Importance of KM in Health: the story of Doctor Anwar and making use of what he and others know in Sudan

Meet Anwar, a Sudanese doctor. Just one of 5 fictional characters created by delegates at the Knowledge Management for Health in Sudan event I spoke at, helped plan and run.

Sudanese Doctor

Anwar

This exercise, Scenarios for the future, was set in 2020 and invited the 80 or so delegates drawn from across the whole of the health industry in Sudan to consider what a day in the life of each character might look like.  This was a new and warmly embraced concept in an environment where my information is my soul and much of the debate about the future takes place against a backdrop of uncertainty and increasing austerity where:

  • 2/3rds of all drugs are purchased ‘out of pocket’ not from health system
  • drugs are proportionately more expensive than in other domains
  • funds from external sources are available to assist with health informatics.

Having settled on a description of each character the delegates who were by this time in groups of 8-10 then set about imagining what their day might look like on January 1st 2020. A vivid imagination is required and was evident in the quality of the stories that were told by each group’s nominated storyteller.

The story of the Health Worker

Ismail’s story – Health Worker

I will in due course and with the organising committee’s permission publish the two ‘winning’ stories; yes we did do voting while the storytellers left the room.

One of Sudan’s leading pharmacists noted in a one:one conversation how important listening was and how difficult a technique this is for many to use when prescribing drugs.

By inviting each of the storytellers to play back the story to each of the other groups it was good to hear them say in the summing up that by the end they really felt they were the character.

 

The previous day I’d invited the delegates to change the way they looked and think about issues and barriers.  Using when you change the way you look at things, the things you look at change exercise conducted in the best breakout rooms I’ve ever worked with, the delegates who are naturally loquacious soon grasped the concept of seeing the room through the lens of different professions.

Breakout room

Breakout room

This change of mindset was important: it allowed the subsequent round table (well round conference room) session that discussed:

‘What are the biggest issues we face in sharing knowledge and information about the health of our nation and how can we overcome them’

I’d invited each delegate to introduce themselves to three people they didn’t know. This worked well and encouraged a very frank discussion. The main issues highlighted were:

  • no systematic collection of information and limited understanding of its value
  • transparency of process (where do the figures go) and credibility of the data
  • lack of human resources to do the collection
  • limited statistical information to undertake scientific research on
  • ownership of data and the whole process – fragmentation
  • accountability to deliver
  • communication/awareness of what each organisation is doing – lots of ‘stuff’ is happening but there is a real risk of duplication of effort e.g. many of the disease control programmes are creating their own informatized information systems

Delegates recognised the tremendous strides being made by the Public Health Institute (one of the event’s sponsors and host of the official dinner) in developing professional public health administration programmes, the creation of a Data Dictionary and the publication of the first Annual Health Performance Review though many bemoaned the lack of official  support for research projects where Sudan has a prominent global position, Mycetoma Research Centre an example.

I came away from reflecting on a discussion I had around the event:

Its all about ‘informization’ – the ability to report from a health centre level with ‘point of sale’ data collected via PDA’s / mobiles as well as computers; about logistics management as a result to ensure supplies get to where they can do the most use.

This can be monitored by the minister, routine reports can be prepared showing which centre reported, which district has complete reporting, which state has complete and timely reporting and % of stock outs of basic drugs or vaccines etc.

And inspired by many of the presentations I’d seen on the morning of the second day from University of Khartoum’s research centre and of course the Public Health Institute who are reaching out to try and create greater awareness through public forum, newsletter and other events.

Perhaps the presentation that struck the biggest chord was from EpiLab
who have achieved impressive results in helping to reduce the incidence of TB and Asthma and whose research and community communication techniques are highly innovative. I loved the cartoons they developed on how to self treat and prevent the incidence of illnesses which were drawn up BY the local communities.  Their pictures and their words are published as guides for the nation and I know they will make them available so I can share them in future blogs.

It was an honour, a challenge but nevertheless great fun enhanced by the warmth of the welcome and a genuine sense of appreciation. Sudan’s people are among the most engaging and intelligent I’ve met. One anecdote from a conversation with a young professional in the communications business illustrates their dilemma:

‘…of the 95 people who graduated in my year a few years back 90 are now working overseas, the majority in highly paid good positions…’

In my address I acknowledged the support I’d had from many people in preparing for the event. They were: Ahmed Mohammed, Dr Alim Khan, Dr Anshu Banerjee, Ana Neves, Andrew Curry, Archana Shah, Chris Collison, David Gurteen, Dr Gada Kadoda, Dr Ehsanullah Tarin, Dr Madelyn Blair, Sofia Layton, Steven Uggowitzer, Victoria Ward

Knowledge Cafe Tips: printers, posters and event management

I’ve been printer challenged: what seemed like a good idea a few years back to buy an all in one inkjet has turned into a logisitical nightmare as printer cartridge costs (at least Epson) have rocketed while I try to become greener, use recyled paper and print less. While social media and emails have an increasing role in raising awareness snail mail and hand delivered notices are still very important especially at this time with the avalanche of material that will greet returning vacationers. If not then why do so many corporates engage in poster campaigns in their offices to augment their online activities?

