All it takes is One

I’ve had a lot of interesting conversations over the past few weeks- and they’ve all revolved around what it means to be a leader, what it means to set an example, and how much good all of that can actually accomplish.

Let’s backtrack a bit. I was watching the French election with a few people here and we discussed politics, what a democracy was, and the relationship between Burkina Faso and France. Needless to say, it’s interesting to see what the perception is versus what I imagine versus what probably is the actual relationship.

When we first started talking a democracy was used interchangeably with utopia which, while that would be awesome, isn’t quite right. But, it certainly contained interesting ideas such as: while a democracy is fair and just for everyone- who decides what is fair and just? For example- a conservative Islamic leadership style might be exactly what a country wants, and is it necessarily bad just because it’s not what we have? And no, someone who is not Islamic is not by definition a member of the Taliban, although that was something I did have to clear up.

So this talk about democracy brought us to France/Burkina Faso relations which, admittedly I know very little about; and, is also an incredibly grey area. Our conversation reflected that we didn’t know for sure how much influence France has over Burkina Faso and how often it is wielded. But, if Burkina Faso as a whole is unsatisfied with the status quo, then it’s the responsibility of the country to change it. It’s one thing to talk about changing something, it’s quite another to get off your butt and actively change it.

Fast forward a few days and we had a staff meeting talking about practices that work at our health center, and things that we could do better, that kind of stuff. And the point that I brought up concerned that ambulance and, more specifically, how we (and other health centers use it). As it stands now, the ambulance is like a giant taxi- with a cool flashing light, the ability to speed (though speed limits seem optional here), and the word ambulance on the side.  So when the ambulance takes people out, there’s no one actually giving care. I tried to point out that this probably wasn’t the most prudent idea ever- and, they just laughed at me. Not the response I was looking for but, that’s life. The doctor and the Major actually did step in and say stop laughing, he’s right- but, that didn’t help anyone take the idea any more seriously.

I decided that I was right about this so kept pushing. I said that sometimes there’s hours between when someone refers a sick person to the hospital and if there was someone in the ambulance they can track changes in vital signs and even perform CPR if needed (I have to train them in CPR first but that’s coming).

The response to the idea was something along these lines: it’s the sick person that pays for the gas of the ambulance. And the gas is: from Poa to the village, from the village to the hospital in Koudougou, and then back to Poa. This means that if any village to the east of Poa (Koudougou is to the west) refers a sick person and if they send a nurse with the ambulance the nurse will only get as far as Poa on the way home unless they pay for the rest of the gas. So, then it became a question of, why should we put extra work on ourselves when other villages don’t. My response to this was simple: it’s your job. You have a responsibility to the sick people- it doesn’t matter where they come from. This isn’t my American imperialness speaking- some of the medical professionals that I’ve met in Burkina have expressed this outlook on more than one occasion.

It was starting to get late and we had a lot of other things to discuss so I let the subject go, decided to let it ruminate in people’s minds and then wait for the opportune moment.

A couple of weeks later, the opportune moment came- and I brought up the subject again, this time coupling it with the argument that all it takes is one person to change the status quo. And, somewhat surprisingly the Major and the Doctor looked at each other and said, let’s do it. So now, whenever our ambulance goes out- no matter whether it goes to the east, west, north, or south to pick up a sick person someone always goes with it. It’s not much. But, it’s a start. And, with a little luck the hospital will notice that when our ambulance comes in, there’s always someone who knows what’s up with the patient and that will then become standard practice.

Because, really, it only takes one to set an example for others to follow.