The Metro Health Club: Grassroots Action for Improved Community Health in the Western Cape
For the past four years Africa AHEAD has been trying to introduce the concept of the Community Health Club Methodology into the informal settlements of the Western Cape. This has presented quite a challenge and it was open to debate whether the CHC approach, so effective in the rural areas, could really have the same appeal in the squatter camps of the Mother City, where there is little community cohesion, and where alienation of marginalized communities and political infighting by gate keepers has undermined so much development.
In 2005 the CHC idea was introduced into Khayelitsha through the University of Western Cape who sponsored a workshop facilitated by Africa AHEAD, where the first 25 facilitators were trained. The training was poorly received by existing stakeholders, and only one facilitator managed to establish a CHC the first time round which did at least demonstrate that a health club could work with the right facilitator.
Later that year working with Africa AHEAD, Hygiene Promotion Partnership, a research wing of BYU University adopted many of the concepts of the Community Health Club approach to start over 75 health clusters (groups of ten families) in the informal settlements of Du Noon, Phillippi Sweet Home and Kwa Five.
In 2007, the City Health Department sponsored Africa AHEAD in the development of training materials to scale up the CHC training, and with the new Tool kit of visual aids and the manual, two workshops have been held in the past two years, with another 50 participants trained in the CHC Approach. City Health Department has been working hard to integrate all development in the informal settlements through CHCs but with over 240 informal settlements this is a real challenge. Ngcwele Dyani was appointed as liason between the CHCs and Health Department and in June 2009, a large graduation ceremony was held for the CHCs in Phillipi. Mr. Armien Petersen of Environmental Health in City of Cape Town Health Department was amazed by the response, as it has shown that Health Clubs are as attractive to women in town, who just like their counterparts in the villages love to come together for self improvement. It is also clear that although the CHCs are well received in informal settlements, to make any impact on preventing diseases like diarrhea there has to be a thicker diffusion of health clubs throughout every informal settlement.
There are now 120 active Community Health Clubs in the Western Cape and in July 2009, they formed an umbrella group to coordinate their activities. The Metro Health Club is the ideal mechanism for replication as it has been started by CHC leaders themselves, and is a genuine bottom up initiative. The executive board gave us a vision with great enthusiasm of how MHC plans to expand the activities of the health clubs through an holistic approach. Currently drafting their constitution in order to get registered, the MHC will focus on coordinating all CHCs in five different fields: Water and Sanitation, Health, Special Projects, Education, Recruitment, Finance. Each health club will have a representative for each field and these will meet regularly to facilitate development initiatives throughout the informal settlements, acting as grass roots instruments for change within their community. The MHC is encouraging those living in the informal settlements to take ownership of their problems and like the ethos of the CHCs the main focus is to stimulate self-help. The Metro Health Club is the best proof yet of the viability of the Community Health Club approach, as a vehicle of change in informal settlements, to uplift communities using health promotion to galvanise the energy of women.
Since the creation of Metro Health Club, the City of Cape Town and the Health Clubs have embarked on a truly special and beneficial relationship. The City has created a database of all the CHC members, to use for employment for city projects involving water, health, sanitation, and hygiene. As all CHC members have a basic training in these subjects, this allows the City a quick and easy way to find knowledgable and reliable employees, while offering much needed employment opportunities for CHC members.
Metro Health Club held its first event on National Hand Washing Day, 15 October 2009, where the health clubs gathered to promote hand washing with soap in the informal settlements of Cape Town.
Africa AHEAD has pledged to support the Metro Health Club, to enable more training and skills development in the 120 CHCs of the Western Cape.
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