Global Health Ideas

Finding global health solutions through innovation and technology

A call for better global health leadership – whistling in the dark?

Introductory post by Sylvia Vriesendorp, our new guest blogger:

“We want better leadership!” It is an often heard call in health programs around the world. Yet when asking those who make this call what exactly they’d like to see done or changed that would produce the missing leadership, the voices stop. Let’s look at reproductive health: one woman dies every minute in pregnancy and childbirth; 99% of these women live in developing countries (UNFPA). These women are not dying of medical mysteries; they are dying because they do not have access to simple, inexpensive, life saving interventions. They are dying because they do not have access to modern contraception methods, even when there are supplies in the country and trained staff to dispense them.

Why is that so? We believe this is happening because many health programs are poorly managed and led. And as long as we believe that only a handful of exceptional human beings, like Mother Teresa, Ghandi or Mandela, can lead and manage us out of these tragic circumstances, we are forced to stand by or throw technical solutions at what are, in essence, challenges of management and leadership. This is a huge dilemma that is exacerbated by a lack of actionable language about management and leadership. After all, if leadership and management cannot be defined, how can we know what to teach?  It is also a dilemma for those who manage and lead health organizations. How can you get your staff to become better managers and leaders when you don’t have any language to help them develop? How can you yourself become a better manager and leader if you adhere to the theory of ‘Great and Exceptional Men and Women’ as they only people who can lead us out of our current stagnation?

There are countless models of leadership; many emphasize personality traits and characteristics (like charisma) that assume that true leaders are wired a particular way, from birth. If leadership were to be innate like that, we are in trouble. We are especially in trouble when we take talented health professionals away from their clinical practice and promote them up to a level where their technical skills are no longer useful and where they discover they have no clue on how to manage and lead. We have turned, in this way, countless superb clinicians into mediocre managers who do not lead. Worst of all, such an approach gives us no guidance on how to prepare current and future generation of managers who lead and produce intended results.

So what to do? We are engaged in remedying this situation in many countries and at many levels, a few teams of health managers at a time. In the process we are learning much about how to turn passive and unempowered midlevel managers into inspired activists for better health. We’d like to share these with you.


Written by Guest Contributor

August 15, 2008 at 1:48 pm

12 Responses

Subscribe to comments with RSS.

  1. We received reports from our various task forces involved in logistics support and program development and are grateful for the remarkable progress already made. We are confident that our time together…

    leadership program

    October 26, 2008 at 2:46 pm

  2. To Ppeach: yes there are, I will write about these in some other entry, later.


    September 5, 2008 at 3:25 pm

  3. Thanks Jessica, Farzaneh (great stories of the unrealized potential that is kept hidden at lower levels), and Eva, thanks for comments and encouragements. It is good to bring to each other’s attention the work that is done, coming out of a similar philosophy – I am always amazed how many small pockets of great leadership initiatives are out there – if we can only connect – so this we will do. Let’s stay in touch.


    September 5, 2008 at 10:38 am

  4. Thank you for your insights, Sylvia. Global Health Progress applauds the work you are doing with the Center for Leadership and Management to create stronger health leaders in developing countries. One of our partners, the Accordia Global Health Foundation, is doing similar work in Africa. Check out this YouTube video of Executive Director Carol Spahn, describing the work that the Accordia Global Health Foundation is doing.

  5. […] A call for better global health leadership – whistling in the dark? […]

  6. […] Posted by Aman on August 25, 2008 More from our leadership and management folks over at MSH. By Sylvia Vriesendorp: […]

  7. I think we must all remember that we can be leaders whoever we are, wherever we are. Gandhi famously said that he was just an ordinary person.

    As Martin Luther King says as well ” Everybody can be great because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and your verb agree to serve. You only need a heart full of grace, a soul generated by love.”

    So how can this be applied to a hierarchical health care system? Just one example from the Positive Deviance approach: At the VA hospitals in Pittsburgh, Dr. Jon Lloyd is spearheading a drive to conquer methicillin resistant staphlococcus aureus infections (MRSA).

    Here is an excerpt from the article “Do What you Can, With What you Have, Where you Are.” by Arvind Singhal, Karen Greiner, and Prucia Buscell

    Culture change is clearly not the objective of the Positive Deviance MRSA project, but it is happening. When every single person in the organization in invited
    to tackle a problem, transformations begin in entrenched traditional hierarchies.

    The story of Edward Yates, a member of the housekeeping staff, is one striking illustration. Mr. Yates had been interested in the initiative from the beginning, and had surprised doctors with his knowledge that Chlorox, not alcohol, is needed to kill spores of Clostridium Difficile, or C-Diff, another virulent antibiotic resistant bug. Mr. Yates was later chosen by unit staff to conduct one of the regular MRSA briefings for some 15-20 staff members, including leading physicians. All
    present shared pride as he reported that the Heinz’s 2 South Unit had no MRSA infections, no colonizations, and had achieved a 100 percent swabbing rate.

    To Jerry Sternin, the fact that a well-informed member of the housekeeping staff was informing doctors and administrators at the top of the hierarchy, was one of the most gratifying instances of cultural change in action.

    Examples of in-house expertise abound, once people start looking. Darryl is a veteran in his 30s who acquired a MRSA infection at VAPH and has endured four surgeries at the site of his infected leg wound. He devised his own polite way of fostering hand hygiene. When doctors or nurses enter his room without washing their hands, he said, he avoids eye contact with them, and looks instead at the sink. If the offender is impervious to subtlety, he added, “I just look back at the doctor, then back at the sink, until they wash their hands.” Wall signs urging EVERYONE to wash or sanitize hands are another focus for a patient’s gaze. Darryl has shared his strategy with dozens of other veterans, adding advice to signal with a smile, not a smirk. He emphasizes that patients can be part of the solution, not the problem.

    Read more here:


    August 19, 2008 at 5:09 am

  8. […] A call for better global health leadership – whistling in the dark? […]

  9. Are there any examples of distributed/collaborative global health leadership using IT tools in this context? Taking the fickleness of a single leadership position out of the equation and putting much of the power in the hands of the stakeholders? I’m aware of the adage “A camel is a horse designed by a committee”. But hey, a camel works well in its environment, better so than a horse.


    August 17, 2008 at 8:59 pm

  10. Hey! Awesome site! My blog has technology chat, gadget reviews, internet chat! Its awesome check it out!

    Technology Blog Online

    August 16, 2008 at 10:10 am

  11. I am looking forward to reading this series of posts as leadership is a topic that complicates several global health programs.


    August 15, 2008 at 9:53 pm

  12. […] Sylvia Vriesendorp at Technology, Health and Development explores what better global health leadership entails. […]

Comments are closed.

%d bloggers like this: