All people have the right to food

In many places, people have lost traditional knowledge of how to produce food. And because of rapidly changing conditions, such as overcrowded communities, less fertile land, and changing weather, old methods often no longer work. When people do not know how to produce food, hunger and a lack of food security is the result. One solution to this problem is to maintain, pass on, and improve knowledge through farmer field schools, farmer to farmer education programs, and agricultural extension services.

All people have the right to food that is safe, healthy, and culturally acceptable to them. Food sovereignty is the right to determine our own food systems, and make sure every community has food security. Security can be achieved only through food sovereignty — when farmers and peasants have the right to decide what foods they produce and how much to sell them for, and when consumers have the right to decide what they consume and who they buy it from. In some places, Vía Campesina pressures politicians and corporations to respond to the demands of local farmers’ unions. In other places they support landless farmers working to reclaim unused farmlands. They also help build local institutions that distribute food fairly to those most in need.  When a huge earthquake and tsunami (a massive tidal wave) struck Indonesia in 2005, most of the people affected by the disaster were farmers and fishers. Vía Campesina provided aid, but rather than simply bringing food and other materials from outside the area, they worked with local organizations to buy food, tools, and other materials from local small producers. They raised important issues such as the origin of food aid (whether it was local or imported), the way farm reconstruction would happen (whether it promoted family based production or large food corporations), and how to strengthen local organizations (not make them dependent on aid).

Most of the money Vía Campesina raised was used for long-term reconstruction, such as rebuilding houses and fishing boats, making new tools for farmers and fishers, and restoring farm lands to production. By focusing on the self-reliance of the people affected by the disaster, Vía Campesina promoted not just short-term recovery, but long-term food sovereignty.

The Importance of Social and Political Causes of Hunger in the community

When food is treated as just another product to be bought and sold instead of something all people need and have a right to, profit from selling food becomes more important than feeding people, and community health suffers. Many people now shop for food in stores owned by large corporations. They buy foods made by large corporations, grown on land owned by large corporations, using seeds, fertilizers, and pesticides produced by large corporations.

Corporate control of all parts of food security forces farmers out of business and off their land. When corporations use land to grow food to sell outside the region, people living and working in those communities must eat food brought in from elsewhere, if they can afford to buy it. Corporations profit from this food “insecurity” as communities, and whole countries, become dependent on the global market for food. When the market fails to meet people’s food needs, people go hungry and corporations profit further by selling food to governments to be distributed as food aid. Until people have control of their food security, hunger will be the biggest product of the corporations that control the production and distribution of food. In Zimbabwe, farmers once planted many kinds of grains. During the Green Revolution of the 1960s, the government and international agencies brought a new kind of maize for farmers to plant. Farmers liked the hybrid maize because it had large grains, grew quickly, and was easy to sell. The government bought much of their crop, and then resold it to other countries and to cities in Zimbabwe where food was scarce. Over time, maize became the most common food to eat in Zimbabwe, and most farmers grew it in large quantities. Then came years of drought. Very little rain fell over the fields of Zimbabwe and other countries in southern Africa. The maize grew poorly, and there was little else to eat. Many families had stored grains for times of hunger, but much of their stores of maize had rotted. This was a surprise, because the millet and sorghum they used to grow had lasted many seasons in storage.

When the rains finally started, they came in huge storms that uprooted crops and washed away precious soil from the dry fields. Hunger grew so severe in Zimbabwe that the government was forced to ask for food aid from the United Nations. Large shipments of maize came in by airplane and were handed out to hungry people across the country. But food aid and the new hybrid seeds could not solve the long term problem of hunger and food security. The farmers realized they could not bring more rain, but they could change how they farmed to make better use of the rain. Farmers began to collect and plant seeds from small grain crops such as sorghum and millet that had always grown well in Zimbabwe. Farmers planted every kind of seed they could get. If drought destroyed one crop, others would surely survive. Some farmers left their crop stubble to rot in the field after harvest, protecting their soil from washing away during the hard rains. The next season, their soil was still soft and good for planting. Some farmers planted lab beans after the grain harvest so something was always growing. They could feed these beans to livestock, and the bean plants also helped to hold and enrich the soil. It still rains less in Zimbabwe than it once did. But some farmers there no longer rely on non-native seeds or international food aid, and have become better able to prevent hunger, by growing crops that can survive the drought.

Ever since the “Green Revolution” of the 1960s, corporations and international agencies have claimed they can “feed the world” with “improved seeds,” chemical fertilizers, and pesticides. While they have succeeded in gaining control of farm land, seed supplies, marketing and distribution systems, and so on, they have failed to stop world hunger, and have often made hunger worse.

What Improving local lood security for the community

Every government should try to make sure people do not go hungry. National governments can make policies that promote the use of land for family farms, protect against pollution of farmlands, make affordable credit available to farmers, and help farmers solve problems. Some national governments offer subsidies (money to support farmers, food buyers, or both) as a way to improve food security. Kinds of subsidies include price supports to help farmers by setting a higher market price for the foods they produce, and price controls for food buyers (consumers) to make sure that important foods are affordable.

