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Contributors
Jennifer Bellot, PhD, RN, MHSA, CNE, Associate Professor and
Director, DNP Program, Jefferson College of Nursing, Thomas
Jefferson University, Philadelphia, Pennsylvania

Jane M. Brokel, PhD, RN, Section Instructor, Online Nursing,

Simmons College, Adjunct Faculty, College of Nursing, University
of Iowa, President, NANDA International, Inc., Registered Nurse,
Parish Nursing Cluster Parishes and Accurate Home Care

Marie-Hélène Budworth, PhD, MS, BA, Associate Professor of

Human Resource Management, Director, School of Human
Resource Management, York University, Toronto, Ontario, Canada

Lynn Christensen, MSN, RN, Safety and Emergency Management

Officer, Inova Loudoun Hospital, Leesburg, Virginia

Sean P. Clarke, PhD, RN, FAAN, Professor and Associate Dean,

Undergraduate Program, Connell School of Nursing, Boston College,
Chestnut Hill, Massachusetts

Karen S. Cox, PD, RN, FACHE, FAAN, Executive Vice

President/Chief Operating Officer, V. Fred Burry, MD, and Sandra
Hobart Burry Chair in Nursing Advocacy and Leadership, Children’s
Mercy Hospital, Kansas City, Missouri
Kathleen B. Cox, PhD, RN, Associate Director, School of Nursing,
Radford University, Radford, Virginia

Laura Cullen, DNP, RN, FAAN, Evidence-Based Practice Scientist,

Office of Nursing Research, Evidence-Based Practice and Quality,
Department of Nursing Services and Patient Care, University of Iowa
Hospitals and Clinics, Iowa City, Iowa

Cindy J. Dawson, MSN, RN, CORLN, Director, Clinical Functions

Ambulatory Nursing, University of Iowa Hospitals and Clinics, Iowa
City, Iowa

Elizabeth T. Dugan, PhD, RN, MBA, MSN, NEA-BC, Chief

Nursing Officer, Inova Loudoun Hospital, Leesburg, Virginia

Michele Farrington, BSN, RN, CPHON, Clinical Healthcare

Research Associate, Office of Nursing Research, Evidence-Based
Practice and Quality and Ambulatory Nursing, University of Iowa
Hospitals and Clinics, Iowa City, Iowa

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, Principal,

EFS Supervision Strategies, LLC, Burke, Virginia

Betsy Frank, PhD, RN, ANEF, Professor Emerita, School of

Nursing, Indiana State University, Terre Haute, Indiana

Maryanne Garon, DNSc, RN, Professor and Nursing Leadership

Concentration Coordinator, California State University, Fullerton,
Fullerton, California

Gregory O. Ginn, BA, MEd, MBA, PhD, Adjunct Assistant

Professor, Embry-Riddle Aeronautical University–Worldwide,
Daytona Beach, Florida

Kirsten Hanrahan, DNP, ARNP, Nurse Scientist, Office of Nursing

Research, Evidence-Based Practice and Quality, Department of
Nursing and Patient Care Services, University of Iowa Hospitals and
Clinics, Iowa City, Iowa

Mary G. Harper, PhD, RN-BC, Director of Nursing Professional

Development, Association for Nursing Professional Development,
Flagler Beach, Florida

Farinaz Havaei, PhD, PhD Candidate, School of Nursing,

University of British Columbia, Vancouver, British Columbia, Canada

L. Jean Henry, PhD, Associate Professor, Public

Health/Community Health Promotion, College of Education and
Health Professions, University of Arkansas, Fayetteville, Arkansas

Julie A. Holt, RN, MSN, CENP, Vice President, Patient

Services, Chief Nurse Executive, The Christ Hospital Health
Network, Cincinnati, Ohio

Cheryl Hoying, PhD, RN, NEA-BC, FACHE, FAAN, Senior Vice

President, Patient Services Division, Cincinnati Children’s Hospital
Medical Center, Associate Dean, College of Nursing, University of
Cincinnati, Cincinnati, Ohio
Lianne Jeffs, PhD, RN, FAAN, St. Michael’s Hospital Volunteer
Association Chair in Nursing Research, Scientist, Keenan Research
Centre of the Li Ka Shing Knowledge Institute, Associate Professor,
Lawrence Bloomberg Faculty of Nursing and Institute of Health
Policy Management and Evaluation, University of Toronto, Toronto,
Ontario, Canada

M. Lindell Joseph, PhD, RN, Associate Clinical Professor and

MSN/CNL Program Coordinator, College of Nursing, University of
Iowa, Iowa City, Iowa

Jayne Josephsen, EdD, MS, RN, CHPN, Associate Professor,

School of Nursing, Boise State University, Boise, Idaho

Susan R. Lacey, PhD, RN, FAAN, Professor, College of Nursing,

Medical University of South Carolina, Charleston, South Carolina

Trudy A. Laffoon, MA, RN-BC, Nurse Manager, Pain

Management and Medicine Specialty Clinics, University of Iowa
Hospitals and Clinics, Iowa City, Iowa

Michael Soon Lee, DBA, MBA, BA, President, EthnoConnect®,

Member, National Speakers Association, Dublin, California

Maura MacPhee, PhD, RN, Associate Professor, School of

Nursing, Associate Director, Undergraduate Nursing Program,
University of British Columbia, Vancouver, British Columbia, Canada
Lynn S. Muller, JD, RN, CCM, BA-HCM, Partner, Muller &
Muller, Attorneys at Law, Adjunct Professor, School of Nursing,
Saint Peter’s University, Englewood Cliffs, New Jersey

Nathan Neis, DNP, CPNP-AC, Nurse Practitioner, PICU/CICU at

Children’s Hospital of Wisconsin, Milwaukee, Wisconsin

Adrienne Olney, MS, Research Associate, Children’s Mercy

Hospitals and Clinics, Kansas City, Missouri

Anne Gallagher Peach, RN, MSN, NEA-BC, Partner, Future

Vision Group, Orlando, Florida

Luc R. Pelletier, MSN, APRN, PMHCNS-BC, FAAN, CPHQ,

FNAHQ, Senior Nursing Specialist, Sharp Mesa Vista
Hospital, Adjunct Professor, National University, San Diego,
California

Slimen Saliba, PhD, MBA, MA, BA, Senior Vice President of

Marketing, Adventist Health System–Florida Division, Orlando,
Florida

Teresa Kathleen Sparks, JD, MSN, BSN, RN, Faculty, MHCA and
BSN Programs, College of Health Sciences, University of Arkansas,
Fort Smith, Fort Smith, Arkansas

Abdullah S. Suhemat, BScN, MSN, Lawrence S. Bloomberg

Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
Linda B. Talley, MS, BSN, RN, NE-BC, Vice President and Chief
Nursing Officer, Children’s National Health System, Washington, DC

Diane H. Thorgrimson, MHSA, BS, Executive Director, Workforce

Planning, Special Projects, and Productivity for Patient Services,
Children’s National Health System, Washington, DC

Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC,

CCM, Principal and Case Manager, Ascent Care Management, LLC,
Quincy, Massachusetts

