Bizarro World

22 12 2011

This morning I arrived at the health center a little later than usual, but still a solid half an hour before the majority of the staff usually arrives. Normally, I find the one staff member who’s on duty watching TV in the waiting room and a small group of patients waiting patiently for the doctor to arrive. Today, however, I found bizarro world.

All of the staff members had already arrived. I checked my watch. Only 7:50, weird. Everyone was wearing gloves and caps, walking around smiling. The patients who had arrived early were already in the consultation room, meeting individually with the doctor. Some patients were even being handed their medications by the friendly pharmacist already. I had never seen medicine distributed before nine o’clock, let alone before 8:00. No patients had to wait. No staff members barked out orders. Things were running quickly and smoothly, and the staff was displaying the best customer service skills I have yet to witness in Cambodia.

As it turns out, two staff members from a leading (US-backed) NGO came to visit the health center today. I watched one of the nurses lead them around the newly-raked grounds, smiling and gesturing while she spoke. It was the perfect picture of what a health center in the developing world can achieve when fully utilizing its material and human resources. Throw a picture or video of my health center in a donor appeal, and you’d be sure to receive record donations.

So I found myself sitting there with nothing to do. Since no patients had to wait, there wasn’t a good opportunity to talk with them about health issues. Since the staff was busy doing their jobs, I was left with no one to socialize with. So I watched, and as I watched, things became increasingly clear. The lab techs had spent a week organizing their slides. A crew had spent several days cleaning up the grounds. Brand new signs were just installed throughout. Everyone had been too busy yesterday to study English. All of these things, all of them, were because of the NGO visit. So I watched for about an hour and then I left, frustrated.

The staff already know what they’re supposed to do, and they have the skills to do it. Today proved that. When they needed to run a good health center, they could. But what about the other 364 days a year? What about all of the patients who come in throughout the year and receive substandard care because there’s no NGO representative in town that day? Why was I sent here to build the capacity of individuals who already knew how to do their jobs, but weren’t?

Yes, I understand there’s a whole host of social and cultural factors here that I need to consider. Maybe the staff really can’t arrive on time everyday because of the responsibilities they have at home. Maybe they don’t have the financial resources to buy gloves and caps for everyday. I get that.  But, if nothing else, they can be nice to their patients everyday. Being nice doesn’t take any extra time or money. And they clearly know how they should be treating their patients, they just don’t.

Now that I’ve seen that they have the knowledge and the skills to be doing their jobs well, I’m left with the challenge of figuring out how to incentivize them to do this everyday. How can the picture perfect health center I saw today function like that all year round?




4 responses

22 12 2011
Anne Marie

Aw, man. They aren’t even nice? Is there a good time to Skype? Awamaki is doing some interesting changes in our health programming and I’d like to run it by you and see what you think.

22 12 2011
Anne Marie

Or, duh, we could talk IN PERSON in two weeks. Let’s do that.

23 12 2011
Mike Warner

Workers not always doing their best or being polite to customers is not just a Third World problem. I bet any manager anywhere in the world would have some of the same complaints. Let me know if you get it all figured out, we’ll make a fortune.


PS – Talk to you in a couple of days.

23 12 2011

AM- Can’t wait. Would love to talk it over… in person!! In two weeks!

Dad- you’re totally right. This is definitely nothing unique to Cambodia or the developing world. Bad customer service and a lack of motivation are found everywhere. Wish those patients could get the care they need though. Talk to you this weekend!

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