Maldivian tourism authorities are pursuing private sector funding to secure advertising with prominent media networks such as CNN, after this week signing a sponsorship agreement with the British Broadcasting Corporation (BBC).
The government yesterday finalised a US$250,000 (Rf3.8million) advertising deal to promote the country’s tourism industry on the BBC through sponsorship of its weather services. Tourism authorities said the strategy reflected a collaboration between the government and the private sector to try and strengthen arrival numbers to the country.
Under the recently reinstated “Sunny Side of Life” branding, Maleeh said the sponsorship of the BBC’s weather services will run from June 18 to August 27 on both the BBC World TV service as well as the broadcaster’s website.
In April, the Maldives Marketing and Public Relations Corporation (MMPRC) confirmed the appointment of New-York based public relations agency Ruder Finn to “oversee the overall media coordination and achievement of PR related solution for destination Maldives.”
According a contract speculated to be worth over US$150,000 per month, Ruder Finn is required to work to: “ instill confidence in the tourism industry of the Maldives, gain understanding and public acknowledgement of the Maldives in the international community and ensure sustainable development of the tourism industry.”
Questioned whether the BBC sponsorship agreement was designed to try and generate greater media coverage about the Maldives on international news services, Maleeh claimed the MMPRC’s promotion plans were focused on tourism rather than generating headlines.
“At present we are trying to build investor confidence in the country,” he claimed. “There has been too much focus on stories such as how the Maldives will be sinking in 30 years.”
Maleeh pointed to recent coverage of several events in the lead up to February’s controversial transfer of power – such as former President Mohamed Nasheed’s proposed spa ban – as an example of headlines that had damaged confidence among tourists and investors in the Maldives.
The previous government under Nasheed claimed a spa ban introduced back in December 2011 was made in response to criticisms made against it during a demonstration of opposition politicians and NGOS relating to “un-Islamic” practices in the country.
Once the present BBC sponsorship agreement ends in August, Maleeh added that the MMPRC and tourism authorities hoped to secure more funding to continue its advertising plans. He said that the motivation at present was to extend advertising ideally to “all mainstream media organisations” such as organisations like CNN.
Maleeh stressed that funding remained the biggest issue at present to extending advertising efforts.
“We are seeking support from local and international hospitality groups right now,” he said. “We are still waiting to receive support. However, other hotel chains have shown an interest.”
During the signing of the BBC agreement yesterday at the Conrad Rangali Island Resort, Tourism Minister Ahmed Adeeb welcomed the assistance of local business tycoons Mohamed ‘Champa’ Moosa and Mohamed Umar Maniku in securing the deal, according to local media.
Adheeb told Sun Online that authorities had decided to re-use the country’s “The Sunny Side of Life” branding due to previous experiences the industry had with the slogan, as well as negating costs associated with setting up an entirely new brand.
“Over the past years it has become a very expensive brand. I believe that if we were to opt for a rebranding it would in the least cost us US$50 million. We don’t have that much of a budget. The new government decided to go forward with the old brand,” he was quoted as telling local media.
Meanwhile, Vice President Waheed Deen, who was also present during the signing, lauded the financing of the new ad campaign as an “achievement” and a “success” for the country as it celebrates 40 years since the inception of Maldivian tourism during 2012.
The 50,000 member-strong opposition Maldivian Democratic Party (MDP) maintains it was ousted from power on February 7 following what then President Mohamed Nasheed described as a coup d’état planned by political opposition, sponsored by some wealthy resort tycoons and carried out by a mutinous police and military. The party has continued to claim that President Dr Mohamed Waheed Hassan’s government is illegitimate and represents a return to the autocratic era of Maumoon Abdul Gayoom.
Such criticisms of the present government have led to the establishment of the Maldives Tourism Advisory (MTA) by the Friends of Maldives NGO that names resorts alleged by the MDP to have involvement in the “coup”.
In April, the Maldives Association of Tourism Industry (MATI) has issued a statement expressing “serious concern” over what it describes as a “concerted international campaign” against several of the country’s resort operators.
MATI claimed that calls from the Maldives Tourism Advisory (MTA) for tourists to avoid certain properties on the basis of ownership were “libellous in the extreme”, as the allegations against the tourist resort operators “have not been proven either through an investigation or a court of law.”
The MTA website features a ‘traffic light’ system with “red” resorts recently appearing to have been expanded to include an assortment of 18 properties owned by Vice President Waheed Deen and senior figures associated with the new ruling coalition, including Jumhoree Party (JP) Leader Gasim Ibrahim and Progressive Party of the Maldives (PPM) MP Abdulla Jabir.
UK media have been covering attempts by Tourism Minister Ahmed Adeeb Abdul Gafoor to restore confidence in the country’s tourism sector following recent negative headlines regarding political uncertainty in the nation.
