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Chapter 3
Chapter 3 Paradigm Pioneers
I have a dream... -Martin Luther King
All leadership takes place through the communication of ideas to the minds of others. –Charles Cooley
A forest-cemetery,that’s new.(actually not a novel idea but new for Philippines?) Mayor X of San Carlos City shared how pieces of the concept came together in his mind. First, he read about the 5-day war in Israel that resulted in some 5,000 casualties. In remembrance of those who died, a forest was planted. Second, he noted how Filipinos no longer cherished the forests and trees. Trees were cut and forests leveled because trees were merely objects to be converted into saleable lumber. That’s why there were denuded hills in San Carlos City. The third recognition was that Filipinos revered their departed family members, traveling from across the islands to visit their tombs on All Saint’s Day. Fourth, the city’s cemetery was getting congested. In the long run, the city could not be expanding acres for the dead as that that would deprive the living of the precious land. Thus, the concept of the first forest-cemetery in the Philippines was crystallized in his mind. A memorial forest would be planted and the remains of the dead would be transferred, after 5 years in the cemetery, to the foot of a specific tree. The family could then visit the tree to remember their loved ones. The forest has become sacred ground, as such no logger would dare cut down those trees. The city cemetery no longer needed to be expanded. Instead, the forest would become dense as the number of memorial trees increased when the departed citizens were moved to their final resting place of shady greens.
Leaders Make Things Happen Everybody has bright ideas about what government should be doing. Radio commentators, newspaper columnists, TV journalists, NGOs and even the beer-drinking bunch next door all have their bright ideas about how the town, city, or nation should be run. Unfortunately, not all of them have the opportunity to turn their ideas into reality. Unless they take things upon themselves and become entrepreneurs or decide to run for office, they remain fence-sitters, watching as others make things happen.
The Leader as Innovator or Early Adoptor Change happens first in the minds of the inventors and innovators. In the LGU, this may be the mayor or governor herself. Marikina City’s Mayor Bayani Fernando, asked what drives him to innovate, cites the “inventor’s high” as a major motivator. He gets a real kick by conceptualizing programs, implementing them, and seeing them succeed. (insert a summary of Marikina’s award winning program under Bayani Fernando.) Sometimes, the idea comes from somebody close to the mayor. The mayor’s role, in this case is to recognize the good idea s and move them forward into implementation. In many cases studied here, the innovations were conceived by the Municipal Health Officers and championed by the Mayors. There are describes five types of individuals within organizations according to the way they accept new ideas.1 These are:
From Insight to Action Once the mayor decides that an idea is worth trying, she now works it through the bureaucratic structures so that it can be implemented. The following seven steps can be thought of as processes for injecting new ideas into the bureaucracy. Similar processes occur as the idea is presented to the citizenry.2
Heading
Steps 1 to 6 are the common steps of in program implementation. This sequence works well in government programs where government provides the services and the citizens are passive spectators or clients. Such is the case in government-run a free clinic, day care center, or waiting shed construction. It’s different for programs where the citizens play an active role in implementation. In such cases, the citizens are not passive clients or beneficiaries of a program, they are themselves the actors. Marikina’s Pulitika Sa Bangketa (Case No.3), would have failed if the citizens refused to follow the rules. Of course, non-compliant citizens would have been fined or arrested, but widespread compliance made the program succeed. Widespread rejection of the ordinances would have resulted in the continuous chaos in the streets, as in many other areas in Metro Manila. In it’s traffic and parking management component Marikina’s Towards Hassle-Free Roadways mobilized the citizens not only to comply but also recruited them to enforce the ordinances through it’s self-policing mechanisms. LGUs as Supporting Actor In the entertainment industry, Sharon Cuneta, the Megastar and Vilma Santos, the Star for All Seasons have played a plethora of leading roles in their films. Through their powerful dramatic acting and sheer audience-drawing power that their movies became box office hits. Exemplary LGU programs, on the other hand, often do not intend for the LGU to be the Megastar. In programs where LGU resources are limited, when the problems addressed are complex and multi-dimensional, government has to recruit the citizenry for some audience participation. In such cases, the government is no longer the lead actor, or bida, but instead relegates itself to acting out supporting roles, allowing the private sector or citizenry to take the lead. Such an approach requires the government to take on a lot of new roles. Likening these roles to those in the entertainment industry, we can better understand what excellent LGUs do.
