Below you will fine Jake Waxman’s account of the extraordinary organizing project he, Natalie Finstad and Hahrie Han have launched with the District Health Borad in Aukland New Zealand. It’s taken our work in some exciting new directions and, as always, offers a great deal of experience from which to learn.
Friends in the Leading Change Network,
I want to share with you all the results of the launch training of Hahrie, Natalie, and I’s partnership with a wonderful group of leaders down here in Auckland, New Zealand. Writing to this group because you’ve been close in my heart and mind (either because of lessons I’ve learned from you about leading these trainings/organizing in general, key questions you’ve asked about the project along the way, or just because I think you’re great…I’ll leave open the possibility that for some of you, it is “all of the above”) as we’ve embarked on this effort and think you might be interested in hearing an update.
A quick review of the project: the District Health Board which oversees health care provision for the government in the poorer and disproportionately Pacific and Maori populated area of the Counties Manukau just south of Auckland has been facing a persistent problem. A brief overview of the nature of it:
- Pacific and Maori communities have worse health outcomes on average than the general population, across all kinds of indicators (obesity, diabetes, heart disease, depression…the list goes on)
- New Zealand’s official health leadership has identified youth mental health as a prime concern for the country as a whole, citing that the country has higher rates of social morbidity and suicide among youth than other developed countries…this is especially problematic in Pacific immigrant communities in which youth face dual and often competing expectations from the dominant New Zealand society and the culture of their families. For example, when a member of a Pacific family dies, the expectation is that the whole family return to their home country to mourn together, often for several weeks. The schools in New Zealand don’t have a mechanism for taking these leaves of absence into account and students are often behind when they return.
- The population in Counties Manukau is rising, as is the use of acute care services. The DHB isn’t keeping up and would have to build a new hospital to do so.
- The DHB controls many of the resources for health care. The Pacific communities – the ones with the greatest interest in change to improve the situation – don’t currently have the power they need to address these problems.
- The DHB has employed a service outreach approach, extending services into the community and promoting them with greater intensity. This has produced only marginal change in usage of services and health outcomes.
In 2011 Hahrie was part of initiating a relationship with the leadership of an innovations team within the DHB who’s charge is to create and test new approaches to tackling these persistent problems (I believe Kate Hilton played an important role in that initial phase as well). After some initial trainings through OfH (holler out to Kate!), the DHB committed to developing the leadership capacity of the communities facing the problem to see how it could help in dealing with the problems laid out above. In order to test this theory, Hahrie recruited Meredith Mira and I to work with a 3 person leadership team at the DHB to develop a pilot project employing the organizing training to launch a mini-campaign in the constituency of Pacific youth around the problem of youth mental health. We worked for 4 months from a distance, coaching Alex Nicholas, a fantastically gifted lead organizer for the project, to recruit and develop a leadership team, and to work with that team to recruit 25 youth leaders for a two day engagement organizing training. During that time we sadly lost Meredith to the demands of dissertation completion and academic job application process but happily added Natalie Finstad to the project team. With Alex having developed her team, recruited the youth, and established a basic outline of a campaign, on April 15th, Natalie and I hit the ground to lead our campaign launch training.
We started with a Thurs/Fri (April 18-19) training for a group of 8 facilitators (7 of whom had gone through the OfH distance learning curriculum, 2 of whom are part of the youth leadership team and 3 of whom are senior managers within the DHB). One of the tensions we experienced was in setting this team up. We grappled with whether to have the youth leadership team Alex had built serve as the facilitation team, which would serve a campaign leadership structure function, or to have members of the DHB OfH trained team serve as facilitators, which would serve a DHB capacity development function (which is a key interest of the DHB in this effort). Ultimately, not everyone on Alex’s team was able to make the commitment to be at the T4T, which helped us to make the decision in favor of the latter strategy.
Natalie and I either led or faciltitated the breakouts for all the sessions, which was great, but also exhausting. Our training team is an awesome and unlikely grouping: a Maori woman who followed in a long line of nurses to become a leader in the Maori mental health community; a half white, half Samoan woman who was the first in her family to go to college and dragged her mom along with her so that they both graduated with degrees in nursing; a tongan man who grew up with an alcoholic father but became a youth leader in his church at 16 and begin a journey to graduating college, and eventually to leadership in this campaign; a young half maori, half cook island woman who is the lead organizer who struggled through and almost died from anorexia and is now one of the better young organizers I’ve worked with; a white woman doctor who is a senior manager in the hospital but believes deeply in working in and around a community; another white woman who grew up in a poor family outside of Auckland and went to school to be a lawyer, dropped it when she failed an exam and realized that what she liked best was sociology and now works in program design for the hospital; a Somoan man who works with youth around drug and alcohol abuse and was learning this approach for the first time; and a Tongan researcher who decided that his best route out of his family’s poverty would be to get a master’s degree, which he has done and is now committed to supporting his community in getting out of poverty.
The two day training 4 trainers worked well. Since Alex’s team was still struggling to establish a clear 3 month campaign strategy, especially around setting a goal, we used the T4T to have the facilitation team go through a generative two part strategy session around the problem of Pacific youth experience of pressure. The first was a great session, which Natalie facilitated wonderfully, and it underscored a key lesson from this effort: a key step in developing strategy is to have the leadership team go through a strategy workshop prior to bringing together a wider constituency. The group came up with a solid 3 month mini-campaign building up to a peak of 5 parent/youth community forums in which youth would engage parents around their experience of overwhelming pressure. Alex noted, astutely I think, that she wished her team had been there for the session, because she couldn’t just tell them this was the new strategy.
