Part 4: Safe Passage to Motherhood 2010

One woman started teaching Home Based Life Saving Skills (HBLSS) in 2009 by training 15 people. One year later those 15 have reached 10,000 people.

The clinic in Bware

But really, what does that mean? Did the people who heard about the program actually learn something that will make a difference? The over arching goal is to reduce infant and maternal mortality. The numbers are alarming, everywhere from 1-13 to 1-22 risk of dying in childbirth in Africa. Many of the deaths are from complications that can be treated if the risk is identified and the woman gets help.

Going to the clinic

One of the core teachings in the HBLSS training is identifying the signs that a mother needs some kind of assistance in her birth. Most women birth at home, so the clinic is a place where women go who need some skilled assistance.

The year before HBLSS, there were 53 births at the clinic.  There were 166 births in the clinic in 2009, 90 already in 2010.

There have been no maternal deaths in the last year. Up until then, there had been 2-3 a year.

Spreading the word to other villages

The Safe Passage to Motherhood (SPM) team knew the biggest challenges the trainers in Kenya were facing from the VisualsSpeak session they did with the group.

1. Transport
2. Umbrellas, rain boots, shoes
3. Bag for carrying materials
4. Money for transportation
5. Badges and uniforms

Walking to nearby villages

All of these things relate to spreading the training to nearby villages. The team in Bware walk to do their work. For hours. In all kinds of weather. Carrying all their materials and supplies. The villages they go have limited resources, so there were times they were not even offered food and water.

Given all of this, the SPM team needed to go to the places the group considered trained, and see what those communities really knew about how to offer assistance to birthing women. They set off walking to the remote sites.

What helped communities learn

The results from the communities were mixed. When the trainers went and simply talked about HBLSS and the steps people could take to assist in birth, people did not remember enough detail to be able to take effective action. When the trainers went several times to the community and did the interactive training that involved role playing the interventions, the information was remembered.

Similar to my experience training with a wide variety of people in the US, lecture didn’t stick and experiential learning did.

Balancing empowerment and effectiveness

There is a certain amount of power in standing before a group to impart knowledge. SPM saw that empowerment in the Bware trainers. Some of it is really important, and shows new levels of confidence. As developing educators, we also need to guard against putting too much emphasis on ourselves, and serve the groups we work with. I know at times I can feel almost lonely facilitating a particularly dynamic conversation. Everyone else is fully engaged and I almost step back to allow the space for it to happen.

The work continues

SPM brought a lot of information back from Bware that is still being tabulated and analyzed. I know there are a lot more stories coming. The group plans to continue working with Bware, but also dreams of working on projects in other part of the developing world. Like so many others, funding is what limits their abilities to do more. If you’d like to help, I’m sure they would put your donation to good use.

Part 3: Safe Passage to Motherhood 2010

Annie, Emily, Julian, Mari, Gabriel and Maggie

The Safe Passage to Motherhood (SPM) team were met at the airport by Emily when they arrived in Kenya. Emily acted as a translator during training, and takes responsibility for much of the communication between Bware and Portland, OR. Annie is a midwifery student, and the boys are Maggie and Mari’s teens. Mari is a physician assistant and Maggie is a nurse midwife.

In Kenya with specific goals

The team was in Kenya to assess the results of the training they started the year before. They identified specific things to look at while they were there.

• Assess the number of communities and participants trained,
• Assess the quality of the ongoing training as they cascade down to more
  and more women
• Set mechanisms in place to track health outcomes in trained communities
• Understand barriers and challenges
• Determine ways to support the sustainability of the program
• Strengthen ties between youth and women leaders
• Increase the emphasis on education and prevention starting with the young and
  extending through child-bearing years

Beginning to gather data

10,000 people trained in HBLSS

The Home Based Life  Saving Skills (HBLSS) program includes keeping detailed records of training and births. The SPM team was thrilled to find that their contacts had kept detailed notes and tracked their progress.

On the wall behind Mari and Emily is a pyramid chart. Each trainer filled in information about how many people attended their training each month.

