Most people find this agenda for building community inspiring. But turning it into action sufficient to shift social norms – so that you begin to wonder whether your elderly neighbour needs some shopping and then you dance across the street to see her! For that to become ‘normal’ is big and difficult, perhaps an unimaginable transition for most communities. But in the end it is simple things like these that create health.
“You cannot care for your community unless you care for
yourself and you cannot care for yourself unless you care
for your community.” African proverb
In the last few decades the scientists caught up with this traditional wisdom and the ‘Social Determinants of Health’ became common linguistic currency.
Here is a six minute summary from one of the leaders of the science, Michael Marmot
Marmot is strong on the evidence of a causal link between our circumstances of living and our health. He is less assured on what action to take, except that the ‘grass-roots’ are vitally important. Read more from Marmot.
So what can these grass-roots do? Notice the African proverb above mentions the word ‘care’ four times. It is caring that goes missing in communities that fail to thrive; it is caring that neither the scientists nor the politicians nor the economists nor the doctors can prescribe, though all of them can make caring either easier or much more difficult. It is caring that is the life-blood flowing around a healthy community. John Ruskin made a similar comparison in his book, Unto This Last, published in 1860 – look for page 147
If it is money or greed that circulates around a community, then the outcome is both very different and sadly familiar. Ultimately, it is the circulation of caring that generates health, caring for ourselves, for others, for the environment. Until eventually, these three become One.
“As the African principle of Ubuntu puts it: ‘I am because you are’. It is this love that makes us one another’s keeper. This ability both to walk alone and yet to know communion, that is the foundation, and the fruit, of community.” Alastair McIntosh in Rekindling Community p70.
Hear Nelson Mandela speak on Ubuntu:
Read more on Mandela and Ubuntu in BHMA newsletter Dec 2013.
The importance of root causes
Understanding illness in terms of the quality of community is about looking at the root causes of health and illness. You could argue that this is what being holistic demands of healthcare professionals. But surely it should concern all of us. You do not need a medical qualification to recognise the symptoms and signs of a sick community. These are particularly obvious in ‘deprived’ communities where everyone will be aware of (and probably overwhelmed by) the social problems and the disease and suffering that attends them. But the social determinants of health operate at all levels of wealth and privation. In fact, sooner or later most professionals will realise that by treating only the illness of individuals, not only do they leave the community sickness untouched, they unwittingly perpetuate the root causes by masking their effects. They are (often very expensively) treating the wrong problem. More on this…
All of us, whether involved in healthcare or not, can play our part in creating caring communities. The question is, how do we do it?