Strategic consultation for the devolopment of Lacor Hospital (Gulu, Uganda) in collaboration with Corti Onlus Foundation- Milan

MAPS is working side by side with the direction of St.Mary’s Lacor Hospital (north Uganda) and with the Piero and Lucille Corti Foundation (main donor of the hospital, based in Milan) since June 2009.

The adventure started with a limited training requirement and grew over time to become a vast and passionate partnership. The consultancy aims at constantly guiding the growth of the hospital’s organizational structure and the changes in the relationship between the hospital and a country in constant evolution. Another large portion of the work consists in navigating through the dynamic relation to the Foundation that has sustained the hospital for many years and a completely Ugandan management.

The story of Lacor is one of those that gives you the chills. It is not a coincidence that it is considered a unique case-study in the world of international development cooperation. It was founded more than fifty years ago, by a couple of Italian-Canadian doctors. In the beginning, Lacor was a traditional missionary hospital in a country on the threshold of independence from British settlers and has been through the tumultuous and tragic history of the country.

From the bloody dictatorship of Idi Amin Dada to the fratricidal wars that opposed militias and government forces in the following years, making it a haven for guerrillas and civilians, who took refuge in its courtyards in thousands every night to escape the massacres.

From the Ebola epidemic that decimated its staff (including the mythical figure of Dr. Matthew Lukwiya, collaborator of the founders, promised director and beloved by hospital staff, who died of Ebola in an attempt to save some colleagues) to the rapid economic and social change of the last fifteen years that has filled the land with opportunity but paradoxically has turned the differences with the isolated north even more strident.

In the rushing flow of this story, the hospital has endured, it has grown stronger and has gone from having a few dozen beds to become the main hospital in the north of the country with over two hundred thousand patients served each year. Thee hospital has 20 units and departments, and more than 600 employees, all Ugandans.

This rapid growth has forced the hospital (and the Foundation established to ensure economic development) to a radical change: moving from a “family” management to a structure of a large organization with a specialized management divided into levels of competence, internal governing bodies and assessment tools, and a continuous improvement in the quality of services.

In these five years MAPS has contributed with the construction of e new strategic plan, accompanied the Foundation in a series of delicate choices and has designed and implemented two large intervention projects regarding the pharmaceutical and medical employees. In particular the last project, aimed at the integrating the specialized medical staff in the management of the hospital, is the most ambitious and exiting. In a country where a medical specialist has a status close to that of a god, it appeared as an extremely difficult challenge to include the medical staff in a process of change that would lead to the creation of a true class of head of departments in close collaboration with the top-management.

After a thorough system analysis, and thanks to the accreditation gained over the years, at the end of the first year of the project this goal appears increasingly at hand. The doctors had finally entered the large hospital organizational machine as we had managed to overcome the factors that made this step very difficult: from their professional “splendid isolation” to the difficulty of delegation of the top management. A mixture of new instruments was introduced (coordination tables, strategic brain storming, procedures and documentation) and interactive practices (interviews, job training on the job, consulting moments and research) prepared the ground.

After more than 15 travels to the African country, MAPS feels like a part of this unique story. That has only just begun.

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