Superheroine in Hijab: Fadumo Ali of Hoiwa is Solving The Health Care and Immigrant Job Crisis

 Women who wear hijabs are not victims, instead, they are change-makers. How does one woman with an immigrant background manage to solve the healthcare worker shortage, pay above-average salaries to their employees, and challenge the recruiters of their biases? 

Our guest, Fadumo Ali, is the founder of the healthcare staffing agency Hoiwa Ltd. She is one of the 100 influencers in the healthcare business in 2021 (Mediuutiset) and the Entrepreneur of the Year of city of Espoo in 2022. Nordic Business Forum chose her to the list of the top 35 most influential North European business owners under the age of 35. Fadumo is a nurse by profession and has worked in the healthcare industry since 2008. Fadumo wants to promote diversity and inclusion. 

Interview with Fadumo Ali

In two years, Fadumo has succeeded to grow a company that pays nurses better than average wages and now employs more than 2,000 nurses.

And most of them are hard-to-emlpoy immigrants. 

She was just awarded as the entrepreneur of the year in Espoo, and in fact we just heard that she has also been selected for the list of the 35 most influential young entrepreneurs in Northern Europe.

But there is currently a heated debate about salaries in the health care industry, and there is a dire shortage of workers in many health care districts.

Employers have actually washed their hands off, and the government is not supporting the salary increases.

And the situation is at a crossroads, to say the least.

Fadumo, the salaries have been low in the health care industry for a long time, but your company Hoiwa has solved this in your own way.  

Tell us how Hoiwa works and why. 

Fadumo: Yes, it's true that we pay a better salary at Hoiwa, because we kind of give from our own. I believe that there is money to share, but companies, and many, one might say even municipalities and the state, do not want to pay a better salary for some reason.

I see that it’s organizational problem, many don’t appreciate the work. It’s the lack of appreciation that is reflects the low salaries. 

So, we provide temp workers, and Hoiwa isn’t the first temp agency. And when you compare to these competitors who have been in this industry before, our costs, for example, aren't even that much higher than theirs, but our employees still get a better salary.

And this says something - and that's what I'm trying to hint at. It's a bit like a question of whether you want to give that money or not. 

How is this equation possible when you say that others have not succeeded in this but you do? So how do you make it possible?

Well, in fact, now that we have succeeded - I always say that it is easy to imitate or learn from good work -  now many are doing the same and they have actually raised their salaries as well. Little by little, I hope that we will go in the direction of raising the salaries of all health care workers.

Employing immigrants is often perceived to be quite difficult, and it is also talked about in public, that it is somehow perceived to be extremely difficult. How do you see this issue, and on the other hand, what kind of advice would you give to other companies?

Fadumo: Yes, first of all, how you asked this question, this already says a little about attitudes - I'm talking a lot about mindset. 

 If the employer already feels that it's difficult, the question is: why? What makes it difficult?What I have always noticed is that many, when they see that the job seeker has a different forgeign name, that alone might be an obstacle. But it could be that this job seeker is Finnish or born in Finland but their name is just different.

The biased attitudes prevents from giving the opportunities. When you see more familiar names, it seems like easier to employ someone. 

It's actually really simple, the solution can be found, but first you have to think a little yourself - what makes it so difficult for the employer or the recruiter or the person who is interviewing?  What's the problem when they are in that position, but why cant’ they give that job?

You mentioned that in the recruitment process, there is bias when someone comes across a name that sounds like a foreigner -  should the recruitment process be changed in a way that we completely abandon the need for example to write our names in the application?  In which case perhaps it could eliminate such prejudices, could this be a way there or what?

Fadumo: So, actually, I just laugh at that suggestion, because when a person who also looks different shows up to work, then the problem is whether people should change their name and....

I have seen such a case. We actually had an employee who changed their name to something new, just to get a job. But I wonder what will happen when this same person goes to the workplace, it might be that they don’t then look suitable. It is again that we have to change attitudes.

It’s like we question if an apple is really an apple, if it looks a little bit different than another apple next to it. It’s not really a question that it’s a different fruit, but people just don’t want to eat the apple when it looks bit different. It’s the attitudes that need fixing. 

So, in a way, it's about prejudices that should be corrected.

Well, there is another topic that constantly surfaces in public discussion: this eternal claim that the health care industry is somehow a vocation profession and since it’s a calling, you don't necessarily need to pay a good salary for it now.

Fadumo: Yes, first of all, when we are talking about a calling profession and then about health care, it’s all of our issue, since we all use health care.

Imagine that what if there is a person in front of you who is not paid a good salary, who is dissatisfied for some reason?  We should make it in a way that these decision-makers understand that will one day they will also face these people. What if there is a shortage of nurses, who will take care of them, or their relatives. 

Health care industry is really important, because I could say that it is one of the biggest and most important pillars of support in Finland or in any country. Now there is already a dire shortage of nurses. And there's a lot of talk about nurses leaving the industry, and I think that's something that should be taken very seriously - whether it's a vocation profession or not.

