Richard Van West Charles

Richard Van West Charles joined PAHO in 1990 following a fast-track public health career in his native Guyana. He was appointed minister of health, water, housing, and the environment in 1980, just a year after receiving his medical degree from the University of Havana. After five years in that post, he became minister for medical education, food policy, and environment. He has served as PAHO/WHO program officer for the Eastern Caribbean and PAHO/WHO representative in Jamaica and Bahamas. He assumed his current position in 2003. He holds a master's degree in public health from the University of Michigan and has done private clinical practice as a general practitioner. He holds dual citizenship in Guyana and Canada, where he completed his secondary and undergraduate education, the latter at McMaster University.

How did you get interested in medicine?
My mother was a nurse, and a close family friend was a physician. As a boy, I would accompany him to clinics. I commenced my studies in medicine at the University of the West Indies and transferred to Cuba my third year. After completing my medical degree, I returned to Guyana and worked in Georgetown Hospital as a government medical officer. During my training in Cuba, I gained a good insight into the role of health in development. I've always been active in and close to politics—first student politics, then national and global politics-—so I got involved in politics, and I became minister of health.

Did you start your career wanting to be minister of health?
No, I was focused on cardiology. But when I became minister, I realized the importance of public health to the country and the region. One of the things I did was to work closely with a number of Guyana's physicians, including Claudette Harry and Roger Luncheon, to establish the first medical school in Guyana. The government had made significant investments in rebuilding hospitals and health centers, but we needed to expand the number of physicians to increase access to these services. Doctors in Guyana had to go abroad to receive their medical education, so Guyana needed its own medical school. PAHO/WHO consultants assisted the Ministry of Health with the design of a problem-based curriculum, and the school was inaugurated in 1986. We started with about 20 students; now there are over a hundred.

Has your government experience affected your work at PAHO?
Ialways say I've seen PAHO/WHO from both sides of the divide, as a minister and a member of the governing bodies for seven years, and working for PAHO/WHO for the past 15 years. That gives me a certain perspective, for example, on the value of PAHO/WHO's current country focus. As a minister of health, I was a member and one-time chairman of the Conference of Ministers of CARICOM, where I realized that there were many common issues among our states and hence the need for common solutions at the subregional level. I also gained an understanding of the need of Member States to have an appreciation of the effective use of quota contributions. As a member of the WHO Executive Board in 1986, I recall dealing with the misallocation of resources by one of the WHO regions. I also gained insight into the demands placed on the secretariat to respond to the interests of different states and how that balance should be achieved. As both minister and staff of PAHO/WHO, I have embraced the principle of Pan Americanism, which to my mind is the foundation of this glorious organization and which directly relates to the important operational component that is knowledge sharing.

What are your goals in IKM?
My first goal is to understand the decisions of the governing bodies and also the orientations of the director and executive management. In this 21st century, the director has identified the importance of PAHO/WHO becoming a more efficient and effective knowledge-based organization to be able to respond to its mission. I led the task force, comprised of staff from across the organization, that developed the information and knowledge management strategy for the organization, which was endorsed by executive management. The strategy identified four states that the organization must achieve: PAHO/WHO as an authoritative source of public health information, PAHO/WHO as a learning organization, PAHO/WHO as a collaboration-based organization, and PAHO/WHO as a networking and partnership organization.

My goals are to collaborate with staff and Members States in the implementation of the plan to give effect to these four states, which will improve our effectiveness as a knowledge-based organization. As for PAHO as a learning organization, there are many best practices in public health that are not available to the Member States and that can give great effect to the principle of Pan Americanism.

What are the challenges you face?
There are many challenges, which were identified by the task force. As with many organizations, we are not working in the best of ways. We are somewhat compartmentalized, and there is need for more integrative working. Another issue is the cultural shift needed to really share information and knowledge and also to devise mechanisms and processes for the capture of tacit knowledge. But the attainment of the solutions is not singularly my remit. It is the remit of all staff and, most important, the role of the leadership and of executive management. As a collaboration-based organization, we will have to intensify our collaboration by virtual means. This is a major change for both staff and Member States that have grown accustomed to working face-to-face. This will be a challenge, but I am sure we will succeed. Much of what we hope to do is linked to technology as an important enabler of the processes. This has a cost, but it will be resources well spent.

How do you get people to buy into information sharing?
First, one has to ensure that everyone is informed. We have to remember that we need to communicate in different languages, and most of all there must be involvement at the beginning. You have to market, you have to move it forward. You have to place it into the managerial process. Buy-in requires a process of sharing information and bringing people on board before and not after the fact. There must be a process for input, and the value of the input must be evident. This does not mean that every suggestion is carried, but it is at least noted and discussed.

How do you get the countries on board to share best practices?
The country offices will have to play a key role, because they are the face of PAHO/WHO in the countries. They will be interfacing with the national authorities; there will be a defined process by which best practices are identified. There will be a process for documenting these practices and making them available via the PAHO/WHO website and knowledge-sharing portal. It will support the operationalization of the principle of Pan Americanism. Countries will not be repeating mistakes made by others. It's a paradigmatic shift toward conceptually recognizing that there is value in sharing and reuse of knowledge. It's moving from the point of view that says, if I have knowledge, I have power, to the view that if I share knowledge, I will be enriched because it will fuel innovation and creation. Once you understand that, you begin looking at the different processes of sharing knowledge, such as communities of practice, after-action reviews, peer assist, for example. There's a lot of interest, because staff realize that their business is dealing with knowledge.

What about information sharing with external audiences?
We have a lot of knowledge and evidence, and we need to know how to communicate it to different audiences. It needs to be contextualized and translated and made simpler for different populations so they can be empowered to use this knowledge. We really have to look at communication as an up-front issue for the organization if we're going to have that impact and the empowerment that we want to see from our work. In this knowledge-based economy, networking and partnership are critical, and this must be an operational principle, supported by policy.

What are the obstacles there?
There is again the need to reorient staff to see that the impact of our work is not just to produce evidence and publish it in journals, which is the academic orientation. We have to bridge the know-do gap. We have a lot of existing knowledge, but it's not applied. We have to understand that this evidence is produced because it is related to problems for a population grouping or groupings. So up front, we have to ask, how are we going to communicate this evidence to that population? The other obstacle is the culture of boxes, and here the culture of the organization may be a problem. People tend to focus on the boxes they're in and to be quite territorial about them. We need to create processes to help us work in a more integrated way. Knowledge management is a crosscutting approach and has to be embraced at all levels if it is going to succeed. It is an approach that will help us be more effective in empowering people. It underscores the importance of human capital to development.