Archive for December, 2009

The Two Kinds of Fear: Afia Mansoor

Wednesday, December 23rd, 2009

 

We live our lives amid two kinds of fear; the fear of God and the fear of Self.

 

The Fear of God can be termed as a Fear of Accountability (FA) and the Fear of Self can be termed as the Fear of Personal Loss (FPL). The FA actually makes one fearless of FPL. It makes one courageous to challenge all that evokes FPL. In simple terms, FA liberates one from littler fears. It equips one with a sense of duty rather than a sense of rights and needs.

 

A person who operates increasingly from the FPL would derive security from things like a cushy job, an attractive (life) partner, a big house in a posh neighborhood. The insecurity for such a person would come from fear of death, losing a loved one, being ill, being jobless etc. His fears would configure how he views the world and works his way through it. His stance would be to Take with a view to be more secure. A person with FPL is powerless because he can be manipulated by the things s/he fears losing.   

 

The person with a heightened FA would derive security from acting in a way that is ‘just’ in his/her perception. S/he would operate from a level of duty. So then, it becomes important for such a person to act appropriately and give everything its due. The ailing parent must be taken care of despite personal discomfort, 200 trees on my estate that serve numerous purposes must not be cut down for my grand stable!

 

A person operating from FA would act against personal interests if appropriateness requires it. He would give away his very sense of self if the situation demands that of him. That’s akin to a firefighter laying his life to save others trapped in an inferno. A sense of duty, and not rights or needs elicits him to lay his very sense of self.

 

But, FA that emanates from FPL serves no good. Consider the case of the suicide bomber. If he strikes with a view to secure a place in heaven, he is still operating from FPL rather than FA. If God is worshipped from a fear of landing in hell, or of the anticipated reward of living in an everlasting garden of pleasure, it is a need-based worship of the Self!

 

The story of Prophet Abraham, in the Quran and Torah, has numerous insights for those who wish to understand FPL. When Prophet Abraham is convinced that a Higher Force commands all that he previously considers worshipping (including the Sun and the Moon), he is removed of the FPL. He then, does not fear the rebuke of his family or tribe and in fact chooses to surrender his very sense of self to the fire Nimrod decides to throw him into, he chooses to slay his beloved son as a sacrifice who is miraculously saved when God deems Abraham has passed the test of ultimate surrender. (Notice, how it is a bigger test to lose a child compared to losing one’s own life as this stage comes later in the prophet’s life).

 

Prophet Abraham challenged the status quo by challenging the tyrant Nimrod who is also the character who got the Tower of Babel (Babylon) built for himself and had according to Talmudic references gotten male infants killed for he was warned of Abraham’s birth, who would grow to challenge his might.

 

The FA liberated Prophet Abraham in a way that he rose to challenge a mighty emperor who believed he was god. Nimrod who operated from FPL is remembered as a fallen emperor with a swollen ego and Abraham is remembered today as a Prophet who strengthened the base of association to God for countless generations after him.

 

That is the degree of liberation FA can bring to an individual.  

 

accountability 

 

 

     

 

 

  

 

 

Feedback to Shahbaz Aftab from Heavy Industries Taxila Education City, Pakistan

Monday, December 21st, 2009

HEAVY INDUSTRIES TAXILA EDUCATION CITY
SECRETARIAT

Dated: 15 Dec, 2009

To: Shahbaz Aftab
Schuitema Associates
Muslim Town, Lahore

Subject: Workshop Feedback

Dear Mr Shahbaz Aftab,

I would like to thank you for an extremely enriching session you conducted for HITEC teachers.

This was a unique experience for the teachers, who were not only inspired but as their comments reflect, lead them to thinking for change. The activities gave them all an opportunity to develop a commitment for the cause of teaching and caring for the children.

I have quoted a few comments given by the teachers in feedback forms:

“Today I am changed. The workshop has set within me an internal dialogue and I pinpoint the flaws in my personality.”

“Today was one of my excellent days; hope we will get the chance in future also.”

“The workshop awakened my inner self and gave a cause to our lives.”

“Your style of delivering the workshop was conversational type. It was quite philosophical and through promoting.”

“It was a great learning experience.”

“A successful workshop done by the resource person.”

Looking forward to seeing you again.

Thank you.