Kathleen A. Vertino, DNP, PMHNP-BC, CARN-AP, Board-

Certified Nurse Practitioner, Psychiatry, Buffalo, New York

Carol A. Wong, PhD, RN, Associate Professor, Arthur Labatt

Family School of Nursing, Faculty of Health Sciences, Western
University, London, Ontario, Canada
Reviewers
Karen E. Alexander, PhD, RN, CNOR, Director, RN-BSN, and
Assistant Professor, Department of Clinical Health and Applied
Sciences—Nursing, University of Houston Clear Lake, Houston, Texas
Barbara B. Blozen, EdD, MA, RN, BC, CNL, Associate Professor,
Department of Nursing, New Jersey City University, Jersey City, New
Jersey
Lori Jo Bork, PhD, RN, MS, BSN, CCRN, Professor of Nursing,
Department of Nursing, Dakota Wesleyan University, Mitchell, South
Dakota
Karen Brown-Fackler, RN, EdD, NEA-BC, CNL, CNE, Associate
Professor of Nursing, Department of Nursing, Saginaw Valley State
University, University Center, Michigan
Beverly Waller Dabney, PhD, RN, CCM, Associate Professor of
Nursing, Department of Nursing, Southwestern Adventist University,
Keene, Texas
Rebecca M. Davidson, PhD, MSN, RN, Instructor of Nursing, Caylor
School of Nursing, Lincoln Memorial University, Knoxville, Tennessee
Richard C. Meeks, DNP, RN, COI, Assistant Professor, School of
Nursing, Middle Tennessee State University, Murfreesboro, Tennessee
Barbara J. Pinekenstein, DNP, RN-BC, CPHIMS, Clinical Professor,
Richard E. Sinaiko Professor in Health Care Leadership, University of
Wisconsin, Madison, Madison, Wisconsin
Darlene M. Rogers, MSN, BS, RN-BC, Clinical Instructor, Georgia
Baptist College of Nursing, Mercer University, Atlanta, Georgia
Preface
Strong leadership and care management are imperatives for nursing.
Highlighted by a series of reports from the prestigious Institute of
Medicine (IOM; now called the National Academies of Sciences,
Engineering, and Medicine, Health and Medicine Division)—most
recently The Future of Nursing: Leading Change, Advancing Health—it is
clear that nurses matter to health care delivery systems. Yet the
United States is in the midst of a continuing and projected nurse
shortage. Strong nurse leaders and managers are important for clients
(and their safety), delivery systems (and their viability), and payers
(and their solvency). Pressures remain to balance cost and quality
considerations in a complex, chaotic, and turbulent health care
environment.
Although society’s need for excellent nursing care remains the
nurse’s constant underlying reason for existence, nursing is in reality
much more than that. Because nurses offer cost-effective expertise in
solving problems related to the coordination and delivery of health
care to individuals and populations in society, they have become a
crucial linchpin in health care delivery and are highly valued. Nurses
are well prepared to lead clinical change strategies and effectively
manage the coordination and integration of interdisciplinary teams,
population needs, and systems of care across the continuum. This has
been especially important following implementation of the 2010
Patient Protection and Affordable Care Act (ACA), and nurses are
needed to address care coordination and integration across the health
care delivery system.
It can be argued that nursing is a unique profession in which the
primary focus is caring—giving and managing the care that clients
need. Thus nurses are both health care providers and health care
coordinators; that is, they have both clinical and managerial role
components. Beginning with the first edition of Leadership & Nursing
Care Management, it has been this text’s philosophy that these two
components can be discussed separately but in fact overlap. Because
all nurses are involved in coordinating client care, leadership and
management principles are a part of the core competencies they need
to function in a complex health care environment.
The turbulent swirl of change in this country’s health care industry
has become a paradigm shift that has provided both challenges and
opportunities for nursing. Nurses need a stronger background in
nursing leadership and care management to be prepared for
contemporary and future nursing practice. As nurses mature in
advanced practice roles and as the health care delivery system
restructures, nurses will become increasingly pivotal to cost-effective
health care delivery. Research is bearing this out. Leadership and
management are crucial skills and abilities for complex and integrated
community and regional networks that employ and deploy nurses to
provide health care services to clients and communities.
Today’s nurses are expected to be able to lead and manage care
across the health care continuum—a radically different approach to
nursing from what has been the norm for hospital staff nursing
practice. In all settings, including both nurse-run and interdisciplinary
clinics, nursing leadership and management are complementary skills
that add value to solid clinical care and patient- and client-oriented
practice. Thus there is an urgent need to advance nurses’ knowledge
and skills in leadership and management. In addition, nurses who are
expected to make and implement day-to-day management decisions
need to know how these precepts can be practically applied to the
organization and delivery of nursing care in a way that conserves
scarce resources, reduces costs, and maintains or improves quality of
care. This is the emphasis on adding value, innovation, and
prevention interventions.
The primary modality for health care in the United States has
moved away from acute care hospitalization. As prevention, wellness,
and alternative sites for care delivery become more important,
nursing’s already rich experiential tradition of practice in these
settings is emerging. This text reflects this contemporary trend by
blending the hospital and nonhospital perspectives with an eye
toward systems leadership and management.
Purpose and audience
The intent of this text is to provide both a broad introduction to the
field and a synthesis of the knowledge base and skills related to both
nursing leadership and nursing care management. It is an evidence-
based blend of practice and theory that breaks new ground by
explaining the intersection of nursing care with leading people and
managing organizations and systems. It highlights the evidence base
for care management. It combines traditional management
perspectives and theory with contemporary health care trends and
issues and consistently integrates leadership and management
concepts. These concepts are illustrated and made relevant by
practice-based examples.
The impetus for writing this text comes from teaching both
undergraduate and graduate students in nursing leadership and
management and from perceiving the need for a comprehensive,
practice-based textbook that blends and integrates leadership and
management into an understandable and applicable whole.
Therefore the main goal of Leadership & Nursing Care Management is
twofold: (1) to clearly differentiate traditional leadership and
management perspectives and (2) to relate them in an integrated way
with contemporary nursing trends and practice applications. This
textbook is designed to serve the needs of nurses and nursing students
who seek a foundation in the principles of leading and coordinating
nursing services in relation to client care, peers, superiors, and
subordinates.
Organization and coverage
This sixth edition continues the format first used with the third
edition. The first two editions were Dr. Huber’s single-authored texts.
The edited book approach draws together the best thinking of experts
in the field—both nurses and non-nurses—to enrich and deepen the
presentation of core essential knowledge and skills. Beginning with
the first edition, a hallmark of Leadership & Nursing Care Management
has been its depth of coverage, its comprehensiveness, and its strong
evidence-based foundation. This sixth edition continues the emphasis
on explaining theory in an easily understandable way to enhance
comprehension.
The content of this sixth edition has been reorganized and refreshed
to integrate leadership and care management topics with the nurse
executive leadership competencies of the 2015 American Organization
of Nurse Executives (AONE) while revamping, refocusing, and
synthesizing the content. AONE has identified the evidence-based
core competencies in the field, and the content of this book has been
aligned accordingly to reflect the knowledge underlying quality
management of nursing services. This will help the reader develop the
crucial skills and knowledge needed for core competencies.
The organizational framework of this book groups the 27 chapters
into the following five parts:
Part I: Leadership aligns with the AONE competency category of
the same name and provides an orientation to the basic principles of
both leadership and management. Part I contains chapters on
Leadership and Management Principles, Change and Innovation, and
Organizational Climate and Culture.
Part II: Professionalism aligns with the AONE competency
category of the same name and addresses the nurse’s role and career
development. The reader is prompted to examine the role of the nurse
leader and manager. Part II discusses the content areas of Managerial
Decision Making, Managing Time and Stress, and Legal and Ethical
Issues.
 Part III: Communication and Relationship Building aligns with
the AONE competency category of the same name. Part III focuses on
Communication Leadership, Team Building and Working With
Effective Groups, Delegation in Nursing, Power and Conflict, and
Workplace Diversity. These are essential knowledge and skill areas for
nurse leaders and managers as they work with and through others in
care delivery.
Part IV: Knowledge of the Health Care Environment covers the
AONE competency category of the same name and features a broad
array of chapters. Part IV encompasses Organizational Structure,
Decentralization and Shared Governance, Strategic Management,
Professional Practice Models, Case and Population Health
Management, Evidence-Based Practice: Strategies for Nursing
Leaders, Quality and Safety, and Measuring and Managing Outcomes.
This discussion highlights the importance of understanding the health
care organizational structures within which nursing care delivery
must operate. This section includes information on traditional
organizational theory, professional practice models, and the dynamics
of decentralized and shared governance.
Part V: Business Skills aligns with the AONE competency category
on business skills and principles and contains an extensive grouping
of chapters related to Prevention of Workplace Violence; Confronting
the Nursing Shortage; Staffing and Scheduling; Budgeting,
Productivity, and Costing Out Nursing; Performance Appraisal;
Emergency Management and Preparedness; Data Management and
Clinical Informatics; and Marketing. These chapters discuss the
opportunities and challenges for the nurse leader-manager when
dealing with the health care workforce. The wide range of human
resource responsibilities of nurse managers is reviewed, and resources
for further study are provided. The significant share of scarce
organization budgets consumed by the human resources of an
institution makes this area of management a key challenge that
requires intricate skills in leadership and management. This section
examines some of the important factors that nurse leader-managers
must consider in the nursing and health care environment. Also in
this section are chapters that build on organizational theory and
demonstrate the importance of integrating organizations and systems
with the current technology and theory applications, including data
management and informatics, strategic management, and marketing.
The 27 chapters in this text are organized in a consistent format that
highlights the following features:

