Designing Humanitarian Action in Three Acts (Or, “How to get Marcus to lose 25kg and save his life!”)
Act 1: The Design
THE AGENCY: “Hi Marcus. We work for a big international organisation—we’ve worked everywhere! We have dirt in our socks and OneWorld miles in our wallets, if you know what I mean.
MARCUS: Umm, sure.
THE AGENCY: Well, Marcus, we’ve noticed you are pretty fat.
MARCUS: Yeah, I know. My wife tells me all the time.
THE AGENCY: Yes. She’s right. You are really fat! This is a big risk. You know that you could die, right?
MARCUS: Yes, I know, I worry about it. Thank goodness I can watch all these videos on my phone! Get’s the mind right off it.
THE AGENCY: Well, no worries. We have a plan. See, we have been doing this type of work for a long time and we know, from our experience everywhere and based on all kinds of research, that basically, you eat too much.
MARCUS: Well, I guess. Yes, I like my steaks and frites, that’s for sure . . .
THE AGENCY: And, you don’t do enough exercise.
MARCUS: Well, I don’t know . . .there is just so much on Netflix.
THE AGENCY: And, you don’t sleep very well.
MARCUS: Well, I guess, my wife complains about my snoring. . .
THE AGENCY: We have designed a plan just for you! We are going to save your life, Marcus.
MARCUS: Great!
THE AGENCY: OK, here’s the plan. First, we write a big report about where you live, what your life is like, your family, your community, your nation--all the wars--the bad schools, the bad healthcare, the dirty markets—I mean, your country is a mess, Marcus—after we write about all of that, we are going to write even more on why it is important for you to eat less, exercise more, and sleep better. And, don’t worry, there’s a lot to tell. Did you know there is research that says you should eat more green vegetables?
MARCUS: Oh, um, OK, like asparagus?
THE AGENCY: Well, no, not asparagus, Marcus, That’s a bit expensive for you, isn’t it now? We mean like broccoli which is also a vegetable that one of our other partners is growing in your country. Isn’t that great!
MARCUS: Um, well, I don’t really like broccoli. . .
THE AGENCY: Sure, but it is very good for you, Marcus. All the research says it! In fact, we are going to put you on a regimen where you will eat precisely 20 grams of broccoli a day along with 6 grams of spinach, and 38 grams of cabbage. Every day. It is going to be great.
MARCUS: Umm, OK, I guess. I mean how much is all of that? Is it a bowl full?
THE AGENCY: Don’t you worry about that. We are going to give you this precise amount of food every month along with a small metal scale, straight from Mingenyan Super-Duper Scale Measure, so you can do the measures yourself. Isn’t that great?
MARCUS: What, are you going to send this to my house?
THE AGENCY: Oh no! You are going to go out to the farthest part of town where two people will sit under a tent and you can line-up for the day and then register. They will give you a card with your name on it. Isn’t that nice? Once you do that, then, we will send the vegetables to a big warehouse, where they may have to sit for a while, to be honest, and then we will send them to a tent on the other side of town where you can pick them up, so long as you bring your registration card and you haven’t worn away your finger prints.
MARCUS: Wait? What? My finger prints? They are going to sit in a warehouse for how long?
THE AGENCY: Oh don’t worry, all of that will become clear. In addition to the 20 grams of broccoli, 6 grams of spinach, and 38 grams of cabbage, every day—every day Marcus—we are going to get you to exercise.
MARCUS: Exercise?
THE AGENCY: Yes, you should do exactly 15 minutes of cardio-rapid-fast (CRF), 10 minutes of muscle adaptive flex therapy (MAFT), and 5 minutes of deep-cardio-rapid-slow (dCRS)—every day, Marcus.
MARCUS: CRF? Every day?
THE AGENCY: Yes, Marcus. CRF, MAFT, and dCRS, every day. It is very important that you do this every day! We are here to help you. We don’t want you to die from a heart attack, stroke, type 2 diabetes, let alone all the wars and droughts, and all the bad schools . . .
MARCUS: Wait a minute. What do the wars and schools have to do with my losing weight???
