New Brunswick Public Service Makes a Difference in Mali
By Ellen Barry
Over the past few years, a small team from the New Brunswick Public Service has managed to play a crucial role in improving Mali’s healthcare system. When IPAC International Programs first asked Arnold Kearney and me to serve as co-leads of the Canadian team for the Mali-New Brunswick partnership in the Good Governance Program, we couldn’t have begun to predict all that the partnership would accomplish. By collaborating with our counterparts in Mali, we have helped improve the way that biomedical equipment is procured and managed, implemented strategies for the prevention of nosocomial infections (secondary disorders associated with being treated in a hospital), and spearheaded a country-wide drive to implement a telehealth system. Who would have thought that all this would be possible in such a short time?
Our journey began with an inception mission in 2004. I traveled with Ann Masson, IPAC’s Director of International Programs, to the capital city of Bamako. Ann had already made contact with Diango Cissoko, Director of the Office of the Prime Minister, and they had corresponded about a Mali-New Brunswick partnership. Thus Mr. Cissoko arranged for us to meet with Ousmane Sidibé, Commissioner of Institutional Development. Mr. Sidibé had been appointed as our partner in organizing and launching the partnership. Over the course of the week, we familiarized him with IPAC’s model of exchanging expertise by partnering senior officials in developing countries with their peers in Canadian provinces. He in turn arranged for us to meet with a variety of senior officials. Excited to proceed, we discussed the next step – putting together a team of senior officials from Mali to be sent to Canada.
At the IPAC Annual Conference and during a week-long study tour of Fredericton, New Brunswick, the Mali team met a range of Canadian Deputy Ministers and senior officials from the Health and Education sectors in Fredericton, the community college in Dieppe, the Université de Moncton and the Beauséjour Regional Health Authority in Moncton. Shortly after, a New Brunswick team took shape, thanks to the willingness of our public servants and experts to volunteer their time. The pride they took in their work shone through – they were all delighted to meet the delegation and share their innovative approaches to providing public services. They truly made us proud to be members of the New Brunswick public service, which also benefited by participating in this exercise in two-way learning. By granting senior employees the chance to take part in such a program, employers push them to enhance their mentoring and coaching skills, as well as gain valuable intercultural experience. Thank you to the New Brunswick team, which included Arnold Kearney, Silvana Bosca, Rino Lang, Suzanne Robichaud, and M’hammed Ratmi.
To learn about each other’s contexts, challenges and successes, the New Brunswick and Mali teams each went on a study mission. Our team first traveled to Mali to meet with health officials. The aim was to familiarize ourselves with the health system and get a sense of the country’s needs. Visits were made to the Ministry of Health, hospitals, and community health centres in Bamako and the region of Koulikoro. Next, the Mali team spent two intensive weeks visiting the regional health authorities in Moncton and Bathurst, regional public health offices, a remote community health centre in Lamèque and the New Brunswick Community College in Bathurst. Particularly striking, from the Mali delegates’ perspectives, were the values demonstrated again and again by our caregivers and health authorities. The Mali team repeatedly commended the way that patients were at the centre of care, and each member of the health team – no matter what his or her status – played an important role in patient care. Presentations were made on a variety of topics. Inspired by what they had seen, the Mali delegates decided that our attentions should be focused on three main initiatives: the development of a model for managing biomedical materials, the development of a national telehealth model, and strategies for controlling infections.
Our team began developing, in collaboration with the Mali team, specific work plans. We established a series of cross-disciplinary committees – involving doctors, nurses, and technicians – to learn from the experiences of the various stakeholders. Over forty people from the Koulikoro region participated in the consultations. In addition, meetings were held with senior officials from the Department of Health, including the Minister.
As a result of the hard work of all involved, we are pleased to report various successes. We have succeeded in helping hospitals implement processes to deal with nosocomial infections. Multi-disciplinary teams have been established in each clinic to educate all staff on how to minimize infections. In the pilot region, hospital staff have become keenly aware of how nosocomial infections occur, thanks in part to posters directing staff to wash their hands, dispose of infectious materials appropriately, and disinfect equipment. In one clinic we visited, hand washing is now taught to patients’ relatives and other visitors.
In addition, we have succeeded in raising awareness about how telehealth can be instrumental to improving healthcare in Mali. By showing the Mali delegation how we use telehealth in New Brunswick – we showed them how dialysis could occur remotely and be monitored by a nephrologists 250 kilometers away, for instance – the delegates quickly grasped how invaluable such technology could be to their healthcare system. Equally well received was a series of video vignettes about hand washing, created by the Beauséjour Health Authority. Disseminated to hospitals in Mali, the videos were a useful training tool. Such successes were facilitated by generous donations from the Beauséjour Regional Health Corporation. The corporation donated video-conferencing equipment, as well as five dialysis machines and sufficient parts for five years of maintenance. A partnership between the Rotary Clubs of Dieppe, New Brunswick and Bamako, Mali raised funds for transporting the equipment. A big thank you goes to these donors! Building on the successes of this mission, we arranged for a second delegation from Mali to study the accreditation system of hospitals in Ottawa and Moncton. This tour was organized by our team member, Suzanne Robichaud.
In March 2007, we travelled back to Mali and found that the action plans developed the previous year were in full implementation. A presentation by the management of the Koulikoro health region outlined the many activities that had been undertaken during the year. The progress was truly impressive. Also, we were informed that two pieces of legislation had been drafted and were ready for introduction in their Legislative Assembly. Both deal with establishing governance structures – one for telehealth, and the other for the procurement and maintenance of biomedical equipment. The team concluded the tour by organizing a workshop entitled “A dialogue on democracy and respect,” aimed at identifying priorities to support the delivery of quality public services.
In the spring of 2008, the New Brunswick team returned to Mali with the addition of Lise Guerrette-Daigle, Vice President of Nursing for the Beauséjour Regional Health Authority. In response to the request of our Mali colleagues that we assist in developing a Nurses Association, Lise energetically stepped forward. We have heard that legislation is scheduled to be introduced this year to form a countrywide Nurses Association.
We have been very fortunate in developing great relationships with our Mali colleagues. There is no doubt in our minds that this has been the key to the success of our collaboration. Our colleagues from Mali can only be described as energetic, motivated and committed to quality public services – our contacts have government-wide credibility at the most senior levels. Thanks in particular goes to Mr. Sidibé and Dr. Lasseni Konaté (Secretary General, Department of Health) for leading the Mali team. Dr. Ousmane Ly, Dr. Seybou Guindo, Dr. Bakary Konaté and Mamadou Sory Keita are also truly excellent partners.
Ellen Barry is Deputy Minister for Tourism and Parks in the Government of New Brunswick.
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