Is the answer right beneath your nose?

Solving complex and intractable problems is the torture test of a leader’s abilities. Yet in many corporate settings we buy into the fiction that the best solutions must be a) imported b) expensive. But what if your problem has already been solved and you didn’t even know it?

In 1990, Jerry Sternin arrived in Hanoi with his wife Monique. They were there to open a Save The Children office as well as to help solve to the nation-wide crisis of child malnutrition in which up to 30% of children under the age of five were at risk of dying.

The problem confronting the Sternins has been described by policy scientists as a “Wicked Problem”, the sort that is difficult (and sometimes impossible) to solve not just for medical reasons but because of competing ideologies, contradictory paradigms or the murky agendas of the many stakeholders involved. Such dynamics are hard to recognize much less manage. The Sternins, for example, soon found out that the Vietnamese authorities still harboured immense enmity for Americans. Some wanted them to fail, threatening not to renew their visas after six months. Meanwhile, stakeholders back home believed the best course of action was to throw imported food and western medicine at the problem.

Though not an expert in malnutrition, Jerry Sternin was, by all accounts, the man for the moment. Bronwyn Fryer of the HBR describes him as a “great soul” with a “preternatural gift for listening”. Sternin held another secret instinctive understanding of the Theory of Positive Deviance.

The theory holds that within most problem universes there are always a few outliers who follow uncommon, beneficial practices that lead to better outcomes than their peers immersed in the same problem.

Sternin’s first move was locate these outliers. He soon found a small but viable cohort in the northern province of Thanh Hoa. Though very poor, they had managed to shield their children from malnutrition despite having no more access to resources than their peers. Their secret(s)? Firstly, outlier mums were feeding their children three or four times a day, rather than the customary two meals a day. It was the same quantity of food, only administered in portions that sickly stomachs could process. Secondly, kids were being hand-fed - another measure that aided digestion. Thirdly, kids were being fed even when sick. Finally, outlier mums were collecting tiny shrimps and crabs in the nearby rice paddies and adding these, along with sweet-potato leaves, to their children’s meals. Interestingly, while both sets of ingredients were readily available, many parents saw them as inappropriate for young children. Thus, it occurred to Sternin that the immediate solution to the malnutrition problem did not require a lot of money or additional outside resources; it simply required the community members to change their behavior and to start copying the outliers.

But, Sternin would later write, “knowledge alone doesn’t change behaviour”. So, rather than broadcasting the findings nationally, people would learn by doing. In buddy groups of ten, mums would first gather the necessary ingredients before meeting in a hut to prepare food together. By doing this hamlet by hamlet, writes Chip Heath, people were slowly “acting their way into a new way of thinking”. Most importantly, it was their change, a change that sprouted from local wisdom rather than outside expertise. “We didn’t do it, they did it”, Sternin’s wife Monique said in her TED Talk. In short, the community cured itself.

After 3 months, 40% of the children in the test region were rehabilitated. Two years after the national rollout, 2 million children had been profoundly impacted. Moreover, nutritionists who visited the country three years later found the results had stuck - not just for primary beneficiaries but for their siblings born after completion of the program.

What can business leaders learn from this inspiring story?

Find the Bright Spots

Though Sternin had read widely about malnutrition prior to his arrival in Hanoi, he was overwhelmed by the data. Head knowledge only made this “wicked problem” bigger and more intimidating. This is the “true but useless” factor at work; information that might be valid but which comes at us in such volumes it paralyses us from taking action. In the end, what proved decisive for the people of Thanh Hoa was not Sternin’s academic understanding but his ability to discern the “bright spots” within the murky pool of knowledge. What knowledge do you need to let go of to see the bright spots in your business?

Script the critical moves

While there was probably a lot of other things that could be done to combat malnutrition, nothing came close to the piercing clarity of:

“Four small meals a day. Hand feed, even when sick. Add sweet potato greens, crabs and/or shrimps from the rice paddy.”

No guesswork. Four simple steps. Mum’s all over the country thought, “hey, I can do this too!” Do your change efforts bring similar behavioural clarity to the people you lead?

Model the critical moves and scale

When “people like me” model the moves in a familiar environment, I’m more likely to change than if an expert tells me what to do. You’ve isolated the bright spots and defined your script. What is the closest parallel in your business to Sternin’s village cooking circles?

“Where others failed in their endeavors to address malnutrition, Jerry and Monique Sternin succeeded...and marvelously” wrote HBR’s Bronwyn Fryer. Hopefully with these pointers you can too. Good luck.


Jerry Sternin and Robert Choo - The Power of Positive Deviancy

Jerry Sternin: The Power of Positive Deviance: How Unlikely Innovators Solve the World's Toughest Problems

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