THE AGENCY: They are all connected! They are all interlinked. You, see, we know, from all the research and all the countries we’ve worked in—we mentioned how many countries we’ve worked in, right?
MARCUS: I guess.
THE AGENCY: 57! 57 countries Marcus! That’s a lot, right?
MARCUS: Umm . . .
THE AGENCY: It is Marcus. It is a lot. And we know, from all our experience and all those countries that wars can make people mad and sad and that bad schools can make people dumb. Don’t you get sad and/or mad about all the wars in your country Marcus?
MARCUS: Well, sure, but . . .
THE AGENCY: And Marcus, do you think you are as smart as I am? I mean, I went to big schools in big countries and I have degrees from these schools that everyone has been telling me are fantastic. They’ve been telling me how fantastic these schools are that I’ve gone to forever! They’ve been telling me how fantastic and expensive these schools are since I was one-years old! 1! Everybody knows how great my schools are!
MARCUS: Well, I’ve gone to school . . .
The Agency. Well, sure but don’t you think the schools you went to could have done a better of a job?
MARCUS: I guess.
THE AGENCY: Let me tell you. They could. They could have done a lot better.
MARCUS: And, what does that have to do with my being, I guess, a bit fat.
THE AGENCY: A bit fat! Marcus, your BMI is way over all international standards. You are more than fat. You are obese. But it is not your fault.
MARCUS: It isn’t?
THE AGENCY: No. Don’t you see? You are so sad and mad about all the wars, and you are so dumb, and have you haven’t been eating 20 grams of broccoli, 6 grams of spinach, and 38 grams of cabbage, every day, have you?
MARCUS: Well, no, no I haven’t.
THE AGENCY: Well, there you go. That’s why we have a plan. Eat 20 grams of broccoli, 6 grams of spinach, and 38 grams of cabbage, every day; do 20 minutes of cardio-rapid-fast (CRF), 10 minutes of muscle adaptive flex therapy (MAFT), and 5 minutes of deep-cardio-rapid-slow (dCRS)—every day; and sleep. Did I mention the sleep?
MARCUS: Umm, no, I’m not sure.
THE AGENCY: Yes. 8 hours, of Rejuvenated-Rapid Eye Movement Hyper Sleep (rREM-hyper).
MARCUS: REM-Hyper?
THE AGENCY: No, no, r-REM-Hyper-Sleep, do you get it?
MARCUS: I guess.
THE AGENCY: Ok. So you get the plan. Eat 20 grams of broccoli, 6 grams of spinach, and 38 grams of cabbage, every day; do 15 minutes of cardio-rapid-fast (CRF), 10 minutes of muscle adaptive flex therapy (MAFT), and 5 minutes of deep-cardio-rapid-slow (dCRS); and 8 hours of rREM-hyper. Make sure to go get registered so that you can get your vegetables and finger prints.
MARCUS: Finger prints?
THE AGENCY: Don’t worry about it! You are going to be great. And, best of all, you are not going to die, Marcus! Isn’t that great? Our plan is going to make sure that you don’t die!
A year later, The Agency comes back and Marcus is still 25kg over weight and has developed high blood pressure.
THE AGENCY: Oh no! Marcus, what happened? Marcus! Did you follow the plan! Why are you are still so, umm, overweight? And the high blood pressure! Marcus! We don’t want you to die!
MARCUS: Well, I did a lot of walking.
THE AGENCY: Did you do the CRF-MAFT—dCRS?
MARCUS: The what?
THE AGENCY: The CMdC! Come on Marcus. We sent our team to sit with you and your neighbors to talk about the importance of the CMdC. Don’t you remember?
MARCUS: Oh yes. The fat lady was really funny . . .
THE AGENCY: Oh Marcus, try not to talk that way about others. We are a rights based organisation, OK?
MARCUS: Um, Ok. But she was funny . . .
THE AGENCY: So you went?
MARCUS: Yes.
THE AGENCY: Good. Let me just make a note of your attendance. Did you bring a friend? Oh, don’t worry about it; I’ll just say you did. What about the Super Green Diet Therapy, the SGDT?
MARCUS: The what?
THE AGENCY: The broccoli, Marcus, and the cabbage?
MARCUS: Oh yeah, sure.
