Jos de Blok, founder of Buurtzorg, speaking to us this week via Zoom.
Ashoka
Jos de Blok is a Dutch nurse who founded Buurtzorg, a network of over 8,000 nurses who participate in a model of home care that KPMG found halves costs, improves quality, and makes happier caregivers. Buurtzorg sounded the alarm early and began managing masks and tests nationwide. Ashoka spoke to Jos to learn more.
What were you doing before the emergency of the pandemic turned the world upside down?
Just before the coronavirus, I was working on home treatment—keeping people out of hospitals. I was managing new projects in e-health, and studying Cuba’s approach to preventive medicine.
But by February it was clear that Holland would also be involved in this Corona situation, and we had monitored our partners in China and Taiwan. We received requests from China for masks, but transport shut down before we could send them. When the virus first hit Italy, France, and Spain, Holland asked, Do we have enough intensive-care capacity? Do we have protective materials, masks and such?
Nurses pledging to wear masks was one crucial early decision. We protect ourselves and others and don’t spread the virus among patients. The psychological component is important too. You feel anxiety, you have a family. We can use that anxiety constructively. At least, masks keep us alert—they are an unmistakable reminder. I told the Ministry that its approach was backwards. They focus on managing a shortage of masks rather than prioritizing everyone’s health and protection. Our young volunteers organized an order of masks from a smaller producer in China. They said, “If you order one million, we can increase production. We said, ok!” And we began producing too.
Testing was similar. I spoke to labs that were ready to test but had been overlooked by the government’s preference for the “formal places.” So we worked directly with the labs to make a test available. We did everything outside the formal authorities. Critics complained that we were amassing too much material, so I opened up our acquisitions. Everyone can have it. We have the capacity, but the government has been slow to accept new actors into the system. Now the government is questioning its own response.
What traits and skills do nurses have that are especially important now?
Creativity—finding solutions on the spot. And empathy—sensing what’s happening, feeling what’s really happening here. Nurses solve problems and organize—things get done 24 hours a day. Nurses support each other, care for each other. That’s the feeling. Even amid death, everybody is watching over everybody. It’s not a theory or skill but an organic process which occurs when you value humanity over bureaucracy. You don’t have to do anything—better to let it happen and let it grow. Organic growth and common sense, with health and safety foremost.
And part of empathy is being able to pull together into teams, not relying on the authority of hierarchy but working towards a common purpose. We started a crisis group that meets every day. About 12 people, self-organized, nurses, nurse specialists, nurse practitioners. Then we have an IT expert. Then we have somebody who worked in public health, two in education. We have an excellent filmmaker. We made our own logistics centers and distribution channels. We didn’t think about what’s the structure; everybody takes responsibility. We do daily updates. My two colleagues and I said, “Okay, let’s ask a few people.” Every day I do a vlog or a blog.
Has the pandemic given you an opportunity to innovate?
It’s been an opportunity to gather the wisdom and experience of many people to make a new kind of organization, centrally coordinated but significantly decentralized in terms of ideas and action. We decentralize and delegate. It’s more flexible. We went from never producing masks to becoming a major supplier within weeks. If you saw the speed in making these materials…everybody in the country was making masks. We had families, patients we know through our existing services. Those producing the masks were happy while large buyers were amazed at our capacity to fill their orders.
What is the greatest lesson of the pandemic?
I want to see more of what the younger generation is doing: Finding a new balance in life, finding what matters, focusing on nature, togetherness, feeling responsible for the community, doing things together. Millennials are doing it, asking how to deal with ecology, how to respect vegan, vegetarian. I have three sons. They’re not attracted by money, they want to learn. They are living global lives, now raising families with wives Tanzania, Britain, Brazil. Two work for Buurtzorg. So, how do we integrate cultures instead of separate them? How do we take care of each other?
Jos de Blok started Buurtzorg in 2006 with four nurses. By 2015, when he became an Ashoka Fellow, it had become a self-sustaining network adding 1000 members per year.
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