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Introduction From Outrage to Activism

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I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one's head pointed toward the sun, one's feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lays defeat and death.

—Nelson Mandela

A REFUGEE CAMP sprawling across a large patch of jungle in Thailand is not the first place most people would expect to enjoy a memorable pickup soccer game. Nor the likeliest wellspring for a life‐changing insight. But that is where I embarked on my journey as a practical activist. I wasn't there as a relief worker, just a 22‐year‐old teacher visiting a friend of a friend who was working for the United Nations. It was January 1980. The Vietnam War had ended only five years before, and thousands of families across Southeast Asia were still reeling from dislocation. They were living in camps and trying to recover, find relatives, and make their way to whatever place would next become home.

The phrase “fish out of water” hardly does justice to how out of place I was, with my backpack, travel guides, and long hair. The camp sat near the Mekong River. It was filled with Laotians and Cambodians living in tents connected by dusty roads, scattered wells, and temporary feeding halls. The air smelled of burning wood. Almost everyone around me was homeless, grieving, and confused. Most had no idea how long they would live there and no place else to go. I'd arrived as a clueless, but curious, American.

Two friends and I, on break from our teaching fellowships at Tunghai University in Taiwan, had decided to spend our lunar new year holiday traveling around Southeast Asia on a shoestring budget. We did exactly as you might expect from a trio of adventurous young Americans—hung out on the beaches in Malaysia, island‐hopped on fishing boats off the Gulf of Thailand, trekked across opium fields in the Golden Triangle, crashed in the bustling hostels of Hong Kong, and ate enormous prawns in the night markets of Singapore. One of my companions had a friend who was working at the United Nations High Commission for Refugees (UNHCR) camp in northeast Thailand, so we'd decided to drop in for an impromptu visit.

Because our host was tending to the camp's children through a makeshift education program, I volunteered to occupy the teenagers with a game of soccer, mostly to make myself feel useful. Despite our lack of a common language, we enjoyed an intense and competitive match, refereeing through hand signals and bits of Lao, Thai, English, French, and Chinese—though I was badly outplayed.

“Where you from?” asked the goalie after we'd been kicking the ball around for a while. He looked to be about 16 and had clearly appointed himself leader of the pack.

“America,” I said with some hesitation, given our recent history in the region. While the “killing fields” of Cambodia had faded, the resulting dislocation had affected every village and refugee camp across the region.

“Oh, U.S. We love U.S.!” he replied, grinning. “America's great. We all want to go to America!”

“Where are you from?” I asked.

“Luang Prabang. But I have no home now,” he said. “My parents are gone, but I'm okay.”

Though he was just a few years younger than me, I wondered how much this teenager could possibly know about the whereabouts of his family, the complexities of world politics, or the future that might befall him. Frankly, I was treating him like a child, a hapless victim, stumbling through my silly grade school questions spoken too loud and too slow. I'll say it plainly: my innocence and arrogance were obvious. Born and raised in small‐town Montana, educated at an Ivy League university, I was open to new experiences but wildly naïve about human suffering across the world—not to mention nuanced notions of justice, dignity, and grace. The teenage goalie seemed to understand and, thankfully, cut me off.

“We are survivors,” he said. “We'll make it.”

Our conversation had quickly veered into territory I was ill‐equipped to navigate.

“So, what do you want to do when you grow up?” I asked, awkwardly trying to guide it back toward benign, introductory questions.

“Become a doctor,” he answered with great confidence.

“Why a doctor?”

He pointed toward the camp. “Because we must help each other,” he said, then looked me directly in the eyes. “You and your friends probably also need doctors, so I can help you too.”

This kid moved me, and changed me. Though I'd been at the camp just a short time, I hadn't missed the determination of everyone there trying to create some sense of normalcy in their upended lives. Their optimism floored me. Not a single refugee I met—including the teenager who'd lost his parents—appeared to consider themselves victims. They seemed to be focused only on taking care of one another and finding a dignified path forward.

After the soccer game, I wandered over to the UNHCR processing tent, trying to get my head around the immensity of this place and the complicated issues it presented. Our friend was working with the U.S. State Department, and he'd said I could listen in on an immigration interview between a U.S. official and a refugee applying for resettlement in America. We sat in a small, airless tent—the State Department lawyer, a stout Hmong man applying for asylum, a translator, and me.

“I was a driver for the U.S. team at the embassy,” the refugee began, speaking through the translator. At the time, it was helpful for refugees to prove that they'd worked with U.S. forces during the war.

“Where did you drive?” asked the lawyer, checking off boxes on his clipboard.

