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Mentoring Moment: The Art of Animating

11/3/2014

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A recent mentoring conversation with a beginner in the art of facilitation prompted this post of things that I think about when I facilitate.   I love the expression that my French friends use "to animate".  A facilitator's role can range from being more of a mediator working invisibly to being more of an animator applying one's unique, dynamic energy to create a container for participants to discover their role as heroes of the unfolding experience.  An effective facilitator of a meeting- keeping focus/time, moderating participation and achieving objectives - falls somewhere in the middle.  

Each person brings uniqueness to the role; each situation invites different ways of being. Building capacity for facilitation is a practice.  The art is knowing what is optimal for the context and having the flexibility to improvise across the spectrum in the moment!
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1. A Learner's Mindset

Facilitation is a skill. Skills are best practiced over time with a learning approach.  I like to identify the one or two skills that I want to focus on in an event that I am facilitating.  Knowing what I want to practice heightens my attention, then I practice it and solicit feedback on that specific task as well as generally so that I develop deeper awareness of both strengths and weaknesses.  Culturally, some people focus too much on strengths and others too much on weaknesses.  

True self awareness sees both as they are.  Hone your strengths and grow your skills around your weaknesses.  Even as you become more experienced, seek feedback as if you were beginner.  Meng's book on Google's program for emotional intelligence development, Search Inside Yourself, provides useful tools to cultivate these skills.  


2. The Prep/Setup

Attending to the physical space is one of those invisible acts that yields great benefits. Here are prompts: 
  • how will the physical space support the intended flow of the event?
  • what will people be looking at (your back/peoples' backs or everyone's faces)
  • how does the space support or inhibit engagement/participation?
  • how will people feel in the space? 
  • what is the shape of the table (e.g. in mediation, we prefer round whenever possible to get over the "idea" of sides), how are the chairs arranged (e.g. if no round table, we seat "opposing parties" on the same side of the table to physically remove an adversarial stance).  

Preparing the flow of an event is crucial.  When I create an experience for people, I consider: 
  • how will people engage with convener, facilitator and each other? 
  • what will be everyone's first shared experience?
  • how does the agenda fit with and/or respond to the people in the room? 
  • what support will people need to fully engage (trust building, food, bio breaks, reflection time, social interaction to enhance/solidify content, scaffolded experience)? 
  • how flexible is the schedule to accommodate the unpredictable?
  • how can we design the flow to yield the desired participant experience?
  • what design of processes/methods will yield the desired outcomes for the event?

Designing what methods/processes to apply is an art and craft that benefits from experimentation, success, failure, spontaneous adaptation, curiosity and flexibility.  

For discussion on these topics, I suggest browsing the Changemaker Bootcamp Watercooler: "space physics", "group physics" and "designing engagement." 


3. The Start

Creating a container that begins with a clear start and a conscious close is powerful. The start creates our first shared experience, it sets the tone and supports shared understanding about our goals (Outcomes), what we'll do to get there (Agenda) and how we would like to engage with each other (what people often refer to as group agreements/ground rules, though I call party favors, see below.)  

I like to ask people as they introduce themselves to answer the question: "what do you hope to get out of today?" and record responses on a flip chart.  This participant generated list sets shared expectations from the outset, serves as a guide for me. and provides a reference to check at the close.  

The Ariel Group proposes a 4 question check in that asks: How are you feeling? What percentage are you present? What is keeping you from being 100% present? What do you hope to get out of ____? and closing with a round of "Aha Moments".   


How are you feeling?  
What percent are you present? 
What's keeping you from being 100% present?  
What do you hope to get out of ______?
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Eugene Eric Kim offers excellent insights on The Art of the Start when creating containers for collaboration and provides more in depth resources for building capacity to facilitate collaboration at Faster Than 20.


4. The Container 

I follow these key points from Angeles Arrien to create a container whether it is a design/product workshop for creative problem solving or a mediation to resolve a conflict. 

A) What will people need to maintain sufficiency?

What do people need to be fully present and engaged?  Attending to this means orienting people to the space (logistically, e.g. bathrooms, fire exits, etc), to the day (e.g. bio breaks, etc) and to the content (e.g. schedule, etc).  It necessitates understanding what "safety" people need to participate fully; often called group agreements (or ground rules), I prefer to call these "Party Favors." I share my basic list then invite people to add any others that they need to participate fully in the experience. 

My basic list includes: 
  • cultivate curiosity (ask questions, allow emergence, think different)
  • radical respect (courage to speak, humility to listen)
  • build on the ideas of others (encourage WILD ideas, have fun)
  
B) What can be used to facilitate shared understanding?

When I address shared understanding, I think about it both as something verbal and something visual. Having someone who can be a "scribe" to record notes, or better yet, a visual notetaker, who can make beautiful picture-filled notes, helps participants know that they have been heard. 

The main areas that I attend to for shared understanding that include a visual component: 
  1. Why we are here: Goals/Outcomes  
  2. Where we are going: Agenda
  3. Perspectives: document what people say, ideas shared, draw pictures to create shared meaning
  4. Artifacts: If one does a good job of taking notes during an event, then these become artifacts for future conversations. 

C) Host Different Points of View

We are increasingly in environments of preference-philia- a homogeneity that diminishes our capacity to host different points of view.  Here are a couple of tips/tools for supporting the expression of diverse views. 

  1. Conversational Justice: when developing an exercise, time structured segments that require each person to participate and that afford each person the same amount of time to participate can provide conversational justice.  This forces participation by quieter people and limits the time of people who might tend to dominate a discussion.
      
