Ideas for action

.:.· 28 sfor action Learning about your community Women's groups, scouts, health volunteers, local organizations and health teams, should know their community if they are to be effective in improving its health. You may already know many things about your community, especially if it is a small one. But do you know enough about it? You will learn more by talking in a systematic way with its leaders and other people. Do not ask too many questions though; it is better to observe, listen and learn! Here are some of the things you should find out. • How many people are there in the community, and how many of them are young, middle-aged, and old? • How do people get food? How do they earn money? Are they farm workers, fishermen, cattle-farmers, estate workers, factory workers? How do they spend their free time? Do they work at night? • Do children work? How many of the children attend school? • Is the community poor? Is it becoming poorer or less poor? Is its standard of living higher or lower than the average for the country? Are there good markets, good roads? Is there a clean water supply? Is there electricity, a telephone service, a bus service? • How do families live? What are the houses like? Do they have a system of >anitation? Are the houses clean and free of pests? • Who makes decisions within the family? How many children are there in the average family? How are the children fed and how are they taught? What are the most common beliefs, values and traditions? • What are the main health problems and what are their causes? Some causes of bad health are: -too many people living close World Health • May June 1992 together; - not enough water or the water is not safe; - not enough food of the right kind; - unclean houses in dirty surroundings; -no way to keep cool in the heat or to keep warm in the cold; - no latrines or the latrines are dirty; - no protection against insects that carry diseases; -the health centre is difficult to reach; - people cannot read and thus do not learn about health and healthy habits. Talk to various groups and people: families or households (both rich and poor), those who make decisions for the community about the community and members of special groups. Try to find out: - what part of their income do they spend on health? -what community problems are World Health • Moy-June 1992 they especially concerned about? - what have they been doing about these problems? - what do they think can be done? - who are the leaders, or those who make the decisions for the community? They may be tribal leaders, religious leaders or political leaders. They are the ones who are most likely to help in improving health. Other people whose opinions and support are valued may include the elders, landowners, money-lenders or businessmen. Find out how the community is organized and who runs its affairs. For example: - Which group makes decisions for all the people? Is it a development committee, a political body, or some other group? -Does this group deal with all the affairs of the community? Or does it have subcommittees that look after different needs of the community, such as health, water supply and education? Draw a map of the area ... Assessing the needs of your community. 29 -Is there a health committee? Who are its members and how are they chosen? What are their tasks? How often do they meet? Are all sections or groups in the community represented? -What other groups are there? For example, a women's group or a farmers' cooperative. If you are a schoolteacher, why not ask your students to do a community survey based on questions like these? Then you could call a meeting of parents and ask the students to present their findings. Maybe a movement to improve health could be started? Drawing a map of your area A map is a useful tool to study the health and sanitary situation in a community. If there is not already a good map of your area, ask other people (for example, the schoolteacher and schoolchildren) to help you to draw one. This map will show the rivers, schools, health centres, temples, roads, shops and other important places. Take the map to the community committee and place it where the people can see it. As new information comes in, mark it on the map. For example, show the wells or houses that are not in good condition. Keep the map up- to-date. It will make it easier to detect some of the health problems, and also to show by how much community health improves from year to year. • The above is adapted from On being in charge - A guide to management in primary health care, WHO, Geneva, 1992, price Sw. fr. 30 (developing countries Sw.fr. 2 1 ), and The community health worker, WHO, Geneva, 1987, price Sw.fr 22 (developing countries Sw.fr. 15 4 0)