Please take a look at the following bleg and offer whatever fruitful ideas you might have.
Dear Freakonomics,
My name is Michael Frank and I recently began working for a start-up NGO in Mali that strives to improve health. One of our programs is called “Action for Health,” which provides in-need families with access to free health care in exchange for doing a set number of predefined actions that benefit public health.
The logic behind this program is that studies have shown there to be an enormous jump in the percentage of citizens who choose to receive health care in Mali when it is free as opposed to just heavily subsidized. We require the actions be done so that the residents don’t take the free care for granted and because these actions improve public health either for the individual or the community.
A good action for health is something that improves health, is easily measurable, and is not so burdensome that it seriously hinders the participation of this in-need population. The action of a comprehensive hand-washing program for example, as detailed in Atul Gawande‘s new book The Checklist Manifesto, fits two of these criteria but it is not ultimately easy to monitor compliance. One recent action for health that fit our three criteria reasonably well was a recycling day, during which residents had to spend the day picking up the trash that is ubiquitous on the streets in Malian slum neighborhoods.
My bleg is: What other ideas do people have for “good actions for health” that fit our criteria? I’d also be interested for any other ideas that people had for our NGO in general. Thanks.
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Recycling is great. Continuing on that track you can have them build solar water purifier or solar ovens. Any kind of contribution to a larger effort at the neighborhood or (village scale) that would improve living conditions hence health.
For more ideas I suggest you check out Barefoot Doctors english web site: http://www.mapn.org/spip.php?rubrique33
I applaud your effort, but question whether a service remains free if action (i.e. work=money) is required.
As for projects, anything towards clean water, sanitation and hygeine will probably have the largest impacts. For hand washing, maybe soap dispensers could be given away and this would give a proxy for compliance as measured by the rate of refills?
Read Dead Aid by Damisa Moyo. I worked in a rural village in SubSaharan Africa for one year and was frustrated by the Euro-Amero centric programs and projects that were be implemented without the buy-in from the local folks who were supposed to benefit from all those resources coming from the West. Too often westerners impose their great ideas on those “less fortunate” because we think they should be like us. In the words of a recent hit movie, you think they want our light beer and blue jeans?
My suggestion would be to live in a village for awhile, see what their lives are like. When you tell them to use water to wash their hands, first you should spend the half hour pumping it into a bucket and carrying it on your head a couple kilometers back to your home. Once you let go of everything you’ve learned about people you don’t know, and then try to see them for who they really are, you will have a better idea of how to help them.
what about community gardening? I don’t know if land would be a problem, but if set up right it would be good for the health and the community as a whole.
What about, I don’t know… asking them what they want?
Get them to stop smoking. There are probably methods that could not be done in the first world.
Try to follow the advice that they get from the health care porviders. Start with checking in at appropriate intervals.
You could offer community family days. There could be fun activities for families to be involved in, building a sense of community. It would also allow a chance to push other public health messages such as hand washing in a more subtle way to avoid people feeling as though you are pushing the message too hard.