by David Stevens, M.D.
At Tenwek Hospital, Kenya, this is how the community health program got off the ground.
In 1983, when I joined the staff of Tenwek Hospital in Kenya, we were overwhelmed with work. Four doctors and five nurses provided the only medical care available for more than 300,000 people. We were not doing the job effectively.
We found that in the previous year, half of the deaths could have been prevented with earlier intervention. Our wards were crammed with an average occupancy of 150 percent. Adults with malaria and tuberculosis, and children with measles, whooping cough, and dehydration, were packed too closely together. Patients often returned home, only to catch the same disease again, because of poor health habits.
The only way to break this vicious cycle was to convince them to change their living habits. We needed to recruit, train, and supervise a team of community health volunteers.
Before we started, we visited many community health programs throughout Kenya. We were told that workers were motivated only by money, and that even among paid workers there was a high dropout rate. Since we had little money, many people to reach, and many problems, we looked for another way.
THE PIE CONTEST
I recalled my college days, when I sold Christian books door-to-door. The promise of making lots of money attracted me. Actually, I didn’t make all that much, and I worked harder than I had ever worked in my life. How had that book company motivated me—not just me, but hundreds of college students—to work 12-hour days, six days a week?
The company used motivational techniques based on meeting the basic desire for recognition and a sense of belonging. They knew we would be willing to compete to meet those needs.
One week we had a “Pie in the Eye” contest. I competed against another salesman who had sold a similar number of books the week before. If I sold the most books the next week, I would get to smash him in the face with a cream pie. If not, well, you know.
I was motivated, and so was he. I worked harder than I ever had before. Fortunately, I won. The important thing was not the contest, but the principle behind it. There are five basic motivational principles that improve both work quality and quantity.
CULTIVATE A SENSE OF PRIDE
The first way to motivate your co-workers is to cultivate in them a sense of pride. By pride I mean a healthy sense of identity, respect, and self worth. Everyone wants to feel that his or her work is important, and that other people recognize its importance.
When we started our community health outreach we purchased a small button-making machine. Using brightly colored paper and our logo, we manufactured badges that health workers, supervisors, and committee members could wear. We also printed our logo and slogan on bright florescent red flight bags that our volunteers used to carry their teaching materials.
These bags and buttons were soon instantly recognized in the community, giving our workers identity and credibility. Some of them were so proud of their buttons, we joked that they wore them to bed.
We also wanted to instill a sense of accomplishment. So we awarded diplomas to those who completed our training program. Since few of them had ever graduated from anything, the diplomas were a big hit. We gave small, practical gifts such as hoes or machetes to recognize students who had done the best work.
STRIVE FOR EXCELLENT COMMUNICATION
The second way to motivate people is to strive for excellent communication at all levels. Everyone needs to know what is going on. Good communication allows each member to share in the team’s accomplishments, and helps each one to feel that his or her input is important. Better-informed workers are better equipped to pray and encourage others to pray for your ministry.
We published a monthly newspaper. Each issue featured a helper or committee member from each area where we worked. These articles told of the person’s successes, techniques they had developed, and significant events inlife. Peopleenjoyed reading about someone they knew; everyone became better informed about theministry.Managersused the newspaper to share goals, projects, and significant events. We found that each copy was read by at least a dozen people, so we reached thousands each month.
We also promoted informal communication at every level. We encouraged volunteers to drop in and let us know what was happening. We told them about other worker’s successes, our plans, and the good things others had said about their work.
FACILITATE NON-THREATENING COMPARISON
When I entered medical school, I was given a student number. Examination results were posted on a bulletin board in the hallway a few days after each test. I can still remember my sense of urgency as I searched the list, looking for my ID number and score.
What did I do next? Like all the other students, I scanned the list to see where my grade fell among the others. My grade really didn’t have meaning until I compared it with the others.