Reporting for The Daily Telegraph newspaper, journalist Oliver Smith said Gafoor addressed sections of the UK media claiming that the current government of President Mohamed Waheed Hassan took allegations of police brutality against protesters opposed to his leadership “very seriously”.
“While it is generally accepted that holidaymakers are unlikely to be caught up in any unrest, as most resorts are found on isolated, otherwise uninhabited islands, the moral implications of visiting the Maldives have been called into question following the downfall of Mr Nasheed,” Smith wrote for the paper.
“Human rights groups, including Amnesty International, have accused the new government of ordering police to violently suppress demonstrations.”
With a small band of protesters handing leaflets to reporters outside claiming that President Mohamed Waheed Hassan was working to undermine the country’s young democracy, the Telegraph reported that Gafoor saw this as a clear indication that human rights were being respected in the country.
“The fact that there are leaflets being handed to you outside shows how open we are,” he was reported as saying.
Beyond addressing the country’s political upheaval, the newly appointed tourism minister said that he hoped to continue to try to open up the country to emerging markets like China, whilst also pursuing more sustainable and community-based tourism projects.
“He [Gafoor] also sought to reassure visitors that the islands’ spas – briefly threatened with closure under President Nasheed, following pressure from Islamist groups – would remain open, and said that no moves to restrict the sale of alcohol in holiday resorts would be considered,” the newspaper added.
The minister also hit out at a travel advisory issued by the UK-based NGO Friends of Maldives. According to the NGO, while the advisory aims to encourage travellers to continue holidaying in the Maldives, it does ask travellers to reconsider staying at a small number of resort properties that it alleges are directly involved in the controversial transfer of power to President Waheed last month.
“Mr Gafoor said he would not recognise the Friends of Maldives campaign and was bullish about the impact that recent negative publicity would have on visitor numbers. He said that a record one million holidaymakers were expected to visit the Maldives this year, including around 100,000 Britons,” the report added.
While the Maldives Tourism Minister hosted a press conference in London to soothe the fears of the tourism industry over the ongoing political instability in the Maldives, opposition activists distributed leaflets outside.
Former Maldives High Commissioner to the UK Dr Farahanaz Faisal distributed leaflets highlighting police brutality in the crackdown on demonstrators on February 8, while the Friends of Maldives NGO distributed its travel advisory highlighting the involvement of several politicians and resort owners in the change of government on February 7.
Monday’s professionally managed event was attended by 25 journalists from a host of prominent UK travel publications.
The Maldives Marketing and Public Relations Corporation (MMPRC) recently appointed Rooster Creative Public Relations Ltd as its official PR agent in the UK. MMPRC Acting Managing Director Mohamed Adam explained this decision.
“The purpose of having a full time PR and Marketing agency is to overcome the image that is continuously spoiling in the UK market due to the current political turbulence,” Adam said.
Adam’s aims were stymied somewhat by the presence of former Maldives High Commissioner to the UK Dr Farahanaz Faisal and the former Deputy High Commissioner, and brother of President Dr Mohamed Waheed Hassan, Naushad Waheed.
MDP supporters Farahanaz and Naushad took the opportunity to distribute leaflets focussing on police brutality in the Maldives. The leaflet described the Maldives as undergoing “one of the most painful and brutal periods of its history”.
Business as usual?
Despite the demonstrations outside, Tourism Minister Ahmed Adheeb Abdul Gafoor remained upbeat about the prospects of the Maldives tourism industry. The minister told Travel Weekly that he was expecting one million tourists to visit the country in 2012, breaking previous records.
He spoke of having visited tour operators during his trip who are eager to launch charter flights to the Maldives and begin new projects.
Referring to the demonstrations, he said, “The press conference was not affected by that. The journalists did not seem bothered. The press conference was a success.”
Former Tourism MinisterDr Mariyam Zulfa has expressed confidence in the sector’s durability, saying, “I don’t think that the political situation is actually affecting the tourism industry as such because Maldives is a well-established destination.”
This current government’s veneer of confidence, however, is belied by the hiring of the professional PR group to protect its image and by reports that bookings were down six percent in February, according to Travel Weekly.
“It has never been the MDPs intention and it will never be the MDPs intention to obstruct the progress that we have made in the tourism industry,” said Zulfa. “It’s not in our agenda to affect the traveller’s decision to choose Maldives as a destination at all.”
“But I think the tourist industry has a responsibility to provide correct information about Maldivian life in general.”
The awareness-raising efforts of the government’s opponents, indeed, do not appear to be registering with those travelling to the Maldives at present, supporting the views of Tourism Ministers past and present.
Asking the opinions of tourists at Ibrahim Nasir International Airport yesterday, the most common response was a vague notion that the Maldives had been in the news recently, without any specific details being recalled.