“I drove officials around Vientiane,” the man responded, referring to the capitol of Laos.

“What kind of car?”

“A Ford truck.”

“What make?”

“F‐150.”

“Do you know how to drive a stick shift?” the lawyer continued with an officiousness that struck me as strange, considering the question.

“Of course.”

“How many gears did the Ford have—four or five?”

This was a trick question, as that model of pickup had just three gears, and I could see that the refugee was confused. His answer might determine the fate of his entire family, and he knew it. Would they be allowed onto the list for resettlement in the United States? Forced to remain in the camp? Or returned to Laos where they could be in constant danger?

“Four,” the man guessed. Immediately, he knew it was wrong. And the interview was over.

I walked out of that tent feeling agitated and confused. My assumptions about America's beneficence, the presumptive roles of aid workers and refugees, and my own blithe detachment from the causes of, or solutions to, this crisis, had all been challenged. The boy with whom I'd played soccer was not so different from me. In fact, we were just a few years apart in age, both strong‐willed and athletic, and I had once considered becoming a doctor too. He clearly considered himself my equal in a very unequal world. And now the Hmong man would be denied a chance to rebuild his life in the United States, simply by dint of a gear‐shift question posed by a self‐important lawyer. These thoughts swirled in my mind, upending my ideas around “us or them” and “survivors or victims,” as it became increasingly clear that the differences between us came down to little more than chance. There was nothing exceptional about me as an American, nothing more than privilege conferred by the luck of circumstance.

Now I wondered about the aid workers. I'd been impressed by their relentless dedication and generosity, even when their task involved making difficult decisions about individual futures. Yet I couldn't ignore the nagging sense that easing people's day‐to‐day suffering, while a necessary Band‐Aid, did not really address their underlying problems. Nor did it provide a sustainable solution. It wouldn't change the political conditions that forced families to flee their countries, nor the economic duress they suffered, nor the government systems that tossed them around like faceless cargo. As we left the camp, I kept asking myself, was there anything a person like me could do to change this?

Back in the States, I would work extensively on refugee‐related programs and interview hundreds of applicants for resettlement, learning on the job to recognize the many forces at work in these stiff conversations. Sure, sometimes people lie or shade the truth, but often their memories are tangled by anxiety. Our bureaucratic questionnaires rarely got at the rich complexity of their lives or made room to note the heart‐rending sacrifices they'd made and the difficulty of their journeys. Yet even back in that Thai camp, I grasped the basic unfairness. And I sensed a few other things too: our world is filled with outrageous injustices, I was going to commit time and talent to addressing a few of them, and every step of the way would be fraught with difficult decisions.

Forty years later, it's clear that the seeds of my approach to activism took root in that camp. My work has almost always been behind the scenes. I've never been one to storm the castle gates. Except for marching in a few demonstrations in the early days of the AIDS epidemic, I haven't spent much time shouting in the streets. And unlike other, more celebrated activists, I have not designed a game‐changing social innovation, discovered a breakthrough scientific formula, started a powerful social movement, or given away hundreds of millions of dollars. Yet, by partnering with many like‐minded colleagues around the globe, I've still been lucky to contribute to the improvement of millions of lives through a roll‐up‐your‐sleeves‐and‐get‐things‐done form of social activism: practical activism.

There is no simple definition for practical activism. It's an approach to the work of making our world fairer, focused on long‐term systemic change. Unlike building homes for the needy or handing out food or medicine on the front lines of a humanitarian crisis, practical activism is often invisible, indirect, and unsexy—aimed at shifting public policies, negotiating partnerships, and innovating to improve government systems. Much of the work is geared toward building networks that develop and introduce new approaches or services, and, more recently, new technologies. But all of these endeavors stem from the same motivation: addressing inequities that cause too much pain and hardship for too many people.

This book is about the powerful forces that will drive practical activism forward over the coming decades. It is offered as a hopeful assessment of the challenges and opportunities that confront us, and the ability of social activists to do even more toward improving our planet and the lives of its people. It isn't a diatribe about all the things that are wrong. Nor does it offer a specific prescription for radical change. I haven't chronicled the biographies of inspiring activists at work—though there are many in these pages. Rather, this book focuses on five large themes powering activism today. I have written it in hopes that those who want to help others might find a vein of inspiration to mine for practical, meaningful solutions to the problems that confront us all.

Though I approach this work as a disciplined, often technical and nuanced, undertaking, every bit of it—from meetings with government officials, to conference calls with funders, to conversations with health providers in the field—is still rooted in sheer outrage. It's about our collective outrage and, really, anger at the enormous inequity and unfairness in this world. It's about how we try to channel that outrage into quieter efforts to find solutions by connecting the dots between governments and people, organizations and communities. And it's about scaling those solutions to get real stuff done, for real people.