Government support is often misused by giving it to corporations that own large industrial farms or produce and distribute unhealthy foods. When government support is corrupted by pressure from large corporations, the result is often more hunger and malnutrition. But with or without government support, there are many ways people can improve local food security. From planting a small garden to organizing a farmers’ market, changes that improve food security can often bring results quickly and motivate people to do more. Food security is strongest when food is produced and distributed locally. Locally grown food is fresher and so more nutritious. It builds the local economy as money circulates to farmers and businesses in the area. And it helps build relationships among people, making communities stronger and healthier places to live. Because poor communities often have little land and few food markets, regaining control of food production and distribution is Community food programs help especially important for them. Most of these projects can be started with little land or money, and help communities get more fresh food. (1)Family gardens add healthy vegetables and fruits to the family meal. (2) School gardens can provide fresh food for children and help keep children in school by providing nourishment. And they teach children to grow food, making sure this important knowledge stays alive! (3) Community gardens provide food and places for people to get together, even if they do not own land. Community gardens can also help people learn about food production, develop skills, and start new businesses such as restaurants and markets. Even small gardens can make a big difference to food security. (4) Community supported agriculture is when farmers sell their food directly to consumers. People pay the farmers before the crops are planted, and then receive fresh fruits, vegetables and other foods each week throughout the harvest season. By making this investment, consumers help farmers stay on the land and in business while getting a dependable supply of nutritious food. (5) Seed saving programs help make sure that traditional seed supplies are available. A variety of seeds is the basis of sustainable farming and self-sufficient communities. The world now produces more than enough food for everyone, but people still go hungry. This is partly because food prices are often higher than people can afford, and healthy food is often not available to the poorest people. Government support is important to make sure prices are fair for both buyers and sellers of food. Some ways people work locally to make sure healthy food is available at fair prices include:

•  Farmers markets reduce transportation costs and the need for merchants in the middle, so farmers can earn more and consumers pay less. Farmers’ markets also let consumers meet and talk with the people who grow their food. This helps farmers learn what consumers need and helps consumers know what farmers do to bring them food.
• Food cooperatives are markets partly or entirely owned by the workers and people who buy food there. Food coop members pay part of their food bill by working at the market. Most food coops try to buy and sell locally grown food.
• Farmer’s cooperatives help farmers get better prices for what they grow, and still offer better prices to consumers.

Safe food storage is as important as the ability to grow food or have access to food. Drought, storms, flooding, pests, or illness can all leave a family or community with not enough to eat and nothing to sell. Community food storage programs can help overcome these problems. For example, on the Pacific island of Temotu, hurricanes frequently destroy many crops. To improve food security, communities build big, communal pits to store fermented cassava, unripe plantains, bananas, and breadfruit. Everyone contributes to making and filling the pits. When crops are destroyed and people are hungry, they use this stored food. Food banks are places where food is collected and then given away to those in need. Food banks help during a hunger crisis. But because people may come to depend on them, they are not a good solution to long term food security. When entire regions suffer from hunger, food aid from international agencies can help them get through the crisis. Food aid is a short term solution to food security, but it does not solve the long term need for food sovereignty.

Why Community changes in farming

In Prey Veng, Cambodia, people have grown enough rice to feed themselves for as long as anyone can remember. Along with rice, they traditionally ate wild greens, fish, eels, snakes and other animals from the rice paddy, as well as fruits, nuts, and roots from the forest, and meat from animals they hunt. This diet gave them good health all year round, except in times of war or flooding.

More than 40 years ago, the government began to promote new farming methods to increase production of a few main crops, like rice, for export. These new methods were part of a worldwide change in agriculture, the deceptively named Green Revolution. The Green Revolution encouraged the use of chemical pesticides and fertilizers to produce more rice than traditional methods. It also used large irrigation systems and machinery to plant and harvest.

When they started using these new farming methods, the people of Prey Veng were able to produce large amounts of rice to sell. They used the money to improve their houses, build roads, and buy personal goods like clothes and radios. The villagers stopped using animal manure, stopped rotating rice with dry season crops, and stopped using other traditional farming methods as well.

The new methods worked very well for growing large areas of a single crop, and increased the amount of rice they had. But over time, they discovered that their land and the way they ate had changed. Herbicides killed the wild greens the villagers had eaten before. Fish and other wild foods grew scarce. Year by year they spent more money on chemicals and had nothing but rice to eat. Before long, the soil in their fields no longer supported healthy crops, and rice yields began to go down.

Coming together to discuss the growing hunger, the villagers recalled the old ways of farming that used mixed crops, field rotations, and natural fertilizers to grow crops all year round. They saw many advantages to the traditional methods, and decided to change back. They also began trying new methods like planting rice plants closer together and growing different crops in the same field

Understanding the problems from unsafe water for community

No one can live without water. To be healthy, people need enough water and they need the water to be safe. Water is not safe when germs and worms from get into it. The germs and worms can be passed through the water or from one person to another, causing many serious health problems and affecting a whole community.

Chemicals from agriculture, industry, and mining, and trash dumping can also make our water unsafe and cause illnesses such as skin rashes, cancers, and other serious health problems. Not having enough water for drinking, cooking, and washing can lead to sickness. Especially when there is no way to wash hands after using the toilet, diarrhea diseases spread quickly from person to person. A shortage of water for personal cleanliness can also lead to infections of the eyes and skin. Lack of water can cause dehydration (losing too much water in the body) and death. Not having enough water may be due to drought (dry weather for a long time), the high cost of water, or because water has not been well conserved. Contamination of water can make the effects of water scarcity worse, and likewise, water scarcity can make contamination more serious.

Many people do not have enough water to meet their daily needs. When there is not enough water to wash, people can get infections such as scabies and trachoma. Not having enough water to drink and wash with can also cause infections of the bladder and kidneys, especially in women. In hospitals and other health centers, if there is not enough water for washing, infections can spread from person to person. Especially for children, not having enough water can mean dehydration and death. Women’s burden

When water is scarce, the people who collect and carry water — usually women and children — have to travel long distances and carry very heavy loads. This leads to injuries to their necks, backs, and hips. Collecting water often takes so much time and strength that they and their families use much less water than they would if it was plentiful. The search for water can take so much time that the other work women do to support family health, including caring for children and tending crops, does not get done. Water is used to reduce fevers and to clean wounds and skin infections. Drinking a lot of water helps to prevent and treat diarrhea, urinary infections, coughs, and constipation. Washing hands with soap and water after using the toilet and before eating or handling food also helps prevent many illnesses.

