How can I deliver good help?

People have many different motives for acting, some overtly stated and others that are not so clear. For example, some people may say they want to help people because "it feels good" or because "it looks good on my resume." Underlying motives may include: "I want to feel better about myself" or "I want to get ahead in the world."

Organizations, as groups of people, often have clear motives spelled out in a mission statement, but also have other motives that are unstated. For example, Nike may have a corporate mission statement "to be the world's leading sports and fitness company."¹ In practice, they answer to the motives of "the shareholders", "the CEO's vision", "the labor union's demands", or "the bottom line."

Questioning the motives of people and organizations before you begin to work with them can help you determine if their motives match with yours. This is not to say that the only appropriate motive is "helping people." It is fine if corporations are also benefitting from assisting -- this "win-win" situation can help everyone. However, if the major motives or missions of an organization are in direct opposition to helping the people they claim to be helping, it is not likely that any helpful assistance will be received.

How can we discern unwritten motives? Ask questions like:

• What does the corporation get from the exchange?
• What do the Third World people get from the exchange?
• What does the corporation lose from the exchange?
• What do the Third World people lose from the exchange?

Even if the motives of a helping organization are well-intended, the outcomes of a program can still be unhelpful to the Third World population. For example, a program in Uganda to increase condom use to prevent AIDS would be not be very effective if it did not address the difficulty of wives asking husbands to use a condom.

Although all outcomes cannot be predicted, it is important to use all the information available to develop the best program possible. Health behavior theories can be used to organize the available information, and to help you use the information to predict how change will best occur. Many of these important theories are discussed in Glanz, Lewis, & Rimer's book Health Behaviors and Health Education.²

However, many of the health behavior theories are based on individual behavior change. Since many of the issues Third World women face are structural problems, an ecological approach which incorporates institutional, community, and policy factors may be more appropriate.³ Finally, feminist theories should also be incorporated into solutions for Third World women. Using theories to inform health programs can make programs more efficient and effective.

Communication between any two people is a difficult process. Basic communication theory describes four areas of potential problems in a single spoken communication between a speaker and a listener:

1. The speaker has an idea in her head.
2. The speaker finds words for the idea and says them.
3. The listener hears some or all of the words.
4. The listener interprets the words according to her own biases.

This framework describes communication between any two people. However, when the two people are also from different cultures, there are even more barriers to effective communication.

Barriers to cross-cultural communication⁴

• Language differences
• Nonverbal communication differences
• Cultural stereotypes
• Evaluation of words and actions as either "good" or "bad"
• Higher level of anxiety

It is not possible for anyone to address all of these issues prior to visiting or going to work in another country. You may be well versed in the language, or you may only know a few phrases. You may have read about the nonverbal communication differences in the culture, but this might also increase your cultural stereotypes. It is not imperative that you "fix" all of these barriers prior to working with another culture. However, it is imperative to be aware of these barriers, and to actively seek methods to remove them.

Perhaps all of these potential pitfalls can be solved by following one important principle: We must work with people, not just for them or to them. Community based planning can ensure that the motives of organizations and people do not overshadow the needs of the Third World community. Incorporating community members in the planning process can inform theoretical approaches. Finally, cross-cultural communication can be strengthened when people of different cultures are working side by side on health issues. Communities should be active participants in improving their own health.

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