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I'll introduce our first panelists professor Peter Donkor is provost
chancellor of the Kwane Nkarumah University of Science and Technology
in Kumasi, Ghana and professor of maxillofacial surgery
He's held many other positions including provost of the college of health
sciences, Vice Dean schools medical sciences, head department of surgery
President of the Ghana surgical research society, President of the Ghana cleft
foundation and inagural president of the Pan African Association for cleft
pallet.
He's also served on numerous committees including some here at the
University of Michigan and the West African
college of surgeons counsel
the american cleft pallet association Ghana medical and dental council and
I'm gonna spare you the list goes on for quite some time.
he
co-founded specialists have pride and head and neck oncology clinic said
Kofi Anala teaching hospital in Ghana.
his research and publications covered medical education, health manpower
global health, open educational resources head and neck cancer cleft
palate trauma care in emergency medicine.
I also want to tell you that he is
Donkor is one of my favorite people in the
world to work with. He's just one of my favorite people period in the world. As I've
come to know him over the past five years
and has been a tremendous inspiration to me.
concern that it was give the same introduction for all four of you though
as hard
Thank you tom
Minus distant and share with you
my thoughts on how to design
beneficial north-south partnerships.
This is Ghana
in bright
yellow or gold.
Ghana was previously called the gold coast
Where I am located
in that part of Ghana.
Kumasi.
Now here is the outline of my presentation Just give examples of partnerships
and how to avoid pitfalls.
The development of partnership that
for partnership to succeed
you almost invariably need a catalyst Someone who can iron out problems
as they arise
through the process and help difficult situations.
This an example of an unsuccessful partnership in our university.
The department of community health
decide to partner with the canadian university
to train PhDs.
it looks like those are as far as it went. They didnt really
go into the details about the process
in the end and they selected students foue training
and none of them ended up in KN University.
The department decided that they wouldn't
going into another partnership.
because the retention that was the base of the whole
partnership
as an issue was over-looked.
I have and number of other unsuccessful ones
this is one what i'll an unequal partnership.
The same community
partnered with the ministry of health
and the british university on their vitamin A supplement attention trial.
Again it was aimed at capacity building
The university committee felt poorly represented on the advisory
board.
They were not consulted on many important decisions that were taken.
In the end
and the
they walked out of the
relationship another's to disadvantage because
when the trials over the whole set up
what's left behind.
At which the they never benefited from But fortunately
it's became an important research center
and which was mom by the minister of health.
They've been very successful partnerships
The Malariagen project which is a Gates funded projects
and you can add malaria
genomic cumulative and it's a symbol or some other countries
and onset of the project they decided
to they agreed on
standards of data collection storage
sharing
of information ethics
intellectual property rights, authorship rights.
As everything that goes out is agreed.
As we speak
they've been doing pretty well and recently the reported that
they've been successfully successfully
identifying a vaccine
which helps to reduce malaria by fifty percent in children.
Another successful one was that
initiatied
our partner
Michigan
was an OBGYN specialitst training program in Ghana. We started nineteen
eighty nine.
Several organizations were involved
So technology catches up with Africa as well.
This was meant to train OBGYN specialist in Ghana
and
to transition the training into to the minister of health after ten years.
Through this program
almost all OBGYN specialist training in Ghana
and i consider it's ninety nine percent retention of those trained. Previously
they were sent outside
trained for several years five years or more
and only about ten percent came back.
Now its been reversed.
And this is a picture I show you now
for that he's not here
Tim Johnson
and young Tim Johnson OBGYN will be there
in 1989.
When they first sent there.
Now
Roger made reference to the MEP project which is currently
in its third year of implementation in Ghana.
Well I'll like to say very simply is a through this collaboration or
which again involves Michigan
Emergency medicine conformity, my university
would be able to for the first time ever trained locally in Ghana.
Six specialist
in emergency medicine who
passed the exam just last month.
The training is all done in Ghana
with the help of
visiting faculty from Michigan. We hope that
as we go into the future to form the basis for future
training.
We've had other successful partnerships with Michigan
which again has been based on
through discussion and engagement.
And the africanscholars program I met a couple of people
from ghana who are currently on that.
Collaborations sometimes go wrong.
and
There are several threaths to them. If
you think you have to look at
collaboration a partnership like a business.
There should be clear lines of management and should have
good managment structure
where
information flows.
It's not like you know your boss, your
boss and subordinate
that the lines for information are very clear.
Sometimes there should be an equal interest. Someone says well you know
I'm the boss, I brought the project so you gotta go along with what I say
It
doesn't work.