• Concept definitions

• Theoretical and research background

• Leadership and management implications

• Current issues and trends

• Case Studies and Critical Thinking Exercises

• Research Notes

This format is designed to bridge the gap between theory and

practice and to increase the relevance of nursing leadership and
management by demonstrating the way in which theory translates
into behaviors appropriate to contemporary leadership and nursing
care management.
Text features
This book contains several interesting and effective aids to readers’
comprehension, critical thinking, and application.

Critical thinking exercises

Found at the end of each chapter, this feature challenges readers to
inquire and reflect, analyze critically the knowledge presented, and
apply it to the situation.

Research notes
These summaries of current research studies are highlighted in every
chapter and introduce the reader to the liveliness and applicability of
the available literature in nursing leadership and management.

Case studies
Found at the end of each chapter, these vignettes introduce the reader
to the “real world” of nursing leadership and management and
demonstrate the ways in which the chapter concepts operate in
specific situations. These vignettes show the creativity and energy that
characterize expert nurse administrators as they tackle issues in
practice.
Learning and teaching AIDS
For students
The Evolve Student Resources for this book include the following:

• NCLEX Review Questions, including rationales and page references

For instructors
The Evolve Instructor Resources for this book include the following:

• TEACH for Nurses lesson plans, based on textbook chapter Learning

Objectives, serve as ready-made, modifiable lesson plans and a
complete roadmap to link all parts of the educational package.
These concise and straightforward lesson plans can be modified or
combined to meet your particular scheduling and teaching needs.

• Test Bank in ExamView format, featuring over 650 test items,

complete with correct answer, rationale, cognitive level, nursing
process step, appropriate NCLEX label, and corresponding textbook
page references. The ExamView program allows instructors to
create new tests; edit, add, and delete test questions; sort questions
by NCLEX category, cognitive level, and nursing process step; and
administer and grade tests online.

• PowerPoint Presentations with more than 650 customizable lecture

slides.

• Audience Response Questions for i-clicker and other systems with two
to three multiple-answer questions per chapter to stimulate class
discussion and assess student understanding of key concepts.
Acknowledgments
This book is dedicated to my husband, Bob Huber. He made this book
a reality and was the text and graphics support behind it through the
fifth edition. For his love, caring, and support I am eternally grateful.
To my children, Brad Gardner and Lisa Witte, and their spouses,
Nonalee Gardner and John Witte, for their enthusiasm and love. I am
forever privileged that they are in my life. I thank them for the gifts of
Kathryn Anne Gardner (the Princess), Anthony James Gardner (A.J.),
Logan Thomas Witte, and Olivia Morgan Witte. I love being Grandma
to these wonderful people. Also special are Chris Huber; Beth Nau
and grandchildren Brandon, Danielle, Creighton, Chloe, and the late
Cameron Nau; and Von and Kirk Danielson and Kory, Ryan, and Sean
Danielson.
To my professional colleagues who inspired me and served as
examples of excellence in nursing, I am grateful that you are in my
life. To my nursing students, past and future, my thanks for being a
source of continual intellectual stimulation and challenge. To all of
you who have read and used this book, thank you. It is so very
humbling and heartwarming when you mention this to me as we
intersect on professional pathways. I am glad it is of use to you.
This book’s first two editions evolved under the tender care of
Thomas Eoyang, former editorial manager at W.B. Saunders
Company, whose guidance, support, and caring were invaluable. To
the editors in the Elsevier Nursing Division who worked so hard to
facilitate everything related to the sixth edition, and to the excellent
staff at Elsevier, a sincere thank you.

Diane L. Huber
PA R T I
Leadership
OUTLINE

1. Leadership and management principles

2. Change and innovation

3. Organizational climate and culture

CHAPTER 1
Leadership and management
principles
Diane L. Huber

http://evolve.elsevier.com/Huber/leadership

Health care is predicted to be in for a “bumpy ride” in the near future

(Curtin, 2016). Both the practice of health care professionals and the
effectiveness of organizations are affected by change, complexity, and
environmental turbulence. The twin skills of leadership and
management are crucial to nurses’ effectiveness and organizational
survival. There is an evidence base of knowledge about leadership
and management, and both can be learned.
Issues of cost, access, methods and structures of care delivery, and
quality form the broader context of health care. The effect on nursing
is an urgent need for leadership and management at all levels and
places where nurses work. With 2.9 million licensed registered nurses
(RNs) in the United States (Bureau of Health Professions [BHPr],
2014), RNs are the largest segment of the health care workforce.
Strong and prepared leaders are needed to guide their practice.
Leading and managing are essential skills, made more acutely urgent
given health care system characteristics of rapid change, complexity,
and chaos.
The BHPr, (2014) noted that the rapidly changing health care
delivery system is redefining both how care is delivered and the role
of the nursing workforce. Emerging care delivery models, with a focus
on managing health status and preventing acute health issues, will
likely contribute to new growth in demand for nurses as they assume
new and/or expanded roles in preventive care and care coordination.
Supply and demand for nurses will continue to be affected by
numerous factors, including population growth and the aging of the
nation’s population, overall economic conditions, aging of the nursing
workforce, and changes in health care reimbursement.
Leaders guide and motivate nurses to achieve their care provision
goals as they practice nursing. Managers organize and guide nurses’
work in organizations where they practice. Together the result is
structures and processes that deliver desired outcomes. For the health
care system, there are two predominant sets of desired outcomes. The
first is the six aims for improvement of the Institute of Medicine (IOM,
called the National Academies of Sciences, Engineering, and
Medicine, Health and Medicine Division, since 2016) (IOM, 2001):
Health care needs to be safe, effective, patient centered, timely,
efficient, and equitable. The second is the Institute for Healthcare
Improvement’s (IHI, 2016) Triple Aim: Health care needs to
simultaneously improve the health of the population, enhance the
experience and the outcomes of the patient, and reduce per capita cost
of care to benefit communities. The major national leadership
initiatives in nursing are the IOM’s (2011) report The Future of Nursing:
Leading Change, Advancing Health and the Magnet Recognition
Program® (American Nurses Credentialing Center [ANCC], 2016a). As
nurses seek to embed themselves and grow in jobs and careers within
health care services, leadership and management knowledge, skills,
and abilities are important to overall effectiveness.
In nursing, leadership is studied as a way to increase the
knowledge, skills, and abilities that nurses need to facilitate clinical
and administrative outcomes while working with people across a
variety of situations, settings, and sites. Effective leadership can also
increase understanding and control of nurses’ professional work
settings. There is a long history, rich literature, and evidence base
regarding leadership theories, much of it from outside of nursing.
Nursing has drawn from both classic and contemporary thinkers.
For example, Bennis (1994) made a strong argument for leadership,
stating that quality of life depends on the quality of leaders. He noted
three reasons why leaders are important: the character of change in
society, the de-emphasis on integrity in institutions, and the
responsibility for the effectiveness of organizations. Fiedler and Garcia
(1987) argued that leadership is one of the most important factors
determining the survival and success of groups and organizations.
Effective leadership is also important in nursing, specifically because of
its impact on the quality of nurses’ work lives, because it functions as
a stabilizing influence during constant change, and because it
underpins nurses’ productivity and quality of care delivery.
Nurse leaders and managers are responsible for designing,
developing, implementing, and sustaining the organizational
infrastructure and environment that enable both large- and small-
scale interventions for quality and safety. Research has shown that
there are organizational and cultural factors that mediate hospital or
system-wide interventions. These include the prevailing culture, such
as being patient centered and having available effort and resources;
human relationships, including leadership styles and teamwork; and
an approach used for routine monitoring of systems and services
(Clay-Williams et al., 2014; Stetler et al., 2014).
This chapter presents definitions and a detailed overview of both
leadership and management. Theories are reviewed and important
elements are discussed. Leadership and management implications
and issues for nurses are presented, and practical examples are used
to explain the content.

