An Interview with SurfAid founder, Dr. Dave Jenkins

By Rachel Lewis

SurfAid is an NGO that aids and empowers remote island communities to adopt low cost, high impact health care for women and children, as well as community-led sanitation. Dr. Jenkins has won several awards for his humanitarian work and was a recipient of the Rainer Arnold Fellowship, which allowed him to travel to remote communities around the world, studying community development programmes that could be scaled and implemented through health systems worldwide. 

When SurfAid asked Betty to be ambassadors for their upcoming #MakeAWave campaign this September, we were stoked to jump on board. Hell, any excuse to surf for thirty days in a row, not to mention raise money to help our fellow humans. But what was the cause exactly? 

I’d heard of SurfAid before, but admittedly I didn’t know much about the work they do. I knew they work in remote island villages, like the Mentawais, whose waves are frequented by surfers but that was about it. So on a day with onshores, I sat in my office chair, artfully turned my coffee cup to hide the side that said ‘Oh, for Fox Sake’ for the fox sake of professionalism, and interviewed SurfAid founder Dr. Dave Jenkins over Zoom. He was casual and at ease in a t-shirt, sitting in Gisborne with offshore winds. 

Your visit to the Mentawais was the start of SurfAid. What did living there look like?

There’s a saying in humanitarian work that the aid stops where the road stops and that’s a very different thing about SurfAid. Our aid starts where the road stops. So it makes [our work] significantly more difficult because of the logistics involved. Everything there is dominated by isolation.

They are subsistence farmers and they do that well, in that they are quite resourceful. Having said that, they don’t have their proportions right. For example, when we got there they had no knowledge what a nutrient or a vitamin was. They weren’t giving their children the wild spinach that grew everywhere in the swamps. They were giving it to the pigs. I used to say to them, ‘You have fat, healthy pigs. But your kids are skinny and sick. Have you ever thought about why that is?’. You’ve got to relate to people how they think, or try to. And they’d say, ‘Oh, so that’s got stuff in it that makes them healthy’. 

The Mentawai people were also forced out of the forest and their way of sustainable living to the coast by Sahartu and his cronies in efforts to build a more modern Indonesia, with offers to grow cash crops and contribute to the GDP. Someone living sustainably in the forest doesn’t contribute to anything but their own wellness and the wellness of the environment. So they’re in this halfway zone where they’ve been forced out of their traditional systems to live a new life but don’t even have the benefits of that new life- the education or the health system. 

SurfAid focuses on low cost, high impact changes in communities. What is the difference between this and organisations that rely on handout models?

You don’t help people by giving them shit. But there’s always an exception. I was in a village in 2010, discussing the Mother & Child programme with the community, and I was sitting in the chief’s house. Four days later there was a tsunami. I went back to that village and stood on the concrete that was all that was left of the house. A man who I met in that meeting had just lost three children and his wife. He hadn’t found the bodies, they’d been washed into the forest. 

Now, that’s an exception because a hammer is like a third-generation, amazing asset for them. A saw and a hammer. Giving them those assets back was the best thing to do. Giving them tents so they could have shelter and giving them food while they re-establish their lives was the right thing to do. Here’s the thing: there’s a right way and a wrong way to do that. 

We brought in an amazing guy who’d been working with us in a model village. He showed them, through various demonstration houses, how to use the scrap wood, iron and everything that had been destroyed and was strewn all over, to rebuild their houses using the materials in a way where the foundations would move in the next earthquake, rather than fall down. We gave them some nails but most of the materials were their own. The design of what you do in anything is so, so key. Really think through the design. 

One of the great things that happened because we had no money was the question, ‘How do I design a mother-child model, or a health model that costs very little money?’. I sent my governance board this spreadsheet that had things like research on how exclusive breastfeeding can reduce infant mortality by twenty percent alone, asking a woman to wash her vaginal area with warm soapy water every four hours when she gets her first contractions dramatically reduces the risk of death from infection, cutting the cord with a boiled knife rather than a dirty piece of bamboo is another fifteen percent reduction in death rate. I put together this package of low cost, high impact behaviours. That is what we focus on, and that is what we’ve gotten very good at. You won’t find many other NGOs doing that.

I’ll end there and that’s another rant. 

In a Ted Talk, you told the story of your first project handing out mosquito nets in a village which they used as fishing nets instead. Tell me about those white knight moments where you realised you needed to rethink what you were doing and how you were doing it. 

The best thing and worst thing happened to us very early on. It was the best thing because we didn’t waste too much money but it was the worst thing because at the time we thought we’d completely failed. 

Handing out mosquito nets doesn’t work. You’ve got to build people’s ‘why’: Why would I sleep under a mosquito net where it’s going to be hotter for me in my terribly hot house? Why on earth would I do that? I went in with a white knight attitude and came out very sobered. But we were persistent and determined so we moved into the villages and learned the language and asked the question, ‘What is good bottom up community development and how we could go about doing that?’. 

I started asking the questions: What change systems were going on here? Who are your natural leaders and influencers and do you even want this project for a start? Maybe you don’t want it. And if you do, this is why malaria is rampant in your village. We can do something about it but you tell me what change process will be most effective and that’s when they came up with a drama and song and the chief cross-dressed as a pregnant woman. You gotta stay open as to what they’re going to come back with. 

The work of SurfAid focuses on providing health and sanitation solutions to the communities you work with but these villages face many other challenges. Have you ever been tempted to derail from your original mission to address these?

As a general principle, why do indigenous communities, as they have in the Mentawais and the Amazon, sell out? It’s because of population growth and financial need. Underpinning that is the fact they have six kids because numbers of them will die, and in that process they’re using more and more resources. What they really want is less kids but they want to know those children will survive. Population growth is the number one destroyer of the environment.  

