Learning to innovate during global emergencies

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.

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.

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 game changer.

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.

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.