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How to Change the World

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How to Change the World: Social Entrepreneurs and the Power of New Ideas is a book by journalist David Bornstein about successful social innovation. It was first published in 2003 and an updated edition followed in 2007.

Contents

The book explores the definition of a social entrepreneur in the modern world, and provides examples of ordinary people who formed organizations centered on making a difference. Bornstein's purpose is "to call attention to the role of a particular type of actor who propels social change."

Bornstein also discusses the rising global trend towards social entrepreneurialism, arguing that barriers to social change in southern and central Europe, Latin America and Africa are weaker than in previous generations.

Erzsebet Szekeres

One indication of a successful Entrepreneur, according to David Bornstein, is a, “Willingness to Break Free of Established Structures.” Such willingness is demonstrated in the life and work of Erzsebet Szekeres, of Hungary. Szekeres created an entirely new procedure to manage the mentally disabled in her country; this is because her son, Tibor, had microcephalus , which is a condition that includes, “abnormal smallness of the head and severe mental retardation.” To many, the simple solution to dealing with the disabled was to send them to institutions for their lives, this was not an option for Szekeres. Many of the institutions that Szekeres could have placed Tibor in were merely there to keep the patients out of trouble, and did not take anything beyond their barest needs into account; she wanted to change that. Szerkeres created her own place for the mentally and physically disabled to live and work, called the Alliance Industrial Union, or Alliance for short. While in state-run institutions the residents were often locked up and/or tranquilized, the higher-functioning residents of Alliance lived in their own apartments with little supervision, those who could not live on their own share a house with other residents and staff members, called helpers. Residents at Alliance were also given jobs that they were paid for, many of which were in manufacturing, according to their abilities. While institutions were generally structured in a manner similar to prisons, Alliance was structured much like an ordinary town, complete with its own restaurant. Also unlike many other institutions that treated their adult residents as children and regulated nearly every aspect of their lives; Alliance residents could act like autonomous beings, and adhered only to rules that were nearly the same as those one might encounter in any other town. Another nontraditional aspect of Alliance was that they encouraged and assisted their residents to move out of Alliance and into towns and support themselves (if they were able, of course).

The entrepreneurship of Erzsebet Szekeres

In chapter 9 of his book, “How to Change the World”, David Bornstein gives us a picture of the impact Erzsebet Szekeres made in Hungary. The standard for the way care was provided for the disabled was forever changed. Because of the vision she had of a better future for her mentally and physically disabled son, Tibor, love and compassion became her motivation. She wanted to see a world in which Tibor could successfully live in society. She began to understand that there is only a quantitative difference between the disabled and the non-disabled. And it does not change their quality in society. As Szekeres began to visit the horrible institutions for the disabled, she saw an urgent need for change, and she engaged in it. It was very difficult to start a private organization at first, since Hungary was a communist country. So she started with a small group of disabled individuals and taught them simple skills that they could use to work a job, and that grew larger and changed over the years. It eventually became a functional and beautiful community where disabled individuals could come and take up a residency, learn a skill and make a living, and learn how to live independently if possible. There were many times where she failed, or her efforts seemed to be going nowhere. But she never gave up, she persevered. There were times where she became depressed from her failed attempts, but she would remember her son and find the strength to persevere. It was her empathy and compassion for the disabled that truly drove her and made her relentless in her pursuits.

Veronica Khosa

Veronica Khosa is a South African nurse who created an AIDS home care organization called Tateni to fill a gap in the healthcare system of Pretoria and the nearby township of Mamelodi. In her work with Tateni, Khosa displayed an entrepreneurial trait that David Bornstein calls “Willingness to Work Quietly” as she focused on serving the community's needs, running the organization out of an old shed and using her own retirement savings when the government and philanthropic organizations would not financially support her work.

Khosa was raised by her grandmother in the township of Mamelodi, near Pretoria in the province of Gauteng in South Africa. From a young age she was interested in nursing, watching her grandmother, a midwife, deliver babies. After completing school, she began training as a nurse at a missionary hospital, where she learned to improvise treatment and teach family members to care for rural patients. In 1991, while working in a Pretoria AIDS testing center, she encountered the problem of hospitals sending home AIDS patients with neither medications nor instructions for home care. Realizing that lack of both correct information about AIDS and home care for AIDS patients was a serious problem in Mamelodi, Khosa enlisted the help of several retired nurses in making home visits to patients who could not afford to visit an AIDS center. Shortly after watching one of her patients die because he was locked in his house with no water, Khosa talked with a group of young prostitutes who wanted different jobs to avoid getting AIDS. She realized that the lack of AIDS home care and lack of jobs for young people could be connected to alleviate both problems. Since no organization existed to provide training for home care of AIDS patients, Khosa designed her own curriculum and held classes in an old shed.

