What eradicating diseases tells us about how to change the world

Let’s talk about eradicating illness and what that teaches us about how to change the world. Specifically, let’s zero in on how healthcare workers approach the different forms of rationality people and cultures use to understand their world, and from there, apply what we learn to global issues.

Rationality is the means through which we understand the world. As I discussed previously, we can classify rationality into four broad categories:

  • Disembedded—Seeks an objective truth that is independent of us; gained through analysis and experimentation
  • Embedded—Focuses on truths embedded in a social context; gained through understanding the social environment in which you operate
  • Embodied—Sees knowledge as something achieved through our visceral, lived experience
  • Collective—The means through which groups and societies understand their world and act.

In this post, we are going to focus on contextual rationality, which is a specific type of embedded rationality that my research shows is vital in the spread of innovations.

Contextual rationality describes truths that members of a culture or group hold in common. For example, in the university where I work, we believe the best teachers are those with industry experience, whereas research-based universities think academics make the best instructors. Different groups “know” (or believe) different things, and so the rational act differs depending on the group with which you are interacting.

What does this have to do with eradicating disease and, as I alluded earlier, changing the world?

The role of contextual rationality in eradicating a disease

A recent Atlanta article discussed the work of Dr. Donald Hopkins who has been instrumental in the battle against not one, but two diseases. Several quotes from the article highlighted the importance of respecting the contextual rationality of the people with whom medical workers dealt. Workers described approaching remote towns and traditional societies in their efforts to eradicate the Guinea worm infection.

Guinea worm is the subject of considerable mythology—the worms have been viewed as both messages from ancestors and the product of witchcraft—and those beliefs need to be addressed respectfully … ‘When you enter a village, you leave your culture behind,’ says Adam Weiss, associate director of the Carter Center’s Guinea worm eradication program. ‘We can’t come in heavy-handed and say, ‘You must do X, Y, Z.’ We all know how human beings respond to that.’

Atlanta Magazine

If we with our medical science, however, “know” the Guinea worm has nothing to do with witchcraft, if we with our medical science “know” how to eradicate this disease, why do care workers still put in time and effort to respect superstitions that, at times, allow the disease to flourish?

Because mobilizing a population to act to eradicate a disease requires collective action between groups. Productive collaboration requires trust, which, in turn, is built on mutual respect. For inhabitants of these remote towns and traditional societies to take the actions recommended by healthcare workers, they first have to trust them. To earn this trust, these workers must respect the power of the townsfolk’s contextual rationality.

How does this help us change the world?

The above insight is likely unsurprising to anyone who has had to work with groups or cultures different than their own. Healthcare workers seeking to stamp out disease in the remotest areas of the world know this lesson well.

Yet, when dealing with people on either side of the vaccine issue, GMOs, climate change, and other hot-button issues of our time, we have forgotten this lesson utterly. We treat those on the other side of the debate with shameful disrespect. Without respect, there is no trust; without trust, we cannot act. We, instead, fight, eroding trust further.

Today, we face some of the biggest challenges of our species’ history. Perhaps such problems call for unprecedented levels of collaboration. If you believe this to be true, maybe the healthcare workers collaborating with isolated communities have something to teach us. They start with a genuine desire to help others. From there, they choose to respect the groups they encounter, create trust, and then build the future.

Do you have experiences bridging the divide between groups? These are the stories we must share. I would love to read them in the comments.

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