  2. Participatory Engagement: engaging people who might be reluctant to speak in a larger group can be done by breaking into smaller groups that enable more participation. Alternatively, an activity in silence ensures that everyone participates or providing everyone with sticky notes and asking questions of a large group but each person has to answer on a sticky note.

  3. Lateral Decision Making: adopting approaches to differing views that allow everyone to look in the same direction at the same time can be powerful.  Edward De Bono's Six Thinking Hats introduces this model that works effectively and efficiently for inclusive, participatory discussions.  See under "Read More" for a version of this method that I adapted and applied for clinical decisions.

  4. Scaffold the Experience: easing people into sharing their views through a staged process can help people to feel comfortable when an issue may be threatening. One effective model that I have used starts with:
  • me (silent/my perspective) 
  • me with you (silent/I look at what you wrote)
  • me (silent/reflect on my perspective informed by seeing yours)
  • you with me (silent/I look at what your wrote and ask/build on it)
  • us (engage in dialogue openly)

D) Hold the Creative Tension 

In addition to hosting different views, one needs to be able to sit with the views in opposition- to lean into the uncertain space.  In a world that rushes to solutions, the facilitator's role is to allow a solution to elude long enough for great ideas to emerge.  This may mean: Sit in the Messiness.  Change the Frame.  Go for a Walk in Nature.  Visit a Toy Store.  Think Different. Most of all, cultivate the capacity for uncertainty. 

At the 2008 World Forum on Facing Violence: Justice, Ethics & Conflict Resolution, Mark Gerzon promised to "Keep it warm, but not too hot;" his book, Leading through Conflict is a favorite resource on building this capacity to hold the creative tension.  

Another favorite is John O'Neil's Leadership Aikido. Building this capacity takes practice.  Each person's journey is unique. I shared insights from my learnings building this capacity for mediation in Passive Participation in Conflict and a chapter on clinical ethics mediation. 



5. The Close

Whether it is a check out, sharing "aha moments" or "jazz hands" moments, or making commitments to action, the act of consciously closing the container strengthens the power of the space created.  



6. The Learning Loop

For the facilitator, the end comes after the learning loop.  At the beginning, we set out our learning goals.  At the end, we need to get feedback on our practice. 

I prefer to do a learning loop by:
  • learner shares what went well
  • learner shares what could be done differently next time 
  • peers:  external people can share their perspectives, ideally in a feedback sandwich:
    positive - growth opportunity - positive.  Feedback needs to include concrete examples fand specific explanations of why it was positive and/or a growth opportunity. 
  • participant group (probably via email): provide feedback
  • learner integrates self-assessment and feedback into a refined understanding of his/her abilities
  • learner identifies new skills for revised learning goals at next experience

Facilitation requires practice of skills as well as the process.  By evaluating participants' feedback and achieved outcomes, a facilitator can assess whether the methods selected were appropriate for the participant's experience and if the process yielded the desired outcomes.  (double learning loop)


On a learning loop note, I would love to hear from you about whether this post is helpful.  Comments, questions and additional resources welcome!  
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Integrity by Design for Appropriate Health Care Technology: TEDxBarcelonaChange

1/5/2013

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Let's harness the power of 21st Century technology 
to assure the quality, reliability and safety of 
health care devices for everyone, everywhere...



On April 3, 2013, I gave my first TEDx: Integrity by Design at TEDxBarcelonaChange: Positive Disruption in Global Health
part of TEDxChange sponsored by the Gates Foundation

Join us as we build integrity by design to positively disrupt global health: http://www.integritybydesign.org

It was a humbling and brilliant experience. I am grateful to the #TEDxBarcelona team who hosted an outstanding, fun event and to my fellow TEDx speakers who inspired everyone! (Full speaker line up here: http://ow.ly/kAldv )

Thanks to our outstanding organizers Aurelie Salvaire Perrine Musset Johanna, rockstar coach Florian Mueck & the #TEDxBarcelonaChange team!  Very special thanks for ubuntu from my community whose contributions were invaluable. 
Let's positively disrupt the status quo! 
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Macroscope Labs 5<5

15/1/2012

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This post is one in a series of posts that document pilot/prototype projects with the format 5 things that I wish someone had told me before I started in <5% of the time spent on the project.  This post also provides some context around the project, since it was a cornerstone project for me in the second half of 2011. 


In June 2011, Edward Harran and I embarkeded on a 6 month experiment. A deep dive collaboration across the Pacific Ocean. Eddie in Queensland. Kate in San Francisco.  Part mastermind for our personal projects and consulting gigs, part virtual praxis of a future of work digital innovation lab for a globally distributed team and part incubator of ideas. We set off to explore. 

Macroscope, coined by Eddie, reflects the "big picture" - multi/inter-disciplinary, systems perspective that we endeavored to sensemake in our lab.  Mindful. Playful. Creative. Engaged. Curious.  The aim was to make complex simple.  To bring big together with narrow in the sacred space of creative possibility between.  To transform the experience of chaos and mess into something sublime. Ultimately, we wanted to build a place to play with our creative potential and to hold a space that would allow the value of the spaces in between to emerge, unfold, expand...  with a macroscope perspective to unleash the potential for social impact.... and we wanted to live mindfully and productively working in a digitally-mediated global context.

In 6 months, we cogenerated amazing ideas that continue to live in us- expressed from time to time in posts and projects.  We honed a vision for Macroscope Labs* (mL) from future of work ideas, such as the world's first Center for the Emerging _____  and a research proposal to pilot and analyze the innovation value of an Ecosystem Diplomatic Corps (Ecosystem Diplomats explained)... to systems issues that we frame-worked* such as Macroscope Playhouse and Macroscope Compass... to finding a home base for our shared personal narratives as "context chameleons"* and knowmads.  