Shaista Shahid
Director Academics

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Schuitema Heroes Series - ‘A Mirror to the Blind - Excerpt 1′

Sunday, December 20th, 2009

Abdul Sattar Edhi is a man who needs no introduction in Pakistan. Nearly 60 years ago, Edhi established the first charity dispensary in a small and backward neighborhood of Karachi. The man, who never completed formal schooling, was ignited by a passion to serve indiscriminately and unconditionally.

 

edhi-3Today, he has the biggest network of ambulances in Pakistan, international welfare offices in four continents, hundreds of medical facilities in Pakistan that offer free care to all irrespective of their religion and social standing, homes for the mentally challenged, the orphans, the elderly and even injured animals. To him an abandoned corpse or a living infant has no religion and deserves equal respect and honor. No other social figure commands the kind of respect and trust Edhi has in Pakistan. He is powerful, successful, and trustworthy at the same time.

 

Edhi is an embodiment of the Schuitema philosophy. He has shown that a single man can truly make a phenomenal difference against all odds if he operates from the Attention: I am Here to Give.

 

The Schuitema blog will carry excerpts from Edhi’s autobiography (A Mirror to the Blind – As Narrated to Tehmina Durrani). Judging by your response, we will continue to carry excerpts from Edhi’s remarkable story of struggle and profound insights to Life.

 

 

 

 

… My mother was feeling and looking weaker by the day. During the last four years, she had withered away to become a faint shadow of herself and she had relinquished her position of authority. She hardly talked to us anymore, only mumbled to herself. Sometimes she cried inconsolably, at other times she laughed about nothing. I knew that the condition was related to her separation from her first born; duty to circumstances her controlled the intensity of the conflict, now her frail spirit failed to cope with the truth.

 

During her illness, I was confronted with the amazing problem of transport, the ailing were provided nothing for mobility. The first time I had attempted to get an ambulance to take my mother to a hospital, I was told that there was only one in the entire city of Karachi, this belonged to the Red Cross and was not easily available. I had often taken her in a rickshaw. After putting her in and holding her tightly, I would jump in beside her and the noisy, reckless machine would transport us. Qualified help was also unavailable, which was the reason I had begun the nursing home. Although, the lady doctor had suggested and many girls offered, I had politely refused assistance for my mother.

 

A neighbour rushed to the dispensary to inform me of my mother’s collapse. The door was open, she had been sitting on the floor cleaning her utensils when some children saw her fall. By the time I reached her, she was gasping for breath, she had suffered a stroke that left her body paralysed. My father and brother were as upset as myself, but neither could give up their work, I took the responsibility of looking after her.

 

That I considered it my first duty to care for the woman who had borne me and loved me, was not important for my mother. Much as I explained that looking after her gave me happiness, she would reject it in an incoherent voice, “Pray that God should free me of this service you do for me. It breaks my pride.” I tried to pacify her, even scold her, but she always became inattentive and detached at such times. In the morning I fed her and changed her, gave her medication and injections, then remained with her until she settled, returning early from the dispensary to relieve my father and prepare the evening meal.

 

 

 

As early as the first few months of her illness, I realized that dependent women become more so with illness. For the poor it was a nightmare. Family members had neither time nor money to spare, sadly, an afflicted woman had nothing to give in return. Healthy people were too alive to become bonded to the life of the old and ailing. To expect more compassion from them was out of place, and yet my upbringing guided me to my mother’s bedside, so that soon, even for the dispensary work, I was contacted at home.

 

 

… my mother had lost her dignity. Paralysis is most humiliating of conditions. It renders the victim incapable of existing without becoming a heavy burden on another human being. Joking about the old times, I tried to make her comfortable with my actions, cleaning her face and hands with a soaped cloth, then with a damp one, “Remember, you washed me like this when I was ill?” as time passed, she became completely bedridden and could no longer be carried down to the bathroom. I brought a pail and tin tub to the room and carried her thin body to a low stool. Supporting her back with the wall to prevent her from falling, I would place two boxes at her sides and pour warm water over her body, soaping her and pouring more water. After drying her, dressing her, and putting her in to bed, I cleaned the flooded room, thankful at our simplicity and lack of furniture.

 

When she used the bed pan, I would wait outside the door, hopelessly trying to retain her privacy; she would turn her face away when I approached her bed again. Washing her was full of sadness, her shameful eyes exposed more than her body. I would make other attempts, “Do you not remember how many times you washed me? You are my child now, I am your mother.” Tears would roll down her cheeks when she heard that. Nothing I said made her accept the reversed condition.

