So Why DOES Social Marketing Always Look Like S*#t?

August 16, 2009
Kabul

After six weeks of reviewing the basic package of health services, the emergency package of health services. the management structure of The Ministry of Public Health, The Pharmaceutical procurement process. the financing mechanisms, the service delivery gaps and the strategies for communicating with the Afghan people about healthy behavior I have come away with these thoughts.

1. There are too many dis-connected health projects in Afghanistan.
2. There are too many pissy, strident consultants rolling out bizarre ideas that are not sustainable and render no results.
3. The Ministry of Health is over-burdened with the management of all these projects and ex-pats.

How the Ministry of Public Health manages to deal with 34 country programs and three major donors is a miracle. My strong suggestion is that all health communications, be it product-driven social marketing or behavior change public health communications, should fall under one roof - with one advisor. Full stop.

As I listened to an annoying World Bank advisor describe their dumb-ass idea of disseminating micro-nutrient "Sprinkles" (crushed-up vitamins) and UNICEF cookies to combat malnutrition I wanted to pound my head on the table. Mercifully the Minster of Health spoke up and said, "Uh ... that's a clever idea, but Afghanistan cannot be eating UNICEF cookies for eternity, could we please think about somehthing more sustainable..?"

And today we are finalizing our report. We have intentionally kept our project design to 30 pages. The other team members are writing 200 page documents ... 200 hundred fucking pages??!! My team of Afghan doctors have spent the day laughing our heads off about how public health professionals are miserable communicators. But it's all been great fun. And this afternoon I submitted my team reports - with a one-page summary of all 430 pages. In exchange the Minister of Public Health presented me with a beautiful hand-made traditional Kuchi dress. I'll take photos tomorrow. Tonight I need to get some sleep.