Making a Plan

It's been nearly two months now since I arrived in Nepal, and the fascination with what is different is beginning to take a back seat to the focus on what needs to be done.  Much of what needs to be done is the creation of systems and processes that can be followed and used to guide good businesses practices - and when even the term "good business practices" is foreign to your audience, you can imagine the challenge in helping them to embrace concepts like transparency, accountability, data management, meeting discipline, etc.

Pharmaceutical Suppliers meet at the Ministry for a 'Bid Opening'

The Nepal healthcare system services the healthcare needs of 30million people - it's not a huge country - so on the one hand it seems manageable, but the flip side, its relatively small size makes it more challenging to attract suppliers to provide products and services to satisfy the needs of this small developing country.  When you couple the size with the geographic challenges and limited economic and natural resources it's a perfect recipe for being overlooked as a market for the private sector.  Add to this the potential for leaders who could potentially be in 'rent-seeking' positions and suppliers really need to think twice about doing business in Nepal - or similarly challenged nations.

The concept of 'rent-seeking' is used to describe a practice whereby political appointees pay their superiors for the 'honor' of serving in a government post.  To earn the funds to pay the rent (so to speak) they often engage in practices that enable generation of funds outside of traditional (or acceptable) or "good business practices".  Now I don't want to implicate Nepal by suggesting that this kind of behavior takes place here - but just wanted to share an example of what happens in some developing countries to cast suspicion on government officials and causes private sector organizations to be wary of doing business in such settings.

Little wonder that the survival of such nations is so dependent on the generosity of donor organizations who seek to improve the lives of the poor and marginalized by creating programs that build infrastructure and systems that aim to build a foundation for growth.

One such program was introduced by KfW - a German organization that has generously underwritten a program to record, track and maintain medical equipment in the two most geographically remote regions of the country.  Leaders within the Ministry of Health participated as the contracted organization shared their plan for service and maintenance.  This is a great step forward, but it will be months before we know how effective this pilot program will be in improving functionality and the overall life of medical equipment.

To strengthen the skills of those entrusted with managing donor and government resources, we are holding regular meetings on a variety of topics that 'enhance the capacity' of political leaders and their delegates.  These range from reporting systems, accountability, working with suppliers, creating and managing budgets, using data to make informed business decisions and general analytical skills.

In the next few weeks we will be coordinating efforts to create a complaint and dispute resolution system; demonstrating how international supply partnerships can reduce costs and improve efficiencies; harmonizing division needs for essential medicines and healthcare products and building the skills of biomedical engineers to provide global insights to medical technology innovations designed specifically to address the needs of developing countries and their healthcare systems.

Every day there are more needs and more gaps that need to be addressed and, while daunting, it's exciting to help people find a way forward.  On the surface the obstacles seem insurmountable, but in reality it can be managed by coming together and Making a Plan.

If  your plan includes going out for a nice glass of Cabernet and a taste of Stilton cheese or perhaps a fine Sauvignon Blanc with a side order of mussels poached to perfection, ....by all means, plan on having a glass for me!  Enjoy the day!

Hard-working Nepali's use their heads when it comes to tackling particularly difficult problems.