Aid and aid work

Sometimes I really wonder why we haven’t seen Madoff coming. Harvard Business School is one of the most high-profile business universities, and when a Harvard assistant professor of organisational behaviour talks about business ethics, you pay attention; so it should be no surprise that a recent interview with Michel Anteby, in which he seemed to support various sorts of fraudulent behaviour, drew quite some attention. His argument is that ‘leniencies’ are part of the standard managerial toolkit and that they are necessary to be able to our work well.

So let’s have a look at some of Anteby’s examples, try to find equivalents in health and aid logistics, and see how this works out.

Managing the store manager

[An] employee setting aside a clothing item in a storage room to later purchase for himself when the item will be deeply discounted is a gray zone as well. In high-end department stores such practices are often tolerated. This leniency when moderately exhibited is widely seen as “good” practice, a small favor done to reward deserving employees, and as such qualifies as a moral gray zone.

The equivalent here seems to be the store manager who ‘sets aside’ spare parts until the equipment for which they are used is superseded, and then buys them at a discount; or the medical store manager who ‘sets aside’ materials until they are almost expired in the knowledge that they will be donated to a befriended charity to prevent expiration. Is this acceptable? Not in my view — but the parallel with Anteby’s example is striking, and suggests that ‘business ethics’ would endorse acceptance of these practices.

Pulping the punch card

… a student who worked in the U.S. pulp industry was asked by his co-workers to punch them out later than they actually finished work. Management apparently was aware of this practice and allowed it.

I dont think I will need to spell this one out.

Medical paras

Paramedics are supposed to bring patients to attending physicians (most often in emergency rooms) and are not supposed to perform many medical acts. Officially, attending physicians are the ones performing the acts. Yet in some instances, to save “crashing patients” (meaning patients who seem about to die), paramedics will perform acts that they are not officially allowed to perform. Not all paramedics, however, are given such leeway—only the trusted ones. When physicians are aware of these breaches, yet remain silent, we are in the midst of a moral gray zone.

A logistics equivalent here would be to allow a storekeeper in an emergency to circumvent certain procedures so the program does not get bogged down in bureaucracy. Seems a good idea, doesn’t it? My view, however, would be that there is no need for it: include an emergency clause in your process description that allows your logistics manager to give dispensation of certain rules, but only after approval from another line manager, only for a limited period, and stipulating that this has to be formalised in writing or an email message. No need to break the rules: the rules should be flexible enough to deal with these situations — most definitely in aid organisations.

… by allowing trusted paramedics to “save lives” even if this means bending the rules a bit, physicians cater to the paramedics’ occupational identities. Paramedics become who they aspire to be, namely “saviors.” These paramedics are also more likely to cooperate with the physicians in the future. Thus, moral gray zones enable both managers and workers to perform their roles.

Anteby himself points the way here to a much better solution. In many countries, paramedics have a much larger role in patient management, in which they are allowed to and have received the training to be able to cope with crashing patients; e.g. in some countries paramedics can intubate, defibrillate, administer certain lifesaving drugs etcetera, and all this at their own initiative. Similarly, store managers who have received adequate training, tools, and discretionary authority, should be able to deal with almost any emergency while staying within the set procedures.

Upping the ante

Two broader implications can be drawn from this example. First, leniencies are part of the managerial toolkit. They allow for “local regulation”: in other words, they allow work to be done.

… Obviously, some level of organizational control is lost because “control” now occurs at the field level between the physician and the paramedic. In a way, top management loses power over its employees. In gray zones involving material pursuits—such as when a clothing item that could have been sold at a higher price to a customer is kept hidden until it becomes deeply discounted—direct losses can be calculated. At the same time, managers gain the employees’ engagement, and perhaps, more importantly, managers get to decide who benefits from its leniencies.

Anteby’s conclusion seems to be a total non-sequitur: as his own examples illustrate, work can be done without breaking the rules, without his ‘leniencies’; and employees can be engaged by other means, e.g. by sufficient training , remuneration, and career options. The telling point seems to be his last clause: power to the managers, whatever the cost.

And in the next episode…

My current project focuses on potentially contested practice where few norms seem to prevail. Whole-body donations for medical education and research provide the setting for this project. The goal is to understand how individuals and organizations operate in this context.

Right, everybody, hold on to your kidneys…

{

Continue Reading 4 comments }Aid and aid work, Featured, Logistics, Public health

Latest job opportunities (19 March 2009)

by Michael Keizer on March 19, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics

Latest job opportunities (14 March 2009)

by Michael Keizer on March 14, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics

SOS: fraud discovered! (Or perhaps not)

by Michael Keizer on March 14, 2009

Michael Kleinman continues to publish one of the most thoughtful and insightful blogs on aid work on his ‘Humanitarian Relief’ mini-site at change.org. This should be on your required-reading list if you are in any way interested in humanitarian relief.

