In his book and seminar series by the same name, Start With Why, Mr. Sinek explains how businesses that are built on, and marketed around their “why,” i.e., the reason they exist, their driving motivation, are far more successful than those that only know “what” they do or “how” they do it. Companies immersed in their “why” are the leaders in their fields and have deeply loyal, committed clients. These companies inspire their customers to take action.

What is our “why?” What is the reason health communication exists? Most would likely argue that our purpose is to improve public health outcomes by conveying the impact and benefits of healthy behaviors. But isn’t that what we do and in its simplest form how we do it, rather than the real “why” of our work? Is that enough however to inspire our “customers”—those on the receiving end of health communication messages—to make the kinds of changes we are promoting? Or should we be involving a more personal “why” to engender the kind of reaction needed to bring about lasting behavior change, the kind of inspiration that Mr. Sinek is referencing?

My goal in this chapter is to present the notion that by infusing health communication with the emotion and passion with have for our work—our personal “why”—we will improve our overall effectiveness. We will also at look how our personal motivation can be a powerful tool to illustrate our commitment to the communities we serve and to our counterparts who are learning to lead programs in their own countries.

Communicating in a Time of Change

Donor-driven development assistance is giving way to country-developed and implemented initiatives, which better serve developing countries and have the greatest chance of sustainability (Kharas et al. 2011). There must be similar modifications in our communication approaches. Over the last 50 years of development, a great deal of time, energy, and money has been assigned to development communication research, models, and strategies, such as Behavior Change Communication, Communication for Social Change, and Participatory Communication, which work on a macro-level (Waisbord 2008). While differing in approaches, the ultimate goal of each of the paradigms utilized today is to empower communities through discussion, training, and education programs (Bessette 2004). These models have their success and a place in our toolbox without question, but we can build upon their benefits and improve success moving forward.

All communication efforts have one inherent weak point: humans. Within all communication is the innately human dimension of what’s heard (received) versus what is shared (sent). Most communication models are based on the notion of a balance or two-way flow of information (Bessette 2004). Almost anyone who has worked in communication or training can tell you that these two factors (sent/received and balance) can contrast widely depending on the message and the audience. Individuals in an audience (communities, health care workers, volunteers, etc.) receive and perceive messages through their own prism. Content aimed at large groups of people will have mixed results; interpretation can vary dramatically as can the acceptance or disregarding of that message (Chandler 1994). One macro-level communication theory, Knowledge Gap Hypothesis (Tichenor et al. 1970), highlights these disparities by suggesting that knowledge and information are not equally distributed across populations and that the kind of increased flow of information from major communication campaigns is more likely to benefit groups of higher socioeconomic status than those at lower income and education levels. The Knowledge Gap theory also states that large-scale public health campaigns would only perpetuate such inequities (Glanz et al. 2008).

If we acknowledge—or at least allow for the plausibility—that variances exist in the receiving and processing of communication messages across populations we can complement the data-driven, science-based communication models routinely employed in development communications with something more personal.

People-driven methods that harness the vision and personal missions of the thousands of dedicated professionals from around the world that comprise the field of development are an untapped resource. Each of us, whether a long-time international consultant from the north or a new local consultant from the south; a program officer or health official; or any other person working in development, has a story (maybe several) to share that illustrates our “why.” In sharing our stories and personal missions, our driving motivation, we nurture one of the most effective communication tools we have to inspire change: human emotion (Ford 1992).

The Power of the Personal Story: Using Our “Why”

Emotion-driven communication, which is often the crux of a personal story, can tap into and build on the very individual nature of what development communication is trying to make happen, i.e., changes in behaviors. Whether as part of a large multi-region project or a small community-driven program, the vast majority of modifications being sought in change communication require changes at the personal level: the use of condoms, hand washing, sleeping under bednets, etc., all rely on individual action. For these changes to happen, however, individuals must act on the message, which means reaching them at the “gut level,” where much of our decision-making takes place (Roller 2010).

So why is our “why” important in development aid communication? Reversing age-old, deeply ingrained “habits” or routines, as is needed to reach most development and behavior change goals, requires an emotional “stirup” (Lewin 1951). Sharing our passion and our belief in the message is one of the most influential ways to reach people at that gut, instinctual level, necessary for an “emotional stirup.” This is where we can create excitement and build sustainable interest.

