Tag Archives: management

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!