In response to the enormous demand for primary-level educators in remote regions of South Asia, Sister Cyril created the Barefoot Activity-based Teacher Training Programme (BABTP), which has trained over 4,000 teachers in fifteen states in India, as well as in locations in Bangladesh and Nepal. The teachers are recruited from local, often indigenous, communities.
Dr. Arundhati Ray, who wrote this month's profile of Sister Cyril, explains: "[P]rimary learning is most effective when children are introduced to formal learning in their mother tongue. Moreover, since many of the barefoot teachers work among indigenous minorities, this method ensures that the languages of these groups continue to be living traditions and not submerged by mainstream lingua franca." The "barefoot teachers" bring modern educational methodologies back to their communities and bring them to life with inexpensive, local materials such as leaves, twigs, natural dyes and fruit husks.
The barefoot professionals approach has major implications for human well-being, particularly in the fields of health care and education
Liszcz is addressing a totally different set of problems faced by Polish families with children who have cerebral palsy, autism and Down syndrome. In a fashion similar in principle to Sister Cyril's approach, he is focusing on bringing professional-level skills to the ground level – to help parents to care for disabled children at home.
Liszcz has developed innovative funding mechanisms to make it feasible for low- or moderate-income families to engage in home-care, a 24-hour job. At the same time, he is giving families the tools to provide far superior care than what is available in impersonal and inefficient state-run institutions.
"A typical daily home-care schedule involves three or four cycles of walking and balancing exercises, therapeutic massages, reading/picture-identification drills and an 'emotional calendar' upon which the child draws pictures to express feelings," reports journalist Steve Owad. "For most of the children, sandwiched in-between are morning or afternoon classes at integrative pre-schools, to provide contact with other children. The foundation gives every family a 'development profile' that helps them gauge the child's progress in areas such as sight, hearing and motor function."
The barefoot professionals approach has major implications for human well-being, particularly in the fields of health care and education. While advances in recent decades have brought extraordinary improvements in human longevity and quality of life, many of these advancements have not reached large swathes of the world's population. The main bottlenecks are distribution and cost.
Real-life problems are complex and multi-faceted; they defy the kind of narrow specialization that goes hand in hand with professionalization
Consider the example of mental illness in India. India has a population of nearly a billion people but only 6,000 trained psychiatrists and psychologists. Estimates of the number of mentally ill people in India range from 20 million up to 70 million if mild depression is included. How to deal with such a massive problem?
One solution would be to train a few hundred thousand psychologists and psychiatrists and dispatch them around the country, both to rural and urban areas. However, it is quite unlikely that anything like this will happen in the foreseeable future.
The only realistic alternative is to develop systems to educate and provide basic skills training to family members to support the professionals. That is what social entrepreneurs Thara Srinivasan, in Chennai, and Ratnaboli Ray, in Calcutta – to cite two examples – are doing.
Working with mental illness, both have found that a key component in the solution is to equip family members with the skills to enable them to manage mental illness. They focus on the "primary caregiver," who is trained to recognize factors in the home environment that lead to crises and to spot warning signs that the mentally ill person is experiencing a higher than normal level of stress or is not taking medication properly.
Barefoot professionals are not substitutes for specialists – indeed they work best when they support existing professional structures – but there are also situations when they can do more than professionals can. Indeed, this is one of the major insights of the social entrepreneurs who work in this area. Real-life problems are complex and multi-faceted; they defy the kind of narrow specialization that goes hand in hand with professionalization.
Barefoot professionals . . . bring motivations essential to success [including] love . . . as well as self-interest and missionary zeal
Often, what is required to deal with a particular problem is a range of skills. For example, Vera Cordeiro, a social entrepreneur in Rio de Janeiro who has created a health care program to provide post-hospitalization care for children from low-income families, employs many trained volunteers to work with mothers of sick children.
The volunteers need to understand how to interview low-income mothers, make proper referrals to doctors, assess housing conditions, navigate the maze of bureaucracy to get essential services, and procure a wide range of items from medicine to food to nebulizers. It's a complex job description – well beyond what a doctor or nurse or social worker can, or would want, to do. But it is all part of the job of managing children's health.
Any anthropologist who has done field research can attest to the fact that it takes years to get to the point where one is able to understand and communicate effectively with people from a different culture. This is another reason why barefoot professionals, recruited from traditional communities as educators or health care providers, can be particularly effective. They have the advantage of understanding the language, the symbolic universe and the cultural mores of the community in question.
Barefoot professionals also bring motivations essential to success. These include, above all, love – as is the case with Liszcz's families – as well as self-interest and missionary zeal.
The Grameen Bank of Bangladesh has developed a system that can manage millions of tiny loans by training village women to self-administer and monitor loan repayment. The women are highly motivated to ensure that their access to credit is not interrupted.
The job of creating articulated structures capable of managing substantial numbers of barefoot professionals . . . may be one of the most vital entrepreneurial challenges of our time.
In Hungary, social entrepreneur Imre Furmann is teaching Roma (gypsies) in villages how to collect evidence and get proper statements after human rights crimes. Their motivation is simply to ensure their own protection.
Jeroo Billimoria, a social entrepreneur based in Mumbai, India, has created an emergency telephone service for street kids, called Childline, which trains street youth to respond to calls. The street youth receive basic emergency health care instruction and learn how to interact with police and hospital emergency staff. Their motivation – and these youth are very committed to Childline – is, like that of the Roma's, to ensure the safety and well-being of their peers and community. This is a powerful source of energy for any organization.
Ultimately, the make or break issue for organizations looking to achieve widespread impact with barefoot professionals is the training. How does one ensure that the barefoot educators, human rights activists or health care workers do quality work? How does one ensure that their skills do not deteriorate? These are important how-to questions.
Liszcz requires progress reports from families every three months. Sister Cyril's BABTP provides periodic follow-up training courses, though at present its resources are too limited to conduct independent checks.
We will certainly hear more from social entrepreneurs making use of this approach. Indeed, the job of creating articulated structures capable of managing substantial numbers of barefoot professionals, scattered across large geographical areas, may be one of the most vital entrepreneurial challenges of our time.
David Bornstein is the author of The Price of a Dream: The Story of the Grameen Bank (University of Chicago Press). He is currently at work on a book about social entrepreneurs, to be published by Oxford University Press.
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