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The Optimist

flooding in the aftermath of Typhoon Ketsana

Learning to innovate during global emergencies

Dr. Valerie Nkamgang Bemo tells The Optimist about her role, innovations in humanitarian aid, and what she’s learned from 15 years in the field.

Dr. Nkamgang Bemo

Dr. Nkamgang Bemo

You grew up in Cameroon. Were there moments in your childhood that led you on this path?

I always wanted to be a doctor, and when I saw television programs as a child about Médecins Sans Frontières (MSF), I thought that’s what I want to do. Everyone around me, especially in Africa, said no, that’s not for women. You should be a “normal” doctor.

After becoming a doctor, I was in a training in Paris and some of the lecturers were from MSF. I left my contact details with them and three months later, I got a call. They said we need you in one week for a year, in a remote part of Kenya.

I had a difficult decision—I remember it was around Christmas-time and I spent two sleepless nights and didn’t talk to anybody as I thought it over. I thought about how many people have regrets when they are 50 or 60. I considered how few people would have their dream handed to them on a golden plate. I was 28.

When I made my decision, many people tried to convince me otherwise. I’m so glad I didn’t ask anybody’s opinion. I left all that I was doing and I just jumped. After a few months at MSF, I realized this was all I had dreamed of...and why I became a doctor. From then, I never left the field.

How does the Gates Foundation decide which crises to respond to?

Our approach is to be fast and flexible because we understand that in humanitarian crises, situations change rapidly. But we have limited resources [dedicated to emergency response], so we have to prioritize carefully, and we have developed some criteria to identify how and where to respond.

We focus on low-to-medium income countries, rather than the U.S., Canada or France, which have greater resources.

We also look at the capacity [of the first responders] to respond. Sometimes if there’s already an appropriate response, we are not needed. On the other hand, there are what I call, the hidden crises, the ones that don’t make the news, that don’t get funding, but often have the most need.

We also look at extraordinary events in terms of scale, say if it’s one of the first, or the worst disaster in 20 years, it might mean there’s a lack of experience or expertise locally. Extraordinary can also mean if there’s a place where there was an earthquake one day, and a flood the next. So even if they have the capacity to respond initially, they become overworked and need support.

Lastly, we look at the acute phase. Even if there’s a place with a chronic crisis and a good level of response, there will be high peaks and the need for more help. We will respond to that.

Is there an example of innovation in emergency response you are proud of?

The mark of the foundation is innovation, and I’ve learned that when people are in distress and have lost everything, they are more open to new solutions.

Our team’s aim isn’t always to develop new things, we’ll also look at what’s already developed, something that’s tried and tested in normal circumstances, and try to understand how it can be used in a disaster setting.

One of the biggest challenges when an emergency happens is sanitation. But the humanitarian sector has continued to use latrines, even when that approach hasn’t worked, because the concept hasn’t evolved in over 20 years.

Our sanitation team is now working on projects that look at different ways to provide sanitation in emergency response situations. One of those, which we’re piloting in refugee camps in Ethiopia and Kenya, is testing technology that converts human waste into briquettes for cooking. This can be a gamechanger.

Where does the humanitarian aid field struggle?

Because everyone is so busy in this sector, there’s no time to reflect on long-term innovation and solutions. We need more long-term thinking. I’ve been a first responder with death and life in my hands, so I know what it’s like when you’re just focusing on the day-to-day situation. Having that experience helps me appreciate the on-the-ground efforts as I focus on the bigger picture. It gives me credibility with emergency responders because I can say I’ve been there.

What were some profound moments for you in your career?

I heard about the earthquake in Haiti and had a feeling that the situation would be very bad. Within 12 hours, we had provided a grant, and followed up with another within 48 hours. But I was frustrated with the international humanitarian response that was uncoordinated and not simply asking the affected population what they needed. It made me realize we need to ask people on the ground what they need.

A few months after the earthquake, I asked a research analyst to look at how many disaster assessments had a local voice; they found that out of more than 300 reports, only five had local voices, and only two [international aid response] places had used those assessments in their response. I realized the system was broken and we needed to involve local voices in responses and finding solutions.

I knew the Ebola outbreak would be a big problem, and that was before it reached crisis stage. Everyone was focusing on the three countries that the media was covering, but I was looking at the four neighboring countries to help them prepare if the disease reached them. So, when two or three months later the foundation decided to get involved, I already had a grant in place.

The foundation donated $50 million—my annual budget is just $15 million! I was at the center of influencing how the foundation's response was being managed, which also happened to be during the time of my wedding, so it was a big time for me personally too.

university student in the Carrefou Feuilles neighborhood of Port-au-Prince
Carl Henry Lamore, a university student, uses his mobile phone in the Carrefou Feuilles neighborhood of Port-au-Prince on January 7, 2011.

What other challenges have you navigated in your career?

As a black woman, as an African, I’ve had my authority challenged many times. It has served me to work doubly hard, to be the best I could. If people performed at a “four,” I performed at a “10.” It helped me push myself more and I moved ahead faster because of that.

But you have to keep proving that you are qualified to be here and that you can manage people. There are times I went to the field with assistants who were white men, and I was ignored and people assumed I was the secretary holding the paper. But I thought it was good, I was underestimated and I ended up proving myself. This is the story of my life and I’ve learned to thrive in it.

About the Author

Ruchika Tulshyan
Ruchika Tulshyan is an author, educator, and journalist. Her writing has appeared in publications including Harvard Business Review, Forbes, and The Seattle Times.

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