 

That pride and self esteem are dependent on well being, over which one had no control, was a frightening revelation. It brought me face to face with the problems of both the family and the sick, so much more went into an illness than medicine.

 

In the meantime, mother had become skin and bones and was so light now, that when I carried her to the low stool for bathing, I wondered if she even breathed. The time came when she was too weak to sit on the stool, then I would only sponge her. When she needed a head wash, I gently pulled her high on the charpoi, let her thin strands of hair down, and lathered and rinsed them over the tin tub with water from the bucket.

 

At first, I had found it difficult to comb long hair, but soon got used to that; braiding it was another matter, I rolled it down, in every conceivable way, and yet it never looked right. When I cleaned the room she focused her eyes on me, following my every move. Her life had ended many years ago, I had watched her slowly fade away, more because of indignity than pain.

 

I would cradle her head in my arms and rock her gently saying, “Remember how you used to rock me to sleep when I was small?” My smile would fade when her eyes would fill. I loved her like a mother loves a child and mourned her loss before it came. One morning she had a brain haemorrhage and went into coma. Five days later she died.

 

We did not believe in dramatic events and carried her quietly on a charpoi to the graveyard. After she was lain to rest and covered with earth, I turned away, leaving my father and brother behind. There was no longer any reason to return home. I walked towards the dispensary.

 

It was over. She had gone. I could no longer contain the lump in my throat. I locked and bolted the windows and doors and cried bitterly. The past turned into heart ache, the little errands, the packets for charity, those cutting remarks at unshared money, the soft breath blown with her prayers came back. She had given me in abundance until the very end.

 

I recalled those moments spent by her bedside, at last allowing myself to acknowledge her torment at being my dependent. Her eyes always imploring me to return to work, never to stay. I had witnessed a battle between dignity and degradation. Dignity had lost. Even from that she left me an inheritance worth many fortunes. Without realization she gave me an opportunity to return some of my debt to her. Through herself, she took me into a world of misery, selfishness and ingratitude. She had been alone despite a loving husband and two sons, uncomfortable despite financial support.

 

As a child she taught me charity, now she taught me collective social welfare. She opened doors that allowed me to experience the numerous difficulties faced by the people. Its lessons were cruel, its reality worse. Her life, her illness and her loss were an education full of tests and examinations, the pain was practical, it was not an illusion, not a dream. As in any other subject, fighting reality requires knowledge and personal experience. I thought of how bewildered I had been with her condition, how helpless and fatigued I had become. How little I knew.

 

Driven by her example and experience, a passion to change the world was born. She had singed my heart with a burning desire to care for humanity the way I had done for her. In respect for charity she had, unknowingly, or perhaps knowingly, bequeathed me to it, from here there was only one way to go. The first night she spent in her grave, I dedicated my life to the service of mankind.      

 

      edhi-21

  

Cultivating Willing Teachers: Shahpur Jamall

Sunday, December 20th, 2009

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In the previous article, “Compulsion cannot lead to Learning”, we saw how engaging the students’ will is the only effective path to meaningful learning. We also saw that the dynamics of the Care & Growth framework, where the student perceives the teacher’s intent as being there to serve his needs elicits a willingness to work and therefore learn, from the student. The next question must be; how do schools create the conditions where the majority of their teachers come to work to make a contribution to children’s lives and not just to collect a paycheck?

Unlike the corporate world, teachers are not rewarded for going the extra mile. Besides the obvious economic ramifications of performance bonuses for teachers, the dynamics of evaluating teaching and learning make it very difficult to quantify the process and thereby not politicize it. Also, there is no upward mobility in the teaching profession. Usually the only factor that is recognized in a teacher’s career is years of service, or seniority.

Not knowing how to motivate teachers, most school administrators turn to the imposition of controls to “make” the teacher work.  Unfortunately the elements that can be controlled in the teaching process are not essential to excellence in teaching.  For example you can ensure that the teachers make long-term plans, and daily lesson plans.  You can ensure that the teacher comes on time and doesn’t leave before the bell. However you cannot put controls on enthusiasm, commitment, and most importantly, care for the student. In fact controls usually de-motivate and discourage even those teachers who want to make a difference. Finally, the most important factor is the teacher’s intent, which cannot be controlled. Is the teacher there to get something from teaching or to contribute something?