One of the best, emotion-based communication “stir-up” mechanisms we have is our own stories: our reasons for working in development and what inspires us to do the often difficult work of trying to save lives, improve living conditions, provide clean water, etc. In short, our “why.” By leaning too heavily on communication models that rely on mass appeal for their success (Baran and Davis 2012) we overlook the impact of our individual “why” to create an emotional stirup.

Ultimately, communicating our inspiration can help others—especially our counterparts and colleagues in developing countries—begin to understand the power their own passion can have to create an emotional “stirup” in their work and communities.

Long before the first formal business was established… the six most powerful words in any language were… “Let me tell you a story.”

Ryan Matthews and Watts Wacker, “What’s Your Story (Matthews and Wacker 2008).”

My Story, My “Why,” My Defining Moment

After years of working in marketing communications in the commercial and nonprofit sectors, I wanted something new, something that would allow me to use my education and experience in a way that truly benefited people. I was motivated to make this change after adopting our daughter, Talia, from Guatemala. The experience of picking her up in a country so rich in natural beauty, yet with such vast poverty and inequities, caused by decades of civil conflict and numerous natural disasters, left an indelible impression on me. These images helped guide me to the career change I was looking for and fueled my desire to someday help my daughter understand the hardships people in her birth country face. I started researching projects and efforts underway at that time to help Guatemala and its people. One of the lessons I learned is that like a lot of developing countries, Guatemala is a class-driven society in which marginalization, poverty, and chronic malnutrition are grimly interconnected. I also quickly began to understand that there was a lot I didn’t know about development. To get a better appreciation of global efforts to help developing countries and build on my education and background in communication, I decided to pursue a career in Global Health Communications, which started with obtaining a graduate certificate in Global Health. I wasn’t interested in implementing large communication campaigns as much as wanted to tell the stories of the people in developing countries—their hardships as well as their dreams—and the stories of the people, perhaps like yourself, from all over the world that have made bringing health and well-being to every corner of the world their personal missions.

Now, many years later, things have come full circle. I have had the opportunity to work on several development projects. I have had the humbling opportunity to coach dedicated health professionals from all over the world to help them improve their work and take their careers to new levels. I have traveled to Guatemala professionally, which gave me the chance to experience the country and its people more intimately, and I have started my own foundation, e-Women: International Mentoring Network, to connect women in the developed world with women in developing countries, like Guatemala, to mentor and coach them in areas such as health, family planning, education, and business. As Talia gets a bit older, I hope to involve her in e-Women so that she, too, can have the opportunity to support girls in her birth country. One day we will take her back to Guatemala so she can meet her country and experience its beauty for herself. Then my initial mission will be complete, but my story will continue.

I have told my story many times in my work and coaching, and each time I feel the emotions of carrying my new daughter in my arms for the first time. I remember how I cried both when we left Guatemala and as we brought her into her new home—the disparity between the two environments hitting me somewhere between immense gratitude for all that I had to share with her and sadness that she would not know her beautiful country, at least not for years to come. I share that emotion with my audience, whether it is one person or a crowded room. Many of those that I have shared my story with have told me that it has helped them find their own mission and they have begin sharing their stories.

Your Story, Your “Why”

That is my story, my reason for doing what I do. What is your reason? Why are you in the field of development? What is your personal story? Have you used your story to help others understand how much you care? Do you find and utilize opportunities to share your vision for development in your work. If not, I encourage you to begin thinking about your career and your knowledge in terms of its ability to motivate and inspire others. Start by thinking about your work; have you led a training session or implemented a program that required motivating people to take action? How do you feel about the experience? Were you able to share your experiences with enthusiasm and a sense of personal investment in the information you were imparting, or did you feel as though you were just pushing the material at people? Were you able to inspire them to apply what you taught or asked them to employ? Were you able to make them “feel” good about the changes you were asking them to make? Think about these ideas as you move forward in your work. How might a personal story—your story—be used to bolster interest and illustrate a genuine concern in helping others?

Perhaps you’re thinking that you don’t have a story to share, or maybe you do have something that drives you but you are not sure who to tell it to or how to begin. One easy way to start is with your coworkers. You may have worked alongside the same people for years, but have you ever shared what motivates you or your inspiration for the work you do? In fact, sharing stories in the workplace is a tool utilized by a growing number of corporations (Smith 2012) to communicate strengths and enthusiasm and to let others know that you are not afraid to take chances and show vulnerability. We can utilize this same thinking in development as a communication and training tool if we look at our stories as an opportunity to share our knowledge.