When the numbers were added up, there were 10,000 people who had heard about how to identify signs that a woman needed help birthing. With proper training, skilled attendants can recognize problems early and can intervene directly or stabilize the condition and help the patient reach specialized care.

One woman started spreading the word in 2009 by training 15 people. One year later, those 15 have reached 10,000 people.

Understanding Barriers and Challenges

Safe Passage to Motherhood is committed to working with the people in Bware to help them solve their own challenges. The process includes listening to stories of what they are already doing, identifying resources they can utilize or reassign, and partnering to learn skills that can make a difference. The organization here in the US operates on a shoestring, and the trainers are volunteering their time and medical skills. This is grassroots. People sharing knowledge to help one another.

There are real challenges to spreading the work. Money to get SPM trainers there, money to pay for supplies and transportation in Kenya, money to pay for the medical supplies. At the same time, the groups have been incredibly resourceful in how they spend the small amounts they do have. The goal is always to think about the sustainability of the approach.

What are the problems?

Making list of challenges

The first step to looking at  barriers and  challenges was to make a comprehensive list of things that had come up in the last year. Seventeen items were identified, the Kenyans picked the top five as the most important.

1. Transport
2. Umbrellas, rain boots, shoes
3. Bag for carrying materials
4. Money for transportation
5. Badges and uniforms

=========================

6. Sickness
7. Work at home
8. No money for help
9. Food for trainers
10. Trainees being late
11. Equipment
12. Vacation from work
13. Cultural beliefs,
14. Different ages and belief systems
15. No light at night
16. New people at repeat trainings
17. Distance

Understanding more fully what this means

Using VisualsSpeak in Bware Kenya

We created a set of VisualsSpeak images to be used specifically to deepen understanding of these challenges. The more the SPM team knew about what people meant when they said these things, the more effective they would be helping them come up with solutions.

Before they left for Kenya, I had a number of conversations with Mari about what prompt to use. She decided to use:

Find pictures that speak about a time you have succeeded at a challenge as a member of BUCHWA (the community health group that does the HBLSS training.)

What happened?

There was no hesitation with the VisualsSpeak process. The Kenyans were very comfortable with the images and process. There was no learning curve. Maggie reported,  “They are very metaphoric, it was like they had drawn the images themselves. We had no difficulty.”

Many of the stories that emerged were less about the challenges, and more about the empowerment. Stories about being lonely and only affecting their homes before learning all the skills, and now being a part of something bigger. Making a difference. Being someone.

Hierarchy is a large part of Kenyan culture. This is a poor rural village. There are not a lot of opportunities for women. The SPM team knew this, but until they heard all the stories, they didn’t realize how huge this was for the group. The uniforms and badges the Kenyans found so important? Very much about being part of, being someone special, being someone with knowledge.

The fifteen Bware United Community Health Workers Association (BUCHWA) members have shared information with 10.000 people. What has happened to them as a result of learning how to help others save the lives of women and babies may be even more profound.

Next up: More stories (and results) from Africa

Coming soon.

Part 2: Safe Passage to Motherhood 2010

The goal of using visual tools in Kenya was to encourage people to tell stories of their experience with the Home Based Life Saving Skills course, HBLSS they learned the year before. Maggie Alexander is the nurse midwife who trained the group the previous year. Mari Alexander  is a physician assistant who was on the assessment trip two years before. She is a VisualsSpeak customer who has used the tools in her mental health practice and in her work in diversity and inclusion training. The two of them were joined by their teenage sons and a midwifery student for the 2010 trip.

What images should we use?

diversifying paintings of people

The original VisualsSpeak tools are all photographs. While we worked hard to make them diverse, they are still a US designed tool, created for a professional market. We were nervous that rural Kenyans would not be able to relate to them. I’ve been working on new products that incorporate my paintings, and have a deck that we’ve been using in testing those products that we knew worked in the US and Europe.

I’ve also been working on a series of paintings for a storytelling deck. They have broad universal themes, and are the images in my online gallery. I plan to create a storytelling product as well as use these in other new decks.

We didn’t know which to pick, so we decided to send both, but with modifications.

