During the 10 City Bridge Run, I might have been pathfinding a new journey for looking at the issue of child survival from a different perspective, but I was not the first person to go this way. In fact, I am following the reliable footsteps of others.
And child survival is not a new phenomenon. Historical records showing the impact of changing medical, infrastructure, social and economic conditions in Europe during the Industrial Revolution points to a time when the incidents of child survival was high much like it is today in the worst places on earth. There was no magic fairy dust to make this change happen. And the impacts can be seen to reliably influence quality of life, wellbeing and population levels across Europe. That historical data points to why improving child survival is important.
Back in 1982, the Executive Director of UNICEF who was then James Grant launched what was called the Campaign for Child Survival. Jeffrey Sachs in his book “The End of Poverty” writes about how this campaign promoted a package of intervention known by the acronym GOBI: growth monitoring of children; oral rehydration therapy to treat bouts of diarrhoea; breastfeeding for nutrition and immunity to diseases in infancy; and immunisation against six childhood killer diseases.
“The results were striking. Child mortality rates fell sharply in all parts of the low-income world, including Africa, where rates were (and are) by far the highest. The campaign was estimated to have saved around 12 million lives by the end of the decade.”
UNICEF leading a coalition of all nations was able to deploy a great mass of resources to achieve this outcome. “The results were striking”, and even so the problem remains today. Bill and Melinda Gates wrote recently in regard to child mortality that “Things can be better”.
The Design Forum which the 10 City Bridge Run is focusing on are not proposing some magical solution that until now no one has ever thought about. The Design Forum are not suggesting that until now there has been no progress. No, the Design Forum readily recognise that this effort is built on top of the excellent work of others. Good progress has been made, but there is still much to be done.
In particular, the 10 City Bridge Run Design Forum argues that there is considerable untapped resources through our own connections which can be engaged with that stands to contribute to the improved progress that is making today. This is not a stand-alone effort, it is part of an existing collaboration to improve child survival.
This is not new, but we stand before an opportunity to perhaps uncover new approaches to help improve the delivery of child survival. Join us. And maybe more importantly, if you are already engaged or know of great work to advance child survival, then bring us into the picture. Let’s open those connections.
2010 was the year an idea about challenging the action that was being taken to address child survival was conceived. The idea was bold, and from the beginning sought participation from others.
It was grounded in a plan to run 10 sub-marathons each of 24 km in 10 cities across 10 countries as a stunt to open a conversation asking: “how might we use our networks to improve the delivery of child survival?”
The reason for running 24 km was in response to the emphasis made by many organisations in 2010 promoting the 2008 figures of child death per day which had been released by UNICEF. The figure was 24,000 children dying on average daily. A wholly unacceptable figure, which has since been reduced by a third, and progress for the future shows signs of being promising.
I wasn’t an expert in the field, and it struck me that few were. Canvassing my friends about the importance of the issue showed the effectiveness of marketing campaigns from institutional aid agencies, but apart from that little more knowledge. I thought that in a networked age where communications and health infrastructure was better than ever, was there not more we could do to crowdsource and then implement some form of solution or positive intervention?
This was the point of the running stunt. I would run in 10 cities, simply to highlight the year 2010, and conclude with what I had loosely defined as a ‘Design Forum’ at the end to address the issue. There was no budget, no institutional backers. Just a mad Australian with a little bit of passion, who had been given legs by many friends each contributing a small amount through a makeshift crowdfunding campaign.
I took the idea to several institutional aid agencies and charities who had a vested interest in the idea. Would they partner, or was there somehow I could support their efforts? I wasn’t asking for money, and it just have been evident that perhaps lacked some experience in that sector. Their response, especially in hindsight having now completed that journey after much tribulation, was astounding. I was met with the same response, and that surprised me: “sorry, that is not consistent with our messaging”, “we can’t quite see how it ties in with our fundraising efforts”, and other such words that effectively closed their door to my invitation.
I was at a loss as how to respond to this response from the aid agencies that so effectively had appropriated the issue of child mortality. Was I mistaken, and maybe my ideas were ill-conceived and ridiculous?
