Systems thinking is an emerging direction in my design and evaluation practice. Though  I've been engaging with systems de facto ever since I left school - now I am  formally engaging with systems concepts and deliberately using systems centred methods.

Long ago when I was a New Zealand emergency doctor systems were not important.  In my ER everything was consistent,  controlled, independently delivered and kept from engaging with each other. I always knew what drugs were available, where, what needles syringes, iv fluids, our communication systems, the training and job definitions of everyone on the floor. Every element of the department was strictly independent. A serious patient in one cubicle had no effect on a boy with a sprained ankle in the next.  If we were one doctor down that did not affect the drugs, the communication or our triage system. Having everything consistent and independent, non-interacting,  took system dynamics out of emergency care. I even  knew  what time my lunch break would be. The only doubt was whether any salmon sushi would be left in the hospital cafeteria… but that was outside my Emergency Room's  system boundary. 

In, boots 'n all- teaching health workers malaria parasitology in Colombia. On that MSF mission swamped in a system of uncontrollable elements we had to find coherent plans.

In, boots 'n all- teaching health workers malaria parasitology in Colombia. On that MSF mission swamped in a system of uncontrollable elements we had to find coherent plans.

 What a New Zealand emergency room  took took out, international health put back in. Before medicine I had already lived in a Brazilian favela, taught in Apartheid South Africa, trapped crocodiles in the Amazon, and volunteered with Mother Teresa in Kolkata- all wildly uncontrollable contexts.  After medical school though my wife and I had respected scientific degrees with which to face the world. We thought that Western medical training might help bring order to the Cambodian slum where we lived and worked. No! What emerged was much more about understanding multiple perspectives simultaneously, about following surprises and most of all about relationships. Next we were posted to  Colombia with MSF. Systems were suddenly critically important. Armed with our medical degrees and youthful hope we stepped into jungle,  war, flooding rivers, anopheles mosquitos indigenous beliefs and the rest..(Here is my blog on that foray.) By the time we flew out to debrief in MSF's Amsterdam office we knew consistency, independent variables and predictability is a rich world abstraction- life on the rest of the planet  is complex and interrelated.

The delicious complexity of systems that first lured me out of the emergency room still challenges and surprises me and  holds me here.From long before I studied medicine I loved uncertainty and the thinking required to negotiate multiple, uncontrolled interacting elements.  Now I am doing it more deliberately, formally.  A really difficult and deeply satisfying evaluation/project design in Afghanistan in February 2017 was my latest step on this learn-as-you-go journey.

What is the systems approach? 

there is no such thing as the systems approach…. Systems thinking is a way of engaging with issues”

Dick Morris quoted in"Wicked Solutions" by Bob WiIliams and Sjon van 't  Hof

"A way of engaging with the world, a way of thinking, a philosopy… Love it."

jeph mathias

What is a system? Let's try a definition. Not the definition, a definition: A system is "a collection of entities, that are seen by somebody, as interacting together, to do something" (DIck Morris quoted in "Wicked  Solutions" ). Conceptually important is whether one sees systems as "real" entities 'out there'  or human constructs that help us visualize and conceptualize the world and our engagement with it. There are proponents of both views. Firmly in the latter camp I see systems as heuristics to understand and navigate the world of my choosing.

Williams' excellent book....

Williams' excellent book....

In design, monitoring and evaluation I increasingly find systems thinking is critical to meaningfully work in complex contexts. There is no one right approach to any of the contexts in which I am asked to help, but I like Williams' approach which prioritizes perspectives (alternative ways situations can be understood) inter-relationhisps (how system elements connect),  and boundaries (what we choose to include/exclude) as key dimensions in answering the “what should we do?” question. Unlike emergency medicine I seek coherent plans not right answers. I can't tell you what the right thing to do is (usually there is no such thing)  but should be confident that from what we know my suggestions are likely to take us closer to our vision.

Systems thinking is almost the antithesis of linear if-then logic. It says that we can only make a coherent plan by considering together a whole group of inter-related elements and people with different perspectives, all within a boundary. If I work with you I may ask for more time than a standard design or evaluation process might or ask to meet more people-some whom you did not expect, I might want to go somewhere  you'd not considered, ask to assess the context in a way you were not expecting…If my approach goes outside your time frame, logistic capability or budget lets talk. I might modify my plan, you might modify your expectations, most likely we'll both move…or perhaps we find it’s better for you to work with someone more standard. I fully expect this kind of negotiation and am comfortable with prospective clients saying they’d prefer someone else. As with so much in life honest communication is key to it all. Let’s make that happen.