THE AGENCY: You got it? You registered and went to Tent Station 2 every month to get your SGDT kit, along with the scale?
MARCUS: Well most months.
THE AGENCY: Most months?
MARCUS: Well, I may have missed one or two . . .
THE AGENCY: Well. Ok. Did you use the scale every day to weigh out the precise portions?
MARCUS: Well, we actually came to like the broccoli OK. But, the spinach gave me bad gas. The dogs really liked the cabbage though.
THE AGENCY: The dogs?
MARCUS: Yep, Virginia, my wife, would mix the cabbage with some of her famous broth and then add a bit of meat fat . . .they loved it!
THE AGENCY: Oh my.
Act 2: The Community Based Design
THE AGENCY: Hi Marcus.
MARCUS: Do I know you?
THE AGENCY: Yes, I work for the same big organisation that came to help you a few years ago? With the weight? The high blood pressure? The risk of a crippling, bad heart-attack. So sad.
MARCUS: Yes, yes, it has been bad. I remember you. The cabbage people, right?
THE AGENCY: Well, yes, green vegetables are really important, that’s for sure. But we don’t have to discuss the SGDT or the rREm-hyper or c-MAFT/dCRS (revised).
MARCUS: Oh. Good. Ok.
THE AGENCY: No, no. Those are all very, very important, to be sure. However, we want to know from you what is going to work best. We care about you. We want to know what you think is going to work. Isn’t that nice, Marcus, how much we care about you?
MARCUS: Well, yeah, sure. Thanks.
THE AGENCY: Great. So tell us, what can we do to help you eat green vegetables—and Marcus, we’ve really grown. We’ve learned. We did all kinds of reports. No more broccoli, spinach, and cabbage! We know about how spinach caused gastrointestinal abnormalities. We know that the cabbage was not culturally sensitive—we now know that cabbage is dog food. Isn’t that great how much we’ve learned!
MARCUS: Well, you know, my dogs really liked the cabbage.
THE AGENCY: We know Marcus. We understand. Now, we want to know more. To know more about you.
MARCUS: OK. That’s cool.
THE AGENCY: Yes, yes, we know. We are cool. So, let’s start with the vegetables. Whatever type you want, so long as you eat 56.3 grams a day—we’ve revised our figures based on a whole range of new research and international conferences. Now we know that the old standard of 64 grams of mixed greens was wrong. Now it is 56.3 grams—of any type of vegetable—so long as they are green—every day.
MARCUS: Well, that’s a lot. I mean, I used the Mingenyan Super-Duper Scale Measure and the, umm, the old way was more than a bowl full. It was a lot more than a bowl full.
THE AGENCY: Don’t worry about the scale Marcus. We are going to give you a voucher that you can use at the market at the far end of town to get precisely what you need.
MARCUS: A voucher?
THE AGENCY: Yes, it is like a coupon. You just bring it to the store and the nice merchants there will take care of you.
MARCUS: So I can buy asparagus?
THE AGENCY: Well, that is pretty expensive, don’t you think? But no worries. The voucher will let you go to the market whenever you want and buy just the right amounts. What about the exercise?
MARCUS: Well, I walk my kids to school every day. That usually takes about 30 minutes . . .
THE AGENCY: I’m talking about a mix of cardio, strength, and deep breathing, a CSB combo. Every day? Do you walk your kids to school on the weekend?
MARCUS: Well, no. I go to the game.
THE AGENCY: Well, that’s not CSB, is it? Do you run really fast to get your heart beat-beating? (The Agency, thinks: “I heard that’s how you describe a high heart rate. Aren’t we cool!) Do you do weights? What about stretching? Do you have a place to do stretching that is culturally sensitive?
MARCUS: Well, I’m not sure about all of that . . .
THE AGENCY: OK. So what can we do to help you? And, by the way, we are really learning. Did I mention all the reports we’ve done? We are working with health centers in your area so that they can take your blood pressure, measure your weight, and do blood tests to see if you are getting enough green vegetables. Isn’t that great? We are training them. We are giving them all kinds of great measuring tools, again from Mingenyan Super-Duper Scale Measure. They are ready to serve you. Do you still have your registration card?