Water is unsafe when it contains germs, worms, or toxic chemicals. Germs (tiny living things, too small to see, that cause many kinds of illness) and worms, such as whipworm, hookworm, and roundworm, cause many serious illnesses. Germs and worms live in human and animal waste (urine and feces) and can cause serious and long-lasting illnesses when (1) there is not a good way to get rid of human and animal wastes. (2) Water supplies are not protected and kept clean. (3) There is not enough water to wash. Some of the illnesses they cause, such as cholera, spread quickly and can cause many deaths. Other illnesses from germs and worms can cause years of sickness and lead to other health problems such as dehydration, infections, anemia (weak blood), and malnutrition. Because the most common sign of illnesses from germs and worms is diarrhea, these illnesses are sometimes called diarrhea diseases.

The importance of community mapping

Community mapping is an activity in which people make a map together based on what they see and know about their community. By making a community health map, you can learn - (1) where health problems are. (2) who these problems affect. (3) how these health problems may happen because of conditions in the environment.

Make maps with pens or paint on paper, or on the ground with rocks, sticks, and Making a map can help people see anything else available. patterns in health problems, begin to identify root causes of these problems, and see how conditions in the community have changed over time. A map can also help people identify important community resources and strengths they may not have been aware of. And mapping can be used as a step in protecting important traditional or sacred places. Finding out what a community needs. People often have different opinions about what the problems are in their community and how best to fix them. Making everyone aware of the range of problems that exists and the various causes of the problems, and helping people decide which ones to work on in the short and long term is sometimes called a “needs assessment”. A good needs assessment process can help make sure everyone’s needs and abilities are considered in planning.

Health walks: During a health walk, people take a closer look at their community. They try to find things that may be causing health problems, such as an unsafe water source, a polluting business, or a lack of firewood. When a health walk is done as a group, people share with each other the different things they know about problems. Then they can work together on possible solutions. The more people involved, the better. Another way to understand problems and needs in a community is to compare conditions now to how it was in the past. Then think about how you would like it to be in the future. One way to do this is to gather stories from elders in your community. Encouraging young people in the community to lead these activities helps build respect and understanding between the generations. It also helps preserve those community traditions that everyone wants to keep. A community timeline can help people understand how changes have occurred from generation to generation, and take into account significant events such as a road being paved, a factory opening, a dam being built, and so on. Mapping environmental changes is another way to share knowledge of community history through pictures or maps of changes over time in fields, farms, forests, settlements, rivers and lakes.

Drawing activities: Making and looking at drawings can help us see solutions to problems that we might not see otherwise.  Drawings can be used to start guided discussions, and drawing can be a way for people who cannot read or write well to express themselves and to participate in group leadership. Some communities work together to paint pictures on the walls of buildings (murals) that express their problems and hopes for a better, healthier future. Community surveys: Community surveys are an organized way to gather information. They can be used to find out what health issues people have, to consider similarities and differences in what people think or believe, or to measure the support for different plans or actions in the community. In a survey, the same questions are asked in the same way to all of the people participating. Surveys can be done in homes, workplaces, schools, places of worship, other gathering places, or even over the telephone or by post. Surveys allow people to share their thoughts privately, without having to come to meetings or other public events. They can be a way for people who might be afraid, or who are not allowed to participate in the community decision making process, to have their concerns and ideas considered. Often people are more willing to talk when women give the surveys.

Theater is a way to explore problems and propose solutions while entertaining and having fun. People can act out their own experiences and imagine the experiences of others. Some issues and conflicts may be easier to consider if they are portrayed in another time and place. A socio-drama allows people to act out a problem and demonstrate some of its causes and effects. Socio-dramas can bring up lots of emotions. Some community organizers like to end by having people sing a song together or do some other ‘cooperation’ activity. Interactive theater is a kind of socio-drama in which everyone both watches and participates. Any person in the audience can tell the actors to stop, and then can take the place of an actor and act out a different solution to the problem. This is especially helpful in situations where people take turns playing the role of the person who has little. Any story can be turned into a socio-drama as long as or no power. It has characters and a problem to be worked out. A role play does not require as much preparation as a socio-drama, and can help explain different points of view or resolve conflicts.

People act out different roles in real-life situations to show what they would do. You can discuss and repeat a role play to understand why people behave a certain way. Changing the way people in power act is easy on the stage, but very difficult in real life. Using a drama to practice how we interact with people who have power over us helps people prepare different ways to respond to power in real life. Puppet show. A puppet show uses puppets instead of people to act out the story of a community conflict. They make people laugh, and can help them see things in ways they are not used to. Some people find it easier to talk through puppets than to act on a stage.

Understanding Community Learning and Social Mobilizing

Group activities can help people understand root causes of health problems and make plans for change. Which activities you use will depend on what you need to know, what you hope to do, and what resources are available. Activities can:

• Bring people together to identify common problems.
• Find out what people feel they need most.
• Gather information about what is causing a health problem.
• Analyze problems to discover their immediate causes and their root causes.
• Gather all points of view in the community. A project will not be successful if some groups or opinions are left out. People will not want to help if their opinions are ignored!

Environmental health is always a community issue, and requires people working together to make improvements. Whether the goal is to reduce the risk of an epidemic, to plant a community garden, to improve the health and safety of people living near a factory or working in a mine, or to address some other environmental health issue, the more people have a shared understanding of the problem and a shared commitment to solving it, the more successful they will be.

