Mountaineering, vaccine delivery and risk management

By Skye Gilbert 09 June 2015

In Nicaragua, Julio Mesa Zelodon and his son deliver temperature-sensitive rotavirus vaccine by any means necessary just to ensure remote villages receive proper treatment. Photo by: Gates Foundation / CC BY-NC-ND

Earlier this year, I caught up with a mountaineering mentor and former professor of mine from Wharton’s Management Department, Chris Maxwell. As we chatted about our respective lives — from career changes to new mountains summited — he talked to me about a body of research he’s conducting on applying mountaineering principles of leadership to the business world.

During our conversation, I realized that the way in which I assess and manage risk in the mountains closely ties to the way in which I assess and manage risk in my work as a program officer for vaccine delivery.

There are two kinds of risks: the ones we can control and the ones we cannot control. Potential avalanches or loose rock decide whether I summit a mountain, while changes in government and oil prices could play a huge factor in whether my investment succeeds. For these risks, the only decision I can make is whether or not to proceed. I’ve learned that while it’s terrifying to traverse a snow field that might slide, it’s even harder to turn around and go home without reaching a summit.

This is why I chose to ascend Washington’s Lane Peak in the dark last February rather than turn around, and why I make investments in places with less infrastructure and higher ratings on the Corruption Perceptions Index.

Then there are the risks we control, which are almost identical in the mountain climbing and development worlds. This is about who you embark on the journey with, how you prepare and design your route, how you make tactical trade-offs (speed vs. safety gear in the mountains; speed vs. going far together in investments), and how hard you push yourself and the people around you.

In the mountains and in our work, we can control process, if little else.

Last fall I had a new experience in the mountains that I’ve been thinking about a lot. My climbing partner and I were planning to ascend Forbidden Peak in the North Cascades. When we arrived in the basin below the peak, we discovered unexpected dustings of snow and ice on our route, and we had to decide whether to push ahead despite the increased risk of falling, or turn around.

Filled with regret and irrational feelings of failure, we left the summit untouched.

But the weekend didn’t end there. We drove for five hours, grabbed a few hours of sleep in a parking lot, rose at 4 a.m. Sunday morning and — there’s no other way to say this — we joyfully ran up a different mountain. Rather than fighting wind and snow and hardship, we moved with gleeful grace and speed to a safe summit. While the view was not quite as elevated or exciting, the journey was an empowering, almost spiritual experience. It surpassed what the other climb would have been.

My portfolio of investments includes high-risk, snow-dusted bets. My portfolio of investments includes high-risk, snow-dusted bets. One investment, the Better Immunization Data initiative, supports countries to develop, finance and sustain their own solutions to improve data quality and use. But government commitment can change with elections, turnover of senior officials or a restructuring of the Ministry of Health.

Another investment explores ways of reducing reporting burden for countries that feel bogged down by global partner data requests. Successfully reducing reporting burden would mean confronting global agencies, including my own, about our reporting requests and the impact it has on individuals working in country. The investment could anger global partners, oblige us to make investment decisions with even less information than we currently have, and make collaboration with others much more difficult.

I think a lot about the breaking point for these investments — under what conditions would it make sense to get out and walk away? What my experience in the mountains helped me understand is that walking away doesn’t have to be a failure. It might just mean choosing a different summit. For example, we’ve restructured our efforts around reporting burden to begin with streamlining redundant data entry, and everyone agrees on the value of doing this.

By choosing to take on this mountain, the team I’m on on will becomes fast and graceful, able to joyfully run up to the summit together. And while we may one day need to return to harder mountains and higher summits, we’re going to be more successful if we train ourselves to climb with joy.

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About the author

Sgilbert
Skye Gilbert

Skye Gilbert is a program officer on the vaccine delivery team in the Gates Foundation’s Global Development Program. In her current role, Skye focuses on improving the quality, availability and use of immunization data to inform decision-making at all levels of the health system.


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