← Nonprofit Leadership Podcast
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- [00:03]
A
I think it's prioritization. I think at any one time, Rob, as a leader, you'll always get faced with a lot of things. But of course, when it's a time of plenty, it doesn't feel like you're making a lot of decision. You have to be decisive. Don't second guess yourself. Don't overthink it. Make decisions. That's what your staff are looking for. They're looking for you to make a decision. Obviously, you need to make the decision with your team and make sure that there is consensus. But don't get into a lot of consensus building. And then, you know, it takes very long prioritization.
- [00:34]
B
This is Dr. Rob Harder with the nonprofit leadership podcast, Making youg World Better. What does it take to be an effective nonprofit leader today? What are the biggest challenges? What are the biggest obstacles? How should nonprofits fundraise in an economy that is constantly changing? All of these reasons combined led me to start this show. And it's my hope that through this series, people can learn not only what it takes to be an effective nonprofit organization, but to hear from effective leaders who are successfully making a positive impact in their communities. We hope you enjoy the show as together we hear how they are making their world better. Welcome to the Nonprofit Leadership Podcast with Rob Harder. I'm Mike Lee. I live in Washington, D.C. and I'm a listener just like you. We are all on a leadership journey looking for ways to learn and grow. Each week I look forward to hearing Rob's latest discussion with his guests. I invite you to join us. Thanks for listening. Now here's Rob. This podcast is sponsored by DonorBox. DonorBox, helping you help others with the best donation forms in the business. Well, welcome back to the Nonprofit Leadership Podcast. So glad you're with us today. I've got a very interesting guest and she's going to talk all about a really unique work that she is in charge of that she's leading. So I have Dr. Doris Macharia with us today. Doctor, thank you so much for joining us today.
- [02:01]
A
Thank you for having me. Looking forward to the conversation.
- [02:04]
B
You got it. Well, I always like to start all my episodes just giving my guests an opportunity to share a bit about their story, a bit about your background, to just give context to what you're doing today. So maybe you could start there?
- [02:16]
A
Yeah. First of all, thank you so much. Once again, I'm Dr. Doris Macharia. I am the president of Elizabeth Glaser Pediatric AIDS Foundation. I'm based in D.C. here in the U.S. but I started my journey Many years ago. I'm Kenyan and a medical doctor and I got my medical degree about more than 30 years ago and pursued the field of public health, worked in the field of in global health, working in HIV programs and also other related fields in global health. So. So it really has been an exciting journey for me. And in just the last year, taking on this role as the president has been eye opening, stretched me quite a bit. But it's just been a tremendous time of learning and just getting even more committed to children, moms and families.
- [03:07]
B
Well, they love hearing about your background and we'll kind of probably come back to that a little bit in terms of how it applies to what you're doing now. Now, it was interesting, I thought that as I learned about your journey a bit, and when you jumped into this role, you stepped into this role as international assistance cuts were already hitting your organization as well as many other nonprofit organizations. So there was no Runway, no typical onboarding. You were new to both the organization and to the country. Maybe you could get us into those first couple of weeks on the job. What was that like? And tell me about how you worked through that.
- [03:38]
A
Yeah, that was really tough. I think one saving grace was I have spent most of my career in global health. I'd spent my beginnings in public health in the area of HIV and aids, aids, starting new programs in Kenya, in South Africa and other countries. So the particular area was not necessarily new to me. What was new was what was happening in our field at that particular time last year. But yes, no onboarding, formal onboarding. However, I met committed colleagues who were passionate about our mission to end AIDS in children, to reach more children, to reach more moms, to reach more families. That commitment, I think, is what continues to inspire me. However, it was chaotic. It was very chaotic.
