Wednesday, May 27, 2020

Hungry, hungry hippos

I don't do this very often, so please indulge me at least this once.  I would like to re-visit one of my old blog posts - in this case, a post entitled from Did he really say "Shut up and listen"? way back on November 30, 2016.  The developmental economist Ernesto Sirolli (and founder of the Sirolli Institute) wrote a book called "Ripples from Zambezi" about the lessons that he learned while working with over 250 communities in Africa, Australia, and North America over the course of his 30 year career.  The book can be summarized by the sentence, "In the same way that you can't lead a horse to water, you can't force economic development on people who don't want to be 'developed' according to someone else's ideas."

Sirolli gave a wonderful TED talk in 2012 ("Want to help someone? Shut up and Listen!") in which he tells of an early experience working in an Italian non-governmental organization (NGO) in Zambia in the 1970's.  As he tells it, "Every single project that we set up in Africa failed."  As I posted in 2016:

He tells one particularly poignant story of an early project that involved teaching the local African population how to grow food.  The NGO brought Italian seeds to southern Zambia in order to teach the locals how to grow Italian tomatoes and zucchini.  The area was located along the Zambezi River, and Sirolli tells how the tomatoes grew to two or three times the size of even the best tomatoes in Italy.  He goes on to say how the locals really weren't that interested in learning how to grow tomatoes and zucchini.  They tried paying them, which did work for some, at least on occasion.  Sirolli and his team were obviously very frustrated with the Zambians, but "instead of asking them how come they were not growing anything, we simply said Thank God we're here!"  The Italian aid workers were really proud of how well the tomatoes and zucchini were growing - "just think what we can accomplish here!  We will save the Zambian people from starvation."  But then, overnight, 200 hippos came out from the river and ate all the tomatoes and zucchini.  "And we said to the Zambians, My God, the hippos!  And the Zambians said, Yes, that's why we don't try to grow things along the river."  The Italians asked why the Zambians didn't warn them of the hippos.  "And the Zambians said, You never asked!"

Sirolli tells the story much better than I can - just check out the TED talk.  But here's my point.  The quickest way for any change initiative to fail is to ignore the perspectives and experiences of the experts on the front line (see HRO: Deference to Expertise).  These front line experts understand the contextual factors that will greatly determine whether the change initiative succeeds or fails.  

Context is defined in general terms as the collection of individual, organizational, and environmental factors that both directly and indirectly impact the success of any change initiative.  Context can encompass things such as the willingness of the organization to change, as well as the organization's ability to adapt to the new change itself.  It can even include the leadership skills of the organization's leadership team, as well as their expertise in quality improvement and change management.  Some of my former colleagues at Cincinnati Children's Hospital published a systematic review of research articles that show that context is critically important to the success of quality improvement initiatives in health care (see article here).  Using this background information, they developed what they call a Model for Understanding Success in Quality (MUSIQ) and, perhaps most importantly, showed that their model could be used to significantly increase the chances of successful improvement (see here and here).

Looking back at Ernesto Sirolli's story - what were the contextual factors that were important to the success of their change initiative in Zambia?  It seemed that the Zambians weren't willing to change, at least at first.  As the Italian NGO learned later, the Zambians knew that the NGO's workers were making the wrong assumptions.  They forgot the very important contextual factor of the hungry, hungry hippo.  "Why didn't you tell us?" - "You never asked us!"  

Don't make the same mistake in your next change initiative.  Ask, and more importantly, listen to the experts.  Learn about the important contextual factors BEFORE starting any new change initiative.  And most importantly of all, never, never forget about the hungry, hungry hippos!

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