Women need a voice: In some communities, women and girls are more likely to participate in organized activities if they are in a group separate from men. The women’s group then presents their ideas to the larger group. This way, women and girls have a chance to speak in a strong united voice before the whole community. By strengthening the voice of women and girls, and building their leadership. To have a shared understanding of health problems, people need to talk to each other. A guided discussion is a way for a group of people to talk to each other and to ask and answer specific questions. 

The “But why…?” activity is one kind of guided discussion. Drawings for Discussion and Body mapping are also kinds of guided discussions. The person who guides the discussion is sometimes called a facilitator or animator. Most of the activities in this book require a facilitator to make sure each person participates to the best of his or her ability, and to help make sure the discussion or activity leads to action.

How to mobilize for Community environmental health

The health promoters and village health educators went from house to house to educate everyone about the problem and what to do. Once the success of the basic treatments had earned people’s trust, the community began to work on the root causes of the cholera and other health problems. Working on the root causes through community participation and education, the community was able to begin making many environmental health improvements. With each improvement, the villagers gained greater confidence in their ability to change their own lives. It is necessary to ask many questions and collect information in various ways to find the cause of a health problem. Often there are strong conflicts in a community that require long processes of discussion and struggle to resolve. While each community will find its own way toward making changes and use different activities as it organizes, the experiences of Mobilizing for Environmental Health give some examples of how communities can learn about the root causes of environmental health problems and work to change them.

After many years of poverty and isolation, the people living on those muddy hills on the coast of Ecuador were discouraged. They did not know how to improve their lives. Everyday life was so hard, it was difficult to believe in or plan for a better future. By working to solve the immediate health problem — cholera — Gloria and the health workers of Mobilizing for Environmental Health saved many lives. The success of the health promoters, local organizations, and the villagers in working together to stop the epidemic motivated and prepared them to overcome other problems as well. When the big storm destroyed much of their work, they were able to organize and recover from the storm’s damage. Then they were able to move on to solve other problems. Their work to make communities healthier continues, as they improve present-day conditions and build for the future.

Change takes time: Improving environmental health does not happen quickly. In Manglaralto, the health workers first treated cholera by giving rehydration drink and also worked to prevent it by making the water clean. Then they organized the community to build new water systems and pit toilets to prevent cholera in the future. But it was only after the big storm came and washed away all of these improvements that they understood the problems of erosion and flooding caused by deforestation (the loss of trees). They needed this understanding of root causes to be able to make lasting changes.

Sometimes, we must struggle and fail several times before we succeed. Often, it is only by seeing what does not work that we learn what does — and why. Improving environmental health takes time because it often requires 4 different kinds of changes:

1. Changes to improve water systems, housing, or other things we build for ourselves (infrastructure).
2. Changes in what we buy, such as refusing to buy junk food, toxic cleaning products, or products wrapped in plastic (consumption).
3. Changes in our habits, such as regular hand washing, separating trash so more can be recycled, or growing crops in new ways (behavior).
4. Changes in how much power local people, corporations, central governments, and others have in making decisions that affect the environment (political).

Environmental health improvement

How the vision of environmental health began to grow: Over time, the health promoters also realized disease-carrying insects were breeding in trash and trash dumps. They held community meetings about the need to clean up the streets and to improve the dumps. Each village formed a group of “environmental health promoters” who organized work days for everyone to pick up trash. With help from an engineer, the environmental health promoters turned waste dumps into safe pits called sanitary landfills. Over the next few years, the promoters talked about starting a recycling program to reduce the amount of trash in the landfills. When an international agency donated a big truck to haul trash to the regional of Ecuador. For 6 months there were strong winds and rain nearly every day. The winds tore up the trees, rain turned the hills to muddy landslides, and the valleys filled with raging brown rivers. The rivers overflowed and changed course, destroying whole villages. Toilets, water pipes, and years of hard work were washed away.

A hill with no trees is like a house with no roof: The hills and mountains on the coast of Ecuador were once covered in thick tropical forests. Mangrove trees grew where fresh water from the rivers mixed with salt water from the sea. The mangroves protected the coast from storms and were home to many kinds of fish and shellfish. Bamboo trees grew along the streams, keeping their banks from being worn down or washed away (erosion). Forests were filled with giant ceibo trees that gave shade. Their deep roots held water and soil. Carob trees grew on the steep mountain slopes, holding the soil in place and keeping the hillsides from falling down.  Leaves from the trees enriched the soil when they fell to the ground. The forests were home to people, and also to deer, birds, insects, lizards, and countless other animals. People built their houses out of bamboo and palm tree leaves. There were animals to hunt, wild berries to eat, and water and rich soil for gardens and small farms. But over the last 100 years, many of the trees were cut down to make a railroad and to build houses. Then a company from Japan came and cut down most of the remaining trees, using the railroad to carry the wood to a port on the coast, and shipped it to Japan. Because tropical forest trees are very strong, they sold for a good price. When the trees were gone, the company left. The railroad fell into disrepair. Over time, it was abandoned.

Now, the mountains on the coast of Ecuador look like a desert. The hills are brown and there is no shade. In the dry season, the soil blows away and the air is full of dust. In the rainy season, the soil turns to mud and the hillsides tumble down. When the El Niño storms came in 1997, there were no trees to protect the villagers from their destructive force.

Finding the root cause of the problem: When they saw how the rains washed away whole villages — taking the new piped water systems and toilets with them — the health workers of Community Mobilization realized they needed to do different kinds of work to prevent disasters like this in the future. Building water systems and promoting safe sanitation only solved one part of the problem. There is a saying in the villages: a hill with no trees is like a house with no roof. This means trees protect the hills and prevent them from being eroded in the wind and rain, just as a roof protects the people in a house.

