Hesperian Health Guides
Building community institutions
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Fair and equal control of natural resources means that all people have a voice in decisions about how natural resources are used and shared. Fair and equal control can take many forms, but all are based in education and organization of people to work together for change.
Environmental health is always a community issue. People must work together, as a community, to protect the resources they share in common. To work together over the long term, people usually form some sort of community group or institution.
When the cholera epidemic began to spread in Ecuador, Salud para el Pueblo organized public health committees to raise awareness and get people to act. To better respond to the cholera epidemic, the public health committees offered knowledge (how to make rehydration drink) and services (building new toilets and water systems). They also helped to restore and strengthen their communities by maintaining a health clinic, and providing health education and training at schools, parks, and in people's homes. And they inspired other people to form groups and institutions, such as the environmental health promoters and the recycling program.
Salud para el Pueblo also worked with organizations from outside their communities to provide money, engineering skills, medicines, and other resources. They made sure these resources were used and managed by the villagers themselves. The communities were also involved in the planning and decision making about expanding the program.
When governments do not provide for the basic needs of their people, the people must build institutions for themselves, as Salud para el Pueblo did, to make sure the future is healthy. Often, when communities organize, the government then responds by fulfilling its responsibilities to the people.
The different resource needs of men and women; of workers, farmers, foresters, and ranchers; and of industries, land developers, and others, can bring conflict into your community and your organization. Sometimes problems can be particularly difficult, such as balancing short-term needs for income and long-term health needs. Building strong community institutions often takes so much time because recognizing these differences and trying to settle these conflicts is difficult. Making long-term health a goal, and finding ways for everyone to work toward meeting this goal together, can help resolve difficult conflicts and build strong institutions that protect the common good.