Eddie brought the knowmads idea fully to life from concept to a brilliant presentation delivered at TEDxBrisbane.  It was an epic achievement and an ideal culmination of our journey together in the Macroscope Labs experiment.


5 Things it Might Help to Know Before You Launch an Experiment About the Future of Work

  • No one will understand what you are doing.  (They'll think you are nuts.) You may not understand what you are doing. (You may wonder if you are crazy)  When it's over, no one, including yourself, will understand what you did or why it mattered. And yet, it is most important that you do it.  Experiments are our learning way into the future. You will learn and the people you work/play with will learn. However, don't expect anyone in the current world of work to understand and/or to value your skills from an experiment about the future of work- now that is nuts!  
          Take home: Don't let the present judge the future.  Let the future judge the past. 

  • While the future is full of possibility, we still live in the present. A lot can happen with alternative, complementary and gift currencies/economies, yet one needs money to live in the present.  TimeBank, for example, still needs about 30% of the value they generate in dollars in order to fund their own operations.  Think about yourself as the TimeBank, make sure that you have enough to cover your basic survival needs in the present before embarking on the future.  Future-focused projects take time to build traction and attract the kind of funding that they need to sustain themselves on an ongoing basis.  Long enough for the present to catch up with that future horizon on which you are operating.  As with any new business, there is a period of time until you have a steady cash flow; likely wise, with a new technology, one has to be adequately prepared to "cross the chasm," the period of time between when an small pocket of early adopters discover and endorse the product until it grows to a steady early market of mainstream users. Think of future-focused projects as both a new business and a new technology and prepare accordingly. Bring extra reserves to cross the chasm between you and the Oasis, it may be like crossing the Sahara.... and that's fun as long as you are prepared!
          Take home: Feet in the present, eye on the future... and mind the Chasm!
  • If you know that you want to leave signposts for others, be sure to have a documentation strategy.  If you want to make things beautiful, be sure to have a designer on your team.  If you want to do things quick and dirty, know how to explain the vision simply and to scaffold the context accessibly, because people may not 'get' the messy version.  If the goals that you have don't align with the skills that you have on the team, then shift the goals to play to the strengths of your team or get the skills. Alignment on this is mission critical. My hunch: skill set for the future worker will be radically different; people will need to know how to communicate simply and effectively in writing, code and drawing. 
          Take home: Know your audience and get the right team- diverse skills sets with varying pockets of depth, 
           what you don't know, you learn rapidly, and eager to do what needs to be done for the project's success. 
 
  • Before you start and along the way, identify a means for you to demonstrate what you learned, what skills you developed, what learning you gained.  When a job/role does not fit in the present, it is hard for people in the present to understand how to interpret what was undertaken.  Some ideas on how to approach that are outlined in a 5*5 Systematic Approach to move from Idea to Pilot and from 5 years ago, I posted a seed {idea post} for the BeWell, WorkWell tool for soft skills development. More recently, a seed {idea post} for a learning journey tool, which would enable people to identify and demonstrate soft skill learning under emergent conditions. 
          Take home: Prepare to document what you are learning at the outset.  Remember to do it along the way! 

  • On the journey to the future, other people will emerge around you who seem to be doing the same thing.  Celebrate that! Celebrate them!  Team up. When possible an open knowledge framework enables you to engage more people and grow more rapidly.  Share your learnings. If they don't want to play, then let it go and celebrate them anyway!  It will take many people trying, many times in order for one team to break through the wall of the present.  Be happy that you are one of those pushing the wall, and be confident that whether you are that one or not, your initiative contributes to launching a new direction.  Those who rise quickly, do so by standing on the shoulders of those who came before.  There are always those who came before.  Find them and learn from them.   Most 'lauded' inventors didn't actually invent what they are known for, they made an vital improvement that took the invention to a new level of market accessibility.  
          Take home: Celebrate others! Open source everything possible. Seek out those who preceded and learn from them.

  • Never underestimate the power of in person

*We had all of these domain names.  My registrations glitched on the renew, and so they are released- all available. Go do something interesting and build on our ideas.  Give us a shout out when you do so that we can amplify your work! 

Thought contributors:  With immense gratitude to and for Eddie Harran,  my brilliant collaborator, awesome ideas instigator, cherished friend, mindful mate and hapatwin.  Thanks to David Hood and the Gathering '11 energy for pulling Eddie and me to Melbourne where we sealed the deal on mL. Never underestimate the power of in person. 
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Interdisciplinary Studies: Structuring Higher Education for the Future

26/9/2010

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Does our education systems need to transform to graduate students who are ready for tomorrow? 

Over the past couple of months, I have heard bright leaders of interdisciplinary centers/programs at top Universities advocate fiercely that what leaders today (and thus, their students) need for success is interdisciplinary education.  This reasonable idea requires "advocates" because it threatens the status quo of traditional academic structures.  A department budget is often based upon the number of students that major in the department. The success of a department may be evaluated by the number of students who go on to get an advanced degree in that discipline.  Interdisciplinary programs make accounting under the traditional system a challenge, and potential casualties of any disruption might include tenure, funding/salaries, departmental size and department status.

Universities have an opportunity to adapt to the rapidly changing world by developing new educational modalities, implementing new approaches to learning, and supporting new programs that will prepare students to lead, excel and thrive.  The public entrusts universities with the task of educating our young people to meet the demands of tomorrow.  Universities have an obligation to look critically at their efforts and to identify structural barriers to empowering students with relevant, applicable knowledge and skills to navigate our complex, dynamic world.   