- [04:28]
B
Oh, I can only imagine it was
- [04:30]
A
really rough because we had projects which had to come to an end in a number of countries, such as in Eswatini, and also even the projects that continue even up to today, a number of activities we could not go ahead with. However, we must always celebrate the wins and we must always celebrate the fact that we continue to show up. So whereas that beginning time was tough, I think it was the fact that, I think as an organization, it was easy to go through that because of the commitment of staff, the mission, the fact that even among board members, staff and communities, which you could not let down, we couldn't say, hey, this has happened. I'm sorry, we can't do this. Absolutely not. It was, how can we do this? Together, how do we continue to work with the ministries of health? So it really enabled me to think, how do we continue supporting our mission beyond and through these funding cuts and make sure that we don't lose sight of children and moms and community members. That's where it's all is, you know, that's what's most important. So it's very easy to feel, oh gosh, this is hard. But it's even harder for those communities who have interrupted services. So it was hard for everyone. But I think it's just because of the Eggpath Elizabeth Glaser Pediatric AIDS foundation and the kind of organization we are that we're able to bounce back. Obviously we are a bit leaner than we were. A few things have changed, but we are still here.
- [06:02]
B
You survived. Yes, we survived.
- [06:05]
A
And we're thriving. And we're thriving.
- [06:07]
B
Rob, that is, I love hearing that. Not just surviving, you are thriving. And I think that's so good. Right? There's so many non profit leaders around the country that are listening to this podcast and they've gone through their own challenge. Right? Particularly post Covid. And then I think now is another round with all this. As we mentioned, the international funding cuts in the United States context, there's so many federal funding grants that have been cut and slashed 100%. And so it's really impacted people and what they can do. So in the midst of that, you are in a position where you have to still lead and you can mention, I mean it's almost like you're leading in a crisis. How did you go about building and earning trust so that you can continue to really not only survive, as you mentioned, but begin to thrive by earning more and more trust with your leadership. Maybe you talk a little bit more specific things you did intentionally to build that trust and grow the organization.
- [07:00]
A
I think one was leading with presence, knowing at that particular time, making sure I can show up in conversation, be empathetic, listening deeply. I had a lot of listening sessions, one on one group sessions to understand not only what has worked before, but how are staff feeling at this particular moment. What are we hearing from the communities that we are serving? What do we need to do differently? How do we continue to show up as an organization? So it is so for me the realization very quickly needs to be visible in that particular moment. And I think that was useful whether it was the one on ones the town halls which we continue to have rolling out newsletters, communicating, you can't over communicate. Silence was not an option. The second thing was being Honest about our challenges. We knew where we were. You know, we have lost some work, We've lost a lot of activities. And unfortunately, we also lost a number of our staff because of the changes and the funding that was no longer there. But we could not lose sight of what I was calling and what I call the horizon. Our horizon is our mission, making sure that we don't lose sight of that. I think, for me, the other thing is, and maybe third thing is drawing from the authority of our mission. Very important. It's very easy to think, oh, gosh, I'm the president and la la, you know, all that, but it's really thinking, what is bringing me here? It's mission alignment with my own values. And we have to name it. We have to name what holds us together. And it was unanimous, almost unanimous, that we need to be here for children. We need to be here for the communities. We cannot let them down. We need to show up. And yes, some aspects of our work has changed, but the problem has not changed. The horizon still remains, and we have to keep moving forward. So for me, those are the things that helped me to say, yes, onboarding and all that. Some things are not there. However, this is what is being presented to me at this time, and we have to move together as a team and ensure that we move from just survival to thriving. And that's where we currently are obviously trying to continue thriving in this new era.
- [09:18]
B
You said something really interesting about the authority of your mission, and I like that. I think there's a lot of organizations that don't probably realize or really optimize the fact that their mission carries with it an authority in the sense that. Not in a prideful way, but just in the sense of, this is so important. This is critical for the community that you're serving. Tell me more about how you discovered what that was and what difference did you see that it made.
- [09:44]
A
Like I said, I met fantastic colleagues who had been doing this work for years. And obviously, with a few changes, you know, scaling up activities, getting projects to scale. But the mission hasn't changed. We've not yet reached zero infections among children. We still have HIV being transmitted from mother to child, what we call vertical transmission. Our job is not finished yet. And for me, that's the authority of the mission, that it's very easy to wallow in pity and like, oh, what do we do? But our mission tells us what to do, and that's where the authority is, and that's what we move ahead with. And right now, we are doubling down on our mission because we know it's critically important and that's what we do best. And we must continue to show up for children and we must continue to show up for moms. Absolutely. So that's what I mean by authority. That's the authority. Not we are doing this because it feels good. It's not about that. It's really at the heart of what we do and who we are as an organization.
