The Value of Being In-Country
Nearly every morning, I am at my desk before the sun rises, talking via video conference with my clients across the world from my home base on an island near Seattle. This service is usually clear and reliable, allowing me to see my clients face-to-face. It’s efficient and pleasant for both of us as we have immediate access to our files and ledgers, and once the meeting is over, it’s a quick disconnect and we’re on to the next meeting.
But what is not there, is a real sense of place. When you are working with an international client or partnership, there is a limit to what you can do from afar, and the connections you can make. I have to rely on the person on the other screen to relay stories and data. I hear about experiences, but I don’t have them. Because of my decades of experience, I can understand and extrapolate, but I’m not there to share the experience myself.
It is important to leverage travel to see clients and partners, build relationships, and understand the context. When we arrive in a client or partner’s home country, we feel the air, we see the town, we meet the local folks running the clinic, and we laugh with the kids checking us out.
A few weeks ago, I traveled to Malawi. Travel is nearly always an exercise in patience and this four-leg trip of Seattle – Paris – Nairobi – Lilongwe was a one for the books. Thanks to flight delays and missed connections, I stood in line after line after line, showing my visa, paying fees, and trying to keep myself upright and lucid after nearly 48 hours of travel. Finally, I arrived and was able to rest before meeting with my Malawian colleagues. For those of us who do global work, this is just one of many relatable stories of how un-glamorous travel can be. And nearly all of us know how important it is to make the trip.
On this most recent trip, I was in-country to work with a colleague to populate and test a tool Kati Collective has developed to help Ministry of Health officials assess what is needed to advance digital health. We were able to sit together in the same room, go over questions, look at the same files, and have a true back-and-forth dialogue regarding what they need in their environment.
When we are in the places we are working to support, we are forced to examine our assumptions and biases. It’s easy—and normal—to create an image or idea based on conversation and what you think you know. When I am in a health clinic and see the multiple single-use digital devices handed out by siloed projects, the six or eight (or sometimes more) patient registers that require repeated entering of patient names, hash marks, and notes, I can better understand the ramifications of adding another indicator on an M&E framework or recommending another digital tool. We see the pleased looks and hear the frustrated sighs of those on the front lines of the work. We see where our theories play out in unexpected ways when put into actual practice.
It’s not that the local community isn’t being upfront when we talk via email or video chat, it’s that they have a different take on their everyday life and processes, than you, as an outsider and sector expert, would have. You can’t get the full picture of the ecosystem until you sit in it with the service providers and recipients.
And whatever country you are in, you chase after busy government health officials who scurry from meeting to meeting with UN agencies and global funders, hoping to secure an hour to tell them about your work. But every minute is worth it. Each relationship is important to the overall goals and every assumption that is challenged makes the work better.
Our goal at Kati Collective is to get to know the actual people whom our strategies, organizational plans, and tools are affecting. We are always asking whether our ideas and assumed outcomes match up with their actual use and needs and whether our recommendations are adding value, not just workload. If the people we work with trust us and we truly understand them and their needs, we can continue to grow our relationship by digital means and together, as partners, reach the goals we’ve set out to accomplish for their community and for our world.
Image: Kirsten Gagnaire, Kati CEO, with Maganizo Manawe, a digital health expert at the Malawi Ministery of Health.