The health workers began to see promoting tree planting and protecting natural resources was as important as promoting health — because they are one and the same! With this in mind, the health promoters started a tree-planting project. But some villagers did not want to plant trees. One man named Eduardo refused to join the tree-planting project.  “Too much work,” Eduardo said. “They just want us to work for nothing.” He convinced some other villagers to go against the health promoters.

What made this health organizing successful?

Community Mobilization was very successful at stopping cholera and moving on to solve other problems. This happened because the health promoters.

Worked with people in their homes. Community Mobilization workers trained people house by house to keep their water supply clean. This helped the health teams learn about other problems and gain trust in the community. Brought many groups together. Local organizations, local government, national and international non-governmental organizations (NGOs), and the Ministry of Health all worked together. This made sure all of their resources and experiences were available to help stop the epidemic. Because they worked together, they avoided the problem of one organization doing the same job as another organization, or working against one another. Valued people as the most important resource. They did not blame the villagers for the health problems, and they did not depend only on help from outside the communities.

Instead, they used the peoples’ own experience to work toward a common goal. They used games, puppets, songs, discussions, and popular education activities to bring people together to share their knowledge and abilities. These activities built self-confidence and motivation as the villagers saw how their own knowledge and participation solved serious health problems.

How to improve Indoor Air Pollution

When people burn wood, dung, coal, charcoal, gas, and crop wastes indoors for cooking or heating without good ventilation, smoke fills the house. This smoke contains harmful gases (fumes) and tiny particulates (soot) that cause breathing problems and other illnesses. Headaches, dizziness, and fatigue are often followed by serious illnesses such as asthma, pneumonia, bronchitis, or lung cancer. Indoor air pollution from smoking fires also increases the risk of getting TB. Women and children are the most exposed to harmful cooking smoke. When pregnant women are exposed to a lot of smoke every day, it can cause their children to be born very small, grow slowly, and have difficulty learning later on. In some cases, it can even cause children to be born dead.

To reduce indoor air pollution, you can:

• improve ventilation
• improve stoves
• use cleaner fuels
• use safer cleaning products
• reduce air pollution from outdoors

Poor ventilation harms health: Ventilation is the way fresh air moves into a room or building, and how old and polluted air moves out. If a house has poor ventilation, smoke and polluted air stay inside. Poor ventilation also traps moisture in the house, causing dampness and mold. The easiest way to reduce indoor air pollution is to improve ventilation. To know if your house has poor ventilation, look for these signs:

• Smoke stays in the house, or the ceilings are black from cooking or heating smoke.
• Moisture collects on windows or walls.
• Clothing, bedding, or walls grow mold.
• Bad smells from toilets or sewers stay in the house.

If you cook with gas and often suffer from dizziness and confusion, this may be a sign of poor ventilation or a gas leak.

What are the Healthy Home

The ideal home is not just a building for shelter. A home should be a place cold, rain and sun, wind, pests, disasters such as floods and earthquakes, and pollution and disease. Unfortunately, many people’s living conditions do not protect their health.  Poor living conditions may even cause illness, or make health problems worse. Whether people live close together or spread apart, poor housing, indoor air pollution, pests, and toxic chemicals in household products can cause many illnesses.

As more people move from rural areas into cities and towns, the way people live and maintain their homes changes, often for the worse. People who spend a lot of time in the home, such as children, the elderly and disabled, and people with long-term health problems such as HIV, suffer the most.

How to improve living conditions by making homes safer and more comfortable depends on local traditions, available materials, and climate. Unfortunately, it also depends on income and ownership. People who rent their homes often have little control over their living conditions and must depend on their landlords to make improvements. People in shantytowns, marginal communities, or other “temporary” settlements (which too often become permanent) live in homes that rarely provide security or comfort. But whether a person owns, rents, or lives in makeshift housing, working with neighbors is the most effective way to improve living conditions in the whole neighborhood.

Health Problems at Home: Our homes are not separate from the environment. They can have many of the same environmental health problems we find in our communities and workplaces. When planning a new home or improving the home you live in, you can protect your health by considering problems caused by how and where houses are built, how they are furnished, and what work is done at home.

What Can I Expect From My Supervisor?

The Home-Based Supervisor’s Manual for the Head Start Home-Based Program Option includes detailed descriptions of the role of the home-based supervisor and strategies that supervisors can use to support the work you do with families. Familiarize yourself with the information in the Supervisor’s Manual so you can talk with your supervisor about the kind of support that would be most helpful to you.

The home-based supervisor has many roles and responsibilities in your program. As a mentor, he or she supports you in your work by doing the following:

Modeling—Your supervisor should be able to demonstrate the skills you are learning as a home visitor. He or she shows you how to have respectful, trusting relationships with others as you observe him or her interacting with families and staff members.

Teaching—Your supervisor shares his or her expertise about the Head Start program, child and family development, and home visiting as a strategy for delivering services. He or she teaches you in many different ways: discussion, reading assignments, in-service training, anecdotes, modeling, or formal instruction.

Planning—Your supervisor contributes to the design and continuous improvement of the home-based program. You share your experiences, successes, and challenges with your supervisor so he or she can use those experiences to inform planning and improve the program.

Leading—Your supervisor sets the tone for how you interact with families and with other staff members. He or she is responsible for team-building efforts that help you feel supported by a network of colleagues working together to realize the goals of the program. As a leader, your supervisor provides an example for how to negotiate the challenges of your job.