Definitions
There are a variety of definitions of leadership, one of which is the
process of influencing people to accomplish goals. Key concepts
related to leadership are influence, vision, communication, group
process, goal attainment, and motivation. Hersey and colleagues
(2013) defined leadership as a process of influencing the behavior of
either an individual or a group, regardless of the reason, in an effort to
achieve goals in a given situation. Burns (1978) noted that leadership
occurs when human beings with motives and purposes mobilize in
competition or conflict with others to arouse, engage, and satisfy
motives. Leaders “mobilize others to want to make extraordinary
things happen in organizations” (Kouzes & Posner, 2012, p. 2).
Most leadership definitions incorporate the two components of an
interaction among people and the process of influencing. Thus
leadership is a social exchange phenomenon. At its core, leadership is
about influencing people. In contrast, management involves
influencing employees to meet an organization’s goals and is focused
primarily on organizational goals and objectives. Bennis (1994) listed a
number of distinctions between leadership and management. He
noted that the leader focuses on people, whereas the manager focuses
on systems and structures. The leader innovates and conquers the
context or situation. Another distinction is that a leader innovates,
whereas a manager administers. Kotter (2001) noted that managers
cope with complexity, whereas leaders cope with change.
Management is defined as the coordination and integration of
resources through planning, organizing, coordinating, directing, and
controlling to accomplish specific institutional goals and objectives.
Hersey and colleagues (2013, p. 3) defined management as the
“process of working with and through individuals and groups and
other resources (such as equipment, capital, and technology) to
accomplish organizational goals.” They identified management as a
special kind of leadership that concentrates on the achievement of
organizational goals.

Leadership and care management

differentiated
Leadership theory is often discussed separately from management
theory. Some say leadership and management are two very different
things. Yet clearly there is overlap in that an individual can be both
leading and managing in some cases. The area of overlap may not be
clear or explained. The premise of this book is that leadership and
management are not identical ideas. This can be seen in their distinct
definitions, yet sometimes they occur together or via multitasking.
If the delivery of nursing services involves the organization and
coordination of complex activities in the human services realm, then
both leadership and management are important elements. The
leader’s focus is on people; the manager focuses on systems and
structure (Bennis, 1994). Thus, although both are used to accomplish
goals, each has a different focus. Management is focused on task
accomplishment, and leadership is focused on human relationship
aspects. They may be sequential, and they are interrelated. Clearly, a
balance of the two is necessary. Leadership and management have
some shared characteristics. There is a “gray area” in which the focus
of their outcomes overlap. In this area of overlap, the processes and
strategies look similar and may be employed for a similar outcome or
blended together to accomplish goals. This overlap occurs where the
two processes are integrated or synthesized to accomplish goals and
where the same strategies are employed even though the goals may
differ. For example, a nurse may use leadership strategies or
management strategies to motivate others, but the desired outcome of
the motivation is likely to be different. For example, leadership may
be used to empower nurses and management to reduce costs.
Leadership and management are equally important processes.
Because they each have a different focus, their importance varies
according to what is needed in a specific situation. Hersey and
colleagues (2013) thought that leadership was a broader concept than
management. They described management as a special kind of
leadership. This view would position management as a part of
leadership, not as a distinct concept. However, according to the
definitions, characteristics, and processes, the concepts of leadership
and management are different; but at the area of overlap they look
similar. For example, directing occurs in both leadership and
management activities (the area of overlap), whereas inspiring a
vision is clearly a leadership function. Both leadership and
management are necessary. Mintzberg’s (1994) idea was that nursing
management occurred in an interactive model rather than through a
stepwise linear process. The interactive nature of both leadership and
management make relationships and relationship building
fundamental elements. “Transformational change happens one
relationship at a time” (Koloroutis, 2004).
Jennings and colleagues (2007) took an evidence-based approach to
differentiating nursing leadership from management to identify
discrete competencies through an integrative content analysis of the
literature base. In 140 articles reviewed, they found 894 competencies,
of which 862 (96%) were common to both leadership and
management. Thus the overlap area appeared to be larger than
previously thought. However, leadership and management do serve
distinct purposes. Perhaps it is time to apply leadership and
management concepts and competencies by setting, level of role
responsibility, career stage, and social context to more fully apply the
evidence base to practice. For example, the American Organization of
Nurse Executives (AONE) (2015) has begun this work by
promulgating two levels of administrative competencies: nurse
manager and nurse executive.

Leadership overview
Leadership is an activity of human engagement and a relationship
experience founded in trust, communication, inspiration, action, and
“servanthood.” The leadership role is so important because it
embodies commitment and forward-reaching action. Arising from a
drive to make things better, leaders use their power to bring teams
together, spark innovation, create positive communication, and drive
forward toward group goals.
Leadership is important to study, learn, and practice in today’s
complex, rapidly changing, turbulent, and chaotic health care work
environment. Such an environment generates challenges to the nurse’s
identity, coping skills, and ability to work with others in harmony. It
also presents the opportunity to lead, challenge assumptions,
consolidate a purpose, and move a vision forward. Leadership is
important for nurses because they need to possess knowledge and
skills in the art and science of solving problems in work groups,
systems of care, and the environment of care delivery. The
effectiveness of an individual nurse depends partly on that
individual’s competence and partly on the creation of a facilitating
environment that contains sufficient resources to accomplish goals.
This is an underappreciated reality when it is assumed that results
occur from only individual competence and effort. However, health
care delivery is a team effort.
The nurse leader combines clinical, administrative, financial, and
operational skills to solve problems in the care environment so that
nurses can provide cost-effective care in a way that is satisfying and
health promoting for patients and clients. Such an environment does
not simply happen; it requires special skills and the courage and
motivation to move a vision into action. For example, it may be easier
to continue on the way things have always been done, but this
strategy would not capture the advantages of new innovations. Thus
the study of nursing leadership and care management directs critical
thinking toward what it takes to be a nursing “environment architect,”
transition leader, and manager of care delivery services.
Strong evidence for the nurse leader’s critical role both in the
business of a health care organization and in the quality and safety of
service delivery has been laid out by the IOM (2004), the ANCC’s
Magnet Recognition Program® (ANCC, 2016a), and the AONE (2015).
The IOM focuses on the following five areas of management practice:

• Implementing evidence-based management

• Balancing tensions between efficiency and reliability

• Creating and sustaining trust

• Actively managing the change process through communication,

feedback, training, sustained effort and attention, and worker
involvement

• Creating a learning environment

The ANCC’s Magnet program acknowledges excellence in nursing

services and leadership based on five components: transformational
leadership, structural empowerment, new knowledge, exemplary
Another random document with
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 DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI

