Learning and Working
with the Community
6CHAPTER
6-1
“In some ways, the village or community health worker has a far greater
responsibility than does the average doctor. The doctor feels a responsibility for
those sick or injured persons who come to him—those whom he sees as ‘patients’.
But the community health worker is responsible to the entire village or community
where he lives and works. His concern is for the health and well-being of all the
people. He does not wait for those in greatest need to come to him. He finds out
who they are and goes to them.”
How nice all this sounds! But in reality, many community health workers do
little more than attend the sick who come to their health posts. They might as
well be doctors!
If health workers are to develop a sense of responsibility to the whole community,
they need these two things (at least) during their training.
• Good role models: Student health workers need the example of instructors
who are themselves active members of the community. This does not simply
mean instructors who make ‘house calls’. It means instructors who are doing
something to improve health in their village and who relate to the poor as
their equals and friends.
• Practice doing community work: Health workers-in-training also need
practice working with people in a village or neighborhood similar to their own.
It is not enough to study in the classroom about ‘community participation’.
Theory is often far different from reality. If health workers are to work
effectively with groups of villagers, mothers, and children, their training needs
to provide first-hand community experience.
Community practice means more than discussions, flannel-boards, posters, and
role plays (although all these can be useful if used imaginatively). It means finding
ways for health workers-in-training to actually visit communities and carry out
specific health-related activities with the people.
For many health programs, this will involve re-examining the course content,
revising plans, and perhaps choosing different instructors.
Learning in and from the community
is essential preparation fro community work.