Connecting local responses around the world
When health professionals and ancillary workers in the health facility actually go out of the compound to listen and learn respectfully what people are really concerned about, and what their hopes are, the ground becomes much more fertile, or to mix metaphors, people become more receptive to all those health messages we have always wanted them to take on board. We are talking far more than tokenistic participation here. The tools in this instance are SALT visits, where mixed groups of 3 or 4 people from the health facility, local churches (this is Africa) and wider community, go and visit households. They go without their badges of office or professional status; they go as ordinary people: fathers, mothers, brothers, aunts etc etc. They go and greet and look for any strengths they see, to affirm them explicitly. They ask well framed questions about the experiences and ways of coping the householders have; they ask about concerns, and hopes for better health. These are not one off visits either. In Malawi, in the first few months of the programme one health facility has visited over one third of the 17,000 households in their catchment area. The number of people who join these conversations is growing. The visiting teams invite those they have visited to come for a debrief session so that everyone hears what has been said, what strengths have been witnessed and what concerns and hopes have been shared. But beyond that the question is always asked: What simple action do you think you and your neighbours - who are all sharing similar concerns and hopes - could take to begin to improve things? What is happening is that trust between the health people and the communities is growing. Simple actions at the initiative of the community are starting to emerge. It is happening at a different and often slower pace to that which we in the health institutions might like, but we are starting to believe that changes are going to be far more sustainable.
This is all a great challenge to those of us with an interest in monitoring and evaluation. We are finding ourselves needing to measure different things. But the local facilitation teams (all doing this work voluntarily, on top of their normal jobs) that are emerging at each health facility and local church participating in the process are getting more and more excited. Their appetite for learning from what they are doing, by conscientiously logging where and when SALT visits are happening and recording the concerns and hopes expressed. They are starting to engage more meaningfully with District Health officials some of whom are beginning to see the value of this new approach.USPG is changing its name on Tuesday 20th November, when we will become Us, as in the word 'us', as in there is no them with Us. The new strapline is "Every person, every community. a full life". In a post colonial era this 311 year old charity need to refresh its image in a big way. Us works in partnership with the Anglican Churches around the world to reach out to the poorest and most marginalised and vulnerable people and communities. From Tuesday 20th November, go to www.weareUs.org.uk