Primary Health Care Is Like A Good Microsoft Word Document

As part of the training course, two students are paired up to chair a committee responsible for a certain task throughout the course. I have been put in charge of the social committee (responsible for organizing activities that bring the group together) and on Monday nights we have put together a computer class where me and two others sit down with other trainees and teach them about the computer to raise their ‘computer literacy’. Last Monday was Introduction to Microsoft Word. For forty-five minutes, I sat at the computer in the library circled by three trainees frantically taking notes on everything I said about the functions of the computer, what the different keys on the keyboard meant and how to use them in Word, and what the different icons were on the top of the screen. They copied each function meticulously and at the end thanked me for taking the time to show them, but I expressed that it would really make no sense until they sat down at the computer and practiced it themselves. After the class I went back to my room and read a little (great book – Just and Lasting Change, by Carl and Daniel Taylor) and reviewed some notes from the day, and it hit me how creating a good MS Word document is like implementing primary health care in a community.

A good MS Word document is created by pulling all the different shortcuts, functions and features into one place making it as easy for the reader as possible to understand the information presented. Shortcuts using the ‘ctrl’ key, making things bold or italicized, numbering or bulleting lists, adding tables and graphs with captions – these are all features of MS Word that, when combined together, make a good document. But as I was speaking during the training session, the other trainees couldn’t visualize the ease and possibility of taking the time to see how each shortcut and feature work together. They simply viewed each function as serving that one purpose and as a single intervention that made their Word-lives easier. They were unable to see how building on each accomplished their overall goal and created an effective document. How similar this is to PHC and what I am trying to accomplish here!

Primary Health Care works to bring all the different sectors that affect your health together to improve your situation. The goal is to be mentally, physically and socially healthy and it’s done by combining multiple types of interventions to change the whole person, not simply the illness, or the economic hardship, or the literacy. In the project villages of CRHP, the community has been empowered to initiate income generating programs (to address financial dependency), women’s development groups (to address lack of self-worth and family status), self-help groups (to address lack of social status), farmers clubs (to address agricultural dilemmas) and village health workers (to address poor health and disease). Overall, a holistic approach to health is accomplished through the melding of multiple aspects of health, rather than just focusing in on one intervention that does makes a change in your health but is not sustainable and fails to truly address the underlying problems.

I frantically take notes during trainings, copying down every word that Shobha or Dr. Arole speak, trying to understand what primary health care means. Just like the trainees in the MS Word class, I am trying to learn about every individual intervention (or feature) and how each affects the overall goal of good health (or a good MS Word doc) but not piecing it all together and understanding how each builds on the other. In reality, I will probably not be able to understand what primary health care means or how all the interventions are related until I can visualize the overall goal in my head. Sure, I can see the goal in front of my eyes by visiting the villages (just like I can show the trainees the goal by showing them a good Word document), but until I understand not only what each intervention means but how it builds on and is related to the others, I will not be able to understand how good health (or a good Word doc) is accomplished. The analogy might be a reach but in some ways it really relates.

Thus, this is a major goal of my year in Jamkhed. The training course is doing a great job by first showing us what primary health care means and how Jamkhed has accomplished it, then taking us through each feature of the CRHP model showing how it was accomplished and giving examples of programs that failed to address that aspect of health. In that sentiment, on September 12th, we wished Alma Ata a happy 30th birthday. Thirty years ago in Alma-Ata, former USSR, governments from around the world came together at the public health conference and, for the first time ever, agreed that good health was a fundamental right to all citizens and that it should be accomplished using the model of primary health care. I don’t think it has come to fruition yet. Regardless, we had a nice party with a birthday cake and balloons popped prematurely by the Africans in the party mood. It was tons of fun and can’t imagine that next year I will celebrate so festively.