Thanksgiving Speech by Wamsutta (Frank B.) James, Wampanoag

ABOUT THE DOCUMENT: Three hundred fifty years after the Pilgrims began their invasion of the land of the Wampanoag, their “American” descendants planned an anniversary celebration. Still clinging to the white schoolbook myth of friendly relations between their forefathers and the Wampanoag, the anniversary planners thought it would be nice to have an Indian make an appreciative and complimentary speech at their state dinner. Frank James was asked to speak at the celebration. He accepted. The planners, however , asked to see his speech in advance of the occasion, and it turned out that Frank James’ views — based on history rather than mythology — were not what the Pilgrims’ descendants wanted to hear. Frank James refused to deliver a speech written by a public relations person. Frank James did not speak at the anniversary celebration. If he had spoken, this is what he would have said:

I speak to you as a man — a Wampanoag Man. I am a proud man, proud of my ancestry, my accomplishments won by a strict parental direction (“You must succeed – your face is a different color in this small Cape Cod community!”). I am a product of poverty and discrimination from these two social and economic diseases. I, and my brothers and sisters, have painfully overcome, and to some extent we have earned the respect of our community. We are Indians first – but we are termed “good citizens.” Sometimes we are arrogant but only because society has pressured us to be so.

It is with mixed emotion that I stand here to share my thoughts. This is a time of celebration for you – celebrating an anniversary of a beginning for the white man in America. A time of looking back, of reflection. It is with a heavy heart that I look back upon what happened to my People.

Even before the Pilgrims landed it was common practice for explorers to capture Indians, take them to Europe and sell them as slaves for 220 shillings apiece. The Pilgrims had hardly explored the shores of Cape Cod for four days before they had robbed the graves of my ancestors and stolen their corn and beans. Mourt’s Relation describes a searching party of sixteen men. Mourt goes on to say that this party took as much of the Indians’ winter provisions as they were able to carry.

Massasoit, the great Sachem of the Wampanoag, knew these facts, yet he and his People welcomed and befriended the settlers of the Plymouth Plantation. Perhaps he did this because his Tribe had been depleted by an epidemic. Or his knowledge of the harsh oncoming winter was the reason for his peaceful acceptance of these acts. This action by Massasoit was perhaps our biggest mistake. We, the Wampanoag, welcomed you, the white man, with open arms, little knowing that it was the beginning of the end; that before 50 years were to pass, the Wampanoag would no longer be a free people.

What happened in those short 50 years? What has happened in the last 300 years?

History gives us facts and there were atrocities; there were broken promises – and most of these centered around land ownership. Among ourselves we understood that there were boundaries, but never before had we had to deal with fences and stone walls. But the white man had a need to prove his worth by the amount of land that he owned. Only ten years later, when the Puritans came, they treated the Wampanoag with even less kindness in converting the souls of the so-called “savages.” Although the Puritans were harsh to members of their own society, the Indian was pressed between stone slabs and hanged as quickly as any other “witch.”

And so down through the years there is record after record of Indian lands taken and, in token, reservations set up for him upon which to live. The Indian, having been stripped of his power, could only stand by and watch while the white man took his land and used it for his personal gain. This the Indian could not understand; for to him, land was survival, to farm, to hunt, to be enjoyed. It was not to be abused. We see incident after incident, where the white man sought to tame the “savage” and convert him to the Christian ways of life. The early Pilgrim settlers led the Indian to believe that if he did not behave, they would dig up the ground and unleash the great epidemic again.

The white man used the Indian’s nautical skills and abilities. They let him be only a seaman — but never a captain. Time and time again, in the white man’s society, we Indians have been termed “low man on the totem pole.”

Has the Wampanoag really disappeared? There is still an aura of mystery. We know there was an epidemic that took many Indian lives – some Wampanoags moved west and joined the Cherokee and Cheyenne. They were forced to move. Some even went north to Canada! Many Wampanoag put aside their Indian heritage and accepted the white man’s way for their own survival. There are some Wampanoag who do not wish it known they are Indian for social or economic reasons.

What happened to those Wampanoags who chose to remain and live among the early settlers? What kind of existence did they live as “civilized” people? True, living was not as complex as life today, but they dealt with the confusion and the change. Honesty, trust, concern, pride, and politics wove themselves in and out of their [the Wampanoags’] daily living. Hence, he was termed crafty, cunning, rapacious, and dirty.

