TanakaS?£o Paulo State sits along the Atlantic coastline of Brazil, just south of Rio de Janeiro. Originally a highly productive coffee plantation state, it is now the industrial and financial center of Brazil, generating more than 30 percent of the GNP.

Dr. Oswaldo Tanaka works and resides in the capitol, S?£o Paulo, which sits 45 miles inland on a plateau. The city of close to 10 million people is one of the largest in the world, and the metropolitan area of close to 18 million people is certainly the largest in South America. Here, Tanaka (as he prefers to be called) serves as Deputy Secretary of Health for the State of S?£o Paulo. His primary charge in this populous area of the country is to develop competence and skills in health workers to allow better service delivery‚, in both volume and quality.

In his role, Tanaka is involved in implementing evaluation as a managerial tool in various levels of the health system to aid in the decision-making process. In working to bring about these improvements, Tanaka strives to invite all points of view and uncover the motivations that will mobilize health professionals.

‚”In any field, the most important thing is to choose strategies to mobilize resources‚, human, material, and financial,‚” Tanaka explains. ‚”The best approach is to listen carefully, try to understand what others have to teach, and uncover what actual motivations there are to deal with the problems we face.‚”

In servicing 37 million people living in S?£o Paulo State, he has had to face political pressure from those advocating for health services that are not cost-effective. ‚”Today, health is a big challenge because it is expected to be provided by the state,‚” he says. ‚”The highly technological procedures have been extremely expensive and they compete with the primary health care needs. To balance between those needs has been the most difficult challenge.‚”

The relationships that Tanaka is able to build from each contact he has in his personal and professional life help sustain him in his work. Even in crisis situations that have called for his leadership, he acknowledges the opportunities presented in building human capital. ‚”A crisis is always an opportunity to grow‚, to understand life. It is there for our growing process.‚” He advises, ‚”Go deeply in any crisis that presents itself.‚”

Tanaka attributes the milestones he has achieved in his career to his experience with the Kellogg International Fellowship Program. ‚”Leadership is a process of relationship construction,‚” he says. ‚”The opportunity the Kellogg International Leadership Program provided me to learn to respect different values and ways of thinking opened up new possibilities to me. To be able to listen respectfully and learn from others brings about success.‚” [9-04]