A knowledge-sharing story offers a surrogate experience… when a story is recounted, the narrative form offers the listener an opportunity to experience in a surrogate fashion the situation that was experienced by the storyteller. The listener can acquire understanding of the situation’s key concepts and their relationships in the same progressive or cumulative manner that the storyteller acquired that understanding. A key point of the surrogacy notion is that even though the listener did not directly experience the story situation, it must be possible, even probable, that the listener could experience a similar situation (Sole et al. 2012).

So How Do We Employ Our Most Effective Communication Tool?

Telling Your Story Effectively

Once you know what story you want to tell, the next step is to think about how you will tell your story. To motivate your audience, it is important to make your story compelling and to tie that excitement to an action you would like the person or people you are talking with to take (Mathews and Wacker 2008). Keeping these main ideas in mind will help you craft your story in an effective way:

  • Start by thinking about what you want your audience to do (what action) and why?

  • Next, think of a time in your career or life that compelled you to take action

    • Did you have a problem that needed solving? How did you solve it? What action did you take?

    • Did something unexpected happen? How did you deal with it?

    • Were you scared, confused, frustrated, or exhilarated?

    • Did someone or something take you in a completely different direction from your initial plan?

  • Share how you felt at the time. What was going through your head? Include all the important details leaving out information that will detract from your overall point.

  • Use humor, laugh at yourself; self-deprecation can be a great tool for breaking the ice and showing your vulnerability.

  • Remember you are the most effective communicator of your own story—don’t take yourself out of the equation. Keep this in mind as you are sharing your story. Tell the story in first person.

  • After telling your story, start a discussion. Ask emotion-based questions:

    • Have you ever had something like that happen to you?

    • How did you handle it?

    • How did you feel when this happened?

    • What did you do about it?

The answers you receive can tell you a lot about a person or group and how best to reach them. With that information you can take communication to the next level.

Fostering Learning and Growth: Helping Others Cultivate Their Passion

Beyond improved acceptance of our training and communication messages, we should also be helping individuals and communities develop their dreams for a better life including better health. It will be their “why” for adapting healthy practices. We can aid this process by thinking about some of our own most memorable learning experiences. When considering your own memorable learning experience ask yourself, they involve someone just lecturing to share facts and information, or did they happen when someone took the time to share their passion about a topic and their enthusiasm was infectious? If we use our own stories of learning and growth as our guides we will make our messages and material more relevant, generate excitement, stimulate in-depth conversation, and earn the trust needed to make sustainable changes. There is a famous quote that has been attributed to both Theodore Roosevelt (The Examiner 2012) and John C. Maxwell (Good Reads 2012) that says, “People don’t care how much you know until they know how much you care.” Our personal missions show that we are emotionally invested in our work. Stories show we care by humanizing us, making us more approachable, and providing the opportunity to produce an atmosphere that allows for meaningful, grassroots communication. In turn, teaching this communication method can “help communities identify true problems and priorities and opens the door for making effective connections and encourages integration with a community’s existing communication networks” (Mezzana 1996).

Sharing our passion and stories isn’t just a communication tool that can inspire others and ignite change; it’s also an opportunity. The field of development aid is rapidly changing as the mindset of “country-owned, country-led” aid grows stronger. Our roles as development professionals are also changing, which, for many, is a frightening prospect. Rather than worry about what these changes mean for us, we can see this is as a unique opportunity to build relationships with colleagues and experts in developing economies who are working hard to improve their communities and their countries. Supporting their career growth and development through personal and emotion-based communication, such as mentoring and coaching, are just a few of the ways we can be more effective and help individuals and groups of health care professionals manage their new country leadership roles. Thanks to e-mail, Skype, social media, and other emerging technologies, developing these nurturing roles has never been easier. The rewards of building a network of support for these health professionals are limitless (Meyer 2001). From an effectiveness point of view such networks are great examples of what success could and should look like.

Make no mistake, these new roles—both for the experienced development professional and for the new professional in-country—won’t always be easy. There are many very real differences in the way cultures communicate. Some things though are uniquely human, like the need to feel appreciated, the desire to do work that matters, to be recognized for that work, to have our opinions heard and respected. As Maslow’s stated in his “hierarchy of needs,” we all need to feel respected and valued and to know that we matter (Maslow 1954). This is true for all humans, not just those of us fortunate enough to be born in a rich and developed country.

