1 - 2 - lecture 2a- definitions of community (33-27)

7/27/2019 1 - 2 - Lecture 2A- Definitions of Community (33-27)

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[MUSIC]With lecture 10, we're starting on modulefour that looks at the community level ofthe ecological model.Looks at community change processes,attempts to understand how the communityis constructed, what kind of activitiesgo on at the community, what we can learnabout health from the community.First picture shows a view of downtownIbadan in Nigeria.Ibadan an old city that was founded over200 years ago by various warring campsduring inter-tribal wars.And the city has now grown to over twomillion people.What is interesting is that the cityitself has many different subcommunities.In the front, one can see large buildingsthat are three or four stories.This is in, what one would call atransitional area.Relatively, modern in construction, built

since the 1950s, of people who come fromall over, Nigeria.But farther in the distance to the left,we have a more indigenous section, ofpeople who are descendants of thoseoriginal, settlers from over 200 yearsago.Houses are still made with mud, even ifthey're two stories tall.People trace themselves to a commonancestor.They still have indigenous chiefs andkings in that area.

Very densely packed.Toward the middle and the back is themodern business district.Off to the far right in the back would becommunities that are like, housingestates or housing developments.And so, there are different kinds ofcommunities within a city and it'simportant for us to realize that theseexist.They have different characteristics,different needs,and different subcultures and

backgrounds.The question, therefore, arises, what isa community?And various definitions are presentedhere.One has community as being a group ofpeople living in the same defined area,and sharing the same basic values,organization, and interests.Two clear components, the idea of


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location, and the idea of social systemand values that distinguish a community.This is particularly true, of places likeIbaden. These days of course, in placeslike US and Europe.Geography does not necessarily definecommunities completely because peoplehave other ways through the internet aswe're using now.And telephones to have contact with a wi,wider group of people that form theircommunity or social networks.But still, for the most part, we'reconcerned about where people live and therelationships they have with the peoplearound them.And, again as noted, if they share acommon sense of identity values,organizational structure, leadershipinterests, concerns, they are then acommunity.Another definition looks at community asan informally organized social entitywhich is characterized by a sense of

identity.This brings us back to our discussion inmodule one about units of identity.And, of course, after one develops from aconcept of an individual to family tosocial groups, neighborhoods, then oneidentifies next as one matures with acommunity.And so, people within that community canidentify, can explain who belongs, wherethe boundaries are.So, this sense of identity is veryimportant in defining a community.

Another definition says the community isa population which is geographicallyfocused, but which also exists as adiscrete social entity with a localcollective identity and corporatepurpose.Here again, the idea of common norms,common culture,and organizational structure, leadershipetc.,defines a community.So, from the foregoing, we can see thatimportant components of community are

locality.The fact that defined social group existsinterdependent among it self.Different social networks combining toform this community.A community consists of relationshipsamong it's members,and a community has a shared culture ofvalues, norms, sense of belonging,identity.


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We'll now talk about the concept ofcommunity diagnosis.During the review of precede model inmodule two, we talked about behavioraldiagnosis, educational diagnosis.If we're going to work with thecommunity, we do need to also diagnosethe community to understand how itfunctions.Community diagnosis is used not only toidentify problems and needs, but equallyimportantly to identify resources thatcan help solve community problems,community strengths.A community is comprised of systems.When a physician conducts an exam of apatient, the physician looks at systemssuch as the respiratory system, thegastro-intestinal system.Community also has a series ofinterrelated systems.And we look though those systems to helpus identify how the community isstructured, what the concerns and issues

are, where the solutions and resources toproblems may be.One of the five systems that we'lldiscuss is the social system.And if we think back, we're parallelingour discussion about the contribution ofthe social sciences to primary healthcareand that let's us see these fivedifferent systems within the community.The social system defines the basic unitsof identity, social groupings,institutions, families and it alsodefines the roles that people play in

these units in the community.In the social system, we're concernedabout a concept called social capital.And this in a way takes us beyond lookingat the community as a source of problemsthat need to be solved to the communityas a location of strengths and resources.We've talked about social networks in theprevious module.And social networks, these groups, clubs,associations, connections, are socialcapital.They are the resources that help people

accomplish their goals.They are the groups and organizationsthat the community can draw upon to helpdig wells, build clinics, make contactswith the outside agencies.So, it's important as part of ourcommunity diagnosis to identify thesegroups, find out what their strengthsare, what types of activities they'reengaged in, and what their connections