MARCUS: Umm, yes, I think so.
THE AGENCY: Great! So, you just have to go to one of these health centers once a month to do this check and that’s when you will get your voucher for the green vegetables.
MARCUS: The coupon? For the shop?
THE AGENCY: Yes, that’s right—and we heard you Marcus. You get to choose whatever green vegetables are right for you.
MARCUS: But not asparagus?
THE AGENCY: Well, no, we are not saying that. Just go to the merchants and they will sort you all out. We’ve worked with them and they are very, very happy about this whole plan. And you know what, we are happy too. It is so much easier than the tents and the warehouses. It is super easy. Just go in with your card and get your fingerprint, and then they will give you whatever you want.
MARCUS: Oh, yeah, that little green light machine. For the fingers. That’s weird. I think I saw it in a movie once.
THE AGENCY: That’s right. No worries. Don’t worry about anything at all. We are here to work for you, did you know that? Just take the voucher to one of our predetermined shops, and everything on the vegetable front will be A-OK!
MARCUS: I guess.
THE AGENCY: Ok. Now. The exercise. What do we need to do to help you with that?
MARCUS: Well, I guess I could go to a gym. But they are expensive.
THE AGENCY: Oh yes, they sure are. And they are not very nice, those gym owners. Not like the merchants. They did not want to give you free memberships even though we told them it could save your life. Can you believe that?
MARCUS: I guess not. Well, I saw one of those automatic runners and some weights at the store? If I had a set of those, I would really, really, really work hard. I would use those every day. Every single day, I would!
THE AGENCY: That’s interesting. Very interesting. It is good to hear from you. That’s why we are here. To hear you—you are right at the center of our plan. Isn’t that great?
MARCUS: Yes, that is great! So you’ll give me the runner and weights?
THE AGENCY: Well, that’s a lot, actually. And our donors—the people that give us money for you. They were worried about all of this. They had a lot of questions. A lot! I can’t tell you how many! We said that you might want your own runner and weights. We got the costs for these all worked out with BIG-BOB International Slim Body Supplies and then, with all the questions, about the vegetables, and the exercise, and the sleep—all the questions! I swear, they never read our reports, all of our research! Well, the long and short of it is, we can give you the runner and weights but you have to share them with at least 3 of your neighbors.
MARCUS: I’d have to share them? With my neighbors? How?
THE AGENCY: Well, we are confident that you can work that out. Maybe one neighbor could keep them for one month, and then you could move them to your next neighbor, and then back to you, all in a big cycle? What do you think about that?
MARCUS: Well, I guess. I don’t want to share them with Morris, though. He’s a real jerk.
THE AGENCY: We don’t want to get into your conflicts. That’s for another part of our organisation. Should we have them come by and talk to you about their plan?
MARCUS: No, no. That’s OK. It is just that Morris is real jerk.
THE AGENCY: That’s really, really, interesting. Does it have to do with the high cost of fuel in your country? Does he come from Valley Green in your country? We heard that you don’t always get along with people from Valley Green.
MARCUS: Well, no, he was born here but I think he does have an aunt from Valley Green . . .
THE AGENCY: Ah yes. OK. Let’s get our conflict people to come talk to you. Would that be all right?
MARCUS: I guess so. So, we’d have to move the runner and the weights from house to house? That seems like a lot of work.
THE AGENCY: Yes, it does. But do you know what the beauty is of that?
MARCUS: No?
THE AGENCY: Even more exercise! You get bonus exercise at least once a month! Isn’t that great?
MARCUS: Sure, I guess . . .
THE AGENCY: This is all very good. I am so happy we could talk. So, you get to choose whatever types of green vegetables you want and you told us that the best way to meet the exercise goal is if we give you a new runner and weights—we are sorry you may have to share these (Our donors!)--but I’m glad you know that this is the best thing for you.
So what about the sleep?
MARCUS: Oh, you mean my snoring?
THE AGENCY: Interesting. Is that what keeps you up at night, Marcus? Is that what interferes with your 8 hours of rREM-hyper?
MARCUS: Umm, I guess. Well, really, it is my wife Virginia. You see, when I snore, she gives me a solid kick beneath the blankets, and up I go.
