Yes, we can make a difference!

Weltfrauentag 2010
Working from within the community.


At some point, all too many humanitarian programmes find themselves trying to force a rectangular object through a triangular opening. Red Cross Red Crescent aims to put a stop to this by introducing something called CBHFA.


CBHFA stands for Community Based Health and First Aid. CBHFA aims at silently revolutionizing the way the Movement is doing much of its health work. Key phrase is “tailor made”, programmes tailored down to community level.


Strong pulse


Recently, representatives from 10 National Societies, IFRC field presence and Geneva headquarters held a CBHFA workshop in the midst of fresh wintery snow, hosted by the Finnish and Swedish Red Cross Societies in Nynäs, Finland.


“We took the pulse of CBHFA and found it thudding very strongly,” says Hannele Virtanen, Senior Health Advisor of the Finnish Red Cross. She is one of the first supporters of the CBHFA approach, and very much a developer of the current form of the concept.


“The basic idea of CBHFA is very simple. We take the core strength of the Movement and really put it to work. Instead of working for or with communities, we work from within. Red Cross Red Crescent is organically part of communities in all four corners of the world,” Hannele says.


CBHFA aims purely at maximizing the self-sustained ability of a community to improve the life of its members, with health issues offering the obvious entry point. Instead of someone coming from the outside, telling the community what to do, the CBHFA approach starts with the community itself identifying its needs.


“We believe that the most sustained of results come from within communities. One needs patience and one needs to settle for less perhaps, but what one achieves will stay. That’s the key point,” says Grace Lo, Federation Unit Manager in charge of the programme at global level.


Implementation marathon


The overarching long term ambition of a CBHFA programme is to create behaviour change. This demands continuous community dialogue, modelling good health behavioural practises and a favourable environment to allow changes to take place. Changing behaviour is difficult and much more than the traditional objective of many projects: providing new knowledge.


“We all know that injections of new knowledge do not equal action. Sustained results are the fruit of tedious toiling rather than a sudden, life-changing strike of a powerful lightning,” Grace says.


“This is a marathon. Timeframe for implementing CBHFA with results is several years, preferably three to five as a minimum,” says Stefan Seebacher, Austrian Red Cross Health Advisor and one of the facilitators of the workshop.


CBHFA brings first aid for common injuries to the community. It identifies and addresses community health priorities, advocates health promotion and disease prevention, along with preparing volunteers to respond to disasters. All CBHFA -programmes match with WHO standards.


Holistic approach


“CBHFA takes a holistic approach to health. Community-based work means that connections between different factors affecting the overall well-being of a community will emerge as part of the process. All important issues will have to be addressed, regardless of which box they belong to,” states Seebacher.


CBHFA will not solve all problems. “There are obvious limits as to what volunteers can and cannot do. They are, however, part of something bigger. CBHFA is the base to build on,” Grace Lo says. One key element of CBHFA is to honour local preferences. Even with a common goal like, say addressing food security issues, local specificities will create different solutions.


 “Volunteers have always been ready for this. It is now up to the management and governance of National Societies to show their commitment through empowering their branches, volunteers and the base of all Red Cross Red Crescent work: communities,” says Theresia Lyshöj-Landiech, Swedish Red Cross Desk Officer with field work experience dating as far back as 1991.


“CBHFA fits completely within the core of the Strategy 2020 of the Federation. If one asks how to achieve the three strategic goals of 2020, the answer as much as the work itself have got to start with work within communities. The first enabling action listed in 2020 is building strong National Red Cross and Red Crescent Societies. This can only be achieved through fostering and maintaining a strong base at the community level,” Theresia states.


Powerful mechanism


“If used wisely, CBHFA has the potential of producing unchallenged cumulative evidence that, as a Movement, we can really make a difference. This is a powerful mechanism to achieve goals, to develop a stronger Red Cross Red Crescent,” says Mary Thompson, Health Advisor with the Canadian Red Cross.


Already, more than 300 participants from over 80 National Societies have been trained at CBHFA Master Facilitator workshops. More than 30 Master Facilitators have helped run further workshops in the regions.


“More than 35 National Societies’ input and reflections over the past four years forms the base of CBHFA. The Finnish and Swedish Red Cross Societies must specifically be credited as initiators and developers of the approach. The Norwegian and the American Red Cross also merit special attention. Without this support we would not be as far as we are today,” Grace Lo smiles.


By Pekka Reinikainen


CBHFA at work


Austrian Red Cross already has an ongoing CBHFA programme in Mozambique. A new community programme started in February in Laos and will go on for three years.


“Instead of something coming from Brussels, the Laos project was a local call from the EU presence in Vientiane. Culturally, in terms of empowerment of communities, Laos is a very challenging place. The Austrian Red Cross have been there since 1997 and know that it is going to take a very, very long time to get communities to take complete ownership and lead. Therefore, long-term support from the EU is crucial.”


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