It’s obvious, right? We’ll ruin the environment if there’s too many of us. The science is so clear that Jane Goodall has an NGO dedicated to saving the environment via population control. The number one thing we can do is to lower the death rate of children. Bill Gates, when he started his foundation, asked some of the top scientists, ‘Where do I get the biggest return on investment? I’m a businessman and I want to apply business principles to aid. I want it to be effective for every dollar I put in’. They said, ‘Bill, stop children dying’. 

When there are no more little graves in the graveyard, parents then say, ‘I don’t need to have six kids. I want two kids and I want to give those two kids, with the little money I earn, the opportunity to have a better life than me. They’re highly motivated to keep those two kids healthy. Now if you give them the knowledge and the process of change in order to ensure their children are well nourished, don’t get sick and grow up fat and healthy, then parents will elect to seek out contraception. 

We have to stick to what we’re very, very good at and look at how to scale that. We, too, have the business principle. We can proudly tell our donors, your dollar is a legacy donation, meaning it will echo on for generations, long after you’ve passed on to the ether or wherever you’re going. 

I would go into the village in the early days when we only had a few villages and they all knew me. We were starting our Mother & Child programme about immediate and exclusive breastfeeding. I’d see groups of women breastfeeding and hanging out, chatting. They’d say, ‘Dr. Dave! Dr. Dave! Look at little Jimmy!’, and little Jimmy would be this four-month-old with fat rolls who the mother had given immediate and exclusive breastfeeding to. So different to Freddy who was this stunted three year old and nothing but sick all his years. The mother was completely convinced, it was now visually obvious to her. I’d ask them, ‘What are you going to do with this knowledge?’. And they’d say, ‘Oh we’re having meetings about it, and we’re talking to the men about letting women do exclusive breastfeeding, and we’re going to teach our children about it’. Boom. When I hear that from them, I know we’re going to have a legacy or exponential return on investments. That is unusual. 

What we do is make long-term commitments. We don’t need to stay
in the villages for long term but we make commitments to regions for the long term because that is how we get that scaling. And that is how we convince not only the people but the authorities and the health service to begin to trust who we are, to trust our results. 

I can tell you a wonderful story that shows this. I went to a meeting with the big cheese, the governor of Nias, a couple years ago. He was clearly bored, another meeting with an NGO. We were saying that we were still working in the villages that we responded to in the March earthquake and he literally woke up, sat up, leaned forward, and went, ‘You guys are the people who helped us out in the 2004 earthquake and you’re still here ten years later? You are the only international NGO that has done that. Thank you so much. Now what is it you wanted?’. And I went, ‘Your health services are keen to replicate our model of training natural health leaders because it’s proven. We want you to give them more money so we can scale that through your own health service in a sustainable fashion and bring down infant and mother mortality rates.’ 

Six months later, the money came down from the government and they didn’t need us anymore. And that’s the first time I’ve ever heard of that happening. That’s a very strong differential in our model: we focus on the core, high impact behaviours that we can scale. It’s a bottom up, top down approach. Bottom up from the village we’re working with, top down from the government and health service in order to sustain those changes and grow them. 

That’s another little rant. There you go, I’ll stop now. 

It’s a process to find ways of working within the context of culture and tradition while still benefiting the health of women, children and also men in the village. What are some of the biggest barriers in overcoming the hesitations of communities?

It is obvious the most successful health projects always involve women supporting women. You have to get the men involved because they’re often barriers. In Nias, if a woman exclusively breastfeeds, the man is going to have to tap the rubber plants. It can be done if it’s only a twenty minute walk, otherwise we have to convince them to take the baby into the rubber plantations. But paradoxically, because they come back filthy from their gardens, they’re paranoid that the dirt is going to be wrong for their baby. 

In the Mentawais, there’s a belief system that the colostrum is not real breastmilk. It’s not the same consistency, it looks different. I could never find where that came from but it’s there and it was a very real challenge to overcome. 

The biggest thing NGO’s can offer is access to knowledge but also systems of change. There’s two things that come to mind with this. One of the most arrogant things that outside NGO’s like us can do is to assume these people need to change and there isn’t any change going on. In every community there is change going on. 

So one of the key things to identify is: what is the indigenous change process? Who are the influencers? And it can be incredibly surprising. Your assumptions can be your worst enemy. It might be the little old grandma at the end of the village. She’s the one all the women go to for breastfeeding advice. If you can convince her, then you can let her loose on the community. 

The second thing is the utilisation of scientifically proven processes. You’re an outside-in change facilitator, which is a highly difficult and focused expertise. We use a great thing called barriers to behaviour change. It’s a process where you can help them- and that’s a key thing, no matter which indigenous community you’re in, identify the barriers to behaviour change. 

In Nias it was, ‘The men won’t let me exclusively breastfeed because I’ve got to go and tap the rubber trees’. Then you ask, ‘Well, are there any women that are allowed to go?’. Yes. What’s the difference? That’s called the positive deviant. Next, ‘What would it take to convince them?’. 

It leaves the community tapping into their indigenous change processes, because in every community there’s these amazing natural leaders that if given the opportunity, if they’re empowered to do so, can create amazing change. 

Another rant stopped. I’ll stop. 

You don’t send volunteers into these remote villages and most of your staff are people from the regions you work with. So what is the best way for people to get involved and support SurfAid?

Become part of our tribe, learn about what we do and why we do it and why we have reduced child mortality rates in Nias by 90% which is world beating stuff. Find out why we’re passionate about it and be able to communicate why we are a very good organisation that’s worth supporting. SurfAid saves children’s lives by teaching mums and dads basic health and behaviour changes. And they do it at scale so your dollar that you donate will be creating healthy babies for generations to come. 

Feeling inspired? To donate, get involved or learn more about the SurfAid story, go to www.surfaid.org.