Global and Local community Conversation (GLOCON): a pathway for re-imaging global health and mission

Presented by Dr Ian Campbell, AFFIRM Facilitation AssociatesIan 1

GLOCON is a global conversation about ‘how health looks’ from different contexts.  It challenges the idea that we can generalise about healthcare or understandings of wellness.  On the contrary, every family and every neighbourhood has its own context, its own understandings, its own ‘narrative’ of wellness and its own dreams and problems.   This has implications for health care, which tends to be ‘delivered’ to individuals, via an interface that takes place in a clinical context, where they are away from home and family, and where even the most well-meaning healthcare professional may have difficulty in accessing or engaging with their concerns.

GLOCON uses a methodology, developed over thirty years of involvement in community conversations about health.  This is known as SALT (Story, Appreciation, Learning, Transfer).  SALT involves communities (ie people in their homes and neighbourhoods) coming together where they live, to share their story (or stories), and to identify their dreams.  The task of the SALT team is to come back with a story from their hosts.  Thus SALT becomes a connecting process, linking church or health facility with neighbourhood – which may not feel organized, but actually is.

This methodology is rooted in a belief in the capacity for human beings to own and respond to issues in their own lives (HCR = Human Capacity for Response).  It enables health care facilities to adapt themselves to the primary responses of the community they seek to serve, rather than the other way round.

Exercise

The principle of Transfer is important to this process, and the idea that handing on ‘the good news’ to others.  Transferrable concepts, here, include Care, Community, Change, Leadership and Hope.  Participants were asked to choose, from a range of pictures provided, the image best depicted each of these ideas, and to unpack the reasons why they found this one particularly powerful.

This is not just a methodology for resource-poor countries: research is going on at the moment with churches in the UK, in accompanying community mapping in relation to (eg) addiction.

The following stories were accompanied by slides:

  1. Women in Kitithune, in Kenya, who were invited to ‘go outside the gates’ and encourage women in other places to develop this kind of neighbourhood conversation. Every few months they would reach out to another community.
  2. Southern China:  conversations developed in relation to the normalisation of HIV, and the move from being taboo.
  3. China (Burmese border): community mapping developed in relation to drug addiction and also HIV prevalence, followed by a significant drop in new cases, as measured by local people.
  4. Stepney, London. A community movement to address health issues and to create a health ‘map‘.

Discussion

The discussion was wide ranging.  Here are some of the issues it covered:

  1. The concept of neighbourhood is a vital expression of community and should not be ignored.  This should not exclude other forms of community.  The common factor is functional belonging, which is not exclusive forms but complementary.  There is a particular need to give space to the reality of geographic neighbourhood.
  2. There needs to be external support, and often funding, in order to link communities to external systems.
  3. In Norway, this idea of neighbourhood doesn’t work so well, because for much of the year you can’t move easily around your local area (because of snow etc).
  4. Traditions of professionalism may exclude natural members of a community from this kind of contact.
  5. Zambia: there is no way round the fact that the health system is burdened by HIV, and by lack of resources to respond.

GLOCON presentation

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