At a free health screening, organized by community health workers at a local school, a group of Somali women learned that they had multiple neglected health issues that they would need support to address. Fortunately, Aisha, a local CHW, had a deep understanding of the issues that were driving these health problems and was able, thanks to the trust she had from her community, to work with her community to develop activities that could help. It is an example of what CHWs do best the world over.
While many of the women at this health screening had worked with CHWs in Somalia, or at the Dadaab refugee camp in Kenya, this particular screening took place in Tukwila, Washington — just outside of Seattle. It was organized by Global to Local, a nonprofit organization that aims to demonstrate the effectiveness of global health strategies to address health disparities in local communities.
While these Somali women may have been suffering from malnutrition in their previous home, in Tukwila they were now at risk for diabetes and heart disease. Upon becoming aware of this, Aisha was able to engage the women about why, from their perspective, they were struggling to be healthy.
One major issue they faced was that they had nowhere to be physically active. They didn’t feel safe walking in their neighborhood where there were no sidewalks along the busy roads and they didn’t feel comfortable exercising at the local gym since their culture requires modesty. What they needed was a safe space to exercise, separately from men.
Aisha was able to approach the Tukwila Community Center, who had been unaware of this cultural need from Somali women, and partner with them to create a women’s only fitness program. TCC installed window coverings and set aside specific hours when Somali (and other women who appreciate a space away from men) could exercise. Hearing that child care and transportation were also major barriers to participation, G2L made sure that those needs were met.
Slowly, the women started to attend the classes; Aisha started receiving referrals from the local health clinic; women were losing weight and inches while lowering their blood glucose, cholesterol and blood pressure; and three years later, this service is still in place and TCC recently won a statewide award for excellence in culturally competent fitness programming.
Reflecting back on this experience, I see three key elements that allowed this program to be successful — and they are all connected to enhancing local voice in program development and implementation:
1. Hire and invest in local community members.
Global to Local started in 2010, and has since tested multiple strategies that have proven successful around the world while deeply engaging local communities to determine how those successful global strategies can be tailored to local needs. While G2L has received invaluable guidance from Seattle-based giants such as PATH and the Bill & Melinda Gates Foundation, the most valuable input and guidance we have received has been from the community.
Like CHWs all over the world, Aisha is a trusted member of her community who can glean insights that a doctor never would in a 15-minute clinical visit. She has a shared experience with the women she serves, spends time in the same places they do, and knows their spouses and children. Her ability to connect, understand, empathize, motivate, and support cannot be matched by a trained professional who is unfamiliar with her community.
2. Go for local solutions.
While the approach of employing a CHW is global, the solution was very localand the process of truly listening to what the community wanted and following their lead was what led to success. There are many best practices around diabetes prevention and care and none of them would have likely worked for Aisha’s participants — at least not as an initial form of engagement (we know, we tried them).
It is important to understand that the community is often the experts, they just need some support from a trusted partner to put their ideas into action. In many cases, the process is as important as the outcome of a specific project because of the leadership capacity that remains long after a given project ends.
3. Donors must believe in the power of community.
This sort of work must be resourced by funders who are willing to invest in this idea of community-led development. Typically, nonprofits write grants to donors to describe how they are going to deliver the project that the donor wants to see.
A community-led approach asks donors to also believe in the power of community, and invest in building community voice and participation. G2L has been fortunate that Swedish-Providence, WA State University, Starbucks, the Seattle Foundation, Bartell Drugs, and other progressive donors have supported this approach.
The final thing I would like to note is that there is also a great sense of liberation in following a community-led approach. How terrible a burden to feel, as an organization, that you, alone, are experts? That you need to have all the answers? By empowering communities to find their voice and pursue the change they define for themselves, we are returning the power to where it rightfully resides — with the people we aim to serve.
Over three weeks, Devex will explore how the development sector can work together to promote inclusive local, and sustainable approaches to development. Global to Local will reimagine how to work together to address a myriad of interrelated challenges, pivoting toward more connected and crosscutting approaches to solving global problems. Join the conversation, tagging @Devex and #Global2Local.
Adam Taylor is the executive director of Global to Local and has been with the organization since its inception in 2010. G2L, based in SeaTac/Tukwila, Washington, aims to bring home global health strategies that have worked overseas so as to address health disparities in our own communities.
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