The residents of Tarboro, North Carolina, came together to map their toughest problems. Along the way, they realized their unique power to solve them.
October 1, 2019
In the Eastern North Carolina town of Tarboro, on a hot but not too-hot Tuesday in July, about 50 people packed into a conference room on the campus of Edgecombe Community College. They represented the diversity of this town of 11,000 in every way: educators, health care professionals, community activists, students, faith leaders, a sheriff’s detective, the owner of the local brewery. And there were Seth and Vichi.
Seth Saeugling (E.N.C. ’12) and Vichi Jagannathan (E.N.C. ’11) are the founders of the Tarboro-based Rural Opportunity Institute. Their quarterly community meeting is the reason 50 people put off other responsibilities for three hours in the middle of a workweek. But to their ongoing consternation, no one in Tarboro actually calls Rural Opportunity Institute by its name. They don’t even use its less cumbersome acronym, ROI. They just call it “Seth and Vichi’s work.”
“Communication is our Achilles’ heel,” Vichi says. If she could explain ROI’s work, the first thing she’d say is that it’s not at all about Seth and Vichi. In fact, that’s the whole point. Rural Opportunity Institute, a lab for social innovations, exists to support the Tarboro community and the Edgecombe County community more broadly, first in figuring out the root causes of inequity in the area and then in finding the right tools to root them out.
The remarkable thing is that it’s working in ways even Seth and Vichi have trouble grasping. Over two years and thousands of hours of precision-tuned work, the community has determined that unaddressed trauma, specifically trauma caused by adverse childhood experiences, has enabled generational cycles of poverty and pain in Tarboro. In response, Seth and Vichi are working with community members to launch solutions that are spreading through the town like wildfire, reaching into systems from schools to law enforcement to individual families, and transforming them.
Adverse childhood experiences, or ACEs, are defined broadly as traumatic things that happen to kids or that kids witness at home: physical or sexual abuse, addiction, mental illness, hunger, insecure housing. Having an incarcerated parent is considered an ACE. So is experiencing frequent discrimination or being the child of a divorce.
ACEs are incredibly common: In one of the largest and most cited studies, 67% of adults had at least one ACE, and 13% had four or more. Numerous studies have shown that among people who identify as Black or Latinx, the prevalence of ACEs is significantly higher. Regardless of race or economic background, the higher a person’s “ACE score,” the greater the link with negative life outcomes like heart disease, diabetes, mental illness, unwanted pregnancies, depression, cancer, addiction, and more.
Dr. Nadine Burke Harris is the surgeon general of California and the author of The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. In her TED Talk, she cites a past president of the American Academy of Pediatrics in calling ACEs “the single greatest unaddressed public health threat facing our nation today.”
The First Try
When Seth and Vichi started ROI in 2017, there was no way to predict that ACEs would emerge as the fulcrum of their work in Tarboro. Being completely open to possible outcomes is a hallmark of the approach they took, called human-centered design. It is built on the idea that people who experience a challenge are best suited to solve it. Developed in Silicon Valley in the late 1980s, human-centered design gave us the computer mouse, the touchscreen, and most of your favorite apps.
More recently, human-centered design has been adapted to solve problems that have nothing to do with technology. For example, school districts often use variations of the approach to redesign schools, engaging students, parents, and teachers as the “expert users” who know what’s needed for an optimal learning environment. Social entrepreneurs use it to design ways to alleviate poverty. At its most basic, the approach works like this—Step 1: Have a lot of conversations and focus groups with relevant users to determine the core problem. Step 2: Brainstorm possible solutions. Step 3: Choose a solution and run with it, leaving plenty of room to iterate and change course if outcomes are not as hoped.
Seth was trained in human-centered design while working in Oakland, California, where he moved in 2014 to be with his girlfriend after teaching high school special education in Eastern North Carolina. Vichi, who had earned a master’s degree in electrical engineering at Stanford University prior to teaching high school science as a corps member, found her way back to the Bay Area to work for Microsoft around the same time.
Seth and Vichi hadn’t been close friends as corps members–they taught in towns separated by about 35 miles of soybean and tobacco fields. But in the Bay Area, they connected over a shared interest in innovation. “We were blown away by the resources, the energy, the networks of people solving problems,” Seth says. “We were hungry.”
