It has been a really difficult month, wait a minute what am I saying, every month is difficult. But this month has been particularly troubling. I have spent way too much time in administrative committee meetings, which I chair. Unfortunately, most of the time has been spent on discipline issues.
Committée de Gestion (Administrative Committee) meetings are much like church board meetings only more painful. We start with prayer, a good thing, and then start working through the agenda. The agenda items are much as you would find in any American hospital or clinic. We have discussed contracts, mission and values statements, policies and procedures, and of course discipline issues. The meetings however, are very warm culture meetings. Everyone has an opportunity to voice their opinion on each item and we go around the circle, sometimes several times. This is a good thing, the bad thing is that each person has to express his opinion with stories of similar past experiences, and multiple examples. It takes forever, but is a very important part of the process. After everyone has spoken their piece we vote, and it is almost always a consensus, which is a good thing as well.
There are some memorable moments with respect to Committée de Gestion meetings. The first few were held in my old office. A 10X10X10 foot room with no windows, and no ventilation, just a wannabe fan. After 2 hours the place was so full of hot air and so humid we could hardly breathe, let alone think or make good decisions. Sweat would be pouring down our faces, we were dehydrated, and when we finally finished and went outside it was like we had stepped into air conditioning. We finally got smart and moved the meetings into the OR, which is air-conditioned. I am not sure Joan Agee would approve of SJRMC having board meetings in OR G, but since the head of the OR is on the committee all is good.
Then there was the infamous “lights out” meeting. This was before we had our new generator and was one of the times when both the old generators were not working and we had no city power. Hence we were running on residual battery power. So we were in major conservation mode. All power was diverted to the refrigerator to keep it running. So we were using flashlights, and the Goal Zero light. We had a committee meeting scheduled that had to take place, so we met in the living room in the dark, with just a dim light to see by. Bekki, Brandon and Johnnie retired to Brandon’s room to wait it out. It was a good thing too because that was one heated meeting. We had it all, yelling, finger pointing, people getting up out of their chairs. I even got into it, yelling “Arretez, arretez” at the other guys to get them to stop shouting at each other. Bekki, Brandon and Johnnie hunkered down, huddled together in the dark, hoping that they would find more than just carcasses in the morning. Maybe the sugar from the Tops sodas we were drinking made us all a little irritable.
I was a little surprised to see our pastor come to our weekly staff meeting. He is on our committee but doesn’t typically come to staff meeting. And he had a few choice words to say to the staff about trust and confidence and treating people right. Hmm, wasn’t sure what was going on, but I was soon to find out. He wanted to talk with David (our administrator) and me after the meeting. Fortunately my new office is bigger and has two large windows, so is much better for meetings now. Turns out a church member had come to the clinic for a consultation and when the nurse ordered blood tests for him, the nurse took the money for the test and didn’t give him a receipt. He thought that was a little strange, and then the nurse drew the blood himself, instead of having the lab tech do it.
He thought it was a little strange and talked with the pastor about it. And that is why the pastor was here, to tell us. After an investigation we were ready to call the nurse in to talk about this. When confronted he confessed, yes, he had taken the money and pocketed it, and then not written a receipt out so there would be no paper trail. I asked him if he had done this before, no never, this was the only time. Yea, right. I was really sad and discouraged. I really like this guy (still do) he is a good nurse, and fun to work with as well. I looked for anyway I could find to not fire him, but after we reviewed the rules governing the organization, we had no choice. Furthermore, what he did is actually pretty normal practice in most medical facilities in Tchad. For instance in the government hospital I am told the nurses will make the patients pay extra to have the nurse administer their meds. Or the nurse will actually steal the patient’s meds and then sell them and pocket the profit.
We, however, like to think we operate on a higher level, and do not tolerate this kind of behavior. So we went through the process. He appeared before the committee, where he gave his side of the story, which wasn’t much, and then the list of charges and his confession were read to him. He was asked if he agreed, and when he did he then signed the confession. The next day he came back and we served him the papers that fired him. It was actually very heart rending. He took it quietly, no shouting or screaming or crying, but it was still hard. I told him he would always be my friend and I thought he was a good nurse and I was sorry this had happened. Good news is when he sees me now he smiles and shakes my hand like nothing happened.
A couple of days later in staff meeting I talked with the staff about what happened. I read to them from the rules and regs, I told them we would fire every one of them if need be, but stealing from patients and the Center would not be tolerated.
David (our administrator) called me into his office four days later, “Docteur, we have a problem.’’ I just smiled, because we always have a problem, not a day or hours goes by without some problem. He had a carnet (patient chart) on his desk.
“Docteur, the nurse Saturday night took money from this patient and didn’t write a receipt.”
I could not believe it. This nurse had been in the meeting just two days before when I warned them about this very thing. Another investigation, another long Committée de Gestion meeting during the day taking up time that I did not have. Another firing of a good nurse who did a really stupid thing.
So these nurses who stole all this money, how much did they take you ask? The first one took 4500 FCFA (Central African Francs), the second one took 3500 FCFA. The exchange rate is about 500 FCFA to $1. So they took $9 and $7 respectively. What makes someone risk their job for $7? Now granted that is almost a day’s wage, and maybe that puts it into perspective. But still, really? This is worth the risk? I am not sure I will ever fully understand the mind set, the thinking pattern. But chronic poverty does really weird things to a culture and to how we think.
I do not hold even the slightest animosity toward these guys, they are a product of their culture, and I am not sure they really fully comprehend that what they did was wrong. They live where the concept of stealing is relative, and very different from what we consider stealing, it is often not considered stealing if the item was just left somewhere (even if you just set it down for a second) or if you are not caught.
That being said I am really sad and disappointed, and I talked with the staff again today in staff meeting. Hopefully they get the point, and believe the message. We have a higher standard here, this is not the government hospital. I pray that God can continue to use us to help lead the way toward being good citizens in His kingdom, where there will be no thieves.
For those of you new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. You will also find links to other missionary blogs such as Olen and Danae Netteburg, Jaime and Tammy Parker and others. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us. For our Francophone friends there is a French translation of our blog that you can find at http://gardnersenafrique.wordpress.com.
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-Scott Gardner
Gardners Under The African Son 