THE AGENCY: She kicks you? Is there other violence in your house, Marcus?
MARCUS: No, no, it’s fine. She just gives me a solid kick whenever the snoring comes in. She is strong! I sometimes have bruises from her middle-of-the-night kicks!
THE AGENCY: Oh, that sounds serious. Maybe we should have our home violence support people come talk with you? Would that be OK?
MARCUS: Well, I guess . . .
THE AGENCY: Is there anything else that bothers your sleep?
MARCUS: Well, the dogs. They bark a lot. But, I have to tell you, when we gave them your cabbage they slept like babies. I don’t know if it was Virginia’s broth or the cabbage, but they slept all night long.
THE AGENCY: Interesting. (Turning to a colleague from the Agency taking notes: “Jeff, maybe we should re-investigate the SGDT programme? Maybe tweak it a bit to account for the cultural sensitivities around cabbage. Maybe add in a domestic animal bit? What do you think?”)
Jeff: Sounds good. I think there’s been some research on that.
MARCUS: Umm, excuse me. So, we can get some cabbage for the dogs? That would be great.
THE AGENCY: Well, let’s look into that. We will come back to you. And, you know what?
MARCUS: What?
THE AGENCY: We are going to come talk to you a lot. Once a month, one of our team is going to come to talk to you and your neighbors. We want to see how the voucher is going—what types of green vegetables you buy every month—and how your plan for sharing the exercise equipment with your neighbors is going. We are going to talk about all the domestic violence you experience, the conflicts with Valley Green, and the health centers—it is very important that you go to the health centers. We are giving them a lot of money, Marcus! So, we can’t wait to come and talk to you about all of these things that are contributing to you being such a fat, dumb, slob—I mean, a weight-challenged, educationally limited, benefit-bound, person of rich cultural identity, that we are here to help.
MARCUS: Well, OK. But, I’m not going to share my runner and weights with Morris!
THE AGENCY: We know and we heard you! We are going to have our conflict people come talk to you and get someone to help you with that and the household violence you mentioned.
MARCUS: Virginia? She’s fine. It is just my snoring . . .
THE AGENCY: Don’t you worry at all. We are here to help you. You just get on with the green vegetables, the exercise--we’ll come back to you about the sleep--and you are going to lose those 25kgs right away. And, best of all, you are not going to die, Marcus! Isn’t that great? Our plan is going to make sure you don’t die!
MARCUS: So, when will I get my runners and weights?
THE AGENCY: Your community runners and weights. Remember, we are not just here for you but your whole community.
A year later, The Agency comes back and Marcus is still 25kg over weight and had a heart attack.
THE AGENCY: Oh no! Marcus, what happened? Marcus! This was your plan. A heart attack? Oh no!
MARCUS: Yes, it was really bad.
THE AGENCY: What about the vouchers? We have data that shows you were using your vouchers at the market every month?
MARCUS: Well, you see . . .the merchant said that I could use the vouchers for chips because they were made from potatoes. I told him—I said it a lot—that potatoes aren’t green. And then he’d show me these potatoes that had a bit of green skin. You know, the really fresh ones? He said that the chips were made from those, so it was all good. I really liked the chips. I ate a lot of them. The doctors said that was probably pretty bad.
THE AGENCY: Umm. Ok. We are going to have to do some research on that. And the exercise equipment? You were very adamant that this was the right plan for you. That you would use them every day. That’s what you told us.
MARCUS: Well, yes, but I had to share them with Victor. He’s a jerk.
THE AGENCY: Is he from Valley Green, like Morris?
MARCUS: No, no. Morris? He’s not from Valley Green. He has an aunt though . . .but no, Victor. He is really into exercise. He does it day and night. He took the runner and weights and added it to a bunch of other stuff he has and then said that it would be better if we all went to his house to exercise. The people you sent here every month? The ones with the funny hats? They know. They loved Victor and his “community athletic commission.” That’s what he calls it. He has a badge he wears around town and the whole thing. Victor. He thinks he is so great. The funny hat people from your organisation loved it. They said he was expanding on their whole plan, or whatever. Making it a whole community thing. He plays music at the gym. Loudspeakers and all—don’t know where he got the money for those, but he got them! I hate that music!
