Charismatic Leadership versus Bureaucratic Technicians

I was encouraged to hear Ruth Sensano talk with such enthusiasm, which is not often the case with project directors and personnel. The bureaucracy of projects makes it difficult for technicians to become involved with peasants. Dr. Daniel Rivas, medical director, and Freddy Martinez, program development director, also shared Sensano’s motivation. They believed in the Bolivian people and were dedicated to improving their country. Selfless dedication, persistence, and motivation are as important as funding in making health projects work; however, these leadership qualities are often overlooked in the assessment of health projects.[46]

Sensano’s charismatic style is matriarchal. She follows the teachings of the Catholic church, especially concerning ideas of the Blessed Mother. As a matriarchal leader, Sensano has adapted Catholic teaching to Andean culture, with its prayers and rituals to Pachamama. At every step of a project, she has sprinkled Mother Earth, thrown coca leaves to divine success, and prayed a rosary to the Blessed Mother. The peasants revere this Jacha Mama (Big Mother). When I asked her why she didn’t become a nun like Mother Teresa, she replied that she had to be “top dog” and could never answer to a superior.

Religious motivation in health projects needs careful evaluation. Nongovernmental organizations (NGOs) currently administer health projects in Bolivia. Many projects receive funding from the United States government and other international sources. Some NGOs are religiously driven, so conversion strings are attached to the health care provided. This is one reason for the high rate of conversion to Protestantism among Aymaras of the Altiplano. Another problem with NGOs is their advocacy of other issues, such as family planning, pro‑life positions, and biomedicine. These politically loaded agendas frequently divide the community; they can subvert the goals of Chagas’ prevention and misdirect the project.

Sensano did not attempt to change the beliefs and practices of the peasants. She respected Andean beliefs and recognized the need for rituals. She invited shamans and yachajsto perform rituals at the beginning and end of the project. Her authoritarian style, however, made it difficult for PBCM to coordinate its efforts with other Chagas’ projects in the Department of Chuquisaca. She admits this. However, she finished everything as she had promised, when the estimated rate of unfinished and unsustained development projects is 90 percent. Sensano’s project was attuned to Chuquisaca peasants and was within their reach. This was partially because it fit into a working health program and also because she walked it through, step by step, developing and making it understood without any glitches.