Advocating—Your supervisor advocates for you and for the needs of the families with whom you work. He or she is your support person—the one you can turn to when you are struggling. He or she works with the program leadership to advocate for the resources you need to work effectively with families.

Assessing—Your supervisor shares in the responsibility for the quality of the home-based services your agency provides. He or she assesses your job performance and supports you in your professional growth. Your supervisor plays a role in program self-assessment and monitoring to ensure that your home-based program offers high quality services.

What are the Differences between Socializations for Preschoolers and Socializations for Infants?

The purpose of these socialization activities for the children is to emphasize peer group interaction though age-appropriate activities in a Head Start classroom, community facility, home, or on a field trip. The children are to be supervised by the home visitor with parents observing at times and actively participating at other times. The Head Start Bureau Information Memorandum titled Child Development Services during Home Visits and Socializations for the Early Head Start Home-Based Program Option clarifies the purpose of socializations for infants and toddlers. Socialization experiences for infants and toddlers are designed differently than socializations for preschoolers.

The purpose of socialization experiences for infants and toddlers is to support child development by strengthening the parent-child relationship. The content of the group experience reflects this emphasis and incorporates the goals of the program and participating families such as: helping parents to better understand child development; encouraging parents to share their parenting challenges and joys with one another; providing activities for parents and children to enjoy together; offering structured and unstructured learning opportunities for both children and parents; and modeling successful strategies for engaging children and supporting their development.

Infants and toddlers are only beginning to build their first and most important relationships: the relationships with their parents. Socialization experiences focus on the parent-child relationship as the foundation from which children will then be able to develop close, trusting, and respectful relationships with peers and other adults as they grow.

In contrast, socialization experiences for preschoolers provide opportunities for peer group interaction because 3-to-5-year-old children are at a developmental stage where they are beginning to form deeper relationships with their peers and where the peer group is beginning to have a greater influence in their lives. The group setting provides opportunities for parents and staff members to learn how children act in a group. The importance and influence of peer relationships grow as children enter preschool and, later, the elementary school environment. The socialization experiences for preschoolers provide a supportive place in which they can practice skills in taking on leadership, developing friendships, and negotiating conflict. Integrating the Goals of Home Visits into Socialization Experiences

Socialization experiences offer additional opportunities to work on the goals you have established with families during your home visits. Socializations should build on the activities and topics you address in the home. For example, if you have a number of families working on early literacy skills with their children, you might develop a number of experiences on this topic.  

socialization experience for infants or toddlers could include time for parents and children to choose and read board books together; activities involving listening to audiotapes of children’s songs and demonstrating finger plays for parents and children to do together (e.g., The Itsy Bitsy Spider or The Wheels on the Bus); or a field trip to a local library to participate in a parent-infant story time. You can develop a socialization on pre-literacy skills for preschoolers that includes an activity for parents and children to make a book together with pictures from magazines or the child’s drawings; a dramatic play around a favorite story; or various activities built around the theme “the letter of the day.” For example, if the letter of the day is B, then plan activities that begin with B (balls, block building, or bubble blowing) and serve snacks that begin with B (bananas, bean salad, broccoli, and blueberry yogurt). Be creative and have fun! Many of the above examples are activities that the parents can recreate at home. You play an important role in linking the socialization experiences and the home visits so parents understand how both aspects of the home-based program work together to help them reach their goals.

Parents benefit from socialization experiences in a number of ways: by observing how other parents and staff members interact with their children; by participating in facilitated discussions on a particular topic related to the socialization; or by conversing informally with other parents or staff members as they interact with their children. However, socialization groups are not the time to conduct formal parenting education classes. More structured parenting education that focuses exclusively on the adult learner should have its own designated time. Reserve the socialization time for experiences that include both the parents and their children as a special time for them to be together, enjoy one another, and learn with others who share common interests and goals. You play an active role in the socialization experience because your relationship is the most powerful tool you have to provide families with the support they need to reach their goals. As part of your ongoing family partnership agreement process, you must build in specific roles for parents in home visits and socializations. These roles provide a way to involve parents in all aspects of socializations, including planning them, carrying them out, and evaluating them. Parent participation ensures that the goals and experiences of socializations are culturally sensitive and relevant to participating families. Parents help you to individualize the curriculum for their particular child.

Socialization experiences are an ideal time to use observation as a tool for parent education. Child observation is a skill that parents and staff members can use to learn about child development, identify individual differences, and create meaningful learning experiences for children. During socialization experiences, you can help parents hone their observation skills by together watching their children at play and noticing aloud what their child’s interests, skills, habits, and preferences are. For example, as you sit on the floor with a parent and his 8-month-old, you might notice, “She sure lets you know she wants that ball. Look how she’s trying to crawl over the pillow to get it.” Or you might ask, “Does she always turn her head away and fuss like that when she’s had enough food?” With the parents of a preschooler, you might observe how imaginatively he or she uses the large cardboard boxes to create “houses” to hide in and “cars” to drive. Or you might reflect on how a preschooler is trying to join in a group of peers: “It looks like Brian really wants to play trains with those kids but he’s not quite sure how to get in on the action.” As you observe and reflect on the child’s behavior, you are teaching parents about reading their child’s cues. You can then build on those insights to foster parent-child interactions that best support the child’s development and learning.

Your agency may have a designated staff person to plan and carry out the socializations. This staffing pattern enables the person in this role to devote focused time to coordinating, planning, and carrying out the group experience. Ideally, this staff person would be an individual with expertise in both child development and in leading activity groups for parents and children together. However, even if a designated staff person manages the socializations, you still play an active role to collaborate with that person because you are the one who has the strongest relationship with the families in your home-based program. You are the one who is consistently available to the families, who is trusted, and with whom the families are most comfortable.