History wants us to believe that the Indian was a savage, illiterate, uncivilized animal. A history that was written by an organized, disciplined people, to expose us as an unorganized and undisciplined entity. Two distinctly different cultures met. One thought they must control life; the other believed life was to be enjoyed, because nature decreed it. Let us remember, the Indian is and was just as human as the white man. The Indian feels pain, gets hurt, and becomes defensive, has dreams, bears tragedy and failure, suffers from loneliness, needs to cry as well as laugh. He, too, is often misunderstood.

The white man in the presence of the Indian is still mystified by his uncanny ability to make him feel uncomfortable. This may be the image the white man has created of the Indian; his “savageness” has boomeranged and isn’t a mystery; it is fear; fear of the Indian’s temperament!

High on a hill, overlooking the famed Plymouth Rock, stands the statue of our great Sachem, Massasoit. Massasoit has stood there many years in silence. We the descendants of this great Sachem have been a silent people. The necessity of making a living in this materialistic society of the white man caused us to be silent. Today, I and many of my people are choosing to face the truth. We ARE Indians!

Although time has drained our culture, and our language is almost extinct, we the Wampanoags still walk the lands of Massachusetts. We may be fragmented, we may be confused. Many years have passed since we have been a people together. Our lands were invaded. We fought as hard to keep our land as you the whites did to take our land away from us. We were conquered, we became the American prisoners of war in many cases, and wards of the United States Government, until only recently.

Our spirit refuses to die. Yesterday we walked the woodland paths and sandy trails. Today we must walk the macadam highways and roads. We are uniting We’re standing not in our wigwams but in your concrete tent. We stand tall and proud, and before too many moons pass we’ll right the wrongs we have allowed to happen to us.

We forfeited our country. Our lands have fallen into the hands of the aggressor. We have allowed the white man to keep us on our knees. What has happened cannot be changed, but today we must work towards a more humane America, a more Indian America, where men and nature once again are important; where the Indian values of honor, truth, and brotherhood prevail.

You the white man are celebrating an anniversary. We the Wampanoags will help you celebrate in the concept of a beginning. It was the beginning of a new life for the Pilgrims. Now, 350 years later it is a beginning of a new determination for the original American: the American Indian.

There are some factors concerning the Wampanoags and other Indians across this vast nation. We now have 350 years of experience living amongst the white man. We can now speak his language. We can now think as a white man thinks. We can now compete with him for the top jobs. We’re being heard; we are now being listened to. The important point is that along with these necessities of everyday living, we still have the spirit, we still have the unique culture, we still have the will and, most important of all, the determination to remain as Indians. We are determined, and our presence here this evening is living testimony that this is only the beginning of the American Indian, particularly the Wampanoag, to regain the position in this country that is rightfully ours.

Wamsutta

September 10, 1970

Why Good Leaders Make You Feel Safe

I was recently reminded of this great TED Talk by Simon Sinek called Why good leaders make you feel safe.  

In his talk, he suggests that when the right environment is created, we are all capable of doing remarkable things and acting in great service to others. He attributes trust and cooperation to building that great environment.

I have found that, perhaps oddly, when I’ve worked in really fast paced environments (ie: disasters, pandemics, epidemics), the tolerance for mistakes is higher. We know that we are making decisions quickly and not everything will go right. But, in some ways, that increases the trust and feeling of safety. It allows for honest conversation. It encourages people to ask for help.

But, how do you do you build a sense of safety? Simon proposes some suggestions, have a listen!

What are your thoughts?

How do you make your team feel safe?

Or, in your own heart, what could you be doing to increase that level of safety and security?  

What it Takes to be a Good Leader

I’d like to share some  ideas about what it takes to be a good leader.

Take a listen to this talk by Roselinde Torres.

She distills the best qualities of leaders into three elements:
1. The ability to see changes that may be on the horizon and prepare for them
2. Networking skills that bring various perspectives to the work
3. The willingness to take some risks and abandon practices that may have been successful in the past but no longer serve the team

The reflection questions below may give you insight into your own practices and habits (and maybe encourage a change or two!):

  • What are your skill levels as they pertain to those three qualities?
  • Take a moment to think about, as she suggests, how you spend your time–do you allow yourself the opportunities to develop in these three ways?
  • Are you cultivating your team to be leaders?

What do you think about her distillation of leadership qualities? I would add skills around trusting and transparent communication to her very valuable list. To me, trusting and transparent communication is critical to giving and receiving feedback and to ensuring that your team is helping you to see what is on the horizon.

Have you considered watching TED talks like this one with your own teams? I have always appreciated leaders and managers who ensure that I keep learning and developing. Plus, they are short enough to fit into team meetings or over a lunch break. How do you help to foster growth and development in your team and in yourself?

Laughter makes us better workers!