adapted from Limlingan
In this scheme of things, an idea starts with a keen eye for the needs of the different sub-groups in society. It starts with a social analyst and critic studying, seeing and being disturbed by the realities around them. Like the social analyst and cartoonist Jess Abrera who comes up caricatures of Filipino life and culture in Pinoy Nga! published weekly in the Sunday Inquirer, the public health leader has to have a keen eye for details, and discern emerging realities and problems, and describe them to the rest of society so that they can be acted upon. Next, the public health leaders has to be a scriptwriter like Pete Lacaba. He understands and lays down the setting, conceptualizes a plot, and imagines the cast of characters and the roles they play in order for the story to unfold. The public health manager then has to be like German Moreno, the talent scout and manager. The talent scouts looks around for potential actors and recruits them for the movie. As a talent manager, he prepares a series of contracts so that the newfound talent hones his skills and grows into a powerful actor over time. A producer like “Mother” Lily Monteverde to assemble the production team to make the movie. She brings in investors, the technical staff (cameramen, lights men, and editors), director, and actors together. She orchestrates the ensemble of resources, manpower, and ideas together to turn the script into a movie With all the requirements in place, the public health leader then sets the stage, brings out the script and calls the people to action like director Marilou Diaz-Abaya. As director she ensures that the actors interpret their roles correctly and that the relationships between the characters develop as planned. The LGU or public health leader often also has to be an actor in the movie. Like Panchito (who was for decades Dolphy’s supporting actor), the supporting actor may play a significant role in bringing out the character of the lead actor and pushing the plot forward. If the actor plays a bit role, then he’s there to spice up the movie and provide a little support here and there. Finally, after the change happens or after the program is accomplished; the public health leader, like film critic Nestor Torre, evaluates the program for its strengths and weaknesses, its successes and failures. Public health leaders, therefore, have to be all these people rolled into one. There are some models in the entertainment industry who take on multiple roles. Jaime Fabregas not only tickles our bones with his comic and sometimes dramatic stints but also impresses us with his musical score. Cesar Montano has his hand on the script and musical score of his films, and even makes his tandem director, Marilou Diaz-Abaya, listen to how he thinks the act is to be staged. Action star Ronnie Rickets has produced (he owns a film production company) directed and wrote many of his films as well.
The Dancers Become the Dance The curious thing about treating the citizens as actors in the story is that sometimes, they take over the entire production. In the Bustos Jogger’s Club monthly dance get-togethers, it was the community’s event and Mayor Arnel Mendoza merely dropped by to say a few words and touch base with the participants. The various barangay “jogger’s clubs” financed the purchase of their own uniforms, and paid for their own merienda. At some point, the municipal bureaucracy had little or nothing to do with the perpetuation of the jogger’s club program. After some time in Marikina City, the citizens imbibed the behavior of discipline in the sidewalks. At some point, Disiplina sa Banketa was no longer a program to be implemented, but a sub-culture of the citizens of Marikina. Cultural evolution occurred. The dancers became the dance.
Transformative Leadership The roles of the public health leader, therefore, are multiple, and they shift over time as the health program unfolds. Table 4 below how the relationship between LGUs and it’s citizenry evolved in the course of the programs described in the cases. Table 4: The Empowerment Loop
An LGU starts out in Quadrant 1 where the problem is not actively being addressed. Once a problem is recognized and a solution is to be tried out, the LGU moves to Quadrant 2. During the start-up of the program, the LGU is the main driver and the program moves along from Stages 1 to 5 (from innovation to awkward application) occurs in this quadrant. Leadership and decision-making is concentrated in the public health leader and the program goes more or less as designed. If the LGU and the public health leaders are willing to share power with the citizenry, the program moves to Quadrant 3 where the partners take a more active role in program in implementation. This quadrant roughly corresponds to Stages 2 to 6 (information to integration) as the partner organizations or the citizenry begin taking on the processes of the program. Some authority and responsibility, and therefore political power, is delegated to the partners. The partners become strengthened by the growing operational and political control over the program. The partners become increasingly autonomous, along with an increasing sense of ownership over the program. Takeover occurs in Quadrant 4, when the partners assume accountability for the program (stages 6-7, integration to cultural evolution). At this point, the LGU leaves the driver’s seat and allows the partners to drive the program. In a sense, the program takes on a life of its own and it become increasingly difficult to attribute the further outcomes of the program solely to the LGU. The program becomes woven into the partner organization’s operations or into the citizen’s culture. After 20 years of implementation, the Surigao Federated Women’s Club (Case 5), is clearly in Quadrant 4. By the time the case was written, the organization was already involved in a gamut of health programs, from family planning, to youth programs, to a health information program through local radio.