This was perhaps typified by the response of a couple from the UK who were asked how they felt about what was happening in the Maldives at the moment: “What is happening?” came the response.
Also outside the press conference was David Hardingham, founder of Friends of Maldives (FOM), who distributed a second set of leaflets publicising his group’s travel advisory.
FOM is a UK based NGO focusing on the protection of human rights, the promotion of social justice and democracy in the Maldives.
The content of the FOM leaflet was interpreted by the Maldivian media outlet Sun Online as claiming that the Maldives was an unsafe travel destination. Newspaper Haveeru also reported that the NGO was advocating a “tourism boycott”.
Referring to Sun’s article Hardingham said, “Responsible journalism involves getting both sides of the story – so we were disappointed not to be asked by Sun for our views as their article is one sided, has factual errors and is somewhat misleading – however it’s not entirely surprising as its owners are known to be supportive of the recent coup.”
Hardingham forwarded the leaflet distributed by the NGO (page one, two), which lists resorts and businesses owned by Jumhoree Party (JP) leader Gasim Ibrahim’s Villa Group, and Bandos Island Resort and Spa owned by Vice-President designate Waheed Deen, and urges “responsible” travellers to avoid these resorts specifically.
“The current political turmoil in the Maldives has deterred people from visiting the islands. Friends of Maldives urges tourists to continue to visit Maldives, as tourism is the mainstay of the economy. We feel the situation is not so bad, as the airport and resort islands are not linked to any population centres,” the leaflet notes.
The leaflet goes on to recommend the travel advice of the UK Foreign and Commonwealth Office (FCO), which currently has no restrictions in its Maldives travel notice.
The FOM leaflet continues to briefly outline recent events in the Maldives before asking that potential tourists “consider the idea of being a responsible traveller” by avoiding resorts that are allegedly involved in “the subversion of democracy, and human rights abuses in the Maldives”.
President Dr Mohamed Waheed has abolished the Maldives Volunteers Corps (MVC) and its work has been reassigned to the Ministry of Human Resources, Youth and Sports.
“The Maldives Volunteers Corps was abolished because a number of its functions are performed by the Ministry of Human Resources, Youth and Sports,” the President’s Office said in a statement.
The Ministry is now overseen by Mohamed ‘Mundhu’ Shareef, spokesperson for former President Maumoon Abdul Gayoom.
The Maldives Volunteer Corps was established in 2009 under the Ministry of Human Resources, to increase the participation of youth volunteers in various national and regional level social and economic programs.
Its international branch, the International Volunteers Programme (IVP), places international volunteers in positions within the health and education sectors in the country and was established in partnership with the Salisbury-based Friends of Maldives (FOM) NGO, and coordinated by the Maldives High Commission in London.
FOM recently announced a travel advisory concerning four resorts whose owners it alleged were involved in the ousting of the Maldives’ first democratically-elected President.
“Since the first free and fair presidential elections in the Maldives in October 2008, FOM has worked on promoting social issues and other development programs, primarily in Health and Education Sectors, with the International Volunteer Programme (IVP), the Maldives Volunteer Corps (MVC) and the Maldives High Commission (London),’ FOM said in a statement on its website.
“This activity has been jeopardised due to the violent removal of the democratically-elected government on February 7, 2012. Where health workers and teachers are able to stay, without danger to their safety, they will continue to work to benefit the Maldivian people.
“Unfortunately, this situation is becoming increasingly fragile as Maldivian people have been beaten, hospitalised and imprisoned across the country, and FOM’s focus is required to revert to protecting human rights and promoting social justice until safety and democracy is restored.”
There are 28 volunteers with the IVP program based across the Maldives for the current academic year.
MVC was the program’s local counterpart with the role of taking care of the volunteers, provide their induction and orientation, and liaise with the Ministry of Education throughout the academic cycle, explained former head of MVC, Mariyam Seena.
“The IVP was designed to meet the shortfall of skilled personnel in the academic sector and if the program is shut down, then it will be the children and the schools that will suffer,” she said.
“The schools that have IVP volunteers rely on them a lot – not only with teaching the students but running English programs for the local teachers as well.
“In late 2010 MVC received close to 100 requests for volunteers from schools all over the country which shows the urgent need for British volunteers.The program is into the third year and beginning to make a huge impact on the education system, so shutting it down would be a huge injustice for Maldivian students from the islands,” she concluded.
In an email to the IVP volunteers currently working in the Maldives, FOM founder David Hardingham advised them to register with the British High Commission in Colombo, “and please leave the country if you feel you are in any danger at all.”
“Friends of Maldives are now no longer official stakeholders in the program and following the events in Male and now in Addu, we are now resorting back to our former role as a human rights NGO,” he said.
Volunteers choosing to stay were advised to “follow their instincts”, “steer clear of gatherings”, and “don’t express an interest in one side or the other.”