Did you catch this great news? Laughter is not only the best medicine, but it makes us better workers, too!  Great news for those of you who (normally) enjoy the water cooler banter with colleagues and organizing the office parties–all of your efforts are justified!

I love tips about increasing productivity, but this one is extra special. Now, how does this news relate, say, to training efforts?

Well, I’ve facilitated lots of training of trainers (TOTs) and I’ve written lots of curricula that other people deliver. One of my great challenges is in convincing novice facilitators that the fun activities are written into the training to, yes, be fun breaks and to allow opportunities for team building, practical application of learning, and create lasting impressions of the materials. Those memories, especially when laughter is involved, can be the most lasting impression of a training and, thus, can help learners to recall other elements of the training.  If you are a novice trainer, challenge yourself to pace your trainings to allow for the active components of the training. If time is running out, consider restructuring your training to limit the PowerPoint or the lectures before you ax the activities. 

So, the moral of this story is…don’t skip the ice breakers, the energizers, and the activities.  Your team will be more productive because of it.

Why Your Doctor Should Care About Social Justice

It seems we’ve all been thinking deeply about race and racism in the United States. My interest in public health stems from a desire to work towards equity and justice.

One of my favorite TEDTalks is by Mary Bassett: Why Your Doctor Should Care About Social Justice.  Dr Bassett is the Health Commissioner for NYC and a long time health activist.

As you may know, I worked for several years at Partners In Health (and am working there on the COVID response now) and so appreciated her nod to the work of Paul Farmer when she says:

“But I knew that epidemics emerge along the fissures of our society, reflecting not only biology, but more importantly patterns of marginalization, exclusion, discrimination related to race, gender, sexuality, class and more. It was true of AIDS. It was true just recently of Ebola. Medical anthropologists such as Paul Farmer, who worked on AIDS in Haiti, call this structural violence: structural because inequities are embedded in the political and economic organization of our social world, often in ways that are invisible to those with privilege and power; and violence because its impact — premature deaths, suffering, illness — is violent. We do little for our patients if we fail to recognize these social injustices. Sounding the alarm is the first step towards doing public health right, and it’s how we may rally support to break through and create real change together.”

She ends her talk with this statement:
“Our role as health professionals is not just to treat our patients but to sound the alarm and advocate for change. Rightfully or not, our societal position gives our voices great credibility, and we shouldn’t waste that.”

Videos like this can be great ways to spark ideas among your team members. What if you showed this video to your team and had a conversation about it?

Here are a few questions that may help to spark conversation:
  • What do you think your individual role is in addressing the social issues that accompany illness?
  • What do you think our collective role is in addressing the social issues that patients experience?
  • Have we pushed the envelope far enough as an organization to ensure that we are using our positions of power to advocate for patients and families?

The Happy Secret to Better Work

Here is one of my favorite TEDTalks—The Happy Secret to Better Work.
 
 
In his very humorous talk, Shawn Archor talks about how we view the world and how that affects our happiness. Seems obvious.

He also says, though, “75 percent of job successes are predicted by your optimism levels, your social support and your ability to see stress as a challenge instead of as a threat.”  

So what do you, as a manager, do to build that optimism and resiliency among your team? I’ve written about the need for feedback, both constructive and positive, in the past. How can we link that to building that ability to see stress as a challenge and not a threat?

I’ve incorporated several of the lessons that Shawn talks about here (and elsewhere) in my life, including keeping a running list of what I am grateful for. Even on the most craptastic days, there is always something out there that can add beauty to our lives. And if I am really struggling to find something, I create something by reconnecting with a friend, setting a (virtual!) coffee date, or even planning a trip (one of my favorite activities! We can hope, right?). I usually write my list before I even get out of bed in the morning as a way of framing the day in the most positive sense possible.  

Of course, we are in trying times, indeed. When Shawn delivered this talk, we were not months into a global pandemic. I, like many, am managing an entirely remote team. One of the things that seems to be going well on my team is that we’ve built and constantly reinforce the expectation that we will change, evolve, and pivot as needed to address COVID. In some ways, knowing that more change will come, even if we don’t know what it will be, disallows the team to settle into complacency or routine. The routine IS change. That clear-as-can-be communication has been crutial.  What tricks do you have up your sleeve for keeping the optimism on your team?

How have you built up your own optimism and resiliency? How have those skills served you now, given that we are living through this pandemic? What new skills have you been able to tap into?

Nine Events of Instruction

Have you ever been in a training where you feel a little bit like Charlie Brown when he is in his classroom? Where your attention everywhere BUT on the topic at hand? 

Maybe what the presenter said was disconnected with your own reality (a la The Office)?