- [10:47]
B
Yeah. It's interesting hearing about your story a little bit, that you really started working in Nairobi with HIV patients when there really wasn't any effective treatment available. Talk about how you led under really extreme scarcity when the sense that there really isn't these effective treatments that are out there, that there's a lot more now, but talk about that, because that's difficult of trying to accomplish a mission where basically had limited resources for effective treatment.
- [11:13]
A
Oh, Rob, you're taking me back to some really interesting times in the.
- [11:19]
B
I bet you have some memories, huh?
- [11:22]
A
Good memories, too. In the late 1990s, I was had trained to be a doctor, and I thought, wow, I'm just going to do my stuff with patients. I'll be this good, great physician and that'll be that. But the patients we were seeing, even as we are admitting patients in the large hospital in Nairobi, which is the Kenyatta National Hospital, the diagnosis was majority was hiv, and they were coming with all sorts of opportunistic infections, tb, kaposis, sarcoma and many, many others. At that time, we could do a HIV test and then we had our ABCs, just to remind everyone, abstinence, be faithful and use condoms. That's in the public sector at that time. We had antiretroviral treatment, we had azt, but it was not available in the public sector. So when I got called by the Centers for Disease Control and Prevention and said, harris, help us think through how we can pull together a program. And I was like, of course. How can I not do that? How can I not do that? Because we, we need to get out of this problem and actually be able to roll out a much larger HIV treatment program in the public sector and not see people dying, not see people having poor quality of life. And that's what got me started that, you know, saying, hey, count me in in looking for solutions. Count me in for really thinking about putting the patient first. And I think that's what got me started. And, you know, worked with the cdc, rolled out a treatment program, HIV treatment programs in a large slum in Nairobi, the Kibera Slums and this was done in partnership. Again, realizing team effort really counts. You cannot do this on your own. You need funding. You need teams. You need different people with different skills to make sure that you're able to deliver up to the patient. So that, to me, was really incredible. And I remember looking back and thinking, I would have not done this if I was just a clinician by myself. Right. This has been made possible by all those enablers and brought so much hope. And, you know, the rest is history as we have it. And for me, that's a really proud legacy that I have. But again, it just came out of hopelessness to hope. But using all those various tools along the way to make sure that we are showing up for our Kenyans, Africans and other people, they also deserve better life. They deserve quality of life as well. Yeah, that's where I started, you know, and thanks for taking me back down memory lane.
- [14:03]
B
You bet. Absolutely. Well, you know, because we. We don't lead in a vacuum. Right. We grow in our leadership. Right. We have to start somewhere where we start. Okay, I'm going to try this and grow and learn from it. And I really like what you talk about collaboration. Collaboration's so critical. And I think in any sector, but certainly in the nonprofit, social impact sector, we can't do this alone. Like you said, no one has all the tools. So we need to work with government, nonprofits, and for profits, all working together to solve, I'd say, society's biggest issues. So I really like that emphasis, and obviously it worked for your leadership. The other thing I thought was curious to learn more about, because this whole podcast is about leadership, and we all go through challenges, and I think particularly in causes or nonprofit organizations where you're working with people that are either on the margins or you're doing a humanitarian work that really has some difficult challenges you have to overcome with the clients you're serving. Obviously, you're working with HIV patients. How did you carry the emotional weight of some of the struggles that you faced? And I'm sure you saw some clients that would die and pass away and families that were affected by that. Tell me how you carried that as a leader and continued leading, but with an empathetic heart and not being callous on the one hand, but also not being so overwhelmed that you couldn't lead the organization.
