Custodian Yaya Koulibaly has worked at N’Zérékoré Regional Hospital since 1980. Below, he recounts how the facility has improved over the subsequent 32 years, particularly since MCHIP’s introduction of the Standards-Based Management and Recognition (SBM-R) process.

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I’ve seen personnel come and go, I’ve observed the role of employees during their time here, and I’ve observed the nongovernmental organizations that have supported us. Above all, I’ve witnessed the evolution of sanitation at this facility.

When I started, the inside of the hospital was full of plants, wild birds, sheep and other small ruminants that had invaded the courtyard looking for food. My responsibilities were to sterilize the surgical equipment and clean the operating suite.

The hospital rooms used to be maintained by parents of the patients. Snakes hid in the bathroom, and birds made their nests there. Frankly, it was dangerous to go to the bathroom—especially at night—because there was no wall separating the hospital from neighboring homes and abandoned buildings. In 1988, a wall was built around the hospital with funding from Doctors Without Borders.

After MCHIP introduced SBM-R, my role became more official. I was trained and given a uniform and equipment for my job. Cleaning and waste collection are now done according to written rules now.





(Above: Before SBM-R.)

In addition to MCHIP assistance, the hospital’s Deputy Director General was a tremendous help, teaching us what to do and working alongside us. The courtyard is very clean now. The bathroom is even better!





(Above: After the introduction of SBM-R.)