In my experience, even classroom observations, while useful for giving teachers feedback, are not useful as an evaluative tool because the act of observation itself changes what is being observed. Both teachers and students behave differently when an administrator is in the classroom.

It is also self evident that a focus on test results makes the student a means to an end.  Once children realize that they are being used for the teacher’s purpose, you have lost them. We all innately resist being used for another’s purpose. Furthermore, the focus on exam results actually detracts from the educational process as teachers zero in on “teaching for the test” and not towards mastery of skills or concepts.

As you cannot compel someone to be a good teacher, any more than you compel a student to learn, we come back to the essentials of Care & Growth and the benevolent intent of the enterprise.

If a teacher feels cared for by his immediate supervisor, he will go the extra mile for that person. For greater insights into this topic please refer to Leadership; the Care & Growth model by Etsko Schuitema.

But more importantly the teaching profession is essentially about caring for and growing the student. When teachers operate in a climate where the aim of the institution is serving the development of the whole child they commit to profession. When they see teaching as furthering the needs of the owners of the school in the case of a private school or the needs of the educational bureaucrats in the case of public education, teachers do not commit to teaching. Test performance then becomes simply an indicator of growth and not an end in itself. When teaching is done to produce good test results to further the needs of the hierarchy teaching become loveless and deadening.

Only if they are allowed to put students back at the center of the educational process will empowered teachers once again realize the value of the contribution they can make to children’s lives.  And only then will teaching once again become a profession worthy of something more then just a paycheck.

The Death of Common Sense: Pam Pretorius

Sunday, December 20th, 2009

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This is a really interesting article from a friend’s webpage, apparently  an obituary originally printed in the Times of London:

Today we mourn the passing of a beloved old friend Common Sense, who has been with us for many years. No one knows for sure how old he was, since his birth records were long ago lost in bureaucratic red tape. He will be remembered as having cultivated such valuable lessons as:

·  Knowing when to come in out of the rain

·  Why the early bird gets the worm

·  Life isn’t always fair

·  Maybe it was my fault

Common Sense lived by simple, sound financial policies (don’t spend more than you can earn) and reliable strategies (adults, not children, are in charge).

His health began to deteriorate rapidly when well intentioned but overbearing regulations were set in place. Reports of a 6-year-old boy charged with sexual harassment for kissing a classmate, teens suspended from school for using mouthwash after lunch and a teacher fired for reprimanding an unruly student, only worsened his condition.

Common Sense lost ground when parents attacked teachers for doing the job that they themselves had failed to do in disciplining their unruly children.

It declined even further when schools were required to get parental consent to administer sun lotion or an aspirin to a student, but could not inform parents when a student became pregnant and wanted to have an abortion.

Common Sense lost the will to live as the churches became businesses and criminals received better treatment than their victims.

Common Sense took a beating when you couldn’t defend yourself from a burglar in your own home and the burglar could sue you for assault.

Common Sense finally gave up the will to live, after a woman failed to realise that a steaming cup of coffee was hot. She spilled a little in her lap and was promptly awarded a huge settlement.

Common Sense was preceded in death by his parents Truth and Trust, by his wife Discretion, by his daughter Responsibility and by his son Reason.

He is survived by his 4 stepbrothers;

·  I Know My Rights

·  I Want It Now

·  Someone Else Is To Blame

·  I’m A Victim

Not many attended his funeral because so few realised he was gone. If you still remember him, pass this on. If not, join the majority and do nothing.

Our Journey to Personal Excellence: Atherly Khan, Jason Naidoo and Lorraine Molope

Sunday, December 20th, 2009

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Experience is the only word to describe what we have been through, this past year. 

 

A host of events which resulted in our final destination.  The same methodology of Care and Growth was applied in the systematic presentation of our Training.

 

The contribution of the Facilitator gave us the result, which was to arm us with the values of a True Leader.

 

The culmination of the Training, feedback session, blogging, newsletters and most of all the Team interaction has brought us to our final destination.

 

Each Month we entered a new journey, where we given tools, means and above all the ability to tackle any issue, practically and spiritually.

 

The most profound lesson was that Lessons learnt are nothing compared to lessons experienced.

 

We have been through Change of every nature, and we had ability to guide us, each of us experienced individual learning’s which were both personal and true to them.

