Community Involvement Some Lessons from Southern India

1. Community InvolvementSome Lessons from Southern India • Hari and Prem John • Deenabandu & • People’s Health Movement • India

2. Community involvement in health or development is not value neutral. It is not a mere methodology to implement a project. It is an intensely political involvement where one identifies victims and oppressors, takes sides, goes behind the barricades with the people against ruling structures that oppress them. Community Health

3. “Health is politics on a social scale - Halfdan Mahler • “The Sole purpose of life is to serve humanity” - Leo Tolstoy

4. “and those who were seen dancing were thought to be insane by those who could not hear the music" (Nietzche) • The medical professionals look down upon other medical professionals working at the community level. Call them quacks.

5. The Analysis • The very basis of community involvement in health lies in socio-political analysis • a Class Analysisand Approach (Marx). • Clearly defined class enemies, therefore entirely pro-poor

6. The Blocks • Ignorance • Class, Caste, Ethnicity, Gender, Religion • Cultural factors such as dress, food habits • Preconceived notions • Rigidity • Arrogance • Haste/Impatience • Long history of insensitivity/oppression

7. Therefore, the Need • Humility • Open mind • Ability to transcend class, caste, education factors • Willingness to deschool • Willingness to learn • Ability to go beyond the boundaries • Capacity in integrate into the community

8. That would lead to • Participation as an internalised value • Participation as a methodology • Where the community participates from the stage of conception to data collection, to collation, analysis, planning, implementation, monitoring, evaluation, course correction

9. Community Organisation • Communities divided along any lines (caste, class, ethnicity, religion) cannot work together • Therefore, the necessity for ‘organising’ the community, to build unity (Ivan Illich) • The biggest investment is in terms of time – to bring the community under the same tree for discussions and agreement on joint action

10. Methods Used • Participatory Strategic Planning (PSP) • Participatory Action Research (PAR) • Participatory Vulnerability Analysis (PVA) • Participatory Training Methodologies (PTM)

11. PSP • PSP is a derivative of Strategic Planning. It comes from the military and corporate sectors and has been specially adapted for communities • The Process affirms the belief that any one, even illiterate, down trodden communities have the capacity to look back, take stock of their present situation and state what they aspire for

12. PSP • Simply stated, it means: * What we want to be * Where we want to be * What is the path to take * How do we want to reach there on a specific time frame

13. PSP • Communities and the organisations that work with them learn to look at it under three circles • The Context Circle (Community and Organisation) • The Vision Circle • The Organisation Strengths Circle (Community and Organisation)

14. The Context Circle • The Critical Issues • The Challenges • Opportunities and Threats • Key Players

15. The Vision Circle * Vision * Mission * Objectives * Strategies * Program

16. The Third Circle • Strengths • Weaknesses • Capabalities • Potential Resources

17. The Three Circles Context Critical Issues Challenges Opportunities Threats Key Players Vision Mission Strategies Objectives Programs Role Models Strengths Weaknesses Capabilities Potential Resources

18. The “F I T” FIT

19. The Fit • The three circles converge and the area of convergence is called as the “FIT” • The more they converge, the larger is the fit • When the “FIT” keeps getting larger, over time, then the aspirations and capabilities of the community and the organisation and the goals and objectives of the organisation are congruent

20. The Methods • The Community uses many participatory techniques. One of them is Village Mapping • The Older people map the village as it was 10 years ago using available materials • The younger people map it as it is today • The community looks at it and sees what changes have taken place over time

21. Then • Our role is only facilitatory • The community then looks at the reasons for change • We help them to reason out why these changes have taken place and what can be done about these changes eg water, deforestation

22. Changes • The Community looks at: • the reasons for change • the trends • If trends remain the same what would be the scenario 5 years from now, • if trends become better what would be the scenario and • if the trendsworsen, what would be the scenario

23. The Probable Scenario • Then they pick from each of the scenarios and come up with a probable scenario, look at what problems would be faced and how the scenario can be improved

24. Joint Action • The Community then gets to know • what needs to be done, • what resources they have, • what outside resources are needed, • how they can go about it, • what the blocks are, • who the obstacles are and at what level – local, national and international, and finally • how to overcome those obstacles

25. PAR • It is a methodology where the community participates fully in getting to know their situation • Strengths and weaknesses • Resources • Problems • Opportunities • Threats

26. PAR • Regenerate and build upon existing knowledge • Regenerate and build upon existing skills • Regenerate, refine and build upon existing practices

27. From Day One • The community participates fully in: • Investigation • Analysis • Planning Appropriate and Joint Action • Implementing the Program • Monitoring and Evaluation • Mid-course Corrections

28. To release To restore To renew To empower and finally Transform PAR empowers, achieves collective power, Makes them realize their collective worth and Builds Self Reliance Goals of PAR

29. PAR • Is committed to the Marginalised and the Poor. Is biased in favour of the poor. • Believes that everyone has intelligence, create knowledge, the right to make history. • Develops critical understanding • Insists on democratic interactions

30. PAR • Is an Action-Reflection-Action Process and therefore is basic to community organisation • Build inter-personal and intra-community relationships, bonds • Re-energises and fosters social capital such as trust, confidence, sharing, care of the poor etc., • Helps breakdown barriers

31. Participatory Vulnerability Analysis (PVA) • PVA is a systematic process that involves communities and other stakeholders in an in-depth examination of their vulnerability, and at the same time empowers or motivates them to take appropriate actions. • The overall aim of PVA is to link disaster preparedness (droughts, floods, state oppression on a large scale) and responses to long-term development.

32. PVA-Community Level PVA enables communities to play a dual role, as informants, but also analysts, by breaking down vulnerability to a point where they can begin to take action to reduce their own vulnerability. The analysis itself has no value unless it is followed by action: people can take action themselves

33. PVA Means • Community meetings • Discussion sessions and analysis • Training of local facilitators • Participatory and reflection approaches • Stakeholders and focal group meetings • Local level advocacy and lobbying • Documentation and liaison • Studies on selected issues

34. Participatory Training Methods(PTM) • Is an enabling experience • Best method for adult learning • Learning by doing • No one comes as empty vessels and that even the illiterate have experiential knowledge • Equality between trainer-trainee

35. PTM • Treats trainees as adults • Shared responsibility for learning • Is a confidence-building process • Mutually enriching • Builds on what they know • Respects cultures, values and life experience • Translates scientific knowledge to real life • Leads to behavioural changes

36. Rights-based Approach • Participatory Approaches empower communities to stand up to ruling structures • Communities know what their rights are: • Human rights • Women’s rights • Peasants’ rights • Rights of outcastes, indigenous people • Children’s rights • And have the knowledge, skills and capacities to fight their own battles