Adding local images

The first deck is a mixture of 24 photographs, 12 illustrations, and 12 abstract paintings. We added 24 photographs Mari and Maggie had from Bware. Most of them were people, but there were also a few of the houses and landscape.

This deck is about the size of playing cards. We made one of those to use with the younger people, but had to enlarge them for working with the adults. We did this because most people do not have reading glasses (other than the gifts the group brings over) so they would have difficulty seeing the details of the images.

Brown is generic not diverse

We felt more confident about the storytelling images for a number of reasons. First, the Kenyans have a storytelling tradition. Second, my style has the flat patterned look of some of the textile work from the region.

When I did the original paintings, I made the people medium brown. As the group looked at them, they felt they were way too light. Especially considering how dark the Kenyans are. They also suggested making them more shades of brown to make the diversity clearer.

I altered many of the people images to be a variety of skin shades. Thanks to the wonders of Photoshop, this wasn’t too difficult. I printed out the images and laminated them. We put them in  zipper pouches handmade by a woman in our town, and sent them off with Maggie and Mari.

Other parts of the story:

Part 1: Sending Visual Tools to Africa

Part 3: Stories from Africa

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Sharing knowledge

Safe Passage to Motherhood was heading back to Bware Kenya for the third time. On the first trip, they conducted an assessment of the community in relationship to maternal mortality. The second time, one midwife conducted a training in Home Based Life Saving Skills, a program designed by the American College of Nurse-Midwives for use in the developing world. The program teaches simple skills to the women in the community that save lives in childbirth.

Multiplying Effect

Maggie Alexander, a nurse-midwife from Oregon taught life saving skills to four lead trainers. Together they taught 12 more. That group taught 44 during the two weeks Maggie was  in Kenya.

During the next months messages arrived from Kenya about training hundreds of people. Then thousands. Women from a rural village. Without transportation. With very limited resources.

Excited Skepticism

Each time a report would arrive in the US, there was excitement. The program was working. People were learning skills to identify when a birthing mother was having potentially life threatening symptoms.

Then there was skepticism. Were they really reaching all those people. What did training really mean? Were people actually learning?

Going Back to Assess

The only way to really know what was happening, was to go back to Kenya. This time there was one midwife, one physicians assistant, and their two teen-aged boys and one midwifery student.

One problem. How were they going to get people to tell them what was really going on? They didn’t want to hear the stories people thought they should tell them. Culturally, it was not considered polite to talk about problems. Especially to guests who were coming to offer help.

Using Visuals to Get to the Real Story

People struggle to tell the story that really matters. Instead we tell stories that we are comfortable with, or ones that tell a flattering version of our part. Or the story we think the listener wants to hear.

When visuals become part of the mix, something else happens. Other memories get triggered. Less conscious aspects surface. You can talk about things that are awkward or hard to talk about because you are now talking about a picture. Not another person. All sorts of different stories surface.

Would the Images Work in Africa?

We know the VisualsSpeak tools work in many places in the world. We know they work with different backgrounds. But would they work in rural Africa? We weren’t sure. But we were willing to try.

Next parts of the story:

Part 2: Adjusting Images for Africa

Part 3: Stories from Africa

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I’d love to hear your comments and stay in touch with you.

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In the webinar, I talk about some of the many uses for the VisualsSpeak ImageSet. Here’s a quick breakdown of what I covered:

• Why use visuals?
• Heart Image icebreaker
• How conversations change when using visuals
• Research in creating VisualsSpeak
• Facilitation Model we use
• Case Study- Developing cultural competence in future leaders
• Case Study- Change Management Initiative and Team Building
• Conflict Resolution
• Strategic Visioning
• Question & Answer

Time: 43 minutes

You can download a free copy of the Heart Image exercise I show at the beginning of the webinar on the VisualsSpeak website.

You can get 20% off any VisualsSpeak product until Jan 9, 2010 by entering the coupon code (vswebcast) in the shopping cart

• VisualsSpeak ImageSet deluxe version Regular price $495 - Sale price $396!
• VisualsSpeak ImageSet Lite Regular price $425 - Sale price $340!
  

