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.