THE AGENCY: Well, that doesn’t sound that bad. Why didn’t you go? A community gym? It sounds great!
MARCUS: I did. Sometimes. But all the chips I was eating made me pretty tired. And Netflix launched a whole new series about the bastards in Valley Green. Well, and then the heart attack. I couldn’t do much after that.
THE AGENCY: I see. We are so sorry for you, Marcus. What about the sleep? We sent our teams to address the violence in the house.
MARCUS: I told them. There was no violence. Virginia—who I love—I had to tell them that a hundred times—just gave me a kick when I snored. My snoring was loud. Anyway, she did stop. She didn’t want to deal with those people from your organisation again, so she stopped.
THE AGENCY: That’s great! I am so glad we succeeded together! (Turning to Jeff, the colleague: “Make sure you make a note for the home violence support team. They will love me for this!”)
And Marcus, the “Cabbage for Dogs” programme that we set up? I see you participated in that?
MARCUS: Oh yeah, that was great. The dogs love the cabbage.
THE AGENCY: So, they don’t bother you at night anymore?
MARCUS: No, no they don’t. That really worked.
THE AGENCY: Great! (Turning to Jeff again: “Hey Jeff, maybe we could do a case study on this? This is a really big success. Could get us some new donors for the ‘Cabbage for Dogs’ programme.”)
Jeff: On it.
THE AGENCY: So, Marcus, this is good. So you can now sleep through the night?
MARCUS: No.
THE AGENCY: Why not?
MARCUS: It’s that damn Victor and his new community gym. They go late into the night and at the crack of dawn every day!
THE AGENCY: Oh my.
Act Three: How we got back to basics and got Sandra to lose 25kg.
THE AGENCY: Hi Sandra. We got a reference from one of your neighbors that you would like to work with us about losing some weight?
SANDRA: Yes, I use to be pretty slim and active but then after the kids, it’s been hard. And, you know, our health care isn’t great, and it is super expensive. So, when I heard about your programme, I thought it might help.
THE AGENCY: Well, weight loss is important and hard. We don’t have all the answers but do have a number of approaches around eating well, exercise, and sleep that could help. We are also very glad that you were referred by someone. That helps us support as many people as possible.
SANDRA: OK. I think I want to just focus on the exercise.
THE AGENCY: Good that you are motivated. Exercise is key. How much do you do now?
SANDRA: I walk every day and play with the kids in the square—they get me moving!
THE AGENCY: Great! What about work around the house?
SANDRA: I do some, but my husband does most of it. I know that’s weird, but he is just better at it. I deal with all the kid stuff and he manages the house.
THE AGENCY: That doesn’t sound weird at all. It makes sense.
What about diet? Do you eat well?
SANDRA: That’s my biggest problem. I try to eat well. There was an organisation here a few years ago that said that green vegetables were important, so I try to eat them.
THE AGENCY: Well, that’s good. Green vegetables are important. What else?
SANDRA: Well, I love creamy minced meat and probably eat too much of it.
THE AGENCY: Oh. That sounds good. What’s in it?
SANDRA: Mostly pig fat, intestines, and a heavy cream that we cook for a few days.
THE AGENCY: (Laughing) Well, I see how that could be good but it isn’t super healthy!
SANDRA: I know. (Laughing a bit as well.)
THE AGENCY: What about sleep? Do you get enough? Are you tired during the day?
SANDRA: Sometimes. With the kids and my work. It is hard. I have to take them a very long way in stinky taxis—that cost too much— to get them to school. It is two hours in the morning and two hours in the evening because of the traffic. Then, when I get home, there Is just so much to do. And, I worry all the time. That keeps me up at night. The conflicts in my country are bad. I worry about what type of place I am raising my kids.
THE AGENCY: I can’t imagine how hard that is.
SANDRA: It is hard. But, you now, we are use to it. I get with my sisters—we play cards every Friday afternoon—and we laugh and cry all afternoon. Margaret, my older sister, has had a very hard time. Her husband is very abusive. Anyway, she has it harder than me. We get by but you know, it is hard sometimes.