Consequently, a central tenet of practical activism is building bridges, usually behind the scenes. It sometimes requires forging alliances between unlikely bedfellows—setting aside preconceptions and refusing to be dissuaded by political differences—in order to reach a common goal. My practical activism has launched me into advocating for foreign aid with staunch “America First” politicians. It has put me in front of Wall Street investors to explain why access to education, healthcare, and a higher standard of living in rural Africa are in their interest. It has led to quiet work on HIV prevention in countries where gay relationships are illegal. For the truly practical activist, opportunities to build bridges surface again and again.

All of us, whatever we do, are working within the context of powerful forces that shape our outcomes, though we may not always be aware of them. So, too, in activism. There are dynamics—economic, political, and cultural—operating beneath the surface of our daily lives that have enormous influence in dictating the world's agenda. This book explores five of those undercurrents and the ways that activists—from the aspiring to the seasoned—can channel them to build a more just and productive planet.

The word undercurrents refers to deep and mighty tides invisible to a person navigating on the surface of an ocean. Undercurrents do not always flow in the same direction as the waves on top of the water; indeed, sometimes these underwater channels can pull us backward. But often, they surge forward, propelling the way water drifts, or landscapes form, or social change moves. For the purposes of this book, I am talking about undercurrents that are creating energy and positive momentum to push us forward; macrotrends that will shape the work of activists through this decade and beyond. While these forces have rhythms that are sometimes inconsistent—or possess the potential for negative consequences—each of the undercurrents discussed in this book represents a macrotrend that I believe is vigorous, intractable, and generally positive for our collective pursuit of improving the world we live in.

The five undercurrents are:

1 Pyramid to diamond: Global economies are moving away from the old model of a pyramid, with mainly low‐income people and countries at the bottom and a few wealthy ones at the top, toward a fat diamond with vastly more people joining the middle class and living better, realizing powerful new possibilities to link entrepreneurialism with improved well‐being.

2 Communities are the customers: Communities are increasingly becoming customers with agency and voice, rather than passive recipients of aid and social change, increasingly playing more of a role in shaping their own futures with community‐ and human‐centered activism.

3 Leveling the playing field: Improving equity—whether based around gender, ethnicity, or sexuality—is radically reshaping the field of social activism.

4 Digital disruption: Data and digital tools will continue to bring valuable new capabilities to our world, revolutionizing everything from health care to education to conservation—even as they present daunting new challenges for activists to navigate.

5 The surprisingly sexy middle: Adapting and scaling innovations for widespread impact, the complex middleware that has often been ignored as one of the less glamorous aspects of social change is becoming more important and, surprisingly, more sexy.

Understanding and exploiting these five undercurrents at work in our world will help practical‐minded activists everywhere turn their outrage into action—maybe even optimism.

So why write this book now, when the world seems convulsed with such immense challenges? How can I possibly be hopeful in the face of growing global unrest, alarming patterns of inequality, shockwaves from a global pandemic, and potentially catastrophic climate change? Actually, I have never been more encouraged. Despite daily headlines, which are frightening indeed, a practical activist focuses on the overarching trendlines, most of which are pretty great. Thanks to some amazing innovations and extraordinary commitments from citizens, leaders, governments, and institutions across the globe, this planet is making undeniable progress toward becoming a place where greater numbers of people live longer, healthier, and more productive lives than ever before. In fact, we live within reach of realities that were once unimaginable: a world where abject poverty is rare, few die of preventable diseases, and everyone has a chance to be healthy. Despite some persistent challenges, this is becoming true for more and more communities. Even the COVID‐19 global pandemic, while laying bare vulnerabilities in our global health and economic systems and potentially setting us back on many fronts, has demonstrated a renewed spirit of collaboration around solutions, innovations, and strengthened communities. If nothing else, the pandemic has illuminated exactly how the five undercurrents in this book can be harnessed to keep bending the curve of history toward progress.

This book is for a lot of people: anyone who is concerned about inequities in health, economic opportunity, and education, but gets overwhelmed by the scale of these problems. Anyone who would like to work toward bettering lives across the planet but feels paralyzed by cynicism or confused about where to begin. Anyone who is looking for ways to channel their outrage into practical action. Anyone who wants a better world.

I've framed my ideas as a business leader and practitioner to help the interested become educated, the committed become activated, and the engaged become more effective.

