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).