“Things are unlikely to improve, at least in the short term,” Hardingham wrote. “The military coup and the subsequent crackdown on the huge Male demonstration has caused a lot of concern amongst progressive Maldivians who remember the heavy-handed former dictatorship. There is a lot of pain and anger out there and if demands are not met for elections then things could spiral for the worse.”
The Maldives Volunteer Corps was inaugurated in 2009 by Dr Waheed and then-President Mohamed Nasheed.
In a statement following the inauguration, Dr Waheed “noted the importance given by the President in establishing the Volunteers Corps.”
“Further, he said that Maldivians, in all walks of life, have been known for their helpfulness and kindness to each other. Speaking in this regard, the Vice President said that purpose of the Maldives Volunteers Corps included strengthening the spirit of cooperation and solidarity among the people and to increase interest in voluntary services.”
Addu City and Hulhumale’ students will compete in an International Rowing School Competition during the 17th South Asian Association for Regional Cooperation (SAARC), to be held in Addu City during the first eleven days of November.
Students over age 11 from Addu’s 12 schools and Hulhumale’ have been training in four-seater crew boats, or ‘quads’, since September. The teams are down to their last three weeks of training for one of the Maldives’ first contemporary rowing competitions.
“Over the past few days we’ve been racing the students to select the fastest from within each age group for every school. There have been some very close results so I’m looking forward to some great racing between the schools come the 4th of November.”
British national rower Natasha Howard trains students from a program base on Hithadhoo Island. She arrived in the Maldives in August with fellow rower Rachel Loveridge to volunteer coach students for the competition.
Unable to exercise during the day in Ramadan and with few resources (boats were imported, and the island’s Utility Office has served as a boat house), Howard used the first month to meet with principals and the city council to arrange a schedule to ensure the teams would be ready to compete in November.
“The City Mayor Abdullah Sodiq and all the council members have gone out of their way to ensure that I have everything I need,” said Howard, who has operated from a desk in the council’s education unit.
Howard said the program has generated great enthusiasm in Addu. Without volunteer support from Hithadhoo Youth Center, only a fraction of interested students would have received any training. Instead, seven volunteers learned the sport in order to help instruct 213 interested students on necessary skills.
But limited resources have made cuts necessary.
“I could have cut the sessions twice over and had children in tears when the cut was made to reduce the group to just 16 boys and 16 girls [from each school]. Others ask me constantly could they come for more sessions and don’t believe me until I show them my schedule that there really is not another hour in the week they could come (unless they skip school).”
Further cuts will reduce the team to four boys and four girls from each age group (U14, U16, U19, U21) for the race on 4 November.
Start line: Zero Degrees
The program began with a world record. On 30 March 2010, British national Guin Batten became the first person to row across the Maldives’ equatorial Zero Degree Channel.
Speaking at a presidential ceremony in April, Batten reflected on her record’s significance. “I hope that my crossing is an inspiration to bring rowing back here to the Maldives,” she said.
Primary school teacher and coastal rower James Cowley took the suggestion to heart. When Batten left her boat in the Maldives in March, Cowley used it to develop the sport of rowing from his volunteer base in Thinadhoo.
One significant step was establishing the Rowing Association of the Maldives. In November 2010, the Maldives became the 131st member of the International Rowing Federation (FISA).
Equipment has been slowly added to the Maldives’ rowing collection. Acting as the Sports Development Coordinator for Friends of Maldives (FOM), Batten arranged for two four-person ‘quad’ rowboats and several coaches to be brought to Thinadhoo and Ghadadhoo in 2010 with the support of British Airways (BA), British Rowing and Westminster School.
This year, Howard and Loveridge were accompanied by seven coastal ‘quads’ from the UK, three of which are being used in Hulhumale’ and four of which are in Addu.
“Our aim is to ensure that when the volunteer coaches leave there is a self-sustaining club in place,” Howard said.
The Addu program instructs 213 students, mostly boys, who are shuttled across Addu’s 14 kilometre road, Maldives’ longest, each day for practice. In a progress report, Howard noted that fewer girls had the necessary swimming skills to participate in the program, “it wasn’t for lack of interest in rowing.”
Remembering the drowning incident at Kuda Huraa earlier this year, Howard reported that rowers will receive swim training by a Maldives National Defense Force (MNDF) volunteer after SAARC. She also mentioned plans for an Addu swimming program next year “as concern is growing at how many of the students do not know how to swim.”
Students have shown enthusiasm for the program, which involves two two-hour sessions of land fitness and water training each week. Most groups are separated by gender, according to school advisories.
“Like everywhere in the world some students are keener than others and push themselves harder but not a single student has refused to do anything we’ve asked of them from carrying 50 kilo boats to and from the water to doing burpees, press ups, squat jumps and sit ups. We’ve had lots of reports of sore muscles during the first week but everyone came back for more,” Howard said.
