Overview
Connie Gates and Shobha Arole of Jamkhed Comprehensive Rural Health Project (Maharastra, India) will shortly take over convening this topic.
The following was written by Ted Lankester:
The ultimate aim of community based programmes is to hand over management of health and development activities to the community. Active participation of the community in all projects is the means of bringing this about.
Unless projects include the community in a genuine partnership, health patterns don’t change and projects don’t last. Participation protects people against exploitation, creating self-dependence and enabling communities to identify problems and devise solutions.
Partnership should be the basis of all project activities. Project members need to learn skills as facilitators so as to encourage ideas. Gifts present in the community should be used as widely as possible. One or two starter-subjects should be chosen as a means of teaching the idea of participation to the community.
For participation to succeed health team members must have clear aims and correct attitudes, making sure they give the community good quality training and preparation. Creating enthusiasm and showing trust are keys to bringing this about.
The process can be greatly helped by the setting up of health committees, women’s clubs or similar community organisations.
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Excerpt from setting up community Health programmes by Ted Lankester
We cannot just walk into a community and start asking questions. We will need time to build trust and friendships before rushing in with questions and programmes. Quite apart from friendship for its own sake we can never act as agents of change unless the community learns to trust both us and our motives. Poor people, after years of being cheated, are wary of outsiders bearing clever-sounding promises.
If we are making our first visits to a community the people will be asking themselves:
• ‘Who are these people anyway?’ Are they locals we haven’t met before, outsiders, foreigners, government workers, family planning of?cers, spies?
• ‘Why have they come?’ Just to do the job they claim, make money out of us, report on us, or because they can’t get a better job elsewhere?
• ‘What can we get from them?’ Free handouts, money, a hospital, a resident doctor, tonics for our children, cigarettes, foreign goods, guns?
It is only by mixing with people that they will learn to trust us and we will learn to appreciate them.
We will learn from the community some of the secrets of living, relating, celebrating or enduring hardship which ‘health providers’ have often forgotten. As we do this our own lives will be enriched, and the people will realise that we come as partners and fellow human beings, not just more outsiders saying their ideas are better.
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