Field Note September 20, 2019

Our Values in Action

It is our values that ground us to who we are and who we aspire to be. We took this summer to re-engage our team, now nearly 200-strong, with the seven values that ground and drive us as an organization. Across cultures and languages, this has been an opportunity for us to collectively deepen our understanding of what these concepts have come to mean in our everyday work. As I reflect on recent milestones, transitions, joys, and challenges, I’d like to share instances in which I’ve seen us embracing our values and holding one another accountable to them:
This year marks a major step in our geographic expansion as we continue to expand services to the most remote areas of the district. In June we launched work in a seventh commune reachable only via an unpaved, 65-kilometer route on motorbike, foot, and river raft. Our operations team committed renovating the health center there, garnered by the knowledge that tens of thousands of people stood to gain access to quality care.
This summer we partnered with peer organization Operation Fistula to raise awareness about healthcare solutions for women suffering from the highly stigmatized condition of obstetric fistula. Twenty-four women received surgery, and our social work and referral teams accompanied them from their communities to the hospital and back home again.
Since 2014, we have been working to gain approval to pay community health workers, and are dedicated to realizing the commitments we’ve made to the government and people of Madagascar. This July, the new Secretary General signed off on a pilot to do just that in our home commune of Ranomafana. We intend for lessons proved there to alter the course of the community health conversation in Madagascar.
One definition of sustainability for PIVOT is capacity-building of the public health system and our Malagasy colleagues, who comprise 91% of our team. Our newly-constituted 12-member Senior Management Team represents equity across gender, age, and nationality, now including 8 Malagasy staff and 5 women. We are committed to providing our Malagasy colleagues and collaborators with opportunities to advance their careers within PIVOT and the global health field.
Momentum continues to build at the national level in support of Universal Health Coverage (UHC). Our leadership team has developed a comprehensive plan for scaling our model health system across the country that includes UHC. We will join President Rajoelina as he presents his plan at the United Nations General Assembly next week, keeping us on track to achieve our goals of replication across Madagascar and advancing health as a human right across the globe.
One of the happiest days of my summer in Madagascar was announcing Laura Cordier as our new Country Director. Laura built our Monitoring and Evaluation department from scratch, and has come to hold an unparalleled depth of knowledge about our programs. In her hands, I believe we will create the best possible conditions for our doctors and nurses to take what we know and allow it to inform what we do.
One question I never want us to stop asking is “are we putting the poor first in all that we do?” I expect our leaders to be humble in the face of our support staff, and our clinicians to be humble in the face of our patients. If we can commit to always ask ourselves whether our decisions will ultimately serve our patients, I believe we will stay true to our mission.

As I look to the next chapter for PIVOT, I feel confident knowing that our commitment to these shared values guides our daily decisions, enables us to meet challenges head on, and connects us to the global movement of achieving #HealthForAll. Together, we can grow this movement. I hope you will follow our journey, join the conversation, and continue to support our work:
Find us on  &   & @pivotmadagascar to share your #pivotvalues!