Finally, since the repercussions of problems often are felt by an entire family, solutions processes must take into account the family as a whole. Who better to provide essential information about family dynamics, and to judge whether a strategy will work in a particular familial context, than family members themselves?
Families are highly motivated repositories of a range of valuable resources, and a key knowledge base, making them logical partners to shape solutions to the problems that affect them. Yet historically, across the North-South divide, neither governments nor CSOs have viewed families in this leadership role.
In more developed nations, interventions typically have tried to supplant the family through institutionalization and professional-intensive approaches, giving families no say in the content or delivery of services. In poor countries like India that lack adequate social security programs, the strong bonds of family and community give the State an excuse to abandon its responsibility towards victims (leaving the family to look after them with virtually no guidance or support). Thus, there has been no serious, systematic effort, from the public or civil sectors, to create solutions that include the family as an active player.
In recent times, several social change programs acknowledge that families of victims also need support and help to cope with problems, and they have brought them into the loop, while executing strategies aimed at the target audience of those directly affected. But this approach, while being enlightened because it recognizes the need for support on the part of family members, remains extremely limited in impact. Its focus is restricted to the weakness and deficit of families, and it ignores the family's powerful potential for bringing change.
Or, to borrow from Nobel Prize-winning economist Amartya Sen's vocabulary, this approach is concerned with only the "well-being aspect" of the family, and not its "agency aspect." Sen has used these terms in connection with women's empowerment, but it can be applied to other constituencies too (in this case the family).
As Sen notes, the two approaches "cannot but be different at a foundational level, since the role of a person as an 'agent' is fundamentally distinct (though not independent of) the role of the same person as a 'patient'." 3
Characteristically, it has taken the vision, creativity, pragmatism and tenacity of social entrepreneurs to recognize that the system is stuck in an ineffective pattern – to understand that the existing perspectives on the family need the "crucial addition" of an "agency-oriented" approach 4 – and to then to conceive and introduce pattern-changing alternatives. Working in widely disparate geographical contexts, and in a range of fields, social entrepreneurs are redefining the conceptual framework for care and rehabilitation of individuals by promoting the family's potential as a lead actor in the change process.
In the United States, Carol Shapiro is meeting the challenge of the "revolving-door" syndrome of the prison system by creating an integrated network of support for offenders' reentry into their community, built on the foundation of the inherent strengths of their family and community. Alexander Chisango is building a grass-roots socio-economic movement in Zimbabwe that is founded on the core perception that progress can be facilitated when families are empowered to be the basic units for social and economic progress.
India's disability sector is in a state of crisis due to a severe shortage of resources and professionals needed to serve the country's some 60 million disabled persons. For Calcutta-based Dr. Purobie Bose, the solution lies in maximizing the return on India's abundant wealth of social capital, represented by its long, robust tradition of intra-familial collaborations.
Bose recognizes that in almost all cases, it is mothers who are the child's primary care-givers and the persons with the heaviest self-investment. She focuses especially on empowering this constituency to assume leadership in matters related to their physically-challenged children.
Mauricio Ramos, too, is utilizing the potential latent in Mexico's strong family structure by enabling family members to become primary resources in home-based care for AIDS patients in Mexico. In so doing, he is providing patients with quality care that would not have been possible in the overcrowded, underfunded hospitals; and he also is easing the tremendous pressure on the country's National Health System as it struggles to cope with some 50,000 AIDS patients and an ever-shrinking budget.
Several other social entrepreneurs are working in different parts of the world to creatively engaging the family in finding solutions for a range of urgent social problems. Many are reinventing existing systems of care.
These include Teresa Hradlikova in the Czech Republic, who is replacing the traditional institutionalized care of blind children with a family-based model. Krystof Liszcz in Poland is empowering parents of children affected by cerebral palsy to manage the care themselves, and not depend on government interventions. Francisco Arroyo is enhancing nutrition levels for low-income families in Mexico by enabling them to manage and improve their food production.
The models developed by these innovators to leverage the family's potential as partners in change are distinct, shaped by the unique insight, experience and context of each entrepreneur. Yet, there are common principles and practices underlying each approach:
- Each family is regarded as a distinct entity with its own set of dynamics. The program acknowledges the diversity of families – different configurations, racial and cultural differences, differences in social and economic status – and they adopt an individualized case-study approach.
- The social entrepreneur finds innovative, sophisticated ways to blend new technology and management practices with age-old family values.
- The strengths of individual family members and family resources, like strong networks of kinship and community, are identified and the program reinforces and augments them. Simultaneously, areas of potential and existing weakness are analyzed, and specialized supports are provided in the form of services like counseling.
- The intervention encourages family members and professionals to collaborate as partners in the delivery of services to individuals by creating a win-win situation for all players.
- The program's empowerment process for family members enables them to see beyond the immediate needs of the person at home, and to gain a broader perspective. They develop an in-depth insight into the larger forces and issues revolving around – and implicit in – the problem. They are in a position to identify the wider areas in which change is required, such as the legislature and public policy. This typically catalyzes them to be powerful advocates, and creates groups that can exert powerful pressure on the government.
For all these social innovators, the challenge is to persuade an entire society that social programs must endorse families as active partners to be effective. The extent to which they have been successful varies widely, especially considering the relatively short periods of time that many of the programs have been functioning. Nevertheless, there are optimistic signs.
In India, for instance, Purobie Bose's ever-expanding army of family and community caregivers is challenging the government's draconian efforts to limit "unprofessional" help. In Zimbabwe, where 85 percent of the population consider themselves Christian, the adoption of Alexander Chisango's program by the powerful and influential Evangelical Fellowship of Zimbabwe (an umbrella organization for the country's churches) indicates real progress.
In the United States, the work of social entrepreneurs like Carol Shapiro has contributed to what has been described as a "dramatic shift" 5 in the rhetoric of public policy. More and more, in both government and public perception, the family is being accorded a decision-making, partnership role in the area of social change.
For instance, a checklist drawn up by the Children, Youth and Families Research Network (CYFERNET) to judge whether a policy is "family-friendly" includes a criteria labeled "Family partnership and empowerment." It states: "Policies and programs must encourage individuals and their close family members to collaborate as partners with program professionals in delivery of services to an individual. In addition, parents and family representatives are an essential resource in policy development, program planning and evaluation." 6
"The family, that dear octopus from whose tentacles we never quite escape . . . ." wrote British playwright Dodie Smith. 7 Around the world, social entrepreneurs are demonstrating how those tentacles can be activated into powerful forces of social development.
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