Through work, Seth used human-centered design to create a community doula pilot program. Outside of their day jobs, Seth and Vichi developed a kit to be used by parents of small children to promote healthy brain development. All around them, money poured into solutions big and small; friends’ whimsical online widgets would net millions of dollars. But almost all of the innovations were “touch-point solutions,” Seth says. They weren’t necessarily bad, but none of them came close to addressing the systemic problems Seth and Vichi saw their students battle every day as corps members in Eastern North Carolina.
Ultimately, living in the Bay Area created a dissonance, Vichi says. She and Seth were faced with a choice: “You can either choose to be part of the dissonance and say, ‘I’m going to join you guys and ignore this other stuff I know,’ or you can say, ‘There’s only one answer to this and it’s to go back and learn more.’”
“Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”
Vichi moved on to Yale University’s business school in the fall of 2015. While there, she and a friend from the corps, Liz Chen (E.N.C. ’10), won a competition giving them $80,000 to design and build a sex ed app called Real Talk, furthering an idea the two had started as teachers. It was one more touch-point solution, Vichi says, but it came with the opportunity to learn human-centered design from IDEO, seen internationally as the leading purveyor of the approach.
By Vichi’s second year at Yale, she and Seth were making frequent visits to Tarboro while pursuing funding to start Rural Opportunity Institute. Both moved there permanently in June 2017, following Vichi’s graduation, eager to see where the design process would lead. Silicon Valley didn’t have the answers, but they believed the people of Tarboro did.
For the better part of 2017, Seth and Vichi conducted interviews, formal and informal, aiming to get at what problems in Tarboro most needed to be solved. Erin Swanson (E.N.C. ’02), the director of innovation for Edgecombe County Public Schools, facilitated ROI’s first community meeting, introducing their work to leaders from the school system, like Lauren Lampron (E.N.C. ’10), the principal of Tarboro’s W.A. Pattillo Middle School, and community leaders like the head of the county’s health department, a well-known pastor, and a county commissioner.
By September 2017, Seth and Vichi had completed dozens of interviews and held many more meetings. At almost every turn, people turned their energy toward tackling the challenges posed by ACEs and unaddressed trauma. Theoretically, Seth says, community members could have named joblessness or housing as their priorities, or something else. But Seth and Vichi were blown away by how quickly participants coalesced around the same critical problem to solve. “That was really powerful,” he says, “people naming trauma almost without being asked.”
Refining The Approach
In a traditional human-centered design process, the next step would have been to brainstorm as many solutions as possible to address ACEs. But that didn’t feel like it would work, Vichi says. She and Seth went over all of their notes and feared they’d simply come up with more solutions that didn’t address root causes. “We literally felt like were going to brainstorm a doula program and Real Talk again,” Vichi says. “And we said to each other, ‘We didn’t do all this to do that.’”
Instead they searched and found an online course for an approach called systems mapping. Systems mapping has its roots in engineering—a point in its favor for Vichi, the trained engineer. Think of an electrical grid—some mess of wires and nodes that sends electricity to, say, a lightbulb. Imagine that one of those wires breaks, or it connects to the wrong node. The lightbulb won’t light up, or it’ll be dimmer than it should be.
In life, systems mapping is a way to analyze how behaviors and beliefs are connected and reinforced like wires and nodes on a grid.
Mapping systems across a whole town requires community members to devote hours of their time to sharing their experiences, ideas, and values in ways that can feel challenging and vulnerable. When Seth and Vichi started asking about where ACEs showed up in Tarboro, they were, by extension, asking individuals to talk about the traumas in their own lives.
But at the end of the process, you get a map: a visual representation of a community’s beliefs, systems, and behaviors. The map makes it obvious where the broken places are causing the community—the lightbulb—not to shine as brightly as it could. It also reveals a community’s assets and the places where a couple of tweaks could ripple in positive ways throughout the grid.
“You can either choose to be part of the dissonance and say, ‘I’m going to join you guys and ignore this other stuff I know,’ or you can say, ‘There’s only one answer to this and it’s to go back and learn more.’”
Engaging Inquiry, a Washington, D.C.-based organization that helps groups map systems around the world, agreed to help Seth and Vichi lead the process in Tarboro. The map that emerged, created with the input of more than 300 community members over months of meetings and working groups, looks something like a multicolored, misshapen peony, or it could be a map of flight patterns.