The Leadership Axis discusses various strategies for change management based on the management sciences. The Leadership Axis arranges managerial phenomena from micro-management on the left to strategic management on the right. It also orients the different change management strategies from evolutionary change on the left to programmed change on the right (see Case 4).
The Leadership Axis To help get a better handle on the concepts presented in this chapter, they are chunked up in the leadership axis (See Fig.1). In terms of management style, intuitive management is placed on the left and strategic/goal-oriented management is placed on the right. Leaders with formal management training or corporate experience are likely to be seen to the right. In terms of change management style, the goal-oriented. Leader-driven. programmed change is located to the right. Towards the left is the more process-oriented, participatory, and less controllable evolutionary and participatory change.
Figure 1: The Leadership Axis
intuitive mgt. - operations mgt. - organization mgt. - strategic mgt. disorder - evolutionary change - emergent change - programmed change people-driven/bottom up- participatory mgt. -leader-driven/top-down
Because of Marikina Mayor Bayani’s corporate background, his management style is highly goal-driven and based on strategic plans. The leadership style which is described as leader-driven, with programmed change based on strategic plan is plotted in the right side of the axis. His projects can be located mostly in Quadrants 2 and 3. (Marikina City is a Hall of Famer in the annual Galing Pook awards. Among the programs that bagged awards for Marikina City were Squatter-free Marikina; Barangay Talyer, Disiplina sa Bangketa and the Save the Marikina River.) Bustos, Bulacan Mayor Mendoza and his doctor-wife, are physicians by training but their highly innovative, process-oriented, people-oriented leadership style more than made up for that slack. At the start of Mayor Mendoza’s term in 1988, he had no strategic plans. His programs were driven primarily by good intentions. The husband-wife team’s leadership style could be located in the left side of the Axis because their efforts resulted in a highly participatory evolutionary change. We must note that the results here are no less effective than the right side type.
Conrado de Quiros describes this all succinctly. He wrote:
We need an ordinary mortal who rises to the extraordinariness by the heroic nature of her vision, by the epic nature of her quest, by the monumental scale of her dedication to it. We need someone who is humble enough to hear the voice of the people and is proud enough to bend the world to their will. We need someone who can push people to transcend themselves, and, doing thus, pull them to reach for things beyond their grasp. We need, in sum, a leader.
Case 4 Marikina City’s Politika sa Bangketa
Anarchy in the sidewalk of Marikina flourished through years of neglect and indifference. There was a call for change with the coming in of a new local chief executive. The battle cry was the need for discipline. " A man may be king in his domain, but once he sets foot on the sidewalk he has to bear in mind that he is bound by the rules of society and has to live by them." Appropriate ordinances, which prohibited the use of sidewalks for other purposes, were passed. Initially, the city disseminated to all households a pamphlet on "Disiplina sa Bangketa" (Discipline in the Sidewalk) outlining the rules and regulations to guide people's behavior in the sidewalk. The city paved around twelve kilometers of its sidewalk with red colored demarcation line to impress upon the public the value of conforming to the rules and mores of society to achieve physical and social order. Its operation was guided by the dictum of checking the smallest infringement in the law with the objective of eventful ease in reducing petty and bigger crimes on account of the citizen's obedience to simple rules and regulations.
The city government succeeded in liberating 90 percent of its sidewalk from any form of encroachment or obstructions. Trees were planted along the sidewalk and in other parts of the city in support of its program called " Puno Kahit Saan ( Trees Everywhere) to convert the whole city into a nursery of trees. Everyone was encouraged to plant trees everywhere with guarantee from the city government to remove and transfer the trees anytime for free. The city acquired a tree mover for balling out and transferring trees. In 1997, around 85,000 trees had been planted. The tree planting is consistently being pursued to attain its goal of having 1,000 to 1,500 trees planted per capita. Added to these accomplishments was the implementation of another program " Towards a Hassle Free Roadways" which strictly enforced the traffic and parking ordinances through self-policing policy. To support the program, a five-hectare parking area was built; street and traffic signs were upgraded; new access roads were opened to decongest main thoroughfares, among others. As a result, Marikina has some of the safest and most convenient sidewalks and roads in Metro Manila today.