Or, maybe, just maybe, you jumped into a lecture that was above your head, your pay grade, or understanding? (this video has always been a favorite–glad I have the chance to throw it in here!)

You have been in those situations. We all have been. As a trainer, I like to cue up a lesson to make sure that the stage is set, learners are ready, and that they know what the point of the instruction is. In order to cue up a lesson, I remind myself of the first three, of nine, events of instruction. 

Robert Gagne famously (ok, “famously” in certain circles) outlined nine events that codify learning and instruction. The events simplified and explained what was thought to be “good instruction”.  

Let’s look at the first three:

  1. Gain attention to ground the lesson and to motivate learners
  2. Describe the learning goal and what will be accomplished by the lesson and how it relates to work/tasks/desired outcomes
  3. Stimulate recall of prior knowledge

It should only take a few minutes to move through all three of the primers. For example, by asking about a problem and how the participants view that problem, you can easily accomplish number one and three. By drawing on the past experiences of participants you can touch on point number three.

I recently wrote training materials for health care workers who were being asked to switch up the treatments that their patients were taking. The activity below was meant to build empathy for the patients, describe a bit of what we’d be learning, and help the participants to consider how medications were currently being prescribed and the challenges patients face…


Activity

·      This activity is intended to inspire an empathetic response among participants to the challenges that their patients may face with adherence to their medications.

Say:

·      As we mentioned in the beginning, we are going to give you opportunities to try to put yourselves in the shoes of your patients.

·      Let us do a short demonstration now to start our discussion on adherence. This demonstration will help us to start thinking about some of the reasons for poor adherence.

Do:

·      Ask for three participants to volunteer for this demonstration.

·      Each of the three demonstrations will be slightly different. Please read the instructions before facilitating the activity.

·      Demonstration One:

·      Hand the first participant volunteer two bowls. One bowl should be empty. The second bowl should have 50 or so small candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies, one-by-one, from the full bowl to the empty bowl. The participant should aim to put the 30th candy in the bowl at the 30-second mark.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, stop the participant and ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How might this demonstration be like taking ARVs?

Answer:

·      ARVs are taken at specific intervals

·      A specific number

·      Regulated, etc.

·      How did it feel to not understand why you were doing this task? Did you think that this activity might be pointless?

·      How might patients feel about taking ARVs when they feel perfectly healthy?

·      Demonstration Two:

·      Hand the second participant volunteer the same two bowls. One bowl should be empty. This time, the second bowl should only have 20 or so candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies, one-by-one, from the full bowl to the empty bowl.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How did it feel to be unsuccessful with such a simple task?

·      How did it feel when you knew you did not have the 30 candies that I asked you to move?

·      How might this demonstration relate to patient challenges with ARVs?

·      Demonstration Three:

·      Hand the third participant volunteer one empty bowl. This time, you, the facilitator, should hold the second bowl with 50 or so candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies from the full bowl to the empty bowl.

·      This time, though, the participant must ask you for three candies at a time. You must hand the participant three candies and he or she will deposit them one-by-one into the empty bowl. Feel free to delay the hand off, give two instead of three, and otherwise make the activity more challenging.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How might this demonstration be like taking ARVs?

·      How did it feel to know that you had to ask for candies often enough that it kept you from reaching your objective?

·      How might this demonstration relate to how clinics and patients interact?

Answer:

·      Clinics do not always work according to the schedule or needs of the patient.

Ask:

·      Why do you think we did this activity?

·      Do you think that we, as providers, are aware of all of the challenges that patients have with adherence?

·      What are some of the challenges we highlighted in this activity?

Answer:

·      Keeping to a schedule

·      Stock-outs

·      Conflicts between clinic and patient need, etc.

Say:

·      In many cases, patients may not understand why they are taking their medications, just as in the first demonstration. Plus, the idea of taking drugs while still well is a new idea that many people do not understand.

·      We also know that health systems are not always in sync with what a patient may need in terms of clinic hours or amounts of medication that they can be prescribed at a time, and so on.


As you can see, this brief activity, designed to take no more than five minutes or so, accomplishes the first three principles of good instruction. The participants are grounded, ready to learn, captivated by the exercise and they are linking what they are seeing to past experiences with patient adherence and, finally, they get a sense of what the lesson will be about. 

I often write curricula that other people will deliver. I often get push back around activities and cue-up questions as trainers sometimes want to rush to “get to the point”. These segues and lead-ins cannot be viewed as simply nice-to-have or superfluous. When learners can’t connect to new or unfamiliar content, the new concepts will become “slippery” and not stick. The next thing you know, you are Charlie Browns teacher. 

