Dr Hasina

One of my highlights about this year has been the success of our ‘big dream’ project – to implement the World Health Organisation Surgical Safety Checklist in all the regional hospitals in Madagascar. It has been a big hairy audacious goal (BHAG). And thanks to a wonderful team effort  - a team made up of some the most incredible people I know – this BHAG has almost been achieved.

One of these incredible people is Dr Hasina Rakotoarison. She is a Malagasy doctor has been working full time on this project since August 2015, and had previously helped me try out some ideas earlier in 2015 that paved the way for this big project. 

Hasina loves her country and her people and is passionate about bringing hope and healing through healthcare to those in need.

Here are some of Hasina's reflections on her experience  which she has allowed us to share. The photos have come from Dr Linden Baxter, another member of the team who originally shared Hasina’s story on her blog a few weeks ago. 

I had never heard of the Checklist until my Supervisor at the Hospital proposed it as an interesting topic for my thesis to finish my medical degree. I chose to study this area because I was very interested in patient safety, and the Checklist was little known in Madagascar but had astonishing benefits for the safety of the patient having surgery. I always had in mind that I want to become a surgeon, so I planned to apply the checklist to my own work, but I never imagined that I could have an opportunity to share the benefits of the checklist with other teams around the country.  For me, this project with Mercy Ships is very exciting because it has made a dream of mine come true; to share what I have learned and spread the message to surgical teams in every region.

During the last 17 training courses, I have discovered that many other people are also very passionate about increasing the security of patients undergoing surgery, but they don’t have many opportunities to discuss this together and find practical solutions. Even though I am Malagasy myself, I did not realise the challenges some of these teams face in their everyday working lives. For example, some teams in remote regions are very isolated, the health care needs of their population can be very great, and the hard-working hospital staff manage in difficult conditions.

 

Hasina the local doctors and nurses adapt their own Checklist for the operating room

This training course has given me an opportunity to encourage those who share the vision to increase the quality of care for patients, and work together with them to make that vision a reality in their local hospital.

I have also seen how a tool like the Checklist can transform the atmosphere in teams, improving communication and working relationships. Even our training team didn’t recognise the significance when some hospital teams said that the secret of their success was ‘love’. This is something I have learned from them when I read the feedback forms! Because even such a simple word like ‘”LOVE” I didn’t understand until much later when I came to realise how right they were in saying you have to “Love each other”. The Checklist is not just a simple tool, it can change the whole hospital. The Checklist brings love with it and can change everything at a place where it is implemented well. We have noticed that where teams support each other and communicate well, you can FEEL the difference in the working atmosphere if they have love in their team.

 

The Checklist can reinforce relationships in the operating room by helping teams work TOGETHER for the good of the patient

The hospital teams I have met on this project demonstrate by their actions the true meaning of ‘love’ described in book of Corinthians:

‘Love never gives up, never loses faith, is always hopeful, and endures through every circumstance.’ 1 Cor 13:7

In the future, I wish to remember those people from the places I have visited where there is great need, and would love to have the opportunity to revisit them to assist in providing healthcare and bringing ‘hope and healing’.

 

Hasina volunteers as a patient for a simulated operation to practice using the checklist. One day she hopes to come back as the surgeon!

Where there is love there is life

Kirstie (my good friend and the Africa Mercy Hospital Director) and I have spent the last few days in the capital city Antananarivo having various meetings. One meeting concerned our program to treat women with obstetric fistula. A devastating condition caused by lack of obstetric care resulting in permanent and constant urinary incontinence. The women are left as outcasts, stigmatised due to the terrible smell. At the end of the meeting one of the doctors told this story. 

