Public Leadership Through Crisis 13: Tolbert Nyenswah on leading through Liberia’s Ebola epidemic

written by Matt Andrews

The Public Leadership Through Crisis blog series offers ideas for leaders questioning how they can help and what kind of leadership is required in the face of a crisis (like the COVID-19 pandemic).

shutterstock_50122132-resized

Tolbert Nyenswah is a Senior Research Associate at the Johns Hopkins Bloomberg School of Public Health. In 2014 he was the head of the Liberian Incident  Management  System (IMS), leading the operational aspects of the government’s response to the Ebola epidemic. Following this, he led the establishment of Liberia’s First National Public Health Institute and became its First Director General and Chief Executive Officer (CEO) 2017-2019.

This is a podcast of a conversation with Tolbert on his experience (interviewed by Peter Harrington and Matt Andrews). Brief summary thoughts follow, with questions for leaders facing crises today.

1.  This can be terrifying

Tolbert relates to the Covid-19 challenge facing many leaders, noting that he was asked to create the Incident Management System when the crisis had already begun  (not in preparation for it): “When you’re in a dire situation where people are in the streets, [you have] no best practice testing capacity … and you are setting up an incident management system at the same time … Before you really understand what the process is about, especially when information is weak …”

I  am sure may leaders feel like this in the face of crisis: unprepared and with much to do. In addition, Tolbert  notes, the country was in a politically fraught position: “The president was in a very, very uncomfortable position as a leader .. in fact political leadership were calling for the president’s resignation [arguing that] the government should step down.”

At 6:38 into the interview, Tolbert simply says, “It was terrifying.” If  you feel you are in the same boat … read on – terrifying things can be dealt with. Continue reading Public Leadership Through Crisis 13: Tolbert Nyenswah on leading through Liberia’s Ebola epidemic

Public Leadership Through Crisis 12: Course correct; it’s hard, but you must—and can—do it

written by Matt Andrews

The Public Leadership Through Crisis blog series offers ideas for leaders questioning how they can help and what kind of leadership is required in the face of a crisis (like the COVID-19 pandemic).

My last blog post recounted, briefly, how Liberia changed the organizational structures it used to respond to the 2014 Ebola crisis, mid-stream through the crisis.  I wanted to tell the story primarily to demonstrate how the country ultimately adopted a flat, fast, and  flexible ‘snowflake’ like structure  (in the Incident  Management  System). Studies show that other countries and organizations adopt similar structures when facing crisis, including Korea during the MERS crisis and private corporations. In upcoming blog posts I will discuss how you might think of adopting a similar structure—especially establishing your core team, thematic focal points, and thematic teams. Even as I share these ideas, please remember that there is no one-size-fits-all crisis response organizational structure; the experience suggests that you do need to adapt your organization to the realities of your crisis  situation, but the structure that works for you will be heavily contingent on your situation.

In this post, however, I want to pause and reflect on an implicit challenge embedded in the Liberian story: how do you, as a leader, course correct when you realize you’ve made mistakes in responding to the crisis? The shift in Liberia was in ‘how’ the government was working, but you could also have shifts in ‘what’ your response looks like, ‘who’ is involved, and more. How do you, as a leader, make these changes and still maintain support and confidence of your followers?

shutterstock_171064508-resized-engaging-others

This is a tough topic for any public leader. But it is really important. As discussed in earlier blog posts, you will make mistakes and/or realize there are things you did not know and have to adapt around. It is impossible not to make mistakes when you face the uncertainty associated with crisis, and the many questions posed by such uncertainty—What should we do? How should we do it? When? Where? With whom? For whom? For how long?  At what cost? Your mistakes will arise because decisions are based on biased and half-informed assumptions and ways of thinking common when dealing with what Michael Osterholm calls the “fog of war” (in  relating to influenza pandemics):

“The “fog of war” describes the level of ambiguity in situational awareness experienced by participants in military operations. The term captures the uncertainty regarding one’s own capability and the capability and intent of the adversary during battle. The conceptual similarities between the fog of war and the fog of pandemic preparedness are unmistakable:

  • We really don’t understand our capability … to respond.
  • We have only a very general sense of what the pandemic influenza virus is capable of doing in terms of human illness or the social, political, and economic collateral damage.
  • We can’t predict with any certainty how the next pandemic virus will behave …”

Continue reading Public Leadership Through Crisis 12: Course correct; it’s hard, but you must—and can—do it

Listen to our second virtual discussion on Leadership Through Crisis

Thank you to all those who attended our second session last week and for engaging with us. If you missed the session, you can listen to it here.