So having secured a date, venue, speaker and got an endorsement from David Gurteen I am going to run the inaugural knowledge cafe in Lewes to discuss a topic that’s been on my agenda for some time – helping to make use of surplus food – the Plan Zheroes initiative. And I’ve been trying out Eventbrite as the management tool for the registration.

For those who are new to Eventbrite it is a very simple free to use and effective tool that handles all the online administration of an event.  It took me less than a couple of hours from zero knowledge to setting up this event online and registering half a dozen people. See what you think? Knowledge Cafe:making use of surplus food

In case you are interested I’ve ended up buying a Brother Wireless All in One (though the reviews say it looks like a tank) that prints A3 as well as A4, essential to produce the worksheets that can often transform a working session.  Here’s one example from the work of my colleagues at Sparknow who excel at this kind of creativity in workshop design.

 

Picture taken by Julie Reynolds at a workshop run by Victoria Ward at The Whitechapel Gallery.

 

 

KMUK 12 closing: getting wet in the shallow end!

At David Gurteen’s Knowledge Cafe Monday run by Arthur Shelley, who coincidentally I interviewed as part of the ‘evolving role of our knowledge manager’ enquiry, I bumped into Adrienne Monteath-van Dok of Plan International who was one of the speakers at June’s KMUK event.  Adrienne said she’d enjoyed the closing session I’d facilitated and that I should share the mechanics with the wider community – so here goes.

If you recall I’d used a ‘swimming pool’ exercise as an ice breaker to promote dialogue and I returned to the same theme to create a sense of animated closure.

I’d left up the six ‘stations’ round the room:’changing room’; ‘poolside’; diving board’; ‘shallow end’; ‘deep end’; and ‘bar’. This is how the 25 minute session was conducted:

I began by describing each of the ‘stations’ :bar = had lots of experiences/war stories and in a position to raise a glass to congratulate or commiserate.

I invited each person to return to the position they’d assumed the previous day. NB ‘newcomers’ had to choose their station at this point as well.

At this point as delegates moved around the room there was a lot of reacquainting and an audible buzz.

The delegates were then asked to consider three questions (and remain standing):

  • What surprised you at KMUK?
  • What are you going to take back to your organization?
  • How do you feel at this point?

I invited them to share the answers with the person next to them.

I concluded the exercise by walking round the room with a roving microphone; each delegate I approached was asked to give a rapid fire answer and to pass the microphone onto a person of their choosing.

This took about 5 minutes culminating in a very positive response (in the shallow end) from a delegate who said what he’d heard over the two days made him believe that far from being dead and in contrast to the feeling he took away from KMUK 2010 KM (in whatever guise it appears) is very much alive. He felt re-energised as indeed did I.

Many events end on an exhausted low note; from the feedback KMUK 2012 wasn’t among them.

‘…they must put something in the coffee…’ from KM Mid East

A quote in conversation with one of my fellow speakers at KM Mid East Abu Dhabi 2011.  We were talking about why people like working in her organisation; she herself has been there many years and now has a Knowledge Management (KM) brief.

That sense of pride was evident among many of the delegates I spoke to. It was borne out in the results of the Knowledge Survey conducted by Sparknow in advance of the event wherein the majority of people said they’d contribute for a sense of wider acheivement suggesting that monetary rewards are not motivators for knowledge sharing.

If I’m honest I was surprised by the number of people in the audience who put their hands up when I asked at the start of my address ‘how many of you are in a KM role?’ Over half of an audience of 120 plus drawn from across the region said they were.

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The event was a delightful mixture of formal and informal in a way the the Arab world excels at. Held in the splendour of the Intercontinental Hotel Abu Dhabi it brought together a mix of KM practitioners and wannabees.  The organisors will be posting speeches, videos and photos here; these are my observations on the people and customs and what might or might not work in KM.

There is great respect for the views and opinions of others and people are listened to attentively; delegates were happy to contribute personal experiences for this is very much an oral culture.  And we were reminded by one of the presenters that

the Koran pushes us for more knowledge

which would suggest KM is pushing against a door that is at least adjar.

The event was a reminder to me of how there is no one size fits all for a KM initative (KM ‘Project’ was fiercely debated and dismissed by the delegates). It was vividly illustrated a day later in a conversation I had in the offices of a government agency when it emerged that it is not uncommon for an employee to be called half a dozen times a day by his or her boss.  Contrast that to Western cultures where interactions usually take place via email or instant messaging. And the option of spending a day working at home to focus uninterrupted on a challenging issue is not one that seems to have permeated practices in the Gulf.

These were my takeaways for those running KM initiatives in the region:

  • An organisation’s culture is the sum of the culture of its individuals
  • Introducing financial incentives for sharing is counterproductive
  • The process of transferring knowledge between expatriate workers who still make up a large part of the workforce and nationall staff works best when additional time is built in at the end of a contract for that process to occur
  • More information does not make for better decisions; a case of paralysis by analysis?
  • Pictures stimulate conversation and brevity in written communication is preferred
  • Formal peer to peer dialogue usually requires approval of superiors which means informal ‘water cooler’ coversations often yield most benefit
  • Stories amplify KM and are readily understood as a way of exchanging lessons.

Here are some of the distinquished speakers (John Girard, David Gurteen, Dr Allam Ahmed, Luke Naismith plus yours truly)

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