Case 4 Federated Women’s Club in Surigao
Surigao City is known to award-giving national and international bodies through its primary health care program initiated and implemented through women's clubs. In 1976 Mrs. Zenaida Arana, a midwife of the City Health Office assigned to two barangays, began organizing mothers at the purok level and training them in nutrition, responsible parenthood, and sanitation so they could assist in the delivery of PHC services.
Barangay Health Workers (BHWs) assisted Mrs. Arana in her pioneering tasks. By the 1980's mothers clubs had become very visible in the city. Because of their success, local politicians took advantage of them and converted them into their private organization. This confused the members, and the organization died within one year. It took Mrs. Arana two years of hard work in 1985 and 1986 to form another set of ten mother's clubs.
LOCAL GOVERNMENT SUPPORT
In 1988 the new City Health Officer gave recognition to Mrs. Arana's efforts and assigned her as overall coordinator of the primary health care programme for all 54 barangays of the city. Because of that support Mrs. Arana was able to organize a functional PHC Women's Club in all the barangays. In 1991 the groups formed a federation. In 1992 it became the Surigao City Primary Health Care Federated Women's Club, Inc., and since then has been instrumental in propagating the PHC strategy.
FAMILY PARTICIPATION The women involved their husbands in primary health care activities. The men got into the program by organizing the BESIG (Barangay Environmental Sanitation and Implementing Group). The PHC Youth composed of 12-21 year-old family members and the Mini-Youth (from 7-12 years old) were subsequently organized by Mrs. Arana. By 1990 BESIG had become an indispensable partner of the PHC women's clubs. TRAINING AND AWARENESS
The PHC activities involve immunization, family planning, nutrition, implementation of the national tuberculosis programme, and control of the diarrheal projects. Believing in the capacity of mothers to implement PHC, the programme put emphasis on training women in leadership, community development, and management. PHC also runs a weekly radio programme to promote health awareness and serve as a communications facility among the members. ORGANIZATION
The federation is organized like a pyramid, with the 7,200 members of 180 chapters at the base. The chapters are grouped into seven districts composed of five to 12 contiguous barangays. Each level of organization has its own set of officers, including its representative to the next higher level. The PHC structure involves the City Mayor and Vice-Mayor as PHC Committee chair and co-chair, respectively. Mrs. Arana remains as PHC Coordinator and adviser.
FINANCING The PHC gets financial support from the development fund (20% of the City's IRA). The City budget also funds its health projects. However, the organization is essentially self-supporting. The annual membership fee is P10.00 (ten pesos). Each member also contributes P60.00 a year for funeral assistance to members. The organization also raises funds from special projects and accepts donations from external sources; cash awards from HAMIS (Health and Management Information System) in 1991 and 1994 went into the financing of PHC activities.
MEASURING SUCCESS
Infant mortality in Surigao City was a high 76.6% in 1981 and 69% in 1984. After PHC became active it was drastically reduced to 29.5%. By 1996 it was only 19.1%. Maternal mortality rate also went down from 1.9% in 1975 to .5% in 1996. In the years PHC was inactive, both infant and maternal mortality rates were high.
Nutrition rates for pre-school children have also improved. In 1980 there were only 38.1% of children who had normal weights. Although the figures fluctuated, the rates were lowest when PHC was inactive. In the last few years of PHC's re-emergence the rate of children with normal weights had been high--- 54.7% in 1992, 59.19% in 1993, 61.02% in 1995, and 62.54% in 1996. The establishment of BESIG in 1990 has increased household access to sanitary toilets (Table 8). Conversely, households without access to sanitary toilets decreased at a rate of 31% in 1990-96.
These figures show the impact of the PHC Women's Club in the lives of Surigao City residents.
I have a dream... -Martin Luther King
All leadership takes place through the communication of ideas to the minds of others. –Charles Cooley
A forest-cemetery,that’s new.(actually not a novel idea but new for Philippines?) Mayor X of San Carlos City shared how pieces of the concept came together in his mind. First, he read about the 5-day war in Israel that resulted in some 5,000 casualties. In remembrance of those who died, a forest was planted. Second, he noted how Filipinos no longer cherished the forests and trees. Trees were cut and forests leveled because trees were merely objects to be converted into saleable lumber. That’s why there were denuded hills in San Carlos City. The third recognition was that Filipinos revered their departed family members, traveling from across the islands to visit their tombs on All Saint’s Day. Fourth, the city’s cemetery was getting congested. In the long run, the city could not be expanding acres for the dead as that that would deprive the living of the precious land. Thus, the concept of the first forest-cemetery in the Philippines was crystallized in his mind. A memorial forest would be planted and the remains of the dead would be transferred, after 5 years in the cemetery, to the foot of a specific tree. The family could then visit the tree to remember their loved ones. The forest has become sacred ground, as such no logger would dare cut down those trees. The city cemetery no longer needed to be expanded. Instead, the forest would become dense as the number of memorial trees increased when the departed citizens were moved to their final resting place of shady greens.