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are.It's the social and economic resources ofthe community that are embedded in thesenetworks.This is where we can find, as we said,the strengths of the community.And again, these strengths go beyond theindividual community.Because these networks have contacts withexternal organizations and can bring inresources for the community.Another important system in the communityis the political system.This is concerned with power relations,leadership structure, subgroups,and how power is shared among thesegroups.Some may be disenfranchised,some may be power elites.It also recognizes that the politicalsystem consists of both formal, forexample, appointed, elected, designatedleaders.And informal leadership are opinion

leaders,people who are valued for theirexperience in the community.People that others go to for help andadvice.Behind the scenes leadership.As we mentioned, the political systeminvolves both informal and formalleaders.It helps us examine the decision makingprocess.Are decisions reached by consensus, byvoting, by strength and power?

What is the level of participation anddecision making?Are all groups involved?Men and women,younger people and older people,different ethnic groups, differentreligious groups.And, ultimately, in terms of ourleadership issues, are the leaderaccountable? Who do they report to? Whoholds them in check?Even in some of the traditional kingdomsin Nigeria, the king, all though his

position was inherited, could be drivenout of the town if the people were notsatisfied with his performance.There was a traditional procedure that ifpeople in the community were unsatisfiedwith the work of the king, or felt thathe was being vindictive, or wasting theirresources.If all the women paraded through thestreet naked, the king would leave the


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town immediately.There was no recourse.So, the question of leaders, whetherthey're democratically or elected, orthey come by their position throughinheritance, they're accountable to thecommunity.But to what extent, and how does thataccountability work?A third system is the cultural system.The cultural system considers the basicbeliefs and values of the people.It also describes their way of life, howthey go about doing things, thetechnologies that they use.If it's a farming community, do they farmusing hoes and cutlasses?Do they farm using tractors?What is the system by which land isallocated?So, this would be an example of acultural system.A fourth system is the economic system.In the economic system, we examine the

resource base.How do people earn a living?And, considering the resources that areavailable, how are these distributedwithin the community by section, bygender, by age group.The fifth system that we will consider isthe geographic system,and this concerns how people use thespace available in their community.Where are important resources actuallylocated?How is movement facilitated?

Communication among people?These are issues that one would look atin the geographic system.And related to the geographic system isthe issue of mapping.Maps help us diagnose the community byshowing us the location of resources, thedistribution of the population, access ofthe population to important resources,and prevalence of health problems.Much more sophisticated mapping hasdeveloped in recent years usinggeographical information systems,

satellite positioning, etc.But, at the local level, if someone isinvolved in public health and wants towork with the community, it's importantto involve the community in mapping andunderstanding these relationships ofresources and population.It's important to get the communityinvolved in doing their own mapping oftheir community.


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This may be done with simple sketches.It may involve bringing community memberstogether in an open space using sticks,bottle caps, stones to draw roads, tosymbolically represent houses ofimportant people.The community can be involved in doingits own mapping, it can come to anunderstanding of some of its basicsocial, economic, political, and healthproblems.The next slide shows a rough sketch mapof Apata village.And this will come up win your laboratoryexercise.This is a prototype of some of the kindsof villages where we're working inNigeria, where Guinea worm and othertropical diseases are common.If you look at the map carefully, you canstart to get some ideas about what someof the health and social issues might be.You can formulate hypotheses based onyour observations.

Clearly, a health worker should not makethese hypotheses and jump to conclusionsin isolation.This is why, we say, it's important thatthe community actually provides and givesmeaning to these observations.If one looks closely at the map and see,there are two different settlementpatterns at the top.The little squares represent houses aretightly clustered but not in particularorder.There are dotted lines that represent

foot paths, there's only one paved roadthrough the middle of that section.Whereas, in the bottom part of the maphave a more laid out area with streetsand houses along streets?One would want to consider why does thatoccur, are there differences in the twopopulations?Do these differences imply differenteconomic status, different diseasestatus?One could ask questions whethersanitation is different in the two areas,

and the diseases that result from poorsanitation.If you look closely, you can see thatwells are primarily located in small,blue circles.In the bottom half of the map, whereasthese oval blue items are pawns, andthey're more common.In the upper section, so people havedifferent access to different kinds of


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water sources.What does this imply in terms of healthand disease?But in terms of the systems, why?Are there different ethnic or socialgroupings?Do people in one section have differentoccupations, different income levels?Other, quote, modern or Westernfacilities that are amenities that areavailable in the community are morelikely to be found in the lower portionof the map.There's a court, a high school, a postalagency, primary school, and thecosmopolitan religions have their majorbuildings in the lower part of the town,too.In contrast, in the upper part of thetown we see shrines with, for indigenousreligion located on the rocks surroundingthe town.There is a King's Palace, the marketthere is not drawn with.