- [15:22]
A
Oh, yeah, that's the hardest bit, because it's about how do the caregivers, doctors, nurses, et cetera, get care themselves? I think I was fortunate and continue to be fortunate to have a good support System, family is so important. You know, even with all that's going on, reminding yourself this also matters. And that warms my heart a lot. And also the values that I have that if I'm singh a patient, at least even that time, even back in the day in Kenya and South Africa, is also to remember this patient is really depending on you and the health system to do something and to make sure that he or she gets well and goes back to their family. Just like I am thinking about my own family. So it's also to think about even my own challenges, to remember that I have a support system, but also to do everything possible for that patient that you have at that time and where you are. And that's the beauty of, I think global health, public health, is that you can do so much for so many people in this sort of collaborative space and be able to sort of sit back and think, this has been a really good job that not only I have done, but we have done. So it's about putting the patient first, but also not forgetting about yourself, that you also need some fuel. Even as you're thinking about the challenges of I don't have drugs, I don't have this, but somebody has a solution, right? So let's get the solution. So, yeah, and that's, I think, I think the beauty, like I said, of public health is that you can do so much for so many people, setting guidelines, you know, working collaboratively with partners who can deliver things which possibly I cannot and I couldn't. So yeah, so I think it's really being able to reach beyond yourself and work with others, but also reach within yourself and know, okay, this is hurting me now. I need to go somewhere. I need family to be able to support me and lift me up so that I can be able to do this another day.
- [17:25]
B
We'll be right back. Are you looking for an easy and effective way to boost your nonprofit's donations? Well, look no further than Donorbox, the online fundraising platform that streamlines your fundraising efforts, maximizes donations and simplifies giving for your supporters. With Donorbox, you can create beautiful donation forms, accept digital wallet payments, track donations and send auto receipts. And the best part, there are no setup or monthly fees and no long term contracts required. So what are you waiting for? Visit donorbox.org today to get started. That is www.donorbox.org. I love that self care. So important, isn't it, that to be sustainable in organization, whatever role. But certainly if you're the leader and the president and CEO, you've got to make sure you're taking care of yourself, because if you don't, the people are depending on you to take care of yourself so you can keep leading. So I love hearing that. It sounds like you've done a good job.
- [18:25]
A
Oh, no, still doing it. Still doing it. I. I don't want to make it sound like I have it all figured out, but it's knowing that all these tools are in your arsenal. You just have to be able to utilize them and reach out. Even when it's so difficult and doesn't look like there are any answers, there's always something. And the strategies and all that, that's there, and you know what to do, but the challenges are still there, and you can be able to get out of that. Yeah, yeah.
- [18:52]
B
No, that's good. Well, there's no doubt all of us have people that have influenced us as leaders. And you have mentioned that your father really had a huge leadership influence on you, and he did a lot of work with young people. The YMCA in Kenya, as I understand. Is there any lessons, as you think about the influence your dad had on you? Is there anything that really stands out, a lesson or two that has really shaped your own leadership today?
- [19:15]
A
Yeah, Rob. Oh, gosh. You know, my own father was. I didn't know at that time, but he was a humanitarian. I did not know what to call it then, but I know what to call it now. He was a humanitarian. He was very much, deeply. You know, he was of. He was a man of his faith. He was a lay preacher. So when he joined the ymca, his values aligned with where he was going. So that's the first thing that your own values have. It's good when they align with the organization, mission and vision. Then the passion comes and the commitment comes. That's one thing. Two is that he used to come back with all sorts of stories about. He used to travel a lot and come back, oh, this happened here, and this happened here. This is what he did. The realization, wow, there are different cultures out there. And what did you do? Oh, I did this and I did this. And the desire to be able to do much more, to have a bigger impact, I think was there even through those stories. The third thing is he was quite articulate. I mean, he passed away some years ago. This is before computers and everything, but he used to handwrite his speeches, and he used to say, no, I have to make sure everything is done well, and I pronounce every. And he used to have, like, a writing pad and write out his. Some of his speeches. Or things like that. So I also learned, you know, take pride in your work. Prepare. Don't just think that you're going to wing it. Prepare. Prepare for not only meetings, prepare to meet staff. Prepare. Prepare for everything. Because at the end of the day, you don't. You have to always show up with your best foot forward. So that whole values and alignment with mission preparation, servanthood, I think, to me, really, really touches me. And I think even as I think of edpaf, it sort of checks all those boxes. And. Yeah, and he did what he cared, of course, for us and for myself and my siblings to have a better life. But in so doing, he also sort of pushed me, in a sense, indirectly to this work, to this work that I'm doing now and having a bigger impact on world and global health and all that. That is, for me, an incredible. I don't know that he had that vision, but certainly I would like to imagine that he may have thought, oh, yeah, maybe I'm gonna do this. But I'm just so proud of that. I'm so proud of all that and all that he helped me to become. And I've been, yes, thanks for sharing that.