He said that recently one of the Chiefs from a rural village had noticed how 'strong' one of the ladies was when she returned home after her fistula surgery The Chief had noticed it wasn't just about her physical strength but she seemed 'stronger'.  Another doctor in the meeting then piped up that she had looked at the Mercy Ships website and realised that we don't just care about the physical healing but about healing of the soul as well. She said that there are ladies far away in the south who could have the opportunity to have surgery there but they have refused because they want to come to Tamatave (several days travel away and where Mercy Ships is) because they know they will find love there. She flung her arms in a big embrace and said,  ‘it is like they know they will be surrounded by love if they come to you’.

Where there is love there is life

It is a quote by Mahatma Ghandi. I had not heard it before until Dr Elizabeth Sercombe from evolute ( http://www.surfmonasteryfoundation.com ) used it in a leadership training course she did for our hospital leadership team on the ship.

Où il y a de l'amour il y a de la vie

This is the French version of the quote. Elizabeth used this to start the Mercy Ships medical leadership training course at the local hospital. And it reminded me of a conversation I had a number of years ago in Congo with an orthopaedic surgeon. I was asking him about training needs in his hospital and how we could help. It was his answer to how we could help his nurses that stopped me in my tracks. He said  ‘can you teach our nurses how to care for patients?’ That answer changed my mind-set forever.

It led me to embrace the idea of ‘loved ones caring for loved ones’. Training is more than just a transfer of information - knowledge and skills. It is something deeper. Transformation is about the head and the hands and the heart.

If I had known of Mahatma Ghandi’s quote ‘where there is love there is life’ I might have used that instead. As part of Elizabeth’s teaching she explains the concept of an organisation as a living system where everything is reaching for life. She encouraged us to ‘stay present in the mess’ and to have those crucial conversations and to help and love each other towards life. Life that releases us all to be more of who were are created to be. It had echo’s for me of Marcus Buckingham’s book, The one thing you need to know…about great managing, great leading, and sustained individual success. The chapters on ‘great managing’ embody the concepts of seeing the best in others and helping them achieve personal success.

SO all that to say, today on Valentines Day, my heart is full. I have heard stories of ‘loved ones caring for loved ones’, and I want to live and work in a system that believes as Mahatma Ghandi said, ‘where there is love, there is life’. And I am grateful I know a God who is the embodiment of love.

Happy Valentine’s Day.

Transformation, as illustrated by a participant on our medical leadership course: Eyes to see, ears to hear, and a heart to love. 

Precipitation

Happy New Year! 

I have had to write two references for two people for completely different things in the last 10 days. One reference actually asked me to comment on the candidates major strengths and their major weaknesses. That was tough, I hadn’t noticed many major weaknesses when they worked with me. Of course there were some, and like most of us, often our major strengths can also be our major weaknesses.

Precipitation is the same. When it is cold enough precipitation becomes snow. A major strength if you run a business in the mountains in the ski season.

But if the temperature rises, then snow becomes rain, and the precipitation becomes a weakness as it washes away all the snow faster even than just a temperature rise without precipitation.

Whether precipitation is a good thing or a bad thing during the ski season depends on the temperature – external circumstances. Our strengths and weaknesses are like that too. They depend on the circumstances in which we find ourselves. Winston Churchill had strengths that made him one of the greatest leaders ……during war-time but peace-time was a different story. 

I have just been skiing (thanks to a generous god-mother and my parents) so we have been taking a keen interest in the weather. Precipitation has been forecast but it is of course the external environment, the temperature, that will determine if the water-laden clouds are going to release their contents as snow or rain. Skier’s heaven or hell?

I have now been a full time volunteer for Mercy Ships for 4 years. And as I reflect on my time and my leadership, I think that for the most part, my external circumstances thus far, have allowed my strengths to flourish. I am thankful for that and pray it continues.

But I also ask myself the question, what temperature am I setting for others? Am I allowing their strengths to flourish too? Just like water-laden clouds, the people I lead are laden-full of talents.  So as a leader I want to set the temperature so they can release their talents like thick chunky snow flakes, that bring a taste of heaven to earth.

Wishing you all a very Happy New Year, and may you find yourself in circumstances that enable you to grow and flourish and may you help others to do the same.