Newala, too, suffers from the distance of its water-supply—at least

the Newala of to-day does; there was once another Newala in a lovely
valley at the foot of the plateau. I visited it and found scarcely a trace
of houses, only a Christian cemetery, with the graves of several
missionaries and their converts, remaining as a monument of its
former glories. But the surroundings are wonderfully beautiful. A
thick grove of splendid mango-trees closes in the weather-worn
crosses and headstones; behind them, combining the useful and the
agreeable, is a whole plantation of lemon-trees covered with ripe
fruit; not the small African kind, but a much larger and also juicier
imported variety, which drops into the hands of the passing traveller,
without calling for any exertion on his part. Old Newala is now under
the jurisdiction of the native pastor, Daudi, at Chingulungulu, who,
as I am on very friendly terms with him, allows me, as a matter of
course, the use of this lemon-grove during my stay at Newala.
 FEET MUTILATED BY THE RAVAGES OF THE “JIGGER”
(Sarcopsylla penetrans)

The water-supply of New Newala is in the bottom of the valley,

some 1,600 feet lower down. The way is not only long and fatiguing,
but the water, when we get it, is thoroughly bad. We are suffering not
only from this, but from the fact that the arrangements at Newala are
nothing short of luxurious. We have a separate kitchen—a hut built
against the boma palisade on the right of the baraza, the interior of
which is not visible from our usual position. Our two cooks were not
long in finding this out, and they consequently do—or rather neglect
to do—what they please. In any case they do not seem to be very
particular about the boiling of our drinking-water—at least I can
attribute to no other cause certain attacks of a dysenteric nature,
from which both Knudsen and I have suffered for some time. If a
man like Omari has to be left unwatched for a moment, he is capable
of anything. Besides this complaint, we are inconvenienced by the
state of our nails, which have become as hard as glass, and crack on
the slightest provocation, and I have the additional infliction of
pimples all over me. As if all this were not enough, we have also, for
the last week been waging war against the jigger, who has found his
Eldorado in the hot sand of the Makonde plateau. Our men are seen
all day long—whenever their chronic colds and the dysentery likewise
raging among them permit—occupied in removing this scourge of
Africa from their feet and trying to prevent the disastrous
consequences of its presence. It is quite common to see natives of
this place with one or two toes missing; many have lost all their toes,
or even the whole front part of the foot, so that a well-formed leg
ends in a shapeless stump. These ravages are caused by the female of
Sarcopsylla penetrans, which bores its way under the skin and there
develops an egg-sac the size of a pea. In all books on the subject, it is
stated that one’s attention is called to the presence of this parasite by
an intolerable itching. This agrees very well with my experience, so
far as the softer parts of the sole, the spaces between and under the
toes, and the side of the foot are concerned, but if the creature
penetrates through the harder parts of the heel or ball of the foot, it
may escape even the most careful search till it has reached maturity.
Then there is no time to be lost, if the horrible ulceration, of which
we see cases by the dozen every day, is to be prevented. It is much
easier, by the way, to discover the insect on the white skin of a
European than on that of a native, on which the dark speck scarcely
shows. The four or five jiggers which, in spite of the fact that I
constantly wore high laced boots, chose my feet to settle in, were
taken out for me by the all-accomplished Knudsen, after which I
thought it advisable to wash out the cavities with corrosive
sublimate. The natives have a different sort of disinfectant—they fill
the hole with scraped roots. In a tiny Makua village on the slope of
the plateau south of Newala, we saw an old woman who had filled all
the spaces under her toe-nails with powdered roots by way of
prophylactic treatment. What will be the result, if any, who can say?
The rest of the many trifling ills which trouble our existence are
really more comic than serious. In the absence of anything else to
smoke, Knudsen and I at last opened a box of cigars procured from
the Indian store-keeper at Lindi, and tried them, with the most
distressing results. Whether they contain opium or some other
narcotic, neither of us can say, but after the tenth puff we were both
“off,” three-quarters stupefied and unspeakably wretched. Slowly we
recovered—and what happened next? Half-an-hour later we were
once more smoking these poisonous concoctions—so insatiable is the
craving for tobacco in the tropics.
Even my present attacks of fever scarcely deserve to be taken
seriously. I have had no less than three here at Newala, all of which
have run their course in an incredibly short time. In the early
afternoon, I am busy with my old natives, asking questions and
making notes. The strong midday coffee has stimulated my spirits to
an extraordinary degree, the brain is active and vigorous, and work
progresses rapidly, while a pleasant warmth pervades the whole
body. Suddenly this gives place to a violent chill, forcing me to put on
my overcoat, though it is only half-past three and the afternoon sun
is at its hottest. Now the brain no longer works with such acuteness
and logical precision; more especially does it fail me in trying to
establish the syntax of the difficult Makua language on which I have
ventured, as if I had not enough to do without it. Under the
circumstances it seems advisable to take my temperature, and I do
so, to save trouble, without leaving my seat, and while going on with
my work. On examination, I find it to be 101·48°. My tutors are
abruptly dismissed and my bed set up in the baraza; a few minutes
later I am in it and treating myself internally with hot water and
lemon-juice.
Three hours later, the thermometer marks nearly 104°, and I make
them carry me back into the tent, bed and all, as I am now perspiring
heavily, and exposure to the cold wind just beginning to blow might
mean a fatal chill. I lie still for a little while, and then find, to my
great relief, that the temperature is not rising, but rather falling. This
is about 7.30 p.m. At 8 p.m. I find, to my unbounded astonishment,
that it has fallen below 98·6°, and I feel perfectly well. I read for an
hour or two, and could very well enjoy a smoke, if I had the
wherewithal—Indian cigars being out of the question.
Having no medical training, I am at a loss to account for this state
of things. It is impossible that these transitory attacks of high fever
should be malarial; it seems more probable that they are due to a
kind of sunstroke. On consulting my note-book, I become more and
more inclined to think this is the case, for these attacks regularly
follow extreme fatigue and long exposure to strong sunshine. They at
least have the advantage of being only short interruptions to my
work, as on the following morning I am always quite fresh and fit.
My treasure of a cook is suffering from an enormous hydrocele which
makes it difficult for him to get up, and Moritz is obliged to keep in
the dark on account of his inflamed eyes. Knudsen’s cook, a raw boy
from somewhere in the bush, knows still less of cooking than Omari;
consequently Nils Knudsen himself has been promoted to the vacant
post. Finding that we had come to the end of our supplies, he began
by sending to Chingulungulu for the four sucking-pigs which we had
bought from Matola and temporarily left in his charge; and when
they came up, neatly packed in a large crate, he callously slaughtered
the biggest of them. The first joint we were thoughtless enough to
entrust for roasting to Knudsen’s mshenzi cook, and it was
consequently uneatable; but we made the rest of the animal into a
jelly which we ate with great relish after weeks of underfeeding,
consuming incredible helpings of it at both midday and evening
meals. The only drawback is a certain want of variety in the tinned
vegetables. Dr. Jäger, to whom the Geographical Commission
entrusted the provisioning of the expeditions—mine as well as his
own—because he had more time on his hands than the rest of us,
seems to have laid in a huge stock of Teltow turnips,[46] an article of
food which is all very well for occasional use, but which quickly palls
when set before one every day; and we seem to have no other tins
left. There is no help for it—we must put up with the turnips; but I
am certain that, once I am home again, I shall not touch them for ten
years to come.
Amid all these minor evils, which, after all, go to make up the
genuine flavour of Africa, there is at least one cheering touch:
Knudsen has, with the dexterity of a skilled mechanic, repaired my 9
× 12 cm. camera, at least so far that I can use it with a little care.
How, in the absence of finger-nails, he was able to accomplish such a
ticklish piece of work, having no tool but a clumsy screw-driver for
taking to pieces and putting together again the complicated
mechanism of the instantaneous shutter, is still a mystery to me; but
he did it successfully. The loss of his finger-nails shows him in a light
contrasting curiously enough with the intelligence evinced by the
above operation; though, after all, it is scarcely surprising after his
ten years’ residence in the bush. One day, at Lindi, he had occasion
to wash a dog, which must have been in need of very thorough
cleansing, for the bottle handed to our friend for the purpose had an
extremely strong smell. Having performed his task in the most
conscientious manner, he perceived with some surprise that the dog
did not appear much the better for it, and was further surprised by
finding his own nails ulcerating away in the course of the next few
days. “How was I to know that carbolic acid has to be diluted?” he
mutters indignantly, from time to time, with a troubled gaze at his
mutilated finger-tips.
 Since we came to Newala we have been making excursions in all
directions through the surrounding country, in accordance with old
habit, and also because the akida Sefu did not get together the tribal
elders from whom I wanted information so speedily as he had
promised. There is, however, no harm done, as, even if seen only
from the outside, the country and people are interesting enough.
The Makonde plateau is like a large rectangular table rounded off
at the corners. Measured from the Indian Ocean to Newala, it is
about seventy-five miles long, and between the Rovuma and the
Lukuledi it averages fifty miles in breadth, so that its superficial area
is about two-thirds of that of the kingdom of Saxony. The surface,
however, is not level, but uniformly inclined from its south-western
edge to the ocean. From the upper edge, on which Newala lies, the
eye ranges for many miles east and north-east, without encountering
any obstacle, over the Makonde bush. It is a green sea, from which
here and there thick clouds of smoke rise, to show that it, too, is
inhabited by men who carry on their tillage like so many other
primitive peoples, by cutting down and burning the bush, and
manuring with the ashes. Even in the radiant light of a tropical day
such a fire is a grand sight.
Much less effective is the impression produced just now by the
great western plain as seen from the edge of the plateau. As often as
time permits, I stroll along this edge, sometimes in one direction,
sometimes in another, in the hope of finding the air clear enough to
let me enjoy the view; but I have always been disappointed.
Wherever one looks, clouds of smoke rise from the burning bush,
and the air is full of smoke and vapour. It is a pity, for under more
favourable circumstances the panorama of the whole country up to
the distant Majeje hills must be truly magnificent. It is of little use
taking photographs now, and an outline sketch gives a very poor idea
of the scenery. In one of these excursions I went out of my way to
make a personal attempt on the Makonde bush. The present edge of
the plateau is the result of a far-reaching process of destruction
through erosion and denudation. The Makonde strata are
everywhere cut into by ravines, which, though short, are hundreds of
yards in depth. In consequence of the loose stratification of these
beds, not only are the walls of these ravines nearly vertical, but their
upper end is closed by an equally steep escarpment, so that the
western edge of the Makonde plateau is hemmed in by a series of
deep, basin-like valleys. In order to get from one side of such a ravine
to the other, I cut my way through the bush with a dozen of my men.
It was a very open part, with more grass than scrub, but even so the
short stretch of less than two hundred yards was very hard work; at
the end of it the men’s calicoes were in rags and they themselves
bleeding from hundreds of scratches, while even our strong khaki
suits had not escaped scatheless.

