no exception.  The patients we serve expect a broken system, where tips and bribes to health care workers replace the right to universal health care, and attention for ailments is purchased by greasing palms. Simultaneously, turning down appreciation tips for services however –especially to someone older than yourself – is culturally equivalent almost to spitting in someone’s face!

So as you can imagine, this was a controversial issue fraught with potholes and layered with thick cultural expectations. It was an amazing discussion to facilitate though – to see the passion of the staff around this issue, and their desire to protect MH from this seductive sin. It took place over 4 morning meetings– with much honesty and laughter and debating with raised voices – before we came to an acceptable standard for the practicalities of dealing with this in the workplace. I’m not 100% sure that the policy we developed will work, but we will find out along the way. Much of the point is the discussion itself and the investment in the outcome that our staff now have.  As part of this policy, the staff agreed that they needed to revisit this discussion every 3 months in the meeting. To keep conversation open to ensure they were keeping each other accountable to the standards we have set.

After one such meeting, I was sitting in Maureen’s office voicing the difficulties of facilitating such discussion. I was complaining that the next section in the handbook is going to be tough to talk through. I was wondering if we should skip it.

Maureen smiled and shook her head and reminded me in words something like: ‘But now Kim, do you see how they are satisfied once they have had the opportunity to discuss and decide? They will hold each other to this. If me and you were to sit down and agree and then order them to do something, even if we knew it was the right thing, do you think they would listen? The minute our backs are turned, they will ignore the order. This way is slower, but it’s the right way.”

Such pearls of wisdom from the woman that has taught me so much about managing staff!

It takes a village

Ugandans love children. As a culture they celebrate them fiercely. Everyone seems willing to smile and get down on their knees to say hello to a child. Babies are cooed at and admired. For women, bearing children is a sign of prestige and of strength.  I have earned a respect through motherhood that I tried futilely to gain for the duration of the time I lived in Kamwenge.

When I speak of African children, the oft quoted proverb ‘It takes a village to raise a child’ comes to mind. In my imagination, this phrase conjures up exotic images of intricate networks of beaded half-naked villagers working together for the good of the communities’ children. Our over-use of this saying in the West highlights the exoticism and idealism with which we frame our discussions of child rearing in Africa. I’ve heard it said that in the developing world, child–rearing is somehow a more ‘natural’ process, beyond reproach.

To confess, I have many times scoffed at this idea.

While I believe wholeheartedly that a village – a community if I may use a less exotic term – is essential for raising children (given how exhausting and monumental such a task is!) it is also true that if everyone is responsible, than in a sense no ONE person is responsible.  My time in Kamwenge exposed me to some of this –children neglected and uncared for, malnourished and left to be looked after by young siblings or distant relatives. I think I saw the worst of this, working at the referral health centre in Kamwenge.

There are many great and (in my opinion) not-so-great things about parenting ‘Ugandan style’, as there are in any culture. I don’t need to thrash them out here.

But one of my greatest reservations about moving back to Uganda as a family were some of those ‘not so great’ bits to Ugandan child-raising, especially when I plan to be a working mother here and have other women look after my son for chunks of time. I would think of all the opportunities that I perceived our son would be missing out on, not living in Australia; that I, as his mother, would be denying him, by making the choice to live here, away from his culture and community.

Before we arrived here, when I was super-stressed or having a moment of doubt, all the marvellous moments of my own childhood unravelled before me, as a taunting list full of red crosses, marking the experiences my own son would not have.  The freedom of playing in parks and exploring creeks, running through sprinklers in bathers on lazy summer days in our backyard, the safety of playing with neighbourhood kids, the amazing quality of suburban kindergartens and playgroups, and most significantly, a community of friends and family that were invested and involved in my upbringing. I feared that we wouldn’t find a community for him to belong to here.


Slowly and surreptitiously

Without any intention or expectation

And in the midst of my concern that this could not happen…

A community has begun to form, winding its way around my son and through his little life.

After all, community is something that Ugandans know how to do.

I see it when I take Dave to our clinic, and he immediately squirms out of my arms into the arms of one of our staff.

I see it when he waltzes into the reception area at Maranatha, climbs onto the receptionist’s lap and begins to play with her phone.

I see it when he hears a cow moo, then searches for and is picked up by our security guard at the clinic, in a successful attempt to be taken to see the cows grazing nearby.

I see it when our landlady at the apartment where we stay buys him bunches of bananas so she can watch the ecstatic little dance he does every time he is given a banana!

I see it when Dave shrieks with excitement and then runs outside to play every day when his 6 year old neighbour (adopted by our American friends that live upstairs) arrives home from school

I see it when we take him to the shop where I buy most of our consumables, and the staff greet him with a big smile and call his name ‘Mandela!’ and produce a ball for him to play with while I shop.

I see it when we attend church on Sunday, and his Sunday school ‘teacher’ cuddles him and jokes that he is now her child, while I hold her little girl of the same age.

I see it when the cleaners or groundskeepers in the apartment block where I stay rush to help Dave down the steps on the compound where he continues to attempt death-defying acts.

I see it when we sit down for lunch and after polishing off his own g-nut stew and rice, he looks to see which woman on our staff will feed him some of theirs.

All these moments are small, but they remind me to take a breath and be thankful for the village here that is helping me to raise our son.

And perhaps

scoff at the proverb a little less.

Cuts and bruises

If you had asked me a few years ago what was the most rewarding part of Maranatha Health in Kamwenge, I would have said without a doubt, the staff community.

If you had asked me what was the most gut-wrenching thing about closing the clinic and leaving Kamwenge, my answer would have been the same.