Group socializations provide you with new perspectives on your work with families as you interact with parents and children outside of the home environment. Group experiences, when conducted in collaboration with your colleagues, also provide you with the support of fellow staff members as you share insights into family strengths and challenges. You should have enough time in your work schedule to fully participate in socializations. If you find that your schedule does not give you the time you need, talk with your supervisor to make the adjustments necessary for your full participation in this important aspect of the home-based program. You determine the size and composition of your group socializations based on child and family needs and goals. First, identify families who are working on similar goals and who could benefit from a socialization experience on a common theme. The socialization experiences should be meaningful for the families and relevant to the goals you are working on in the home.

Next, consider the individual needs of the children. Individual temperaments, learning styles, or other special considerations may indicate a smaller and more intimate setting to optimize the children’s comfort and ability to interact. Groups of infants and toddlers should be small to enable the trust, predictability, and responsive caregiving that very young children need. In some cases, you might group your socialization experiences according to developmental level—young infants, mobile infants, toddlers, or preschoolers—and in other circumstances, you might prefer a mixed age group. Each grouping has different advantages. Separate age groups may be easier to plan for and facilitate, and they may allow parents to socialize with other parents who have the common bond of raising a child who is at a similar stage of development. Mixed age groups allow parents with more than one child to participate in a single socialization that involves all the siblings. They also provide older children an opportunity to be a leader, teacher, or helper with younger peers. Younger children learn from their older peers as the older children model self-help skills or new ways to play with objects.

The setting of your socialization experiences should be developmentally appropriate and should support the goals of your socializations. You should have a designated space for your socializations so families have a predictable, stable, and safe environment. This space should have adequate facilities for diapering and toileting, hand-washing, food refrigeration, and temperature control. You must make sure that the setting is accessible to children with disabilities so they can actively engage with others and fully participate in the activities. The setting you choose should be comfortable for both children and adults. For example, you can provide comfortable seating for adults that also promotes parent-child interaction. You might place portable stools around a child-size table for the adults to sit next to their children. Offer adult-size chairs that can easily be moved around the room or places such as a hammock or rocking chair where a parent and child could snuggle together. Young infants need safe places to lie down; newly mobile infants need space to crawl and pull themselves up to stand; and toddlers and preschoolers need large spaces for climbing, running, and tumbling.

Socializations are a time for fun, learning, and support. In addition to the structured learning that takes place, they provide informal “teachable moments” that offer rich, responsive, and relevant learning experiences in unplanned and often unexpected ways. These are the learning experiences that usually have the greatest effect. Recognize how the unique qualities of the socialization experience strengthen and enrich the work you do in

What is the Purpose of Socialization Experiences in a Home-Based Program

Socialization experiences provide families and staff members with special opportunities to support child development and learning. Socializations build on the experiences and goals that are addressed during home visits as well as attend to the needs of both children and parents. The group experience is a valuable strategy for delivering services because it provides parents with the opportunity to obtain feedback from staff members and other parents about their children’s activities, strengths, and resources; to observe their children (when age appropriate) interacting with other children and adults; and to share and learn with others about the challenges and joys of parenting.

Socialization experiences incorporate all of the services required by the Program Performance Standards. For example, you can develop socialization experiences around topics related to medical, dental, mental health, nutrition, or child development and education issues. Families are involved in all aspects of socialization experiences, including planning, implementing, and evaluating. Community partners might be involved in socialization experiences as guest speakers, or they might provide space or other resources for socialization experiences. Finally, in keeping with the Performance Standards, socialization groups require effective management systems such as planning, record keeping, and self-assessment.

Socializations are individualized to address the developmental level of each participating child and the goals, needs, and resources of each family. The goals and outcomes for socialization experiences vary depending on the developmental level of the child and will change as a child’s development progresses. Socialization experiences and home visits are based on a curriculum that:

 Articulates goals for children and parents;

• identifies the experiences through which they will achieve these goals;
• determines appropriate roles for staff members and parent
• provides the necessary materials to carry out the plan;
• includes all areas of child development—cognitive, motor, language, social, emotional; and
• considers each child’s cultural, ethnic, and linguistic heritage and experience.

What We Can Do? - Your Role as a Home Based Visitor

What do you actually do on a home visit? Are you supposed to greet a family in a certain way? Do you fill out particular forms? Are you expected to say or do specific things? In reality, no two home visits look exactly alike. You bring your own temperament, personality, beliefs, and values to any role you have. Each family similarly comprises its own personalities, history of relationships, and cultural and familial values. Your relationship with each family is influenced by this rich past and is further colored by current circumstances—including variables such as how confident you feel in your job, the amount of support you receive from your agency, and your own personal life circumstances. Families are also influenced by their current situations—job stability, financial concerns, housing, or the quality of their relationships with others. Given this complexity, we can offer no simple answer to the question what do you do on a home visit? However, the following three principles provide a framework for how you can approach each home visit, despite the great variability in the families with whom you work. Each of the next three points will be discussed further in the following sections.

You are in the home to support child development, the overall goal of the Head Start program. Thus, one of the first tasks you must accomplish with each family is to identify that family’s child development goals. Your challenge is to ensure that each home visit maintains a focus on those goals. Your program’s approach to curriculum helps you to meet goals for children’s development and learning by providing experiences to meet those goals, by identifying the roles of staff members and parents, and by identifying the necessary materials and equipment.

You recognize parents as their children’s first and most important teachers. You support parents so they can best support their children. You provide comprehensive Head Start services to families because children do best when you attend to all areas of their development—physical, social, cognitive, and emotional. Similarly, parents are best able to provide the support their children need when their own needs for a healthy lifestyle are met—physical and emotional health, social support, adult education or job skills, financial stability, and safe housing.

