Andrew Conte in Rwanda
1. Please describe what the organization/company you work with does, how it is set up and where it is located?
The organization that I worked for is the “Women’s Equity to Access Care and Treatment” (WE-ACTx) initiative in Kigali, Rwanda. WE-ACTx operates three primary care clinics in the Kigali region and offers non-clinical and family support programs for those living with HIV/AIDS, many beneficiaries of which were afflicted by HIV from events of the 1994 genocide. The first clinic was launched in Fall 2003 by front line AIDS physicians, activists and researchers. The organization’s primary goal is to increase women’s and children’s access to HIV testing, care, treatment, support, education and training in resource-limited settings at the grassroots level.
In clinical programs, I assessed the feasibility and commenced procurement procedures for enrolling WE-ACTx’s patients as members of Mutuelle de Santé, Rwanda’s community-based health insurance program. This opportunity gives WE-ACTx a feasible strategy for integrating themselves with the local health system using a sustainable vehicle.
In non-clinical support programs, I have been assisting in developing a business plan for a sewing collective program has employed a small group women living with HIV/AIDS who have been crafting various textile-based products and bead-based jewellery. To date, these products have been subsequently sold at WE-ACTx fundraising venues that include Barney’s New York in Chicago, Women’s Interagency HIV Study in Chicago, and the International AIDS Conference in Toronto.
2. What is the organization/company doing well?
Engaging local stakeholders is a fundamental requirement of any grassroots movement. In only two years, WE-ACTx has established outreach and referral relationships with 24 domestic community-based organizations that serve those living with HIV/AIDS and victims of the genocide.
Also effective is how the project has started to construct active relationships with local health centers. WE-ACTx recently funded the opening of their third facility which has the scope to serve patients at the district-level and operates in partnership with district health authorities.
3. Where could the organization/company improve?
Although tremendous efforts have been focused on achieving outreach at the level of the community and providing assistance and support, there have been many business functions in the delivery of health care that have been compromised. While clinical programs are constantly being pushed to grow and serve greater numbers, functions of strategic planning, funding strategies and the measurement of clinical outcomes are not rigorously performed.
In non-clinical programs, a lack of skills and experience in operational and marketing functions makes generating program growth a core challenge, especially for the sewing collective project. In addition to recruiting an effective program manager, achieving better product quality using hand powered sewing machines is an obstacle that will have to be overcome in the short term by recruiting the proper training team form the surrounding community, which has already been sourced from the Gisenyi region.
4. What are some aspects of the local cultural that should be understood when foreigners consider doing business in this country?
The post-genocide era in Rwanda plays a very vivid component of visiting or doing business in the country, so a strong understanding of this history is essential. Access to infrastructure, civil discipline and a national development strategy allow Rwanda to be a great prospective country that offers great ambition for doing business in Africa. Political instability along the eastern border with the Democratic Republic of Congo remains an ongoing threat to future conflict.
5. What are some aspects of the local business environment (e.g. registration of company, government’s role in business, business items unique to this country) that should be understood when foreigners and locals consider doing business in this country?
As a landlocked country everyday commodities are at least 10% to 20% more expensive than other East African nations. Rwandans constantly travel to bordering Uganda, Tanzania, Burundi, or Congo for basic staples, even rice. Right-hand drive automobiles imported from Uganda where recently banned making the price of a left-side vehicle double overnight.
Businesses also face the challenge of very high operating taxes. Electricity, water, and petrol are usually in good supply with rare shortages. To establish a new business, a license must be obtained from the commerical court and a license for exportation must be obtained for any export shipment value over $10,000 USD.
6. What were the direct and indirect results/deliverables as a result of your placement? Please be as specific as possible. Please provide both soft and hard examples. Hard examples include number of clients/people trained, dollars raised, people impacted, etc)
• Built and managed an operational and financial plan and advised for export-ready retail partnerships
• Performed tariff classification to utilize international opportunities such as the African Growth and Opportunity Act, U.S. General System of Preferences provisions, and Binding Ruling standing with U.S. Customs and Border Protection
• Implemented training programs in bookkeeping and workplace payment scheduling
• Gauged metrics on what is to be achieved to comply with fair trade standards and trade association membership.
• Developed pilot product brochure
• Initiated a feasibility and budget impact study that facilitated the enrolment of 4000 HIV positive patients into the membership of a national community-based health insurance plan.
• Sourced and managed rapport with government personnel in National Mutuelle office of the Ministry of Health for ongoing feedback and assistance.
Questions about Personal Experience:
1. Why are you interested in international development and private sector development?
Since the year 2000, never before in our history have so many people been empowered with so many interventions to influence the convergence of global economies and politics to improve their quality of life. The social entrepreneur has been able to use this playing field to make positive social change by providing the poor with access to the institutions and tools that will enable them to help themselves. The need for international development institutions, programs and interventions to become more modernized and integrated with trends of economic globalization is, in my view, the most critical issue related to international development.
2. Originally, why did you want to participate in this program?
My interest with the MBAs Without Borders program stems from my career aspiration as a development practitioner and a genuine desire to empower people of low-income countries to make progress in their continuous struggle of poverty. It was an opportunity to apply myself as a social entrepreneur, and to develop innovative solutions to improve population health outcomes and urgent social challenges.
3. What were your main challenges, both personally and professionally?
Rwanda is a very accommodating place for a shoe string traveler, making personal challenges rather irrelevant if you’ve experienced developing countries before. Many professional challenges arose trying to communicate actions items to leadership and program managers that gave direction form across the ocean. There were constant skills and resource gaps in-country that made desired targets impossible to achieve over several instances. A repeated course of this dysfunctional cycle requires one to “go back to the drawing board”, and evaluate the top-down and bottom-up work flows at an executive level.
4. Was the monthly stipend of $1,000US/month sufficient and how, if needed, would you change the way and what MBAs Without Borders financially covers?
Yes, the stipend was sufficient. Any external finances that MWB had to cover were arranged. There was often need for an operational program budget and this did prevent progress in the field.
5. What would have made this experience even better for you?
Not being picked up from the airport on arrival to a new country was a sign of the challenges that laid ahead. As mentioned previously, an operational program budget for the sewing collective sourced by the partner would have made the placement and the program more productive over the course of the 3 months.
6. What advice would you like to offer future MBAs who work abroad for MBAs Without Borders?
* Be Patient, creative, and demonstrate initiative to work through organizational challenges
* Keep in close contact with MWB to report any prospective threats to health and safety; this will ensure contingencies are accounted for should the need to act arise.
7. Why would you recommend others to participate on MWB programs?
MWB placements are a great opportunity to immerse your professional talents in a new environment. Being able to adapt to a new environment and to be challenged by cultural obstacles is an invaluable life lesson, from which experience can be leveraged in many contexts of international business and new professional challenges..
8. What are some of your goals and aspirations (i.e. job, personal, etc), that you are planning for once this placement has concluded.
Considering the experience I’ve gained in corporate social responsibility projects and social marketing campaigns, MBAs Without Borders has allowed me to tap into new development and investment models and give me the innovative tools to make me more effective as a leader in future career ventures. I’ll remain focused in global health development, particularly health care system and economic development delivered through public-private partnerships.