Many health planners think of a community as a group of people living in a certain area (such as a neighborhood or school district) who have common interests and live in a simlar way. In this view, emphasis is placed on what people have in common. Relationships between members of a community are seen as basically agreeable, or harmonious.

But in real life, persons who live in the same neighborhood or school district do not always share the same interests or get along well with one another. Some may lend money or extend credit on unfair terms. Others may have to borrow or beg. Some children may go to respected private schools and have tutors. Other students may be in special education or English as a second language programs, or attend school in a juvenile detention center or psychiatric facility. Some persons may lavish money and time on food. Others may have limited access to fresh food, limited time, facilities, or ability to prepare food, or may go hungry. Some may feel protected by police, some may feel under occupation by police. Some speak confidently in parent-teacher meetings and on community advisory boards. Others may fear to open their mouths. Some give orders. Others follow orders. Some have power, influence, and self-confidence. Others have little or none.

In a community, even those who are poorest and have the least power are often divided among themselves. Some defend the interests of those in power, in exchange for favors. Others survive by cheating or stealing. Some quietly accept their fate. And some join with others to defend their rights when they are threatened. Some families fight, feud, or refuse to speak to each other — sometimes for years. Others help each other, work together, and share in times of need. Many families do all these things at once.

Most communities are mot homogenous (everybody the same). Often a community is a small, local reflection of the larger society or country in which it exists. It will have similar differences between the weak and the strong, similar patterns of justice and injustice, similar problems and power struggles. The idea that people will work well together simply because they live together is a myth!

Elements of harmony and shared interest exist in all communities, but so do elements of conflict. Both have a big effect on people's health and well-being. Both must be faced by the health worker who wishes to help the weak grow stronger.


This page adapted from: David Werner & Bill Bower (1982), Helping Health Workers Learn. Berkeley: Hesperian. "Hesperian Health Guides encourages others to copy, reproduce, or adapt to meet local needs, any or all parts of this book…, provided that the parts reproduced are distributed free or at cost — not for profit."

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