Building a Winning Nation by Building a Healthy Nation

By Dr M. Kilufya

The African continent is called “the cradle of humanity” and it is endowed with numerous resources both in human capital as well as in natural resources. Despite this advantage, the continent as a whole has been lagging in terms of its population’s well-being, scientific progress, and economic prosperity compared to other continents.

The D.R.C is a strategic country for Africa, as well as Nigeria and South Africa “Mzansi”.
The D.R.C is peculiar because of its strategic position and the enormous resources which if unlocked, can influence the whole continent in terms of economic development.

This book targets every African irrespective of his or her race, from high school pupils to university students and academics and more importantly, the African political leaders. It addresses key issues of the causes of this situation and the way forward to transform the D.R.C potential in particular and the African continent in general by creating healthy individuals through awareness and developing an entrepreneurial attitude by collective participation and great leadership.

About the Author

Mansensu Kilufya is a qualified medical doctor from the University of Kinshasa in D.R.C and has a Master’s degree in Project Management from Cranefield College, South Africa. He is a married father of two awesome boys. Dr Kilufya is a founder of Penny-Wise and Guts Health Center in D.R.C.

• Language: English
• Publisher: Dr M. Kilufya
• Release date: Apr 3, 2019
• ISBN: 9780463024072

Book preview

Building a Winning Nation by Building

a

Healthy Nation

Building a Winning Nation by Building

a

Healthy Nation

The DRC (African) Perspective

Dr M. Kilufya

Copyright © 2019 Dr M. Kilufya

Published by Dr M. Kilufya Publishing at Smashwords

First edition 2019

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage or retrieval system without permission from the copyright holder.

The Author has made every effort to trace and acknowledge sources/resources/individuals. In the event that any images/information have been incorrectly attributed or credited, the Author will be pleased to rectify these omissions at the earliest opportunity.

Published by Dr M. Kilufya using Reach Publishers’ services,

P O Box 1384, Wandsbeck, South Africa, 3631

Edited by Frankie Kartun for Reach Publishers

Cover designed by Reach Publishers

Website: www.reachpublishers.co.za

E-mail: [e-mail]

Dr M. Kilufya

[e-mail]

I humbly dedicate this work to both my late parents, Kilufya Mansensu Petwe and Tshibangu Munyenze, for teaching me the right as well as the wrong ways in life.

Table of Contents

Introduction

1. The DRC’s Health Profile

2. The Community’s Profile Served by the Small Hospital

3. The Hospital

4. The Hospital’s Operational Phase

5. Observations Made From Operational Phase

6. The Human Being as Crucial Asset

7. How Do We Introduce Change

8. Conclusion and Recommendations

References

Introduction

The world evolves at different paces with regard to scientific progress, human spiritual enlightenment, human relationships and human financial capability. Each part of the world has its own characteristics of this evolution and individuals of every community are the driving forces of the evolution, as well as the environment surrounding the community, and sometimes unforeseen circumstances dictate the progress.

The human being is the key to any success or failure, therefore the quality of the human being - both spiritually and emotionally, on the one hand, and intellectually and physically on the other hand - is the determinant of the road to success, failure or regression.

In modern life, we do not produce everything we need in one place; goods and services may only be available far away from our residence, but we can still have access to them through the logistic management process. This is also reflected by the availability of many professionals from different nationalities, in different parts of the world.

Logistic Management is the part of the supply-chain process that plans, implements and controls the effective, efficient flow and storage of goods, services and related information, from the point-of-origin to the point-of- consumption, in order to meet the customer requirement. In order to improve any process, a system approach is needed, which states that all functions or activities need to be understood in terms of how they affect and are affected by, others elements and activities with which they interact. Actions should not be looked at in isolation, but as a whole picture.

By borrowing from the logistic-management and system-approach concepts, the society can be regarded as a system of supply and consumption of human beings. These human beings come from stable or dysfunctional families, single parents or orphanages, and sometimes, unfortunately, from the streets. Schools, universities, families, and the society by and large, or their respective environments, mould these individuals into an acceptable or non-acceptable product to be consumed by the society. What is acceptable in one society or workplace may not be acceptable in another society or workplace. It is not only the geographic area that determines what is acceptable and what is not, but the time-frame as well. Corporal punishment at school, as well as capital punishment by law, were acceptable in the sixties, but today things are different.

