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Intro
This is the story of positive deviance . . . the story of how a simple, counterintuitive approach transformed the lives of children suffering from malnutrition, empowered their families, and changed the way that aid agencies work all over the world.
In this episode, that story and how it provides hope for all of us facing intractable societal problems. You’re listening to “I Heart This” everybody. I’m Ben Lord. Let’s talk about what we love.
Hook
Sometimes, the news feels like a dangerous place to go–every day a new disaster.
I tuned in a few days ago to see a family torn apart. A few days before that it was people cut off from the life-saving medicines they depend upon. Before that, it was children killed in a vengeance war that no one can seem to stop.
Often, I go to the news because I feel guilty for not going, as if somehow my “being an informed citizen” could stop the avalanche of awfulness, or that it is my responsibility to bear witness to the shittiness of the world. But it’s hard to believe that this bearing witness actually does anything.
Disease, injustice, racism, war, . . . these are intractable problems. People way smarter than me have devoted their lives to solving them, and so often efforts look like bailing the ocean with a pail.
It is easy to feel defeated before I begin. But as easy as it is to believe, this kind of defeatism isn’t the truth . . . or at least not the whole truth. And today, I need a story that reminds me of that.
Inciting Incident
This story takes place in Vietnam about 35 years ago. Then, as now, Vietnam was a country beset with the kinds of intractable problems that you see on the news . . . and one of those intractable problems was malnutrition. Nearly half of Vietnam’s children were malnourished.
Malnutrition is intractable mostly because it’s so complex. What causes malnutrition isn’t lack of nutritious food; what causes malnutrition is poverty.
To solve the roots of malnutrition, you’d have to solve sweeping inequities in global food distribution systems, poor sanitation, access to clean water, and access to education.
The Vietnamese government at the time knew that it was up against intractable problem . . . and it knew it needed help . . .but many people in the government were reasonably skeptical of “do-good” missions from the outside.
Other programs had come and gone, they’d passed out formula or built some infrastructure and then they’d go away and there’d be no more formula and no one who had the know-how or the money to keep the infrastructure working.
When they invited Jerry and Monique Sternin to open a chapter of the nonprofit Save the Children in Vietnam, the foreign minister gave them a chilly welcome. They had six months to show they could make a real and lasting difference, he told them, then, they’d have to get out.
Jerry later said that they felt like orphans at the airport. They had little money, a tiny staff, a demanding and somewhat hostile patron, little knowledge of the land or the language . . . and no preconceived plan of what to do. But the clock was ticking.
Someone who studied development in a university might have been tempted to start by analyzing the systemic roots of malnutrition, all the things I just mentioned about sanitation and global food supplies. I think that’s what I would have done.
But instead the Sternins pretty much ignored them. Later, they would explain that even though those things were true, they were useless. There was no way that they could address malnutrition by fixing poverty.
Not in six months, anyway. Instead, they would have to find a way of addressing malnutrition in the midst of poverty. But how?
Inspired by some recent nutrition research, they decided to try something very different from the typical NGO program.
They decided to just start by making observations–to listen instead of talk. And so, the Sternins headed out to one of the poorest regions of the country, and got to work.
Rising Action
They started by partnering with a local women’s union. Then, together, they all set about asking one question–In this village … a village where some 64% of the youngest children were malnourished . . . are there any families who face the same challenges as everyone else … endure the same poverty and live in the same constraints . . . and yet have still managed to raise well nourished kids?
So the women in the union went out to measure the height and weight of the local children. The results intrigued everyone. Yes. There were, indeed, healthy, well-nourished children who came out of poor households . . . households with no rich uncles or other advantages. But, how?
The women of the union worked with the Sternins to figure it out. It was like a scientific experiment. They studied the food habits of all the village’s families as a kind of control group.
Then, they compared that overall picture with what they called the ‘positive deviants’–the families that had somehow beaten the odds and had kids with healthy sizes and weights. And as they analyzed the data, the outlines of an answer began to form.
In most households in the village, food was typically served in two big meals over the day. Families took what they needed from a communal service and the most important food was rice. But the families with well-nourished children had several key differences:
1.) instead of feeding their children twice a day, they fed them smaller meals more often, making it easier for their kids’ small bodies to absorb the nutrients from what they ate,
2.) they added tiny shrimp from the rice paddies and greens from plants like sweet potatoes to the food,
3.) instead of letting kids fend for themselves at the communal food service, those families actively fed their kids. They would spoon out nutritious bits from the bottom of a bowl to make sure the children got them, and
4.) they washed and had their children wash, their hands.
Wait! That’s it? Is that really all it took? Could the difference between a listless, stunted, anemic kid and thriving one, really just come down to these simple changes?
Climax & Reveal
I imagine, if it was me, that I’d immediately start knocking on doors and telling people about the miracle solution that we had found. But the Sternins and their partners didn’t.
And I love what they did instead.
How many times in history have a group of well-meaning, comparatively fortunate people come into some formerly colonized part of the world and started handing out advice . . . running a program to fix what is broken.
It is like the paid presenter who has been called in by the schools I’ve worked for to fix our broken test scores. They show us revolutionary techniques, the audience applauds, and six months later nothing has changed. Perhaps this is why the Vietnamese foreign minister’s reception to Save the Children had been so cold.