This led to our big innovation for the participant training: after much deliberation, we decided to use the strategy sessions at the youth leadership training to engage in a group decision making process in order to establish a campaign goal. After a 7 hour facilitator prep day on Monday, April 22, we led 24 new youth participants (in addition to Alex and Va’a, a total of 26 Pacific youth) in a two day training (April 23-24), launching 5 leadership teams for a campaign building up to youth led communication skills workshops in July. The DHB also organized two additional DHB staff teams to go through the training, which was a great choice as they came out excited to use this approach in their work. One of those teams is already working on a organizing ready project to increase hand washing in the hospital. Lots of possibility there. The youth have already begin their campaign by recruiting 74 additional youth to join the first peak of 5 youth meetings (one led by each team) during the week of May 20th during our action session at the close of the training.
A few other highlights:
- lots of laughter and wonderful engagement from the youth. The two days of trainings were over 20 hours of training time, and the youth were present from beginning to end (save for one who couldn’t return for day two due to illness).
- Perhaps the best facilitation by a first time facilitiator team that I’ve been a part of. They asked such good questions in the story coaching and moved groups along in learning very effectively, even reteaching aspects of curriculum that an upfront trainer may or may not have missed (ahem…).
- An opening ceremony led by community elders (called “Kaumatua” and “Matua” in Maori and Pacific cultures respectively): we were received with such warm and open arms (a far cry from experience in Vancouver brother Dan!)
- Closing ceremony led by Alex and her team that included two wonderful linking public narratives from participants, a tearful close from one training team member, and final words of blessing from the Kaumatua and Matua. Oh, and Alex organized certificates which she awarded each trainee.
- Several participants, both youth and more veteran DHB employees, said this was the best training they’d ever been too. For some this meant they were stacking this up against a lot of trainings.
- At least 5 youth mentioned in their evaluation that they were feeling more confidence coming out of the training about their ability to lead effectively.
- Natalie was wonderful. She led one of the better sessions on Team Structure that I’ve seen. It incorporated not just the teachings about launching a good team, but also the importance of establishing space for the snowflake to expand by using the story of how she’s built out the snowflake at Tatua in Kenya (org she helped start there). She also did a wonderful session on tactics and timing that highlighted the need for flexibility in tactics through the story of a campaign she was part of with the Episcopal church in Boston. Again, a great session. You might be wondering, “did they get those on tape?” To which I might answer: YES!!!
- A very solid story of now sample from Katrina, our Maori training team member.
- The creation of a strategic 3 month peak goal! (see above…youth leadership teams leading trainings for youth on communication skills)
- The adjusted strategy session took much longer than we’d anticipated and though we did reach a strategic decision, it left us 35 minutes behind in the training schedule. Interested in learning whether this could be taught in a shorter time and how we might use this GDM process in future efforts.
- The short term nature of the project made coming up with a change in the world goal much more difficult for the youth to conceptualize. I think the key here was to distinguish between a meaningful strategic 3 month peak and a longer term motivating change in the world goal. We have the former (youth led trainings), but haven’t articulated the latter (the equivalent of measurable increase in hand hygiene). Alex and I will be coaching around that this week.
- 2 youth didn’t show up.
A couple of ideas germinating/lessons not captured above (using “a couple” to mean “an indeterminate amount that will be determined only in the writing of said ideas”):
- We might experiment with teaching strategy in three parts: 1. People (breaking down actors map) and Problem (which go together in a back and forth manner), 2. Purpose (strategic goal setting) and Power (analysis of main decision makers in making goal reality), 3. Path
- The problem questions can get deeper I think: really breaking down the component parts of the problems: experiences of problem, causes of problem, and results of problem (for example, with unfair wages: people experience problem as not having money to pay rent, put food on table, etc; problem is caused by low pay, and results of problem are things like malnourishment, illness, etc). I think we can work backwards here from lived experiences by asking “why is that a problem”. Once these are laid out, the strategic question might be: “Given our current resources/capacity and points of potential leverage, which of these should we tackle first?” Or could we just say, “okay, let’s tackle one of these problems and work through our power questions…which one first?” Or perhaps work to combine them, find a common fount of the problems, and tackle that.
- When tracking down the power, would it help to ask: “what resources/decisions do we need to solve our problem?” and list those out before going to the 2nd question of tracking down the power (“who has the resources to solve the problem?”)?
- The participants at the trainings said several times that having to move people from the michelin man diagram to the field of play helped them to understand teaching point about needing to be specific with names of actors instead of general institutions. It’s hard to move an institution, but a name you can move/engage with.
- There may be too many criteria for choosing a strategic goal as the number of them seems to confuse rather than help participants. Natalie and I broke them down to: 1. Meaningful motivation – Changes lives of constituency and hits hearts/guts, 2. Measurable – focuses on single outcome and we can see if we’ve achieved it or not 3. Time-bound – foreseeable victory. This might not be it, but would like to hear other thoughts. (means we would take out contagious and leverages our resources…the former is a bit fuzzy in my mind and the latter might be a question for tactics rather than goal setting).
- Total trained: 8 facilitators + 24 youth + 10 DHB employees = 42
And a final highlight: on a scale of 1-10, the training got a 9.56 average rating. One youth gave us a 10,000,000,000,000 out of 10. That number was not used to reach the 9.56 average. He might need some help with math, but he made his point.
Big hugs all around the globe,
Jake, Natalie, Hahrie