Discussions on the merits of remote control management of humanitarian projects have been particularly intense over the last few years. MSF is not an exception and we are pleased to share this contribution published in Humanitarian Exchange Magazine (January 2013, No. 56) by Joe Belliveau, the operational manager for Somalia in the Dutch section of our organisation.

In it, he explains how 'remote control' is an effective tool in the implementation of MSF programs in Somalia. Mr Belliveau describes a successful strategy which is based on increased control of national staff by a coordinating team located several hundreds miles away.

"REMOTE MANAGEMENT" IN SOMALIA
By Joe Belliveau

Core to Médecins Sans Frontières (MSF)'s approach to assistance is sending international staff into foreign contexts to work with, and usually direct, locally recruited national staff. Outsiders bring experience, leadership and technical skills, and are in a better position to ‘witness' intolerable situations and speak out about them. International staff are also better able to resist local pressures for resource diversion, giving MSF greater confidence that donor money is being spent appropriately. For many within and outside MSF, this model is the only responsible option because the compromises assumed to be inherent in a remotely managed programme are unacceptable. MSF-Operational Center Amsterdam (MSFOCA)' s experience in Somalia challenges this paradigm, and suggests that the specific remote management model developed in this context works well and does not entail unacceptable compromises. While remote management should never be a first choice, in some contexts it can be a viable operational alternative to the deployment of international staff.

Background

On 28 January 2008 three MSF employees, one local and two international, were killed by a roadside bomb in the Somali port city of Kismayo. The deaths prompted the withdrawal of all MSF international staff across Somalia. As the risk of deploying expatriates, at least permanently, became too great, the mission set about adapting to this new reality.

Remote management was not without precedent within MSF, but there was little documentation of lessons learnt, necessary preconditions and tools, protocols or strategies that could help guide the process in Somalia. The mission therefore started from scratch by identifying the following risks:

- Reduced control over resources, especially cash and consumable items.
- Declining medical quality.
- Limited or no programme expansion or adaptation, including emergency response.
- Increased risk to national staff, especially in senior positions.
- Impartiality could be compromised by local clan dynamics reflected in the staff corps.
- Limited or no témoignage (witnessing and speaking out on behalf of the affected population).

A system was subsequently developed to mitigate these risks, based on new and adapted tools and procedures. Gradually mission culture shifted and national staff, supported and held accountable by a mixed Somali, Kenyan and international Country Management Team (CMT) based in Nairobi, took greater ownership of programme activities.

The system

The remote management system is based on several key concepts:

Centralised decision-making. To maximise control over resource flows and reduce the risks to national staff in the field, most resource-related decisions that would normally be taken at field level are instead taken by the CMT.
Micro-management and cross-checking. The Nairobi CMT is much more closely involved in project details than CMTs in most other MSF missions. Information coming from the field, especially resource-related information, is cross-checked through other sources within and across departments.
Support and training. Field staff are brought out to Nairobi (and in some cases sent to Europe) for meetings and training more frequently and for a wider range of topics than in other MSF-OCA missions. In 2011 and 2012, staff came to Nairobi (or were sent further abroad) 116 times.

Each support department - medical, logistics and finance/HR - has developed new ways of working to meet the particular demands of remote management, while continuing to use the same performance indicators as any other OCA mission. Medical staff based in Nairobi work very closely with their colleagues in the field. Daily contact, through email, phone and now video, is standard in order to track developments and coach, support and advise field staff. Weekly medical and surveillance reports are submitted, mortality reviews are conducted of all deaths, referrals are done in consultation with staff in Nairobi and exit interviews are conducted to help ensure that patients are receiving proper care. Patient registers are kept in duplicate, and individual files are monitored, either scanned and sent to Nairobi upon request or checked during visits. Prescriptions are checked for accuracy as well as to compare against drug consumption, and counter-signatures are required for external services like X-rays and lab work. For the two projects where international visits are possible, checklists are created to maximise the efficiency of visits, some of which last only a few hours...

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