NATIVE PATH THROUGH THE MAKONDE BUSH, NEAR

MAHUTA

I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
 The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.

MAKONDE LOCK AND KEY AT JUMBE CHAURO

 This is the general way of closing a house. The Makonde at Jumbe
Chauro, however, have a much more complicated, solid and original
one. Here, too, the door is as already described, except that there is
only one post on the inside, standing by itself about six inches from
one side of the doorway. Opposite this post is a hole in the wall just
large enough to admit a man’s arm. The door is closed inside by a
large wooden bolt passing through a hole in this post and pressing
with its free end against the door. The other end has three holes into
which fit three pegs running in vertical grooves inside the post. The
door is opened with a wooden key about a foot long, somewhat
curved and sloped off at the butt; the other end has three pegs
corresponding to the holes, in the bolt, so that, when it is thrust
through the hole in the wall and inserted into the rectangular
opening in the post, the pegs can be lifted and the bolt drawn out.[50]

MODE OF INSERTING THE KEY

With no small pride first one householder and then a second

showed me on the spot the action of this greatest invention of the
Makonde Highlands. To both with an admiring exclamation of
“Vizuri sana!” (“Very fine!”). I expressed the wish to take back these
marvels with me to Ulaya, to show the Wazungu what clever fellows
the Makonde are. Scarcely five minutes after my return to camp at
Newala, the two men came up sweating under the weight of two
heavy logs which they laid down at my feet, handing over at the same
time the keys of the fallen fortress. Arguing, logically enough, that if
the key was wanted, the lock would be wanted with it, they had taken
their axes and chopped down the posts—as it never occurred to them
to dig them out of the ground and so bring them intact. Thus I have
two badly damaged specimens, and the owners, instead of praise,
come in for a blowing-up.
The Makua huts in the environs of Newala are especially
miserable; their more than slovenly construction reminds one of the
temporary erections of the Makua at Hatia’s, though the people here
have not been concerned in a war. It must therefore be due to
congenital idleness, or else to the absence of a powerful chief. Even
the baraza at Mlipa’s, a short hour’s walk south-east of Newala,
shares in this general neglect. While public buildings in this country
are usually looked after more or less carefully, this is in evident
danger of being blown over by the first strong easterly gale. The only
attractive object in this whole district is the grave of the late chief
Mlipa. I visited it in the morning, while the sun was still trying with
partial success to break through the rolling mists, and the circular
grove of tall euphorbias, which, with a broken pot, is all that marks
the old king’s resting-place, impressed one with a touch of pathos.
Even my very materially-minded carriers seemed to feel something
of the sort, for instead of their usual ribald songs, they chanted
solemnly, as we marched on through the dense green of the Makonde
bush:—
 “We shall arrive with the great master; we stand in a row and have
no fear about getting our food and our money from the Serkali (the
Government). We are not afraid; we are going along with the great
master, the lion; we are going down to the coast and back.”
With regard to the characteristic features of the various tribes here
on the western edge of the plateau, I can arrive at no other
conclusion than the one already come to in the plain, viz., that it is
impossible for anyone but a trained anthropologist to assign any
given individual at once to his proper tribe. In fact, I think that even
an anthropological specialist, after the most careful examination,
might find it a difficult task to decide. The whole congeries of peoples
collected in the region bounded on the west by the great Central
African rift, Tanganyika and Nyasa, and on the east by the Indian
Ocean, are closely related to each other—some of their languages are
only distinguished from one another as dialects of the same speech,
and no doubt all the tribes present the same shape of skull and
structure of skeleton. Thus, surely, there can be no very striking
differences in outward appearance.
 Even did such exist, I should have no time
to concern myself with them, for day after day,
I have to see or hear, as the case may be—in
any case to grasp and record—an
extraordinary number of ethnographic
phenomena. I am almost disposed to think it
fortunate that some departments of inquiry, at
least, are barred by external circumstances.
Chief among these is the subject of iron-
working. We are apt to think of Africa as a
country where iron ore is everywhere, so to
speak, to be picked up by the roadside, and
where it would be quite surprising if the
inhabitants had not learnt to smelt the
material ready to their hand. In fact, the
knowledge of this art ranges all over the
continent, from the Kabyles in the north to the
Kafirs in the south. Here between the Rovuma
and the Lukuledi the conditions are not so
favourable. According to the statements of the
Makonde, neither ironstone nor any other
form of iron ore is known to them. They have
not therefore advanced to the art of smelting
the metal, but have hitherto bought all their
THE ANCESTRESS OF
THE MAKONDE
iron implements from neighbouring tribes.
Even in the plain the inhabitants are not much
better off. Only one man now living is said to
understand the art of smelting iron. This old fundi lives close to
Huwe, that isolated, steep-sided block of granite which rises out of
the green solitude between Masasi and Chingulungulu, and whose
jagged and splintered top meets the traveller’s eye everywhere. While
still at Masasi I wished to see this man at work, but was told that,
frightened by the rising, he had retired across the Rovuma, though
he would soon return. All subsequent inquiries as to whether the
fundi had come back met with the genuine African answer, “Bado”
(“Not yet”).
 BRAZIER