The type and model of relationships created between children and parents at family level; at school between teachers and pupils, as well as pupils among themselves; at universities between lecturers and students, as well as students themselves; at work between employers and employees; as well as employees themselves; and in the society in general, will determine the type of individuals the society will have, hence also the type of society that it will be. As already mentioned, the activities of its citizens affect the environment or society, and the society likewise affects its citizens.

Life itself is a dynamic process, and thus neither the individual nor society itself is something static. Thus, one can envisage that the way to build a winning nation is by intervening at each individual, or possibly at critical-mass, individual level, from the cradle to the grave, thereby building healthy individuals and, by extension, a healthy society. According to the World Health Organization (WHO), health is a state of complete physical, mental and social well-being. Health is not necessarily merely the absence of disease.

Poor human relationships, poor financial status and unsafe environments, create unhealthy individuals, as well as an unhealthy society and environment in general. That is why building a healthy nation should be a pre-requisite to building a winning nation. To win is to achieve one’s set goals. No goal-setting, no winning. The first step is for each individual to set reasonable and noble, achievable goals. Stealing is a goal that is achievable, but not noble. Singing (most of the time), dancing as well as drinking excessively, are achievable goals, but not noble.

To build is to construct by putting materials together. A blueprint is needed for any building and so it is for building a winning nation, which comes about by first building a healthy nation. No nation can win when its citizen are unhealthy. The blueprint must be well-conceived, implemented and monitored by a great team of visionary leaders at each level of the society, and necessarily with the participation of the community, in order to deliver healthy individuals for the society’s consumption. No involvement equates to no commitment. Such a society will have goal-orientated individuals, capable of producing better individuals than themselves through ongoing improvement. In life, things don’t just happen. A well-conceived map, as well as the required resources, is needed to achieve something worthwhile.

The idea of writing a book on how to build a winning nation by building a healthy nation, emanated firstly from my reflections on the first six months of 2012, when I was running a small, private hospital in a poor community, in the Democratic Republic of Congo, and secondarily by comparing the DRC’s experience with quarter-of-a-century of working in a rural and semi-rural, public-sector hospital in RSA (Republic of South Africa - "Mzansi). Although they are differences in terms of resources, there is a similarity mostly in the type of patients one deals with on a daily basis. Both in the DRC and RSA, these patients are poor - both financially and emotionally - and most of them are almost without goals, which is reflected in and by their conditions, such as teenage pregnancies, unstable family relationships, having many children and expecting others to rescue them (i.e. the government and relatives in the RSA and in DRC, respectively, as the governments in these countries cannot provide sufficient social services at address the needs of their citizens). Initially, this account was planned to be a scientific publication entitled: The impact of the environment on the quality of health service delivery for a new, small, private hospital in the Democratic Republic of Congo". Later on, I thought that the research publication would reach only a few people, while the ideas needed to be shared with the scientific community, as well the layman. Hence, I decided to change the title and format to accommodate both audiences, hoping that my assumptions were correct.

This decision has required me to adopt a balanced approach between the layman’s need and the scientific community on the one hand and, on the other hand, a balance between the business and medico-social aspects, hence my decision to review the title and adopt: Building a winning nation by building a healthy nation instead.

The small hospital is the place where most of the activities, findings, conversations and challenges happened, therefore a reference to the small hospital building and the way it’s being run is included, because without this small hospital this undertaking would not have been possible.

The standard of practice of Medicine should be universal, meaning at the same level and standards everywhere. However, this is not always the case, for many different reasons such as: economics, knowledge and skills, regulations, structures, cultural, private or public service, academic or non-academic institution and so on. The adherence to the recommended standard will definitely impact positively on the quality of healthcare and will benefit both the community served and the healthcare provider - in this regard, the hospital and its staff - whereas the non-adherence to the standard will result in many negative outcomes, from the poor health status of the community, to diseases, to patients’ resistance to some drugs, as well as patients’ deaths.

The standard can be defined as: an agreed level of performance, negotiated within the defined limits available resources (Iraj Abedian et all 1998:96). The standard is also defined as: an object, or quality, or measure, serving as a basis to which others conform or should conform (Oxford dictionary 1991:1188). No one should ignore this principle, without jeopardising human lives, and all efforts should be made through regulation and by the monitoring of any healthcare provider to meet the minimum requirement. As the definition indicates the importance of available resources, these resources range from human, capital, equipment as well as skills and medicines.

