Q&A: Meet the New Executive Director in Malawi

Basimenye Nhlema was announced as the executive director of Abwenzi Pa Za Umoyo (APZU), as Partners In Health (PIH) is known in Malawi, in November 2023.

Originally from Karonga, a district in the northern region of Malawi that borders Tanzania, Nhlema is one of 18 children from three mothers in her family, and the first woman to have received a university education. She started her career as a project manager for a theatre company, having studied drama and public administration in college. After a few years, she transitioned to working with nongovernmental organizations, focusing on community health in her home country.

This introduction to public health sparked a passion to make meaningful change that has guided Nhlema's career. In 2017, she relocated to Neno District to join the APZU team as Director of Community Health and has been a leader among her colleagues since then.

We spoke with Nhlema about her time at APZU, the challenges she anticipates as she looks to the future, and her guiding principles as a leader. Below, edited and condensed, are her responses:

Tell us about your journey with APZU since you began in 2017.

I joined PIH in January of 2017 as APZU's Director of Community Health. I joined at a time when the community health worker program was transitioning from a program supporting only HIV and tuberculosis (TB) patients, to a comprehensive program involving household assignments. During my four years as Community Health Director, I was also responsible for the Program on Social and Economic Rights (POSER) as well as the Community Engagement Program.

In January 2021, I transitioned to the role of Chief Operating Officer, heading up our operations and administrative functions. In November 2023, I became the Executive Director.

How did you feel when you learned you were selected as the executive director?

My family and friends were happier about the news than I was. Personally, I would say this was the most difficult period of my professional life because I had so many fears and questions going on in my mind, and genuinely wondered whether I had made the right decision. I feared I wasn't going to be good enough for the position and that I would fail in my duties and end up undermining the great milestones that my predecessor and the organization had achieved. Not having a medical background made me feel even more vulnerable and fearful of the task that was before me.

But, I can say after a year, that the yoke is lighter. The task generally remains daunting every single day, but I have learned that I don't need to know or have answers to everything. All I need is to continue leveraging my strengths, strengths that gave the organization confidence to appoint me in this position. And most importantly, I have also learned that it's okay to ask for help and rely on the strengths and support of my team.

How have you grown personally and professionally at APZU?

As someone who does not have a clinical or medical background, working with PIH has helped me gain a deeper understanding of the Malawian health system and the factors that affect health, health care delivery, and health outcomes in the country.

When I was joining PIH, I had a superficial understanding of health and what is involved in health care provision, but with time, I have come to learn the depth to which forces such as economic policies, economic systems, political systems, social norms, as well as development agendas directly influence health in a country or specific context.

What is one of your most memorable moments as executive director thus far?

One moment was the day I welcomed 9-year-old Promise and 49-year-old Vitalina home on their way back from Tanzania, where we had sent them to access heart surgery services after they could not find help in Malawi. This day is deeply ingrained in my spirit because we, as an organization, demonstrated through tangible action what we mean by pragmatic solidarity and what we mean by providing a preferential option for the poor in health care. I was happy beyond words to see restored hope on their faces and those of their family members.

What are some of the challenges that you and APZU may face as you look ahead?

While there are noteworthy milestones that we have achieved, there are several significant challenges in health care delivery as we look to the future including resource constraints, burdens of disease, and climate change. The lack of resources in the country poses a huge risk to universal health care and the provision of quality care for people in Malawi.

However, demand for health services is growing rapidly in Malawi. Our country continues to struggle with a high burden of infectious diseases, such as TB, HIV/AIDS, and malaria, while at the same time facing rising noncommunicable diseases like diabetes, hypertension, and cancers.

Malawi has also been experiencing a rise in events like floods, cyclones, and droughts caused by climate change. We have seen these exacerbating problems such as poverty, malnutrition, increasing spread of diseases such as cholera, and even the resurfacing of diseases that were once controlled.

As you face these challenges as a leader, what are some of your guiding principles?

I have three major rules that I live by. The first is to practice kindness. Life is tough as it is, and I don't need to add any acts of unkindness. I treat others with compassion and empathy, as I know everyone is fighting their own battles. Second, I practice gratitude. I remind myself to be content with what I have because someone, somewhere is praying for what I have. Last is to embrace curiosity. I seek to learn and understand the world around me. I stay open-minded, explore new perspectives, and am not afraid of mistakes because they are necessary for growth and success.

What inspires you to continue your work with PIH?

When I first started with APZU, I had given myself two years. Living and working in the 'village' was not meant to be a long-term plan, but when I started working, I fell in love with the organization, its values, philosophy, mission, vision, work environment, and people. I can't believe that I will soon be celebrating eight years in Neno with APZU.

There are many things, but at the very core is our philosophy that all life matters and that we do whatever it takes to take care of each life. This is the driving force of our progressive and relentless problem-solving spirit, particularly when it comes to finding solutions for the most vulnerable groups.

We are bold and daring in our overall approach to work and health care. We do not allow problems or circumstances to limit our imagination of what is possible. We believe that if there is a solution, we will find it, implement it, document it, and even share it with others so they can learn from what we have demonstrated as doable. I find this utterly beautiful and reassuring, especially in a world that is systematically structured to oppress the vulnerable and poor.