Community Health and Training of Carers
Country
France
Description
Consciousness raising actions:
Theses actions are means to take advantage of a useful activity to inform the people cared for by the organization and to stimulate their interest in health problems. Activities such as footbaths, toilet set distribution, well-being workgroups, community talks allow people to better handle their own health problems. These activities go beyond the specific issues addressed to aim for a global well-being of the persons. They are a way to inform these persons and strengthen their bonds with the organization.
These experiments were discussed within the organization and lead to new projects of awareness raising actions, such as working on meal quality, not only to address dietetic issues, but also to share a moment of pleasure; resting beds that must not be mistaken for infirmary beds.
A whole new field remains to be explored regarding such actions, e.g. for homeless women who are especially lacking lodging and may have experienced mistreatment. The organization has also worked on the links between health and insertion problem, thus exploring the meaning of the "I" in RMI (revenu minimum d'insertion, a kind of social welfare allowing a minimal monthly income in exchange of an agreement to try and regain an active social role. Insertion is meant in this context as the process of regaining an active social role, mainly through employment.).
As varied as they are, these experiments must focus on the community health principles to gather useful experience.
Aims
The community health approach discussed here started with an action centred around HIV/AIDS with the ARCAT SIDA project, where 120 employees and helpers were trained. This experiment showed that AIDS prevention was not a major concern inside the EMMAÜS organization, even though the training project raised a considerable interest. Members were interested both by the acquisition of new skills in AIDS prevention and cure and by the way health issues were addressed through a person-centred approach.
The information and training process through community talks was itself a community-based process, implying a more person-centred approach, health being only an aspect of global problems. Obviously, such a mode of operation requires a re-organization of the departments and human resources, which can only be gradual, in the following areas:
- Social and medical needs of the people cared for by the organization;
- Global health care and security policies;
- Evolution of social and medical policies;
- Adaptation of professional and institutional patterns.
Areas
Health, Housing, Social services, Training
Effectiveness
Inclusive experiments were conducted on two occasions, even though they were not identified as such: public health care professionals mobilised themselves to allow people taken care of by health lodges to benefit from medical check-ups, adapting schedules and freeing dedicated time. A similar experiment was conducted around mental health problems.
Sustainability
People living in the street have lost all practical means to exert their fundamental and social rights, including those related to health. Even though the health lodges are accustomed to weave links both between various EMMAÜS departments and the suffering people and between these people and the health care organizations, the public health system (hospitals, medical practices and laboratories) should also welcome this population that does not have much resources
Innovation
People living in the street have lost all practical means to exert their fundamental and social rights, including those related to health. According to the principle of inclusion, health professionals, health lodges and the whole EMMAÜS NGO shall make sure their fundamental rights are respected.
Added Value
The added value of the project is guaranteed:
- Since it allows the participation of deprived people, who can acquire skills and improve their social conditions through training and voluntary work.
- Because this process contributes to an increase in self-esteem of local populations, especially the deprived people who can regain control of their lives and health-related choices.
- Because all actors on a given territory are involved (helpers, professionals, institution employees, politicians and the people themselves).
- Because it conveys a potential for dissemination (awareness raising, training, outward communication) and mainstreaming.
Transferability
The community care model exists in another countries in Europe.
Mainstreaming Potential
The principles of this model can be mainstreamed, provided they are validated internally by the organization wanting to start such actions and externally by the local powers and institutions involved in the process.
An analysis of other EMMAÜS actions could show the changes brought by the community health approach to the attitude of public institutions implementing the common law toward the most insulated people.
The inclusive approach also works for representation since in case of extreme discrimination victims are simply ignored. In that case, the main goal becomes to prevent this disregard from the public institutions
People involved in the Project (number of people and profession)
Professional social workers and head of departments, helpers recruited among strongly alienated people such as homeless or immigrants cared for by the NGO, partner institutions, professionals from the medico-social sector, research or training institutions, local political instances.
Strengths and Weaknesses of the Project
Difficulties could arise with the change in the involvement and representation of homeless people and the model of assumption of responsibility. Increasing these actions requires at least new ethics and resources.
Contact Person for the Project
Florence de Grammont
EMMAÜS