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Marcel was fortunate. He and his fellow health workers succeeded in overcoming
obstacles that might have prevented a fair selection process. The people at the
village meeting were able to elect a committee that would fairly represent the poor.
In many communities, however, the persons with power will not be willing to
remain silent during meetings. And even if they are, the poor may be afraid to speak
in public. In places where truly democratic selection was not likely to work, other
ways of forming a committee have been tried. Here are two examples.
In Pueblo Viejo, Mexico, the health
committee is made up of the village health
worker’s good friends, relatives, and
compadres (those who are godparents of each
other’s children). These people have a genuine
personal concern in seeing that the health
worker keeps doing a good job. (However,
several problems have resulted. One is that the
health worker’s friends and relatives expect free
medicines and services, which means there is
never enough money to replace supplies.)
In Nigeria, one program has divided the
tasks usually done by a health committee
among other village organizations. The
local women’s league is in charge of health
activities that affect mothers and children. The
older children are responsible for organizing
sanitation projects. The religious societies help
with supplies, planning, and supervision.
It is not enough simply
to hope that a health
committee will function
effectively. Both the
health worker and the
program leaders need
to give the committee
encouragement, advice,
and organizational help.
But it is important that
they provide support
without taking charge!
This requires skill,
understanding, and
patience.
Role playing
about how to
work with a
health committee
should be part
of the health
worker’s training.
SUGGESTIONS FOR AN EFFECTIVE HEALTH COMMITTEE
• Select an active, just committee in a way that is acceptable to the community,
yet with strong representation from the poor.
• Meet regularly.
• Talk to each member personally before each meeting to be sure they come.
• Include some kind of fun or excitement in the meetings (perhaps short videos
or role plays related to an activity the committee is planning).
• Plan activities with specific objectives. Plan enough details so that everyone
knows what he or she is expected to do, and when. Post a written plan of
action listing the responsibilities, people, and dates the group has agreed upon.
• Have someone check to see that each person completes what is planned or
gets the help he needs.
• Plan enough activities to keep everyone interested and active—but not so
many that the committee will not have time to carry them out
• Replace inactive members quickly.