Leaders Make Things Happen Everybody has bright ideas about what government should be doing. Radio commentators, newspaper columnists, TV journalists, NGOs and even the beer-drinking bunch next door all have their bright ideas about how the town, city, or nation should be run. Unfortunately, not all of them have the opportunity to turn their ideas into reality. Unless they take things upon themselves and become entrepreneurs or decide to run for office, they remain fence-sitters, watching as others make things happen.
The Leader as Innovator or Early Adoptor Change happens first in the minds of the inventors and innovators. In the LGU, this may be the mayor or governor herself. Marikina City’s Mayor Bayani Fernando, asked what drives him to innovate, cites the “inventor’s high” as a major motivator. He gets a real kick by conceptualizing programs, implementing them, and seeing them succeed. (insert a summary of Marikina’s award winning program under Bayani Fernando.) Sometimes, the idea comes from somebody close to the mayor. The mayor’s role, in this case is to recognize the good idea s and move them forward into implementation. In many cases studied here, the innovations were conceived by the Municipal Health Officers and championed by the Mayors. There are describes five types of individuals within organizations according to the way they accept new ideas.1 These are:
- Innovators – these are the dreamers who hatch new ideas.
- Early adopters – these individuals recognize a good idea when they see one. Their ideas are respected within the organization. Though the ideas are not theirs, they try to convince others to accept it.
- Middle adopters – accounting for the majority of the organization, they respond to the opinions of others. They are reasonable in their analysis of an idea but are inclined to maintain status quo.
- Late adopters – these individuals are the last group to accept an idea and will often speak out against the proposed changes. They will usually adopt an idea only if the majority demonstrates support.
- Laggards – these individuals are committed to the status quo and the past. They are always against change.
From Insight to Action Once the mayor decides that an idea is worth trying, she now works it through the bureaucratic structures so that it can be implemented. The following seven steps can be thought of as processes for injecting new ideas into the bureaucracy. Similar processes occur as the idea is presented to the citizenry.2
| Step 1 | Innovation. The innovator dreams up a new approach to current problems. He presents it to the Mayor. |
| Step 2 | Information. The Mayor rounds up a technical working group to put together a program concept paper. The concept paper is then circulated. Initially, the new concept is not embraced. The new idea meets apathy, tradition, and prejudice. People resist change and point out the problems of the new concept. They try to prove how the status quo is better. |
| Step 3 | Individual Change. The early adopters (often members of the initial technical working group) begin to see the strengths of the proposed concept and embrace the idea. Personal convictions replace complacency. |
| Step 4 | Organizational Change. The early adopters are able to persuade more individuals (inside the bureaucracy and partners from the private sector or civil society) to support the program. Less defensiveness and more openness can be observed. Operational issues of the program are hammered out. |
| Step 5 | Awkward Application. The program is implemented and early successes and failures are experienced. The learning process is rapid. Some assumptions are validated. |
| Step 6 | Integration. Awkwardness begins to decrease. Efficiency and effectiveness increases. As new successes occur, more support from the middle adopters and late adopters is generated. |
| Step 7 | Cultural Evolution. After repeated cycles of program implementation, the new scheme becomes the norm, the status quo, part of the culture – until the next wave of innovation. |
Heading
Steps 1 to 6 are the common steps of in program implementation. This sequence works well in government programs where government provides the services and the citizens are passive spectators or clients. Such is the case in government-run a free clinic, day care center, or waiting shed construction. It’s different for programs where the citizens play an active role in implementation. In such cases, the citizens are not passive clients or beneficiaries of a program, they are themselves the actors. Marikina’s Pulitika Sa Bangketa (Case No.3), would have failed if the citizens refused to follow the rules. Of course, non-compliant citizens would have been fined or arrested, but widespread compliance made the program succeed. Widespread rejection of the ordinances would have resulted in the continuous chaos in the streets, as in many other areas in Metro Manila. In it’s traffic and parking management component Marikina’s Towards Hassle-Free Roadways mobilized the citizens not only to comply but also recruited them to enforce the ordinances through it’s self-policing mechanisms. LGUs as Supporting Actor In the entertainment industry, Sharon Cuneta, the Megastar and Vilma Santos, the Star for All Seasons have played a plethora of leading roles in their films. Through their powerful dramatic acting and sheer audience-drawing power that their movies became box office hits. Exemplary LGU programs, on the other hand, often do not intend for the LGU to be the Megastar. In programs where LGU resources are limited, when the problems addressed are complex and multi-dimensional, government has to recruit the citizenry for some audience participation. In such cases, the government is no longer the lead actor, or bida, but instead relegates itself to acting out supporting roles, allowing the private sector or citizenry to take the lead. Such an approach requires the government to take on a lot of new roles. Likening these roles to those in the entertainment industry, we can better understand what excellent LGUs do.
