query: is organizing good for your health
colist at comm-org.utoledo.edu
colist at comm-org.utoledo.edu
Wed Feb 25 09:06:47 CST 2004
[ed: thanks to Howard for contributing an international perspective to
From: "howard sobel" <hsobel at hotmail.com>
I have benefitted from reading many discussions here, but now feel
compelled to contribute. Anyone who has worked in well-organized
communities in poorly developed countries (amid the typically fatalistic
poorly organized communities) knows effective community organization
equates to better health. Unfortunately, documentation in this area is
not the best. Defining effective community organization is also difficult.
Below are a few examples of effective community organization
Drs. Mabel and Raj Arole ("Jamkhed" for those interested) brought to
this very poor part of Maharashtra, community-based primary health
care which, in large part involved empowering mothers, underclass, etc.
through community organizing--women's clubs, farmer's clubs, village
health workers. Through their organizing, women banded together to
root out domestic violence; undercast and marginalized sought for,
achieved and demanded equitable access to basic needs: water, food,
health care, income generation, bank accounts, etc. Infant mortality
before they arrived was 180/1000 live births (18% of infants died before
their first birthday!). Maternal mortality was likewise awful. 20 years
hence, infant mortality got below 20/1000. Outside Jamkhed,
Maharashtra had the same infant mortality (180/1000) and continues
above 50/1000 (probably many undocumented as well here; while in
Jamkhed, the documentation system is excellent).
Daniel and Carl Taylor explore other such systems in "Just and Lasting
Also, check out Calcutta (Sonagachi) where organized commercial sex
workers have low HIV prevalence (few percent) compared with just
about anywhere else in India. E.g., Mumbai CSWs have prevalence in
excess of 50%.
This is a bit outside of the impact on health of joining an organization,
but shows organizing an effective community-based village health
worker (VHW) system with strong community and health system
interaction impacts mortality. Abhay and Rani Bang (NGO= SEARCH)
trained community-based VHWs in basic antibiotic management and
other care. There was a strong mentoring and supervisory system put
in place. They additionally observed infant mortality in a control
community which continued the usual public health system. In their
studies (see Lancet), the intervention communities to have 1/2 the
infant mortality of control communities.
Another aside is the "Alma Ata Declaration." This is more for reference
where WHO recognized the effectiveness of community-based primary
health care, of which organizing is recognized key.
Hope you find this useful,
> From: "Jennifer Flynn" <flynn at nycahn.org>
> Does anyone have any studies that say that being involved in
> community organizing (involved in civic participation, being a
> member of an organization, etc.) is good for your health?
> --Jennifer Flynn
> NYC AIDS Housing Network
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