What are some of your favorite cue-up activities or questions?

PS: You can find the entire OPTIMIZE curriculum on the ICAP website. 

Feedback

Not to toot my own horn, but I tend to be quite good at accepting feedback and and incorporating it into my work.  I value feedback as an essential tool of collaborative work and as a means of ensuring that multiple voices and perspectives are heard and incorporated.

Of course, I’m sure we’ve all had those painful moments when we’ve gotten unsolicited feedback so late in the game that we end up facing a sleepless night on the eve of a big event or before a deadline.  Oh, the wound is still fresh!

In any case, we can always try to be proactive about getting feedback.  I like the AWARE model for asking for feedback that is highlighted in this talk:

Ask for feedback, 
Watch your emotions, 
Ask questions to clarify, 
Reach out for perspectives, and 
Engage your potential.
 

I particularly liked the description of why feedback can be difficult–as it lives in that tense spot between the need to learn and grow, and the need to be accepted just the way we are. Yet, becoming comfortable asking for and giving feedback helps to hone our growth mindset and helps us see feedback as a gift. 

Consider watching the video with your team and leading them in a discussion about how they like to get feedback from you and how you can solicit feedback from them.  A sign of a healthy team is one where feedback is readily given and received and expected. 
 
Can you shift your mindset to one of growth and see feedback as a gift? Your challenge for the week? Ask for feedback from one of your colleagues by using the AWARE model.  

What type of leader are you?

I often teach leadership and management courses and, inevitably, there are folks in my courses who believe that leadership skills are innate. Either you’ve got what it takes or you don’t.

I could not disagree more.

If you break down what it takes to be a good leader and/or manager, it comes down to a collection of tasks and skills that can be cultivated and improved upon over time. Yes, there will be some that will come more easily than others. I also firmly believe that, as leaders, we can build teams to compensate for our areas in need of growth. No one person is going to excel at everything, but by being mindful about creating teams with diversity of skill, thought process, and experience, we can build a team of leaders. 

A colleague recently shared this article with me… The Three Leadership Types in a Nimble Organization.  What stands out to me in this article is the notion that leadership and the opportunity for leadership can and must come from all levels within an organization. 

I couldn’t agree more.

My take away, though, is to take these three archetypes into consideration as I build future teams for every global health team must be nimble and prepared for just about any twist or turn that our changing world throws at them. 

Would you like to bring leadership and management training to your team or organization? If so, please reach out and let’s make it happen!

 

Public health is activism

A while back, I worked on developing a training for ICAP at Columbia University on training on the optimization of HIV treatments. Meaning, simply, that HIV treatment has to be effective, simple to take, and affordable. 

We created a series of trainings for health care workers on new HIV medications. Check it out here if you are curious! Over the course of the development of the materials, more information was coming out about risk to fetal development when pregnant women take the medication. We developed updated materials specifically about the use of the drug during pregnancy and the breastfeeding period. You can find those here if you want to get granular. 

So, why is this important? Well, due to the risk, there was a moratorium in some countries on the use of the new drug in all women of childbearing potential. Some countries decided to offer the drug only to women who are on effective birth control. You can imagine that in some countries that equates to a very very few women who would be eligible. All men were eligible. But. Wait. Didn’t I just write that this drug was easier to tolerate, more effective, and more affordable. Yes. Yes, I did.

As you can imagine, this has caused a lot of consternation and, luckily, activism, too. Treatment protocols like this are a result of sexism and promote further sexism for sure. This is not the only example of systematic failures to women related to their healthcare. For example, the Global Gag rule has disallowed organizations to use US funds for abortion services. You can read more about the effects of the Global Gag rule on this new drug here

What is always remarkable to me is how people come together in solidarity to shine light on injustices and, hopefully, to change them. Women living with HIV came together in Kigali when this was happening and wrote a statement together that says, powerfully, “We, the women living with HIV at this meeting, conclude that blanket exclusions that deny women equitable access to this optimal HIV treatment are not warranted or justified.” Each woman, they wrote, is not just “a vessel for a baby, but an individual in her own right, who deserves access to the very best evidence-based treatment available and the right to be adequately informed to make a choice that she feels is best for her.”

As the story unfolded and as more data was collected and more voices were raised, the World Health Organization changed its tune and now recommends the new drug as a first- or second-line treatment in all populations. Critically, women decide on what is best for them and their health based on accurate, unbiased information. 

Stories like this, especially when I have even a teeny tiny part in them, are completely buoying to me. This work can be hard and tiring and I can feel like Sisyphus more than I wish. But, then. There are wins and those wins motivate me to work towards the next win. 

What keeps you going in this work?