Christopher Wahlfeld in the field

As I reflect upon my time at Lwala, it is difficult not to focus upon the relationships forged over the past few months. As anyone who has spent time in “the field” can attest, the relationships built with staff and local residents form the basis of everything that is possible. In addition, these connections feed our memories and draw us back once we have completed our tenure on the ground. These are the ties that bind us, personally and professionally, to the communities in which we work, and vice versa. This holds just as true for organizations and communities, as it does for individuals.

Global health is rooted in relationships. The partnerships, or lack thereof, formed between organizations/institutions and the communities they serve, shape the approaches taken to reduce stressors and improve the overall wellbeing of community stakeholders. In turn, the extent to which organizations actively engage with, and listen to, their local stakeholders has implications for the long-term sustainability of an intervention or program.

I am reminded of a conversation I had with a friend, and fellow Vanderbilt graduate student, at the beginning of our time at Lwala. Out of curiosity, Caroline had looked into the etymology of the word “community,” and discovered that it originates from the Old French word comunete, which means “reinforced by its source.” I found this to be rather apropos, and well suited to Lwala’s approach to improving the lives of the population it serves. To wit, in addition to Lwala’s utilization of local residents as community health workers, the organization nurtures its relationship with the residents of North Kamagambo by holding community consultations. These community consultations take place twice a year, providing local residents with focused occasions to voice their thoughts and opinions on barriers and opportunities to improving the services Lwala delivers. Fortunately, I had the opportunity to partake in aspects of Lwala’s most recent community consultation, as the process began in the weeks just prior to my departure.

Reflecting the organization’s comprehensive approach to community wellbeing, all four of Lwala’s programmatic arms (clinical health, community health, economic development, and education) are involved in the consultation process. Based on information gained from monthly scorecards, and other regularly collected data points, each program is tasked with the creation of surveys and questionnaires aimed at engaging the community in conversations pertaining to issues impacting the lives and wellbeing of the residents of North Kamagambo.

Community consultations

I had the pleasure of collaborating with staff from several of Lwala’s teams as they constructed their interview tools and tailored elements of their surveys to targeted audiences. While many survey components were specific to one particular program or another, it was impressive to listen to the open conversations among staff from different branches within Lwala as they worked to identify common ground and collaborate on questionnaires to achieve shared goals. This was a good reminder to all of us involved in the process that health (and life) does not take place in a vacuum, and that solutions often require teamwork.

Towards the end of my time at Lwala, I had the privilege of working with colleagues from the community health office as we implemented one of questionnaires during a small focus group discussion with local teachers. I was particularly struck by the way in which conversations were structured, not only to inform and educate the community about recent health trends, but also to empower community members to become active participants in identification and implementation of potential solutions.

Lwala Community workers

As I left Lwala, staff had nearly completed their most recent community consultation. These conversations not only provide Lwala with feedback for quality improvement, but also guide the direction of the organization’s long-term, community-driven, goals. In other words, Lwala’s community consultations reify the concept of being “reinforced by its source.”