Instead, Jerry, Monique, and their local partners operated under the assumption that just having knowledge wouldn’t change behavior. If people were going to change, they were going to have to live it.
So instead of handing out sweet potato greens and lecturing people about handwashing, they invited mothers and their kids to dinner.
They would invite groups of about ten to come and cook together. To be a part of the meal, you had to bring your own greens or shrimp to contribute. This puzzled folks. This wasn’t what they’d expected. But maybe just out of curiosity, people showed up.
Before the meal, the mothers and their children would wash their hands together. As they cooked together, they added the ingredients that they themselves had brought. And as they ate, they fed their children together.
And the women from the union, who had seen the evidence of these practices in the real lives of their neighbors, told the guests the story of what they had learned.
When I think of what that must have been like for the mom of a hungry kid . . . a mom who felt helpless in the face of her poverty … who could see a way to help her child … who had just physically done the thing that could make that difference, herself . . .
and to think to herself that her kid could be okay because of something that she could do . . . I imagine a strange and powerful feeling of relief . . . and . . . and power . . . and gratitude.
Question
When I watch the news, I feel stymied and angry and sad and helpless. And I guess that makes sense because the news is nothing more than an endless stream of updates about intractable problems.
When I give my attention to the news, I am giving my attention to tragedy. I know that’s important. If I don’t give my attention to problems, I’ll never solve them. But the problem isn’t the whole story.
Out there . . . in the real, unreported, everyday world . . . are people who are making something just a little bit better, even if it’s just getting a more nutritious meal to their kids. That’s never going to show up on the news. But it happens. And it matters.
And if we also pay attention to those things . . . sometimes the intractability of those problems begins to unravel.
In the case of the Save the Children nutrition program in Vietnam, finding those bright spots . . . those positive deviants . . . solved so many things at once.
Not because it fixed poverty or sanitation or global injustice. But because it gave people practice and insight and hope.
Resolution
In that Vietnamese village, malnutrition dropped 85%.
Now, 85% is just a number, but think for a moment of all the real children that number contains. From there, the Sternin’s brought the approach to four other villages. And they didn’t just recreate the hand-washing and kid feeding and sweet potato greens.
They recreated the whole process of finding the positive deviants, the bright spots. And the solutions weren’t the same in every village. In some places families nourished their kids with sesame seeds. In some, it was peanuts. In some, it was snails.
Each of these villages found its own way and experienced similar drops in malnutrition. And then each village, in turn, became a kind of living university training the villages nearby, until the model extended through hundreds of them and millions of lives had been touched.
Decades later, that knowledge is still alive in the countryside of Vietnam. Mothers have taught their children who’ve taught their own children in turn.
It is a source of well-being, but also a source of pride. We did this thing … we, ourselves … using our own knowledge, our own hands, for our own children.
For their part, Jerry and Monique Sternin took what they learned to other countries . . . and their “positive deviance” approach is now employed throughout the world.
Conclusion
When I only focus on the problems of the world, it is easy to assume that people are flawed, that everything just sinks to the lowest common denominator, and that cynicism is just realism.
And I come by that honestly. Evolution has biased my attention to focus on problems. That’s a good thing, I think. Focusing on problems is what got my ancestors to address them . . . and addressing problems increased the chances that they, and I, would survive.
But as adaptive as that bias has been, it is still a bias. It is just as blinding as its opposite . . . the comforting but illusory belief that everything’s worked out okay in the past so it’s probably going to be just fine in the future.
But when I think of the story of Save the Children’s work on malnutrition in Vietnam, it reminds me that despair and denial are not the only options.
We can, instead, turn our attention toward things that work . . . We can find neighbors whose kids look healthy and strong. We can find out what they’re doing differently.
We can also look to our neighbors that have reduced their carbon footprint or the frequency of emergency room visits or the number of kids who can’t read. We can find people who have pushed back against autocrats and gained ground for democracy.
And when we do, we find a gritty and realistic kind of hope. A hope where our hands are dirty. A hope with direction … for our minds and our hands . . . and our hearts.
Even in an uncertain world, where there is no guarantee of success, we can move forward with faith and confidence.
Because if that mother has figured out a way to let her kid thrive despite the challenges she lived with, then … maybe … we can too.
Outro
Hey, everyone. I’ve been making this podcast for well over two years now, and I am try to follow my own positive deviants, to make this podcast better for you by learning from the episodes that have been most impactful, the ones that have most help you appreciate the world you live in and the people you live in it with.
Now, if all I wanted to do was grow the biggest audience I could, the bright spots would be easy to find. The internet is built to feed back listens, views, and subscribers, but the real positive deviants, for me, aren’t necessarily the episodes with the most listens . . . they’re the ones that most deeply touch your heart.
And the only way I know which episodes those are, are if you tell me.
So please, help me out, let me know which episodes you liked best. Send an email to ben@iheartthispodcast.com. Post your favorites in the YouTube comments. or Leave a message on our “I Heart This” facebook page. I’d love to hear from you.
I Heart This is written, edited, and produced by me, Ben Lord. Our logo was designed by Briony Morrow-Cribbs. Our website is iheartthispodcast.com. Thank you so much for listening. And, as always, Be kind. Be curious, and be thankful.