| Example | Role | Tasks |
| social analyst/ critic | segmentize, understand publics, identify needs, wants, and motivations |
| Scriptwriter | conceptualize plot, write script, strategize |
| talent scout and manager | identify and nurture talents, identify lead and supporting actors |
| Producer | negotiate, contract actors, support crew, find investors |
| Director | Director, orchestrator, coach |
| Supporting Actor/ Extra | Helps lead actor act out his role as extra, spices up the movie with antics and bit roles |
| Film Critic | evaluate, review, rate |
In this scheme of things, an idea starts with a keen eye for the needs of the different sub-groups in society. It starts with a social analyst and critic studying, seeing and being disturbed by the realities around them. Like the social analyst and cartoonist Jess Abrera who comes up caricatures of Filipino life and culture in Pinoy Nga! published weekly in the Sunday Inquirer, the public health leader has to have a keen eye for details, and discern emerging realities and problems, and describe them to the rest of society so that they can be acted upon. Next, the public health leaders has to be a scriptwriter like Pete Lacaba. He understands and lays down the setting, conceptualizes a plot, and imagines the cast of characters and the roles they play in order for the story to unfold. The public health manager then has to be like German Moreno, the talent scout and manager. The talent scouts looks around for potential actors and recruits them for the movie. As a talent manager, he prepares a series of contracts so that the newfound talent hones his skills and grows into a powerful actor over time. A producer like “Mother” Lily Monteverde to assemble the production team to make the movie. She brings in investors, the technical staff (cameramen, lights men, and editors), director, and actors together. She orchestrates the ensemble of resources, manpower, and ideas together to turn the script into a movie With all the requirements in place, the public health leader then sets the stage, brings out the script and calls the people to action like director Marilou Diaz-Abaya. As director she ensures that the actors interpret their roles correctly and that the relationships between the characters develop as planned. The LGU or public health leader often also has to be an actor in the movie. Like Panchito (who was for decades Dolphy’s supporting actor), the supporting actor may play a significant role in bringing out the character of the lead actor and pushing the plot forward. If the actor plays a bit role, then he’s there to spice up the movie and provide a little support here and there. Finally, after the change happens or after the program is accomplished; the public health leader, like film critic Nestor Torre, evaluates the program for its strengths and weaknesses, its successes and failures. Public health leaders, therefore, have to be all these people rolled into one. There are some models in the entertainment industry who take on multiple roles. Jaime Fabregas not only tickles our bones with his comic and sometimes dramatic stints but also impresses us with his musical score. Cesar Montano has his hand on the script and musical score of his films, and even makes his tandem director, Marilou Diaz-Abaya, listen to how he thinks the act is to be staged. Action star Ronnie Rickets has produced (he owns a film production company) directed and wrote many of his films as well.
The Dancers Become the Dance The curious thing about treating the citizens as actors in the story is that sometimes, they take over the entire production. In the Bustos Jogger’s Club monthly dance get-togethers, it was the community’s event and Mayor Arnel Mendoza merely dropped by to say a few words and touch base with the participants. The various barangay “jogger’s clubs” financed the purchase of their own uniforms, and paid for their own merienda. At some point, the municipal bureaucracy had little or nothing to do with the perpetuation of the jogger’s club program. After some time in Marikina City, the citizens imbibed the behavior of discipline in the sidewalks. At some point, Disiplina sa Banketa was no longer a program to be implemented, but a sub-culture of the citizens of Marikina. Cultural evolution occurred. The dancers became the dance.
