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Ambulances for India: (7) India

November 17, 2011

Activity Report

With the new 90-vehicle operations in Punjab up and running, I returned to the Mumbai head office of Dial 1298 (Ziqitza Health Care Ltd.) in May 2011. My duties now revolved around three projects.

1. Coordinating Investment in New Ambulances

Dial 1298 has a plan to expand the Rajasthan ambulance fleet by 200 vehicles and the Punjab fleet by 150 vehicles over the course of the next several months. My work has centered on coordinating the various tasks—such as hiring and training new staff and procuring new vehicles—required in preparing for the expansion.

Specifically, I created a work schedule and a chart outlining who's responsible for what. Those in charge of specific assignments were asked to report their progress every day, and daily teleconferences with the CEO and various supervisors have been held.

2. Full Implementation of the New IT System

I’ve been working with our staff in Punjab to fine-tune the new call center and ambulance IT system as well as to provide user support. A decision has been made to implement the same system in Rajasthan, and I'm part of the team involved in making the preparations. (Owing to the success of the Punjab system, with which I was intimately involved, Ziqitza has decided to expand its use within the company.)

3. CEO Management Support

I’ve been responsible for coordinating the CEO's monthly review meetings with the company’s founders and division mangers.

Leadership Lessons

1. Maintaining Quality and Efficiency in a Growing Company

In May I again ran up against a wall owing to differences in communication styles. There was a need to relay the new operating procedures to our call center, accounting, and warehouse staff in Punjab. I was the one who created the procedures, but since I was already back in Mumbai I was unable to speak with the Punjab managers in person.

So the task of relaying the information to the staff fell on the shoulders of the managers, and I feared that the instructions might become garbled in such a “telephone game.” There was also the risk that people’s memories would fade with the passage of time. Once they started filling such lapses with guesswork, quite a different set of rules could take hold.

I naturally concluded that the best solution would be to compile a written document based on shared understandings with the managers. Imagine my surprise when the CEO told me just prior to the start of on-site training that there was no need for me to distribute the materials.

I halfheartedly followed her directions. Rather than circulating the manual I had prepared, I phoned each manager and went over the key points several times to make sure they understood. Later, the managers explained those same procedures to the staff, and that was the end of it. Indeed, the process of developing the new IT system had progressed much the same say, as my colleagues hardly relied on written documents in communicating with the IT vendors.

My apprehensions aside, the approach seemed to work. I can't say for sure, since I haven't personally seen how things are going in Punjab, but there have been no reports so far of operational breakdowns.

While I'm impressed that this method worked quite well, I also suspect that heavy reliance on personal rapport would have its limits in a quickly growing company like ours. That said, perhaps a labor-intensive approach is the best solution in a country like India, where labor is comparatively cheap. Maybe it best fits the culture of India. These are key considerations in exploring the best mix of policies to achieve growth and improve quality at the same time. The success of this approach turned many of my assumptions upside down; I was no longer sure of what was the "correct" approach.

2. Task Management

The workforce at Ziqitza has constantly kept growing. At the Mumbai head office there have been 20 new employees since I arrived in November last year. My six months at the company now gives me more seniority than half of the staff.

As in-house operations become increasingly compartmentalized, the quality of instructions comes to take on growing importance. I see great differences in individual output, perhaps owing to educational background or previous work experience. New workers often find themselves struggling or falling short of expectations if they don’t thoroughly understand the rules.

Unless an effort is made to explain everything step-by-step and to follow up on each point, there is no way of confirming how much workers have understood (or misunderstood) the instructions given. Because (for better or worse) employees are accustomed to receiving detailed directions, they are likely to take no action at all if the instructions are vague. Communicating what I want done is an area that I clearly must brush up.

3. Managing People

My position at Ziqitza is not very well defined on account of the fact that I'm a fellow here on a training assignment. I do give instructions, based on the responsibilities assigned to me for particular projects, but I do not have any subordinate staff.

Still, from my admittedly limited experiences, I can't avoid feeling that there is perhaps too much emphasis on just completing the task at hand and not enough on motivating and empowering employees with a view to strengthening the company from the bottom up. There are times when workers are treated almost like interchangeable parts. Dial 1298 is a company with a clear mission—to save lives—so I feel there is potential for achieving a more closely knit work force.

A common thread running through the three points I raised above is a question of which management values are universal and which are unique to the local community or culture (and must be respected). This is a point that I have been mulling over in my head. The easygoing attitude toward work in India appears incompatible with the sort of meticulous workflow and quality management that is required to meet established targets in a modern economy. I'm still groping for an answer to how hard I should push to achieve the latter.

    • Tokyo Foundation Acumen Fund Fellow, 2010-11
      Secretary-General, Gaia Initiative
    • Chikako Fujita
    • Chikako Fujita

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