Note to Neil and Massimo -- from David Werner
I am glad to see the resurfacing of concern about empowering versus disempowering approaches to health education. The crucial differences between these opposing educational methods is discussed at length in the handbook "Helping Heath Workers Learn".(Werner and Bower, Hesperian Health Guides). This book -- a companion to "Where There Is No Doctor" -- gives a lot of examples of disempowering "authoritarian training methods", which push ideas into the learners' heads, as distinct from empowering "discovery-based learning methods", which draw ideas out of the learners' heads and help them think for themselves. The disempowering approach is routinely used by the controlling class of a polarized society, where education is essentially obedience training: full of rules and regulations designed to manage the underprivileged majority and thus perpetuate the unfair status quo. The empowering approach, on the other hand, is used by advocates of social change, to enable people to analyze their situation, draw their own conclusions, and work together to build a fairer, healther, more inclusive society.
Thus health education -- like school education -- can fall anywhere on the continuum between the two poles of "community oppressive" and "community supportive". These contrasting methodologies -- spelled out in Paulo Freire's classic "Pedagogy of the Oppressed" -- are explored in detail in a paper I wrote titled "The village health worker: lackey or liberator", published in WHO's "World Health Forum", #1, 1981. While the examples may be dated, the implications in the pursuit of Health for All are as relevant as ever in today's ailing world.
David B Werner
HIFA profile: David Werner is author of the classic book Donde No Hay Doctor (Where There is No Doctor), which has been published in more than 75 languages. He is co-founder and co-director of HealthWrights, a non-profit organization committed to advancing the health, basic rights, social equality, and self-determination of disadvantaged persons and groups. A biologist and educator by training, he has worked for many years in more than 50 countries, in village health care, community-based rehabilitation, and Child-to-Child health initiatives. Website; www.healthwrights.org david.b.werner AT gmail.com