I know, it's shocking. Not only have I allowed myself to be defeated and acknowledged this situation to myself but I've then decided to tell everyone about it. I must have taken a bump to the head!
A couple of weeks ago I was discussing the challenges I've been facing with a wise old man that I occasionally ask for advice, and then sometimes I act on what he says. He was telling me that he was only just learning that one can't always get the outcome desired, however perfect you think you are. I said that I'd already worked this out, and I had, but I'm not sure I'd internalised it.
For as long as I can remember I've been told that I'm perfect and can achieve whatever I want. My Mum says so (except for me allegedly not being as generous at sharing sweets as my brother and having fat legs) and my Dad (except for my tendency to chubbyness and inability to suffer fools gladly). Then at school we were taught that we could achieve whatever we wanted if we worked hard enough. Broadly this seemed to be the case all the way through to the end of Uni.
But it seems there was a slight flaw in all of this teaching, [there's a bigger flaw in the school teaching because they totally overlook the reality of gender equality in the average workplace - easy to do if female teachers are in the majority and it's the men that get sidelined at a girls' school], and that flaw is other people. At school and university you only have to control yourself! If you do that then everything goes swimmingly but when you enter the workplace you need others to help you achieve what you need.
In the management books (or self help books, as my Dad calls them) they explain the principle of your sphere of control (those things you can control the outcome of) and your sphere of influence (where you have some degree of ability to manipulate but it's weaker) then there's everything else where you have no chance!
Entering the Pharmacy there was nothing in my sphere of control - I don't work here, I won't be here for long, no one knows me - I have no authority whatsoever. Mr Nyirenda was loosely in my sphere of influence because his boss had asked me to be there and he wouldn't want me to go and complain about him to his boss. But really this wasn't a big concern for him because I was working with his team and it was unlikely that I would find things that he had to do personally.
As with pretty much all of the consulting jobs I've been on, I start from the position of knowing no one and nothing about the project and I've been put there by some high level management but have to deal day-to-day with a lower level of management. No one I have to learn from or speak to wanted me there. And I'm just making work for them. That's fine, I can do this. It's a bit more difficult here because I don't speak Nyanja so I miss a lot of the interactions between people and it's harder for me to read them because the culture is so different.
Thankfully I quickly discover that Abraham will be a good ally because he can speak Nyanja and he has some degree of influence over Mr Nyirenda, which should mean I can make some of the changes that I need to without it seeming like it's coming from the Muzungu girl. So far so good.
After a couple of weeks it becomes clear that the guys in charge of the stores have no real desire to use the computer or change the way they do things. They don't seem to see a problem with erroneously telling people that something's out of stock or realising too late that we are low on something critical. They do the things we need doing because they are told to by Abraham and Mr Nyirenda. This isn't ideal because it means that they will need supervising closely pretty much every day if they are going to be anywhere near 100% compliant with the data entry.
When I got on to looking at the dispensing staff it suddenly became clear that pretty much all their passwords had expired many months ago and they hadn't told Mr Nyirenda. So their claims to have been doing the dispensing on the computer when they had time were clearly false. OK, this is going to be tricky because now someone is going to need to check everything in the dispensary daily too. I'm pretty sure Mr Nyirenda doesn't have time to do that and there's not really an intermediate level in terms of line management in the team - it's incredibly flat.
Abraham and I have been in touch with the UK software developers to work out how to unlock the patient dispensing software. It was quite simple in the end. Mr Nyirenda is very pleased and wants to implement it straight away - 'now my reports will be very good!'. Um, no, no they won't because they rely on the data that's in the computer and it's not right..... it's not even close.
The deliveries that have come since Sande showed me that he knew exactly how to book stuff in haven't been booked in and some stuff has already been dispensed. Every time an anomaly crops up Sande and Kapapi just have a massive argument. And the guys in the Dispensary have taken to lying to me and Abraham about who is supposed to be dispensing that day. They also complain at Abraham about 'you and your Muzungu'. Only very occasionally is Mr Nyirenda there to step in [He is busy with lots of meetings and doing his job!].
He made Kapapi do his data entry from the CSSD this Friday (I have done it the past 3 weeks) and I was asked to sit beside him and watch. Amusingly he was quite happy just to sit there and stare out of the window whilst I was sat beside him. At home you'd work much faster if you had someone sat watching you but he didn't care. 'You see, the problem is that I don't like this type of job' Yes, no one does, but the more you do it the faster you'll become! 'I'd rather be jumping up and down' I resisted the urge just to do it myself. For the past few weeks they have tried to make me so frustrated that I would do it myself but I haven't fallen for it. I have been oh so incredibly patient and waited for them to join in.
Right, so where's the defeat? The defeat comes from the initial phrasing of my brief by the Acting Medical Superintendent - 'Can you go to Pharmacy, understand the software and make sure the reports are correct?' Yes, yes, No. The only way I can make the reports correct is to be there all day every day and do every bit of data entry and stock taking myself. But that would be pointless because it would only make the data for November, December, January and half of February accurate. Then I'd leave and it would stop being accurate again.
And anyway, I can't do it. Emotionally, I can't do it. I couldn't work out why I'd been miserable the past couple of weeks and then it struck me. I can't stand being in Stores and seeing critical items going out of stock whilst little is done about it.
On Thursday evening at dinner one of the medics accosted me. 'Charlotte, we've run out of Lente Insulin' Really? I'm surprised you've only just run out, I thought it would run out last week 'It's ridiculous and unnecessary' I told Mr Nyirenda 2 weeks ago, he said there's lots in Petauke [It's about an hour away by car and brings patients here about once a week] 'But we've run out and it's virtually impossible to manage Diabetes on the ward now. I'm going to have send people home to die'. This is not my fault and totally outside my control to change. I noticed the short stock and flagged it. A week later Kapapi flagged it. I'm not going to be made to feel personally responsible for the plight of the diabetics when there was nothing else I could have done.
Yesterday Geoff rang mid-morning (it's operating day and he had a massive list so I was very surprised) to ask if there was really no Ketamine (they use it for anaesthesia) in stores. There is none but Mr Nyirenda says there's plenty in Petauke. He promised they'd send a car and it would be here by 2pm. Geoff rang me again at 3pm - no sign of the car... I hope it came later in the day or operating on Monday might be a little interesting 'Yes, Mrs Phiri, we can do your operation if you wouldn't mind being awake and conscious for it, obviously you'd be able to remember every detail but imagine the tales you could tell your kids...'
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