Governments are most important in times of public crisis, such as the COVID-19 pandemic. Individuals—no matter how talented or self-reliant—look to their governments for help, to empower or deploy the powers and potentialities of the collective. But many people tasked with leading public organizations in times of crises struggle to know if and how to rise to the occasion. This is a particular challenge in governments that have low capability or are trying to build capability: leaders in such situations can easily feel like captains on small boats facing high winds and big waves.

BSC’s new Public Leadership Through Crisis blog series offers ideas for leaders questioning how they can help and what kind of leadership is required in crises. Each blog offers a few ideas as well as questions for reflection, thus creating a space for learning and contextual reflection.

 

 

Listen to our first virtual discussion on Public Leadership Through Crisis

On March 27th, 2020, we hosted a virtual discussion with Matt Andrews, who answered audience questions on his new Public Leadership Through Crisis blog series.

Here are some of the questions he answered:

  • What, in your opinion, are the capabilities required for public leadership through crisis, and what are the biggest challenges to building these capabilities?
  • In a time of crisis like this, no matter the amount of resources a government has, it will never be enough. How does a government gain public trust and be able to mobilize all the community resources have?
  • How do we influence people to change norms?
  • How do public leaders build multi agent teams during a crisis, such as during the COVID-19 pandemic?

We converted the Zoom session into a podcast for those who missed this session. Stay tuned for more virtual discussions!

 

 

 

Public Leadership Through Crisis 10: Lessons from experience

written by Matt Andrews

The Public Leadership Through Crisis blog series offers ideas for leaders questioning how they can help and what kind of leadership is required in the face of a crisis (like the COVID-19 pandemic).

shutterstock_194811881-resized

As we ponder how you as a leader should consider organizing your organization(s) to respond to the crisis, let’s listen to some advice from someone who has led through various crises. Below is a podcast interview with Shruti Mehrotra, who  has advised various Heads of State on effective government and statebuilding and currently helps oversee George Soros’ Economic Development Fund and Economic Advancement Program. She has worked in a variety of leadership roles on crises in contexts like Sudan and Liberia and beyond.

Here are some points from the  interview that relate to organizing yourself and your organization/team to lead through crisis.

1. Three lessons for leaders

Shruti notes that leading in these situations requires that you:

  • recognize there are no obvious, clear or easy decisions (or perfect decisions); what you need to do is get the best information you can to make  decisions (even though you know the information is imperfect),
  • need to have a process in place to discipline how you engage the information (access it, interpret it, debate it, etc.) and monitor the process (ideally from some kind of situation room), and
  • need trusted people (advisors) around you—including people with expertise in the subject matter (the technical dimensions)—to help make the decisions.

As she says: “there will  be debate, [but] as a decision maker and a decision making team, one has to go through that debate process and come up with a conclusion that is trusted and can be communicated to foster trust with the population about choices that were taken.”

An emergent idea, then: It is important to think about the information sources you  have, the process  you have for interrogating information, and the team you have doing this  work (“your trusted people” and the “technical experts”).

Continue reading Public Leadership Through Crisis 10: Lessons from experience

Coronavirus and behaviour: Why leaders need better ‘risk communication’

Guest blog written by Peter Harrington

Last week I wrote a post on how the Coronavirus pandemic, like Ebola, needs to be understood as a complex adaptive problem which requires mass learning to solve. In this post I want to focus in on one area of that learning – the behaviour change required to stop transmission, and the leadership and risk communication methods that are needed to make this happen. Coronavirus is both a biological and social phenomenon, and leaders neglect the social dimensions at their peril.