Right angles, straight line the, themarket spreads into the surroundingneighborhood.So, these could represent differentpopulations or the same populations butdifferent economic strata within thatpopulation.You wouldn't want to investigate and askpeople why these services are located inone place.What are the differences?We've done simple studies in communitieslike this and found that for example, the

health center being closer to one sectionof town influences whether women willdeliver their babies in the health centeror not.It's less likely in the.Upper section.The farther section of town for women tocome down to the health center and useit.In terms of community diagnosis, lookingat a map like this, one would want tofind out something about Guinea worm.We can clearly see that there is a

geographical influence.The people in the upper section of towndo not have easy access to safe watersupplies so they can get Guinea worm bydrinking water from those ponds.There's probably an economic issueinvolved to dig and build sanitary wells.Money is needed.A proper well may cost $500.People in the south side of the town, the


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lower side, may be able to mobilizeresources and construct these things.Whereas, in the upper section of thetown, they don't.There may be cultural differences.People in the southern or the lower sideof the village have more access toeducation and they may have imbibedscientific beliefs about guinea worm,whereas people in the more congested.And possibly more indigenous area of thecommunity probably hold on to the beliefsabout getting warm, being in someone'sbody.And you can see they may have theseshrines here.And consider an outbreak of Guinea wormbeing caused by the anger of one of thelocal divinities.So, this is the way that one can usemaps, but also looking at maps andgetting ideas about what is happening inthe community, confirming those with thecommunity, and reviewing the different

systems, the geographical, the cultural,the economic, to find out why problemsexist.And identify where the resources are tosolve the problems.Where the political leadership is whocould mobilize people.Where staff may be that have knowledgeskills to, to share with the people tohelp them solve problems, like in thehealth centers and the schools.So, maps are important adjunct to ourcommunity diagnosis to help us learn more

about the communities.In the next slide, we'll talk about someof the characteristics that differentiatedifferent types of communities.As mentioned in a couple of thedefinitions, the issue of identity isvery important.How strongly do people feel that theybelong to a particular community?How much aware are they of their localvalues?How strongly do they feel that they sharea common destiny with the other people,

their neighbors?Is there a consciousness of where theircommunity is spatially politically andthey point out the boundaries and theydifferentiate their land from otherpeople's land?A question arises. How do we know ifthere is a strong sense of identity ornot?And some of the questions we may ask


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people in the community, or we mayobserve if we walk around the community,is that people are generally gettingalong with each other.They're friendly, they talk in thestreets, we can ask people what theirinterest and concerns and values are. Andif you talk to enough people, you'll seethat they share these values andinterests.There's feeling of comfort with theirneighbors.People feel free to leave their childrenwith their neighbors if they go to themarket or go on errands.Also, in terms of identity there's astrong sense of place, of their location,of their neighborhood and as seen in thenext slide, a strong sense of communityhistory.They know where they're coming from andhopefully they will be able to plantogether for where they're going in thefuture.

Another important communitycharacteristic is integration.How often and to what extent do peopleget together, visit, interact, havefestivals, do things in common?What does bring them together?Do they socialize together?Is this evident in former communityprojects, activities?Have they engaged in self-help?Have they built a primary school?Did they dig a well?What have they done together?

A good place to start our diagnosis toobserve interaction is in the market.The market brings people together fromthe community.Are they going from shop to shop talkingto people?Do they gather in a small eating ordrinking place and share news aboutcommunity happenings?Are community leaders present in themarket and people are bringing theirconcerns and complaints?In addition to observing interaction,

integration, one can also again, observecertain important things about the healthand the structure of the community.The economic status is important.Can people afford to buy goods?We observed in a small community likeApata that even though the town is 10,000people, the butchers do not evenslaughter one cow to be selling the meatin one day.


