I’m currently reading a book called Better, by Atul Gawande, that shares insightful stories about medical practice from a surgeon’s perspective. The stories highlight how medical professionals are only human and therefore must always be diligent and resourceful in fulfilling their duties — and the stories have lessons that spill outside of the hospital and even into the education system. What stuck out to me was a story about how hospital microbiologists tried and failed at getting medical staff to wash their hands more frequently — as you may know med staff were/are the primary carriers of infectious bacteria in hospitals so minimizing the amount of bacteria on their hands dramatically decreases the rate of infection in hospitals.
A hospital in Pittsburgh brought in Industrial Engineer Peter Perreiah to solve the problem of hospital infections in one wing of the hospital — and he created systems and structures that â€œmade each hospital room work more like an operating roomâ€� (where they are very diligent about being disinfected). For a while his â€œSearch-and-destroyâ€� strategy worked: â€œInfection rates for MRSA fell almost 90 percent.â€� However, after two years these great ideas only spread to ONE other wing at the hospital… Why? Perreiah came in and told people how they had to change rather than â€œbuilding on the capabilities people already had.â€�
After reading an article about how Save the Children changed their approach to improving child nutrition in poverty stricken villages in Vietnam, he came across the idea of Positive Deviance, which “is an approach to behavioral and social change based on the observation that in a community, there are people (Positive Deviants) whose uncommon but successful behaviors or strategies enable them to find better solutions to a problem than their peers, despite having no special resources or knowledge.” Through the positive deviance approach, an important assumption is that communities already have the solutions to the problem. They are the best experts to solve their own problems.
So this time they tried the positive deviance approach with a series of 30-minute, small group discussions with all the health care workers in hospital. They had no agenda: â€œWeâ€™re here because of the infection problem and we want to know what YOU know about how to solve it.â€� And from this came great discussion and furthermore ownership of the solutions. And the results were staggering: rate of MRSA infection dropped to zero the next year and stayed that way.
What does this have to do with education or for any kind of initiative, you ask? If you think about it, organizations–whether governmental, nonprofit or business–approach problems like that industrial engineer approached the problem initially. He used his expertise to to minimize waste and increase efficiency, and above all he mandated the solutions to the hospital. Many organizations purport to have the best solution, most efficient way to handle a situation, or the most optimal way to eradicate a problem. But how many of those solutions actually stick around once the organization leaves? And isn’t the point of a nonprofit organization to work its way to nonexistence — because by reaching the nonprofit’s mission, you thereby render that nonprofit irrelevant.
Yet there are many examples of organizations that operate in communities without drawing solutions, ideas, and representation directly from the very people in the communities. Please note that I’m not criticizing how well these organizations operate. In fact, some operate extremely well. But if that organization, or that group of people, left the community, would their lasting legacy be a self-sustaining system that empowers the people of the community or would their lasting legacy be forgotten in a dusty pile from those who tried and failed to create something that the community embraced?
This makes me think of the renewed energy in the New Orleans’ education sector where most of the schools are now run by national charter management organizations and staffed by bright-eyed outsiders. When the appeal of “saving” New Orleans runs out, will these people stay? And more importantly, when shaping the new education landscape, did they elicit solutions from and empower the citizens of New Orleans to create a sustainable new education system?
I hope so. Sustainability and a community-based approach should be tantamount to any organization that wishes to improve the livelihood and well-being of those living in poverty.