 

We believe in the concept of Care and Growth and we will definitely continue to use the principals in both our personal and professional lives. We have seen the effects of the transformation in our leadership style and it has been phenomenal to say the least.

Who makes a successful Doctor? Afia Mansoor

Monday, December 14th, 2009

There is no escaping a doctor. One encounters all sorts of them. The pediatrician, the dentist, the vet and so on. But there are reasons we keep running into the same doctor frequently apart from the reason that we or our loved ones get ill.

 

What is it that makes us go to a particular doctor for our treatment, despite so many others out there with the same specialization? What is it that makes a doctor really successful?

 

Measuring Success:

Is success a measure of wealth?

 

Does that mean a successful doctor is wealthy and vice versa?

 

The reason why a doctor becomes one is to treat patients for illnesses, not to become rich. It is a given though, that the one who does his job well has profoundly more chances of getting rich. So a successful doctor is not one who earns pots full of money each day; it is one who treats his patients well.

 

I avoid the words, ‘cures the patients well’ as a successful doctor will not try to define outcomes, but he will try to do the job as best as he can given his knowledge and skill. He knows that his knowledge is limited in case it is a disease the cure for which has not been found. But that does not deter him from trying his best to cure the illness with the minimum side effects on the patient’s health.

 

Given that one is qualified and skilled in his profession, some additional attributes that make a doctor truly successful are:

 

Being human

Fore mostly, a successful doctor must first be a good human being working with the benevolent intent to serve the patient. Whether it is about breaking bad news to the patient or convincing him of a treatment procedure, the key is to do to the other as you would have it done to you.      

 

The Element of Care:

The doctor who takes genuine interest in the welfare of his patient will be more likely successful than the one who is merely concerned with attempting to remove his patient’s illness.

 

My son’s pediatrician’s is a very successful doctor if you measure it by the number of people coming to his private clinic for a consult. The reason why I take my 3 year old to him is that he avoids giving medicine to him unless it is absolutely essential.

 

Many a times, he sends me off with only a suggestion of patience and a list of natural remedies that eventually cure my child’s viral illnesses. He reads up on latest medical research and backs it with the most natural substitutes he can come up with. When he has to administer stronger medicine, he explains its need to me carefully and is always very friendly to my son. I trust him for my son’s health because of his genuine concern.

 

Over a period of time, I have also noticed that hospitals and doctors who maintain a database of their patients themselves, with a view to ease their next appointment or maintain a comprehensive history, also have a loyal clientele. Procedures like these tell the patients that they are cared for. 

 

Unconditional Service

Another immensely successful doctor in Lahore is a young homeopath. The striking feature of his clientele is that it comprises of rich celebrities and impoverished nobodies simultaneously!

 

This doctor does not discriminate on the basis of the client’s financial status while treating. He maintains a detailed database of each patient, does not charge those who cannot afford to pay, is extremely docile to all and insists all patients gives him a phone call after the first few doses to tell him how they are.     

 

Now that is Care and Unconditional Service to me.

 

Humility

The word doctor is derived from docere in Latin. It means to teach and also means to be docile!

 

There is no end to knowledge really. You cannot stop learning and you cannot stop giving it back as service. The doctor who is arrogant and rude is the antithesis of the giving messiah!

 

I have noticed at OPD clinics, that the most crowded waiting areas are for those doctors who are the most humble and kind to the patients. People are willing to wait for hours to get to talk to these angels who are really good at listening. They grant significance to the patients.

 

This humility also goes a long way in making a doctor successful if each case is treated uniquely. Many a times, patients have to go through the torture of a misdiagnosis because the doctor impatiently attributes the symptoms to earlier observations of similar cases or has not been thorough enough in investigating the symptoms in further detail.

 

Once, I landed up at a doctor’s clinic for an internal infection. On examining, she gave a colorful verbal description of the scale of damage. She failed to explain how various symptoms were linked and brushed it aside with the sweeping suggestion that a surgery would cure it all and that I should be admitted next week because that’s when she had time to accommodate a surgery. When I asked her if the surgery would hurt, she replied, “Obviously! That’s why I’ll sedate you.” I was scared. 

