Health Champions in the Eastern Cape

I saw 3 giraffes and 2 warthogs on my way to work yesterday….not something you see every day but what a great start to an informative and inspiring day spent with Lucy O’Keeffe and Kath Court from the Angus Gillis Foundation (AGF). AGF are based in Grahamstown in the Eastern Cape, considered to be the poorest province in the country with 72% of the population living in poverty and a third (32%) of households having an income of less than R200 (£20) per month.

Like Altogether Better, the AGF takes an empowerment approach, as illustrated in this quote from their website:

“The Angus Gillis Foundation facilitates and does not drive development in communities because we believe that, with the right support, community champions can drive their own development, thus bringing about genuine and lasting change” (Angus Gillis Foundation, 2011)

The AGF works with 12 communities in the Eastern Cape and facilitates development using asset based approaches which emphasise people's existing skills and capacities. They take a truly holistic approach operating 4 key programmes: 1) Self-help groups 2) Education 3) Economic Development and 4) Health.

Whilst the health and social needs in the Eastern Cape are very different to those in Yorkshire, AGFs Positive Health programme, facilitated by Kath Court, has many similarities with Altogether Better. They even have their own Community Champions and Positive Health Champions! I was keen to meet some of them and find out about their work. Kath told me that the Positive Health programme aims to, “provide communities with as much information as possible, to enable them to achieve optimal physical, mental and spiritual well-being. It's about presenting methods of preventing illness and staying healthy.”

Lucy (left) and Kath (right) from AGF with Health Champion, Novulo
in the herb garden at the Community Centre

The Health Champions are people from within the community who have leadership potential, have good language skills and have developed the necessary health related knowledge. Kath told me how the self-help groups (SHG) which AGF established are often where the Champions are identified and first emerge. Through the SHGs, the women  begin to start sharing their problems and discuss social issues in the group. This helps a new relationship of trust and togetherness to develop so the SHGs  become a breeding ground for social capital as well as future community champions!

We travelled to the Brandeston community (situated within a private game reserve) to meet with Noluvo, a Positive Health Champion working in the community. Noluvo showed me around their community centre which housed a number of facilities for use by community members including a simple gym, a knowledge centre/library, a crèche and pre-school, a herb garden, and the workshop of the Siyakhula Doll Cooperative, run by women from the local area as a means of generating income.  Kath later explained to me how, before her involvement with the self help group and becoming a Health Champion, Noluvo would not have had the confidence to talk to a stranger such as me, "the strides she has made in terms of her knowledge, confidence and ability to engage with others have been huge."

We arrived at the Centre lunch time as the children were tucking into a healthy meal. Kath explained how the Centre used to provide the food mixed together, like in a stew or a soup, but that she had worked with the Champions and the children to explain the different food groups and why each was important in health terms. The children were proudly able to tell me that carrots were good for their eyesight, that the potato (carbohydrate) gave them energy and that the chicken (protein) made them strong. Kath had encouraged the workers to serve the food on a plate with separate sections which helped remind the children about the importance of different food groups (see photo above).

We then went on to a nearby community, Kalkeni, to meet Nomhlobo (see photos left and below), a retired nurse who had grown up in the area and moved back in recent years. She now works as a Positive Health Champion and told me how she helped with a range of health issues in the community including child health, nutrition, keeping active and sexual health. Nomhlobo felt strongly that people should be encouraged to help themselves and be self-sufficient, not always relying on help from outside. She explained how she had a role in encouraging people to grow and cook their own food and showed me the goats they were breeding which were then sold on to generate income.

Positive Health Champion - Nomhlobo

Our last stop was to meet Lindi in Glenmore (see photo to the left) – a community of around 2000 people. Lindi, in addition to working at the community run bakery, is also a Positive Health Champion. She attends the local health clinic (staffed by 3 nurses) every day to provide advice and support to people, she also runs workshops for community members on a range of different topics including child development, hygiene, gardening skills and parenting. She also provides 1:1 support and advice to people in their own homes when they are too sick to attend the clinic. Lindi told me how her own knowledge and confidence had grown enormously since becoming a Champions - and how she got great satisfaction from sharing her knowledge to help people.

On the way back, we stopped by at one of the safe play places for children. Kath explained how they had been taught about the importance of hand washing and, on Kath's instruction, all the children rushed outside to the hand washing bucket and duly washed their hands. Kath  explained how the children  were also 'champions' and in teaching them about basic health and hygiene, they will grow up as a future generation who value the importance of health and of keeping healthy and also understand and share what they can do to help with this.

Waiting in line to wash their hands.

There is much to be learnt from the AGF asset based approach to development. They deliberately avoid using any external material resources in the initial stages as this is seen as contrary to the Self Help concept. Although the people AGF work with are very poor, their personal assets and natural potential to manage their lives is identified and mobilized.  AGF see development as, "not about resources but about unlocking human potential". Conventional approaches often assume that poor people have no assets, AGF is clear that this is not the case and that they must first work with the assets people have and affirm them that they can do it. Then when they are strong, material resources can be introduced responsibly.

Worker in the Dolls Workshop

“As outsiders we cannot empower the weaker section, only they can empower themselves, to make choices or to speak out on their own behalf. We can walk alongside them, introduce resources responsibly when they are needed, and provide necessary training, support and motivation.” (Angus Gillis Foundation, 2011)

Wise words and important learning for us in the UK, especially at a time when external resources are scarce, and where the culture is often one of 'provider' and 'client' rather than one of  true empowerment.