Reflecting on their response, I remembered back to Boxing Day 2004 when a catastrophic tsunami would smash against Aceh and many other towns in the Asia Pacific. It was an unprecedented event. At the time, I was still serving as an Australian Army Officer and then had a responsibility for planning emerging operations across the region. From the moment the first phone call was received on Boxing Day afternoon and being probably the first person in Australia to hear about the incident, we spared no effort for the following weeks with literally no rest or respite so as to respond with critical support to assist the logistical, recovery and humanitarian needs which were many.
Aid agencies of every manner were part of what I describe as a third wave of tsunami after a second wave of tsunami crashed around the world as the general public awoke to the horror of what had happened. Many aid agencies were quick to adjust their messaging to receiving funding from an empathetic public.
A short while later, reports in Aceh were of degraded roads and bottle-necks from the inundation of traffic of aid agencies wanting to be the first organisation to be seen to arrive and distribute food and blankets. This hampered getting water and other critical supplies to remote areas. It would have made more sense for the aid agencies to coordinate their efforts in Kuala Lumpur and deploy as a collaborative effort without concern for which person from what organisation arrived first.
Now, a decade on, we look back on Aceh. There are questions about where some aid money ended up. Such questions are worth examining, but not too pointedly perhaps. The generosity that allowed the aid in the first place does deserve accountability, and that is a separate issue from that which is being raised in this post.
Child survival is an issue which has been strongly advocated for, from politicians such as Hilary Clinton to actors the like of Ben Aflick. All have spoken with the same staunch plea, demanding urgent attention, mirroring the words of Tony Lake the Executive Director of UNICEF who in 2012 rightly described child mortality as a “moral obscenity” and a “moral abomination”.
Earlier this year, we saw a very positive report from Bill and Melinda Gates in their Annual Letter which has taken a different approach to the ‘alarmist’ view of an appalling situation that has underpinned the messaging of institutional aid agencies to date. We have turned a corner. He future looks bright.
There is no better time to conduct the Design Forum for an issue like child survival. Just because the future is painted as a bright place to visit, it doesn’t mean the road is downhill from here. There is still a lot of work today, but through collaborating with those interventions that we know work and learning from interventions that have been less successful.
The Design Forum is a conversation that will last nine months and beyond. Is picks up a conversation which has started many decades prior. And everyone is welcome. I expect many people will watch to see how it unfolds, and then get involved once it takes shape closer to May. In the meantime, there is a lot of information out there, there are many people with first-rate experience to draw upon, there is a lot of data.
There is no ownership in this conversation. It is a collaboration. Part of that involves challenging and questioning that which has been said in the past. Even Bill and Melinda Gates’ aspiration should be challenged in order to understand it better. Theirs is a bet. I don’t propose we refute it, but we definitely should examine and scrutinise it rather than just accept everything because it is already on the interwebs. What better form of respect can we give reasoned thought than to challenge it with our own intellect, rather than just accept it blithely?
We are breaking new ground in a conversation that is long established. We give ourselves permission to question everything, even the experts.
In their Annual Letter published this year, Bill and Melinda Gates set the scene by betting that there would be greater progress to end extreme poverty than in the previous 15 years. And they are probably right. All indications point toward this as an outcome, and their keen interest over the last 15 years would suggest that this is actually a well-tested assumption rather than an idle wager.
Progress is good, and the message from Bill and Melinda Gates is positive. Are we out of the woods yet? Does that mean the crisis is over?
The 2014 Bill and Melinda Gates Annual Letter framed the issue of child mortality as one of three key areas where they sought to dispel myths that they rightly claim are held about addressing global poverty. At the beginning of the document, they wrote how they were “disgusted” by child mortality.
Other people have used equally strong language. Tony Lake the Executive Director of UNICEF described child mortality in 2012 as a “moral obscenity” and a “moral abomination”.
What does this mean for the 10 City Bridge Run, a citizen-led initiative to open a conversation asking “how might we use our networks to improve the delivery of child survival?” Is the war over, and we didn’t hear the news? Isn’t it all over bar the shouting? After all, Bill and Melinda Gates have spoken.