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They may bring over a portion of a cowfrom a neighboring town and sell thatmeat so people do not buy much meat.Maybe there's only one or two peopleselling cloth, whereas in the next town,there maybe six, seven, or ten shopsselling cloth.So, one can get some idea about what isavailable, what people are buying, howmuch money one can find out about prices.Nutritional options are important.What crops are being sold?Is it primarily carbohydrate?Do people have variety?As mentioned, we can look at socialsystems.The market itself may comprise socialsystems,different sellers associations.But also, an opportunity for familymembers who may be living in dispersedvillages to come together and havemeetings implies that the market is agood communication network and we can

learn more about the community byvisiting the market.Another word for integration of acommunity is also cohesion.The next two slides show examples of acohesive community, when people cometogether to enjoy festivals.One festival that happens every year insouthwestern Nigeria is the GeledeFestival.It's partly a fertility festival.And interestingly enough, the women takea major role in this festival.

As you can see in the slide, we have amasquerade, or a statue that's paradedaround the town.There are various parades, events likethat, people come together and cook andeat together.And so, this is an opportunity for peopleto show their membership in thecommunity.In the next slide we see picture from theSierra Club magazine showing an AmericanIndian festival.One of the concerns that was expressed in

the article that accompanied this picturewas that such ceremonies are decliningand there's concern that.General environmental conditions that mayreduce the presence of salmon, would makeit difficult for communities to holdtheir salmon festivals.And so, environmental impact on thesocial structure and the cohesion of thecommunity, is a concern we should be


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aware of, in terms of social change.Another important communitycharacteristic is group orientation.How important is the welfare of thecommunity or social group compared to theneeds or rights of individuals.Are decisions made for the benefit ofindividual members or for the benefit ofthe community as a whole.To strengthen and hold the communitytogether.How strong are social norms.To what extent is there social control?We talked about perception of socialnorms and people's desires to comply withwhat other people think they should do.How strong is that pressure to comply?Another characteristic is linkage.After we looked at the map, after wetalked to people, we realize that veryfew communities have all the resourcesthey need to, to solve their problems.What linkage do they have with outsideresources, with a larger.

Community.For example, the old intersection of thecity of Ibadan, to the residents therehave connections with the localgovernment, with the university.With various ministries, so that they canobtain information and resources to helpthem.What channels did they have to makecontact with outside groups andresources?This may come, simply by membership, forexample if someone is employed outside in

the larger community.Or if someone is member, a member of agroup, social institution, a religiousgroup that also has branches in otherparts of the community, outside.Do people interact with these outsidegroups?Do they bring back news and ideas totheir own community?The next four slides shows some examplesof what the concept of community linkageis, is all about.First we see a community that is

dedicating a new well.The people in the community were able todonate money to hire people to dig, tobuy the cement, to hire the laborers thatwould actually do the construction.But they lacked.The technical skills to know where tosite the well, what is the bestconstruction design.And so when members of the community who


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worked at the district headquarters inthe district hospital were consulted,they were saying okay when we go to work,we'll talk to our colleagues, we'll findother agencies that can provide thistechnical skill.So here is an example of linkage to theoutside community.In the next slide,we can see the doors and windows of arural clinic, they're fallen off becausetermites ate through the wood.Such a community has little linkage,little influence over government.They probably don't have the an electedofficial in the state legislature.They may not even know anybody who is onthe county or district council.At their clinic, drug supplies areirregular, no one knows who to complainto, very few linkages.These linkages again may be through, ourconcept of social capital.We can see in the next slide that people

may belong to associations.In this case, the National Union of RoadTransport Workers, and they haveconnections throughout the state and thecountry.And in the process of their travelingaround, they can learn about importantresources, programs, political eventsthat they can come back and share withtheir community, so they can keep up todate and take advantage of new programs.Finally, another important aspect oflinkage, particularly in Africa, is the

concept of the hometown association.Rural to urban migration is, in somesenses, a problem.But what happens when people reach theurban areas is that they join togetherand form clubs and associations of peoplefrom their own hometown or home district.They meet once a month, they discussissues and problems back home, andthey're in a position. Because they'reworking in an urban area and earningsalary, or in business, making somemoney, to collect funds that they can

send back home to help make improvementsat home.So, here is another example of linkages.Based on these different characteristics,one can hypothesize that there aredifferent types of community.One can think about neighborhoods in yourown work area where you live at, at home,places you've visited, they're not allalike.