In fact, we can learn a great deal from our colleagues in the developing world. Two great examples are within this book. I urge you to read Sam Daley-Harris’ chapter on “Advocating for Aid Effectiveness,” for his inspiring story, and the stories of the “everyday heroes” that motivated him to start RESULTS, a nonprofit, grassroots citizen’s lobby group and the Microcredit Summit Campaign. Another chapter with powerful stories is that of Glenn J. Schwartz, the Executive Director of World Mission Associates. In his chapter Mr. Glenn shares some of the many stories that inspired and educated him throughout his missionary work. Like Mr. Daley-Harris and Mr. Glenn, as you begin using your story, remember to collect and share stories from your colleagues, people you encounter in your work, and especially the people you serve.

One amazing story of leadership that I often share is that of Sister Claudia Tukakuhebwa, Coordinator of the Rushoroza Community Based Health Care Programme. Sister Claudia looked at the high population of orphans and vulnerable children in the rural Kabale district of Uganda and immediately saw the need to support the hundreds of orphans and vulnerable children and families living in the area. She and her small but dedicated team set the goal of dramatically improving the lives and livelihoods of the more than 800 orphans and other vulnerable children (OVC) and 600 families in their community. Drawing inspiration, optimism, and enthusiasm from a story she read, Health for All NOW, (Beracochea 2005), about Amos, a district health officer facing seemingly insurmountable challenges to achieving better health to his district, Sister Claudia’s team stated working with families in their homes and children from the OVC groups in educational environments. Through their hard work they have reached each of those 800 plus orphans and vulnerable children in less than a year, resulting in a huge reduction in the number of street children and those at risk of becoming one. They also brought about a greater awareness among community members of ways to assist orphans and vulnerable children, which has led to an overall reduction in the stigma for those with HIV and AIDS and has greatly reduced traumatic tensions and bereavement. Her team also noticed a much greater utilization of counseling and guidance, which has led to increased self-esteem among children and an on-going interest in health. I have shared Sister Claudia’s remarkable story several times in my coaching to illustrate what one person can make happen when they put their mind to it. Sister Claudia was motivated to action after reading about Amos (the story of Amos is actually a composite of a number of people’s stories presented together for even greater impact). One person has impacted the lives of more than 800 children and 600 families because of a story that compelled her. Another 700+ other health professionals from around the world have been moved to action through Amos and the Health for All NOW story, and now several hundred more through Sister Claudia’s story. One story; many lives changed. Passion. Enthusiasm. Emotion. Powerful tools too often overlooked.

Women: The Ultimate Emotion-Based Communicators

Sister Claudia’s story not only shows what one person can achieve but also highlights the important role women are playing in development. Involving ever greater number of women in development decisions will continue to be a priority for years to come. A 2008 report from The Development Assistance Committee of the OECD reported that in 2005–2006, approximately $8.5 billion was spent each year for gender equality and women’s empowerment—almost 33 % of the $26 billion in overall aid spent by about 16 bilateral donors. This figure did not include the additional $27.8 billion in bilateral aid spent by seven other countries, including the USA (Selvaggio et al. 2008).

This investment in women is based on a single yet profound shift in global thinking: women are now seen as the economic engines of their communities and by extension their countries (Foroohar 2009). Moreover, it is quite often the sole responsibility of the woman, especially in rural areas, to raise and feed their families. However, the role of women working or engaged in development however is not equal to their level of responsibility. A 2000 report by the Food and Agricultural Organization of the United Nations (FAO) stated:

Given the opportunity, women have shown themselves again and again to be highly responsive and responsible when helped to mobilize themselves, build upon available resources and produce sustainable results. Women need to learn additional technical and organizational skills and more women are needed at the center of decision-making. Specific challenges where communication is vital include helping women’s groups to increase their self-determination and to broaden the dialogue between the sexes regarding rights, privileges and responsibilities (Colin and Villet 1994).

Working with women in developing countries as decision-makers is the perfect opportunity to utilize emotion-based communication. Women excel at open, horizontal, inclusive communication (Stillman 2005). Their stories inspire other women to take action, discover their own missions, and understand the impact they have on their families, communities, and country. Helping your counterparts in developing countries becomes more involved in development, and development communications is a logical step to harnessing their power to bring about change. Share your story or personal mission with them. Ask them to tell you a story about themselves; why are they working for change or pursuing a career or new livelihood? Collect their stories and share them yourself. You will discover the unique impact their stories can have. Given the opportunity to use these skills, women in resource poor settings can help lead their communities and countries especially in areas of development decisions. Helping women around the world find their voice through storytelling is a powerful and effective way we can help them be part of development process in their countries.

