About - Relational Futures

The thread that runs through my approach

This work did not begin at the World Health Organization (WHO). It began earlier, in direct contact with what fragmentation does to bodies, to relationships, to the possibility of coherence. Not as story to be told, but as orientation. An ability to recognize when connection thins, when systems lose their organizing center, because it was first known from within.

That orientation shaped a path across fields usually held apart. Community development, nursing, journalism and public health. Each field encountered the same underlying condition from a different position. Under pressure, what allows connection to hold? What enables voice, coordination, and action to remain intact rather than fragment?

Nursing brought direct contact with vulnerability and the demands it places on presence and holistic care. Journalism revealed how voice is shaped, amplified, or constrained. Community work showed what belonging requires to sustain itself collectively. Public health made visible what happens at scale when these conditions are absent.

Across all of them, the pattern remained consistent. The limiting factor was not primarily technical. It was relational.

Islands of Coherence emerges at this point of convergence. Not as a synthesis of disciplines, but as recognition that they were tracing the same terrain.

I have always known myself as the hand on the back. Just behind the heart.

I have stood at the front of rooms as the one expected to know. But knowledge, on its own, has never felt sufficient.

Across contexts, the same conditions kept determining what became possible. The quality of relationships. The presence of trust. Whether value could be seen, especially when it could not yet be named.

Offering that presence to others was not separate from learning to offer it within. This work rests on that continuity.

Islands of Coherence gathers what twenty-two years have made visible. It offers a map: not as direction, but as ground that can be found.

The beginning

My work began in community development with refugee populations in the UK. It later moved into social mobilization and programme communication within the United Nations.

Something became clear early: No technical solution takes root without the human conditions to receive it.

People are not passive recipients of intervention. They are the intervention.

The Story of Zanzibar, WHO, 2002

The turning

During the era of the Millennium Development Goals, a dissonance began to take shape. I worked across local, national, and global levels on community engagement in disease elimination programmes.

Campaigns succeeded. Targets were met. And when they ended, much of what had been built did not remain.

Health Promotion within Ministries of Health was rarely resourced for the long term. Health and community workers were positioned as conduits for delivery, rather than recognized as conditions for change.

Top-down programming and accompanying marketing and behavior change worked for time-bound outcomes. It did not sustain what could outlast funding cycles.

That gap remained. And this bothered me deeply.

The emergency years

Eight years in emergency response followed: avian influenza, dengue, Ebola, yellow fever.

Across contexts, something became unmistakable: What moves within people moves between them and shapes what systems can do.

Inner states are not separate from professional function. They are part of its mechanism.

This showed itself most starkly during emergency preparedness training with national rapid response teams across the Pacific. The teams that outperformed were not the ones with the strongest individual experts. They were the ones who communicated, trusted each other, and could form working relationships quickly under pressure.

Neuroscience and communication science offered language for what had been sensed. These were held across both directions: External programme work. Internal organizational change.

Leadership revealed itself differently here. Positional authority could open conditions for transformation, or constrain them entirely. The fish rots from the head. But it can also be healed from there, if the conditions are right.

The crystallization

During the pandemic, while supporting community engagement research in Cambodia, Lao PDR, and Malaysia, something clarified.

What had been forming across years began to cohere: An infrastructure present in all systems, yet rarely named. A relational field.

The conditions through which teams collaborate, systems function, and communities come to trust. Or withdraw.

This was not a new construct. It was a convergence: Neuroscience. Communication science. Complexity thinking. Contemplative practice. Field experience.

As internal coherence deepened, the work moved differently. What had been fragmentary began to hold.

Islands of Coherence emerges from this integration.

A scientific foundation. An open invitation.

Polyvagal Theory (PVT) is one of several frameworks that provide a biological grounding for this work.

Safety is not a feeling. It is a neurological condition. This understanding came through practice.

In outbreak responses and high-pressure program work, I saw capable teams lose coordination when pressure rose. The technical strategy remained sound, but something else was driving decision-making. When people felt safe, they could think clearly, collaborate, and adapt. When they did not, communication broke down and performance suffered. What is often described as relational dynamics is, at its root, biological and physiological.

This science did not introduce something new. It clarified what had already been visible. It helped make sense of patterns I had experienced directly — in my own responses under pressure, and in how teams functioned across contexts. Why some environments supported coherence, and others did not. Why inner states showed up in system behavior and outcomes.

These patterns pointed toward something that the existing literature had not yet fully mapped.

The evidence base for relational infrastructure in the workplace is still emerging. Relevant knowledge exists across neuroscience, communication science, organizational psychology, and complexity theory, but remains fragmented. At the same time, field observations have been accumulating across decades of practice in demanding health system contexts. Islands of Coherence is a contribution from within that accumulated experience.

The invitation to co-create this evidence remains open. To researchers. To nursing faculties. To public health institutions. To those working at the interface of relationships and system performance.

Inspired by the work of Nobel Laureate Ilya Prigogine: in a sea of chaos, small islands of coherence have the power to organize the whole.

learning from health system changemakers

During the pandemic, collaboration with artists through a World Health Organization-commissioned film opened another dimension.

Into my life came Danny Scheinmann, Sarah Sutcliffe. And with my co-convener, Megan Seneque, from the Presencing Institute, we listened to health system changemakers share their stories.

Something became visible in that process: The sciences offer understanding. The humanities offer language. The arts offer form to hold and transmit the human experience in a way that exceeds explanation.

The people whose contributions shaped this work

This work did not emerge in isolation. It took shape through sustained collaboration and integration of theory across disciplines, institutions, and contexts.

With colleagues across decades at the World Health Organization. With health workers, community health workers, Ministry staff, researchers, communities and policy makers across more than twenty countries. With scholars and practitioners whose contributions widened and deepened my understanding of the field.

Relationality is not an idea applied to this work.
It is what this work revealed— because of those who were part of it.