THE AGENCY: I have a group of friends at home that I rely on like that. We share and discuss all our problems—all the problems we have with men—and life, and kids. We laugh and cry too. It helps.
SANDRA: Yes, the men!
THE AGENCY: I know, right!
In any case, I and see why all those worries and concerns can keep you up at night. Let me share some of our research. Is that OK?
SANDRA: Sure.
THE AGENCY: Well, the research talks about the importance of good diet, exercise, and sleep. The problem is, for most of us, it is nearly impossible to try to do all three all at once all the time.
SANDRA: I agree! That’s why I want to focus on the exercise.
THE AGENCY: Exactly. Focus is key. The research is not clear on which one of these is better than the other, between exercise, sleep, and diet. However, other research talks about how people succeed and stay motivated. This basically says that we do best when we have small, attainable goals, that over time contribute to much more. Does that make sense?
SANDRA: Yes. That’s why I want to focus on the exercise. If I can do a little bit, every day, I will work myself up to be super strong.
THE AGENCY: I can’t wait to see that! We can share some schedules and motivational tools that can help you with that. Do you have a mobile phone?
SANDRA: Yes.
THE AGENCY: A SMART phone?
SANDRA: Yes.
THE AGENCY: That’s great. You probably know that there are thousands of exercise apps out there.
SANDRA: Yes, I have the Apricot Well-being App. It is very cool.
THE AGENCY: That’s perfect. We have an app that links with that and most other health and exercise apps that track your progress, especially during weeks where you hit all your goals, and then we can come back and talk to you about how to build on those successes. We like to do that with a bunch of your neighbours--usually around an exercise class or something fun.
SANDRA: That sounds very interesting.
THE AGENCY: Well, it is something. Some people use it a lot. Some people don’t use it all. All of which is fine. In fact, the research shows that regular exercise is really hard for people. We all have so much going on; so much we have to do. So, the notion that we are going to suddenly become exercise queens is a bit of a stretch. But, if we do a little bit, focus on our successes, and then slowly, slowly increase our goals, then we can become exercise queens. Get to be super strong, just like you said.
SANDRA: Does the app cost anything?
THE AGENCY: No, no. If it is alright, I will have one of our tech people call you to walk you through the set-up. Is that OK?
SANDRA: Sure.
THE AGENCY: OK. So, with the exercise—and I know this myself—slowly, slowly is the way to go. But you know what worries me the most?
SANDRA: Oh no! What?
THE AGENCY: Your diet. While creamy minced meat sounds delicious, it is surely filled with a lot of fat and salt and can’t be good for your weight or your heart.
SANDRA: I know, I know.
THE AGENCY: Well, so how can we help here?
SANDRA: I could eat less creamy minced meat?
THE AGENCY: Well, sure, but I bet other people in your family love this dish as well.
SANDRA: Everyone loves creamy minced meat—especially my recipe!
THE AGENCY: Well, let’s not stop that then.
THE AGENCY: What else do you eat?
The Agency and Sandra spend quite a bit of time talking about her diet, how it changes during the year, around holidays, what she likes and dislikes, and they develop a diet that cuts down on the fats and salts and increases the use of fresh vegetables and fish. The Agency uses an app that has recipes and, more importantly, the local costs of all the food items. The Agency works this out on a tablet, letting Sandra type in most of the information. Sandra likes the tablet and is pretty good at maneuvering around the different tabs and links.
SANDRA: That all looks great but all that food is so expensive. I can’t afford that!
THE AGENCY: We understand this. This is why we have a cash programme that gives you a weekly amount of money to help with the high costs of food.
SANDRA: Fantastic! How much! How do I get it! Can I use the money for everything or just food?
THE AGENCY: Yes, everyone loves our cash programme. OK. This is the way it works. We give you a small amount of money every week—everyone in the programme gets the same amount—that you can use however you want. Basically, you can use a card or the app on your phone or any other cash-based payment system. However, every time you buy the foods we’ve listed on this diet plan, you should take a picture of them. This will then automatically include the time and date, the store you were in, and other data.
SANDRA: Oh. OK. I just use my phone to take the picture of what I buy?
