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Bringing social change with the precision of a surgeon

Published on Dictions used in epidemiology and sociology converge in relevant literature due to the similarity between social problem and illness. Both affect a demographic, which present symptoms through which we can identify the problem and eventually address with a cure.

In his article “Race hatred is a deep sickness in American society,” Eric Liu refers to Charleston Shooting as a symptom of “racialized violence” that has afflicted the Deep South since the days of slavery. Dame Cath Tizard, the former Governor General of New Zealand, labeled family violence a “sickness of society” in her call to overhaul the court system as a cure.

When approaching a broad, complex issue as social change, establishing a framework to monitor and evaluate the progress is indispensible. The analogy of social problem as a disease makes a compelling metaphor in speeches, but it additionally offers a systemized methodto make a difference.

A review of Tuberculosis control in developing nations published by USAID, for example, outlines methodsapplicable not only to health initiatives but also to social enterprises of varying objectives.

Raise awareness

A major reason for TB prevalence is lack of knowledge regarding TB and its symptoms. Patients are often unaware they have been infected, and non-patients have incorrect knowledge of how to avoid infection. In addition to the rampant misconceptions and misinformation, one may be unaware of the severity of the disease.

A social problem similarly often arises from lack of education.Racial hatred, for instance, is often rooted in ignorance of other culture. Being able to recognize difference in physical appearance used to have an evolutionary advantage in hunter-gatherer stage of human history, which may explain why alien appearance can trigger fear and suspicion. Today, modern media contributes to racism in its reinforcing of stereotypes. Through intercultural education, one can be taught that color is irrelevant to a person’s qualities today.

The first step to any social change is accurate research and dissemination of correct information to the larger mass.

Create Demand
Patients of TB are reluctant to seek treatment because of several reasons, including fear of cost of treatment, fear of being identified as a TB patient in the community and lack of personal attention from facility staff.

Likewise, a victim of family violence may refuse to report the abuse because they fear the cost of lawsuit, being identified as a victim of domestic violence, and facing apathetic police officers. Even if social workers, councilors and even lawyers are willing to support a victim, if the victim themselves are not willing to come forward and demand justice, the problem will persist.

Changes thrust upon an individual or a community cannot last. Create demand through analysis of hindrance to demand and removal of the hindrance.

Enable Supply

Different categories of TB require specific diagnostics and drugs for proper treatment. Limited access to treatment regimens is a major contributor to mortality rates among patients in advanced stages of TB.

No project is immune to delay or shortage in supply. A venture may face unexpected budget cut, an entrepreneur may facea disruption personal life and an organization may be restrained by bureaucracy. Streamline consistent supply for those who are dependent on it to gain credibility.

Ensure Continuation
There is a tendency among TB patients to stop treatment once the symptoms subside. The inconvenience of making visits to clinic and unpleasant side effects of drugs are common reasons for discontinuation of treatment. From defaults, however, patients develop drug resistance, making it more difficult to cure the infection when they resume treatment.

Social entrepreneurship has become a major global trend since we entered the new millennium. Despite the boom in entrepreneurial start-ups, and remarkable successes of some, many others have disappeared, forced to discontinue their cause in the face of adversity.

Even the most innovative idea can be reduced to nothing, be forgotten, and their work undone, unless it is implemented with the consistency and intensity the project requires for it to become successful. Don’t be a one hit wonder.

Provide Incentives to Target Demographic
In many cases, patients resort to borrowing money or selling assets to fund their treatment. Studies show improvement in patient compliance with the use of incentives in forms of nutritional supplements and vouchers to compensate for the direct and opportunity costs.

Making a change in one’s life often incurs material and non-material cost. For those in lower-socio economic class, costs as a proportion of income are much higher than it is for those of privileged class. Rememberreducing the burden with incentives is crucial, especially for humanitarian projects.

Provide Incentives to Competitors

This may seem counterintuitive, but it is a realistic measure to take for a better overall outcome. For social ventures there are often “competitors,” or alternative suppliers other than the social entrepreneur himself who provide the service.

Despite the efforts to publicize the efficacy of government health care, there will always be patients who choose private providers over public clinics. Accordingly, it is more realistic to encourage private providers to adhere to responsible treatment rather than prohibiting private care altogether, driving it underground and obscuring transparency.

In India, for example, almost half of TB treatment is conducted by private providers, separate from the national TB control program. TB patients choose private providers for various reasons such as more empathetic attitude and timely provision of drugs. To ensure the quality of care provided in the private sector, the government offers incentives to private hospitals and clinics for successful treatments.

Improving education resembles closely in this matter. Public schools can be held accountable for their curriculum, teacher qualification, and other criteria, but private schools cannot be regulated to the same degree. Providing incentives for those who adhere to desirable norms can promote consistency across private and public institutions.

If there is an alternative source of theservice or theproduct, cooperate with the competitor and reduce deviation from desired path of social change you are trying to generaterather than trying to remove them, causing conflict.

Establish Support Groups

The Russian Red Cross Society in the Republic of Khakassia, Siberia, has established a social club called the “White Chamomile” for Tuberculosis patients. Patients can share their struggles and support each other. Those who fully recover are invited to share their experience, thereby boosting morale among those who are still recovering. The support is shown to bring positive attitude and reduce default among current patients.

Formation of Self-Help Group is a well-established practice in addressing issues such as alcoholism, drug addiction, griefand disability to list a few. Through self-disclosure, members can reach catharsis from stress. Through listening to others’ issues, they learn that they are not alone.

Self-Help Groups can either follow “peer participatory” or “professional expert” model, where the first emphasizes reciprocity and equality among peers and the latter leadership and supplementary knowledge.

Both models lessen the feelings of isolation and enhance self-esteem, inducing positive mindset and consequently positive results.  

For Surgical Removal
Human society today is more complex than it has ever been, with a degree of specialization and entanglement no one subject could encompass. A combination of the logical framework in epidemiology and considerations of sociology might have a stronger chance at removing problems from society permanently, instead of putting it through a remission.

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Liu, Eric. “Race hatred is a deep sickness in American society.”CNN.

Cheng, Derek “Courts need overhaul to cure ‘sickness of society.’” New Zeland Herald. 16 Jun. 2014


Jakubowiak WM, Bogorodskaya EM, Borisov SE, Danilova ID, Lomakina OB, Kourbatova EV. Social Support and incentives programme for patients with tuberculosis: experience from the Russian Federation. Internation Journal of Tuberculosis and Lung Disease 2007 Nov


Petite, Patrick U. Creating a New Civilization through Social Entrepreneurship. Transaction Publishers. December 31, 2011.