The easiest way to understand the map is not to look at it but to interact with it. Start at any one point—say, “mental/physical health problems.” That point connects to four other points by arrows, including “strain on existing systems/orgs.” With the help of tiny plus and minus signs along the arrows, you can read the connection between those two points like this: “The more that mental and physical health problems exist in Tarboro, the greater the strain on its existing systems.” Then, keep following the arrows to another point: “The greater the strain on Tarboro’s existing systems, the less community capacity is available to offer support and solve problems.” Keep going: “The less community capacity is available, the less there exists information and resources for treating trauma.” And on and on.
The arrows and points form interconnecting loops. The loops unlock stories. No blame is attached to any one system, and no solutions are suggested. The map simply shows people who they say that they are, and in doing so, it reveals opportunities for change.
During one of Seth and Vichi’s first presentations of the finalized map, a woman raised her hand. She said, “I’m watching my grandson’s face go through this map,” Seth recalls. She explained that one of the hundreds of possible loops tracked almost perfectly with her grandson’s difficulties in the school system. Soon others were doing the same. “You could trace any loop on the map and tell somebody’s story,” Seth says. “It was people saying, ‘Wow, I see my voice showing up here.’ And it was people who didn’t take part in the process of creating the map, seeing it upon completion and saying, ‘Holy cow, this is my experience.’”
“That was a turning point,” Seth says. “We were overwhelmed by the connectedness of oppression.”
After finalizing the systems map, Seth and Vichi convened a group of community members to figure out how to respond to the findings. If ACEs and unaddressed trauma were the problem, and they were showing up in all of these ways on the map, what were the solutions? The group developed a three-pronged approach that includes spreading knowledge of trauma and its impacts; promoting healing from trauma through learning and sharing new practices; and connecting people throughout the community to opportunities to grow as leaders in the work.
The group then approached several organizations that offer trainings in trauma-informed care and landed on Asheville, North Carolina-based Resources for Resilience. In October 2018, Resources for Resilience offered their first training session in Tarboro—two full days, open to anyone, of what felt like a cross between professional development and group therapy.
Plenty of organizations across the country have a vision to address trauma, but it’s harder to find those that have succeeded, Seth says. He and Vichi hoped the trainings would be a start.
The Community Advocate
Felicia Cofield attended the first training. Cofield has spent her entire life in Edgecombe County. She works two jobs—one selling skin creams to help manage chronic pain and one recruiting people to a law firm “membership” program, offering lower-cost legal services should members ever need them. She’s also active in her church and neighborhood, a reliable vessel for friends’ stories and troubles.
Much of her neighbors’ traumas stem from the region’s experience with flooding. In 1999, Hurricane Floyd put much of Edgecombe County underwater, particularly low-lying areas where housing is most affordable. Cofield’s son was 6 months old at the time. She recalls evacuating her home, carrying her son close as waters rose as if filling a tub. She and her son made it to her car, but it stalled as the waters climbed higher. Cars passed by on the road, already packed with people. Cofield, holding her baby and unable to swim, wasn’t sure they’d survive. Finally, a car carried them to higher land. The flood filled her house, destroying it. The memory still haunts her.
In October 2016, Hurricane Matthew brought more devastating floods. Cofield’s house escaped the worst of the damage; only her roof and her HVAC system needed repair. But others saw everything they owned swallowed up all over again. Cofield started helping friends and neighbors apply for relief funding. Nearly three years later, she’s still at it. Hundreds of neighbors are still in temporary housing, awaiting payouts from the state’s backlogged distribution system.
Cofield attended the Resources for Resilience training on a hunch that it would help her to help her friends and neighbors. And she was right, she says. “But in the meantime, it was helping me to overcome my stress and trauma at the same time. It’s helping me to deal with me—to make sense of things that have happened,” she says.
She attended one session with a pounding headache, unable to focus. But when the facilitator led a breathing and relaxation exercise, she gave it a try. “When I finished it, that headache was gone. That amazed me,” she says.
After going through the training, Cofield says she’s more calm—less likely to let anger drive her reactions and more likely to step back and focus on how she has made it through frustration before. She has invited many people to attend upcoming trainings, including her mother and members of her church.
Pastor Kelly Andrews grew up on a tenant farm in Edgecombe County before joining the military and serving three years in Iraq during the Gulf War. He came home and taught high school history before entering the ministry full time at Tarboro’s Eastern Star Missionary Baptist Church.
Andrews heard about ROI’s work in 2017 when a friend invited him to attend an early community meeting. He had his doubts. Countless outside groups with good intentions had tried to help Edgecombe County in his lifetime, but hardly any followed through, he says. He assumed Seth and Vichi would be the same.