 

I went for a second opinion to another doctor. She recommended surgery without colorful comments. When I put the same question to her, she replied very sweetly, “You will not feel a thing because you will be sedated.” She suggested some more tests and when they showed it was nothing serious, she asked me to come in for surgery when I was stronger from the medicines I was already taking.

 

It doesn’t take a genius to figure out which of the two ladies has a bigger following.

 

Involving the Patient

 

It is exceedingly important to involve the patient in the process of treatment. Somehow your anxiety dissolves (if only temporarily) on the dentist’s chair if the dentist kindly explains what’s going to be done next and whether it will hurt or not.

 

A successful doctor also does not force the patient to his opinion. It is always up to the patient and/or the family to choose the course of treatment. The more complicated the illness, the more a patient and the family needs to be involved in discussions and even decision making. For patients who are illiterate and unaware of medical procedures, the doctors should be doubly humble and considerate. 

 

Each case comes with an opportunity to show care and to grow in return.

 

 

Photo courtesy:

 

 

 

Transforming Pakistan’s Healthcare. Afia Mansoor

Saturday, December 12th, 2009

 

Huma Wasim

Huma Wasim

In October this year, the death of legendary cricketer Wasim Akram’s young wife, Huma shocked many around the world. What started as a minor ailment of tooth fungus, took Huma eventually to a ventilator and she lost her battle with death to convoluted bureaucracy and even intentional malevolence. A traumatized Wasim revealed to the press later that two of the best hospitals of Lahore had failed to diagnose her wife’s disease and in a bid to prolong her treatment, ended up extorting a total of $200,000 from Wasim.

   

 

Only a few weeks later, another tragedy took place. The news of three year girl Imanae Malik dying at one of the best hospitals in Lahore due to negligence has initiated a serious debate into what needs to be sorted out in Pakistan’s healthcare. Imanae Malik was brought to Doctor’s Hospital during the Eid holidays with minor burns. She was injected with anaesthesia in doses unsuitable to her age and died within minutes. According to Imanae’s father Aqeel Malik, precious time was wasted by the hospital staff which kept saying that Imanae was asleep even after he failed to detect the child’s heartbeat. Children and adults like Imanae and Huma die everyday at the hands of medical practitioners and many don’t even make it to the news as they are illiterate, poor and accept it as their fate.

 

 

Imanae Malik

Imanae Malik

On one hand, Pakistani doctors are considered to be one of the most capable ones in the world. Hospitals like Shaukat Khanum Memorial Hospital, Sindh Institute of Urology, Pakistan Institute of Medical Sciences, Jinnah Post Medical Centre, Aga Khan Hospital and the Civil Hospital Karachi to name a few, are being run by some of the finest doctors. The Consultant doctors in Public Hospitals are specially skillful because firstly they handle the most difficult cases coming from the most backward areas on a daily basis, and secondly, they usually have a very successful private practice which allows them to earn a very handsome amount of money and therefore they approach their profession unburdened by the need to make money.

 

On the other hand, sickening cases of neglect make it to news every now and then. A cat eating a newborn baby in a gynae ward of a public hospital in Karachi several years ago, a private hospital in Lahore sealed for running a kidney smuggling racket and an unqualified neurosurgeon at a hospital are some examples that send shivers down one’s spine. In a country where a population of 10,000 has access to only 8 qualified physicians and 0.9 pharmacists, there is an immense burden on the available staff and a tremendous potential for quacks to flourish. In a situation like this, when established hospitals for the affluent start showing signs of criminal neglect, it shows that conditions are appalling at large for the majority of common people.

 

The uproar in the Imanae and Huma Wasim cases has led to suspension of the concerned doctors and staff. It has also led to calls for strict accountability of health practitioners. However a deeper probe may reveal that the issue at hand has less to do with accountability, and more to do with a radical change in the way health services are provided in Pakistan.

 

It is naivety to assume that the government will be able to reform the health sector of evils completely. There is only a limit to which legislation can bring in change. Law can ensure a hospital verifies the qualifications of doctors before hiring them, it can ensure that adequate training has been given to paramedical health staff for treating patients. It can ensure that all patients, irrespective of their financial status, are entitled to finest treatment. It can specify the maximum working hours and minimum salaries for the overworked and underpaid health sector. But that is about it.  

 

Laws do not bring a caring smile on the face of a medical practitioner, neither will they bring humility and patience. They will certainly not guarantee a genuine interest by the health professional in the patient’s condition. The essence to reform lies in the intent with which medical practitioners approach work.  

