Dejemos de buscar líderes y busquemos personas conectoras / Let’s stop searching for leaders and let’s start look for connectors instead

El distanciamiento físico ha afectado a la capacidad de conectar; sin embargo, en muchos casos, las comunidades han seguido prosperando. Dentro de nuestras comunidades, ya sea en el trabajo, en casa o en nuestros vecindarios, identificamos individuos a los que podemos denominar «personas conectoras». Estos vecinos y vecinas dentro de las comunidades asumen un rol específico, muchas veces de forma natural e involuntaria. Sin embargo, al observarlos podemos identificar una serie de rasgos o de costumbres que se repiten sistemáticamente. La influencia que estas mujeres y hombres tienen en sus comunidades los define como ciudadanos y promueve la cohesión social. (AU)

In times of physical distancing, connectedness has been affected, but in many cases, communities have continued to flourish. Within our communities, whether at work, at home or in our neighbourhoods, we identify individuals we can call "connectors". These individuals within communities assume a specific role, often in a natural and involuntary way. However, by observing them we can identify a series of traits or habits that all of them share. The influence that these agents have in their communities defines them as citizens and facilitates greater social cohesion. (AU)

Supporting community participation in a pandemic / Apoyar la participación comunitaria en la pandemia

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the “Virus Dragon” and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity. (AU)

Los gobiernos, sin variación, han respondido al impacto de la COVID-19 como caballeros blancos al estilo de Don Quijote cuando defendió a la población del virus-dragón y dedicó la caballería andante a la defensa de su dama Dulcinea. Aunque esenciales, los nuevos tratamientos, las vacunas, el distanciamiento físico, los estándares rigurosos de higiene y unos servicios sanitarios eficientes no bastan para contrarrestar el efecto del virus. El cumplimiento individual de las medidas de salud pública también importa, pero igualmente resulta insuficiente para disminuir la amenaza. Estrategias más terrenales, lideradas por ciudadanos y con participación comunitaria, conducen a medidas innovadoras en cuanto a que se ajustan mejor a las necesidades de la diversidad de entornos y aseguran una mayor resistencia al virus y una mejor salud que los caballerosos esfuerzos aislados. El reto de la COVID-19 ofrece a las comunidades la posibilidad de hacerse más resilientes y menos frágiles, y no solo sobrevivir a esta crisis, sino florecer tras ella y estar mejor equipadas para los próximos retos. No son tiempos para caballeros andantes ni para las payasadas de Don Quijote enfrentándose a las aspas de un molino. Estamos en tiempos de Sancho Panza, o lo que es lo mismo, de ciudadanos normales no acreditados y sus esfuerzos colectivos, que hasta ahora han sido considerados meros peones. El desarrollo comunitario basado en activos rechaza tanto a los individuos aislados como al caballeroso énfasis institucional al valorar las necesidades y los déficits en las comunidades. Favorece la identificación y la movilización de los activos disponibles y latentes en las comunidades para forjar conexiones más próximas entre individuos, que es lo mejor para colectivizar los esfuerzos y solucionar los problemas. Las iniciativas lideradas por las comunidades se ven apoyadas por agencias locales sin ánimo de lucro. (AU)

Supporting community participation in a pandemic.

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the "Virus Dragon" and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity.

Does more medicine make us sicker? Ivan Illich revisited / ¿El uso de más medicina, nos vuelve más enfermos? Retorno a Ivan Illich

A proper understanding of health is a social and political challenge, the modern social medicine approach to public health and health approaches more generally tend to minimise this, making the isolated individual the primary unit of health. Ivan Illich, social critic and philosopher, was at the forefront of arguing for a collective health approach and challenging medical hegemony. His theories of institutional counter-productivity, proportionality and his critique of the medical model which he argued was entrenched within an economics of scarcity are as relevant today as they were at their height of popularity, in the 1970s. Applying his analysis to current trends in health approaches I conclude, as did he, that beyond a certain institutional scale or intensity more medicine is making us sicker. Therefore public health requires a dramatic shift away from a focus on individual deficits, lifestyle diseases, behaviour change and health promotion approaches towards genuine community building and significant political investment in the health creation of local communities. Moreover, there is need for more resolute regulation of the marketplace to prevent the health-harming behaviours of industrial and other institutional interests, including public sector and third sector organisations engaged in institutional overreach

La sanidad, propiamente entendida, es un reto social y político. La medicina social moderna apunta a la salud pública y, por lo general, los enfoques sanitarios tienden a minimizar este hecho, convirtiendo a la persona aislada en la unidad primaria de la salud. Ivan Illich, crítico social y filósofo, encabezó el debate a favor de un enfoque basado en la sanidad colectiva y la lucha contra la hegemonía médica. Sus teorías sobre contraproductividad y proporcionalidad institucional, y su crítica sobre el modelo médico, del que argumentó que estaba arraigado en una economía de escasez, son relevantes hoy en día, al igual que lo eran en la cima de su popularidad, en los años 1970. Aplicando su análisis a las tendencias actuales, yo concluyo, como hizo él, que más allá de una cierta escala o intensidad institucional, el uso de más medicina nos vuelve más enfermos. Por ello, la sanidad pública requiere un cambio drástico, alejando su objetivo de los déficits individuales, las enfermedades relacionadas con el estilo de vida, los cambios de comportamiento y la promoción de la salud, centrándose en cambio en el desarrollo comunitario genuino y la inversión política en la creación de salud en las comunidades locales. Además, existe una necesidad de regular firmemente el mercado para evitar los comportamientos nocivos para la salud provenientes de los intereses industriales y demás instituciones, incluyendo el sector público y las organizaciones del tercer sector, implicadas en las extralimitaciones institucionales

Does more medicine make us sicker? Ivan Illich revisited.

A proper understanding of health is a social and political challenge, the modern social medicine approach to public health and health approaches more generally tend to minimise this, making the isolated individual the primary unit of health. Ivan Illich, social critic and philosopher, was at the forefront of arguing for a collective health approach and challenging medical hegemony. His theories of institutional counter-productivity, proportionality and his critique of the medical model which he argued was entrenched within an economics of scarcity are as relevant today as they were at their height of popularity, in the 1970s. Applying his analysis to current trends in health approaches I conclude, as did he, that beyond a certain institutional scale or intensity more medicine is making us sicker. Therefore public health requires a dramatic shift away from a focus on individual deficits, lifestyle diseases, behaviour change and health promotion approaches towards genuine community building and significant political investment in the health creation of local communities. Moreover, there is need for more resolute regulation of the marketplace to prevent the health-harming behaviours of industrial and other institutional interests, including public sector and third sector organisations engaged in institutional overreach.