All staff, including people in charge of healthcare, conservation, agriculture, driving, education, finances and more, get together at 8AM Monday to Friday at ASRI for morning meeting.
Hoping to be as helpful as possible during my visit, I'd emailed my friend Dr Anne-Marie Pegg, who has a tremendous amount of experience heading up projects in essentially every country your parents wouldn't want you to travel to (as well as some that they'd be OK with) as a physician and now frequent Head-of-Mission with Doctors Without Borders/Medecins Sans Frontieres. I asked her, "What are the top 5 most common hospital badnesses/structural problems that you see that I should look out for?"
Her answer came quickly, and two of her points were "Rigid hierarchy which prevents people from speaking up about problems," and "Lack of staff motivation (often related to late pay, poor pay, no recognition)."
So when I showed up for morning meeting on our first day, I was meeting people with AMP's questions in mine. Basically--I was feeling out the hospital's vibe. In my 4 years as a locum doctor at multiple hospitals in Ontario, the NWT and Nunavut, I found that my initial impressions about whether a hospital was a happy, functioning place were rarely later contradicted.
Well--the bottom line is that it was clear from our first morning meeting that major efforts have been made to maintain a relatively horizontal power structure here--and that staff morale is good.
In terms of structural elements that demonstrate respect for different roles, all staff sit in a circle, mostly on the floor, physicians beside agricultural staff, drivers beside nurses. On any given day, most staff will be wearing shirts with the same attractive green and black batik print--I later saw these same shirts on the Forest Guardians, villagers who are the link between ASRI and the communities. A pen is spun in the middle of the circle to determine who leads the meeting, and then the ability to speak is passed with a hand motion from person to person.
They pass this opportunity around the circle three times at every meeting, and then finish off by asking if anyone has anything else to contribute. If not, they end with a cheer of, "Selamat bekerja dan tetap semangat!" which apparently translates roughly to"Work hard and be energized!"
Incredibly, this is not the half-hearted thing I feel like it might be back home--but brings about big smiles as people pump their fists in the air. Nice way to start the day.