1) Maximizing the value of an interdisciplinary education
While appreciation for the value of interdisciplinary studies is new, they are not novel. I was an interdisciplinary studies major (Humanistic Area Studies), yes, four quartets ago. Ironically, I would say unequivocally that the process of making my interdisciplinary major happen was the most valuable part of my college education. I learned how to negotiate in the face of a Goliath of unknowns, politics, bureaucracy and resistance.  It was an early success and remains a constant reminder that I can make the seemingly impossible- happen. I apply those skills everyday in my life work as an entrepreneurial social change agent. The lessons of practical experience are invaluable and must be better integrated into whatever new interdisciplinary structure emerges.  Beyond the substance of interdisciplinary problem solving, students need to learn how to apply these ideas in context so that they can concurrently develop the skills to lead and flourish as an interdisciplinary agents of change. (Great example from U of Calgary featured in Tools of Engagement on innovating experiential learning)  The MDG and CGI have galvanized terrific momentum in the SE ecosystem, and we will still have work to do! Our global economy and society will benefit from students having more access to interdisciplinary studies, so yes, let's have more of that, please! 

2) Creating change requires humility and depth
Interdisciplinary programs allow synergistic ideas to emerge and unleash the possibility that stems from bringing multiple views together to create new perspectives.  Yet, interdisciplinary programs need to provide students with depth.  The green MBA and Skoll Scholarships for Social Entrepreneurship MBA  provide students with necessary MBA skills while adding focus, connections, resources to apply these in a novel domain.  Likewise, having a law degree with my Certificate in Alternative Dispute Resolution grounds my negotiation and mediation skills in a concrete actionable framework.  The Certificate in Bioethics & Medical Humanities program that I completed was designed for working clinicians.  Today, many people are graduating with advanced degrees in Bioethics but with no clinical background and they have difficulty getting a job.  In practice environments where the goal is to make and lead change, one needs concrete skills to contribute to the effort.  Stand alone programs run the risk of providing students with great ideas and new perspectives, but without the depth of concrete skills (MBA, JD, MD, Design, Engineering, IT, Art) necessary to catalyze change.  Changing the paradigm of the traditional degree is essential and preparing students with a foundation that affords humility and depth that adds value in at least one arena is critical.   

3) Allowing the dynamic vision of interdisciplinary perspectives to flourish
Interdisciplinary centers bring people from different disciplines together to facilitate dialogue and problem solving.  Open minded people meet, projects emerge and collaborations begin.  Supporting students to find interdisciplinary links is an important opportunity for degree programs.  In the absence of interdisciplinary programs, I had the opportunity to envision my own linkages in the rich, vast sea of humanities. I combined Classical Studies with Latin American Studies- not one that comes to mind on first review, but my thesis was a comparative study of ancient Greek and ancient Mayan mythological views of the underworld and its impact on their world view and approach to living.  Unlike the traditional comparative literature focus of contrasting, I was most interested in the commonalities.  Part of the opportunity of absence of an interdisciplinary program was that it allowed the envisioning of a new perspective- an innovative view.  When the faculty are already there and the interdisciplinary seeds are planted by the courses, I wonder will the opportunities for dynamic vision be accelerated, better channeled, or lost?  

What do you think tomorrow's leaders need? 

This is the first in a series of posts about structure and change in the social enterprise ecosystem.  These are my musings and reflect my views following conversations with people who work in both undergraduate and graduate environments at universities around the world. 
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Minds the Gaps - Scribd

15/3/2008

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This paper is shared under a creative commons license 3.0 Attribution Non-commercial Share Alike. 
Available for download via the link below.

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Personal Reflection 

1. Engaging Change
2. Gaps of Culture
3. Gaps of Geo-Political-Socio-Economics (GPSE)     
4. Gaps of Systems
5. Gaps of Power Perspective
6. Mind the Gaps: Applied to Individual
7. Mind the Gaps: Applied to Institutional/Systems Issue
8. Mind the Gaps: Conclusion


mindthegaps.pdf
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Mind the Gaps Conclusion [8 of 8]

10/3/2008

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Mind the Gaps [whole document ]
Mind the Gaps Applied: Institutional/Systems [7 of 8]

Conclusion


In discussing this poster and working with people of diverse and vulnerable populations, I discovered that creating an inclusive space remains elusive, even for people who are committed to doing important work for social good. I offer a backbone for building capacity so that those who are committed to cultivating inclusive spaces might be able to realize their aspirations. 

Until we can fully embrace the truth of our wholeness, we may have difficulty gaining the trust of those who have been oppressed.  For if we hasten to challenge injustice, we bring our blindness, (we do not see ourselves in wholeness), deafness (we do not hear because we do not ask/listen) and arrogance (we ignore guidance from those we claim to help because we know better).  Masked by our good intentions, we may recommit the problems of the past as our actions contradict our stated intentions. Our actions, motivated by an unhealed state, are like shooting arrows at those we claims to defend.  

As a previously oppressed person, I may develop the capacity to deflect this arrow and realize that I am an unintended target. When no longer in fear and having healed any prior injury, I may ask the person who shot the arrow, “why have you shot this arrow?”  And the person, whose identity as ‘fighter against injustice’ is so strong that s/he cannot see that s/he could possibly shoot an arrow responds earnestly, “I did not shoot an arrow.”  The powerful force of cognitive dissonance blocks him/her from seeing an arrow, and s/he becomes indignant hearing the statement of an alternative perspective as an accusation, “I would never shoot an arrow.  I am not an archer, I am a pacifist.” … 

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Mind the Gaps Applied: Institutional [7 of 8] 

9/3/2008

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Mind the Gaps [whole document ]
Mind the Gaps Conclusion [8 of 8]
Mind the Gaps Applied: Individuals [6 of 8]
III. Mind the Gaps: Applied

The following two scenarios reflect the application of how one might apply Mind the Gaps to promote inclusive action.  The first scenario shows an administrator using the Mind the Gaps framework to consider how to address a conflict at the school.  The second scenario demonstrates how a proposed government action was evaluated under the Mind the Gaps framework and illustrates the responsive action that sought to promote conscious, inclusive action for social change.