Transformative Leadership The roles of the public health leader, therefore, are multiple, and they shift over time as the health program unfolds. Table 4 below how the relationship between LGUs and it’s citizenry evolved in the course of the programs described in the cases. Table 4: The Empowerment Loop
| Partners passive | Partners active | |
| LGU active | 2 Early LGU-driven Well-defined program design Simple structures | 3 participatory partner-strengthening LGU and partners as Co-equals |
| LGU passive | 1 Stagnant, inaction | 4 People-driven and LGU supported Diversification Differentiation Increased complexity LGU takes a back seat Evolution to a learning community |
The Leadership Axis discusses various strategies for change management based on the management sciences. The Leadership Axis arranges managerial phenomena from micro-management on the left to strategic management on the right. It also orients the different change management strategies from evolutionary change on the left to programmed change on the right (see Case 4).
The Leadership Axis To help get a better handle on the concepts presented in this chapter, they are chunked up in the leadership axis (See Fig.1). In terms of management style, intuitive management is placed on the left and strategic/goal-oriented management is placed on the right. Leaders with formal management training or corporate experience are likely to be seen to the right. In terms of change management style, the goal-oriented. Leader-driven. programmed change is located to the right. Towards the left is the more process-oriented, participatory, and less controllable evolutionary and participatory change.
Figure 1: The Leadership Axis
intuitive mgt. - operations mgt. - organization mgt. - strategic mgt. disorder - evolutionary change - emergent change - programmed change people-driven/bottom up- participatory mgt. -leader-driven/top-down
Because of Marikina Mayor Bayani’s corporate background, his management style is highly goal-driven and based on strategic plans. The leadership style which is described as leader-driven, with programmed change based on strategic plan is plotted in the right side of the axis. His projects can be located mostly in Quadrants 2 and 3. (Marikina City is a Hall of Famer in the annual Galing Pook awards. Among the programs that bagged awards for Marikina City were Squatter-free Marikina; Barangay Talyer, Disiplina sa Bangketa and the Save the Marikina River.) Bustos, Bulacan Mayor Mendoza and his doctor-wife, are physicians by training but their highly innovative, process-oriented, people-oriented leadership style more than made up for that slack. At the start of Mayor Mendoza’s term in 1988, he had no strategic plans. His programs were driven primarily by good intentions. The husband-wife team’s leadership style could be located in the left side of the Axis because their efforts resulted in a highly participatory evolutionary change. We must note that the results here are no less effective than the right side type.
Conrado de Quiros describes this all succinctly. He wrote:
We need an ordinary mortal who rises to the extraordinariness by the heroic nature of her vision, by the epic nature of her quest, by the monumental scale of her dedication to it. We need someone who is humble enough to hear the voice of the people and is proud enough to bend the world to their will. We need someone who can push people to transcend themselves, and, doing thus, pull them to reach for things beyond their grasp. We need, in sum, a leader.
Case 4 Marikina City’s Politika sa Bangketa
Anarchy in the sidewalk of Marikina flourished through years of neglect and indifference. There was a call for change with the coming in of a new local chief executive. The battle cry was the need for discipline. " A man may be king in his domain, but once he sets foot on the sidewalk he has to bear in mind that he is bound by the rules of society and has to live by them." Appropriate ordinances, which prohibited the use of sidewalks for other purposes, were passed. Initially, the city disseminated to all households a pamphlet on "Disiplina sa Bangketa" (Discipline in the Sidewalk) outlining the rules and regulations to guide people's behavior in the sidewalk. The city paved around twelve kilometers of its sidewalk with red colored demarcation line to impress upon the public the value of conforming to the rules and mores of society to achieve physical and social order. Its operation was guided by the dictum of checking the smallest infringement in the law with the objective of eventful ease in reducing petty and bigger crimes on account of the citizen's obedience to simple rules and regulations.
