Managing the Impossible

Prior to coming to Ethiopia, we hadn’t anticipated how difficult being a manager would be. Lalmba Ethiopia is a unique place to manage. We’re an NGO-run health center but also considered governmental; we pay most of our employee’s salaries yet some receive theirs from the government or even other NGOs; we, the head management team, are expats but the employees are all Ethiopian, and the cultural differences can be huge. We learned to listen closely to our Ethiopian managers who try to interpret these differences for us. If a government employee goes away for 2 weeks and comes back to tell you he needs another week off because his brother is sick, that is code for “I’m looking for another job but don’t want to tell the government so my paycheck keeps coming.” If you tell an employee that you are taking away some of their pay as a penalty for an unexcused absence and they agree, be aware that they will not agree when payday comes around.

The examples of management difficulties here are endless. Every time there’s a chance for the nurses to get per diem pay (extra pay for going to a training or meeting) there’s going to be some trouble. Fighting about which or how many nurses go will doubtlessly ensues. And there’s always the issue of productivity at work. How does a manager who’s in a place for a year deal with tardiness and laziness of his staff, especially when his expectations may be too high coming from the U.S.? There’s no easy answer. And sometimes the problems escalate even more…to the point of a strike. What do you do when your government nurses threaten not to work at night because the government isn’t meeting their demands? Do you close the clinic completely so that it becomes a real threat to the community so the government actually does something about it? Or do your expat doctors and one private nurse work because you can’t let a sick patient not be seen, even if it means potentially burning out these staff? Or do you just go to your office and hide and hope that someone else will fix the problem? Regardless of the answers to these difficult questions, I have a newfound respect for those who manage.