Hope and Healing Through Comprehensive Community-based Primary Health CareHealth is a state of complete well-being-- physical, mental, social, and spiritual-- not merely the absence of illness. The aim of the General Board of Global Ministries' program of Comprehensive Community-based Primary Health Care (CCPHC) is to restore harmony with God, with family, with society, with nature, and with self. Proponents of CCPHC believe that health is a fundamental human right that no individual should be denied. Jesus, the greatest healer, taught us this principle through his miracles of healing. Following Jesus' teachings and example, Christians over the centuries have brought healing to millions through hospitals, clinics, and health posts. People and their communities can and should be responsible for their health. Health is attainable, accessible, and sustainable by people for themselves and their communities if they are given the opportunity. Eighty percent of the illnesses that affect populations in poor countries are preventable. Unless people are empowered to take charge of their own lives and health, no sustainable achievement in improving health is possible. CCPHC initiatives therefore support effective community programs of awareness, education, and development of human and economic resources. These programs also value local cultural practices as a source of preventive and curative health. Comprehensive Community-based Primary Health Care was started during the early 1990s by Health and Welfare Ministries and by the United Methodist Committee on Relief (UMCOR). It is derived from the Jamkhed model created in the early 1970s by Dr. Mabelle Arole and Dr. Rajanikant Arole in the villages of India's Maharashtra State.
Seeking to reach the goal of health for all, General Board of Global Ministries (GBGM)-- in partnership with the Council of Evangelical Methodist Churches in Latin America and the Caribbean (CIEMAL); with episcopal leaders in Sierra Leone, the Democratic Republic of Congo, and other countries in Africa and Asia; and with Dr. Rajanikant Arole of India-- participates in a program of assessment, training, and implementation in several countries around the world. This program prepares lay and professional health promoters from both rural and urban areas. The training is conducted in Jamkhed, India, as well as in the participants' own communities. Training does not come from an academic manual but from interaction with a working model. This South-to-South cooperation-- with interaction from poor to poor, community to community, lay to lay, and professional to professional-- demonstrates that all people are capable of receiving and giving,affirming their interdependence and their human dignity. Three PrinciplesAccording to Dr. Raj Arole, three principles serve as the basis for the CCPHC programs.
With these principles in mind, a CCPHC promoter needs to go to a community with humility, honesty, boldness, and faith. The health promoter must go to the people, live with them, learn with them, love them, begin with what they know, and build with what they already possess. Then they will be able to say: "We achieved it and we'll work hard to sustain it and improve it." Changing the WorldAt the present, Comprehensive Community-based Primary Health Care is being implemented in more than 20 countries. The GBGM is exploring the potential for starting CCPHC programs in additional countries, such as Kazakhstan, Lithuania, and Afghanistan. As we enable the promotion of this preventive community-based health care, we must also make sure that communities have access to quality curative care through hospital, clinic, or health post, as appropriate. There is no either-or when it comes to institutional and community-based health care. Both are important and should be utilized in ways appropriate to the needs of the community, as determined by community members. According to Dr. Raj Arole, "Community Health is a spiritual thing." One of the health workers at Jamkhed summed up the impact of CCPHC training in her life in these words: "As I change, I change the world around me."
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Testimonies to ChangeThe words of the following health coordinators and health promoters speak loudly about the success of CCPHC in different regions. Eliene Bispo (São Paulo, Brazil): "CCPHC means enabling people to realize their own worth, to become responsible, and to do something about their situation. It takes people from hopelessness to hope." Juanita (the Altiplano, Bolivia): "CCPHC means empowering women so that they can become responsible for their own health and development, realizing their own potential." Eluzinette Garcia (Brazil): "My time in Jamkhed helped me to discover my own potential and motivated me to work with poor communities. The church has a responsibility not just to run clinics but to raise people's consciousness about their health and their rights." Sara, Blanca, and Elli Flores (Cochabamba, Bolivia): "Before CCPHC training, we were not very clear about what we were doing. Now our commitment has been challenged and deepened. We have found alternative ways to work in communities. We have learned to be creative and to start from basic things in our work with people." Beth Ferrell (Maxixe, Mozambique) reports: "In 1994, the Community Development and Preventive Health Course Project was initiated for pastors' wives and churchwomen from all over Mozambique. It was to address the needs of underserved areas and to promote preventive rather than curative care as a more fiscally responsible approach in places such as Mozambique where there are limited resources. For example, in 1995 and 1996, Mozambique was listed as the poorest country in the world by the World Bank and the United Nations. In 1997, Mozambique 'graduated' to become the world's next-to-poorest country. "This ongoing community health program to empower women in Mozambique has been well received and continues to be necessary if women are to attain the abundant life Jesus talks about in John 10:10. Five courses of four weeks each have been given to date, with a total of 60 participants from nine of Mozambique's ten provinces. "The course is a very basic one. It focuses on sanitation, hygiene, clean drinking water, adequate nutrition, family planning, maternal and child health care, and disease prevention, recognition, and treatment. It is a vehicle to achieve positive results in all these areas through community development and use of existing resources. Continued cooperative efforts among course participants in the same locale and faithful prayer support for all members of the group are encouraged. "The participants return to their homes, communities, and church groups to share what they have learned. This enriches the lives of others at the basic level of need. Ideas regarding how to generate income are also discussed. These ideas depend to a great extent on land, roads, rainfall, material available for crafts, and tourists." Nora Quiroga Boots, the Coordinator of CCPHC in Latin American countries, reports: "During a Spirit-filled Sunday morning just before Christmas 1997, 12 adults and youth were baptized into the Christian faith in Emmanuel Methodist Church in Cochabamba, Bolivia. That same evening, another 15 adults took vows of membership in this same faith community. They are mostly very poor people working as domestic helpers and day laborers. Many live on the equivalent of less than $100 a month. "It is most significant to note that the lives of all of these people have been touched and impacted by the comprehensive community-based health-care ministry of Emmanuel Methodist Church that was begun just two years ago. The congregation and pastor give enthusiastic witness to the new vision and to the renewed energies for mission and ministry that have been called forth through this health initiative. "This 'health for all' community project is one of a number of outreach ministries initiated by CIEMAL, Health and Welfare Ministries, and UMCOR through Methodist churches in seven of the countries of Latin America and the Caribbean. "Comprehensive Community-based Primary Health Care, as developed through Methodist churches within an ecumenical context, is a ministry of service. No distinction is ever made between Methodists or other Christians and people of other religions or people of no religious faith. But while this ministry is not undertaken as a means of evangelization, the witness of loving service sometimes falls on fertile ground, leading some to consider the challenge of Christian discipleship and to accept Christ as their Lord and Savior. Comprehensive health is always open to embrace the spiritual for this is the ultimate dimension of human existence. And what is evangelization if it is not to share the Good News of Jesus Christ, who was the Great Healer." |
This article has been adapted (March 2001) from "Hope and Healing Through Comprehensive Community-based Primary Health Care," New World Outlook, March-April 1999, pp. 22-25. © copyright 1999 General Board of Global Ministries, The United Methodist Church. Used by permission. At the time this was written, Sarla Chand was executive secretary of Congregational Health Ministries in the Health and Welfare Ministries section of the Health and Relief program unit of GBGM. Beth Ferrel and Nora Q. Boots were both United Methodist missionaries with the General Board of Global Ministries.
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