To measure performance, we need to know how we stack up against our peers. This illustrates the third way to motivate people—nonthreatening comparison. The job of the motivator is to make that evaluation as easy as possible. This is how we did it.
Each month our newspaper listed the output of every health worker. We measured not just results, but also effort. It’s important that both be compared; we wanted to recognize and encourage those who were going the extra mile.
We tabulated effort—the number of home visits, revisits, and groups taught. We also counted results—the number of latrines built, families now boiling their water, and persons coming to faith in Christ. We didn’t collect and publish these statistics to be used as a management club. We did it to make peer pressure a motivator, and to enable the leaders to evaluate how well they were doing as motivators.
Mason Hare has said, “What gets measured gets done.” If you want to see greater achievement in your ministry, start measuring performance.
CREATE OPPORTUNITIES FOR COMPETITION
The fourth way to motivate people is to create opportunities for competition. Most people love to compete, and we used many types of competition in our community health outreach. Monthly, each community gave special recognition to the health worker who made the most home visits, and to the volunteer with the best overall results. We also selected a community health worker of the month and a committee of the month, and published these names in our newspaper. If we wanted to achieve a specific result, we sponsored a contest.
For instance, let’s say we wanted to increase greatly the number of families boiling their water. We would organize a contest that awarded a T-shirt, emblazoned with our logo, to each worker who convinced 20 families to do this.
These kinds of awards are very important. Also important is how the awards are made. They should be given as close as possible to the time of the activity. We tried to give awards that in some way symbolized the importance of what had been achieved. Awards should be given in front of as many people as possible, by someone of significance.
Well earned, well chosen, and well presented awards will be significant motivators. For example, if I handed a teacher a simple ink pen and told her this was her reward for being the best in the country, I would be accused of giving cheap prizes. If I did it at the local PTA meeting, it would be more meaningful. If I did it at the National Education Association convention, in front of teachers from all over the United States, it would have even greater significance. But if I had the president give the pen to the teacher on the White House steps, the teacher would probably frame the pen and exhibit it proudly. If the president added symbolism by signing an important education bill with the pen, the reward would become even more meaningful. In each case, the same pen was the prize; the only thing that changed was how it was awarded.
ENCOURAGE A SENSE OF FAMILY
Tomotivate people,encourage a sense of family among your co-workers. We used every group and individualcontact topromote asense of belonging, the idea that we shared common values and had the same concerns. We wanted all our workers to understand that they were important in setting and reaching our goals. They needed to know that their contribution was as important as anyone else’s.
We shared common experiences by having our leaders go on home visits with a health worker in their communities. We had regular meetings and parties to cultivate a warm, family feeling. We wrote short notes of appreciation and commendation. We encouraged our volunteers as they matured and opened decision making to them.
We looked for opportunities to give our volunteers credit for their accomplishments. Whether they were a supervisor, committee member, government official, or health helper, we wanted them to feel that much of what had been done was due directly to their efforts. Most important, we tried to set a high spiritual tone. The Lord Jesus Christ was our pattern. The health program, ultimately, was not our work, but Christ’s ministry through us.
CONCLUSION
Did these motivational principles work? Definitely. The community health program radically changed the spectrum of disease at Tenwek Hospital. By 1992, it was reaching over 200,000 people regularly. Groups from 18 countries had come to Tenwek to find out the secret of the program’s success. Because of its success, we have been able to bear witness to the gospel to government officials and to the American ambassador to Kenya.
In 1989, we started training community development helpers to teach income generation techniques as they evangelize their villages. On the drawing board is a plan to train volunteers to lead two weekly discipleship groups in their communities.
Ministries far removed from community health care can use these same principles. Although the specific methods may vary, some, if not all, of these principles will work in almost any culture. As we learn how to motivate those with whom we work, we can accomplish greater things for God’s kingdom.
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Copyright © 1993 Evangelism and Missions Information Service (EMIS). All rights reserved. Not to be reproduced or copied in any form without written permission from EMIS.