The city government succeeded in liberating 90 percent of its sidewalk from any form of encroachment or obstructions. Trees were planted along the sidewalk and in other parts of the city in support of its program called " Puno Kahit Saan ( Trees Everywhere) to convert the whole city into a nursery of trees. Everyone was encouraged to plant trees everywhere with guarantee from the city government to remove and transfer the trees anytime for free. The city acquired a tree mover for balling out and transferring trees. In 1997, around 85,000 trees had been planted. The tree planting is consistently being pursued to attain its goal of having 1,000 to 1,500 trees planted per capita. Added to these accomplishments was the implementation of another program " Towards a Hassle Free Roadways" which strictly enforced the traffic and parking ordinances through self-policing policy. To support the program, a five-hectare parking area was built; street and traffic signs were upgraded; new access roads were opened to decongest main thoroughfares, among others. As a result, Marikina has some of the safest and most convenient sidewalks and roads in Metro Manila today.
Case 4 Federated Women’s Club in Surigao
Surigao City is known to award-giving national and international bodies through its primary health care program initiated and implemented through women's clubs. In 1976 Mrs. Zenaida Arana, a midwife of the City Health Office assigned to two barangays, began organizing mothers at the purok level and training them in nutrition, responsible parenthood, and sanitation so they could assist in the delivery of PHC services.
Barangay Health Workers (BHWs) assisted Mrs. Arana in her pioneering tasks. By the 1980's mothers clubs had become very visible in the city. Because of their success, local politicians took advantage of them and converted them into their private organization. This confused the members, and the organization died within one year. It took Mrs. Arana two years of hard work in 1985 and 1986 to form another set of ten mother's clubs.
LOCAL GOVERNMENT SUPPORT
In 1988 the new City Health Officer gave recognition to Mrs. Arana's efforts and assigned her as overall coordinator of the primary health care programme for all 54 barangays of the city. Because of that support Mrs. Arana was able to organize a functional PHC Women's Club in all the barangays. In 1991 the groups formed a federation. In 1992 it became the Surigao City Primary Health Care Federated Women's Club, Inc., and since then has been instrumental in propagating the PHC strategy.
FAMILY PARTICIPATION The women involved their husbands in primary health care activities. The men got into the program by organizing the BESIG (Barangay Environmental Sanitation and Implementing Group). The PHC Youth composed of 12-21 year-old family members and the Mini-Youth (from 7-12 years old) were subsequently organized by Mrs. Arana. By 1990 BESIG had become an indispensable partner of the PHC women's clubs. TRAINING AND AWARENESS
The PHC activities involve immunization, family planning, nutrition, implementation of the national tuberculosis programme, and control of the diarrheal projects. Believing in the capacity of mothers to implement PHC, the programme put emphasis on training women in leadership, community development, and management. PHC also runs a weekly radio programme to promote health awareness and serve as a communications facility among the members. ORGANIZATION
The federation is organized like a pyramid, with the 7,200 members of 180 chapters at the base. The chapters are grouped into seven districts composed of five to 12 contiguous barangays. Each level of organization has its own set of officers, including its representative to the next higher level. The PHC structure involves the City Mayor and Vice-Mayor as PHC Committee chair and co-chair, respectively. Mrs. Arana remains as PHC Coordinator and adviser.
FINANCING The PHC gets financial support from the development fund (20% of the City's IRA). The City budget also funds its health projects. However, the organization is essentially self-supporting. The annual membership fee is P10.00 (ten pesos). Each member also contributes P60.00 a year for funeral assistance to members. The organization also raises funds from special projects and accepts donations from external sources; cash awards from HAMIS (Health and Management Information System) in 1991 and 1994 went into the financing of PHC activities.
MEASURING SUCCESS
Infant mortality in Surigao City was a high 76.6% in 1981 and 69% in 1984. After PHC became active it was drastically reduced to 29.5%. By 1996 it was only 19.1%. Maternal mortality rate also went down from 1.9% in 1975 to .5% in 1996. In the years PHC was inactive, both infant and maternal mortality rates were high.
Nutrition rates for pre-school children have also improved. In 1980 there were only 38.1% of children who had normal weights. Although the figures fluctuated, the rates were lowest when PHC was inactive. In the last few years of PHC's re-emergence the rate of children with normal weights had been high--- 54.7% in 1992, 59.19% in 1993, 61.02% in 1995, and 62.54% in 1996. The establishment of BESIG in 1990 has increased household access to sanitary toilets (Table 8). Conversely, households without access to sanitary toilets decreased at a rate of 31% in 1990-96.
These figures show the impact of the PHC Women's Club in the lives of Surigao City residents.
1 Winifield Arn, Growth Report No.5., Ten Steps for Church Growth (New York: Harper & For, 1977). As summarized by John Maxwell, p.64.
2 Adopted from Maxwell, p.65, Developing the Leader Within You
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