 

To the Health Practitioner

Medicine is the quintessential example of a profession that is there to serve the other. Examples of the healthy becoming terminally ill or dying due to negligence at a health facility are a stark manifestation that the profession is being used as a tool to TAKE rather than GIVE.

 

Unless medical practitioners realise that their task has phenomenal consequences, things will not change. The intent to serve the patient, the intent to save lives is the core of a health professional’s work. The patient is the customer. He is the reason why a medical practitioner gets his bread and butter.

 

The base of transformation lies at the level of intent.

 

A benevolent intent to serve sees each patient, each case as an opportunity to learn and grow professionally. Each case is new. Each case is phenomenally significant. Each case besets you with a chance to do what is correct rather than what seems easy. Each case that makes you do the correct, steps you up on the level of success and excellence. Each of these appropriate steps secures you trust, equips you with courage and gives you Power.

 

Each case is a chance to save the entire mankind.

 

 

References:

 

  1. http://www.emro.who.int/emrinfo/index.asp?Ctry=pak#HealthStatus
  2. http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/cricket/health+ministry+suspends+doctors+in+huma+akram+case
  3. www.imanae.co.uk

Care and Growth: Compulsion Cannot Lead to Learning. Shahpur Jamall

Thursday, December 10th, 2009

 

Shahpur Jamall

Shahpur Jamall

You can force a man to dig a hole at the point of a gun, but you can’t force a student to learn.  All higher level thinking tasks, in fact anything beyond rote learning as in simply memorizing something to be reproduced on a test or exam,  requires for the learner’s will to be engaged in the activity.  Real learning does not take place under compulsion, and this is why the Care and Growth framework developed by Schuitema  is the single most important intervention required in the education sector in this 21st Century.

 

The basic structure of today’s schools designed for mass education was first developed in the middle of the 19th century in Europe. Its purpose was to develop low level administrators for the growing European empires of that era. The need was for developing people who could follow order and had basic reading and writing skills necessary for correspondence and record keeping. In this model the previous approach of one-to-one, or even small group instruction where the teaching was designed for the learners needs and ability went out the window.

Demands for the 21st Century work force are completely different. Our goal is to develop young people who have initiative, who can think independently and critically, and can sort though vast amounts of information available  and make sense of it.  The focus on strict discipline and do as you are told because I say so, no longer works on today’s young people who are growing up in a different world. For reasons of practical economics, mostly student teacher ratio, we are stuck with the same19th Century  model with one teacher teaching 30 students of the same age group, regardless of ability or commitment to learning.

 A teachers role in today’s learning environment is to get the learner to function in the upper end of Bloom’s Taxonomy;  which means the student must be engaged in activities that require analysis, integration and evaluation.  A teacher must therefore create a learning environment  where a student’s attention is on the activity and where his will is engaged.  Real learning, as defined above, cannot take place in an environment permeated by fear or anger.

shahpur-at-school

Unfortunately, most of today’s classrooms require teacher’s to first  “control” thirty odd rebellious teenagers who don’t really want to be there. This control is usually achieved by some degree of threat or intimidation and therefore fear, resentment and rebelliousness are the two dominant feeling tones that define most middle and high schools.

The Care & Growth model teaches us that when the “little one”, in this case the student, no longer experiences the teacher as being there to get something from him, and instead perceives him as someone who is there to give something to him, the whole dynamics of the classroom changes.

Bayview School in Karachi: Shahpur Jamall's School

Bayview School in Karachi: Shahpur Jamall's School

We have all experienced classrooms where tough,  mean  looking,  teachers spend most of the class period screaming at children to sit down, or be quiet.  We have all also experienced classrooms where soft, gentle seeming teachers have burly teenagers completely absorbed in the activity planned for them.   In my experience as a school administrator I have found the difference is Care and Growth.  Even the most unruly fourteen year old, and yes I am firmly convinced that 14 is the bottom of the barrel in terms of Classroom behavior, is willing to do anything for the teacher he believes genuinely Cares for him and want to Grow him.

When a student does an assignment because he “has to” he does the minimum required which at best leads to mediocrity.  It is only when we do something because we “want to” that we can achieve the excellence required of today’s schools.