Let’s first establish how behaviour change relates to the epidemic. A couple of weeks ago a viral article called for radical action by authorities to replicate the Wuhan lockdown, in order to save lives and prevent the overload of the health system seen in Italy. A graphic was presented (below) which showed the effect of the lockdown on ‘true’ cases (the grey bars). It then took about two weeks for the effect of the lockdown to be visible in official cases (gold bars). As soon as a lockdown started, new cases plummeted. This is what underlies the lockdown policy in most countries – the only way to stop transmission is if people stay at home. Behaviour change, whether enforced or voluntary, directly translates into lives saved.

Screen Shot 2020-03-23 at 5.27.18 PM

The problem is, many many people in countries with a serious number of cases are not complying with guidance about social distancing, home-isolation and closures of business and various establishments. A public and private tug-of-war is raging between those who take this epidemic extremely seriously and are urging others to observe social distancing and stay at home, and those who see over-reaction and hysteria or don’t want to change their routines. This is going to lead directly to deaths. So what is happening here? Why are leaders’ entreaties being ignored? And should the authorities simply force everyone to stay at home?

I worked in the team that coordinated messaging and communications for the Liberian’s Ebola response. This branch of the response was known as ‘social mobilisation’, working to build citizen understanding and consent, and to change key behaviours to stem the epidemic. What we learned was later documented by Princeton, and has relevance today.

It is well documented that in the early stages of Ebola, the widespread belief that Ebola was not real perpetuated behaviours (like dressing highly contagious dead bodies for traditional funeral) which helped spread the disease. People were not reporting cases, and avoided Ebola Treatment Units (ETUs). Although the affected countries lacked beds, ETUs, burial teams, protective gear, it was people’s behaviour which was paramount in the spread. This relationship between the hard infrastructure of beds, staff, equipment, quarantine, ambulances etc., and the ‘soft’ infrastructure of social networks, messaging and norms is extremely important to remember for Coronavirus too. The hard infrastructure matters hugely: when cases mount, the number of beds, healthy medical personnel and equipment will be crucial. But it is the soft infrastructure that determines how many cases develop and therefore the burden on the hard infrastructure – i.e. the shape of the transmission curve.

Continue reading Coronavirus and behaviour: Why leaders need better ‘risk communication’

Public Leadership Through Crisis 9: Pursue flat, fast, and flexible organizing structures

written by Matt Andrews

The Public Leadership Through Crisis blog series offers ideas for leaders questioning how they can help and what kind of leadership is required in the face of a crisis (like the COVID-19 pandemic).

In my last post, I argued that you should prepare to work differently. In this blog  I will offer ideas on doing that. I am informed by my BSC team’s work with countries employing PDIA (problem driven iterative adaptation) in the face of problems (some crises) and the work of people like Dutch Leonard (whose video was included in the last post).

shutterstock_323129195-resized

Let me start with an observation of the organizing structures typical to public organizations (school systems, local governments, national departments, and more). Most of these organizations tend to be bureaucratic hierarchies; with a defined mission determined (or managed) by the people at the top, and pursued through formal processes by people in highly specified jobs. Using words from the last blog, the authorization mechanisms, acceptance requirements, ability needs, and mobilization mechanisms are all set in place. My guess is your organization looks a little like this?

But there are variations of such structure:

  • Some bureaucracies are stand-alone structures like the Figure 1 below. A single school might be an example of this. The  principal sits at the top and everything is led by her/him.
  • Other organizations are bigger hierarchies with multiple embedded hierarchies, as in Figure 2 below. A school district might be an example. The District commissioner leads a system in which other people lead schools B, C, and D. The leadership and coordination tasks are now split across a group.
  • Other organizations are distributed hierarchies (as in diagram 3 below). A state or national government is an example. One hierarchy (A) is the education department. Another (B) is the health, another (C) is the public works department, etc. In these systems, leadership again is about a group.

Screen Shot 2020-03-23 at 2.45.36 PM

Screen Shot 2020-03-23 at 2.45.50 PM

Continue reading Public Leadership Through Crisis 9: Pursue flat, fast, and flexible organizing structures