OkaZHI: Okanagan-Zambia Health Initiative

Multi-Level Leadership – A Critical Factor


Jun 15



Multi-level Leadership – A Critical Factor

Over a 3-month period, 8 OkaZHI members worked in Zambia, ostensibly to pursue our OkaZHI Documentation project, to support the UBCO Nursing student program, and to teach “The Acute Infective Process.” During our collective trips we thankfully found what we have been intuitively searching for all along.

At the end of our trip during a dinner with our partners, which included Margaret and Mobito Maimbolwa, and with Professor Chifumbe Chintu, we declared our discovery after these past seven years of wandering in ‘the Western Province wilderness’ – Multi-Level Leadership.

Our discovery was humbling after hearing Chifumbe Chintu say in response to our presentation – “I have been walking in the Sickle Cell wilderness for 40 years!” Finally, he has been given a Government mandate to implement his long-planned national program of mandatory neonatal testing for Sickle Cell disease – a topic in which he is undoubtedly the world’s expert. Professor Chintu is Zambia’s founding Paediatrician and former Dean at the University of Zambia Medical School. He has been honoured multiple times by distinguished orders for his contributions to tropical Paediatrics – and he’s our OkaZHI source of inspiration.

Mobito, a former Permanent Secretary for Western Province, responded with, “Patience and commitment – important programs take time to evolve.”

There appears to be a lot of support. Margaret, the Assistant Dean of the Medical School when we first met her, now the Country Coordinator for the Southern Africa Consortium for Research Excellence (SACCORE) and Director of the Zambia Forum for Health Research (ZAMFOHR), said to me, “Keep going Bill, you are nearly there.”

Chifumbe, Mobito, and Margaret’s words echo from their collective wisdom on ‘Leadership.’

At a 2013 meeting with UNZA’s Dean Goma explained, “In Africa, we tend to teach knowledge and skills at the expense of leadership – that is changing.”

In Mongu we have worked closely with Dr. Andrew Silumesii over the years. He was formerly the Director of the Lewanika General Hospital, now the Provincial Health Director for Western Province. He completed his Master’s Degree in Belgium in 2012. In his thesis, “Building leadership capacity to improve work climate in a Zambian Hospital: An Action Research Approach” Dr. Silumesii said, “Limited health leadership capacity has been identified as one of the main barriers to scaling up proven health interventions in low and middle income countries. Conversely, strengthening leadership capacity is now seen as a critical factor needed for health systems and healthcare organizations to succeed. We take the modern perspective, which emphasizes that individuals at any level of the organisation are able to exercise leadership regardless of their hierarchical position.”

Our collective activities in WP went well, but – most importantly – we were to see first hand the nature of the leadership structure forming in Western Province – the result of Health Ministry planning, UNZA’s lead on leadership, and the indelible footprint of Dr. Andrew Silumesii. Andrew has re-appointed Dr. Mapani, a Paediatrician to the post of Director at Lewanika General Hospital. Dr. Mapani, in turn, has appointed Dr. Soko as Director of Clinical Services, and she is empowering members of what she calls her “A team.” Most notable were the efforts and dedication of Drs. Idi and Dare, who took on the task of co-ordinating our “Acute Infectious Disease Process” teaching. Thirty learners attended – Nurses, Medical Officers, Clinical Officers, Medical Licentiates and students – complementing our hopes that our teaching would reach an interdisciplinary audience. The details regarding this trip will be posted to our www.okazhi.org website.

Mrs. Pelina Chibanje has returned from Australia with a Masters degree in Nursing to lead at the Lewanika School of Nursing in Mongu, and Clinical Officer Inyambo Siluka has been appointed to liaise with Dr. Linda Hawker and the OkaZHI family doctors as they continue to deliver Skype teachings to Mongu.

Dr. Francis Liywali, Mongu District Community Medical Officer has also recently completed his Masters degree. He has been a constant source of encouragement and inspiration to us.

We also acknowledge the leadership contributions made by Sister Maxwell from C Ward, and Sister Etna from Maternity.

Other local leadership profiles are also arising. Dr. Douglas Singini has returned from Lusaka with his Master’s degree in Epidemiology, applying his newly specialized knowledge as the District Medical Officer in one of the new nine districts recently created in WP, Limulunga District. Dr. Mwewa, his counterpart in Kaoma is currently taking his advanced degree in Lusaka. Dr. Patson Mukubesa has been appointed as District Medical Officer in Mulobezi, another new WP District. Dr. Willard Mumbi, one of our favourite former students from Kalabo, has returned to Mongu from Kenya with specialty training in Ophthalmology. And then there is Precious Nasilele Huizing – Precious in name and by nature – embedded in all of our hearts. She returns from specialty training in Ophthalmology Nursing from the Gambia. We congratulate her on the arrival of her first child – a boy! Ronald Solami, along with two other RN colleagues provided leadership in establishing the busy male circumcision unit in Mongu, as did Frederick, a Medical Licentiate in Kalabo… and the list goes on.

Yes Dean Goma – now we understand – multi-level leadership is becoming the crucial link to the future – and we see it playing out in Western Province, our home away from home.

Emerging from our interactions throughout the leadership chain in WP, and supported at a high level in Lusaka by Margaret Maimbolwa and Dean Goma, is the notion that we could develop a “Train the Trainer” program over the next 3 to 4 years. Our themes going forward will be those of Trauma Management, and the Documentation project so ably led by Fay Karp and Alex Malloy. We are mindful of past teachings in surgical services, hernia repair, hypertension, diabetes, ICU, communication, and a wide spectrum of nursing skills.

Bill Nelems MD, Executive Director, OkaZHI. June 2015



Dr. Andrew Silumesii (left) at the University of Barotseland


Dr. Mapani, Director of Lewanika General Hospital

Drs.Idiand Dare

(Left to Right) Dr. Linda Hawker, Dr. Idi, Dr. Bryan Tighe, Dr. Dare


Dr. Soko, lead in clinical services at Lewanika General Hospital


Mrs. Pelina Chibanje returns to the ZEN School of Nursing


Willard and Bill


Willard and Precious at the new Eye Centre


Clinical Officer Inyambo Siluka, with Linda


Tyrone McKeith and Alex Malloy – Book a safari in Western Province http://www.jmsafaris-zambia.com


Chifumbe Chintu with Fay Karp


Jessica Barker, Bryan Tighe and Jackie Denison


Mobito Maimbolwa with Gary O’Connor


Margaret Maimbolwa with Linda Hawker


Linda and Gary on their 35th wedding anniversary in Mongu; April 26, 2015

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