problem solving

I found this “bleg” (a new word for me–I think it is synonymous with “beg”) in the NY Times Freakenomics Column. The content is not really new to me, but I was drawn the post because it stirred up memories of my undergrad at UNC Chapel Hill. While there, I received my first impressionable introduction to public health, global health, ect. I was also deeply (and still am in a different way) passionate about sub-Saharan Africa. As a result, I would jump in on any discussion related to societal problems owned by African countries. In retrospect, it seems my perspective on these issues was often seasoned with cynicism and a healthy appetite for critique. At some point along my path, I set down a refreshing naivete and optimism about how issues impacting the developing world could be resolved, and I picked up a bag of unproductive, strong opinions in their stead. I skimmed through the comments to the “bleg” and cringed when I read the dour responses of who I can only assume to be disillusioned aid workers? Or perhaps they are just regular readers with very high opinions of their own thoughts on the matter. Either way, I was reminded about how I want to think about such issues. Realistic, constructive, thoughtful and rooted in evidence. These features, however, do not need to be adopted at the expense of compassion, hope, respect for others’ good intentions and a healthy appreciation for cultural context. End diatribe.

“Dear Freakonomics,

My name is Michael Frank and I recently began working for a start-up NGO in Mali that strives to improve health. One of our programs is called “Action for Health,” which provides in-need families with access to free health care in exchange for doing a set number of predefined actions that benefit public health.

The logic behind this program is that studies have shown there to be an enormous jump in the percentage of citizens who choose to receive health care in Mali when it is free as opposed to just heavily subsidized. We require the actions be done so that the residents don’t take the free care for granted and because these actions improve public health either for the individual or the community.

A good action for health is something that improves health, is easily measurable, and is not so burdensome that it seriously hinders the participation of this in-need population. The action of a comprehensive hand-washing program for example, as detailed in Atul Gawande’s new book The Checklist Manifesto, fits two of these criteria but it is not ultimately easy to monitor compliance. One recent action for health that fit our three criteria reasonably well was a recycling day, during which residents had to spend the day picking up the trash that is ubiquitous on the streets in Malian slum neighborhoods.

My bleg is: What other ideas do people have for “good actions for health” that fit our criteria? I’d also be interested for any other ideas that people had for our NGO in general. Thanks.”

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