PIMCO Foundation

Global Health Corporate Champions - The Return

All too soon our project and time in Ghana have come to an end.

All too soon our project and time in Ghana have come to an end. Our month-long, pro bono consulting assignment culminated in a 45 page report of findings, together with a final presentation of our key recommendations, which we delivered to our client and a broader audience of key stakeholders related to the Global Health Corporate Champions program in Ghana.

Our task was to tackle the issue of financial sustainability for our host client, a network of 291 hospitals and clinics across Ghana, focused on providing health care services to the poor and marginalized, as well as those living in underserved locations. Having mostly relied on external funding for the last 50 years, our client has been hardest hit by Ghana's recent reclassification as a country to lower-middleincome status, and subsequent withdrawal of international development partners and donors as a result. As our client continues to grow and expand their network, trying to reach every household without health care access, so do their financial support needs. Our goal was to leave our client with tangible as well as feasible recommendations, the implementation of which would put the network on a path to long-term financial sustainability, while also addressing near term financial and operational shortfalls from expiring cash flows. The scope seemed infinite, while our time on assignment was definitely limited.

Truthfully, we started off feeling somewhat overwhelmed and uncertain about what we could accomplish for our client. My project team mate and I both hail from private sector, for-profit backgrounds, his expertise being in operations, logistics and supply chain management, and mine being in finance, investments and client relationships. In our first conversation, I recall asking each other: What do we really know about health care? About Ghana? About the social sector? If our client, a well-established and prominent organization that has been around for 50 years, is out of ideas, what could we possibly bring to them with no local contacts or relevant experience? What exactly can we accomplish with that tremendous learning deficit, combined with only four weeks on the ground and needing to learn about local business practices?

Perhaps this sense of initial helplessness was a blessing in disguise . We were determined to get up the learning curve quickly, to explore as many options as possible in order to come up with something meaningful and substantial that our client could implement with ease after we left.

Through our research we attended our client's annual conference, a six hour drive away from Accra, where we interacted with network member institutions, corporate partners which included pharmaceutical companies, Board members, doctors and nurses, as well as public officials. We met with international development agencies, funding partners, strategic business partners, water sanitation experts, external consultants and the different departments at our client's offices. We researched countless non-profits, both local and global, the health sector in Ghana, the economy, and local financial markets. We visited health care facilities, from larger hospitals to smaller clinics. We learned how to diagnose malaria, observed medicine inventory practices, assessed hygiene circumstances, and spoke with patients as well as hospital management staff. We traveled around the country and spent time in the communities our client serves, engaging directly with local residents and health service providers, growing in understanding of the sobering reality of their circumstances. Eventually, we started to grasp what real poverty looks like when we learned it costs USD $0.25 a day to send a child to public school in Ghana, a cost these families cannot begin to afford for one, let alone multiple children.

Data collection is also a challenge nationally within the health sector, so we tried to make ourselves useful on our group community service day, by going around individually to patients and registering their key information. The individuals we registered don’t read or write, and speak different dialects, so our ability to write down their information helped streamline the wait so nurses could devote their time to treatment, rather than administration. Of the 300+ patients registered that day, over 95% of them didn’t know how old they were. Connecting the dots, you realize they don’t celebrate birthdays...and then you realize they live day to day, rather than year to year.

All around, we navigated different initial conditions, from the standard of work environment to the feasibility of our recommendations. We experienced frequent power outages, or dumsor as they are referred to locally, and inconsistent internet access. There were days we would be reading documents in the office with a flashlight when the lights went out and mopping our faces with cold water when the AC broke down. Simple things we take for granted like swallowing contaminated water in the shower can cause serious water-borne illnesses. We spent our days covered in bug repellent and diligently covered up in long sleeves and pants at night.

In the lead up to our project recommendations, we had to figure out how to get information to locations of the country that don't have a phone or a mailing address, let alone electricity or an internet connection. We had to figure out how to educate large communities about health topics, when basic hygiene doesn't exist. We had to figure out where to cut costs when people earn barely enough to live and feed their families, let alone take a family holiday. Crucially, we developed ways to plug the funding gap when the nationwide supply of donor funding is dwindling and demand continues to grow. Indeed, a highlight was educating our client and their key constituents on the use of an endowment to finance their operations, a concept that is in its infancy in Ghana and only present in the education sector according to our research.

We also made recommendations that, while very important to the organization’s ongoing sustainability and ability to attract future funding, are unpopular to suggest. For example, we made the case for more talent management, and why employees need to be developed or replaced, in an environment where these people are already making huge sacrifices to uproot their lives and go work in remote and underdeveloped locations of the country. We had to make the case for profit-generating revenue streams, when the concept of profit is public enemy #1 in these circles. We educated our client on branding, marketing, and general business strategy, appealing for them to invest time in this when right now the focus is first and foremost on people receiving quality care when they need it and not running out of money to achieve that mission.

Along the way, we learned a lot from our Ghanaian friends and coworkers, professionally as well as personally. We experienced a business culture where relationships come first and the task comes second. We learned that our concept of timekeeping and a day scheduled down to the last minute doesn’t apply in Ghana; instead, flexibility and patience are key to successful business outcomes. With a number of variables beyond our control, we eased into going with the flow rather than going with the plan.

We also fully embraced the local culture, food and social experiences, with delicious and fulfilling discoveries. We bonded with our Ghanaian hosts, as well as among our multi-company, international cohort, and developed deep friendships I am sure we will have for a long time. We explored the country outside of Accra in our free time and took in the rich history and stunning landscapes of the Gold Coast. We were humbled by the lessons we took away from visiting the slave castles and the impoverished communities we drove through.

We basked in the Ghanaian gladness and joy of every person we met. A people who, for the most part, gets by with so little and yet feels rich in blessings, the ability to live another day and have each other. Now back home, we are learning to appreciate more what we have. We know now we worry and stress too much. We don’t live in the present and savor each experience enough. We no longer take for granted the roof over our heads, clean water, electricity, abundant food and access to quality healthcare. We know we can be more helpful, more generous, more forgiving and understanding. We endeavor to welcome visitors with the warmth and friendliness of Ghana’s welcome, or Akwaaba, as they say in local language Twi.

Throughout this program, which combines the skills and experiences of the private, public and social sectors, we were delighted to impart some of our private sector knowledge to our client hosts and gained so much more in return. The tremendous gratitude and appreciation we received for our input, our time and our help, is something I will never forget. While I embarked on this journey with the goal of delivering a successful project outcome, I never could have imagined the professional and personal growth that would come of this experience. Some of the more difficult aspects I can’t unsee, and I carry those in my heart as I return to everyday life. I hope to embody the more positive aspects and incorporate those in my day to day. As we departed for the trip back, our Ghanaian friends had a simple parting request: Tell our story. Tell your friends, colleagues and family about Ghana, about us, about what you saw, lived and experienced. You are all welcome to visit us, anytime. This is my story of Ghana.

The Volunteer

Marta Bezoari

SVP, Account Manager

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