6-16
Too often, training programs (especially government ones) fail to advise health
workers to look critically at leadership. They simply tell health workers to “work
closely with the local authorities.”
If the local authorities are honest and try to deal fairly with everyone in the
community, all is well. But when the interests of those in power conflict with the
interests of the poor, the health worker is faced with some difficult decisions.
Unless his training prepares him for these, he may be at a loss. There is little doubt
that. . .
Corruption of local authorities, together with
the frustration of health workers required to
work with them, helps explain the lack of
effectiveness of many health projects.
But frustration can be transformed, at least partly, into a challenge—if
the health workers’ training prepares them for it. Such preparation is of key
importance in regions where corrupt leadership is common.
Learning to identify and work with leaders of the poor
You can start by having the group of health workers list the different types of
leaders in their own villages or communities. Be sure they include unofficial
‘opinion leaders’ as well as local authorities.
Encourage the students to discuss each leader, using questions like these:
• How was this leader chosen, and by whom?
• Does this leader fairly represent the interests of everyone in the community?
• If not, for whom does he play favors?
• From whom does he take orders or advice?
• What has this leader done to benefit the village? To harm it? Who benefits or
is harmed most?
• In what ways do the actions or decisions of this leader affect people’s health?
Next try to get the group thinking about:
• Which leaders should we try to work with? In what ways?
• Should we include unfair leaders in our community health projects? If so,
what might happen? If not, what might happen? If we do (or do not) include
them, what precautions should we take?
• If local leaders do not fairly represent the poor, what should we do?
◆◆ Keep quiet and stay out of trouble?
◆◆ Protest openly? (What would happen if we did?)
◆◆ Help people become more aware of The problems that exist and their own
capacity to do something about them? If so, how? (See Chapter 26.)
◆◆ What else might we do?