Evolution of an NGO – Case Study: Dentistry for All

Greetings from Guatemala! This is my first time in Latin America and so far I have loved every minute!  Funny enough, the most difficult part of the trip was leaving the Calgary Airport! Picture 24 hockey bags filled with dental equipment and supplies carried by 8 dentists, hygienists, dental assistants, and other support volunteers; each bag being hand-searched.  From this point it has been smooth sailing (with the exception of the earthquake that shook me awake this morning).

The last couple of days I have been thinking about how organizations evolve.  This started with a conversation with a colleague about risk tolerance and trust.  Typically individuals evaluate how we interact with each other, businesses and organizations on a scale of trust.  The more transparent an organization acts, or the more self-disclosure an individual provides, the greater the risk tolerance of those parties.

During growth stages of an organization, typically seen and experienced at points of major transition, transparency is important for all stakeholders.  I am witnessing this first-hand during my 10 days in Guatemala with Dentistry for All (DFA), a Canadian NGO.

16 years ago this organization started as a “voluntourism” trip for dentists to travel to Guatemala to pull teeth.  Today the organization is still 100% volunteer run and is evolving into an agency that is exploring its role within Guatemala’s dental and medical communities.  (For more information on the difference between voluntourism and philanthropic travel please click here).

Part of the evolutionary process is to ask questions.  Basic questions that DFA is asking itself include:

1.    In what ways are we making a difference if we only come to Guatemala 6 weeks out of the year?

2.    What are the best ways to partner with local businesses, community agencies and NGO’s?

3.    How can we work with the indigenous culture and still encourage good oral hygiene (something that is not part of their daily routine)?

4.    What piece in the Community Economic Development (CED) and International Development web do we play as a dental organization?

These questions are being asked and answered in several ways ranging from operational changes to governance structures.  I have been a part of the transition at a governance level, having worked with DFA and their key volunteer leadership in formalizing their board procedures and operations.  Now I am witnessing how board policies are starting to impact the operations of the agency on the ground.  Some of the most notable changes are in the way that data is being collected, recorded, and stories are being told.  For example, today we were out in a village called La Reforma.  DFA has been going to this village for a few years, but this is the first time that the organization started tracking, not only dental procedures, but ages of clients and if they attended a DFA clinic in previous years.  The purpose for this tracking is not only to see demographics, but also to start seeing whether the individuals and families that are treated are keeping up with some of the oral hygiene.  This is not something that will be measured from 2009 to 2010, but will be measured over time.

But it’s not just about treatment numbers.  It’s about relationships between the dentists,  their assistants and their patients, who have been coming to the clinic year-after-year.  Dr. Shane, the on-the-ground director,is so loved and respected in these communities.  Today a woman stopped the truck we were driving just to find out how Dr. Shane Fisher was doing and how the clinic was running.  Dr. Allan Ross, an oral surgeon from Saskatchewan is down for another year. Through his connections he has created a pen-pal relationship with a local school and one in Winnipeg, Manitoba.  The kids in Winnipeg have raised funds to ensure that the breakfast program in the Guatemalan school is funded; the teachers are connecting as professionals and the children are leading the way through letters and story telling.

A final piece of this evolution is the succession planning of the group.  Measures are being developed to ensure that leadership; both on the volunteer level and the management level ensure relatively seamless transition when required.

By no means are these the only questions and steps that this agency will be taking through this evolutionary process.  Nor will this all happen at once.  Done systematically and with open communication the transition from one evolutionary stage to the next can be managed and most importantly be fun!

Over the past 48 hours the team of volunteers have seen over 100 patients, worked with two different NGO’s (Ammid & US Peace Corps) and trained three non-dental support staff.  All of this in an effort to be a piece of a larger solution to international development; your role as strategic and adaptive donors to this very complex puzzle, is to support organizations that are exploring these evolutionary steps and provide guidance and resources as required.