Leadership in Action

Leadership in Action

GNU Fellow Marzila Mashal (far right) of Afghanistan attends Leadership Development Program in Egypt

Editor’s Note: Marzila Mashal, an Administrative Coordinator working in Kabul, Afghanistan, was awarded a month long fellowship that is awarded to two MSH staffers each year. The Fellowship was established in honor of Carmen Urdaneta, Amy Lynn Niebling, and Cristi Gadue who on February 3, 2005, died in a plane crash outside Kabul, Afghanistan. The Gadue-Niebling-Urdaneta (GNU) Memorial Fund was established to further the work to which these remarkable women dedicated their lives. Each year, the GNU Fellowship provides MSH employees based in the US and the field with an international public health opportunity at another MSH location. This exchange experience is intended to assist the employees in developing a career commitment to international public health and to increase the understanding of issues facing the people MSH serves.

On January 15,2011, I arrived in Aswan the capital of Aswan Governorate, a city in the south of Egypt, to start a fellowship program that I was awarded through MSH. I chose Egypt for my GNU fellowship out of my wish to help women providers and managers in Afghanistan find their voice and take on leadership roles to address the specific challenges women face in my country.

I hold this wonderful memory of being with an incredibly well aligned MSH team that included both male and female staff. It was an opportunity of a lifetime to see leadership in action in Upper Egypt. I observed firsthand how the Leadership Development Program (LDP) is bringing about change in the workplace and in people’s personal lives. The LDP, developed by MSH, helps organizations develop managers who lead with a vision of a better future. The program has three major learning objectives: learn the basic practices of leading and managing so that managers are capable of leading their workgroups to face challenges and achieve results; create a work climate that supports staff motivation; create and sustain teams that are committed to continuously improving client services.

I learned that the new skills and the resulting attitudinal changes affected life at work and at the participant’s homes. People told me how they changed the way they interacted socially and within their families after completing the program. I found a great sense of commitment among the LDP participants I met.

One doctor (a participant from the first generation of LDPs) told us about a village where the men do not let their wives seek care from a male provider. It is as if the men of this village prefer women die, rather than to be seen by a male doctor. It is not because they do not love their wives, but because of cultural barriers that make it inappropriate for a man to examine a woman. The LDP tools led the doctor his team to the conclusion that the doctors should not stay in his room and wait for the patients to come. Doctors should be part of the community, mix with the community, so that people get to know them and trust them, and see they have high morals.

The constraints are primarily at the social and family level, which is not dissimilar to the situation in Afghanistan. To encourage more female health workers in the community, the LDP team decided to focus on removing cultural barriers by educating people about the role of doctors and nurses and their values to family health. These messages were conveyed through community health workers, radio, TV, and posters.

They also met with religious leaders and encouraged health workers to interact more with the community. This helped to change some of the negative perceptions.

As a result of all these efforts, the women of this village are now seeking help from health providers and more girls are getting educated to become nurses (in their own communities) as barriers to their employment are being removed.

Talking with health providers who had benefitted from the LDP program in Upper Egypt, I learned how they were better able to analyze problems, listen more to others, communicate better and acknowledge the contributions of others. These skills have a positive impact on the work climate in health facilities with staff working more closely as a team.

The LDP teams of Upper Egypt were able to change the behavior of individuals in the workplace and in the community. For example, they were able to establish a discipline of hand washing in one facility and focus attention on other infection prevention measures in another. They introduced the idea of family medicine in one village, and used follow up cards to make sure patients and clients came back for preventive health services in another place.

Some parts of Egypt are like Afghanistan. Both countries are Islamic and many of the cultural barriers are the same.  In Afghanistan, men usually do not want their wives to be seen by male health providers. Yet, it is also difficult for women to be trained or appointed as health professionals. This creates an access problem for women who come for help or advice.  Because of these similarities, I think we can follow the good examples I saw in Aswan.

Unfortunately, I had to cut my visit to Egypt short because of the ‘Arab Spring’ that had erupted on Tahrir Square in Cairo. Although I was never in personal danger, the closing of public facilities and smaller demonstrations in Aswan led to the decision to evacuate me back to Afghanistan.

As a young Afghan woman, I know that this trip was only possible because of a very sad event in which three other young women lost their lives, six years ago in my country. As they dedicated their lives to helping women who needed our help, I will continue this tradition as best as I can in Afghanistan. My trip to Egypt has equipped me to do this well. I am very grateful to the families of these women to have given me this opportunity.

Marzila Marshal is an Administrative Coordinator working on the Tech-Serve project in Kabul, Afghanistan.