In addition to gaining physical strength and finesse, rowers develop strong communication skills.
“The art of communicating with each other and doing the same thing together and at the same time are crucial and something we have been working on with the students,” said Howard, adding that each student learns at an individual pace.
“How quickly a student learns the new skills will vary with each individual – if they are naturally shy and quiet building the confidence to talk and give instructions to their partner will take that little bit longer than it does for an out going, noisy and naturally bossy person! However, the desire to win races is a great motivator and all our students have worked out their various ways of communicating.”
Not just kids’ play
As Batten noted in 2010, the Maldives has a unique appeal for rowing. Howard highlighted the climate’s unique advantages for coaches, novices and experts.
“The area of water we use here in Addu is great for getting novices started – sheltered by some small islands it never gets rough and there are no strong currents. Even when the wind is blowing hard the boats cannot be blown out to sea.
“The warm weather and water also means everyone is very happy to get soaking wet (the more often the better) and we, as coaches, are able to hang off the back of the boats as the students learn to row and so provide one on one coaching support very easily.
“The other great advantage is the ability to look over the side of your boat and see coral, fish and turtles swimming by – definitely not something many other rowing locations can boast about!”
While rowing was a traditional transportation method in the Maldives, contemporary facilities are sparse. Howard said resources are currently being channeled into SAARC preparations on Addu, but that improvements are expected after the summit.
After consolidating the programs in Addu and Hulhumale’, “our next priority is to utilise the local boat building skills and investigate the possibility of having the boats built here in the Maldives to reduce costs and so make them more widely available.”
According to Howard, there is plenty of demand for expansion.
“Interest is not just limited to the students. Teachers, parents, doctors, council members and the ladies in the Education Unit are all desperate to come and have a go and race. Time and too few boats means that everyone has to wait their turn right now,” Howard observed.
For Maldivian rowers, Batten’s record remains fair game for the breaking.
After failing to break her own record in the Zero Degree Channel in November 2010, Batten told the public, “The record is still there for the taking, and there’s a good chance somebody local could break my time of 7:16.”
President Mohamed Nasheed, Vice President Dr Mohamed Waheed and Chief of Staff Ahmed Mausoom yesterday met with Outgoing Director of UNESCO and Former Minister of Education of Mauritius, Amroogam Parsuramen, to discuss strengthening collaboration in the areas of higher education, trade and economic development.
During the meeting Parsuramen also congratulated the Maldives for its promotion of the values of democracy, human rights, and efforts to seek regional cooperation in an international arena.
Nasheed also met yesterday with the Salisbury-based Honourary Consul of the Maldives and Friends of Maldives founder David Hardingham, and discussed providing overseas volunteers to assist in areas of development and trade.
Cathy Waters is the new Chief Executive of Indira Gandhi Memorial Hospital (IGMH), the main hospital in the Maldives. She is one of three foreign medical experts brought out by the UK-based Friends of Maldives NGO and the Maldives High Commission to improve the country’s standard of medical treatment, alongside Medical Director Dr Rob Primhak and Nursing Director Liz Ambler.
JJ Robinson: How did your role at IGMH come about?
Cathy Waters: I’ve been on holiday to the Maldives many times, but it’s been a very different experience living and working here, compared to the sanitised version [of the country] you get at the resorts.
I knew nothing about Friends of Maldives – instead a friend of mine sent me an advert in the Health Services Journal, and said “This is the job for you.” I thought it was interesting, was interviewed in December and found myself out here very quickly, in February.
My background is 28 years working in the UK’s National Health Service (NHS), starting as a clinical nurse and working my way up. For the last 15 years I’ve been working in management, and the last eight as Chief Executive of a primary care trust, which commissions health care services.
I’ve had lot of exposure training and working in hospitals, as well as the broader healthcare system. I left the NHS three years ago and worked in a small management consultancy in the UK, which involved going into companies that were facing problems, and working with them to solve those and bring about change.
My last big contract involved working with big local authority in London than needed a transformational change. In reality it meant making significant savings – we had to make 80 people redundant.
JJR: What was your understanding and knowledge of what the position involved before you arrived?
CW: I understood that IGMH is one of five entities that comes under the umbrella of the Male’ Heath services Corporation (MHSC), IGMH being the largest entity, at about 90 percent.
I knew they needed to make significant changes to patient care, and the overall environment for patients. I knew IGMH needed change, which was part of attraction for me as it was somewhere I could utilise all the skills I had to bring about that change.
I also knew it was a hospital that people care passionately about. There’s a real sense that it belongs to the community and that we should be providing high quality services.
One of the things I noticed early on was that staff morale was very low, and people were unsure about what was happening with the organisation and had all sorts of concerns about the future. One of the things I did when I started was observe what going on and try to be very visible as a chief executive, spending time with the doctors and in the labour ward.