The impact is: the action of one body coming forcibly into contact with another, or an effect or influence (Oxford 1991:590). Here, it is the environment that comes into contact with the quality of health service. The environment is a complex concept, therefore very difficult to define and contain. In this case, two aspects are considered for environment: the business aspect and the medical aspect.

Medically-speaking, the environment is considered to contain different variables, internal and external, which play a major role in the health of the human being, the family, the community, and the whole country. The external variables are: water supply, sanitation, exposure to industrial hazards and so forth. The internal variables relate to individual peoples’ characteristics such as, age, sex, immune system, attitude to risky behaviour and so on.

The business aspect of the environment refers to the aspects surrounding the business. These surroundings comprise a set of conditions that are uncontrollable in nature and affect the functioning of the organisation or business.

The business environment has two components: the external and the internal components. But others consider the environment as being only the external component of the organisation or business. The internal component refers to human resources, equipment, funds, material and the management. The external component consists of the micro/operating environment (suppliers, customers) and the macro/operating environment (economic conditions, policies, banking system, political, technological, etc.).

The practice of Medicine, either private or public, should follow a Business Model for its survival, and efficiency is paramount in this context of limited resources and healthcare-cost escalation. Astute leadership, managerial skills and, of course, clinical skills are required to ensure that resources are efficiently used and customers are retained as a result of their satisfaction, and also new customers are acquired, and possibly that services are also expanded as a consequence of ongoing growth.

‘Business’ refers to the human activities such as production, extraction or purchase or sales of goods, and services that are performed with the aim of earning profits.

‘Quality service’ refers to delivering a service in relation to client need and expectation relative to planned (internal) standard and available resources (Iraj Abedian et all 1998:95). Quality is also meeting the clients’ requirement; it is doing things better. Sometimes, the customers’ expectations may be so low due to their environment and ignorance, so that the quality is not even appreciated in relation to cost.

The quality concept is multidimensional and comprises: reduced waiting time, a clean environment, friendly staff and an adherence to protocol, when required. The quality of healthcare will depend on the response from the community to the offered health package. This response can be below or above the expectation of the Healthcare provider.

This quality concept may vary, depending on the type of industry one may be dealing with. In a service industry, quality dimensions are: reliability, which is the consistency of performance and dependability; responsiveness, which is the willingness to provide service; timeliness; competence, which is the possession of skills and knowledge required to perform the service; access, which is the approachability and ease of contact; courtesy, which includes politeness, respect, consideration for property, clean and neat appearance; communication, which is educating and informing customers in language that they can understand and also listening to them; credibility, which is trustworthiness, believability, and having customers’ best interest at heart; security, which is freedom from danger, risk, or doubt; understanding, which is making an effort to understand the customers’ needs, learning the specific requirement, providing individualised attention and recognising the regular customer; and tangibles, which is the physical evidence of service (facility, tools, equipment). Many quality pioneers are recognised, among them W. Edwards Deming; Joseph M. Juran; Kaoru Ishikawa, etc.

Old organisations in an industry, have the advantage of setting up standards and costs. New entrants have to adhere to the established standard and practices, which may be lower or higher than required. If the standard and practices established are very low, the new entrants, with higher standards, will face opposition from the competitor, and rejection from some customers, mostly regarding the cost. Quality and standards come at a price, but customers often want high-quality and low cost, although some customers will appreciate the quality and are prepared to pay the price. Being a start-up in any industry, means having limited resources (financial, human, equipment) and having to go through the phases of organisational growth, which are: the introduction phase, the growth phase, the maturity phase and the decline phase. Each phase has its own challenges. During the introduction phase, customers are scarce, cash flow is very low, and the responsibility assignment is very fluid. The employer or entrepreneur should expect to work long hours and be very flexible in supporting some areas of activity when needed, such as the cleaning of toilets, the waiting area and even security.

The educational level, the economic conditions, the epidemiological status (the incidence and distribution of diseases in the community) and the culture of the community, will dictate the health-package that can be offered, and adjustment should be expected in this regard.

Starting-up any activity is always based on