It should be openess
and there should also be discussion on how
and the benefits are to be
shared.
Communication difficulties are real.
They can be institutional until next
and
team members
also can be incompatible.
And that can only come up later
but one must make an effort to find out
compatibility issue. There are also local politics,
local politics takes many many shapes. I am
some people must be involved.
Otherwise you run into difficulties
but you calls it should not
pick people who wil also obstruct your
authorships.
Now I put this inheritance without sweat now
I put this
something I coined this phrase.
It is not
its a bit like
my father leaves me a lot of money and I
I spend it and without knowing how he sweated for it
In the end I'm going to run out of money
and it's it's like people spent enough time buildup these relationships
like
partnerships
between institutions
Others may come in to see these relationships texas
they have to be brought on board
and be made up out of it.
Otherwise they take it for granted and trample on toes
and threathen the relationship. So this is to
bring everybody on board
many conflicts will be avoided.
There was a project
which Ghana had with the University of Michigan called a CHARTER.
Which amuse us an example of how some of these can be avoided and
one of the duties of the charter was devoted to discussing
from the outset
how conflicts could be avoided
and these are the partners.
and
among the objectives which mainly included training research
data for policy-making and human resources
and research
what which was important to ensure that those
these guiding principle
for the CHARTER
guided us.
So we don't do the wrong thing.
It was made easy because
Michigan and Ghana had a history
uh... which is always useful but he doesn't have to have a history of us
begin to to talk honestly.
This is a group of people
who were at the first meeting
and at the end of the meeting we agreed that
would do certain things
which hopefully we did
and then we signed a charter
for collaboration.
You can see Tom
in the picture
and this is the team.
Now as one things back on the charter project uh...
we had some successes
those improve dialogue with stakeholders
and new collaborations also started
and students staff exchanges came as a result of this.
That it's important that
they gain the benefits that you derive especially from the individuals who
first
went into that
extended to
other people who will be part of
future partnerships.
I think
at the beginning of every
collaboration
and these bold tenants must
ensure that everyones interests
in the partnership is known and addressed.
You cannot assume it.
Question is
what is the interest
of the steadwell partner
in this collaboration what was interest
northern partner in the interest you must address that.
You must look to sustain it beyond
the end of the project.
So I think as I said before to find the interests of all parties
there should be trust
mutual respect, communication, accountability transparency these are words that the
everyone is familiar with
wWe have to ensure that
this is sustainable
and can be modified as we go.
This is my
This is the entrance to my University
Thank you very much.
Before I intorduce the next panelist
Professor Donkor will be speaking tomorrow from noon to two p m
in sixteen eighty community crossroads room here
on perspectives on the whole sector in Ghana so
you're all invited to join us.
Okay
our next speaker is Gary Harper
Professor Harper and received his MPH from the University of California
Berkeley in nineteen ninety-four his PhD from Purdue University in nineteen
ninety three
also masters from Purdue as well
He went to Washington University in Saint Louis for his
undergraduate.
His major areas of interest include *** *** risk among homeless
adolescents
community-based *** prevention for gay bisexual youth and latina female
adolescence,
effects of negative affect and substance use on adolescent *** risk
collaborative research with community-based organizations
community-based *** prevention for adolescents in both the united states
and in kenya
lesbian gay bisexual transgender adolescence adolescent masculinity and
*** risk
psychological functioning of adolescence living with *** and community
university partnerships.
He has published extensively on topics
as a result of his innovative and collaborative partnerships.
Professor Harper
Good Morning Everyone
Is everyone awake?
Alright come one now, I know a lot of you are students and you got the day off of classes
but you don't get to snooze
so I'm filling time as she pulls up the slides so
Those of you who don't know too I'm also a new faculty member here I've only been here a month
So I'm very excited to be here
I spent seventeen years at DePaul University in Chicago
and I'm really excited to to bring
my knowledge my projects and enthusiasm to to Michigan. So what I want
to do is to in my short little time to talk to a little bit about both
work that I've done domestically and globally because I think that is other
previous speakers talked about
a lot of what we learn globally informs what we do locally and what we do locally
informs what we do globally. And I think when we talk about
creating sustainable partnerships a lot of the elements that we use in
both types of partnerships weatherby domestic or
globally we use the same kinds of things. So
will be talking about some of my work and in Chicago where I worked for many
years developing and maintaining partnerships with communities
organizations.
And a lot of well talk about is actually based on
an article that I wrote in collaboration with communities organization
members
and students on what are some of the the elements needed
in sustainable partnerships.