- [21:44]
B
I mean, it sounds like you learned some great lessons from your dad, and obviously it's shaping you as a leader and even to the point where you're in humanitarian work yourself, partly because of his influence. Love hearing that. Well, you've been in this particular role now a little bit over a year. What are some of those things you've really feel like you've learned in terms of the models you've created, the partnerships, any of the relationships with governments or communities that you have learned? This is how you do it to be more effective. Anything you want to share in terms of advice for those listeners who are trying to do the same in their own context, in their own nonprofit organizations?
- [22:16]
A
Yeah. I think the first thing, Rob, is think about your mission. Your mission is your guide. Like we said, it's the authority. What's your mission? How can you ensure that you keep track of your mission, ensure that you can still thrive there? One thing for me is towards the end of 2025, with the realization we have in these funding cuts, the ship has sailed, so to speak. It's not going back to where we were in 2024. It's different. So one of the things which I had to work with the team is doubling down on our mission. We had to ask ourselves, have we met our mission? We haven't met our mission. We've not. Zero infection. So there's work to be done, but how are we going to do this work in this moment and in this environment? So it's also thinking about different ways of partnering. How do we go to donors and tell them about our work? So it's also thinking about that as well. So your mission still is the light and it's still in the horizon. And it's very easy during these times when it's very easy to scamper around and think, oh, gosh, I think we need to change. I think we need to do this. In my honest opinion, you really double down and also you show your true who you really are as an organization. And I think that that resonates well for most donors. And they can hear that and you can articulate it because that's what you've been doing for years. So it's looking at our best capabilities and being able to package them in a way that makes sense in terms of mission alignment. So for me, that's the other thing I learned. I think the other one is realizing that as an organization and as the staff, the resiliency people want to do more. They want to put up their hands and say, doris, what can we do here? Here's an idea. Listening, continuous listening. Even when you think you. I think we've checked all these boxes. Continue listening. And that will be important going forward. And then, of course, lastly, is looking for other newer ways of doing our work, of getting new donors to support the work that we're doing. Telling our stor in a different way. Our stories continue to matter. What is happening at community level continue to matter now more than even yesterday, making sure those stories really show up not only for our own staff or our donors, but even for policymakers as well, so that they can also see, oh, this is what our money is. This is the impact of our money. Yes. And this is what it's doing. And if you do the following, we can be able to reach that generation which has zero new infections among children. So doubling down is very scary. But I honestly think it's the right thing to do. And then we look for other capabilities. Now you can say, what else do we need and how do we need it? How do we get more efficiencies and things like that? So it's just been an incredible time of learning and growing from a personal level, but also as an organization.
- [25:10]
B
Well, I'm guessing so some of my listeners may be in a place where maybe it's not quite as dire as when you first came into your role, but they're facing similar challenges and they're really dealing with financial issues, fundraising issues, staffing issues, you name it. If there's someone listening and they're hearing your story, is there any recommendations? When it comes to feeling like you've got multiple challenges on multiple fronts, what is the way they should tackle the issues? Should they focus on one and then the next and sequentially, should they try to tackle them all with help all kind of the same time, or what kind of advice would you give them? When it comes to when a leader is feeling like they're being hit by multiple issues and multiple challenges, what have you learned along the way that has helped you stay focused and to move forward?
