The Power of Narrative and Local Tradition in International Health Development: Reducing the Incidence of Malaria among Three Villages in SE Asia

International development is at the center of efforts to reduce poverty worldwide. Most development projects are based on the idea that economic growth results in poverty reduction. Economic growth, a laudable goal, cannot alone serve as the most important marker for sustainable development, as noted by the lack of progress in reaching the Millennium Development Goals in 2015. We argue the case for more culturally and socially centered purposes to inform the development act. There needs to be a broader research and development base for the developer as we increasingly recognize the tyranny of poverty plaguing millions. The traditional development format relies on an epistemological framework for determining needs and for measuring success. As anthropologists, we introduce an ontological and interpretive framework, grounded in critical hermeneutics, exemplified by a health project carried out among three Ahka farming villages in SE Asia, the goal of which was to reduce the incidence of malaria, which prevented the locals from working in their fields. Cultural difference come into play when we enter the development act as do people’s narratives, imagination, ceremonies, and understanding. The over use of the economic paradigm centered on sets of technical principles does not reach into the heart of on-the-ground projects where the recipient population together understands, imagines, and celebrates new ideas and actions. Moving successfully within different cultures requires a certain degree of complexity and dynamism that allows us to escape overly simple ordering principles and algorithms, and yet affords the developer to carry out research and practice with a focus. Sustainability, marked by living with dignity and purpose, includes actions that make sense to the local population, rather than only to the developers.