Some consolation was afforded me by a brassfounder, whom I

came across in the bush near Akundonde’s. This man is the favourite
of women, and therefore no doubt of the gods; he welds the glittering
brass rods purchased at the coast into those massive, heavy rings
which, on the wrists and ankles of the local fair ones, continually give
me fresh food for admiration. Like every decent master-craftsman he
had all his tools with him, consisting of a pair of bellows, three
crucibles and a hammer—nothing more, apparently. He was quite
willing to show his skill, and in a twinkling had fixed his bellows on
the ground. They are simply two goat-skins, taken off whole, the four
legs being closed by knots, while the upper opening, intended to
admit the air, is kept stretched by two pieces of wood. At the lower
end of the skin a smaller opening is left into which a wooden tube is
stuck. The fundi has quickly borrowed a heap of wood-embers from
the nearest hut; he then fixes the free ends of the two tubes into an
earthen pipe, and clamps them to the ground by means of a bent
piece of wood. Now he fills one of his small clay crucibles, the dross
on which shows that they have been long in use, with the yellow
material, places it in the midst of the embers, which, at present are
only faintly glimmering, and begins his work. In quick alternation
the smith’s two hands move up and down with the open ends of the
bellows; as he raises his hand he holds the slit wide open, so as to let
the air enter the skin bag unhindered. In pressing it down he closes
the bag, and the air puffs through the bamboo tube and clay pipe into
the fire, which quickly burns up. The smith, however, does not keep
on with this work, but beckons to another man, who relieves him at
the bellows, while he takes some more tools out of a large skin pouch
carried on his back. I look on in wonder as, with a smooth round
stick about the thickness of a finger, he bores a few vertical holes into
the clean sand of the soil. This should not be difficult, yet the man
seems to be taking great pains over it. Then he fastens down to the
ground, with a couple of wooden clamps, a neat little trough made by
splitting a joint of bamboo in half, so that the ends are closed by the
two knots. At last the yellow metal has attained the right consistency,
and the fundi lifts the crucible from the fire by means of two sticks
split at the end to serve as tongs. A short swift turn to the left—a
tilting of the crucible—and the molten brass, hissing and giving forth
clouds of smoke, flows first into the bamboo mould and then into the
holes in the ground.
The technique of this backwoods craftsman may not be very far
advanced, but it cannot be denied that he knows how to obtain an
adequate result by the simplest means. The ladies of highest rank in
this country—that is to say, those who can afford it, wear two kinds
of these massive brass rings, one cylindrical, the other semicircular
in section. The latter are cast in the most ingenious way in the
bamboo mould, the former in the circular hole in the sand. It is quite
a simple matter for the fundi to fit these bars to the limbs of his fair
customers; with a few light strokes of his hammer he bends the
pliable brass round arm or ankle without further inconvenience to
the wearer.
SHAPING THE POT

SMOOTHING WITH MAIZE-COB

CUTTING THE EDGE

 FINISHING THE BOTTOM

LAST SMOOTHING BEFORE

BURNING

FIRING THE BRUSH-PILE

 LIGHTING THE FARTHER SIDE OF
THE PILE

TURNING THE RED-HOT VESSEL

NYASA WOMAN MAKING POTS AT MASASI

Pottery is an art which must always and everywhere excite the
interest of the student, just because it is so intimately connected with
the development of human culture, and because its relics are one of
the principal factors in the reconstruction of our own condition in
prehistoric times. I shall always remember with pleasure the two or
three afternoons at Masasi when Salim Matola’s mother, a slightly-
built, graceful, pleasant-looking woman, explained to me with
touching patience, by means of concrete illustrations, the ceramic art
of her people. The only implements for this primitive process were a
lump of clay in her left hand, and in the right a calabash containing
the following valuables: the fragment of a maize-cob stripped of all
its grains, a smooth, oval pebble, about the size of a pigeon’s egg, a
few chips of gourd-shell, a bamboo splinter about the length of one’s
hand, a small shell, and a bunch of some herb resembling spinach.
 Nothing more. The woman scraped with the
shell a round, shallow hole in the soft, fine
sand of the soil, and, when an active young
girl had filled the calabash with water for her,
she began to knead the clay. As if by magic it
gradually assumed the shape of a rough but
already well-shaped vessel, which only wanted
a little touching up with the instruments
before mentioned. I looked out with the
MAKUA WOMAN closest attention for any indication of the use
MAKING A POT. of the potter’s wheel, in however rudimentary
SHOWS THE a form, but no—hapana (there is none). The
BEGINNINGS OF THE embryo pot stood firmly in its little
POTTER’S WHEEL
depression, and the woman walked round it in
a stooping posture, whether she was removing
small stones or similar foreign bodies with the maize-cob, smoothing
the inner or outer surface with the splinter of bamboo, or later, after
letting it dry for a day, pricking in the ornamentation with a pointed
bit of gourd-shell, or working out the bottom, or cutting the edge
with a sharp bamboo knife, or giving the last touches to the finished
vessel. This occupation of the women is infinitely toilsome, but it is
without doubt an accurate reproduction of the process in use among
our ancestors of the Neolithic and Bronze ages.
There is no doubt that the invention of pottery, an item in human
progress whose importance cannot be over-estimated, is due to
women. Rough, coarse and unfeeling, the men of the horde range
over the countryside. When the united cunning of the hunters has
succeeded in killing the game; not one of them thinks of carrying
home the spoil. A bright fire, kindled by a vigorous wielding of the
drill, is crackling beside them; the animal has been cleaned and cut
up secundum artem, and, after a slight singeing, will soon disappear
under their sharp teeth; no one all this time giving a single thought
to wife or child.
To what shifts, on the other hand, the primitive wife, and still more
the primitive mother, was put! Not even prehistoric stomachs could
endure an unvarying diet of raw food. Something or other suggested
the beneficial effect of hot water on the majority of approved but
indigestible dishes. Perhaps a neighbour had tried holding the hard
roots or tubers over the fire in a calabash filled with water—or maybe
an ostrich-egg-shell, or a hastily improvised vessel of bark. They
became much softer and more palatable than they had previously
been; but, unfortunately, the vessel could not stand the fire and got
charred on the outside. That can be remedied, thought our
ancestress, and plastered a layer of wet clay round a similar vessel.
This is an improvement; the cooking utensil remains uninjured, but
the heat of the fire has shrunk it, so that it is loose in its shell. The
next step is to detach it, so, with a firm grip and a jerk, shell and
kernel are separated, and pottery is invented. Perhaps, however, the
discovery which led to an intelligent use of the burnt-clay shell, was
made in a slightly different way. Ostrich-eggs and calabashes are not
to be found in every part of the world, but everywhere mankind has
arrived at the art of making baskets out of pliant materials, such as
bark, bast, strips of palm-leaf, supple twigs, etc. Our inventor has no
water-tight vessel provided by nature. “Never mind, let us line the
basket with clay.” This answers the purpose, but alas! the basket gets
burnt over the blazing fire, the woman watches the process of
cooking with increasing uneasiness, fearing a leak, but no leak
appears. The food, done to a turn, is eaten with peculiar relish; and
the cooking-vessel is examined, half in curiosity, half in satisfaction
at the result. The plastic clay is now hard as stone, and at the same
time looks exceedingly well, for the neat plaiting of the burnt basket
is traced all over it in a pretty pattern. Thus, simultaneously with
pottery, its ornamentation was invented.
Primitive woman has another claim to respect. It was the man,
roving abroad, who invented the art of producing fire at will, but the
woman, unable to imitate him in this, has been a Vestal from the
earliest times. Nothing gives so much trouble as the keeping alight of
the smouldering brand, and, above all, when all the men are absent
from the camp. Heavy rain-clouds gather, already the first large
drops are falling, the first gusts of the storm rage over the plain. The
little flame, a greater anxiety to the woman than her own children,
flickers unsteadily in the blast. What is to be done? A sudden thought
occurs to her, and in an instant she has constructed a primitive hut
out of strips of bark, to protect the flame against rain and wind.
This, or something very like it, was the way in which the principle
of the house was discovered; and even the most hardened misogynist
cannot fairly refuse a woman the credit of it. The protection of the
hearth-fire from the weather is the germ from which the human
dwelling was evolved. Men had little, if any share, in this forward
step, and that only at a late stage. Even at the present day, the
plastering of the housewall with clay and the manufacture of pottery
are exclusively the women’s business. These are two very significant
survivals. Our European kitchen-garden, too, is originally a woman’s
invention, and the hoe, the primitive instrument of agriculture, is,
characteristically enough, still used in this department. But the
noblest achievement which we owe to the other sex is unquestionably
the art of cookery. Roasting alone—the oldest process—is one for
which men took the hint (a very obvious one) from nature. It must
have been suggested by the scorched carcase of some animal
overtaken by the destructive forest-fires. But boiling—the process of
improving organic substances by the help of water heated to boiling-
point—is a much later discovery. It is so recent that it has not even
yet penetrated to all parts of the world. The Polynesians understand
how to steam food, that is, to cook it, neatly wrapped in leaves, in a
hole in the earth between hot stones, the air being excluded, and
(sometimes) a few drops of water sprinkled on the stones; but they
do not understand boiling.
To come back from this digression, we find that the slender Nyasa
woman has, after once more carefully examining the finished pot,
put it aside in the shade to dry. On the following day she sends me
word by her son, Salim Matola, who is always on hand, that she is
going to do the burning, and, on coming out of my house, I find her
already hard at work. She has spread on the ground a layer of very
dry sticks, about as thick as one’s thumb, has laid the pot (now of a
yellowish-grey colour) on them, and is piling brushwood round it.
My faithful Pesa mbili, the mnyampara, who has been standing by,
most obligingly, with a lighted stick, now hands it to her. Both of
them, blowing steadily, light the pile on the lee side, and, when the
flame begins to catch, on the weather side also. Soon the whole is in a
blaze, but the dry fuel is quickly consumed and the fire dies down, so
that we see the red-hot vessel rising from the ashes. The woman
turns it continually with a long stick, sometimes one way and
sometimes another, so that it may be evenly heated all over. In
twenty minutes she rolls it out of the ash-heap, takes up the bundle
of spinach, which has been lying for two days in a jar of water, and
sprinkles the red-hot clay with it. The places where the drops fall are
marked by black spots on the uniform reddish-brown surface. With a
sigh of relief, and with visible satisfaction, the woman rises to an
erect position; she is standing just in a line between me and the fire,
from which a cloud of smoke is just rising: I press the ball of my
camera, the shutter clicks—the apotheosis is achieved! Like a
priestess, representative of her inventive sex, the graceful woman
stands: at her feet the hearth-fire she has given us beside her the
invention she has devised for us, in the background the home she has
built for us.
At Newala, also, I have had the manufacture of pottery carried on
in my presence. Technically the process is better than that already
described, for here we find the beginnings of the potter’s wheel,
which does not seem to exist in the plains; at least I have seen
nothing of the sort. The artist, a frightfully stupid Makua woman, did
not make a depression in the ground to receive the pot she was about
to shape, but used instead a large potsherd. Otherwise, she went to
work in much the same way as Salim’s mother, except that she saved
herself the trouble of walking round and round her work by squatting
at her ease and letting the pot and potsherd rotate round her; this is
surely the first step towards a machine. But it does not follow that
the pot was improved by the process. It is true that it was beautifully
rounded and presented a very creditable appearance when finished,
but the numerous large and small vessels which I have seen, and, in
part, collected, in the “less advanced” districts, are no less so. We
moderns imagine that instruments of precision are necessary to
produce excellent results. Go to the prehistoric collections of our
museums and look at the pots, urns and bowls of our ancestors in the
dim ages of the past, and you will at once perceive your error.
MAKING LONGITUDINAL CUT IN
BARK

