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Contents:
COMMUNITY BASED SOCIAL WORK
by Phil Bartle, PhD
In honour of Rädda Barnen*
Training Handout
If a community can organize to build a latrine, why not organize it to do social work?
Introduction:
This is another training document in the series of community mobilizing methods for results other than a physical construction such as a communal water supply, clinic or school.
The product or output is a programme of services for vulnerable members of the community, many of whom can help themselves if only they are provided with a relatively small amount of help and encouragement.
What is Social Work?
The profession of Social Work is an odd mixture of many things. It is usually practised by government civil servants in the west (Europe and North America) while many international NGOs have social workers on their staff.
The clientele of social work are often called the vulnerable, ie people whose special conditions or circumstances put them in positions of weakness or vulnerability in comparison with the mainstream of a society. Generally they include members of society who need some help. Typically, these include those with physical or mental disabilities, persons who are not able to work for a living or not able to care for themselves. In special cases, these may include battered women (those who have been physically or emotionally assaulted – eg by their spouses –and can not escape dangerous situations on their own), frail elderly persons, children without parents to support them, or who are being mistreated,
The tasks of a social worker mainly include administration and counselling, along with a little bit of medical (usually psychological) intervention and advocacy. The social worker provides her or his clients with little bits of wisdom, advice, information, counselling, as needed. Every case is different.
The government (or NGO) social worker in a western country (Europe and North America) provides services that are usually provided by elders and family members in other countries. Social work services are too expensive for governments in the least developed countries.
The word "social" is a bit misleading because, in the west, where it is mainly practised, the social worker does not work with a whole society, or even with a community or a group in a social context. The social worker usually handles "cases," and a case is usually about an individual or lately increasingly, a family.
This is even more ironical because where social work is taught, usually in a university in a department or a school of social administration or social work, often (where they are small) they are attached to sociology departments. Such schools or departments, in turn, are then usually also where community development (like much of the material on this web site) is also taught. Community development, in contrast, is an activity aimed at social institutions, such as communities or groups, rather than at individuals. (See Community).
One of the many motivating facts pushing the development of this web site is that the empowerment of communities is important and highly needed in low income countries. Limiting the training of community workers to those who are studying in universities, limits the available number of potentially capable community workers; this should be taught to middle school level students (after they have been working out in the real world and have some life experience).
This document will not teach you how to become a social worker (any more than the water module will teach you how to become a civil engineer), but will help you in initiating and developing a community based social work (CBSW) programme. The training on this web site is aimed at community workers who do not have to be educated to university level.
Where is CBSW Appropriate?
Rich countries can usually provide social work services (on an individual or family basis, not community based), and poor countries rely on the advice, experience and knowledge of elders and family members. So where would it be appropriate to place a community based social work programme? Community based social work services are needed where they can not be provided by elders and families, but where there is not enough finance available to provide it on an individual basis.
The situation which comes to mind most readily is where there are large displaced or refugee populations, in camps, in poor countries. Further to that, after the emergency is over, those same refugees may return home. Their lives will have been interrupted, losing many family members, including elders and family members, thus the need for social work services remains. So long as there is enough funding available for a professional social worker to supervise the community based work, keeping it up to required standards, the community itself can supply the energy, time and interest in making it work.
Apart from refugee situations, wherever there is a large disaster that results in the removal of elders and family members, and/or which disrupts the normal and traditional social organization, are included among situations where it would be appropriate to set up a community based social work programme. Post disaster situations would be included in these.
Where there are large refugee populations, the basic services, food, water, shelter, elementary medical, are usually provided, often by UN agencies and international NGOs. Finance is not unlimited, however, so there may only be a token attempt at providing social work services, if any at all. This is a good situation in which to consider organizing a community based social work programme.
Community Perceptions:
When a child is a witness to atrocities that destroy her world, she is affected. To watch your family members and/or neighbours being shot or bombed produces immense trauma if you are a child. In many cases, the experience results in the child withdrawing into herself, refusing to talk, and/or refusing to respond to daily interactions. The child who is traumatized by the same events which lead to refugee or displaced communities, may display behaviour that is often misinterpreted by her remaining family or care givers. Sometimes she is deemed as mentally retarded, and beyond recovery. Sometimes she is seen as affected by evil spirits. Sometimes her condition is seen as a punishment for previous misdeeds by her family members.
