The Internationalization of Where There Is No Doctor

The Hesperian Foundation, as well, has been involved in activities that have taken us far beyond our original focus on rural Mexico. The new English edition of Where There Is No Doctor is already being used as a training manual for village health workers in at least 100 countries. As a result, we are establishing communications with community-based health care programs all over the world (including some Native American, farmworker, Appalachian, and inner city groups in the U.S.A.). Our two papers, “Health Care and Human Dignity” and “The Village Health Worker—Lackey or Liberator?” have been reprinted and widely distributed in countries as distant as the Philippines, Kenya, and India, and have helped us move toward a world allegiance of humanitarian persons and groups dedicated to what might be called the “health care of liberation.”

Last November I was invited to give the opening address at a workshop to be held in India on rural health, development, and technology, called “Let the Village Hear.” Since the workshop was supposed to be at the village level, I thought it far more appropriate that Martin Reyes, the coordinator of Project Piaxtla, attend in my place. The coordinators of the workshop agreed to the suggestion, so Martin went to Calcutta to, as he put it, “let the village be heard.” Martin got a great deal out of the workshop and, according to letters we have received, he in turn contributed much. He was also able to visit and exchange experiences with several exciting, community-based programs in other parts of India and in Bangladesh.

Prospective Publications

One of the main focuses of the Hesperian Foundation has increasingly become the development of simple, clearly written handbooks and teaching materials for people-based health care in poor countries and communities. Apart from Where There Is No Doctor, of which we are now winding up a completely revised Spanish edition, we are in the process of preparing a number of publications that will probably appear in the following sequence in the next two to four years:

  1. (Just begun): Methods, Aids and Ideas for TEACHING HEALTH CARE IN A COMMUNITY—especially for use with Where There Is No Doctor, a village health care handbook.

  2. (Half-done): SELF-EVALUATION OF A COMMUNITY-BASED HEALTH
    PROGRAM (evaluation as if people mattered).

  3. (Begun): The Role and Training of VILLAGE HEALTH WORKERS IN
    LATIN AMERICA—a sourcebook for planners, educators, and
    half-done agents of change.

  4. (Begun): WHERE THERE IS NO PHYSICAL THERAPIST—Home care and
    exercise of the physically handicapped child. (To be co-authored with Sophie Levitt, a South African physiotherapist.)

  5. (Research in process): THE POLITICS OF HEALTH AND HEALTH CARE IN LATIN
    AMERICA from the village to the international level.

We have been working on #3 (the sourcebook), for over two years, and have had to put it off several times already to complete work on the English and then the revised Spanish editions of Where There Is No Doctor. Nevertheless, Bill Bower and I have decided to put it off once again and first try to complete a simple teaching guide for the use of Where There Is No Doctor (#1). From this January to March, Bill and I will once again be attending the annual training program for village health promoters. We hope to observe and write up—for others to use- many of the educational approaches and techniques developed and used during the course. As this training program will include some health education with mothers and school children, as well as community involvement and “teatro campesino,” we hope the coverage of the teaching guide will be both ample and entertaining.