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Why is that?And the presence or absence of some ofthese characteristics may explain.For example, in community typology, anintegral community would have a strongsense of identity. Would have be wellintegrated with a lot of interaction andgroup activities, community activities,with projects planned.And they would also have strong linkagesto the outside so they can get resourcesand support that they need to carry outtheir projects.This would be a cosmopolitan community,individuals are in close contact.They have concerns about their owncommunity but they also have interest inthe larger city, state surrounding them.A parochial community, perhaps a moreindigenous local community would have astrong sense of identity.As we noted in the example of Eu Baden,they traced themselves back to a certainancestor.

they did have festivals and ceremoniestogether.But, being more working and lower classpeople, they don't have as muchinteraction with the cosmopolitan largercommunity.They don't have as much connection withthe local government.They don't have much connection witheducational institutions.And so, in a way, they are cut off.They have a strong sense of ethnic orclass identity.

They are more homogeneous in nature,self contained.Somewhat independent.In fact, this independence mayintentionally be preserved.People do not want outside influences tocome into their area and they may be ableto screen these out if they don't conformwith the values and beliefs of the localpeople.This may explain in part why some of theamenities and resources seen in Apatavillage such as the high school, a

church, a health center, are locatedoutside of the main, indigenous town.In fact, when either the government ormissionaries, or the people came to thevillage and talked about these resources,people were polite enough not to refusethem and were willing to consider thatthere may be some future benefit.But they didn't necessarily want thesethings right in their midst in case there


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were any problems.So, it was better to give them landfarther away from the center of thecommunity.A diffuse community may be exemplified bysome of our housing estates, subdivisionsoutside of cities.There's a strong sense of identity ofwhere I live, what kind of communitywanting to preserve that.Often homogenous middle class people,similar background.They have things in common.Char, their personal characteristics,their economic background, theireducational level, maybe even religion.But oftentimes, there is no internallife.People live somewhat isolated, not asmuch involvement with the neighbors.I don't know who lives next to me.Their connections maybe more with theoutside, they may identify more withtheir place of work.

Other examples are given in thesubsequent slides, and in your notes.And you may want to think about these andhow they apply to communities where youhave actually lived to see if they makesense.Are there other kinds of communities thatyou've lived in with differentcharacteristics?A stepping stone community where peopleare active in the neighborhood in orderto gain social status and move along,move on.

Transitory population is changing.Some of the peri-urban slums in, in manydeveloping countries exemplify this.People come and go.There's really no sense of ownership ofthe land.And so, people are not secure.They may come from all different parts ofthe country we may have some inner cityneighborhoods that are very weak in allof the characteristics.Economic communities were there's notmuch cohesion, identity, interaction.

So, one needs to think about this. It'snot that these typologies represent everysingle possibility, but it's important tothink of these characteristics as thestrengths that lead to a competentcommunity that we'll talk about.And the basis if we work with communitiesthat do have serious problems. They cantell us where we might need to interveneto help strengthen communities.


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Can see in the slide of a small isolatedrural settlement in the northern part ofNigeria,a group of maybe ten or fifteen huts.They may belong to a larger clan withanother village a mile, half a mile away.There may be strong identity within, butthey have poor access to externalresources.In the next slide, we can see a villagesetting southwestern Uganda.A village may cover several squarekilometers, but only have a few hundredpeople.Because of the nature of the land andtheir farming activities, they're spreadquite wide.In contrast, we can see an urbancommunity.People living in buildings three or fourstories, all different kinds of ethnicgroups gathered together.No clear king, or chief, or leader.People's main contacts may be with

members of their own ethnic group inother parts of the city.So, there may be a weak sense of identitywithin that neighborhood.In some urban neighborhoods, there's astrong street life.People interact.There may be some cohesion.People come together to set up vigilantegroups to protect themselves againstthieves.So, there are different kinds ofcommunities and it's important to

recognize that whether it's in a rural oran urban area.We need to talk to the people in thatcommunity,find out their own sense of identity,their own definitions of theirboundaries,their own sense of leadership and socialgroups.And again, when we decide to work in anarea,it's the people themselves that will tellus their units of identity which will

become our units of practice.

1 - 2 - lecture 2a- definitions of community (33-27)

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