Food for the Hungry Logo Barrier Analysis: A Tool for Improving Behavior Change Communication in Child Survival and Community Development Programs
Background Information
What is Barrier Analysis
Behavior change theory
Seeing the need
Fisherman story
Seven steps
The "Exercise" exercise
How to Conduct Barrier Analysis

Masai villagers shaking hands

  The Fisherman Who Ran Out of Excuses Before He Ran Out of Time

by Tom Davis

One day in January in Hula Hula, an old fisherman walked merrily up the hill by the house of the Health Promoter, Raffaella. He was smoking a cigarette. Raffaella remembered her own father’s painful death from cancer due to his smoking, and she resolved to do something about it in her community. Raffaella talked to the old fisherman from her yard for a while and then told him that he really should stop smoking because it could give him cancer. The old fisherman said, "I'll never get cancer. The people in my family are very hardy and healthy." So Raffaella explained to him how anyone who smokes has a higher risk of getting cancer. Illustration of the fisherman smoking and talking to Health Promoter

Illustration of community members looking at a no smoking sign on a building.

In February, the old fisherman walked by Raffaella’s house again. Raffaella saw that he was still smoking and mentioned to him that he could get emphysema from smoking, too. The old fisherman laughed and said, "Well, I don't even know what emphysema is, but I'm sure it won't be anything that I can't handle even if I do get it." So Raffaella explained to him what a terrible disease emphysema is.

Raffaella realized that she needed to do more than just talk to the fisherman if she wanted to do something about cancer. She worked with the local community leaders to create and display several posters in local gathering places that pointed out the health hazards of smoking. She was also successful in getting community leaders to agree to not allow smoking during official community meetings.

March came and the old fisherman came puffing up the hill and puffed a `hello' to Raffaella. Raffaella asked him if the cancer had set in yet. The old fisherman said, "I don't have it yet, but if I'm supposed to get it, I'm sure I will whether or not I quit smoking. I've smoked all my life!" So Raffaella explained to him how quitting smoking at any age could make him live longer.

In April, the old man slowly walked up the hill, coughing and hacking. He knew Raffaella was going to ask him, so he called out before she could ask, "No I haven't stopped smoking, but I want to. And I did try! It's just too hard!" So Raffaella explained to him some ways to stop smoking more easily.

In May, the old man took forever to get up the hill since he was breathing like a mule loaded with salt. Raffaella asked him, "Are you still smoking?" and he said, "Well, I finally gave them up on Wednesday . . . but over the weekend I forgot that I wasn't smoking anymore, saw a pack on the table and lit one up! I just can't remember that I don't smoke! So Raffaella explained
to him that he should get rid of all the cigarettes and ashtrays to "remind him" that he doesn't smoke.

In June, the old man had to stop three times coming up the hill since he was breathing so hard. Raffaella said, "You STILL haven't given them up?!" and the old man said, "Well, it would be a lot easier if all my friends didn't smoke! Every time I see them, it makes me start up again!" So Raffaella explained to him that he needed to either find friends that didn't smoke or convince his smoking friends to give it up, too. Raffaella met with the old fisherman and his friends and, with Raffaella’s help, they began a support group to help each other stop smoking.

In July, the old man had to stop five times coming up the hill. He called out to Raffaella: "Don't tell me anything else. I know that it must be God's will for me to smoke and die of smoking since I can't seem to stop.” Raffaella called the old man over for coffee, and read to him from the Bible where it says that our bodies are temples (1 Cor 6:19-20). She explained that it was not God's will that he die of his habit (Isa 65:20). She agreed that he probably could not stop on his own, though, and that he did indeed need God's help to do it. She suggested he pray to God for strength to quit, and for more ideas on how to do it.

Illustration of farmer and health promoter having coffee.

In August, the old fisherman climbed the mountain very happily as if he were a young man again! He called to Raffaella, "I'm no longer a smoker and neither are my friends! I convinced them that with the money we would save by giving up smoking, we could form a fishing cooperative. Now, none of us are smokers. Thanks a lot, Raffaella!! I thank God that I ran out of excuses before I ran out of time!" The fisherman regained his energy and died at 95 years old.

Illustration of fishing cooperative.

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© November 2004

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