A new executive nurse director Liz Ambler is already here, and a Medical Director Dr Rob Primhak will be joining in July, so together we want to be able to demonstrate importance of management staff and clinical teams working closely together. We need to break down some of those barriers and reduce the divide between management and clinical services.
JJR: You arrived three months ago on the tail end of the collapse of the Apollo deal, a 15 year agreement signed in January 2010 with India’s Apollo Hospital Group to manage IGMH. What actually happened?
CW: I did read about Apollo. My understanding was that they wanted to bring about significant change but they wanted significant resources to do that, and that wasn’t an option. One of the things I’m very clear about is that we need to bring about significant change, but within the existing budget. That might involve reviewing everything we do as an organisation.
Unless we can find resources elsewhere we have to work within the budget we’ve got. That’s quite a challenge, because previously there may not have been the same budgetary controls [there are now]. We have to be careful how we utilise our very precious resources.
JJR: What parallels have there been so far with your earlier experience?
CW: Working in an organisation where there are significant financial challenges, and working in an organisation where patient needs are very clearly evident. The population is very vocal about what they want and need – some of that is about manging expectations.
One of the things I know we need address is that people can’t access doctors as quickly as they want. We need to increase outpatient appointments. At the same time there is no system of triage, or prioritisation of the emergency room, which we are now developing.
JJR: It’s true that many people claim the quickest way to get an appointment is to have the mobile number of a friendly doctor.
CW: We have a Maldivian ER consultant in training who is coming back to develop a triage system and ensure those patients who need to be urgently seen are seen straight away, or that those with minor ailments are seen by someone else, or not as quickly.
From what I understand there isn’t a word in Dhivehi that translates into ‘urgent’. We have quite a lot of work to do to make sure patients get to the right place at the right time.
One thing common to people working in the NHS and IGMH is that staff are passionate about what they do. We have to channel that in a positive way. We need to engage staff in decisions rather than it being a top-down management style.
This means helping them to be part of the decision making process, which can be difficult to get your head around. The key groups are patients and staff – happy patients mean staff are pleased they are doing a good job, equally, happy staff are more likely to perform well.
Sometimes it’s very simple stuff – such as saying ‘Thank you, well done.’ I don’t think that’s happened here very often. It doesn’t take a lot to say thank you.
The work that went into planning for mass causalities for the Friday of the recent protests was great. It was a really great example of working as a team and getting everything ready for an influx of casualties.
I recognised the hard work that had gone in so I made sure I came in on the Friday and was part of what was going on, so staff felt supported, and afterwards I wrote a thank you memo. Simple stuff like that makes people feel valued for what they are doing.
JJR: What have been some of the key cultural challenges?
CW: There is a very, very different work ethic to the UK. Some of the things I’ve found very different and very frustrating are about how people manage their time, and motivating people to work. That’s a huge issue.
Getting people to plan ahead and put processes together is challenging. One exciting project is expanding the intensive care unit – I said we need a proper process and justification of the expansion, a proper plan about how we are going to do this. For me there’s a discipline to this, but it’s not always the way things have been done.
Also different and very distinct to IGMH is the lack of use of email – staff still attempt to use memos. I’m trying to encourage the use of email, and encourage people to think ahead and write agendas for meetings.
JJR: On other side of the cultural question, what has been the reaction among staff to a foreigner coming in as a top-level manager?
CW: Inevitably there’s been a degree of suspicion at someone new coming in, at someone from the UK coming in and imposing their views. For me what has been important is how we work with people and lead. I firmly believe that how you lead is important – working with staff, rather than telling them what to do. You do need boundaries and parameters, but people need a sense of direction, and permission to do things themselves.
The other issue is that my contract is for a year with the possibility of extending to two years. Whatever I do, I will feel I’ve failed if I haven’t managed to find someone in IGMH to transfer leadership skills to, and leave a positive legacy. The worst thing would be for me to do would be to go back to the UK and for things to tumble down. That would be an absolute failure on my part.
JJR: How did these obstacles come across? Were there initial difficulties?
CW: People have been very accommodating and very welcoming. I’ve convinced people that they don’t need to stand up when I walk into the room, which was very traditional, and I don’t expect people to call me “ma’am”. People generally been very welcoming. There’s been a few challenges with language barriers, although this has proved less of a problem than I thought it would be. I have very good support in meetings- I might do an overhead presentation, and it is translated into Dhivehi. Unfortunately I’m failing miserably at learn Dhivehi words. Generally people have been helpful and make sure I’m involved in what’s going on.
JJR: What are some of the unique characteristics of the Maldivian hospital-going public?
CW: They are very demanding, and very quick to blame the doctors if things go wrong. Inevitably in a hospital things go wrong, by the very nature of the work we do. And because IGMH is the country’s main hospital, we inevitably get the more complicated and high-risk cases. People are quick to be cutting.
