OR IN OTHER WORDS, KISSES AND HAND-WASHING WITH NATALIE PORTMAN AND PARISIAN SMOKERS
It is a hot, sunny morning in downtown London. Hurried cars and people pack the ever-bustling city streets and sidewalks. At a Piccadilly Street corner, a young woman confidently crosses the road after a quick check gives her reassurances that it is safe to do so. Next scene, the young woman, played by Natalie Portman in the movie Closer, lies unconscious on the floor—she didn’t see the car coming from her right. The ensuing birds-eye view shows her lying next to a sign painted on the street: LOOK RIGHT.
Many tourists get hit by cars in London despite the massive presence of signs. The main reason is that not all citizens in the world tackle a simple activity like crossing a street in the same way. Outside the United Kingdom, in countries like Argentina or Spain, for example, people automatically turn their head to the left before crossing the road. Needless to say, these automatic responses hide a more complex reality, particularly when related to other, more complex matters.
The Guardian recently reported that “each year 4,900 City of Paris employees collect 350 tonnes of cigarette butts from city sidewalks at an enormous cleanup cost.” The problem was made worse in 2006, when a smoking ban in public places was introduced, forcing French smokers out of cafes and bars and onto the street. This marks a sharp contrast with the widespread image of Parisians as citizens with a high environmental awareness.
Research recently conducted in Haiti (see Perez-Rodriguez research coming up in the next month) shows that 55 percent of the 3 million Port-au-Prince inhabitants are served by informal water supplies. The most common such supplier (29 percent) is a household with a home connection selling water to its neighbors. The other amazing feature is that each connection is shared on average by two homes, with sometimes up to seven houses being connected. The research, a combination of a drinking-water-points survey, random home polls, and semi-structured interviews has revealed that the 45,000 active connections of Port-au Prince’s water utility company actually provide water, although in a highly precarious way, to nearly one million people.
In the Port-au-Prince households survey, virtually all respondents said they washed their hands after using the toilet, but virtually no house included in the study had the proper facilities to do it. The survey included non-structured interviews (see Perez-Cardosi interviews protocol and results) to 36 homes and a study of water and sanitation services providers. When asked, “Why do you wash your hands?” the universal response was to avoid germs, microbes, or viruses. A mother in the Mariani neighborhood gave a typical response: “We wash hands with water and soap to avoid catching diseases from germs.”
Therefore, we are witnessing two apparently “non-rational” behaviors which nevertheless follow a pattern and rules that, although currently beyond our comprehension, were built during people’s socialization process. In this particular case, by rules we do not mean rigid guiding principles such as those that govern the chess game, but more flexible rules that are permanently being subject to participants’ interpretation.
The fact that these rules are social constructs forces us to take an approach quite different from the simple causal approach. Looking at them from a purely rational perspective won’t help much—it would be like trying to explain why we greet an Argentine friend with one kiss and a Spanish friend with two. If we intend to change social habits such as those of the Parisian smokers, the number of kisses given in a given country, or hand-washing in Haiti, we need to resort to tools far more sophisticated and from a variety of fields as far apart as marketing and anthropology.
Not far from the street where Natalie Portman was lying unconscious is the London School of Hygiene and Tropical Medicine (LSHTM) and its Behaviour Centred Design (BCD), a center dedicated exclusively to behavior change analysis. The scene of the accident can provide a first approach to the three types of behavioral control mechanisms encompassing the BCD’s theory of behavioral change: automatic, motivated and executive. The automatic mechanism is the most basic type of behavioral control—in this case, the almost automatic reaction of Natalie’s body when hit by the car, for example grabbing her head with her hands. The motivated behavioral control relates to the act of looking to one side or the other before crossing the road. In evolutionary theories, it is linked to issues such as the search for food or for a mate. Lastly, the executive mechanism focuses on planning based on short- and mid-term goals such as when Natalie decides which way to follow as she walks around London. Many behavioral change campaigns have focused on executive control, linking for example handwashing with healthcare, whereas other mechanisms, such as reassessing behavior through surprise, have proved more effective. The SuperAmma campaign is an excellent example of the change theory applied to handwashing in India.
From its inception, the behavioral change approach has been part of the IDB-financed project to improve access to drinking water, sanitation and hygiene in Haiti. The LSHTM has won a bid to provide support to DINEPA in areas such as condominial drinking water supply systems in poorer quarters or the improvement of hygiene habits.