We know that failures and missteps can be vital inflection points that lead to deeper insights and greater heights. We feel that failure is not studied enough for the value it can provide. As a result, this page outlines mistakes we’ve made or disappointments we’ve encountered and the subsequent lessons we’ve learned.

Lessons Learned

Lesson #1: Being pennywise and pound-foolish. Working within a lean budget has made volunteer assistance or in-house development often tempting. However, time and time again this has been the more expensive option. This was particularly the case for us during the development of our small-scale fortification technology where we spent too long boot-strapping our product and technical development, using volunteer or in-house resources, which in the end cost us more money and significantly more time. This same mistake has also been repeated in the development of simple software tools such as the current monitoring tool we developed, or the handheld mobile survey tool, which we used to survey the nutritional practices of the populations we work with. We are working hard now to more carefully weigh our external options knowing our tendency and our past history.

Lesson #2: Providing consistent in-country support. PHC currently uses a model whereby a Country Coordinator is hired and placed in each country of operation for 3-5 years to lead the design and implementation process with the government. This allows for a structure that ensures fortification is given due attention on a regular basis and is built into current government structures. However, PHC did not always use this model. When PHC first began, US-based staff flew periodically overseas to provide support to country programs, stayed a few weeks, and left. This proved ineffective and threatened the timely and comprehensive adoption of a program. The Country Coordinator model has not only proven essential for PHC’s operations, but it has also caught the attention of the international fortification community as a model not previously used in the past that produces meaningful results.

Lesson #3: Staying current with field communications. Once again, in an attempt to be economical, we have often sacrificed good and reliable communications for on-the-cheap solutions that make it more difficult for us to share information and make timely and good decisions. We’re in the process of updating our communications network to solve this problem.

Lesson #4: Sticking to government timelines. Working within country-specific time lines, not necessarily our own, has proven imperative. Although this may cause program timelines that extend longer than we feel is necessary, it ensures the program is owned by the country government and its staff increasing the likelihood of ownership. We have learned that pushing our timeline against a national timeline only leads to frustrations on both sides of the table and jeopardizes important working relationships.


Disappointment #1: Lack of government support for a national program. Although we point to the need to stay true to in-country timelines, significant delays in program work streams may be a signal of diminishing high-level government support threatening the sustainability of the program. In Rwanda, we faced just this scenario. After waiting eight years to get a mandate in place for fortification, PHC had to face the fact that the government had decided (without saying it) that fortification was no longer a national priority. During this time, significant funds were spent by PHC waiting on the government; funds that could be used more effectively elsewhere. We, therefore, had to make the decision in April 2016 to begin closure of the program. This was an extremely disappointing time for us. As of July 2016, however, with the recent departure of Rwanda’s Minister of Health, it was not yet clear what stance the government would take towards a national program. As a result, PHC’s next steps in Rwanda have yet to be determined. If deemed appropriate, we would be eager to re-engage.

Disappointment #2: Political and other disruptions and our response. We have chosen to work in difficult parts of the world, because those are the places most often neglected by outside organizations. The consequence of that is we are often faced with challenges that severely impact our work streams: recent examples include the Ebola outbreak in West Africa, and the political situation in Burundi. In the case of Ebola, we had to remove our Country Coordinator from the country to work remotely, eventually causing us to lose a key resource altogether. In the current Burundi situation, work has slowed considerably, increasing our expenses in that country.

Disappointment #3: Failing to understand the challenges of in-country manufacturing. We wanted to produce the Sanku product inside the countries we work in order to create local jobs, reduce costs, as well as increase our ability to monitor quality. While noble, in fact the dosifier is complex enough that it needed to be manufactured in areas that have more experience with electronics and materials engineering. We failed to produce a suitable product in both Kathmandu and Dar Es Salaam, costing us about 18 to 24 months of time and at considerable expense.