B. Institutional:  Emergency Preparedness


In December 2005, the Center for Disease Control (CDC) hosted a teleconference proposing that local governments throughout the United States adopt “Community Legal Preparedness for Public Health Emergency” and expand the public health authority for an infectious disease outbreak, like avian flu.  During the Questions & Answers, I inquired how this proposed scheme to broaden authority would address the needs and protect the rights of people from diverse communities, such as those who didn’t speak English; there was a long pause, and someone attempted to respond but didn’t actually address the question. I wondered what an inclusive preparedness plan would look like?

Public Health Authority is the power that government has over the people to protect the public’s health.  The public entrusts discretionary power to the public health authority, and the proposal sought to broaden discretionary authority even further eliminating restrictions placed after historical episodes of misuse of authority over marginalized communities. I reflected on the response to my question about non-native English speakers and wondered who else might not be adequately included in a plan developed by people who aren’t thinking consciously about inclusion. Below are outlined some of the questions that I considered when thinking through how to make the CDC’s proposed course of action truly inclusive.

1. Gaps of Culture: Public Health

- What if the public health authority’s good intentions to protect the public good gets overrun by the politics of fear and discrimination in a time of panic and uncertainty?

- How does the public health authority intend to use their discretionary power?

- Is there concrete guidance on how to use discretionary power in difficult situations?

- What protections exist for the public, if we fail to meet our ethical aspiration to use our power well?

- What if the public does not trust the public health authority or it’s good intention? 

– what if the public health authority is not as good as it presumes to be and what has been done to ensure that the good intentions are realized?

Having done a critical legal history of public health’s treatment of vulnerable populations[1] during infectious disease outbreaks, I wondered whether the public health authority would be able to carry out its noble intention amidst the heavy political pressures that dominate, particularly in the initial stages of a public health disaster, when fear looms and science lags. I also wondered how those who do not trust the public health authority, or government in general, would be affected during a public health emergency and what the implications would be for the public’s overall health if some sub-groups did not follow the public health directives.  I also considered that getting funding and support for preventative efforts and for marginalized communities is nearly impossible, and I considered that if there were a collective interest, it might facilitate funding for inclusive policies.


2. Gaps of GPSE: Public Health

- How might people from different GPSE be affected during the critical stages? (awareness/prevention, screening, treatment, vaccination, quarantine)

- How will geography play a part in an epidemic? With regard to limiting access to treatment and spreading disease?

- How will political status influence the public health authority efforts?  What happens to non-English speakers, what happens to recent immigrants who are often scared to access public services in the US?  What happens to prisoners?  What happens to people who are not legal citizens?

- What social factors will influence the epidemic?  What happens to the elderly?  the elderly who are institutionalized in nursing homes?  What happens to a child whose only parent may become ill? 

- How might different economic status impact the public health authority plans?  How will the homeless be contacted?  How will the poor be impacted?  Will the need to eat and fear of job loss lead people who work rather than stay under quarantine?

Relying on my historical identification of marginalized communities and scenarios from the SARS outbreak in Toronto, I developed 5 scenarios and used them to identify who might be impacted but might not be considered in the planning events.

I identified the following groups seemed the most likely to be omitted from the traditional planning strategies: homeless, poor, persons with disabilities, persons who are institutionalized (prisons, nursing homes), children, elderly, illegal immigrants/immigrants (incl. language access).  These groups all have little political power and thus have minimal access to ensure that their interests are included in emergency preparedness endeavors and protected during times of crisis.[2]

In an infectious disease outbreak, the personnel of transportation become key players in a variety of circumstances so paying attention to the geography of a situation remains important. 
 

3. Gaps of Systems: Public Health

- Who is not adequately served by the current health care system?

- Will people who are illegal and fear deportation be afraid to come to the hospital during a pandemic?

- If the strategy is to use media to promote awareness and prevention, who will that miss?  How will people who don’t speak English learn of this?  people who cannot read?  people who cannot afford a tv/radio? people who are homeless?

- How do public systems, such as public transit, affect who may come into contact with an infectious disease and how does it inform the way that disease may spread?

I considered that the public health system relies on three critical systems – the public health authority/government, the health care system, and the media.  For people who have historically poor relationships with government, it is important to consider how they might respond/ignore the admonitions of government. 

The government and health care system systemically alienate certain members of our community, particularly illegal immigrants.  The fear that illegal immigrants have of government might prompt them to respond/ignore public health advisories in a way that would have significant implications to the overall health of the public.  Considering the manner and degree to which this community is alienated from the health care system, I wondered what would be necessary to promote compliance and trust in the public health directives. 

Most public health announcements are made through media channels, and I wondered what would happen to people who are not part of regular media.  Homeless people who don’t have a radio/TV, deaf people who don’t listen to the radio, illiterate people who can’t read a flyer, and announcements made in English would miss a number of community members who don’t speak English.


4. Gaps of Power Perspective: Public Health

- How does this proposed action reflect assumptions of my power and privilege?

- Where and how can I use my power most effectively?