But when he met them, he felt his cynicism recede. “They didn’t come in saying, ‘This is what you need to do.’ But they provided the space and the climate for ideas organically to happen,” he says.
As a pastor and teacher, Andrews was accustomed to meeting the needs of others, sometimes at the expense of his own. But the Resources for Resilience trainings provided a “personal revelation,” he says. They allowed him to explore the challenges he experiences as a pastor as well as some of the dysfunction he faced throughout his childhood. “Being able to understand that, and articulate it, has been very empowering,” he says. “And that’s not something I can keep to myself. Part of my mission and purpose is to help others heal as well.”
The more you talk to people who have taken part in ROI’s work, the more Andrews’s and Cofield’s experiences begin to feel like the norm. Talk to enough people and you get the sense that the whole town is going through an awakening.
When Byron Hall, 41, looked at a list of 11 ACEs, he counted 10 from his own life, including divorced parents, physical and sexual abuse, neglect, and incarceration. “My whole life, I thought I was a plague,” he says. He connected to ROI through his part-time work as a mentor to teen fathers in Tarboro.
Learning about ACEs was like finally receiving the right diagnosis. It explained Hall’s anxiety, his anger, his struggles to control his temper. And being in a community of people who were all exploring childhood trauma gave him the courage to talk about his own, and gave him the tools to change. “I had to time travel and dig into all this stuff that happened to me that made me a hard, rough person. I always thought feelings made you soft. But for my own children, I have to be softer,” he says. “They’re not going to grow up the way I grew up.”
In August, Hall led the second meeting of ROI’s community board. The board, which includes Cofield, came together in June as a next phase of ROI’s work—an effort to provide leadership opportunities to community members and ensure the work is aligned with their needs. Hall led board members through discussions of whom to recruit for upcoming Resources for Resilience trainings (about 180 people had attended already) and whom to recruit to expand the board. They talked about the need to find mentors for the board members, too. Hall said he wanted a mentor who could teach him professional habits—stuff he missed by not having a model. And he wanted to learn how to write grants so he can continue his teen mentoring full time without the constant threat of funding running out.
“I tell people I feel like a broke Batman,” Hall says. “I walk around with the knowledge of ACEs on my utility belt.” Operating with an understanding of trauma “equals the playing field,” he says. “By doing work on my own issues, I’m giving the people who I know the strength to work on their own.”
By late 2018, the Resources for Resilience trainings had become a well-known piece of ROI’s work, but they weren’t the only effort. Since March of that year, Seth and Vichi had been working with a professor at East Carolina University and Pattillo principal Lauren Lampron to design a biofeedback pilot program focused on helping students to identify stress and respond to it in a healthy way.
Biofeedback tools use a person’s biological responses, like heartrate, to detect stress and other feelings. Once identified, simple tools like breathing exercises can bring the heartrate back to a calmer zone. It’s not new—elite athletes and high-level executives have been benefiting from biofeedback tools for years. But it hadn’t been tried in Tarboro.
Starting in April 2019, six Pattillo students, all of whom had struggled with behavior and attendance, started and closed each school day in a designated homeroom where they checked their heart rates through a small earpiece hooked up to a computer. They talked as a group with their homeroom teacher about how they were feeling and if their breathing exercises were helping. As the pilot went on, the students sometimes asked to use the equipment midday when they felt anxious or needed to de-escalate a tense situation.
The sample size is too small to draw broad conclusions, but among the students who participated, attendance improved and behavioral incidents decreased. Overall anxiety levels decreased by 57%, according to an East Carolina University analysis. Lampron is expanding the pilot to more students this school year.
Sheriff’s detective Matt Johnson grew up in Edgecombe County and graduated from Tarboro High, where he starred on two state championship football teams. Off the field, his grandfather was his rock. Johnson lived with him, along with his grandmother, mom, cousins, and aunt. For most of Johnson’s life, his aunt struggled with a fierce heroin addiction that nearly sucked the family dry, both financially and emotionally. “It formed a lot of biases and beliefs I was unaware I had,” he says. His grandfather died in a car accident while rushing Johnson’s aunt to the hospital for treatment.
In 2015, Johnson joined the Edgecombe County Sheriff’s Office with the goal of locking up the users and the pushers who perpetuated the county’s drug crisis. But the more he understood the challenges of addiction, the less effective it seemed to toss addicts in jail. In June, he went through a weeklong training to become a certified recovery coach. “I know it sounds counterproductive for a law enforcement officer, but incarceration is not a fix,” he says.
