Leading NIP through a crisis
When I joined the Namibia Institute of Pathology (NIP) in February 2021, I returned to a principle that has shaped my professional life: leadership is ultimately measured by its impact on people. During my tenure, that principle guided decisions about laboratory capacity, institutional resilience and the speed at which patients could access results on which their care depended.
I began my career as a professional nurse after four years of studies at UNAM. The profession taught me skills that have remained relevant to leadership: teamwork, through collaboration among doctors, nurses, patients and families; listening, including hearing the concerns of patients; remaining composed when circumstances are difficult; making decisions based on evidence; and, above all, remembering that behind every case, statistic or diagnosis is a person whose life may depend on a critical decision.
Those lessons followed me through subsequent roles at the Legal Assistance Centre, the Attorney General’s Office, Namibia University of Science and Technology, the Motor Vehicle Assistance Fund, Business Intellectual Property Authority and, ultimately, the Namibia Institute of Pathology. Each institution gave me a different perspective on leadership, governance, service delivery and institutional resilience, preparing me for the responsibilities of CEO at NIP.
As my career progressed, I continued my education, pursuing an LLB, a Master’s degree in Law & Business and other postgraduate qualifications. These strengthened my understanding of governance, risk, compliance, business strategy and the legal environment within which organisations operate. The disciplines may appear different, but together they informed my approach to leadership.
At NIP, the experience I had accumulated over the years was tested in circumstances I had not anticipated. I took office as CEO in February 2021, at the height of the COVID-19 pandemic, when NIP had no substantive executive leadership team and laboratories around the world were under significant pressure.
At the time, Namibia depended on international laboratory capacity for COVID-19 sequencing and some critical tests. For other tests, blood samples sometimes had to leave the country before results could return to clinicians, delaying decisions about a patient’s care. I kept returning to one question: Why should a patient have to wait for another country to confirm what their own health system needed to deliver?
“In those early days, I carried the patient’s waiting with me into every meeting.”
During my tenure at NIP, we focused on expanding and maintaining laboratory capacity. We expanded regional diagnostic capability, introduced new tests, decentralised testing, improved sample transportation and logistics, and established genomic sequencing capacity. Ageing infrastructure was renewed, supply-chain and logistics processes were reviewed, turnaround times improved, and ICT infrastructure and systems were upgraded to enable clinicians to receive results more quickly.
The measure of this work was not only in the targets themselves. It was also whether patients across the country could access laboratory services, whether doctors could make treatment decisions with greater certainty, and whether Namibia could reduce its dependence on external laboratory capacity. The work continues.
The public often sees the healthcare system through its hospitals, doctors and nurses. Yet diagnosis also depends on scientists, medical technologists, transport systems, quality controls and laboratories. NIP is part of that infrastructure. Although much of its work takes place out of public view, its services support diagnosis and treatment across the health system.
I worked with a team of professionals who understood NIP’s role in the health system. Together, we worked to improve institutional performance. Testing turnaround times improved from 59% to 93%. This required changes to processes, infrastructure, staffing and the way services were coordinated across the institution.
We strengthened leadership development, provided scholarships for targeted specialist training and introduced a graduate development programme to support 13 laboratories that had operated with one employee before my time. Through collaboration with the University of Namibia, pathology and medical science specialisations are also expected to be offered locally soon.
The COVID-19 pandemic exposed the risks countries face when essential supplies and expertise depend on sources outside their borders. That experience informed the establishment of NIP’s Medical Innovation Hub in Swakopmund, with the aim of developing local medical manufacturing capacity. The hub was intended to contribute to local skills development, employment, innovation and the ability to produce some of the commodities required by Namibia’s health system.
Its objective was straightforward: “Namibia must locally produce commodities and develop expertise required to sustain its own health system for a better tomorrow.”
I am proud of the work undertaken during my tenure, but institutional leadership also involves difficult decisions and public scrutiny. Public institutions exist to serve the public interest, and their leaders must be prepared to explain and account for the decisions they make. Accountability is part of the responsibility that comes with occupying a position of trust.
My years at NIP reinforced another lesson from nursing: you cannot treat what you are unwilling to diagnose. Institutions, like patients, require an honest assessment of what is working, what is not and what must change. Sustainable improvement requires the willingness to confront those realities and the discipline to act — particularly in a public health system on which more than 80% of Namibians rely for medical care.
NIP should not merely be viewed as another parastatal. Its work is connected to Namibia’s broader development objectives and to the United Nations’ third Sustainable Development Goal: ensuring healthy lives and promoting well-being for all. Public health is not only a service obligation; it is also part of the infrastructure required for sustainable development.
Kapena Tjombonde is the former chief executive officer of the Namibia Institute of Pathology and a transformationalist. She writes in her personal capacity.