I saw the greatest contribution I could make to support the “vulnerable populations” I identified was to speak to the group that I was a “part” of and to use the tool of my training, law and ethics, to suggest ways to guide this very broad discretionary power.  I developed an ethical argument to justify preventative policies that address the unique needs of vulnerable populations during a public health emergency.   To see what an effort for inclusion on this issue looks like, I made that paper into a poster, Vulnerable Populations During a Public Health Emergency[3], that was presented at the CDC’s Public Health Law Conference in June 2005.  When Hurricane Katrina hit three months later, the groups identified and the issues anticipated in the poster became a part of tragic history.  It is my hope that if we endeavor to use these steps rigorously and consistently, we can promote inclusion action for social change.

The opportunity here that I did not undertake due to my position (a student writing a paper rather than a policy maker) would be to invite the now identified constituents into the problem solving process to ensure that any subsequent actions, such as the proposed preventative policies, were not based upon the power perspective of the problem solver. 

In discussing this poster and working with people of diverse and vulnerable populations, I discovered that creating an inclusive space remains elusive, even for people who are committed to doing important work for social good. I offer a backbone for building capacity so that those who are committed to cultivating inclusive spaces might be able to realize their aspirations. 



[1] Ettinger,K. A Critical Legal History of Public Health’s Treatment of Vulnerable Populations during a Public Health Emergency.  (available from the author)
[2] This is not intended to indicate that this is the state of affairs at present.  Though reports indicate, overall emergency preparedness planning is not well developed.  As such, one wonders how much attention will be paid to the interests of marginalized communities in the time of a crisis and that was the purpose of this endeavor taking the focus that it did.
[3] Ettinger, KM. Vulnerable Populations During a Public Health Emergency, available at: www2a.cdc.gov/phlp/conferencecd2005/docs/kettinger.pdf


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Mind the Gaps: Applied to an Individual [6 of 8]

7/3/2008

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Mind the Gaps [whole document ]
Mind the Gaps Applied: Institution/Systems  [7 of 8]
Gaps of Power Perspective  [5 of 8]
III. Mind the Gaps: Applied

The following two scenarios reflect the application of how one might apply Mind the Gaps to promote inclusive action.  The first scenario shows an administrator using the Mind the Gaps framework to consider how to address a conflict at the school.  The second scenario demonstrates how a proposed government action was evaluated under the Mind the Gaps framework and illustrates the responsive action that sought to promote conscious, inclusive action for social change.


A.  Individual
As the principal of the private school where a bullying incident occurred, Mrs. M considers how a response to the situation might be most inclusive. 


1. Gaps of Culture


Mrs. M questions how the approach to handling the situation would appear to someone who felt uncertain about the school’s commitment to the girls’ education.  She wonders whether the private school status might make a student or parent uncertain about whether the discipline was based on wealth or on culpability.

She decides to call all the families into meet with each other and the administrators. She considers that this approach fosters the kind of open communication that the school advocates.  She wonders whether the parents may feel a perception of partiality since she has a conflict in complete neutrality for economic reasons, and she decides to hire a neutral mediator who can facilitate the conversation.  She considers that a mediator has the ability to foster dialogue and understanding and the practice of mediation/facilitation is generally accepted across communities.  To be certain, she asks all sets of parents whether they are comfortable with having a mediator present to facilitate the dialogue. 

She doesn’t consider that the remaining parents may have concerns about the situation, nor does she consider that the other students not directly affected may have residual concerns arising from this event. 


2. Gaps of GPSE

Mrs. M does not recognize any geographic considerations in this case, but there are political concerns.  Mrs. M recognizes that the two sets of parents involved between the instigator and the victim have vastly different political outlooks, social status, and wealth.  The instigator’s parents are wealthy, prominent business people with a lengthy lineage of family who have graduated from the school; the victim’s parents work in the public health and government, and both parents are second generation immigrants of comfortable means but limited wealth.  She wonders how to create a more level playing field for the conversation, and decides that it will be the work of the mediator to balance these disparities.

She does not consider that the two sets of parents come from vastly different backgrounds may have different experiences of justice in their personal history, nor that they might have different understandings of the cause of the situation and diverse needs to have a sense of justice achieved.  She does not consider that other students may identify with qualities of the victim and in turn from empathic identification they may experience a sense of ongoing fear from this event.


3. Gaps of Systems

Mrs. M was aware that her approach to this situation was dependent upon trust in the school’s handling of difficult situations as well as in trust in the mediation process.  She recognized the potential mistrust of the school’s commitment to discipline arising from the need for funding as well as the mission to educate its students.  To promote a sense of confidence in the school’s commitment to neutrality, Mrs. M chose to use a mediator. 

To inspire confidence for the handling of this situation, Mrs. M decided to work with a coalition of teachers, parents, and students to identify and develop a way to handle a future incident with consistency and transparent, while retaining flexibility. 

Mrs. M did not consider whether the victim’s parents who have a health background are familiar with mediation and whether they would be comfortable with mediation.  Mrs. M does not check to see whether the mediator has experience with multi-cultural conflicts and does not consider what qualifications the mediator might need to have to establish legitimacy with the parents.


4. Gaps of Power Perspective

Mrs. M reflects on her power in this situation and sees that while she has authority at school, she does not have authority over the parents and in many ways, she is accountable to the parents.  She considers that by inviting a mediator to facilitate the conversation she will enable the removal of any power conflicts that she might hold in this situation.

Mrs. M did not consider that her position could be perceived differently between the two parents.  While the instigator’s parents who are wealthy patrons of the school feel comfortable expressing their perspective and needs, the victim’s parents who do not have a strong economic relationship with the school do not feel equally entitled to ensure that their perspective is understood and their concerns are met.  She also does not consider that the victim’s parents are concerned about their relationship with the school and ensuring that their daughter will not have a difficult time, whereas the instigator’s parents do not even consider that stating their thoughts would have any implication on their daughter’s educational experience at the school.   These are difference arising out of the parents different power positions and the perspective of their privileges.  Mrs. M is not aware of her own privileged perspective and thus, is not able to be sensitive to the ways that privilege informs actions.

