I just got back from a class on Community Outreach in the developing world, and I want to provide you all with a brief overview of what we covered, in the context of Pure Water Access Project.
The two rural communities we visited in March, El Bejuco and Malacatoya Dos, are great examples of what a typical "community" in a rural setting in the third world look like. Typically, a "community" consists of approximately 500 people or less, and this was the case in our two communities. Throughout the world, not just Central America, there are villages and communities of similar sizes, with the majority of them being separated from the nearest cities by large distances, with poor (if any) means of transportation between them. This poses a major problem for health care, as you might imagine. If there is a medical emergency, or an accident of some kind, it is often impossible for the patients to access the necessary health care in a timely fashion. Furthermore, even if there is a doctor somewhere nearby, the ratio of citizens to doctors can be as great as 1:100,000 in some countries, such as Malawi. The difficult logistics of travel and the shortage of trained health care providers creates a great need for "primary care" in the rural settings.
El Bejuco was a phenomenal example of how to establish a primary health care model in a rural community. AMOS Health and Hope, our non-profit partner in Nicaragua, has close ties to the community. Over time, they have established a hierarchy of health care service in the community by recruiting members to be part of a "Health Committee." In El Bejuco, there are about 100 households. From these households, 10-15 individuals were recruited and volunteered their time to be part of this Health Committee. One individual was designated to be the Health Promoter for the community. In El Bejuco, this role was carried out by Marlena. Marlena had no medical training, but she had been educated by AMOS on how to provide basic health services such as first aid, suturing, and even some antibiotic distribution. AMOS designated a small building in El Bejuco to serve as the clinic, and they provided Marlena with an easy-to-use guide on how to assess and treat a variety of health issues. Unfortunately, for a large majority of health issues the treatment was essentially "refer to the hospital in Managua (the capital of Nicaragua)". But still, the fact that a person with no formal medical education could play a vital role in improving the health of her community is a powerful testament to individual capability.
The generic term for workers such as Marlena is "Health Worker," and as global health continues to shift its emphasis towards public health infrastructure and preventing easily-preventable illnesses, the role of such health workers is imperative. By effectively organizing and training community members to take charge and address health concerns, you bypass the need for physicians in these settings and empower the community. Individuals are much more likely to respond and adhere to advice from a family member or neighbor, rather than an "outsider" such as someone like us from PWAP.
To create sustainable models of intervention we must continue to emphasize the need of these Health Workers from the community. Ultimately, the goal of Pure Water Access Project is to identify the barriers to sustainable interventions, and this is a key element of that.
I hope this gave you some insight into the methodology that we use, the same methodology that is recommended by the World Health Organization. We must continue to improve our understanding of these communities' culture and lifestyle in order to ensure that interventions are not wasted, and that the good intentions of NGO's actually translates into tangible health benefits.
As always, never hesitate to reach out to us on Facebook or Twitter if you have any questions, or would like more information on International Health and PWAP's approach to solving these problems.
Have a great week!
Director of Organizational Development