But that also have been working in kenya since about two thousand four. And
there I'd been partnerships as diverse as working with
the catholic church and education commission within the catholic
church
to all the way to working with small LGBT organizations in Western Kenya.
They're fighting for human rights and for health for young gay men.
So a lot of diversity of different types of partnerships. So in the field of
*** for those of you who
who don't know
a lot of the work that we do in *** prevention
really needs to be rooted in the realities of communities
'cause people receive services in the community they don't receive services
and in the lab or in an academic institution. So we really need to make
sure that the work that we do in these institutions are able to
be transferred and that's why
when doctor about his family implementation science that's so
important
that we really know how do we put these things into practice in the real world.
A lot of times there is a break between
institutions of higher learning work in the way the community
agencies and organizations that deliver the interventions work.
There are different reward structures different ways
that people come to those spaces. and so it's important that we we bridge
some of those gaps. And we need to make sure that those partnerships that
we create
are really working on developing interventions that are relevant to the
community
but that also feasible to be delivered.
We can spend two million dollars developing a randomized controlled
trial of an *** prevention intervention, but if you can't deliver it
in a small community based organization with a small budget
then we really are using our money in the best way.
When we form this clever partnerships researchers can share existing
evidence-based knowledge in science agencies can use the data that's
collected from these
for policy and advocacy efforts and grant applications to
informing guide to future work.
Also they can serve
as a catalyst for discussions.
Especially in working with youth between youth and adult organizers in
the community to see
what should be the next steps.
The three i'm going to go over three kind of primary areas are
building partnerships
and this is based on an article you see up on the screen
diverse pays a collaboration working together to improve community based ***
interventions for adolescents.
This article probably me the longest to write of any article that I've ever written because
it was actually
it was literally co-written by three members from the community
organizations, two students and myself
that was truly co-authorship. There wasn't
I wrote it and give it to them we sat down for hours and hours days for days
and mulled over
every paragraph every section. We had to do two sets of revisions
we were ready to shoot the attitude of times but on the really did result in
what i think is a is a good paper a little bit bias I guess.
So one of the things that we talk about is really important building
relationships
we really have to invest time and
and sharing information about work related constraints the demands and dynamics.
If you're working with an organization either globally or locally
that has some real physical limitations you need to know that.
Also defining and teaching members roles and responsibilities thing
sometimes we make assumptions about
ah well youre the academic you're going to do this to the community member you're going
to do that.
and those it'd be very clearly defined from the outside of the project.
Also we're learning about their community agency culture by participate
in activities events.
Part while of doing events in development work and you made this work
is
i get to learn about people when i learned about cultures. So when i'm in
Kenya
I don't just go to my meeting sit in my office and go back to a hotel room
I go out and I have dinners I go to dance clubs I
I go to schools
I was in kenya in august and i was hanging out at a
and a kind of
hidden gay dance club on friday night. had the best time
you know the of the whole trip because it was just hanging out with the guys and
talking to them and dancing.
They were surprised that I could accidents so
they breaks down misconceptions you know you look at you know a white dude and
think you can't dance but you know you'll have skills you don't always know
about.
uh...
So to me that's what makes this work really
exciting
also sharing your belief systems in value systems. We don't all have the
same value systems and when it comes to issues like *** we're talking about
sex we're talking about drugs we're talking about condoms.
These are things that are loaded it with social political cultural
on religious values and so we have to be very careful that we have those open
discussions.
Are you an agency the blues and harm reduction or abstinence?Are you an agency
that supports anti retrovirals
at different levels for for pregnant mothers when should we give them when
should we not so there's a lot of issues.
And then also
there certainly rituals that occur within agencies.
So certain ways that we do things like for instance is an agency that i used to
work with in Chicago, project Vida,
in the little village
community in Chicago which is primarily Mexican, Mexican-American.
meant everything stops at the agency to go out get your food well we will apply
for a grant from the cdc
and the cc came into the site visit
and there there and it was this big thing we're really excited the first
time the agency ever applied for a CDC grant.
Well ten-thirty comes hearings a little bell and everyone bolts out of the
agency.
And the CDC folks in there look at me like "whats wrong?" which I'm like well
let's go eat.
so we got out the kind of you know i don't think wanted to really go
at first but
down we went out we got some food came back and carried on the meeting. And that's
that's part of the ritual. We have to make sure that that we conform
and learn and adapt and grow with agencies and learn about kind of
what what their culture is not just culture ethnic racial culture but
culture of the agency in of the organization.
We need to build on existing strengths.