We should see the current situation as the end of a beginning, and the beginning of the end. We are now riding the waves of change. There has never been a more critical time to convene the Design Forum which will unfold this conversation about child survival than now. There is political will, institutional interest, a wealth of information, technology and the ability to communicate is better than ever, and along with increasing developments in medicine and infrastructure.
The Design Forum is not a silver bullet. And in a relative sense, together we are a minnow in an ocean of information and activity. But we are part of a much larger connected effort. And that is why this is important as a conversation. We have a real part to play, and as that conversation takes shape, it will become more obvious where we can best effect change.
The Design Forum which will commence in Osaka on 9 February is a blueprint for change for improving child survival. We are not reinventing the wheel, but drawing upon the experience and networks of others to amplify our intention. And we need your voice to help make that possible.
The Dali Lama has a quote which I like:
“If you think you are too small to make a difference, then try sleeping with a mosquito.”
We are about to begin the series of Design Forum. You can join in at any time, but why not begin with us at the beginning. We are starting by asking how might we Design the Design Forum. This will be an event in Osaka to draw upon best practice, and examine how we can organise to be effective in making a difference. The first Design Firum in Osaka convenes concurrently with an Acumen Fund/IDEO free online, seven-week course which provides an introduction to Design Thinking. You can get involved. You will make a difference. So why not sign up? It is all free.
Sign up for the Introduction to Design Thinking here.
Sign up for the Osaka Design Forum here.
Looking forward to seeing you on the journey!
This year in their Annual Letter, Bill and Melinda Gates included a short phrase which I think underpinned the whole of their document seeking the dispel three myths of development: “Things can be better.”
It was a clear signal of optimism, and the leadership Bill and Melinda Gates bring development is far and beyond the capacity that is afforded through their financial clout. Having money helps, but shaping the conversation through influence counts for much more.
A similar sentiment was expressed by Tony Lake, the Executive Director of UNICEF, in a post recorded for the ‘A Promise Renewed Initiative’. You can see it below. It is only short and goes for less than two minutes.
Tony Lake is an interesting character. I have never met him, but would love to sit down over a meal if ever I had the opportunity. Search his name on wikipedia and you will see he has a very interesting past. Kudos to him for turning his energy to addressing the needs of those most in need.
His statement: “We gotta do better”.
These statements actually rely upon each other to be complete. They are almost the same message, but not quite. Without both of these, it is either a case of striving without a sense of what is possible, or a view of what could be without the driving motivation to act.
We are very lucky to have Bill and Melinda Gates and Tony Lake expressing so much passion for a worthy cause.
Ok, so there seems to be a new phrase entering the lexicon of child health.
‘Child mortality’ is being used less frequently in favour to the use of ‘child survival’.
What’s in a name? Does this really make a difference at all? I think it does. It is a more optimistically framed language, which sets our minds looking towards the solution, rather than the seemingly impossible wall of death to overcome.
Changing the name doesn’t change the facts. We are still falling short, and there is more work to be done. But with a renewed focus, maybe at least we can have a clearer view on where our emphasis is best placed.
UNICEF last month announced a breakthrough new initiative: they would ask everyone to visit ‘A Promise Renewed’ website and take the pledge to help reduce child mortality.
I was especially intrigued when I heard of this campaign. Intrigued because this is completely aligned with what I am seeking to achieve through the 10 City Bridge Run. Or maybe to rephrase that better, in light of their initiative, I am completely aligned with the campaign ‘A Promise Renewed’.
Let me tease this out a little first. Follow me here: I am being objective in my thinking. These initiatives must be able to stand up to scrutiny. It ought not to be a case of everyone just drinking the Kool-Aid.
So what is this pledge all about? Let’s start with that.
It works on the premise that governments can’t do it alone. Making change happen in not something that can be only left to the G20 or the G192. We are all in this together. My thoughts: No problem with that – I think everyone would agree with that assertion.