A Year in the Life of a Production Manager in a Biscuit Factory: Mercy Tshikhase

Thursday, December 10th, 2009

bk-leadership-front

AT THE START

 

The factory was a shambles.  People were literally sleeping on the job.  Tasks,  which should take an hour, took a day.  The Team Leaders had no sense of urgency and the operators were not committed.  Absenteeism and late coming was poor.  There was control on the line only when the Team Leader was present on the line.  There were Team Leader vacancies with operators in “Acting” Team Leader roles.  Most of the Team Leaders had been “written off” by management as not up to the job.

 

There was no consistency across lines or shifts.  The Team Leaders kept changing.  As Production Manager, she did not know who would be in charge of a line from one shift to another.

  

Changes which made the difference

 

-       The initial Care and Growth training brought clarity regarding the crucial difference between management and leadership.  The Care and Growth model gave her a way to do what she knew intuitively.

 

-       Changes in structure made it possible for the first time to hold people appropriately accountable. This happened when the structure was changed so that operators were dedicated to a line with a Shift Leader for all the operators on each line  A Packing Team Leader was appointed, but each Process Team Leader was accountable overall for the line

 

-       There was an ongoing incremental suspension of control as the Production Manager began to handover specific accountabilities to the Team Leaders A good example of this was accountability for start up on a Monday.  She used to come in early and run around frantically checking that everything was in place for the start up This when she set a clear standard (08h30 start up), provided a Start Up Checklist (a guide only) and required Team Leaders to account for the “why” behind exceptions.  Another example was the chairing of Production morning meetings which used to be done by the Manufacturing Manager.  Now, one of the Team Leaders do it if the Production Manager is not there. The  next step is for operators to chair their own meetings on their line.

 

-       She worked at ensuring that Team Leaders had the support they needed from Support functions like Engineering and Logistics.  According to her: “my Team Leaders only started to believe in me once I made sure that they had the support that they needed to run their lines.”

 biscuits

The right level/kind of service from Support functions was achieved not by finger pointing/blaming.  She went to Functional Managers with specific issues, eg. no raw materials for Line X, explained the impact it had had on performance, eg. waste due to stopping and starting the line, and then required them  to come back on the “why” behind the specific problem and what they were going to do about it.

 

-       The Manufacturing Manager deliberately ensured that he respected the line of command.  Her standpoint was: “if the Manufacturing Manager changes the plan and communicates this to Team Leaders, then he can’t hold her accountable for the plan.”  The Manufacturing Manager gave her the space to run production.

 

-       She applied the golden rule/value of fairness for any disciplinary action that was taken in Production  The key issue, she believes, is to have the right intent when disciplining.  Her view: “the difficult part is having the courage to initiate discipline, not chairing the enquiry.”

 

-       She focused on “ turning around “ individual Team Leaders who seemed to be hopeless cases.  She did this through a combination of finding out their strengths, understanding their reasons for poor performance and appealing to their sense of pride/believing in them.

 

She was not successful with every Team Leader – an individual was dismissed for poor performance.  She believes, however, that she has killed the perception that “Team Leaders at the factory are useless.”

 

-       She focused on doing what is right/not what the business wanted  from her in terms of results.  She says: “if you do your own investigation and then act on what is right, your people will walk through fire for you.”

 

-       She has committed to lead from the following standpoint:

 

·         Suspend your own agenda/understand that you are accountable to your subordinates, not the other way around.

 

·         Take responsibility for providing the means and ability for your people.

 

·         Have the courage to be fair (there have been four dismissals this year and all have been upheld by the CCMA).

 

-       She put a lot of  emphasis on one-on-ones discussions with each of her team leaders  This, more than anything else, she believes is what builds the relationship and an individual’s confidence/performance.

   

-       She recently established weekly plan/do/review meetings with each Team Leader and their team.  Guidelines were provided by her in the form of an agenda printed on flipchart page (one flipchart per Team Leader for each week in the year).  Her standpoint was: “Keep it simple and make it engaging rather than technically sophisticated.”

 

-       She used the opportunity provided by the Line 7 crisis (OEE – 16%) to demonstrate that the right people (new Team Leader and Operators) doing the right thing, can produce the right result.  (OEE now 97%).

 

 AT THE END OF THE YEAR

 

A credible leadership level (Team Leaders) has been established in the factory replacing the previous lead operators who were Team Leaders in name only.  The results (quality, volumes, speed) have improved accordingly.

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