A lesson in Change Management from Bangladesh

How to deal with resistance to change?

"Change or get left behind!", warn management magazines. The myth of our era of smartphones and instant messaging is that every new innovation is going to transform the world.

The reality is that change takes time because—except for the brave explorers who expand our view of the world—mistrust of the unkown is part of our survival instincts.

In 1968, one of the most important discoveries of medicine was published. A solution of 6 teaspoons of sugar plus a half teaspoon of salt, dissolved in a liter of water, reduces the mortality of cholera from more than 30% to less than 4%.

It is a magical solution and within reach of the poor in rural areas with the potential to save the lives of the 5 million children who, at the time, died from diarrheal diseases every year.

Unfortunately, ten years later things had not changed much. "Mass media campaigns failed in all countries," recounts Atul Gawande in his excellent article Sharing Slow Ideas.

In the early 1980s, dehydration remained the leading cause of death in children under 5 worldwide.

People do not easily change their beliefs, even if their life depends on them

In 1980 a Bangladeshi NGO proposed to have the serum used throughout the country. At that time, Bangladesh had more than 100 million people, 60% of whom lived in extreme poverty.

The way they intended to do it seemed totally impractical and inefficient: to teach their use to mothers in rural areas going from house to house! The pilot aimed to visit 60,000 women in 600 villages.

The logistics were extremely complicated. They had to prepare teams consisting of 14 "promoters" (many illiterate), who would go from village to village, camping out of each village to complete their visits to all homes. The promoters were of the same social extract as the mothers so they quickly gained their trust.

Going from house to house achieved a lasting cultural change in a country of 100 million people

The pilot was an impressive success and the program spread nationwide. In all, 12 million visits were made in 75,000 villages.

Thirty years later, nearly 90 percent of children in Bangladesh received salt and sugar whey when they became ill. The grandmothers now teach their daughters how to prepare and administer the serum.

Thanks in large part to programs that followed this model, worldwide mortality of diarrheal mortality has decreased by 80%.

It is not just people with low educational level who need to be convinced by someone you trust. Teens are a group that is supposed to have a high ease for change. But if we look at how they are encouraged to install a new app ("sacrificing" part of the valuable memory of their smartphone), we will see that they usually do so at the suggestion of a friend, who teaches them tricks to start using it.

The pattern repeats itself: change occurs when someone you trusts encourages to do it.

As the Bangladesh case shows, communication alone is not enough, isolated events are not enough. That's why in a corporate environment a nice speech or a seminar may generate enthusiasm but rarely a lasting commitment to change.

We are tribal. Change is a social process in which one trusting person convinces another

In a company, middle management the main challenge for sustainable change because —as for a tribe shaman—they are the ones that have more to lose if a change goes wrong. They will have to manage her people's frustrations and staff reductions once efficiencies work.

A Human Resources Manager confessed to me once: "For years we have tried everything to implement a common sales force methodology: presentations, courses, campaigns, awards and punishments. The courses have not worked for us because people quickly forget what they hear. Only a structured program with constant follow up of supervisors worked for us. "

Every change requires effort and entails a loss. Getting people to make sacrifices requires going door-to-door to gain people's trust and convince them of the advantages of change.