December 10, 2014

Why We Do What We Do: Dawit Tatek

Dawit Tatek, GHLI Program Manager for the Ethiopia Hospital Management Initiative (EHMI) became interested in public health after seeing people unnecessarily die from preventable diseases. “The problems I saw were more common among residents who lived far from health facilities. Seeing positive results from health programs in improving equity in access to health service was the turning point in my career as public health professional.”

Dawit completed his undergraduate training in Medical Laboratory Technology and Clinical Nursing at the University of Gondar, Ethiopia. After working at the Gondar hospital for six years, he joined the Clinton Health Access Initiative to work in the Ethiopian Millennium Rural Initiative program, and was appointed primary health care unit coordinator. He worked in remote areas to improve implementation of the health extension program, increase HIV counseling and testing, and increase delivery of services. In 2011, Dawit joined GHLI and has been working with EHMI, managing two Master’s of Hospital Administration programs in Ethiopia while acquiring a Master’s Degree in General Public Health. 

One of the aspects of GHLI that Dawit enjoys most is the use of critical thinking and an evidence-based approach. He commends GHLI for applying scientific problem solving techniques to improve quality in hospital and healthcare management.  

“I find it extremely rewarding to help transform hospitals managers into confidant and outstanding leaders through the MHA program. It is very satisfying to receive good feedback on the program and know that I have helped.”

But Dawit's job is not without its challenges. Working with stakeholders who may not always understand the urgency of the problem can lead to inefficiency in job performance, and students are not always willing to learn and change as quickly as the program demands. However, despite these challenges, Dawit hopes to assume more leadership responsibilities and become involved in strategy management processes. He also hopes to pursue a Ph.D. in health economics and health policy in the near future.

December 1, 2014

Call me Shelemat

Shirin Ahmed, Program Manager, GHLI 

As I sat at a restaurant not far from the White House discussing Ethiopian (and Pakistani) politics and bonding over honey wine with my friends from the Ethiopian Ministry of Foreign Affairs (MFA), it struck me how issues of regional security and organizational capacity are quite similar across borders.  

I was at the end of spending two weeks with delegates from Ethiopia who were visiting the United States as part of Yale GHLI Strategic Thinking in Foreign Affairs Symposium followed by a tour in DC to meet with leaders on Capitol Hill, at think tanks and the State Department. I felt so welcomed by the group— they even gave me an Ethiopian name, Shelemat, a prize or reward in Amharic. 

During our time in DC, I was pleased to see the enthusiasm on both ends, reinforced by mutual commitments to resolving regional conflicts, fostering business development and strengthening US-Ethiopia relations. But I also sensed a concern from the Ethiopian side about its “image” in the US, often misrepresented by western interest groups and now exacerbated by Ebola. However, it was encouraging to hear that despite these perceptions, as noted by someone from the US Chamber of Commerce, Ethiopia stands at the “cusp” of economic growth and it is only a matter of time that the country would become a major player for US investments.  

One individual at the Foreign Services Institute asked me what Yale was doing with the group -- a question I asked myself at the beginning of the program. But I get it—building and strengthening.  I had seen those words in writing in our Symposium brochure, but I truly understand it now. The learning at Yale coupled with relationship building in DC may be the jumpstart for the MFA to advance its foreign policy agenda. 

With each passing day, I have new Ethiopian followers on twitter and Shelemat continues to receive thank you messages from the MFA.

November 21, 2014

Foreign Affairs in Ethiopia and U.S. – Different yet Similar

Mekonnen Haddis, Chief Advisor of the Minister, Ethiopia 
As I sat and listened to U.S. public servants discuss problems they have faced regarding employee retention and recruitment for the government, I was surprised, yet somehow comforted to realize that Ethiopia and the U.S. face similar challenges. 
Our Ethiopian delegation was so pleased to be invited to Yale University by the Global Health Leadership Institute for the Strategic Thinking in Foreign Affairs Symposium. During our visit, my Ministry of Foreign Affairs colleagues and I heard from leading practitioners and U.S. public servants who were candid in sharing their views and knowledge with us on a range of issues. Their insight helped us to develop better strategic plans on our own foreign policy, organizational capacity and leadership, which will prove invaluable when we return home.
During our week on the Yale campus, some of the work I most appreciated involved our Yale colleagues sitting down with us to solve problems we had identified within our government system. Through discussion and exercises with some of United States’ leading grand strategy thinkers, we learned to put theory and practice together to address critical problems.
We left New Haven to spend a week in Washington, D.C., visiting the State Department and government representatives. What impressed us most in DC was the priority that the U.S. officials gave us, ensuring they spent time with us in spite of their work load to help us in our endeavors to transform our ministry and country. The level of respect we received at the Department of State and all other places was exceptional. As this was the first visit to D.C for many of us, we were also anxious to see the landmarks about which we had heard so much. The Foreign Service Institute was much bigger than we had expected, and The White House, Capitol and Lincoln Memorial visits were unforgettable. 