Equally the general public should demand good care, and rightly get that care.
We need to work to enhance communication. One of the things I’ve noticed that is quite different from UK is that different departments still work in silos. We’re trying to break down these silos and get people to work across the organisation.
JJR: There has previously been conflict and misunderstandings between Maldivian doctors and foreign doctors working at the hospital, amid the cultural challenges of having a high turnover of foreign medical staff. Is this something you have observed?
CW: It fascinating that the hospitial talks about ‘Maldivian doctors’ and ‘foreign doctors’ as though they are completely different. Part of the problem I think for the Maldivian doctors who are very dedicated and are here for the duration is that they don’t get some of the benefits expatriate doctors get, such as support with their accommodation. Inevitably that brings some degree of conflict.
Expat doctors are also here for a short time, and I’m making a huge generalisation, but the commitment of some of them may not be as high as that of the Maldivian doctors. Some of that is the sort of contract we have for expatriate doctors, and that needs to be reviewed. Some of the expatriate doctors see IGMH as a staging post to get broader experience and go off to somewhere else, which must be quite annoying for the Maldivian doctors.
We’re trying to move to a position where as much of the workforce as possible is Maldivian, but inevitably that takes time.
JJR: What about the training of local staff, such as nurses?
CW: We have a good relationship with the Faculty of Health, and more Maldivian nurses are coming back into the system. Liz [Ambler] is very keen on in-service training to make sure we are training effectively, and Dr Rob [Primhak]’s background is in education so I’m sure he’ll be keen to ensure high standards of education and training when he starts in July. It’s an area we’re developing.
JJR: How have you found living in Male’?
CW: We’ve settled in well. My husband is semi-retired; he used to be a director of Mental Health Services. He’s made a decision not to work at the moment – he’s a diver and he’s doing his diver master training and really enjoying it.
One of my worries at the hospital is that we haven’t got the facilities to care for patients at the acute stages of mental health problems, and we haven’t necessarily got the right staff.
JJR: What do you think of the relationship the hospital has with the community, and what did the outcry over the widely reported ‘baby decapitation’ incident tell you about that relationship (the head of a deceased newborn had to be surgically removed during labour after its shoulders became stuck during delivery, endangering the mother).
CW: I had only been here a few weeks when that happened. Without going into the details, what surprised me was how quickly quite confidential details about the patient and the case were spreading like wildfire across Male’.
Understandably there was a lot of anger and concern, and fear generated. One of the key learning points for IGMH was how we need to handle that more effectively with the media – we didn’t handle that very well at all. It’s in the hands of lawyers now – it was a tragic and very unfortunate case, and a very emotive situation. From the hospital’s perspective we did all the necessary investigations that we needed to do.
JJR: Does it come back to this recurring mistrust of doctors?
CW: That’s one of the things I’ve picked up on – there is this mistrust. We still have to rebuild that, because we have some fantastic doctors and clinical staff in IGMH, and inevitably when we have high profile cases like that it creates more damage for the medical profession, which bore the brunt of that incident. We need to be more proactive about how we talk about some of the great things that happen in the hospital.
I’m not sure Male’ is ready for it, but I’d like to start a patient involvement group – a number of people from the community who work with us to improve what we do in the hospital. We do that a lot in the UK, but I’m not sure people here would be interested in doing that yet. It does help people understand the challenges we face as an organisation on a daily basis.
The President has appointed an envoy to work with the hospital. He has already brought through some significant changes in terms of the environment. It’s looking much better when people come in, and the outpatient area is now air-conditioned.
We need to focus on what we need to do to implement quality of care and improving access – there are hundreds of things need to do, but have to manage expectations.
One of the things we want to introduce is catering – at the moment patients’ relatives have to bring food in for them. That’s so different to the UK – nutrition is so important to a patient’s recovery. We want to try and introduce a catering service before the end of the year, so patients get a better service.
JJR: What are the hospital’s key strengths and weaknesses at the moment, aside from the shortage of mental health support you mentioned earlier?
CW: One area we do need to improve on is diagnostic capacity, and tools for helping diagnose. We are going to get a mammogram machine, which will have the facility to do biopsies, and we are going to get an MRI scanner which will improve diagnostics.
One of the key problems we have is access to equipment and medical consumables. We’ve put new processes and deals in place which will hopefully improve that, but I didn’t realise until I lived here that absolutely everything has to be imported. We are reliant on things coming in a timely way, and I don’t think that just affects us.
We also have a hospital kindly donated by the Indian government, but inevitably the building itself is in need of renovation. It was fit for purpose then but with the influx of people living in Male’ the need for services is huge. We have 500-600 patients a day, sometimes more, and the building is almost too small now. We have to look at how we take care of it and develop a more modern facility.