In 1995, Veronica Khosa retired from working with the Pretoria City Council and started Tateni Home Care Services. From their first office in the old tin shed where classes were held to a larger building where supplies were often stolen, Tateni faced financial difficulties. Early on, Khosa found that patients did not want their neighbors to know that they were receiving help from an AIDS care organization, because this would make it obvious that they had AIDS. However, after publicly changing Tateni’s focus to general home care in response to a community survey, she found that potential donors were reluctant to give to the organization, since it was not specifically focused on AIDS. Because of Tateni’s financial difficulties, Khosa ended up using her retirement savings to run the organization.

Finally, in the late 1990s, UN attention to AIDS home care and to the work of Tateni caused the government of the province of Gauteng to seek change in the healthcare system. Their approach was modeled on Tateni, and they implemented as policy some of Khosa’s main suggestions to them. The government began supporting several AIDS care organizations, including Tateni, and continued to increase its support as more home care organizations were formed.

Fabio Rosa

According to Ashoka, “Social entrepreneurs are individuals with innovative solutions to society’s most pressing social problems. They are ambitious and persistent, tackling major social issues and offering new ideas for wide-scale change.” Entrepreneurs are consumed with ideas. They aren't happy to simply express their idea; they need their idea to make a change in society. Another quality about entrepreneurs is the ability to be realistic. "A real entrepreneur has to listen to the environment very well. You cannot cause major social change unless you really understand what's going on." All of these qualities were displayed in Fabio Rosa, a man with the desire to spread electricity to poor sections in Brazil. In 1982 Ney Azevedo, the new mayor of Palmares, got Rosa connected in hopes of improving the lives of the people living in that region. Rosa initially started working on solving the problem of irrigation for the farmers. The price of water was high for them, and the only good solution for this problem was to use electricity to get the water out of the ground. In his research, Rosa heard about Ennio Amaral, a professor who had devised an effective yet relatively low-cost electrification system. Rosa was able to gain permission to experiment with Amaral’s system, and then using water pumps he was able to start solving the irrigation problem for the citizens of Palmares. After that Rosa experienced many difficulties. He found it hard to gain financial support so that he could continue to spread electricity and irrigation systems to areas outside of Palmares, and changes in government officials caused his work to almost come to a complete halt. Rosa continued to persevere despite this though, and he was able to get electricity to 25,000 farmers in the early 1990s. His work was slowed again though, and he changed his method of action. After starting his own company, Agroelectric Adequate Technology Systems in 1992, Rosa began selling low-cost products that converted solar energy into electricity. He knew that the lack of fencing in Brazil was causing there to be overgrazing by the livestock, so he started distributing electric fences to solve this problem. Rosa acquired national recognition through this process, because his method was so successful. By this point he had distributed solar electric systems across Brazil. After this Rosa developed more projects, including the Quiron Project which saved poor families money while using various methods to protect the environment, and The Sun Shines for All which provided families with solar panels using a rental system. All of these accomplishments could have caused Rosa to acquire an inflated ego, but instead he refused to receive all the honor. He displayed what David Borenstein has called “Willingness to Share Credit”, which is one of the qualities of a social entrepreneur.

Jeroo Billimoria

Jeroo Billimoria is the founder of Childline, which is a twenty-four-hour helpline for children needing help. Billimoria did post graduate work in New York City, becoming involved in a project called “Coalition for the Homeless”, a nonprofit that assists the homeless. “I was very moved by the spirit of survival among the homeless,” Billimoria said. She found herself drawn to the children back home in Bombay, India, and discovered that they needed to be acknowledged, that they were “proud”. The children began calling Billimoria, “Didi”, which means “big sister”. Soon, Billimoria realized that it could take days for a street child to receive help in an emergency, and her idea for Childline was born. Billimoria wanted to network the various organizations that give assistance to children together. Ultimately, Billimoria was inspired to start a twenty-four-hour hotline that could provide immediate response to the needs of Bombay’s street children. Since then, Childline has expanded into forty-two cities, 120 organizations implement the service, and as of October 2002, Childline has fielded over 2.7 million calls. Childline is an organization that deeply cares for the rights of a child, and goes to great lengths to demonstrate respect and curtesy for each individual they work with. Despite all this, Billimoria is humble and acknowledges her weaknesses. Since resigning from Childline, she stated, “I was a lousy administrator”. Billimoria’s genius for setting up a thriving organization that assists children lies in her ability to synthesize available resources by linking various programs together, seeing a problem, and envisioning a bold, simple solution.

