Leadership
From inner city neighborhoods to the deepest jungles, the world
is full of failed healthcare projects. Most share in common a
lack of community participation in their genesis, planning and
management. Only when local people are involved in the process
of identifying their own healthcare needs, and managing the response
to those needs, can a healthcare program become truly independent
and self-sustaining over the long term.
Even in communities that apparently have no resources to devote
to a healthcare program, there are many vital sources of support.
Foremost among these are the human resources of the community.
The four thousand residents of Cotogchoa established formal responsibility
for leadership of their own healthcare program by organizing two
different community meetings in June of 2006. The state of the
current healthcare system and alternatives to government-sponsored
healthcare were discussed. Proposals to maximize community participation
were also suggested, including the establishment of a corps of
community-based healthcare workers that would focus on promoting
preventative healthcare in such critical areas as nutrition and
waterborne illnesses.
Finally, responsibilities for the members of a Directiva
de Salud (community-healthcare management team) were
agreed upon, nominations for the positions were accepted, and
an election was held. In true Ecuadorian style, both community
meetings included surprise elements of music designed to foster
a sense of community spirit in the project, as well as to set
the tone for such all important events, as the election of the
Directiva
de Salud.
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