- [25:56]
A
I think it's prioritization. I think at any one time, Rob, to be very honest with you, as a leader, you'll always get faced with a lot of things. But of course, when it's a time of plenty, it doesn't feel like you're making a lot of decision. You have to be decisive. One of the things I learned way back in Kenya when I was, you know, treating patients in the large hospital there is you have to make decisions. With scarcity of data, you have to. And of course, you get better at it. So don't second guess yourself, don't overthink it. Make decisions. That's what your staff are looking for. They're looking for you to make a decision. Obviously, you need to make the decision with your team and make sure that there is, there is consensus. But don't get into a lot of consensus building and then, you know, it takes very long prioritization. But also, where is the shoe pinching? If I can use that? Where, where is, where does your shoe pinch, for instance? We had to scale down our. We had to be a much leaner team. Number two, we had to think about our office space. Do you need all this office? I don't think so. We can move. Does moving change our mission? No, it doesn't. We just change our location and let people know. Let me say in quotes, the small stuff, because if that's what is the painful part, if that's where the shoe is pinching, you must take care of it and then work with your team. Divide and conquer. Prioritize what is most important. You need to increase and diversify your revenue. We are doing the same thing. We need to get new talent. We need to move on quickly, make decisions quickly. Don't wait for a lot of information. It's never going to happen. You need to be bold enough to make those decision. But Your staff and your team will help you move along. And once they get the vision, they will be like, as you're pulling all these levers, they'll be the ones holding your hand to pull up the levers and to pull down the levers. So that's how I see things. And I do think it's better boldness and being courageous, but also ensuring that you have the experience to be able to walk through this. And you have to believe it that way. Yeah. And the organization has the resilience and the mission. So you just have to show up and be able to lead and move forward.
- [28:11]
B
Well, you've shared some great insights with all of my listeners today. So for those who are listening and want to get to know a little bit more about you, maybe more about the organization, the foundation you work for, for where would you send them?
- [28:21]
A
Oh, that's lovely. Okay. We are Elizabeth Glaser Pediatric AIDS foundation. Our website is www.pedaids p e d a I d s dot org. We are also on Instagram. Our handle is eggpath bgpaf. You can find us there. And we are also on LinkedIn. Please engage with us on our socials. Please come to our website, learn more about the work that we are doing. And we are only a chat away, a tweet away and a post away to engage with you. We are just looking forward to engaging with everyone to tell them more about what we're doing, but also for them to help us champion our mission and end pediatric AIDS once and for all.
- [29:06]
B
Well, again, thanks so much for taking time to be on the show and share your insights. It's obvious to me that you've learned a lot along the way. What a wonderful example of your dad having such an influence on you. But then for you to put it into practice and to shape you as a leader today and all the work that you're doing. So again, thank you for sharing that with the listeners here. And I just thank you for what you're doing because the work you're doing is really hard. It's not easy, and yet you've really worked through some difficult circumstances to keep not just surviving but thriving. So thanks again for being on the
- [29:33]
A
show today and thank you so much. We have exercised our muscles, so we are hoping that muscle works for us in the future as we continue doing the work we're doing. Thanks for having me and thank you so, so much for this opportunity, for sure.
- [29:46]
B
Well, for my listeners, again, as you listen in, as always, there'll be show notes. You can learn a little bit more about Dr. Makarias as well as the work that she is doing and the foundation that we're talking about today. But I just encourage you, if you're really struggling and really having a hard time, maybe you came in and didn't have onboarding, just like the doctor did not have onboarding, or you're just dealing with resource challenges or donor challenges or staff issues. Whatever it is, take some encouragement from Doris today that she has gone through similar and maybe even more difficult things and she is thriving. So I encourage you to listen a little bit more to her story, find out a little bit more about her. Feel free to reach out and I'm glad you've tuned in today and we will see you next week. Hey friends. Well, I wanted you to know that this podcast can be found on itunes, Spotify, Amazon, Google podcasts, and wherever you listen to other podcasts. I also want to encourage you to like subscribe and share this podcast with others. This will actually help us get this great content out to more nonprofit leaders just like you. You can also join the nonprofit leadership podcast community, find other resources and interviews of past guests, all on my website, nonprofitleadershippodcast.org well, thanks again for listening and until next time, keep making your world better. This podcast is sponsored by DonorBox, DonorBox, helping you help others.