Stories Rarely Heard

The “last mile” is a term usually used in the telecommunications and technology industries to describe the technologies and processes used to connect the end customer to a communications network (http://www.investopedia.com/terms/l/lastmile.asp#ixzz2DjEguWlk). More recently the last mile has come to have a more profound meaning:

Those living in the last mile comprise the majority of the world’s poor. Most are disconnected from education and economic opportunities, and many more lack access to basic goods and services. Last mile work, therefore, implies a dedication to extending the benefits of development to everyone—even the hardest to serve (The Aspen Institute 2012).

We have accomplished a great deal in development, but we are not there yet. We still need to go that “last mile.” Our communication efforts need to be evaluated and updated along the way. What if we apply “last mile” thinking to current development and behavior change communication methods? Are we getting there? Are we reaching the hardest to serve with models that mainly see communication as a “process of exchange, mutual influence, co-orientation, normative control, etc. of cognitive information processing (Bartsch and Hübner 2005)?” For communication and training efforts to be effective across all populations, we need to look beyond standard definitions and data and ask ourselves: Do our messages generate empathy while teaching new skills and encouraging individual participation in development activities such as hand washing and condom use? If not, then the likelihood is that we are not nearly as effective as we could be. Illustrating empathy shows we understand and care about a person’s condition. Rather than just messages about the germs and disease associated with the lack of proper hand washing, for example, what if our efforts to teach communities the value of clean hands also included a vision for their “why.” Instead of just the standard “hand washing saves lives (Center for Disease Control 2012)” message, if we begin talking about our desire to see people have a healthy life free from disease so they can watch their children grow, and help their families and communities improve, the message then moves from being about not getting sick and possibly dying to one of what a healthy future might look like for them. This is helping the person, group, or community define its “why,” which is more powerful because the message is about them in a personal way. Starting with a story that illustrates your understanding of another human being’s situation is a persuasive way to generate empathy and encourage greater response to your message.

What good is an idea if it remains an idea? Try. Experiment. Iterate. Fail. Try again. Change the world. Simon Sinek

Improving Our Effectiveness

Evaluating aid effectiveness should not only look at what has worked in the past that we can build on; such evaluations should also consider how we can look at things differently. There is so much more to our work than how many people we have trained or how many communities received a behavior change message. Our work is, and must be, about getting the kinds of results that come from reaching people on a personal level. Sometimes, the most effective way to do to that is by reaching a few people, or even just one at a time, with a message that really resonates so they take action. Little else is as empowering, easily implemented, or constructive as personal, emotion-driven communication. We need not abandon current development communication models which are working at the community level to involve stakeholders in messaging and planning. However, passionately augmenting these efforts will make the message more personable, relevant, and powerful to exact a level of lasting change. Personal, emotion-based communication built around storytelling is one such model. Employing this approach will require that we step out of our comfort zone, to be sure. It won’t always be easy; there will be naysayers, perhaps even harsh critics, but that often happens with new techniques. That doesn’t mean we shouldn’t use our “why”; it just means we need to show disbelievers that it can and will work. Our continued efforts will help us reach the level of consensus needed to bring about real, lasting change. Communicating our stories and our missions, with emotion, will help us reach our audiences more effectively and likely on a much more profound level.

As you start to integrate your story into your work, remember:

  1. 1.

    What is it you want to communicate and why? What do you want to have happen?

  2. 2.

    Adapt your story to be relevant to your audience. How can your story help them?

  3. 3.

    Don’t just share knowledge; show how you feel about your work. Show your vulnerability which can be a powerful tool for supporting an environment for change.

  4. 4.

    Ask emotion-based questions to understand personal, social, and environmental factors.

  5. 5.

    Think about how you can use your story to coach others to take action.

  6. 6.

    Think about mentoring a colleague in a developing country. It could be a great new story for you and the beginning of your mentee’s own personal story that she will be able to use to motivate and inspire others.

  7. 7.

    Never underestimate the power of reaching others on an emotional level: aid effectiveness starts with each of us.