Greater impact starts with tough questions, says one NGO

34 community health workers, medical assistants, and nurse midwives in Malawi participate in a Helping Babies Breathe training.
34 community health workers, medical assistants, and nurse midwives in Malawi participate in a Helping Babies Breathe training.
Physicians for Peace

How do humanitarians know when they succeed?

It may sound like a silly question with an obvious answer, but for one group asking it sparked some positive changes in strategy.

“One of the questions we ask ourselves all the time is, “What does success look like?”” said Physicians for Peace President and CEO retired Brigadier General Ron Sconyers.

The question has led the organization to think hard about the way that it tries to support health around the world. One of the first steps was hiring an external evaluator to provide feedback to Sconyers and the Physicians for Peace.

“We can now say, not necessarily with impunity, this is what we are doing that works and this is what we are doing that does not work,” said Sconyers.

Plastic surgeon Dr Charles Horton developed an interest in global health, after setting up his practice in Norfolk, VA. In his travels to the Middle East, Haiti and elsewhere, Horton met other medical professionals who were working in the countries. In many cases, these healthcare workers had not received updated education in their respective fields for years.

People trained in medicine had stopped learning the day they graduated. A recent survey of doctors in Nigeria found that the average date of graduation from medical school was twenty years ago. With no continuing education, the doctors have gone two decades without updating the way they provide care.

Horton founded Physicians for Peace 1989 to fill the education gap by connecting medical professionals in developing countries with educators and updated information.

Training healthcare professionals builds up the skills of the individuals who participates and allows for them to deliver better care for patients. Additionally, the knowledge that is imparted spreads from person to person, creating a sort of education multiplier as a result of the training.

“Because we are focused on education training, we are low tech high touch,” explained Sconyers. “You will seldom see us contribute a x-ray machine.”

The focal areas for Physicians for Peace include care for burn victims, amputee rehabilitation, eye care, surgery, and maternal and child health. Training in these areas have led to changes in patient outcomes. Burn victims are getting better initial treatment, thus reducing the need for future surgeries.

Taking a hard look at what the organization was actually accomplishing led to the realization that Physicians for Peace was taking few chances. Sconyers says that they need to have bolder thinking that will allow for breakthroughs and learning through failure.

To do so, he has a budget line for 2014 for innovation. It is a part of a broader realization to shift towards what Sconyers calls “data-driven decision making.” What that means in practice is still to be determined.

“I don’t know what that innovation is, but if we don’t have it a part of our budget then we can’t make sure it happens,” he said.

There is a personal drive in Sconyers to see the organization started by Horton succeed. His candor about the learning within Physicians for Peace communicates the gravity with which he takes the work. It is partly because of a desire to bridge his military career with humanitarian work.

“The relationship between militaries and NGOs, particularly in humanitarian disaster areas, has not often been good,” he said.

Improving that relationship is one of the ways that he answers the question of what success looks like for him. Finding the answer for Physicians for Peace has led to tough criticisms and valuable learning for the health educator. Sconyers knows that the organization will succeed when it is no longer needed. Reaching that point, he knows, will involve asking tough questions about what they do.

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Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.