Being an experiential facilitator, it was strange to work from a script on PowerPoint. Even though there were over 300 people signed up for the call, I was talking to my computer monitor and a cat. It was such a relief to have attendees ask questions so I could get a sense of the audience. So different than working with the energy in the room with a face-to-face audience.

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follow me on twitter @cmartell

Tom Crawford from VizThink recently invited me to facilitate part of his pre-conference session, Visualization for Learning: Approaches, Tools, and Applications to Improve Effectiveness, at the Brandon Hall Innovations in Learning conference.

We asked each person to select photos in response to the question, Why did you come to the conference and this session? In small groups, they told their stories to each other. In the second round using the same question, each small group created an image together with input from each person.

These are the videos of the small group reports. Each small group used the same set of 200 images from the VisualsSpeak ImageSet. I highlighted the main points from each group below the videos.

• expansive nature of knowledge
• connected and web-like
• solve our own problems
• we will get tools
• truth shining light on things previously in shadows
• access for everyone
• stands out
• help pieces come together

• we are on a path and its all good
• learn tips to for keeping training from being boring
• inclusive of everyone
• universe to investigate
• keep it simple and on target

• taking things we are familiar with and recombining them
• origami sheets can become anything
• taking resources that we see at the conference, bringing them back and shaping them into something new
• excitement and energy form people who are here
• same building blocks, but new tools
• beating the drum to share the knowledge when we get back
• everyone putting their heads together to share knowledge

• people get together to share ideas
• discovery, people coming together
• discovery of each other
• interesting things
• path to discovery & knowledge
• learning new & interesting things
• contrast and same, create intriguing ideas
• measuring your progress

Working with the visual themes

What do you do with this kind of information? First, you can look at the visual quality of the images. Many of them are radiating forms, several groups using the exact images. So visually, radiating forms are attractive and speak to why people came to the conference.

When you look at the conference logo, all the words surrounding the brain are horizontal. They could have been arranged in a radiating pattern. It would have made the design more dynamic, and perhaps subconsciously more attractive to people who are looking for innovation.

The group participating in this workshop are particularly important to the success of a conference, since they were willing to make the investment of time and money to attend both the conference and a pre-conference workshop. Looking at the visual quality of the images these attendees selected, and repeating them in the marketing materials, could have helped to speak to them.

Working with the word themes

You can take the themes or the words people say, and build them right into your marketing descriptions. This group of people are interested in:

• bringing tools and ideas back to their organizations
• learning from each other, sharing knowledge and ideas
• making sure the learning is accessible and inclusive
• making sure the learning is on target and you can measure progress
• learning new things they can incorporate with what they know, restructuring and combining

When looking at these trends, you do need to be conscious of what the group has seen before. Like the advertising that brought them to this common event. Looking at the conference description in this case, the bolded section of the ad copy  is consistent. Perhaps that part of the message stuck?

The theme of this year’s conference is “Get your head in the clouds.”

Why clouds?

• Tag clouds, which are synonymous with Web 2.0 technologies
• Cloud computing, which refers to accessing shared computing resources
• Many original ideas come from innovators having their heads in the clouds.

We’re not inviting you to come daydream. Instead, this event will provide you with actual skills you can apply to advance learning within your organization.

You can also take this type of insight and apply it to physical space. This group wants to connect with peers. Are there conversation areas? Does the space support informal connections especially as people get tired? You need SEATING! Standing in the hall isn’t the same as being able to chat with someone at a small table.

What else do you see for patterns?

I hope this example gives you ideas for how you can use visuals to understand how people are thinking about something. In the process, they have fun and connect with each other more deeply.

Do you see anything else Brandon Hall might want to pay attention to for next year?

Ever wonder why sometimes even the most talented group of people can’t come together to realize their goals? Everyone can see the opportunities ahead, but they just don’t function as a team.

A Clear Path

Fostering a sense of inclusion, trust and mutual respect are the deep roots needed for building effective teams. With these in place, you can create a well-defined path for achieving your goals. Consistently.

Receive 3 Free Gifts ($100.00 Value!) when you attend this VisualsSpeak training!