In all these cases, there is much shame and secrecy associated with her behaviour. All too often her care givers do not understand that she is reacting to the terrible events of the disaster or civil war, and they do not know that the condition can be reversed by a few simple interventions.
Many times such children are hidden (even tied up) in darkened rooms away from public view. They can not dress or clean themselves, and often are found in their own filth and in poor health, hungry, dirty, sick, weak and helpless. Public announcements do not get the message across. Hands on intervention is needed to assess each child.
If they are traumatized by atrocious events, and not retarded or otherwise disabled by other factors, they can show remarkable changes, learning to dress themselves, clean themselves and feed themselves. This requires patience, love and care, extended over several weeks and months. A stimulus or two in the form of a doll, and perhaps later a ball, are effective and useful tools for the job.
Here is a situation, repeated hundreds of thousand times around the world, where a community based social work programme is appropriate. This is a typical or classic situation for CBSW.
A single, university educated, professional social worker can appraise the situation, prescribe appropriate interventions, and monitor. Community mobilizers can work with the community members to identify hidden and suffering children, recruit community level social workers, arrange for their training and supervision, organize CBOs to manage and operate the CBSW programme at community level, and ensure an effective flow of information. Local residents, on a volunteer basis or with some incentives, can provide the care and stimulation to the children in need, and keep the mobilizers informed about changing conditions and further needed training.
This is only one of many kinds of situations involving vulnerable refugees or displaced persons in communities disrupted by (but surviving) disasters caused by natural or human made events.
The PHC Principles:
The "Primary Health Care" (PHC) policy promoted by WHO (UN World Health Organization), has several basic principles, perhaps the best known one being that prevention is better than cure.
Another, that is particularly applicable here to community based social work, is the idea that resources should not be spent on expensive cures for a few people.
Underlying this is a public health policy in support of the greatest good for the greatest number. With a limited budget available, that means to concentrate on a few common diseases, to provide elementary training to persons educated at low levels, and reaching the most rural and remote patients. This gave rise to the popular (but slightly inaccurate) concept of "The Barefoot Doctor." (Also see Water and PHC). If the PHC policy is transferred to the need for social services, then the idea is to give elementary training to persons without university level education, concentrating on the most common and easily treated conditions, and relying on a referral system for more complicated diseases or conditions.
The goal in community based social work, then, is to organize a cadre of community members who can be given low level training (ie not requiring university education) to treat a limited number of social conditions of vulnerable community members. Their interventions will not be as flexible or a sophisticated as those of social workers with university level education and extensive social work training, but they will be able to reach a wider proportion of the population than if only highly skilled and relatively costly professionals are employed.
"The greater good for the greater number."
Structure:
What is a possible structure for a CBSW programme?
Where you have a population of refugees or others who have had severe disruptions in their community lives, where they are able to access support for their immediate needs (food, shelter, water, housing) but no social welfare. Where you may have a professional social worker or two for a population too large for them to reach everybody. Where you have a situation conducive to organizing voluntary community groups.
There you have the basis for CBSW.
The professional social workers need to make a needs analysis to determine the limited number of conditions that can be addressed by community workers with low level training. They then need to train and to supervise the training of a cadre of community workers who have access to the client community or communities. Both the needs assessments and the training would not be once-off, but ongoing. They and the community workers (mobilizers) need to identify, recruit, and train community members, as community leaders of the programme, as practitioners of social work interventions in their communities, and as monitors of the changing situations in their respective communities.
Members of the community groups conduct the social work interventions. They need to be supported with training and guidance by the mobilizers and (more indirectly by) the professional social workers.
What results in effect is like a social work pyramid, with the professional social worker(s) at the apex, possible social work trainers (temporary or long term) supervised by the social workers, mobilizers, community leaders and managers of the community groups (CBOs) and community and CBO members who conduct most of the interventions.
Training and Support:
In general, community mobilizers should never be trained once-and-for-all, but need regular support, encouragement, and a forum in which to ask questions that arise in the field (See Training Methods). In CBSW this is even more a requirement. First, mobilizers without formal training (the main audience for this web site) need continued support and professional inputs.