James P. Grant

During his time of leadership at UNICEF, James P. Grant demonstrated the social entrepreneurial characteristic of a “Strong Ethical Impetus”. Simply, the entrepreneurial trait of a strong ethical impetus means to be motivated by a desire for justice, not wealth or power. Grant demonstrated this quality by his constant, energetic motivation to put an end to the premature deaths of easily cured, sick children around the world. In 1980, James P. Grant became the leader of UNICEF. When he acquired this leadership position, Grant had already perceived a strong vision of where he wanted UNICEF to make its mark on the world. Although the specific strategies had not yet been evaluated, Grant knew that he wanted to put an end to the easily curable, premature deaths of unvaccinated, malnourished, and severely dehydrated children. Although seen as slightly crazy by co-workers and the public alike, Grant initiated UNICEF’s core strategy: GOBI-FFF. This acronym, which addresses the specific areas that Grant desired to reform, stands for Growth monitoring, Oral Rehydration Therapy, Breastfeeding, Immunization, Food supplements, Family planning, and Female education. Establishing this new foundation attracted many prominent supporters, such as William Foege and Audrey Hepburn; however, it also attracted quite a few cynics, such as Halfdan Mahler. Due to his integrity and hard work, Grant was finally able to gain the support of the president of Columbia for a vaccination campaign. This campaign consisted of three days of vaccinating the children of Columbia. Because of this campaign, more vaccination campaigns were able to be established in other countries. Another a huge accomplishment Grant achieved was the World Summit for Children, which consisted of seventy-one world state leaders meeting together to discuss UNICEF and its mission of saving the sick children. Amazingly, the World Summit for Children was the biggest collection of world leaders who had come together to discuss one specific concern. Despite having to go against the very grain of society, James P. Grant radically changed the lives of children everywhere.

Florence Nightingale

Though no one believed in her, even her own parents, Florence Nightingale proved to be one of history's greatest example of a social entrepreneur: an individual with innovative solutions to social issues. In her time, nursing was considered a very negative term which generally implied a woman of a rough nature who was often drunk or involved in illegitimate sexual activities. However, as is evident now, Nightingale transformed nursing into a highly respected vocation. How did she perform such a monumental accomplishment against all odds? Not through gentle charm or merely giving her time and resources, "it was by strict method, by stern discipline, by rigid attention to detail, by ceaseless labor, by the fixed determination of an indomitable will." She knew she had the ability to make an extremely beneficial impact, and even though it reversed society's norm, she succeeded in fulfilling her dreams. Florence Nightingale will forever be remembered as a great social entrepreneur for her heroic work in the field of nursing.

Nightingale's "indomitable will" may have been her most instrumental trait in accomplishing her radical ideas and plans. Beginning with strong resistance from her parents, and continuing to the point of defying army officers, her calling was a constant struggle against society's standards. Like Nightingale, every social entrepreneur will face opposition at some point in their career. It comes with the very definition of an entrepreneur. Their job is to defy cultural norms to find revolutionary, though often seemingly insane, ideas to solve the problems of life. "It takes concentrated focus, practical creativity, and a long-term source of energy to advance a system change and to ensure that the change becomes well rooted in institutions and cultures." Social entrepreneurs must have the courage and indomitable will of Florence Nightingale to succeed in a world so resistant to change.

Vera Cordeiro

Vera Cordeiro is a physician as well as a social entrepreneur. She founded Asociação Saúde Criança Renascer (Rebirth: Association for Children's Health), which is a network of organizations that continues giving health care to children after they are dismissed from public hospitals. In Brazil millions of children suffer from chronic malnutrition. When Cordeiro founded Renascer in 1991 she was working in the public ward of Hospital da la Lagoa, which was a public hospital in Rio. Seeing the children get discharged from the hospital and returning sick again weeks later broke her heart. She said, “I could not stand to go one more day seeing children locked in this cycle of hospitalization, re-hospitalization, and death.” She founded Renascer so that sick children would not return straight to the slums after being dismissed from the hospital only to get sick again. By 2007 Cordeiro opened sixteen public hospitals in Rio de Janeiro, São Paulo, and Recife, helping more than 20,000 children. In 1999 the director of Lagoa's pediatrics unit, Odilo Arantes, reported that, between 1991 and 1997, Renascer had brought a 60% drop in readmissions to the unit. Arantes is quoted as saying, “Before Renascer, we used to spend lots of effort and money in the emergency room or ICU on treatment knowing that there was a high probability that kids might die afterward from lack of assistance and followup at home. Now when we discharge a poor child, we can feel at peace. And this makes our work more meaningful and rewarding.” In Renascer's headquarters there is a framed quotation from Goethe that says,”Whatever you can do or dream, you can begin it now. Boldness has genius, power, and magic in it. Begin it now.” Vera Cordeiro certainly lived up to that quotation in her life. Cordeiro displays an amazing determination and love for the children and their families that lived in the slums. She is someone who was able to put her city in order and benefit thousands of children and families around her.

References

How to Change the World Wikipedia