I recently had the good fortune to travel to three countries in 30 days with Lara, my colleague at Global Partnerships. We needed to meet with existing partners, as well as explore some new potential opportunities. While any time I venture into the field I have a well-organized schedule and set of goals to achieve, I always return with an unexpected set of ideas, observations, and revelations that only field visits reveal.
As this was my inaugural trip to Honduras, I was looking forward to experiencing the land and the people first-hand. We met with our partner in the Health Services Fund, COMIXMUL, and their sister organization FUDIEMFA. Together, we met four of the micropharmacists or ‘dispensadoras’ – these are the volunteers whom we train to become community pharmacists – the key individuals who bring access to affordable, critical medicines in their communities. Meeting directly with our colleagues and our stakeholders made me pause and consider what factors are critical in developing strong, effective partnerships in the challenging world of efficient, sustainable healthcare delivery.
1) Thinking about what is possible – together. Global Partnerships (GP), the lead partner in the Health Services Fund, has a clear philosophy when it comes to implementing new solutions: Conceive a business model that can deliver essential health services at scale and on a sustainable basis. To those of us who are knee-deep in this area, this concept sounds rather straight-forward, and yet it is not. For partners who have been traditionally funded through donations, this can be a wholly new approach. For example, prior to participating in the Health Services Fund, COMIXMUL’s definition of sustainability meant continued funding through donors. Today, a sustainable solution typically implies that a business aspect is embedded in the solution…that is, the solution must self-sustain itself without the need for external funding/donations.
By closely communicating this concept and strategizing about implementation, GP, COMIXMUL, and Linked Foundation have developed and is now testing a business model that well demonstrate that the micropharmacy model can reach all of its clients on an economically sustainable basis. What does that mean? They won’t need donor-funding year-in and year-out. And guess what? They are 70% of the way toward reaching that goal. Impressive.
This philosophical shift did not arise as a result of one partner exercising supremacy over another. Rather, it was the result of intensive meetings and reviews, co-creating and exploring various models and scenarios together. It was so rewarding to see partners working alongside each other toward a shared aspiration; problem-solving and thinking through the issues and solutions together…imagining, then implementing, and finally succeeding together.
2) Learn from all stakeholders – Along with spending time with the COMIXMUL and FUDIEMFA teams, we had the great pleasure of visiting four of the community pharmacists or ‘dispensadoras.’ There is no knowledge as valuable as that learned directly from the consumer or customer. In our case, our consumers/customers are the dispensadoras, the women who actually operate the pharmacies on a daily basis. They provided unique insight about what was working and what was not; about what was selling and what was not; and what new services or products should be offered.
The dispensadoras are trusted sources in their communities because they provide education and consultations – they determine what medicine is needed for what condition and the proper administering of it. They underscored a need to provide nebulization services due to the increased incidence of respiratory problems…particularly in children. In addition, we learned that sales had increased substantially after a summer promotional campaign was conducted at several pharmacies to create awareness within its community. It was particularly rewarding to learn that Ana Joaquina Martinez, one of the community pharmacists we met, said that having the pharmacy has inspired her to pursue a degree in nursing. She’ll be a degreed nurse by this month.
I was inspired by every person I met; touched by their personal stories, and their unwavering commitment to improve the health of their communities.
3) Trust – When we arrived in San Pedro Sula, we were greeted by Glenda Ferrera, director for the health program for FUDIEMFA, the nonprofit arm of COMIXMUL. I’ll never forget seeing her smile and the warm embrace she gave to me and to Lara. As she greeted my colleague, she said, “Ah…Lara, you’re here.” Those four simple words…and the way they were delivered, spoke volumes. This was not a casual acquaintance, nor a corporate relationship; it was a trusted colleague and friend.
This hospitality and openness was replicated from each staff member I met. They included me in the conversation – candid discussions on current program issues, and the flow of ideas to resolve them. It was a real dialog between organizations to figure it out and agree on next steps. There was a sense of transparency; people unafraid to say what needed to be said so things could be understood and resolved and moved forward. I was deeply struck by the commitment of the staff to the people they are serving; traveling far and wide to work with the community pharmacists, providing training, restocking the stores, and the ongoing coaching and support.
Our exhausting, but invaluable day ended with warm, homemade tortillas, fresh oranges, and coffee at Jorge’s home. Jorge is a manager for FUDIEMFA and had been driving us to the pharmacies throughout the day…and they’re not located on superhighways. Not a coffee drinker himself, Jorge enlisted his neighbor to brew a delicious pot of coffee for his weary charges. As we sat on the porch sipping hot coffee and watching the Honduran rain against the verdant landscape, I reflected on how meaningful this genuine hospitality coupled with the authenticity of trusted partners was…a memory I hope will stay with me forever.