Second, the tragedies witnessed in CBSW require field workers to meet with their colleagues to share experiences and to be re-energised and re-infused with enthusiasm and positive attitudes. A CBSW programme as described above needs a routine and predictable forum for getting mobilizers together to share experiences, to ask questions arising from the field, and to obtain inputs from more highly trained and educated social workers. A training unit could be an answer to this need. How it is to be set up depends upon available finances and circumstances.
An initial training programme for the mobilizers could use the first six training modules from this web site. They can be printed and handed out in the training programme. They can be easily adapted to developing a CBSW programme. The training for social work, in contrast, needs to be defined and generated by the professional social workers, after they make their initial appraisal of the situations, and will be modified as new information comes in.
Conclusion:
Where there are only one or two highly trained professional social workers for a large population, perhaps involving several communities (as in refugee and similar situations), so that no social work interventions would reach the majority of the population, and where that population has extra need of such interventions following natural or human made disasters, CBSW may be the answer.
It requires rearranging available resources, putting the available social workers into positions of appraisal, monitoring and guidance, using mobilizers to organize community groups to do the daily work, setting up a training programme, concentrating on a few of the most common situations that affect the greatest number of persons, and maintaining the training, encouragement and guidance of the mobilizers and community workers. In the appropriate situations, such a programme can be effective and useful.
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Acknowledgement:
I wish to acknowledge the role of Rädda Barnen (Swedish Save the Children) for opening my eyes to the potential of this sector of community mobilizing. I had the privilege of working for Rädda Barnen for just under four years, 1988-1992, as Country Representative for Afghanistan and Pakistan.
There I found the development of a CBSW programme in progress. A few years earlier, while the Soviets still occupied Afghanistan, a single Swedish social worker seconded to UNHCR found herself alone responsible for the non material needs of about two and a half million Afghani refugees in the NWFP province of Pakistan (another one and a half million were in Baluchistan province). They were at first refugees from the soviet occupation then, from 1992, refugees from the civil wars between Afghani war lords after the soviet departure.
Because the refugees were mainly very conservative Moslems (many of whom later became supporters of the Taliban), there were several issues the programme needed to address. Women were usually not allowed out of their homes, could not talk to male mobilizers or trainers, and could not be educated in western subjects.
Experts in Peshawar with refugee experience said again and again, "It cannot be done."
The Rädda Barnen and Government staff – Swedes, Afghanis and Pakistanis – social workers, mobilizers, support staff and trainers – made it happen. They worked through the Moslem clerics – malaams and sheikhs – carefully explaining what they were doing, diligently following Islamic rules of behaviour. The clerics eventually conceded that women were most suited to work with the disadvantaged children, but needed training to do so. They allowed female social work trainers to work with them in their homes.
The newly formed community social work community groups worked within local homes and followed Islamic precepts. After a few notable successes with a few disadvantaged children chosen by the social workers for that very purpose, the clerics were brought on side, one at a time. Eventually one came to remark, "This is our social work jihad." Their support eventually came through carefully worded announcements in the mosques.
The programme survived – and grew – at a time when other international NGOs working with women were running into heavy opposition, some even being asked to leave, accused of being corrupting influences on the people.
I was not responsible for creating the programme, or making it work (although I wish I could say so). I came and I learned.
More information about the programme can be seen in: Phil Bartle and Eva Segerström, "A Community Self-Help Approach; Refugee Children in Pakistan," pp 6-9, Children Worldwide, vol. 19, No 1/1992, ICCB, 65 rue de Lausanne CH-1202, Switzerland.
I wish to recognize the incredible creativity, dedication, perseverance and loyalty of all the Rädda Barnen staff, Swedish, Afghani and Pakistani. Although I cannot name them all here, I particularly want to mention Häken Torngärd and Eva Segerström. They are heroes among heroes.
For further information, see the Rädda Barnen web sites, (English): http://www.rb.se/eng/, (Swedish): http://www.rb.se/sv/, or email a question to: [email protected]
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Community Organizing in a Refugee Camp:
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