By Nick Cuneo, a 2013 graduate of the GHD Summer Intensive program. Nick is currently a Harvard Medical School Doris Duke International Clinical Research Fellow and a fourth-year medical student at the Johns Hopkins University School of Medicine.
“My global health training began in the undergraduate classroom at Duke, with foundational coursework in development studies and public health complementing rich on-the-ground learning experiences in countries such as Costa Rica, Guatemala, and South Africa.
When I graduated college, however, I encountered an entirely new arena, within which that prior education was only of partial value.
Thrust into a position of tangible responsibility at a nascent primary care clinic in a low-resource setting on Haiti’s Central Plateau, I was compelled to take on practical tasks across a range of activities: supply chain management, staffing, sustainable initiative implementation, and new systems development, to name a few. Most important, I had to gain the trust of the clinicians and staff with whom I was partnering on these endeavors.
Thrust into a position of tangible responsibility at a nascent primary care clinic on Haiti’s Central Plateau… I quickly realized that, it was managerial skills…that were most essential to success…. I can’t imagine how different it would have been had I benefitted from the GHD Summer Intensive experience prior to my departure.
I quickly realized that, more than anything, it was managerial skills – not my knowledge of the nuances of the development community’s alphabet soup – that were most essential to success in carrying out core objectives, despite my never having received formal training in management.
While I am proud of the work I was able to do, due to my limited prior experience I had to learn a tremendous deal as I went along—I can’t imagine how different it would have been had I benefitted from the GHD Summer Intensive (GHDI) experience prior to my departure.
I am fortunate now to have a chance to go back to Haiti, this time with a different organization but still very much within the delivery role. GHDI provided so many practical tools with which to be a more effective leader and manager, and the resources to reflect more productively on our experiences throughout. Specifically, GHDI challenged me to reexamine the way in which I: 1) define value in health care delivery; 2) build operations and processes; and 3) plan for scale (on multiple levels).
Moving from the predominant cost-effectiveness framework to one where end-user value is prioritized is a subtle but important distinction paralleling our recent transition from vertical to horizontal models of preferential delivery. Prevention- and Care-Delivery Value Chains as hard tools may seem somewhat intuitive at first but the perspective they bring to conversation surrounding a deliverable is actually quite transformative, forcing those in the delivery role to consider the efficiency of all operations and processes associated with the end-goal (value) on a much higher level, inviting synergies and streamlining throughout.
GHDI guest speakers provided tremendous practical examples from their work in delivery, demonstrating innovation amidst the challenges of building operations and processes, as well as planning for scale.
Kristian Olson showed us the benefits to the co-creation model, emphasizing, above all, the need to address the right questions and rely on context-driven solutions. Bill Rodriguez took us through the compelling case of the portable CD4 counter, emphasizing operational and process-level challenges above all else. And, Prashant Yadav and Jarrod Goentzel took us deep into the field of supply chain management science, urging us to “hire a nerd” should we really want to optimize the flow of information, materials, and money (considering I did not know such an option existed before, I considered this sage advice).
Other outstanding alumni, program directors, and global health innovators inspired us to respond to new challenges and scale up, providing models for conflict resolution, working within existing governmental and policy structures, defining strategic objectives, and building strong management—models which I will certainly refer back to in the future as I work to scale up existing programs and pilot studies.”
This piece, by Nick Cuneo, is a first in our series of first-person reflections from our 2013 GHD Summer Intensive alumni.