When you attend our 1-Day Team Building training you will learn a simple, effective approach that consistently brings people together, fosters trust and gets people beyond surface level solutions.

Sign up now to receive 2 Free Gifts!
1 visual icebreaker set ($40.00 value)
1 VisualsSpeak tote bag ($20.00 value)

If you sign up by the early registration deadline you will receive an additional visual icebreaker set ($40.00 value)

Total Value of Gifts $100.00

Save $55 by registering before September 30!
Use Coupon Code: trg2008

This is a hands-on training, which utilizes visual tools, for people who aren’t satisfied with mediocre team results.

Team Building: Unleashing the Potential of Your Teams
1 Day Training
October 8, 2008
Portland, OR, USA
Your Investment
• $295 Early Registration Before September 30)
• $350 Full Price (After September 30)

Click here to learn more about this training and to register

Hope to see you there!

This program can also be brought to your company or organization. info @ viusalsspeak.com

Next public trainings in Portland Oregon

November 7, 2008 Creating Inlcusive Programs for Success

January 28, 2009 Working with Individuals: Getting to What Matters

February 5-7 Let’s Get Strategic: Tapping Into Creativity

I will be facilitating a session, Using Visuals to Unlock Strategic Processes

In this experiential session we are going to tap into strategic problem-solving capabilities quickly and deeply. We’ll be using photographs as a way to unlock a group’s ability for innovation and creativity. This process is a way to bridge the verbal and visual, the tactical and strategic, and with the added benefit of building stronger teams. This is a low-tech process for getting high-tech results.

A number of my colleagues are facilitating pre-conference workshops.

Tom Crawford, the CEO of Vizthink, is facilitating a pre-conference session. Visualization for Learning: Approaches, Tools, and Applications to Improve Effectiveness. Here is a podcast with an interview I did with Tom.

During this one day workshop, we’ll explore what visualization approaches exist, how they can be applied, and what tools can be used to assist in the process. Visualization approaches can be used to improve the entire learning development process. Regardless of your specific development approach, visualization techniques can provide dramatic improvements to your analysis, design, development, implementation, and even evaluation processes. During this session, we’ll explore a variety of techniques that can be applied to each step of the development process. We’ll even put several of them to the test both on paper and online. No drawing skills are required.

Michele Martin from The Bamboo Project is also doing a pre-conference session with Janet Cleary, Social Media Jumpstart. Here is a podcast with an interview with Michele.

This pre-conference workshop is for those who want to maximize their conference experience by exploring the social Web before the conference begins. The workshop will introduce you to social media like blogs, social network sites, wikis, social bookmarking, photo sharing, Voice over IP, virtual worlds, instant messaging, videosharing, microblogging, etc. Delegates will be exposed to applications like WordPress, Facebook, Ning, wikis, delicious, SlideShare, Flickr, Skype,SecondLife, YouTube, Twitter, etc. Each media will be presented Pecha Kucha style followed by a brief, hands-on trial or demonstration. You’ll leave with the skills to explore each of these social media applications on your own while at the conference and later, at your workplace.

Gary Woodill and Anya Wood are doing a pre-conference workshop, Emerging Learning Technologies in Healthcare Training. Here is a podcast interview with Gary.

The use of technology in healthcare education has increased dramatically over the last decade, and none too soon. Because of rapid change, providing meaningful access to learning opportunities for both practitioners and the general public has become increasingly important. With the advent of the Internet the general public has become more knowledgeable and, in turn, demands access to healthcare education in a variety of different formats. Practitioners continue to experience time constraints and a need to relate training to practical, real-world experience, making accessibility and application to real-life top priorities.

I presented at this conference last year, and it was great. Not only were the sessions high quality, but the other participants were also very engaging. Here are posts I wrote about sessions last year:

• What is innovation in learning? This was the session I did.
  
• OilSim: Learning to explore for oil in an hour This session was facilitated by Olavur Ellefson who will be doing another session this year.
• Five Worlds of Learning 2.0 This session was facilitated by Lance Dublin, he is one of the keynotes this year.

I hope you will consider joining us in San Jose!

We are inviting the VisualsSpeak Community to donate to a good cause. And it won’t cost you a cent!

