Finding Leverage Points for Learning: Titi Tade discovers the value of allowing her medical social work students to digress

Pure water

Sachets of pure water that are available in Nigeria in both urban and rural settings

Pure water?

“Pure water” in Nigeria refers to a sealed polythene sachet containing 500mls of water at a minimum cost of ₦5 ($0.03 or £0.02) per sachet. It is available on every street corner across the country in both urban and rural settings. The “pure water” phenomenon started in Nigeria sometime in the 1990’s as a response to poor access to drinking water that was potable and affordable. With a population of 167 million, over 63 million Nigerians do not have access to safe drinking water. Entrepreneurs identified the gap and filled it by providing water which was cheap and also ensuring that the water product got certification of its “purity” by the National Agency for Drug and Food Administration and Control (NAFDAC). It is believed by some that the “pure water” phenomenon apart from providing safe water also contributed to the reduction of cholera incidence in the country.

Attitudes to “pure water” among Nigerian medical social work students

During a Social Psychology class, I gave medical social work students an assignment asking them to carry out a survey amongst health workers within the Teaching Hospital about their attitudes toward “pure water” use in the country. During the oral presentations of this assignment, the social work students identified the pros and cons of “pure water”:

Advantages of “pure water”:

1. It is cheap
2. It is potable
3. It has helped reduce water borne diseases
4. It is a means of poverty alleviation by providing a source of income for producers and retailers (It is a ₦7 billon industry).

Disadvantages of “pure water”:

1. The alleged “purity” cannot be ascertained as some of the “pure water” companies do not bother to obtain the NAFDAC registration required for legitimate trading.
2. It is a major source of environmental pollution: The streets of urban and rural areas are littered with the “pure water” sachets; most of which are non -biodegradable. The litter caused by sachets block canals and gutters which in turn overflow during the rainy season.

It started as a digression

Next, the students discussed whether the advantages overweighed the disadvantages and how best to overcome the attendant environmental pollution. At this point the class had digressed from discussing the attitudes of Health Workers to “pure water” to how to ensure that “pure water” could be produced in an economically feasible and environmentally-friendly way.

Do we have a “pure water” expert in the class?

We realised that one of the students had a small scale business producing “pure water”. This student walked the class through the process of “pure water” production. He informed the class that that the Federal Ministry of Environment had developed a draft Action Plan for phasing out light weight non-biodegradable plastics starting with “pure water” sachets and polythene bags, an idea which does not augur well with the “pure water” industry. However the student noted that it may be inevitable on the long run.

Discovering the leverage points for learning

At the end of the presentation, despite our digression from the initial topic, an opportunity had been provided for unintended learning to take place. The digression was a leverage point – because this enabled me share with the class some of the things I had learned in the LEAD programme i.e. Systems Thinking and Unintended Consequences. It also gave the student invested in the business an opportunity to provide practical information about “pure water” production in Nigeria which has led him to consider the move to biodegradable (cost effective) sachets for water.

It’s good to digress

The students learned more practically about the linkages between health, attitudes and the environment, while I learned that not all digressions are detours but rather possible leverage points to the new stage of learning.

Titi Tade works as a Senior Medical Social Worker at the Lagos University Teaching Hospital (LUTH), Nigeria. A lecturer, trainer and facilitator, Titi has garnered over ten years international experience working with a focus on capacity development within diverse groups. Titi is a member of the Health Research and Ethics Committee of LUTH and consults for Non-Governmental-Organizations (NGOs).

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