Community Change, From the Inside Out

Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.
—Margaret Mead

From infectious disease to opioid addiction to sexual violence, there’s a myriad of pressing health and social issues facing communities around the globe. Sometimes the global community steps in to help, providing aid where needed, but other times local communities are left to fend for themselves. Unfortunately, low-income and underserved communities not only have limited resources to tackle such issues on their own, but they also often find themselves facing an intricate web of many other deeply-rooted challenges. Despite the injustices of these situations, we often see people within these communities who take it upon themselves to inspire the change they want to see around them. At TEDMED 2018, we’ll feature 4 Speakers and 1 Hive Innovator who are employing innovative ideas and unwavering determination to address the complex challenges facing their communities. Through their work, these individuals are proving that the most sustainable and effective change often starts at the local level—from the inside out.

In Malawi, nearly 1 in 5 babies are born prematurely, and the southeast African country has faced significant challenges supporting these babies with basic functions such as breathing, feeding, and body temperature regulation. Refusing to be a bystander in the face of these heartbreaking statistics, pediatrician Queen Dube and the Queen Elizabeth Hospital have been working with Rice University in Texas, along with other international partners, to test and implement life-saving technologies through the NEST 360 program in order to avoid preventable deaths and save babies’ lives. These technologies are unique in that unlike most medical equipment, they are built to withstand the harsh environments in which many African hospitals operate. In an interview with the BBC, Queen describes one of the life-saving technologies, a bubble CPAP machine, which her hospital uses with premature babies who are struggling to breathe. Between these new technologies, government initiatives, and innovative partnerships, infant mortality rates are now on a steady decline in Malawi.

Infant receiving care at Queen Elizabeth’s Hospital

Sometimes a community is forced to face an onslaught of seemingly insurmountable challenges all at once—such as when it is confronted with a natural disaster. After Hurricane Maria, Puerto Rico found itself in this difficult position. With power outages that lasted over 8 months and an alarmingly high death toll that wasn’t updated until nearly 11 months after the initial tragedy, many Puerto Ricans reported feeling a lack of support in their efforts to rebuild after the storm. Fortunately, amidst the devastation, there were community members like Christine Nieves who rolled up their sleeves and got to work. A few weeks after the hurricane, Christine and other community members opened Proyecto de Apoyo Mutuo Mariana (Project for Mutual Aid Mariana), a “comedore social” (social kitchen) in La Loma that not only provides the community with rainwater collection and filtration for cooking, solar panels, and free Wi-Fi, but also serves up to 300 meals per day. As Christine put it, she saw “Hurricane Maria [as an] opportunity to see the power is in ourselves and not in America.” Following in the footsteps of Christine’s community-led approach, buildings across the island now display a new motto: “Puerto Rico se levanta” (Puerto Rico raises itself). Not only is Christine’s work helping to revive a struggling community, but it is also instilling a strong sense of community pride and inspiring more community-led recovery projects across the island.

While it’s no secret that the United States has an unfortunate history of exploiting its farmworkers, many might be surprised to learn that there are still American farms utilizing slavery practices today. Greg Asbed co-founded the Coalition for Immokalee Workers (CIW), a worker-based human rights organization, to help end the systemic abuses he was seeing in Florida’s tomato fields. In the years following, Greg helped to expand CIW’s standards into a broader framework called the Fair Food Program (FFP), a unique partnership between farmworkers, Florida tomato growers, and select retail buyers. With the help of Gerardo Reyes Chavez—who was a farmworker for most of his life and is now a key leader of the CIW and FFP—the organization has helped to liberate over 1,200 farmworkers from farms where they were being held against their will and forced to work. Additionally, the CIW has gotten major corporations such as McDonald’s and Whole Foods to sign “Fair Food Agreements,” in which the companies agree to only do business with tomato farms that provide workers with fair pay and labor, education, complaint management systems, health and safety agreements, and more. Greg and Gerardo’s Worker Driven Social Responsibility model is now being applied beyond the agricultural industry—as far away as in garment factories in Bangladesh. In addressing and improving the unfair food system, Greg and Gerardo are giving a voice to an underserved community and paving the way for large-scale social impact.

CIW-organized farmworkers’ protest

Affecting community change often demands addressing systemic challenges head-on. Toyin Ajayi co-founded Cityblock Health to tackle the barriers to good health facing people in underserved areas and to provide these populations with the personalized care that they require. Driven by the belief that truly serving a community means extending healthcare services beyond the doctor’s office, Cityblock Health works to become active and responsive members of the communities they serve—providing its member base of those who access Medicaid, who are dually eligible for Medicaid and Medicare, as well as people living in underserved city neighborhoods, with high-quality care where-needed and when-needed. The company’s tech-enabled model not only effectively meets the complex care and social needs of its members, but it’s also helping to shift care away from the reactive, hospital-based acute healthcare system and toward a system that is more focused on prevention and community support. By providing customized local health care, Cityblock Health is improving the health of its community, block by block.

When it comes to driving meaningful change, sometimes it takes someone on the inside to clearly identify the problem and to find the best path forward. From Queen’s work implementing life-saving new technologies in Malawi, to Christine’s inspiring community resilience efforts in the wake of Hurricane Maria, to Greg and Gerardo’s victories in improving working conditions for Florida’s tomato farmers, to Cityblock Health’s implementation of personalized and localized healthcare solutions for underserved neighborhoods, TEDMED 2018 will showcase individuals who are not accepting the status quo. These outstanding Speakers and Innovators are stepping up to the plate and solving health and social challenges from the inside out.