One of our big concerns in relation to the operating theatre is lack of anaesthetists. We have to pay a premium for them to come, as there’s international shortage. That’s a real problem for delivering key services.
Those are some of the key areas. We have a good team paediatricians, and a very busy but effective neonatal intensive care unit with 20 cots.
JJR: Is it difficult to attract people to come and live and work in the Maldives?
CW: I think it’s becoming more difficult now because of the dollar situation, and the cost of accommodation in Male’. The MHSC provides accommodation to doctors as part of their package, but nevertheless food prices and living expenses are going up.
A big problem is paying people in rufiya – the expats who come and work in the Maldives want to send part of their salary home but banks are struggling to enable them to send dollars. That seems to be a very major problem at the moment.
The big thing is making sure there is the right commitment from expatriates to stay and make a positive difference. There’s got to be some way of making the working conditions right for the Maldivian doctors as well. They are the life of the organisation, and we are dependent on making sure they don’t move elsewhere.
We are in the process of expanding inpatient facilities, and renovating the old staff quarters into more private facilities. We will have 56 beds finished in late summer, and we have also signed an agreement with the 11 storey building next to IGMH to provide 72 beds. This time next year we will have a significant increase in the number of beds, but that brings its own problems, such as where we are going to get staff. We’re trying to make sure there is joined-up thinking going on.
The Malé Health Services Corporation (MHSC) is expanding its senior management team with three health professionals from the UK, who have been recruited to support the health transformation agenda of the MHSC, accelerate quality improvements, and rigorously hone cost efficiency.
The volunteers were recruited with the assistance of UK-based NGO Friends of Maldives and the Maldivian High Commission in London who together,have selectively been placing health volunteers around the Maldives through the International Volunteer Programme (IVP).
The three volunteers will initially come for one year, extendable to two years, and say they hope to leave a lasting, positive legacy within the MHSC, by developing local leaders in the medical sector.
Cathy Waters will start as the new General Manager of IGMH at the beginning of February 2011. Waters has 17 years of senior health management experience, including eight years as a Chief Executive in the UK’s National Health Service (NHS), where she demonstrated exemplary management of staff, personnel issues and substantial budgets in the face of major financial challenges.
Waters has also worked effectively as a senior management consultant, achieving organisational change and strategic development targets. Amongst her many qualifications, she has two Masters Degrees (one in Business Administration), an Advanced Diploma in Coaching, a teaching certificate in further education and is a qualified nurse, midwife and health visitor.
Waters says she believes wholeheartedly in involving the public and service users in providing better health care, and in coaching and developing individual health professionals into new and sustainable roles.
Liz Ambler will begin in the role of Nursing Director for MHSC in mid-March. She currently works for the UK’s Department of Health, whilst her specialist clinical background is in blood disorders and cancer care. With significant senior management experience in UK, the Middle East and Africa, she has a proven track record of improving health care quality whilst reducing expenditure.
Ambler has a Nursing Degree, a Masters in Public Health and a postgraduate certificate in Global Development Management, and says she “can’t wait to get stuck in” training, auditing, and developing clinical guidelines with MHSC’s nurses.
Liz is passionate about nursing, improving patient safety and motivating others to achieve good governance.
Rob Primhak has been appointed as Medical Director of MHSC and will make an initial visit mid-February 2011, before starting in earnest in July when he retires early from his Consultant Paediatrician post to take up this new and challenging role.
Primhak has 35 years of clinical and research expertise, primarily in the fields of respiratory medicine and treatment of children and newborn babies, both in UK and Papua New Guinea. He has successfully introduced innovative services and demonstrated a life-long commitment to the education and training of doctors, through the establishment of new curricula and training programmes. He aspires to leave a lasting impression on clinical governance at MHSC through development of health professionals and clinical quality standards.
“We look forward to working with the UK experts in revamping health care quality at MHSC, and are very optimistic about their successful team efforts in turning around IGMH”, said Mr Zubair Muhammad, Managing Director of MHSC.
Much of the current tourism development in the Maldives does not seem sustainable in terms of its impact on the environment or on the economy, writes Friends of Maldives (FoM) NGO founder David Hardingham for Tourism Concern, a UK-based charity ‘fighting exploitation in tourism’.
“Tourism has already played a pivotal role in bringing democracy to the country. It will also be the means by which the country achieves economic recovery. Now the ethical tourist’s attention must turn to sustainable tourism.
“Preference must be given to resorts making efforts at recycling, alternative energy and environmental protection (with particular reference to the coral reef ecosystem). The government must be called to task on these issues.
“A new and exciting development is that of the family-owned guesthouse. This sector of the industry deserves whatever help it can get – especially since benefits will flow directly to those most in need. The finest beaches in the world await the intrepid traveller who wants to see the real Maldives.”