I think a lot academics come in and think that they know everything
and we don't.
We know something and some of us are members of the group's you know from.
Some of us
work in certain populations were were brother community to
I'm part of some the communities that I work with as an academic but as a
human and I think that
we need to realize that we're working with different agencies and
organizations
they have a lot of stress so we need to create strategies for decreasing
power differentials because again the lot centers that initial hierarchy.
Doing things like just conducting meetings of the agency.
In our work in Kenya we trade-off facilitation of meetings.
the US partner leads it one day
a Kenyan patner the other day. And we go back and forth quite a bit with that.
Work with staff to decrease or share staff members to be responsibilities if
you're working with small
non-profits or small NGOs globally or locally
sometimes they may be juggling twenty jobs and so
really making sure that that they're able to put the time and energy into it.
We do a lot of educational sessions to explain the purpose of the research
evaluation activities to make sure that people are really clear.
and I have 2 minutes so I'm gonna go really fast
Assess the necessary skills and resources required
for the completion. So basically whatever skills and resource aren't
there
we do a lot of training to make sure that people are walking away from this
partnership with new skills and new abilities.
The last general areas building a sense of commitment to the project.
And if you don't have a sense a commitment then
again you might as well go home. Because
both members of the partnership everyone involved has to really feel
like they have apart and they have a real say in it.
And it should just be tokenism that's another thing they had to be really
careful about
and I get really frustrated unseen other projects where there's tokenism from
people in the community. I get the here's the token gay man and
here's the token african-american here's the token
you know fill in the blank we need to really make sure that there's true voice
in these partnerships.
So we have to make sure that information is communicated
with the team and the agency
in whatever ways most efficient. When i'm in kenya
it's always SMS, text messaging.
You know we don't call and leave a voicemail there is no such thing as a
voicemail.
So you have to learn that, that's the mode of communication.
My work some with students I have back in Depaul of that we're working
with community agencies and well I sent them an email
and its like well maybe they don't have an email mail on have a blackberry. Maybe
they don't like email and don't want to be tied to that. So we should be
careful about that also creating short and long-term goals. I think is academics
were used to
delaying gratification you know how long does it take to get your PhD your
MD all these other things.
agencies may not have that luxury. Or may not have that mindset so we have
to cripple short long term.
Get input from all members throughout the collaboration. Again do
training I think I use a lot of visual timelines and accomplishments and
then
a big thing that that idea again made missus cuz I'm a fun guy
I like to celebrate success. If something we do something well when
we when we accomplish something celebrate it.
You can also be a lot of weight is way too.
because
back in Chicago we had a really good cupcake placed on the street from my office and
so every celebration mad cupcakes and sometimes my partner would tease me and say
it's thursday are we gonna celebrate that?
But you'll have fun and again in another great way to learn about the culture.
These are just some quotes from the article and i read this one wrote quote
from our that executive director "This relationship began to continue to be one
of mutual respect participation at all levels of a valuation planning a
partnership where we all benefit.
The evaluators presence and extensive knowledge
helped us learn a lot about process evaluation of their patients with ur
question sees the feeling that we were intellectually inferior to them they
were consul inspired us to achieve higher goals.
Taught us become better evaluators ourselves we felt that there was no
hierarchy in that we're all equal partners in an exciting project. Our
experiences meaningful they were truly joy to work with and we're sure that the
relation will continue to grow
well after that which is over."
I still work with this agency now fifteen years later
I mean I'm in michigan and I actually just got a text message from one of the
guys yesterday.
Kind of check in with me and see how I'm doing.
Just some publications to i think it's also important that we put
what we're doing our partnerships out there and venues on the other then peer
review publications. Those are great those are the currency
in academic institutions, these are just some
some work from our partnership in Kenya. We're funded from PEP-far
through the American International Health Alliance which is twenty
partnerships. And they fund
north north and south south planning partnerships
and these are two recent publications that we've been working on the put those
out there so people can learn from our partnerships.
Last things is from an article that one of my on grad students has
in press that was just accepted we would also studying partnerships from the
from the side of the community partners and and talking to
them about what they want
in partnerships. And some of things is taken and leave it to think about is how
do you define partnership in project success?
we may not defined in the same way. The partner may not see it in the same
way as you. We need to build mutual trust and respect,
we need to explore power dynamics. We need to share power if desired. Some of
our community artists are there some things i don't want to have any control
over i want you to do that.
Assessing strenghts
and then creating equitable resource access and allocation to make sure
that
all the money doesn't just come to the academics with equally shared
between on both sides of partnership
thank you very much