After our impressive visit to the U.S., we confidently take home guidance and experiences to embark on a strategic mission to implement our foreign policy both with vigor and commitment.

November 17, 2014

A Closer Look at Cardiac Care

Heather Fosburgh and Dayna Keene, YSPH Professor
Heather Fosburgh, GHLI Program Manager

It’s still hard to believe that in the course of seven weeks, the GHLI Leadership Saves Lives team has travelled to ten hospitals in ten different states to conduct more than 150 interviews to learn more about the cardiac care process in each of the hospitals.

I had the opportunity to participate in interviews and observations at three hospitals in Arizona, Illinois and Florida. Each hospital, like its geographic location, was unique … as were the people. However, interwoven in these differences, were common threads of excitement and eagerness to find new ways to improve patient care. Whether it was a nurse, a physician or an information technology specialist, hospital staff and faculty were truly interested in how they could help make a difference. It was inspiring to see their passion and motivation. 

Conducting these interviews for the LSL program provided me a brief but up-close glimpse into how things are behind the scenes of hospital patient care and management. We spoke with more than a dozen staff members at each hospital who shared, stories, experiences, and honest feelings with us.   

We have six months before the next round of hospital site visits start and during that time, we will be busy reading and analyzing the information collected to date. I find it fascinating to know that taking these individual experiences and combining them all together will contribute to a body of research that strives to understand what aspects of organizational culture can help improve mortality rates for patients with heart attacks.

Although it was less than two months work for me, I remain impressed by how much coordination it takes to effectively care for a patient who suffers from a heart attack coupled with the dedication of the people who provide this care.

November 5, 2014

Using My Words – In Amharic

Elizabeth Bradley, Ph.D., Faculty Director, GHLI

Kebahd! Thanks to some brief tutoring in Amharic I was now able to communicate more fluently on my recent trip to Ethiopia. Most of my new words, and the language itself, are lyrical – “silematachu des bolognal” and “bet’am tiru enimesagenalen” – syllables tumbling out with the sound of a bubbling brook. I had been using these phrases to say “I am happy to be with you” and “thank you for being here” to the delight of my Ethiopian colleagues who seemed tickled that I finally could say more than “excuse me” and “thank you.”  

My Amharic words also helped my sureness, as I could detect meaning in what previously had been a jumble of foreign sounds. This ability was invaluable when we met with the director of the CDC in the US Embassy and received a personal briefing on Ebola - and during my visit to Black Lion Hospital, where I saw where people suspected of having Ebola were to be placed until they could be transferred to a clinic or hospital for treatment. Later, my visit to the US Embassy where the transport system and Ethiopian policies were described went smoothly, and I felt comfortable.  

I thought about how much I loved Ethiopia with all its pleasure and beauty. And I was heartened to see and get a better grasp of how honest the work is to keep the country moving ahead to improve not only health care, but all social services for its citizens.  While I still see young mothers struggling and small children put to work instead of being in school, I know with the dedication being shown by the government this will be less and less. But still "Kebahd" – difficult.

As I experienced both aspects of this country on this visit – the tremendous strides and evolution they have made since my first visit eight years ago – and the inequity that still exists here as well as around the world – I realize that even knowing the language doesn't make it any easier to understand sometimes.  

October 9, 2014

Clean Hands in Rwanda

April Budd, GHLI Health Management & Leadership Mentor

In 2013, Muhima Hospital started on its journey to improve hand hygiene for its patients, staff and visitors. For years, the hospital struggled to provide proper hand sanitizing resources to employees and patients. At times, a department would have soap but a non-functioning sink, or the sink would be working and soap was absent. In cases where both were present, there was the issue of no paper towels to properly dry hands. This occurrence led to staff members who diligently wash their hands having to use their own, often soiled, clothing to dry hands, therefore re-contaminating recently cleaned hands. 

After hand hygiene was acknowledged as a deficiency at the Hospital, the Human Resources for Health Program (HRH) management and leadership team joined Muhima to work on pertinent quality improvement needs. The HRH managers from Centre Hospitalier Universitaire de Kigali (CHUK) suggested implementing hand sanitizer production locally. In January 2014, specifically trained staff produced the first batch of sanitizer at Muhima Hospital using a formula from the World Health Organization. Over the next six months, a Hand Hygiene Initiative team managed a gradual roll out to implement the hand sanitizer project across the hospital including sensitization sessions and demonstrations to teach physicians, nurses and staff on the most effective sanitizer use methods.  

Currently, hand sanitizer is available for patients, staff and visitors in all inpatient departments at Muhima Hospital and hopefully will be in outpatient areas this month. The team most recently celebrated acceptance to the Infection Control Africa Network conference to be held in Harare Zimbabwe this year at which they will present on lessons learned from the process. This project has largely been successful, not only due to a having a great team pushing it out to users, but mostly due to the staff buy-in. The staff are demanding the hand sanitizer through utilization and ordering and due to a good planning team, the hospital is prepared to meet the need.