THE AGENCY: Yes. Our tech teams will explain all of that. They are very friendly and nice and will take all the time you need to understand how all of this works. You know what else I find cool about this app?
SANDRA: What?
THE AGENCY: Every month that you use at least 75% of the cash for the food we discussed, you get ‘bonus cash’—you get a bit more money each week, for the next month.
SANDRA: Wow. That’s great. I will use all the cash for this improved diet, so that’s great.
THE AGENCY: Well, sometimes you will and sometimes you won’t. We know that. You may have to buy stuff for your kids, there may be holiday expenses, or all kinds of other things may happen. That’s all fine. Use the cash as a kind of buffer for these things and then try to use it for the diet as much as possible. We just want to help out so that you can do what works for you. And, we’ll also learn from you.
SANDRA: You will learn from me?
THE AGENCY: Well, yes. This may sound a bit weird—like we are watching everything—but we want to learn about when and how you succeed. So, for instance, if for a few months you are reaching every one of your goals—that everything is going really well—we might send you a message to set up a call where we can discuss what worked and why. Then, when things perhaps don’t go so well, we will send you a message where you can fill out a quick survey about what happened—good or bad—like a birthday or celebration that required a bit more money. Does that sound OK?
SANDRA: I guess it is fair. If you are giving me money, I guess I can tell you how I use it.
THE AGENCY: Well, I don’t know if it has to do with fairness. You deserve this help. It is for you. It is your right. It is just that we need to learn from you, and your neighbors, and others, all the time and as much as possible, so that we can assess whether our programme is working. We don’t want to get 12 months from now and find that you are still struggling with your weight! We want to help you make progress. To achieve your goals. To do this, we do a lot of analysis, week-by-week, day-by-day, to see if there are any trends that can tell us about what’s working and what’s not.
SANDRA: You are like Google!
THE AGENCY: Well, I guess, but all that techie stuff is a bit beyond me. What I like is that we can see, for instance, when there have been events across your community that may impact our shared goals. That way, we can react. We can reach out to you and your neighbors to see if it is something we should worry about, what we can do, and what we might do when and if it happens again.
SANDRA: That sounds OK. What about all my worries and sleep. How can you help me there?
THE AGENCY: Honestly, it is hard for me to understand all your worries. I sympathize and really care but our research there is just not enough. We just don’t know how to help.
SANDRA: Oh.
THE AGENCY: I know. I wish we could do more but the sleep one is complicated. We do have another team that is looking into sleep and how it affects diet, exercise, and weight control. They are talking with people like you to explore the issue in more depth and with a focus on what we can do, in very practical terms, to help. Could I pass your name on to them?
SANDRA: Oh sure.
THE AGENCY: This is very good Sandra. I’m happy that you are excited about the exercise app. I must admit, I use it and like it a lot. I found the reminders and ‘success alerts’ a little annoying at first, but I like them now. There are also a bunch of ways to track your progress, goals—all kinds of data stuff that I don’t care much about but maybe you will.
SANDRA: Yes. I like that stuff. Hitting 10,000 steps a day and everything.
THE AGENCY: Cool. So make sure the technician who calls you answers all of your questions. Take your time with them; they really like making sure that people can use all of their bells and whistles.
On the cash programme, we have monthly 2-hour workshops at Big Elephant Market to walk through how all of that works. If you are still keen after the workshop—and almost everyone is—then you can register and we can get going on that. Shall I have them contact you to schedule you for one of the workshops?
SANDRA: At the Big Elephant Market? Which one? I shop at the one near my house all the time.
THE AGENCY: Umm (checking notes), in fact, the next one is at the Ring Road Big Elephant Market. Is that near your house?
SANDRA: No, not really, but I can get there.
THE AGENCY: Well, here is the schedule for the next few months. I hope something in there will work.
SANDRA: Oh, yes, the one in two months is at my market!
THE AGENCY: Great. I’m sorry we could not be as helpful with the sleep?
SANDRA: Yes, it is hard . . .
Sandra and the Agency continue to talk about hardships—in both their lives—and then The Agency answers a few more questions and they agree to meet again when the Agency is back in town, in a few months.