In Australia, I really missed being a part of the Maranatha Health Uganda team, especially when coupled with the grief that it may not ever exist again.

But when I reflected on our Kamwenge team, wearing the rose-coloured glasses of distance and with the nostalgia of time passed,  I often wondered if the memories I had floating around in my head were deceiving me in the way memories often do.

Memories of hard long hours but with people that really cared about outcomes for those we were serving. Memories of staff giving of themselves to others. Memories of making a difference in peoples lives, together. Memories of laughing and frustrations and chaos and fun. Memories of real community. Certainly not perfect. There were also lots and lots of hard bits.

Sound cheesy?

So we are back.

And do you know what the absolute coolest thing is?

Most of the staff DO want to come back and work for Maranatha Health again, just like me!

Since we have arrived back in the country, most of our old staff – be they nurses or cleaners or receptionists or security guards – have contacted us asking for their jobs back. They have called us from new work places, from training schools they are attending, from their gardens in Kamwenge, and from various places around western Uganda. But the message is almost always the same – when can we start?!

And then when staff come to talk with us about their position, there are reunions as those that are already here greet those returning. There are hugs, questions about families and marriages, stories of new babies (at last count there are 5!) and lots of excitement in finding out about who is returning.

Some of the staff are taking pay cuts to come back and work for us. Some are relocating families.

The whole experience of gathering our team back has been extremely counter cultural – for Australia also but definitely for Uganda. Generally, money and conditions are the determining factor in jobs here. Ugandans aren’t generally very sentimental people.

But again and again, staff are saying that they miss the team, they want to work with us to make an actual difference to patients, and they want the experience, skills and training that comes along with being a part of MH in Uganda.

Which is good news, considering our new project is very much focused on sharing all of those aspects of MH with other clinics!

The other day, Michael met with a key former staff member – someone we were hoping would come back to join us for MH#2.

That staff member agreed to join us, a decision we are incredibly thankful for. But in discussion with Michael (which he relayed to me later), this staff member thanked us for returning to this place and for trying again, and acknowledged that almost nobody would have come back to this country, after what happened last time (read here).

That is the first time someone here has openly acknowledged us for this.

And do you know what? Despite knowing I should be here, and despite enjoying the first few months, moving back to Uganda has been tough.

And so here it is. The acknowledgement I needed to give myself:  It should be tough!

My trust was broken. Last time I was in this country, my idealistic, hopeful self – the self that wants to see the best in people and tries to downplay the corrupted agendas of others – took a good ol’ beating.

The staff returning, however, has helped to heal some of the cuts and bruises I collected from the last time I was here.

The woolworths of Kamwenge: ‘The fresh food people’

Going to the food market is one of my favourite things to do in Kamwenge.  I normally go to the market a few times a week to buy our fruit and vegetables.

The market, with the dusty well-worn path leading to the semi-undercover, crumbling old building full of wooden stalls and umbrellas and loosely hung material shade; with its neat piles of freshly picked garden vegetables and mothers sitting lazily at their stalls chatting in Rukiga; the market that is brimming with life.  The market proudly presents the picture of Uganda that I love the most: the localness of all things, the respect and time for relationship, the placid pace of life, and the now-familiar smells of Kamwenge: the smell of  dust, smoke from charcoal stoves, matooke, boda-boda fumes and most importantly, lots of ankole cows. Now, it has become a part of my everyday life.

When I first started coming to the market, no one knew the story of this strange white girl – she buys her own food from the market? She cooks? She walks? She carries the food in our local baskets? One of the first times I went there I wrote about it in my journal:

“I asked for green pepper. The woman took my hand and guided me past several little food stalls, each selling the same food – matooke, rice, sweet potatoes, cassava, groundnuts, millet, spinach, tomatoes, a million different types of banana, and pineapple. I am careful to avoid the spread of fresh beans, maize and sorghum laid out on sacks on the uneven ground, drying or waiting to be sorted by hard working women doubled over at the waste, ensuring the purity of their produce. Most people would look at me in shock but smile their jovial Ugandan smile, surprised that the Mzungu has braved the food market; it seems this is a rare occurrence.  Mischievous kids follow behind me cautiously, the light pitter-patter of their bare feet drowned out by their chanting of ‘mzungu’. A few are daring enough to come and hold my hand. As I pass one stall, a little semi-naked boy playing beside his mother’s vegetables begins to quiver, then shake, then scream at the top of his lungs and cling to his mother’s legs in a fit of fear at the sight of this strange ghost-like person. It must be his first time. The mother tries to sooth him between her own fits of laughter. She catches my eye and I laugh and shake my head, as a crowd gathers around entertained by the boy’s reaction. This is my first time causing someone to hyperventilate – I feel caught somewhere between a super-celebrity and a school yard bully. But alas, the boy calms as I continue on my way, now loaded up with a limited variety of fruit and vegetables.”

Now when I enter, I am met with familiar faces greeting me in the Batooro pet-name the women there have chosen for me. So much of the beauty and strength of communal living is disrupted and distorted in Uganda these days; but it seems this is one of the places where it stays true to form. And for a brief moment when I am there, I also feel a part of this living, breathing organism. The women allow me to practice my Rukiga on them, free of the laughter and ridicule that I sometimes find in town. They help me stumble over new words, teach me phrases that I didn’t know, and throw in free produce when they have excess, well aware I am a loyal customer. I hear their stories of illness and burial, of the woman at the corner stall who has just lost her daughter because of an obstructed labour, or the struggle of a bad harvest for a particular food due to the never ending dry weather. I also laugh with them now, when they introduce their shy children who don’t quite know what to do about the muzungu that knows their mother…

And in return? I can offer almost nothing, except to buy their fresh food at fair prices.