I am a housewife, attests Preeyanan Lorsermvattana, who spoke at a plenary discussion organised by SMU's Lien Centre for Social Innovation, the Singapore International Foundation (SIF) and Ashoka. Preeyanan works with a broad coalition of health professionals, media, consumer rights activists, lawyers, and medical malpractice victims to change policy, public attitudes, raise professional medical standards, and establish a clear system of legal redress for victims of medical malpractice in Thailand. Her organisation, the first of its kind in the nation, is called the Thai Medical Error Network (TMEN).

A victim of an emotionally and financially devastating medical malpractice, Preeyanan endured a decade-long struggle against social injustice. In Thailand, doctors are held in high esteem and rarely challenged. Access to medical records and the exercise of fundamental patients' rights are seldom guaranteed, thus giving rise to a system that favours the interests of medical institutions over that of individual patients.

Preeyanan responded by pioneering a process for other victims to use in their battles for legal redress, and through that, advocate for systemic changes. Thanks to her efforts, other victims are now able to step up and reproach authorities, where not long ago, many would have simply resigned to the situation.

All of this might sound like a tall order for just a housewife, but Preeyanan shares her story with the view of wanting to stir greater social consciousness amongst others - to show that anyone can be the change that they want to see.

Working with stakeholders

When I spoke nicely, no one listened. When I protested on the mass media, they got angry. From the beginning, Preeyanan realised the importance of leveraging existing resources and networks to sustain such an initiative. After an intense personal struggle to seek redress for an egregious medical error against a family member, she began a broader campaign for patients' rights. Preeyanan came to understand that one voice is easily suppressed, hence she leveraged the popularity of Thai print and broadcast media throughout her endeavours, to inform the public - drawing their attention to the long-hidden issue of medical malpractice and its corresponding effects on people's lives.

Joyce Djailani Gordon, founder of Yayasan Harapan Permata Hati Kita (KITA), employed similar strategies in her efforts to highlight issues related to substance abuse. Through her extensive work with youths on reproductive health and AIDS prevention, Joyce observed that young drug users in Indonesia were one of the most high-risk groups for the rapid transmission of HIV. She also noticed that the issue in Indonesia was fast becoming an epidemic, and that it was crucial to create circles of influence while raising awareness at a national level - to help people see that HIV is not simply a problem that affects marginal groups. At the end of the day, it's about getting critical mass. It's about getting the media to pay some notice.   Joyce described an awareness campaign that involved thousands of people gathering in front of the mayor's office in Indonesia. It was a statement. We used the media to change ideas, and to say things as they are. She added, If the media is not writing about the issue, you write it. That way, you can still sell your agenda. However, to create an effective campaign, you need to know the cutting-edge stories, know what sells and make a politically correct splash. On that note, she cautioned that social entrepreneurs need to be prudent and stand by what they say.

Casting a wider net

If you're my key stakeholder, how can I make you into a change maker? What kind of information do you need from me so we can work together? - A rhetorical question Joyce posed to the audience at SMU. For her, stakeholders should not limit themselves to silent involvement when they can add volume to the collective voice: Stakeholders can't change if they don't know what you're talking about; they can't be concerned if they don't understand what's going on... We need both our voices to make changes.

While popular practice would have us believe that society needs to change before individuals can reap the benefits, Joyce's experiences has revealed quite the opposite. She pointed out that sometimes, the most important stakeholders are those that are the least obvious. It could be the addicts, the inmates, or the people who open doors for us.

Rural Educator, Padmanabha Rao, agrees. He helps children in rural villages gain the perspective that is necessary for them to do well at school. His organisation, the Rishi Valley Institute for Educational Resources (RIVER), helps to bridge gaps between the curriculum and the local environment. He saw a dire lack of resources and support for both teachers and students in government-run rural primary schools, and so he stepped in to help.   The system is failing the children. They aren't dropouts. They are push-outs. The textbooks do not replicate the child's experience. They are produced in faraway capitals. The contents are irrelevant and the children lose interest, he said. Teaching in small, remote rural schools is an isolating experience for primary school teachers. Frustrations arise when a single teacher has to handle 25 to 40 students across five different grade levels, with each child learning at a different pace. A rigid government-imposed curriculum using poorly written textbooks adds to the stress. Very often, teachers become indifferent.

To address these issues, RIVER engaged with the stakeholders (the teachers) and empowered them to work their way out of the situation. We helped the teachers reformulate the curriculum. We stuck to the national curriculum framework, but we allowed the teachers to make meaningful support structures by involving the community - the mothers and the grandmothers. We involve them in telling stories and documenting the old traditions. They become a part of the programme, and the result is a school that's free of fear. Today, more than 75,000 schools use Padmanabha's methods.

Changing patterns

You can't really expect anyone to make the changes, so you have to make the changes you want to see. None of us grew up trying to change the world. Joyce was elected to the Ashoka Fellowship in 2002 for her efforts to change the way Indonesia sees and responds to drug abuse and addiction. We just did what we can, where we were. It just sort of happened. It's about love, work and playing at the same time. And when you have all three in balance, it's a perfect life.

Padmanabha gave a more pragmatic exposition. When we started out, we only had five or ten schools. How did we get to 75,000? Well, seeing is believing. Instead of trying to convince the public schools to change, we invited teachers from some of those schools to visit our model schools and try out our methods. Then we invited other teachers to come and observe our methods, and watch their colleagues doing this marvellous work. This created the critical mass that was needed to take the programme forward.

Apart from enabling stakeholders and developing critical mass, the constant that exists between Preeyanan's work with victims of medical malpractice in Thailand, Joyce's work with addicts and inmates in Indonesia, and Padmanabha's work with students, teachers and families in India, is that all of their methods can be replicated elsewhere.

This is not just an Indonesian thing, said Joyce, our methods have been replicated in maximum-security prisons in the US. So I guess we're doing something right. Similarly, Padmanabha shared that RIVER's vision has been to design teacher-training diploma and degree courses, and to translate their manuals into various languages so that a number of developing countries can adopt the same methods.

This is what identifies them as social innovators; that their techniques can transcend geographical and cultural boundaries, and can enable rapid change if implemented appropriately - that, and sheer pluck:

Why are you here? You are here because you care about what we're talking about. So let's talk about that, because that's sowing the seeds of change. Let's not talk about who's not here yet. We'll talk about who's here and do something about that, Joyce concluded.