6-11
COMMUNITY DYNAMICS AND PARTICIPATION
To do their work effectively, health workers need to be aware of many aspects
of community life: people’s customs, beliefs, health problems, and special abilities.
But above all, they need to understand the community power structure: the
ways in which different persons relate to, help, and harm each other. In the rest of
this chapter we explore these aspects of community dynamics and what is meant
by community participation. As we shall see, ‘community’ and ‘participation’
mean dangerously different things to different persons. In fact, the way we look at
‘community’ can strongly affect our approach to ‘participation’.
It is essential that instructors and health workers together analyze the
conflicting ideas, and draw conclusions based on their own experience.
What is a community?
Many health planners think of a
community as “a group of people living in a certain area (such as a village)
who have common interests and live in a similar way.” In this view, emphasis is
placed on what people have in common. Relationships between members of a
community are seen as basically agreeable, or harmonious.
But in real life, persons living in the
same village or neighborhood do
not always share the same interests
or get along well with one another.
Some may lend money or grain on unfair terms. Others may have to borrow or
beg. Some children may go to school. Other children may have to work or stay
home to watch their younger sisters and brothers while their mothers work.
Some persons may eat too much. Others may go hungry. Some may speak loudly
in village meetings. Others may fear to open their mouths. Some give orders.
Others follow orders. Some have power, influence, and self-confidence. Others
have little or none.
In a community, even those who are poorest and have the least power are
often divided among themselves. Some defend the interests of those in power,
in exchange for favors. Others survive by cheating and stealing. Some quietly accept
their fate. And some join with others to defend their rights when they are threatened.
Some families fight, feud, or refuse to speak to each other—sometimes for years.
Others help each other, work together, and share in times of need. Many families do
all these things at once.
Most communities are not homogeneous (everybody the
same). Often a community is a small, local reflection of the
larger society or country in which it exists. It will have similar
differences between the weak and the strong, similar patterns of
justice and injustice, similar problems and power struggles. The
idea that people will work well together simply because they live
together is a myth!
Elements of harmony and shared interest exist in all communities, but so do
elements of conflict. Both have a big effect on people’s health and well-being. Both
must be faced by the health worker who wishes to help the weak grow stronger.