One of his more humorous postings deals with allegations of corruption towards InterSOS, an Italian NGO that (mis)handled a hospital project in Afghanistan. Whether or not InterSOS mishandled the project itself, one thing is sure: they definitely made a mess of the PR side of things.

So what are some lessons that we can learn?

  1. Make sure that you can articulate the added value of your organisation in every project. InterSOS has left the damaging impression (warranted or not) that they have skimmed off a large part of the available funds for the project without being able to demonstrate what they have delivered in return.
  2. Make sure that you can communicate the measures that you have taken to minimise fraud and corruption. Make sure that your logistics processes address these issues, and that you are able to tell how they do. InterSOS has never been able to tell us what exactly they did to avoid fraud and corruption.
  3. When addressing allegations like this, taking legal action is usually counterproductive. InterSOS mentions that they have started legal proceedings seeking compensation. Whether they will be succesful is an open question to me (I just love that pithy acronym IANAL), but I am pretty certain that the negative effects of their litigation (cost, loss of reputation) will easily outweigh the funds recuperated (if any).
  4. Never, never, never require that anything is ‘taken from the internet’. It won’t happen. Yes, The Guardian has removed the video, but copies are archived in many other places (e.g. Michael Kleinman’s blog, as well as YouTube). You will not be able to eradicate whatever is published about you, but you will succeed in giving the impression that you have something to hide. It is much more effective to ask for a rectification on the same page — if The Guardian would have distanced itself from its reporter on the same page as it published the video, things would have looked decidedly different.
  5. If you publish a press release in a language in which you are not fluent, make sure it gets copy-edited by somebody who is. InterSOS’ press release is a terrific example of Italish, and as such is rather funny, but it does not leave a very professional image — and that is putting it mildly.

Any additions? Experiences from readers who have been confronted directly with this sort of media scrutiny?

(Photo: Anti-corruption sign by Mike Blyth. Some rights reserved.)

{

Continue Reading 1 comment }Aid and aid work, Logistics

Do you know what you export?

by Michael Keizer on March 12, 2009

I must admit that I am guilty: I have brought my Dell computer into Sudan — and out again, I am happy to say. But in doing so, I was in technical violation of various US export regulations. Over at Aid Worker Daily, Jon Thompson warned us about this already some time ago. I know that at least one international NGO decided on not buying Dells because of these regulations, even though they actually were otherwise the best for their organisation (they seemed to forget that almost every computer these days has regulated technology on board, even if it’s only wifi, so this was a particularly pointless exercise).

You might say: what does that have to do with me? I am not in America, my organisation is not incorporated in the US, what can the US government do to me? The problem here is that the US claims extraterritorial jurisdiction in many areas, of which this is one. When you bought your laptop or router, somewhere in the small print a clause was hidden stipulating that you would not export the technology to any country that is in the US’ bad books. Still, if you feel that you are untouchable for the US government, go ahead. I am sure SportingBet, a UK internet gambling site, felt much the same — until US law enforcement arrested their chairman. And don’t forget that many international NGOs get a large part of their resources from the US…

So what can you do? I see a couple of options:

  • Not use any regulated technology in prohibited countries. Might be an option for some organisations, but in view of the array of these technologies this is simply not an option for the (vast) majority of us.
  • Go the official route: get a license. Not easy, it needs expert legal input, it is a lot of work, and how are you going to do that in the throes of an acute emergency response? And one can wonder whether you will actually get a license for export to e.g. Sudan… although leveraging public opinion might force BIS to relent.
  • Keep your fingers crossed, go ahead anyway, and (again) plan to use public opinion if things do go pear-shaped and your CEO is arrested the moment she sets foot on US soil.

Whatever you choose to do, make sure it is a conscious choice: don’t get caught on the hop.

{

Continue Reading 2 comments }Aid and aid work, Logistics

Gaza convoy has arrived

by Michael Keizer on March 10, 2009

A short update on my previous posting: the Viva Gaza convoy apparently arrived yesterday (or today, depending in which time zone you are) in Gaza — which makes it the first succesful privately organised aid convoy of this size.

Although… my friend and fellow humanitarian Paras Valeh points out that, back in 1995, a privately organised aid convoy negotiated its way from London to Bosnia. Apparently the convoy was organised by UCL Medical School students. I have tried to find some further information on this convoy, but so far without luck. Anybody who would be able to shed some light?

{

Continue Reading 3 comments }Aid and aid work, Logistics

Australia to Indonesia: thanks, mates!

by Michael Keizer on March 9, 2009

And sometimes, just sometimes, I see so much hope in a small newspaper article.

