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What Expert Sushi-Making Can Teach Us About Global Health

November 07, 2012

What can we learn from the expert practice of sushi-making for our work in global health? The documentary “Jiro Dreams of Sushi” gives us insight into that question with a glimpse into the life of Jiro Ono, the 85-year old chef and owner of a three-star Michelin sushi restaurant in Tokyo. Jiro has been making sushi for more than 60 years and is widely recognized as a master in his field.  In his kitchen, apprentices spend 10 years on average before they “graduate” into the role of chef. And what we learn is that sushi-making, much like in other fields, requires the application of practical knowledge and the performance of painstakingly repetitive tasks.

This can lead to marvelous results.

In recent weeks we have witnessed a revived interest in this kind of “Practical Knowledge”. The most recent was a keynote speech by Dr. Jim Yong Kim, the head of the World Bank, at the World Knowledge Forum. He spoke of the need to “lay the foundations for a new field that will collect and distribute Practical Knowledge that countries can use to get delivery right in their unique contexts.”

Practical knowledge is a topic worth exploring and better understanding for business, governments and philanthropies. In its most popularly used context, practical knowledge strongly resembles what is often called know-how. It has attributes that make it different from what we normally call “knowledge”.

Think of a midwife and the skills she acquires for delivering babies.


First, practical knowledge is deeply ingrained in the routine practice of individuals and groups. Practical knowledge is always used in the context of doing something that has been done for a time and that often has its own tools, language, history, traditions and specific actions. Think of a midwife and the skills she acquires for delivering babies. Practitioners in this field can oftentimes move across national borders reasonably easily because the practice they have mastered is durable and based on a shared understanding.

Practical knowledge is also hard to document. It has tacit dimensions that are acquired by participation in a practice over time. It’s like watching a community health promoter talk to her community about the importance of getting antenatal care during a pregnancy—those subtle messages and the ways to deliver them are particular to that community and can’t be mirrored by just anyone. We know when we see practical knowledge at play. But witnessing it or reading about it are insufficient to replicating it by ourselves.

Know-how also involves judgment. Skilled practitioners are valued not only for their skills to do something, but also for their ability to evaluate and discern the environment they are working in, and to make choices that aren’t obvious or clearly deductive. For example, that midwife may be recognized as one immediately after her training, but more often than not, her expertise arises after years of disciplined, rigorous, and dedicated execution of her craft.

Dr. Kim’s words underline the renewed urgency to better understand practical knowledge and in finding ways to scale it up. Such ability to scale up know-how, even incrementally, can have huge benefits for global health and can be a very powerful and constructive tool in the arsenal of the global development community.

With the same degree of patience, rigor, and openness to failure that a Master Chef uses in crafting extraordinary culinary concoctions, such as sushi, the global health community faces the challenge to better understand, foster, and share practical, implementation knowledge that can, in turn, improve people’s lives. In order to accomplish this, deeper connections with communities and with individual practitioners will be necessary, as will more effective mechanisms for knowledge sharing, for example through storytelling.

The challenge that Dr. Kim presents to all of us is not how to find practical knowledge--for, in truth, it is all around us. It is in the distribution portion of his sentence. This will involve new methods, tools and thinking about knowledge that challenge all of us involved in scale-up efforts.  It may be a challenge, but one very much worth our struggling with. We have a world to win.

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