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Gaps of Power Perspective [5 of 8] 

6/3/2008

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Mind the Gaps [whole document ]
Mind the Gaps Applied: Individual [6 of 8]
 Gaps of Systems  [4 of 8]
D. Gaps of Power Perspective

Assessing Gaps of Perspective, we consider how our power perspective informs the proposed action.  We often develop strategies for social change unconsciously informed by our power perspective, and we may not realize that others do not enjoy the same power, privilege, and position.  For example, if we choose to use a peaceful protest, we assume that others, whose rights may be the subject of the protest, will be comfortable demonstrating and exercising the right to peaceful protest in this manner.  But for some whose experience with the law reflects inconsistent or unequal justice, there may be less security in exercising one’s rights.   The exclusion of segments of interested parties reduces the inclusiveness of the action and may undermine the entire effort.  So, we must endeavor to consider how our experience of power, privilege, and position shape what we do, and we must reflect upon how we can use our power, privilege and position most effectively to share our power.

Picture
Reflections and comments welcome. 
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Gaps of Systems [4 of 8] 

5/3/2008

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Mind the Gaps [whole document ]
Gaps of Power Perspective  [5 of 8]
     Gaps of GPSE  [3 of 8] 

C. Gaps of Systems

Assessing Gaps of Systems asks that we consider the inclusiveness of the systems upon which our proposed action depends and that we reflect critically upon the limitations of those systems.  For example, if we propose to communicate a message – upon what systems does our message depend?  We must consider how we will reach people who do not speak our language, who cannot hear/read, and to what extent there may be communities who lack access media.  Alternatively, if we locate a free mediation service at the court-house, we must consider whom our legal system serves and fails to serve and whether our efforts to provide alternative methods for conflict resolution might be limited due to the legal system’s limitations.  Ultimately, this aspect of Gap review asks whether we aware of the limitations of our existing systems and how we may create more inclusive systems.

Picture
Reflections and Comments Welcome. 
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Gaps of Geo-Political-Socio-Economics (GPSE) [3 of 8]

4/3/2008

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Mind the Gaps [whole document ]
 Gaps of Systems  [4 of 8]
     Gaps of Culture  [2 of 8]
B. Gaps of Geo-Political-Socio-Economics (GPSE)

To assess the Gaps of GPSE, we consider how these contextual layers – geography, politics, and socio-economics that impact communities differently, might limit a proposed action.  The Gaps of GPSE are already well recognized as critical components of ongoing disparities.  For example, the GPSE factors constitute ‘social determinants of health;’ they reflect recognized barriers to accessing legal services and equitable remedies; and they associate with exposure to environmental hazards.  Thus, when we aspire to take conscious, inclusive action, we want to make sure that we reflect critically upon these components and assess whether our proposed action may unintentionally exclude groups based on GPSE attributes?

Picture
Reflections or comments welcome. 
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Gaps of Culture [ 2 of 8]

3/3/2008

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Mind the Gaps [whole document ]
     Gaps of GPSE  [3 of 8]
Mind the Gaps: Engaging Change [1 of 8]

A. Gaps of Culture

To assess Gaps of Culture asks that we cultivate the awareness that we are a fish swimming in water.  We look to see the layers of assumptions that underpin the actions that we choose, the language that we use, the approach to problem solving we select, and the values that we promote.  We do not need to, per se, challenge these assumptions rather that we must be sufficiently aware of the assumptions so that we may begin to consider where and how diverging perspective may exist that may shift the way we understand the situation. 

While this inquiry may include the traditional concepts of ‘culture’ related to one’s customs, values, and beliefs in this context Gaps of Cultures demands that we examine the assumptions implicit within our professional disciplines, selected strategies, preferred methodologies, and presumed doctrines.  We are looking for barriers we don’t see based on our disciplinary assumptions and we seek to find different approaches to how we might address the situation.

Picture
Reflections or comments welcome. 
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Engaging Change [1 of 8] 

2/3/2008

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Mind the Gaps [whole document ]
     Gaps of Culture  [2 of 8]

I. Engaging Change

“ ‘Mind the Gap’ a voice overhead calls out as the doors open for the Tube in London, that is precisely the same thing we aspire to in meditation, to mind the gap between where we are in this moment before we act to get where we are going.  If we can recognize that space, hold it open, then we have a chance to transform our actions from blind habit to conscious action.”[1] 

Identify gaps in our society and responding wisely to these situations is a critical component of creating a just, democratic, and civil society.  Meditation and mindfulness facilitate developing the capacity to recognize gaps within our daily life, to be present with gaps in order to gain clarity and understanding, and to respond to gaps with insight and wisdom for the betterment of ourselves, for our communities and for the world.

The paper explains a framework to promote conscious, inclusive social action, and demonstrates how this framework could be used at the individual and institutional level.  It culminates in describing the capacity we need to build to support inclusive problem solving, a necessary step to promoting inclusive, conscious social change.

II. Mind the Gaps: Conscious, Inclusive Action for Social Change

The “Mind the Gaps” framework is broadly applicable to a variety of issues.  This 4-step Gap Analysis enables one to “check” the inclusiveness of actions by individuals or organizations. When we encounter a gap in our action plan, the capacity for inclusive problem solving will allow participation of voices not historically engaged in the problem solving process.  To be inclusive we need to create a space that allows for diverse constituents to input understanding the problem and for diverse perspectives on the appropriateness of proposed strategies.  After we take a proposed action through the 4 steps, we may, ultimately, determine that our initial action is optimal, even if not fully inclusive, but we make that choice consciously, more aware of future opportunities for more inclusive solutions.

