Hope for Africa

Many young people in Africa want to leave and live in other countries to make 'better life for themselves'. Why? Because they believe Africa has no hope. They feel there is not enough food, not enough water, that Africa is over populated, and there is no hope for them if they remain here. Yet, this belief, is built on ignorance and lies.

In truth, Africa is least populated continent; Zimbabwe, Zambia and DRC have the potential to feed whole of Africa, there are great rivers in Africa for water and Africa has 40% of the world's hydro electric power potential. Every single African nation has mineral wealth and many coastal nations also have oil wealth. Africa is a beautiful rich and abundant continent. Yet many people (African or not) do not know this.

I learnt some of these facts from Chris Ampadu. We have just finished running a Medical Leadership course in Pointe Noire, where Chris and I shared the speaking. Chris is from Ghana and has run leaderships conferences for Mercy Ships for 7 years training government, community and church leaders. He works for Samaritan Strategy.

How can Africa, which is the richest continent in terms of natural resources, be also the poorest continent?

Because many people in Africa do not believe the truth. Many have a mindset of hopelessness. A worldview that is actually built on ignorance and lies, thinking Africa is cursed, but in fact, Africa is blessed. Blessed with abundant natural wealth and resources.

Apparently between 1980-1988 sub-Saharan Africa received $83 billion, and yet loving standards declined by 1.2% a year and the GDP (in per capita terms) declined 2% in 1986 and 2.2% in 1988. From 1990-2003 the region averaged $20.4 billion per year in foreign aid, yet the GDP was lower in 2002 than 1980. Africa has attracted more aid per capita than any other region, and yet it remains poor. Africa has rightly rejected colonialism, yet has not yet moved into embracing her independence. Instead, she continues to rely on western aid.  Needing external money for development instead of using her own resources. Chris encouraged Africans not to see themselves as beggars. But as people with dignity and resources. To move away from the 'poverty mindset'.

Chris asked another question, When major life events happen such as death to young people, how do people in your culture explain these things?

For many African's the answer is 'Witches'. When bad things happen the first question people ask is 'who did this to you?'  

What are the consequences of this? Eg when you as a doctor make a mistake, what will people think, how will they interpret it? 'It is not your fault, it was a witch / curse'. So if people don't hold you responsible where is the motivation to improve? Doctors don't worry they will be taken to court. Witches are blamed instead, which could be rather convenient.

Beliefs ....lead to.......values......which lead to.....behaviours.....and then.......consequences

We also discussed cultural attitudes to time, women, corruption, reliance on external aid and 'the white man'. Lies such as 'corruption is normal', and it doesn't matter if you are late for work. This is why there is poverty. This is why life feels hopeless. Yet only the people themselves and their leaders can change these things.

In discussion groups the medical leaders discussed cultural lies in the domain of medicine and what impact these had. Changing these mindsets is difficult. But if we are serious about improving quality of care and patient safety doctors need the humility to admit their mistakes and short-comings, and courage to initiate change. We know on medicine that Quality Improvement is a combination of leadership and process, not just better training  and technology. But for medical leaders here to feel empowered to lead well and initiate good processes in their hospital their need to understand their own worldview and the pervaded worldview of those they work with. Otherwise they will not be able to initiate lasting change.

The conference consisted of three days. The first day was all about exposing cultural lies. The second day, the 'soft' side of medical leadership, the 'heart' side of the head, heart, hands voice concept, otherwise known as the 4 'T's of leadership: truth, trust, teamwork and training. Chris brought the African side and I brought the western medical perspective. On the final day we spent a lot of time talking about one of my favourite topics, the World Health Organisation Safe Surgical Checklist. This is an example of good process which requires leadership, communication and teamwork to successfully and sustainably be implemented in Africa. No country in Africa has managed this yet. Perhaps the Republic of Congo could be first. They certainly have the potential to be. Only time will tell. I pray that these few days have sown some seeds. I leave you with an African proverb I learnt this week

'You can count the seeds in a mango, but you can't count the mangos in a seed'

It was a pleasure to work with Chris Ampadu and the rest of the team, Krissy, Stella and Francis. Thanks for all your hard work.