In November 2018, Johnson attended an ROI community meeting where he heard a presentation about the biofeedback pilot at Pattillo Middle School. The sheriff’s detective thought, “Why couldn’t we use this at the jail? What group of people better fits the description of unaddressed trauma leading to destructive behaviors?”
“It’s understanding that nobody wakes up and decides they want to be a heroin addict, but some chain of events or some traumatic moment has led to that point.”
Johnson went to his boss, newly elected Sheriff Clee Atkinson, and made his case: Could they try for a jail where inmates turn to healing behaviors instead of destructive ones? If biofeedback could help inmates manage their stress, that would improve their lives during incarceration and afterward, as well as make life easier for the jail staff.
Atkinson, who was named North Carolina’s Sheriff of the Year in 2018, signed on. Seth and Vichi helped Johnson secure funding through a University of North Carolina program pairing public health graduate school students with outside partners to complete the students’ capstone projects. The students researched and recommended the company HeartMath, which provided their devices at discount; HeartMath had never heard of a county jail using biofeedback.
“We’re shifting from a punitive approach, which has proven since the Dark Ages not to work, to a reformative approach,” Johnson says. “It’s understanding that nobody wakes up and decides they want to be a heroin addict, but some chain of events or some traumatic moment has led to that point.”
Seth and Vichi take a rigidly agnostic approach to tools like the Resources for Resilience trainings and biofeedback. Their intent is to be accountable to what the community determines it needs, not to become the salespeople for any one solution.
Vichi says she was surprised that Pattillo’s biofeedback pilot produced such positive results. “If we trusted the people in Silicon Valley to have understood [Eastern North Carolina] and built something perfect for them, that’d be one thing. But I fundamentally believe that they made it for NASA and football players,” she says. “But I’ll do what the data says.”
In late July, Vichi met Edgecombe County Manager Eric Evans in his fourth floor office in the county building in downtown Tarboro. Seth had presented ROI’s work at a meeting of local government officials for Eastern North Carolina counties, and Evans’s interest was piqued. Prior to Vichi’s arrival, Evans and the county’s assistant manager had already looked into the promise of the work, particularly the biofeedback tools. Their public-facing employees, like the people who staff the notoriously stressful Department of Motor Vehicles, might benefit from an opportunity to de-stress during the day. And it might improve their attendance and health outcomes on the job, Evans said.
Vichi also asked Evans if he might host a Resources for Resilience training session for county employees. Evans made a note to check for dates.
Over a mid-July breakfast at Tarboro’s Country Sunrise Grill, Pattillo principal Lauren Lampron said that part of the power of Seth and Vichi’s work is how quickly it spreads. When she started as a principal in 2014, she subscribed to accepted beliefs that strict discipline would create space for a culture of learning. But she soon saw that it created deep inequities in her school, particularly along lines of race. When Seth and Vichi started to bring the community together to discuss what issues most needed to be addressed, Lampron felt part of “a collective of people who’d given themselves permission” to understand ACEs and unaddressed trauma, and how to heal.
“When the sheriff is championing the fact that we should do something different, and a nurse, and a religious leader, and other people, now I have the permission to do this, too,” Lampron says. “It’s given me courage.”
Prior to the start of this school year, Lampron shuffled her budget so she could afford to hire a full-time staff member devoted to restorative justice, a nonpunitive approach to managing student behavior and helping students heal and grow. She also invited Resources for Resilience to run a two-day training for all her staff members, making Pattillo the first school in the district where every staff member is informed about trauma, its impacts, and how to address its symptoms. Two more days of professional development were led by an expert on restorative justice.
Sitting at a small sunlit table at a Tarboro bakery, Vichi seemed genuinely surprised by the idea that the work she and Seth started had taken on a life of its own. After two years, countless meetings and conversations, three iterations of a systems map, and probably a million sticky-notes stuck to poster paper, community members saw their lives reflected and were taking action. People who had never thought they had power felt activated to create change. People who had long held power felt supported to use it to address trauma in new ways.
“It’s the outcome we would want to see,” Vichi says. “It feels like part of a systemic shift—being able to shift from punitive responses to responses that are more healing, just as a result of being in a place with shared knowledge and common language.”
It felt to her like a validation; People in Tarboro had the answers. “They just needed the support and capacity and space to be able to find them.”