Mind the Gaps

1. Gaps of Culture
2. Gaps of GPSE (geo-political socio-economics)
3. Gaps of Systems
4. Gaps of Power Perspective

          
While the 4-steps of Mind the Gaps may seem familiar or intuitive, we have the opportunity to adopt using the 4-step framework consistently in our personal and professional activities to raise our awareness and Mind the Gaps in our daily life.



[1] Ingen Breen, a soto zen priest, who shared meditation practice guidance and this brilliant analogy. 
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Live Well Platform   {idea post}

10/7/2007

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Originally posted on Planet Well blog and posted on NetSquared Mashup 2.0 Competition 2007

Live Well

What is the Idea?

Elders and the rapidly aging within the nation will receive the connection to resources and support that they need in a manner that enables them to Live Well independently within the community and supported by the community.

Live Well is a platform that will enable individuals and those who support them to meet their ongoing needs through a community network and that harnesses the potential of technology to integrate their support within the communities in which they live.


What will change in the world because this project happened?


As care delivery is increasing pushed out of acute care facilities, as people are able to live longer with the assistance of chronic care treatments, and as the population ages, there is a need to improve access to social services for social services professionals, family/caregivers, and the individuals who need external support to Live Well in the community.

We aspire to promote people's independence and ability to live in the least restrictive environment possible. When adequate resources don't exist, people require "placement" into places where their needs can be met. A huge gap exists in the availability of place as well for people who do not require such restrictive measures, yet still need assistance to meet their daily needs. At this juncture, our country lacks the infrastructure capacity to "care" for people "in facilities," which necessitates developing means to support people who require assistance to Live Well in the community.

Live Well will provide a technology platform to fill the capacity gap in a democratized way while supporting our deepest aspirations for promoting liberty to all and the pursuit of happiness throughout all stages of life.


What information will people interact with to make this change?

Live Well will create a virtual nexus for connecting social services with the public in a dynamic way and will enable actual meeting of needs for people who require assistance.

e.g. Mrs. Jane Hammond, an 87 year old widow, lives alone and is assisted by neighbors. A neighbor creates a Live Well profile for "Mrs. J" and the profile enables the neighbor to see what social services exist for Mrs. J's needs within her city. The profile also links into programs like "neighborhoods" on facebook. The neighbor is able to indicate on the profile that Mrs. J needs some cat food, that request pushes to the "neighborhoods" application and another person who lives within a few blocks but doesn't know Mrs. J is going to the pet store and picks up cat food for Mrs. J. As, well the neighbor indicates that Mrs. J needs a quart of milk. A young professional stops at the grocery store en route home and using his iPhone checks local grocery store needs from Live Well, his grandparents use it in Ohio and he isn't there so helps other folks out locally. Finding Mrs. J's request under "grocery needs in your area," he picks up an extra quart of milk and drops it by her house on the way home. Reimbursement can integrated with a credit/debit network established directly to the stores and integrated to interface with Medi-aid and Medi-care. Community service effort may be credited to the individuals through a "time bank" system and/or employer recognition for companies that encourage participation by their employees as "in kind" donations.

Live Well uses technology to facilitate meeting social support both through virtual connections and "live" connections. Live Well disrupts and innovates the way we live in and think about our "communities" by creating a platform that bridges the virtual community world and integrates it with our residential community, that bridges the communities of needs with the resources for benefits, and that brings people together across boundaries to care for our community wellness.

While this is local in the sense of meeting needs peculiar to the way of western development, transience, and independence, as more people become geographically mobile and the displacement of people from larger family structure trickles into the developing world as the unintended (untold) cost of industrialization and 'economic opportunity,' the development of this kind of platform will be universally applicable.

What else have you done in this cause area?

This is an area that is ripe to grow. There is a real need for harnessing technology to meet the needs of those already aged, most importantly for those entering into this group. I am involved in bioethics, mediation, elder care plan facilitation and elder ethics issues, and I am particularly focused on the needs and concerns of marginalized populations.

I worked under the leadership of an ex-IDEO health innovation startegist and product designer as part of the product development team at ePatients.com, a web 1.0 company that sought to create products and services for patients and their families in the acute and post-acute care setting. Following the implosion of that company (not due to the product/fundability), the product development team co-founded a venture to support patient adherence in the chronic care market through user-focused design of a web-based platform, but the market bust at that time made funding impossible although people "got" the value and concept, the profits margins weren't big enough and the SE world only in its nascent stages focused primarily on education.

At this juncture, I envision this application could be developed as a stand alone or integrated into a portfolio of another company.

What inspired you?

An awareness that we are only as strong as the weakest among us and that though in the West, we fear aging, it is simply another process in the beautiful mystery of life. If we continue to deny it and fail to make the resources available to make this time of life one of possibility, the only people we fail are ourselves. I also see the grave economic disparities between our life in the West and those in other countries, and the influence of outsourcing and industrialization means that we are exporting an economic system that breaks down the social structure of those countries. It is my hope that if we can learn from those communities how to care for people within our own community and potentially reduce the export of practices that result in the transaction costs of destroyed social networks and/or to use technology to innovate the way we address this problem that exists increasing also in China and other countries.


What do you need at this juncture?


- Funders for initial development through Pilot
- Developers to realize a beta version
- People committed to harnessing technology and resources to meet local community needs as the first step in promoting the global wellness







Live Well by
Planet Well is licensed under a
Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
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