I don’t think that many people will have noticed the almost historical occasion celebrated in a recent article in The Jakarta Post. Indonesia is not the poorest country on earth, yet it is definitely not in the same league as Australia. However, the recent bushfires in the Australian state of Victoria have caused the unprecedented: Indonesia gave international aid to its southern neighbour. Sure, we are talking about US$ 1 million, which is not a huge amount by any standard of international aid, but just this idea is so hopeful: a country that is still on its way to prosperity and not that long ago was recipient of massive aid, is now able to give some of this same aid to a country that is in the top-20 of the most prosperous countries in the world.

Perhaps we are finally getting somewhere.

(With thanks to Cempaka Projects for putting me on this trail.)

(Photo courtesy of Duncan Cumming. Some rights reserved.)

{

Continue Reading 0 comments }Aid and aid work

I don’t know. And I suspect that those who pretend they do[1], don’t know either.

I don’t think it will have escaped anybody’s notice (or at least anybody who would read this blog) that the ICC issued a warrant for Al-Bashir’s arrest. Nor will it have gone unnoticed that he retaliated swiftly by expelling at least 13 international aid organisations from Sudan. The discussion whether or not the warrant is A Good Thing is raging across a million, million blogs (well, a couple of hundreds at least), with most pro- and opponents presenting their viewpoints with astounding assuredness that they know what is Right[2].

To reiterate: I just don’t know. I am angry and sad, but that is angry with Al-Bashir and his cronies, and sad for the Sudanese population. But there is more to this.

At the last count, I have worked in over 30 countries. None of them is able to get at my emotions like Sudan does; and none save Sudan has made me decide that I never want to go back. Sudan is is blessed with a population that comprises some of the best, noblest, and nicest people I know. It has also produced some of the most callous, cruel, and abhorrent people I know. The strangest thing: the two groups overlap largely — and that is something that I have only experienced in Sudan. I don’t think that there are many countries where it is normal that the same colleague who risks his life trying to get a couple of very sick kids out of a incredibly tight spot, will tell you at some other occasion that he feels that all [fill in your favourite ethnic/cultural group] should be exterminated, and that he would not hesitate to pull the trigger if he had the chance. Yes, it happens occasionally in other countries as well, but as an everyday matter of course? Only in Sudan.

Sudan is one of the most complicated, intractable settings I know; and I find anybody who pretends that they know what is best for the Sudanese highly suspect.

(Photo courtesy of Ammar Abd Rabbo. Some rights reserved.)

Footnote

[1] In my original draft (which, I am glad to say, I let cool for a day or so before publishing), I had a couple of links to some of my co-bloggers here. But what’s the use? You know who you are.
[2] No, I haven’t suddenly contracted capitalitis; this is a result of the way this occasion seems to be celebrated with discussions that usually feature Ideas With Capitals.
[3] With apologies to Wronging Rights for the blatant plagiarism

{

Continue Reading 2 comments }Aid and aid work

Latest job opportunities

by Michael Keizer on March 5, 2009

{

Continue Reading 0 comments }Aid and aid work, Logistics

The new pirate threat: germs

by Michael Keizer on March 5, 2009

If you are interested in logistics, health, and aid, the United States Naval Institute (USNI) blog is a wonder. Really.

The more-or-less recent attention in military circles for soft power means that the USNI is also more and more interested in how the Navy can be involved in aid, in order to win hearts and minds (force multipliers[1], anyone?). Of course, the US Navy is also one of the biggest logistics operations in the world (hey, logistics originally is a military science). So of course the USNI can be a source of fascinating stuff about the two.

One of those little gems was published a couple of weeks back. As the Navy is actively involved in catching those elusive Somalian pirates, some people are getting worried what an outbreak of e.g. MDR-TB, brought across by captured pirates, could do on a closely-packed military vessel. The stuff of nightmares, apparently, and they even quote MSF to support that. Luckily a commenter makes clear that TB is not that easy to transmit, but still…

My first posting ever on this blog was about the threat to aid (and hence to population health) posed by Somalian pirates. Apparently that threat goes further than that, and Navy sailors can be threatened by more than bullets.

(Picture: Arrrgh! | Pirates by Joriel “Joz” Jimenez. Some rights reserved.)

Footnote

[1] I find it curious that nobody noticed that Powell used the term ‘force multipliers’ routinely — he even had a personal rule: “[p]erpetual optimism is a force multiplier.” So his description of aid organisations as force multipliers might actually have been a lot less meaningful than it has been described. Still not a smart thing to say, though.

{

Continue Reading 1 comment }Aid and aid work, Logistics, Public health, The light(er) side