Many such people sit before me in the class I teach on social innovation at Stanford University's Graduate School of Business. Others, like my former consulting clients at McKinsey & Company, lead corporations or philanthropic organizations and are trying to figure out how to engage more meaningfully with social issues. And some are people like many of my mom's neighbors in rural Montana—interested, but often underinformed; stymied by doomsday headlines but unaware that if you take a longer view, many trendlines bode well. I am talking to all these potential activists who want to roll up their sleeves and contribute, but don't know where to start.

The class I've taught at Stanford for the past six years is one slice of this audience. Consistently, these smart young adults pepper me with questions about the role of business in society and the effectiveness of our approaches to alleviating poverty. They want to know how to engage with a world that seems broken or, at best, rigged. And they want to see proof of progress.

When I shut my eyes and picture these students, I see three rows. In the first sit young people fired up with idealism. They ask lots of questions and some already have on‐the‐ground experience inventing environmentally friendly toilets or other products designed to help the planet. Many are not even business majors. But they're ready, intellectually and emotionally, to charge out the door and take on the world.

In the second row are standard business school students. They're attentive, and they work hard. They want to be financially successful, but they also want to feel that their lives have meaning and purpose beyond earning gobs of money. They want to know how to achieve both ends, simultaneously.

Then there's the metaphorical back row, full of people who remind me of myself as a young man. Sometimes they're distracted, other times snarky. They seem to bring little passion or commitment to this topic, believing that a class on social innovation is “soft,” an easy A. Not long ago, one of these students—his name is Michael—approached me after class. He was tall and athletic, with a tidy career path all laid out. Michael was already working as an investment analyst, and he struck me as largely indifferent to what I was teaching. Over the term, he'd lobbed a few questions from the back of the room, most of them suggesting to me that Michael thought social innovation wasn't really business and needed much harder metrics to claim success.

I'd formed all kinds of unflattering opinions about this student and what his life post‐Stanford would look like. But over the summer, Michael emailed me. He was working for a presidential candidate—someone I'd describe as a centrist—and he was collaborating on a book about values‐based business practices, the importance of business in society and how it could be used to advance social innovation. This blew up all of my preconceptions. It also reminded me that today's young executives view the world very differently from those of previous generations. They appreciate that we need to reengineer our approach to global problems if we are going to sustain ourselves as a species. That group inspires me.

This book is also written for seasoned business leaders like the executives at French insurance giant AXA. Though it is among the oldest and largest corporations in the world, AXA's top managers are determined to reinvent their company for the twenty‐first century. Its board regularly solicits advice from social innovation experts in health, environmental science, digital transformation, and inclusive economics. I leaped at the chance to be part of this advisory team because bringing business into the work of social change is essential. And because helping a corporation think through how to divest from tobacco or coal, invest in disease prevention, and support gender inclusion actually helps their bottom line, ultimately benefiting employees, the communities they serve, and the globe overall.

Beyond corporate titans and the young people who aspire to join them, there are other types of readers I am speaking to very directly: policymakers and donors who influence trends in global development; people who have little money or influence but want to learn how to become more engaged; and citizens like my friend Heather, a former teacher turned stay‐at‐home mom, who follows politics with great outrage, worries about her children's future, and wants to find a way to stay positive.

My aim is to help turn the frustration of these readers into optimism and, ideally, activism. But I am no Pollyanna. There is real cause for outrage. And the obstacles we face—whether confronting growing race‐based disparities, economic inequality, political corruption, or climate change—are enormous. I could write a whole other book on what I consider to be fundamental flaws in the field of global health and development, which were thrown into even starker relief by the COVID‐19 pandemic. It is this very outrage that offers the opportunities to spark activism and inspire hope. And there are also signs of important change on the horizon. For the first time in history, two‐thirds of all people on this planet have access to infectious disease prevention and newborn care. More people than ever before have reached the middle class, and almost 90 percent of adults can read. Those are incredible shifts, and they portend rapid progress to come.

In Undercurrents, I'll zero in on stories from my own life to illustrate important principles for driving change, moments that could be those of any determined global citizen. My journey has not been the stuff of cinematic tragedy or epiphany, yet I've been able to engage deeply in a number of critical social issues as a student, teacher, frontline worker, and leader. Over the 40 years since that soccer game in Thailand, I've worked hard at figuring out how to capitalize on broad social undercurrents to advance larger social‐justice goals. By the end of this book, I hope you'll be able to do the same.

These are perilous times, and I understand why anyone might feel discouraged. But the levers for historic change are within our grasp. Undercurrents is a blueprint for how to use them and move from outrage to optimism.

Undercurrents

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