About Human Error

Big story in the Johannesburg media today was about a derailed luxury train in which three people lost their lives. In situations like this, you never get the whole story as "investigations" have to be done to establish the official course of the incident. In this case initial reports indicate that brakes were not applied on the stationery coaches when locomotive engines were being changed and the coaches rolled downhill and derailed at the bottom killing three people.

Despite the confusion that has been thrown in about signals not working properly (I am battling to understand how faulty signals can cause train coaches to roll downhill), the fact is that brakes were not applied to the coaches during the locomotive changes. This, we are told, was standard procedure. The question is why this was not followed at this time?

I guess we can ascribe this to human error. Sometime, human error is ascribed to those incidents in which someone simply did not follow procedures and regulations because they thought nothing would happen. Cutting corners without having any adverse consequences (and I am not by any account suggesting that this was the case here) creates bad habits which are only revealed when a calamity such as this one happens. This is why complacency should be guarded so much against. Cutting corners is never good.

Getting the Whole Picture

In my last post, I wrote about what seemed to be a flawed consultative process in the planning for the World Cup stadiums in South Africa. Two reports in the Johannesburg newspapers recently got me thinking about this issue a little bit more. The first was the protests by taxi-owners about the new cheap, efficient and clean bus system and the second was the recent protests by musicians against the small number of South African musicians included in the official entertainment about the world cup.

It would be easy to suggest that the exclusion of these two stakeholder groups was merely an oversight and therefore we should just forget and forgive. It would probably be so if it was not so endemic. The reason it is so endemic is because of tghe tendency to look at projects from their own perspectives alone.

Some years ago, I was associated with an organisation which employed someone full time just to travel around to look at business areas of the organisation and its customers to assess in advance where the potential problem areas were and to address these before they developed any further. The strategy worked and the reason it did was because all stakeholders shared their needs and were part of planning processes. The current situation does not seem to have the same hallmarks.

Let us hope though, that we learn from these and in future planning processes should be a bit more inclusive. There is a word for it. It is called "systems thinking". Precisely because you are building a road, you need to consult pedestrians, some of whom do not own cars, the noise and pollution from fumes will affect all.

Dialogue

World Cup 2010 in South Africa, a very well planned affair so far with FIFA complimenting South Africa's Local organising Committee. A matter of great celebration for attaining such a major task and a cause for celebration for all South Africans and their well-wishers everywhere. Just as some of us are about to purchase a bottle or two of champagne (while prices are still affordable before tourist enduced inflation) we read about a protest by disabled people about lack of access to the 2010 stadiums (or stadia in "proper English") for disabled people.

According to the newspaper reports, they protested against this lack of accessibility by burning wheelchair tyres at the offices of South African Football Association. Two interesting things about this story: the first is that the planners should have engaged all stakeholders in the planning process. Done properly, this consultative process should have identified this shortcoming. It is possible that this shortcoming could be addressed even at this late stage.

That being said, did they have to burn wheelchair tyres to get attention? I think not, but what I think is not the issue here. The issue is the absence of dialogue processes which would ensure that all parties engage each other meaningfully. This process would avoid violent protests. interestingly, media commentators seem to accept violent protests as norms sometimes justifying such behaviour on "anger". Protest and violence are too separate issues.

Do we really have the skills to engage each other in dialogue?

Reversing the Trend of undesirable behavior

Change management or effecting behavioral change is often seen only as a process of changing from the current behavior to a desired behavior. Effecting the desired change usually involves a number of certain steps including understanding why people behave in that manner and communicating the benefits of the desired behavior with shared vision and leadership playing a critical role. With such a clear objective it is natural to celebrate once the desired behavior is seen to have been adopted. What is often overlooked is the fact that the adoption of the desired behavior is the start of another process to ensure that the change is sustained.

What brought this trend of thought into my mind? It is the driving etiquet (or more precisely, the lack of) on the Johannesburg city streets!!!

About two to three years ago, almost everyone in Johannesburg was complaining about the dangerous driving of taxi drivers and how they put other road users at risk. At the time, such criticism was justified. However, while the taxi drivers are still the worst transgressers of driving by-laws, they have been joined by ordinary road-users: men, women, young and old in increasing the risk of harm in driving on Johannesburg streets. The result is unnecessarily congested streets during peak hour traffic and a plethora of avoidable accidents on a daily basis. The question is what happened to get us where we are?

The answer to that is speculative and possible a combination of a number of issues. The failure of law enforcement agencies in controlling bad driving through the enforcement of existing by-laws possibly created an impression that motorists were on their own when using the roads and thus starting the dangerous attitute of everyone for themselves with total disregard for other road users. Clearly, this has to stop somewhere to give sanity the opportunity to prevail as the current situation is totally out of hand and insane. The challenge will be to reverse this unsafe driving behavior and replace it with safe and considerate driving etiquette. Would behavioral communication initiatives attain this change? I have no doubt that they would but they would need to be reinforced with some law enforcement initiatives to convince all of us that we need to operate within the parameters of existing laws. A free for all, every one for himself attitute has proven to be a disaster.