Yes, and during the pandemic it was well noticed that it is quite critical, that the health care works and that it has sufficient capacity. And now we can see all the time that even in Finland, in a certain way, it is deteriorating.

How do you think this current situation between these salary increases and lack of employees should be resolved?

Fadumo: Well, first of all, now that there is a shortage of nurses, other solutions should be found. I do encourage that there could be more care assistants, because there are people or employees who complain that they do too many non-nursing tasks, and many of those non-nursing tasks could also be delegated to care assistants.

And about the salaries - maybe the decision makers should just see it at the field to see how it feels and what the nurses actually do. 

After all, nurses get more tasks all the time and their job description expands. In many cases, the nurse also does the work of a doctor. I've noticed in some places where I've been that the doctors have a little lighter work loads, and nurses have been given more tasks, but it doesn't show in the salaries.

We should look at how the work and the salary compare, and whether the salary is worth it, or the work is worth the salary.

You have really big vision for growing and internationalizing Hoiwa, so tell me a little about these plans.

Fadumo: Yeah, now we've gone to the German market and then we'll go to France or England next. Now that we have noticed that Hoiwa has been very popular here in Finland and has been successful, we also want to take Hoiwa to other countries.

It is patriotic to want to promote and take Finnish companies outside Finland, and this shortage of nurses is not only in Finland, but is a global problem, it is everywhere. We want to take Hoiwa abroad, that's our vision.

And now when we got financing, and the first country open, we will keep going, and yes, we want to be in multiple different countries. That’s our big vision.

What is your recipe for success - how would you somehow summarize what you are actually going to take to the world? What's your thing?

Fadumo: We have many ways we stand out. 

First of all, a new way of leadership, we lead in a different way. 

And then how we adapt when the world changes. 

In our concept, technology plays a big role, we have our own app.  And also, the way we value our employees, they are not pawns, but really the ones who run the business. We want to show that happy employees can also be seen in economic results. 

And then lastly, the diversity and inclusion are also important aspects, and we also want to export that mindset. 

So it's not just about the nurses, but the whole concept as a whole is what we want to take to the world.

We lead with emotional intelligence, meaning that we listen to the employees, especially the nurses, and I realize as a nurse myself, when the nurses feel that they are not listened to, not cared for, not appreciated and that salary is only one of those parts.

And since we are a temp agency that provides nurses to our target customers, we also take care that our employees are treated well at our customer locations.

We want to make it easy to receive both good and bad feedback from different customer locations. Or we give constructive feedback to the customer, how they can maintain these good aspects and good employees, so that it's like a win-win situation.

Our app is really such a large entity for us, we run the whole business through the app. 

We built our own software, which has an HR portion, where we put all the shifts. Either we ourselves add them, or our customers put it in themselves. They have their own IDs, and they can manage the recruitment themselves.

The customers see the nurse profiles, and the nurse can pick the workshifts as they open for them. Someone takes the shift, and the customer gets an employee. 

And the app includes the payroll administration side, invoicing, the entire financial side, and we are constantly developing it forward. We are a small team, who runs a large mass of nurses.

The nurses choose themselves where they want to work, they also see the salary in real time, they see the salary statement, what is coming in the next paycheck. 

We try to be a really transparent company, and it shows in the salaries and that there are different customer companies, with different salaries, then everyone can take what job is closest to them, or because of the salary.

When we look at this situation in Finland, only about a third of entrepreneurs are women. What do you think we could possibly do to get more girls and women interested in entrepreneurship?

Fadumo: Yes, it probably feels like there could be more girls and women, but they have been given expectations that they belong at home or they should do this or that. 

I believe that if everyone did what they like, whether they are an entrepreneur or something else, but especially if we are talking about entrepreneurs, and if they do it fully without thinking that they are women or girls, or that they are minorities, they can really succeed too.

But if it's already a bit like a fear that you won't make it in that male-dominated world, that fear will probably win. 

But I haven't thought like that at all. 

When you think about my background, I'm a different-looking “scarf head”, but when I succeeded I just then realized "hey, this is actually quite unusual."

So, in a way, you just have to do what you like, and because the business world is competitive, you just need to focus on your own strengths, what you are good at, that's how you notice how you stand out from others. 

I always emphasize that it's good to be different, because I don't like it if everyone is the same, I find it somehow oppressive.

I like to stand out from the crowd, and I say that being different is always what in the end is your super power, you could say.

What is a myth that you would like to crush?

Fadumo: Well, now that I think about it - when we talk about diversity in Finland, and when people talk about Muslim women like we are like victims. 

But many muslim women are like me and it's just not visible. 

I don't stand out in any way when I'm with them. 

It doesn’t mean that if you have a hijab some man has forced you, but we have our own free will, and we are very strong women.

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Crush Movement was founded by Anna Pyykkö and Katja Presnal. Crush Movement brings thought-leaders together to redefine what success means today. Together we crush the patriarchic norms, and build a better future by empowering feminine energy and soft values. Together, we will change the world through female entrepreneurship.

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