Here is what UNICEF Executive Director Anthony Lake said to explain the pledge:
Sign the pledge, which will mean you’re pledging to do what you can to change behavior in your communities — you’ll encourage local NGOs to sign the pledge and to work harder, you’ll pledge to advocate your governments to follow through on their pledges and make real progress. You can make a difference.
I think that too is sound. It is not saying that people have the power to make change themselves necessarily, but the corporate act of persuasion that leveraging your voice is not to be discounted.
There is some further wording in their release which gets a little wishful. That is where they hope that by posting videos, that some of them will go viral. My thoughts: The truth is that no one really knows what makes a video go viral. ‘Going viral’ is really mostly outside of our control. I think that Anthony Lake got it right when he placed emphasis on advocating for change.
His closing words are worth noting. They are worth reading twice, because they are easily to just read past the first time. I agree with him:
[We should all] start advocating with [our] governments to live up to their commitments to do everything we can to save children from what is a moral abomination. If we don’t do it, shame on us.
So will we? This is where the fine line between slactivism and game changing behaviour comes along. If it is just a few thousand people doing it along with their friends, there is a lot of feel-good value in that, but not enough force to change the game. If a significant amount of the global population are involved because people care enough, change will happen.
Moral abomination. Those are strong words. Will you just click off this page, or click onto this link APromiseRenewed.org and make the pledge? “If we don’t do it, shame on us.“
Here is a beautifully presented photo-essay by UNICEF that helps to tell the story about what work is going on around the world to combat child mortality. It doesn’t cost you to look a these photos, except for your time.
Take a look through this link here which opens the photoessay. Leave a comment below with what your favourite frame was and why.
The 10 City Bridge Run is funded through the pre-sale of a book called ‘Life Bridge’ which will feature 100 photographs of ‘human bridges’. Describing a human bridge in words is best achieved through drawing inspiration from a quote by Ophelia Dahl, cofounder of Partners in Health and daughter of renowned children’s book author Roald Dahl, quoted Adam Hochschild who wrote about the importance of “drawing connections between the near and the distant”:
Linking our own lives and fates with those we can’t see will, I believe, be the key to a decent and shared future… Imagination will allow you to make the link between the near of your lives with the distant others and will lead us to realise the plethora of connections between us and the rest of the world, between our lives and that of a Haitian peasant, between us and that of a homeless drug addict, between us and those living without access to clean water or vaccinations of education, and this will surely lead to ways in which you can influence others and perhaps improve theworld along the way.
You too can join this journey but supporting this effort, and receive a copy of the book Life Bridge when it is published early next year. Please visit www.pozible.com/lifebridge. Your support is important.
UNICEF reported in 2009 that 8.8 million children under the age of five died during 2008. Tragically this would be the same as 24,000 children dying every single day. For comparison, it is worth noting the stark contrast that 50% of these deaths occurred in sub-Saharan Africa while only 0.1% occur in the “Industrialised Countries”.
UNICEF, the United Nations funding agency for the relief of children in need, is a reliable source of information. In their November 2009 publication The State of the World’s Children Special Edition: Celebrating 20 Years of the Convention on the Rights of the Child gives insight into how different the lives of others can be, and how great their need can be often in comparison to our own. For example, UNICEF report that in 2008:
- 2.5 billion people lacked access to improved sanitation
- 1 billion children were deprived of one or more services essential to survival and development
- 148 million children under the age of five in developing regions were underweight for their age
- 101 million children were not attending primary school, with more girls than boys missing out
- 22 million infants were not protected from diseases by routine immunisation
- 4 million newborn babies worldwide died in the first month of life
- 2 million children under 15 years of age were living with HIV
- 8.8 million children under the age of five died, equivalent to more than 24,000 children dying daily
- 500,000 women died from causes related to pregnancy and childbirth
(Source: UNICEF The State of the World’s Children Special Edition: Celebrating 20 Years of the Convention on the Rights of the Child, November 2009, p.18-19)
Anup Shah produces a website with much of this information presented clearly for easy reading and can be found here.
How should we respond to this information? Shock, disbelief, vigilance, anger, compassion, sadness?
Maybe the bigger question is what are we prepared to do about it.