Changing behavior from bad to good is difficult. However, failure to take preventative steps to stop the deterioration of good behavior makes reversing the process that much more difficult. That is why continuous re-inforcement of positive behavior is critical in ensuring that adoption of good practices is sustained.

Assessing Risk for Whom

Terms such as impact or risk communications are often associated with large projects managed by large organisations. Much too often we forget that the assessment is for the potential impact on people. Looking at risk assessment in relation to people makes the issue more real because it is no longer about things but about people. Regrettably, this viewpoint is often overlooked leading to harm being unintentionally committed on innocent people.

A case in point is the regrettable developments of the past few weeks which started at the recent athletics games in Berlin. What should have been a moment of great glory for an exceptional athlete has increasingly become a matter of public spectacle and political upmanship.

At issue is who knew what when, who lied and why and lastly why didn’t they do anything to minimize harm to an individual who brought glory to the country. Naturally, issues like these sell newspapers and has broad media interest, local and international. While we may argue about the insensitivity in how the media dealt with the issue, the fact is that it is not up to the media to be sensitive. Officials responsible should have handled the matter differently to ensure that any media reports on the issue are packaged differently. This did not happen and now everyone seems to have an opinion on the issue with some suggesting a commission of enquiry on this saga. If this takes place, this issue will further drag the issue that much longer in the media.

The debate ranging on the athlete in question is taking place around her without her involvement. Nobody seems to be considering her feelings and the humiliation she may be undergoing and the
potential for astrocisation from her community and her friends.

Amidst all the debate and discussions about her, it is clear that no proper assessment was made on the impact of enquiries about her gender. Once the debate was started, there seems not to have been any proper risk analysis, or strategy, to deal with such risk once it occurred.

How long it will take before the athlete in question starts to live a normal life out of media glare and intrusion into her life is thus far unknown, particularly if the speculations about her gender turn out to be true and are pronounced publicly. At this stage, those in a position to do so, are taking no steps at some form of public education to about this status with the likelihood that in future, anyone known to be similar, will continue to be perceived as some form of a natural anomaly.

Her crime? To win decisively at an international athletic competition of note.

Communicating Risk

Risk Communications is one of the most difficult aspects of communications particularly because the extend of the risk to be communicated is never clear. This is because Risk Communications is not about announcing what happened, it is about communicating what might happen if certain precautions are not taken. However, once harm starts to happen, it is important to act decisively.

For the first few weeks after the first person was confirmed to have Swine Flu, the statement from the health authorities was "don't panic". Weeks later, after a number of people had lost their lives, an announcement was made that a "call centre" had been established to respond to public enquiries on the epidemic. Blame will be apportioned on what could have been done by whom and when it could have been done. That however is not as important as learning from this situation and being better prepared for any other risk in future.

Importantly, with past experience and modern day travelling, it should have been clear that it was only a matter of time before the epidemic hit South Africa. A Risk Analysis should have indicated the need for a communication campaign as the first step towards developing a Risk Communications Strategy. To do this, you need people who understand Risk Communications.

Hopefully, lessons have been learned from this experience.

Why did I start this blog?

I got involved with behavioural communications very early in 2008 in one of the most ambitious programmes undertaken by the Chamber of Mines of South Africa. The programme, Mining Industry Occupational Safety and Health Leading Practice Adoption System (MOSH) had as its objective, the improvement of health and safety performance in the mining industry. Behavioural communications was the vehicle used to encourage people to adopt healthier and safer working practices for the improvement of theirs and their co-workers' lives.

It was the idea of being part of an initiative that would actually contribute to saving people's lives in the mining industry that got be involved in this initiative. To me this became much more than just a part of my job. As I got involved, I discovered that Behavioural Communications was an involved process with a great potential for actually contributing to changing people's lives for the better if implemented properly. I have been very fortunate because I have had Decision Partners coaching me all along and sharing their years of experience with me. It may sound sappy, but I actually found myself in a project that made me feel that I was doing something positive and not just making a living.

I found myself compelled to start writing this when I was alerted to a website in which an organization was claiming to specialise in "behaviour communications". The problem was that the "specialist" mentioned was someone I know and the information on the website was misleading. I am a bit calm as write this because I have had two days to think about it and consult before I started writing. In my initial state of extreme rage when I first came across the website, words like plagiarism, fraud, theft and betrayal of trust came to mind in reference to this individual and his organisation.

My extreme rage was because he started using our terminology and the concepts that we introduced to him as his own "specialisation". I was enraged because, as a consultant, some may believe him and he may start implementing what he knows and this could endanger people's lives and eventually lead to loss of confidence in something that can really make a difference if properly implemented.

I think what pushed me into outing this pretender, whose name and organisation's name I have not mentioned as yet, is because the need to safeguard standards to ensure that implementation of this process, in improving health and safety, is done well so as to succeed. This can only happen with the continued support of industry leadership. They can only support if convinced that this process will achieve intended results. People who start making claims of being specialists, without the necessary depth of knowledge can actually lead to doubts of its effectiveness and that would not be good. That is the reason why I believe it is important that "specialists" are actually what they claim to be and not pretenders out to make a quick buck while putting people's lives at risk in the process.