While working on my Masters in Public Health in Boston, Partners In Health (PIH) represented the ideal organization to work for: completely committed to the notion that health is a human right with an amazing global reputation among those in the public health field. Therefore I jumped at the opportunity to spend a fellowship year working at their Rwanda headquarters.
As a supply chain fellow, I am looking at the inside of the organization and seeing the way everything operates. Understandably I am introduced to all aspects of our supply chain – selection, quantification, procurement, storage, distribution, and use. Surprisingly to me, I am also learning about every PIH program that orders through the pharmacy department as well as the public supply chain system, the Rwandan National Insurance Scheme, and pharmacy regulations for importing and distributing medicines and health commodities. Who knew that those who manage the medical supplies become so integrated in the entire operation?
Through my daily work as part of the PIH team, here is my “inside” scoop on what makes PIH and the Rwandan Health System operate successfully:
1) Rwandan government support makes all the difference. Back in 2005, PIH began working in Rwanda because the Rwandan government asked them to work in Rwanda. This invite made the channels to working together open from the start, greatly influencing the close relationship between the two organizations.
2) Extensive trainings. Aside from clinical staff, a large portion of PIH staff work on conducting trainings. Our Rwinkwavu site hosts the Training Center, or “TC” where the main offices are, and a plethora of conference rooms. The dorms where I live house new guests every week. Trainings range from NCD nurses working in our affiliated clinics to data collectors who assist research teams to quality improvement seminars for all programs. Almost every day at least one training is going on either here at headquarters or amongst our other districts, Kirehe and Burera.
3) Strict but clear policies and job descriptions. The chain of command is very tight and job descriptions are iron clad. Everyone knows what their responsibilities are and completes them. This does not mean that staff don’t pick up extra work on the side, because they definitely do, but it means that each task is delegated to a specific person.
4) Community. PIH has a very strong community feel amongst the staff. Everyone knows each other, eats lunch together, works in the same small spaces, travels together (in packed vehicles), etc. This constant interaction allows for a feeling of community and for personal relationships to develop between staff members of different departments as well as between Ministry of Health employees and Partners In Health. Networking is the secret to success.
5) Follow up; Monitoring and Evaluation. Constant feedback and supervision allows for progress and a higher quality of care. PIH heavily focuses on following up on trainings and indicators to ensure that each program is making improvements as well as to identify those that aren’t to provide additional support. Really all I need to say is MESH – Mentoring and Enhanced Supervision at Health Centers. If you haven’t read about it, you probably should.
6) Health is a human right. All of the staff members share the same ideal and final goal. This makes all of our work, no matter what department, build to the same idealistic endpoint. The combined efforts of every person striving for this mission knits our program tighter together and maximizes the positive value provided to the community.
7) Comprehensive Plan to Health Care. PIH Rwanda consists of over 20 different departments at the headquarters. All of the departments tackle separate clinical or non-clinical operations to keep the program running. Each niche understands its targets, knows its indicators, and enacts tasks to achieve their specific piece of the PIH model.
Of course with all of the good, I also see all of the negative sides to the organization. Fortunately those are much fewer than the positive; and most represent the typical struggles one would face working in rural healthcare: resource scarcity, cross-cultural communication issues, etc.
Regardless, my view after over two months on the job remains the same as before: PIH remains as committed to the health care cause as they appear to the rest of the world. Even now with the new partnerships fighting Ebola, PIH works to adapt their model to provide excellent healthcare to all. I plan on learning as much as I can while on the inside so that I can spread the knowledge to those outside.