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Section 4. Analyzing Root Causes of Problems: The "But Why?" Technique

"But why?" in Latin America

David Werner, a community health organizer in Latin America, used the "But why?" technique to get to the more fundamental, underlying causes of widespread ill health of villagers in Western Mexico:

"...(At first) I did not look far beyond the immediate causes of ill health. As I saw it, worms and diarrhea were caused by poor hygiene and contaminated water. Malnutrition was mainly caused by scarcity of food in a remote, mountainous area where drought, floods and violent winds made farming difficult and harvest uncertain.

Little by little, I became aware that many of their losses -- of children, or of land or of hope -- not only have immediate physical causes, but also underlying social causes. There is a photograph of a very thin little boy in the arms of his malnourished mother. The boy eventually died of hunger. The family was -- and still is -- very poor. Each year the father had to borrow maize from one of the big landholders in the area. For every liter of maize borrowed at planting time, he had to pay back three liters at harvest time. With these high interest rates, the family went into further debt. No matter how hard the father worked, each year more of his harvest went to pay what he owed to the landholder." - D. Werner, Helping Health Workers Learn, Front-7


The "But why?" method is not explicit in this story, but by asking "But why?" questions, Werner could help people analyze their problems, and prevent waste of tactics and resources. Using the "But why?" technique, he could see beyond the most obvious causes for the problems he was trying to eliminate. For instance, he learned that malnutrition may have more causes than simply lack of food.

Christine Lopez