So many of the problems that we deal
with in the public sector are what my
colleague Lant Pritchett calls "wicked hard
problems." These are problems that involve
many different agents and have many
different paths to them. Oftentimes, I
think people don't deal with these
problems because they saw wicked hard.
In the literature, people call them "meta
problems," which means that they're problems
with many other problems hidden
within them. I just like to call them
quicksand; which means, essentially, when
you take people into that problem, they're
easily going to get stuck, and if they
get stuck, they're going to get
disillusioned, and if they get 
disillusioned, you're not going to get any
change. So one of the key things you want
to do when you have a wicked hard
problem is you want to have very, very
basic instruments that help you break
down the wicked hard problem so that you
can make it something that people can
actually deal with, and that they can
feel confident about it. Now when I
work in places, I use the most simple
tool out there. It's called an Ishikawa
diagram or a fishbone diagram. Some
people call it the problem tree. The first
thing that I do is I ask people to
define what the problem is, and I'm going
to use an example from the country where
I worked recently of maternal mortality.
And they would say, well the problem is
that our maternal mortality rate is at a
certain number, and it's too high. And
then I'll say to them, "what do you think
is causing the maternal mortality rate
to be that high?" And this is the first
time that people have been able to have
a conversation in the room without
having to argue about the cause because
usually people have to identify the one
thing that matters and they fight about
that. So you'll find the people working in
the hospitals who're looking for resources
for the hospitals will say "we don't have
enough beds in the hospitals"; and then
the people who work maybe with the
ambulances will say "we don't have enough
ambulances"; and then you end up fighting.
And I say to them, "why don't we just put
both of those on the board." So let's say
this is the head of the fish, and these
are the bones, and one of them is about
access to hospitals, one of them is about
access to ambulances, then other people
in the room start to realize that they
can actually put their ideas up there,
and they say, "well how about local
traditions that don't allow a woman to
go to the hospitals?" They say, "well, that's
interesting, let's put local traditions
here," then other people will say, "well,
it could also be the fact that the women
go to the hospitals, but they go too late
in their pregnancy. So that if
there is any complication in the
pregnancy, they're arriving when the baby
is coming, and when they are already in
deep, deep danger. They're not going in
the first few weeks, for the first few
months." Now what I'll do with the group
is I'll start breaking these down and in
each one,
I'll find sub-causes as well, which allow
you to really break the problem 
down and have a look at it to know
you're not dealing with one meta
problem-one huge quicksand-you're
dealing with a lot of different parts.
Then I'll say to people, "now, how about we
go down." And we say, well, you some use
some sticky notes to tell me which of
the problems you think you have any
ideas about solving, and I'll say, "you
know, go and put them on there." And people
will put them on there, and you'll see
already that people start to identify
that maybe this is a place where we can
deal with things, that these other places
are not so approximate for our solutions
right now. Using these kinds of diagrams,
these kinds of processes: very, very easy
way to turn gigantic problems into
problems that you can deal with, problems
that you can solve, problems that you can
mobilize attention around. It's very
important that we deconstruct problems
in this way so that we can actually
break into them and solve them.