DRAWING THE BARK OFF THE LOG

REMOVING THE OUTER BARK

 BEATING THE BARK

WORKING THE BARK-CLOTH AFTER BEATING, TO MAKE IT

SOFT

MANUFACTURE OF BARK-CLOTH AT NEWALA

To-day, nearly the whole population of German East Africa is
clothed in imported calico. This was not always the case; even now in
some parts of the north dressed skins are still the prevailing wear,
and in the north-western districts—east and north of Lake
Tanganyika—lies a zone where bark-cloth has not yet been
superseded. Probably not many generations have passed since such
bark fabrics and kilts of skins were the only clothing even in the
south. Even to-day, large quantities of this bright-red or drab
material are still to be found; but if we wish to see it, we must look in
the granaries and on the drying stages inside the native huts, where
it serves less ambitious uses as wrappings for those seeds and fruits
which require to be packed with special care. The salt produced at
Masasi, too, is packed for transport to a distance in large sheets of
bark-cloth. Wherever I found it in any degree possible, I studied the
process of making this cloth. The native requisitioned for the
purpose arrived, carrying a log between two and three yards long and
as thick as his thigh, and nothing else except a curiously-shaped
mallet and the usual long, sharp and pointed knife which all men and
boys wear in a belt at their backs without a sheath—horribile dictu!
[51]
Silently he squats down before me, and with two rapid cuts has
drawn a couple of circles round the log some two yards apart, and
slits the bark lengthwise between them with the point of his knife.
With evident care, he then scrapes off the outer rind all round the
log, so that in a quarter of an hour the inner red layer of the bark
shows up brightly-coloured between the two untouched ends. With
some trouble and much caution, he now loosens the bark at one end,
and opens the cylinder. He then stands up, takes hold of the free
edge with both hands, and turning it inside out, slowly but steadily
pulls it off in one piece. Now comes the troublesome work of
scraping all superfluous particles of outer bark from the outside of
the long, narrow piece of material, while the inner side is carefully
scrutinised for defective spots. At last it is ready for beating. Having
signalled to a friend, who immediately places a bowl of water beside
him, the artificer damps his sheet of bark all over, seizes his mallet,
lays one end of the stuff on the smoothest spot of the log, and
hammers away slowly but continuously. “Very simple!” I think to
myself. “Why, I could do that, too!”—but I am forced to change my
opinions a little later on; for the beating is quite an art, if the fabric is
not to be beaten to pieces. To prevent the breaking of the fibres, the
stuff is several times folded across, so as to interpose several
thicknesses between the mallet and the block. At last the required
state is reached, and the fundi seizes the sheet, still folded, by both
ends, and wrings it out, or calls an assistant to take one end while he
holds the other. The cloth produced in this way is not nearly so fine
and uniform in texture as the famous Uganda bark-cloth, but it is
quite soft, and, above all, cheap.
Now, too, I examine the mallet. My craftsman has been using the
simpler but better form of this implement, a conical block of some
hard wood, its base—the striking surface—being scored across and
across with more or less deeply-cut grooves, and the handle stuck
into a hole in the middle. The other and earlier form of mallet is
shaped in the same way, but the head is fastened by an ingenious
network of bark strips into the split bamboo serving as a handle. The
observation so often made, that ancient customs persist longest in
connection with religious ceremonies and in the life of children, here
finds confirmation. As we shall soon see, bark-cloth is still worn
during the unyago,[52] having been prepared with special solemn
ceremonies; and many a mother, if she has no other garment handy,
will still put her little one into a kilt of bark-cloth, which, after all,
looks better, besides being more in keeping with its African
surroundings, than the ridiculous bit of print from Ulaya.
MAKUA WOMEN