Leading Through Complexity


This is a guest post by Janice Tomich.

How as a leader do you lead when you are not sure yourself – when the issues are complex? The answer is leading with an open heart. Those that you lead may disagree with your decisions but cannot fault your intent.

North America or Africa – no difference.

The request to be the project coordinator/clinic assistant for a mobile dental team was too tempting to pass by even though I had not held dental instruments in my hands for over six years.

It’s only been a few days since my return from a month long visit to Kenya where our lean team of six provided dental care for six orphanages. There has been a lot to process and I’m still working through what I felt and saw.

Kenya (and Africa) is a fascinating place burdened by the complexity of its problems. It is laden with resources tilled by a “dime a dozen” workforce. As westerners we are challenged to understand the low average wage where a land so rich cannot provide basic human needs. Many households barely keep their head above water with their eye each day on putting food on the table. Clothing, hygiene, and safe shelter are secondary considerations.  Many families struggle to pay school fees, which often only requires paying for uniforms.

From a western perspective we may think we have answers but sometimes our answers can cause more harm than good.

For those of you who have children, do you remember how you thought you knew what it was like to have kids in your life before you had them? The sage advice you knowingly shared with parents who should know better. Africa is like that–until you go there you cannot understand. At least I didn’t. The cultural difference is immense.

The abject poverty, the filth, the smells, the corruption and conversely the ready smiles and the heartfelt hugs make it a confusing place.

And pushing the veil back to understand what is going on is difficult because there are so many layers involved. Leading a team through these complexities was interesting, challenging, and rewarding.

My partner, who is a retired dentist, had visited Kenya before and he arrived with knowing eyes. I was blindsided.

How do you persuade a team of healthcare workers that familiar sterilization procedures used at home are often out the window and good enough actually is?

How do you come to terms when the orphanage’s owners’ relatives and friends are first in line when the kids we came to serve are continually bumped back?

And how do you rationalize that some of the over 1,000 toothbrushes that you gave away may be for sale used as barter in the market tomorrow?

These are examples of only a few challenges we found ourselves managing daily.

The answers are not simple. They require taking the whole into consideration and even then because of lack of cultural understanding the likelihood of making an error in judgment often is a possibility.

The answers we came to although not right by Western standards were right for the current situation.

The slums and orphanages had little access to water. In Nairobi’s Soweto Slum the taps had been shut off (however the taps flowed in other parts of Nairobi) and water had to be purchased. We maintained infection control with bottled water best we could while using as little water as possible and knowing it was better than the access to care that many usually receive.

Relatives and friends were seen first because they were supporters of the orphanages and the impact they had as a whole reached farther than treating individual children (this was an extremely hard decision to make and we still did push kids to the front of the line).

If food (or whatever) was more important than a toothbrush than that’s reality. We were neither judge nor jury.

Ryan Williams


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