You capitalize on the learning opportunities in the home environment. The home-based program is effective in fostering healthy development because you use the setting in which children and families spend the majority of their time. You emphasize how everyday routines provide meaningful opportunities for children to build on their developmental skills. You help parents understand how simple household items and experiences captivate children’s imagination and promote learning. For example, literacy experiences occur as parents talk and sing with their children, as they follow a recipe during a cooking activity, or as they name objects in the grocery store. You also support and empower parents to recreate and build on these learning experiences for their children during the time between home visits. These repeated experiences have a significant influence on learning and development, helping children to gain the motivation and curiosity to learn as well as the specific language, literacy, and numeric skills essential for success later in school.

Developmental Screening, Ongoing Assessment, and Curriculum Planning: One of your first tasks with a family is to conduct a developmental screening (within 45 days of entry into the program) to identify any concerns about a child’s developmental functioning. The screening process helps you decide whether developmental skills are progressing as expected or whether certain concerns indicate the need for further evaluation. An important point to remember is that the screening process does not lead to a decision about whether or not a child has a developmental delay. Developmental screening is, by definition, a process to determine whether further evaluation is necessary. The screening process begins during the enrollment period as you build partnerships with families and initiate Head Start services. Screening requires more than filling out a formal tool such as a checklist or form. Developmental screening involves observing the child as well as learning from parents and other significant caregivers about the child’s development and behavior.

Parents take an active role in the developmental screening, ongoing assessment, and evaluation of their children. Parents know their children best. They can tell you how their children typically act, the skills their children have, and their children’s likes and dislikes. They are also the ones with whom their children are most at ease and will therefore act more naturally, demonstrating their true abilities. The results of the screening and ongoing assessment are used to inform your goal setting with families and to track progress over time. If you discover a concern about a child’s development, the next step is to get a more in-depth evaluation from your local early intervention program. For infants and toddlers under the age of 3 years, contact your Part C. For preschoolers ages 3–5 years, contact the Preschool Grants program.  Ideally, your Head Start program has strong collaborative relationships with these community providers that enable the referral and follow-up to occur in a timely and effective manner.

Things We Can Do to Build a Partnership with Community

Always remember that you are an invited guest in the families’ homes. The Family Partnership Agreement Process that families open their homes and allow us into their lives in such personal ways. The family partnership agreement is a process rather than a form. This process provides an opportunity to identify family. Think about the characteristics of trusting relationships in your own life and the qualities goals and how the families will achieve these goals. At the heart of the families that make them unique—the feeling of partnership agreement process is the individual pittance, being understood, and organization of Heart Start services having your needs met. These are the same qualities that you want to bring to your relationships with Individual families what makes partnership about feel agreements describe families and understood? Goals, perhaps it is how responsibilities, a person list-timetables, and strategies for achieving family goals you without judging, gives you another perspective from which to view things. These agreements also describe a family’s progress into achieving provides concrete help when you need it. Goals they set. In the home -based program option, Maybe it is his or her tone of voice, this agreement must include an empathy information just mentioned and the esthetic ear, or simply a hug when the person senses that you need it the most. Role of parents in home visits and group Consider socialization experiences [how your interactions with families convey those messages.

Give families the time they need to get comfortable with you, with the home visiting process, and with the way that you will work together. Each family you work with will move at a different pace. The first couple of home visits provide an opportunity to establish rapport—a way of being together that is comfortable, builds trust, and inspires honest communication. It is often wise to let the relationship develop during the first few home visits before you focus on specific issues such as the child’s developmental screening or the completion of required forms or other paperwork. Once you have established your relationship with the family, you are much more likely to have meaningful conversations about child and family needs, resources, strengths, and goals.

Familiarize yourself with principles of adult learning. Adults learn best when they are actively involved in the learning process. Parents decide their own goals for learning, share in the planning process, and are equal partners in decision making. By demonstrating respect and confidence in parents’ abilities, you help them discover their own solutions. Use a Parent’s Guide to the Head Start Home-Based Program as a tool to introduce families to your program. The Parent’s Guide includes three parts:

(1) Introducing Home-Based Programs, which describes what a home-based program is and what parents can expect;

(2) You and Your Home Visitor, which explores how families work with you to best support their child’s development; and

(3) Everyday Moments are Learning Moments, which offers ideas for how parents can help their children learn by using objects and materials in their home. You can use the Parent’s Guide to explain your home visiting program and how you and the family will work together. Use the space provided in the Parent’s Guide to personalize it with important information such as your name and contact number as well as the day and time of your home visits and socialization experiences.

Recognize that who you are as a person—your temperament, past experiences, family and cultural values, and current life circumstances—shape how you respond to the families in your program. Some families will “click” with you right away, and others might not feel like a good match. Talk openly with your supervisor about the reactions you have to the families with whom you work. There is no “right” or “wrong” way to feel. It is normal and expected that each family will elicit different kinds of feelings in you. Your supervisor can help you to better understand your own reactions to the families and can help you develop strategies that use this self-awareness to enrich your professional development. The family partnership agreement does not have to be a written document. The focus is on relationship-building, not on record keeping. You can creatively document the family partnership agreement process and keep track of how families are making progress toward their goals through activities such as journals, video or audiotape recordings, or written plans. Each family partnership agreement will be different because it is individualized to meet family needs and goals. Your job is to document the process in a way that is meaningful to you and the family and in a way that (a) demonstrates to others how you have thoughtfully engaged the family in this process and (b) allows you to effectively track change over time.