Send us your VisualsSpeak story and we will make a contribution to Mercy Corps. This Portland, Oregon based group has a global perspective. Presently they are contributing their resources to relief in China and Myanmar after the recent disasters there.

This is a Win-Win-Win scenario:

• You win – Your story is converted into dollars and then contributed to an organization doing great work on a global level.
• VisualsSpeak wins – We get your great stories to share with current and potential community members.
• Mercy Corps wins – They receive money from our community to help continue their great work.

About Mercy Corps

Mercy Corps works amid disasters, conflicts, chronic poverty and instability to unleash the potential of people who can win against nearly impossible odds. Since 1979, Mercy Corps has provided $1.5 billion in assistance to (more)

The Details

Send us a story* about something that happened while using VisualsSpeak. This might be about a time when there was a significant breakthrough, or something unusual happened, or new insights were inspired, or anything you think others might want to hear.

Include as much detail as possible such as:

• Who was the audience?
• What was the purpose of the process?
• Where did this take place?
• How did your participants respond?

Please include the following information about yourself: (as much as you like)

• Name
• Title/ Profession
• Company/ Organization
• Website/ Blog
• Digital Photograph (or where we can find one on the web)

How to send your story

• Leave your story as a comment on our Blog post “What’s your story?”
• Send a separate email to info at visualsspeak dot com

Show me the money!

• VisualsSpeak LLC will donate $10.00 per story
• Christine & Tom will personally contribute $10.00 per story for a total of $20 per story
• $300.00 total potential donation! (15 stories)
• Donations to be tabulated on June 18, 2008

Why?

We believe in giving back. And one of the ways to give back is to support organizations doing great work. There’s not enough time in a day to do everything, so contributing to groups that benefit us all makes sense.

* By sending your story to VisualsSpeak, you agree to give us permission to use it in various ways including but not limited to our website, Blog, and marketing materials.

Thanks for your story and for supporting an incredible organization like Mercy Corps!

More often in life, making a difference is about all of the small steps we take along the way.

Yours in service,

Christine Martell & Tom Tiernan
VisualsSpeak LLC

Jeremy has been a learning consultant for five years working with the Information Technology area in one of the two largest sports & fitness companies in the world. He introduced the VisualsSpeak ImageSet to his training department as soon as it was available.

How has the VisualsSpeak ImageSet worked as a training department tool?

VisualsSpeak can be used to develop intuiting skills and strengthen dialoguing overall. As users become more practiced in the method, overall communication improves. I have a co-worker who has always given me fits. So much of what I wanted to say seemed too hard to handle directly.Through using VisualsSpeak together, we find it is easier to express ourselves in direct ways. That practice of tapping the deeply felt, describing, and interpreting it for another has carried over into day-to-day communication

How have you been using the VisualsSpeak ImageSet?

We’ve used it three ways so far.
1. In a visioning session with a small team.
A group of four specialists whose work is interdependent.We used VisualsSpeak images to visualize what an inspiring communication environment is like for each person. Then we built a joint image to remind us of our shared aspirations.

2. In a group undergoing transition.
The images helped them to share hard feelings and moods they couldn’t otherwise make available to others. The images of VisualsSpeak became an interstitial space where emotions can inhabit tangible symbols; symbols we can try to understand and begin to work with as we commemorate endings and start looking ahead to what is becoming.

3. In a prototyping session.
Got a group of software developers together and taught them to look for asymmetric approaches to design and problem-solving. For example, pick an image, describe the image, then ask how some of those words describe our process. Another example, pick images that represent user friendly to you. Where does what we do align with these qualities? Where are the opportunities?

What have you learned about the tool?

VisualsSpeak often creates unexpected openings and surprising insights. Being able to adapt in the moment can allow some of those moments to flower. Because VisualsSpeak is so morphic, taking advantage of its full potential encourages the facilitator to mirror that flexibility.

What words of wisdom do you have for others who are considering using VisualsSpeak?

Get it and use it every chance you can get. It is engaging and changes the energy around many kinds of exchanges. People respond to the way it helps them talk.