Health and Joy ∗ Brazil

Photo by: Emilia Szekely

Health and Joy Project  (Health and Happiness Project) 
Centro de Estudos Avançados de Promoção Social e Ambiental - Projeto Saude e Alegria 

Healthcare, education, territorial management, alternative energies solutions, etc.
Santarem, Brazil 

The Project Health and Joy operates programs for integrated and sustainable community development with indigenous populations of the amazonian region of Brazil. They include territorial development, health, education, culture and communication aspects.

The Health and Joy Project has 26 years of experience working with socially and geographically excluded populations in the Brazilian Amazon region. The credibility that the organization has gained among the people as a result of all of this time of work has allowed it to expand its areas and purpose of interventions. Now it has a more comprehensive agenda for integrated and sustainable community development, and a methodology that the organization is purposely systematizing with aims at scaling the project within and beyond the region.

Health and Joy Project initiatives are divided into Territorial Development, Health, Education, Culture, and Communication, and they are all structured through a permanent process of institutional integration that enables their mutual support.

Photo by: Emilia Szekely

This integrative approach has been one of the organization’s main strengths from the very beginning. Health and Joy Project started as a health delivery program in the year 2006, when the organization acquired a boat (the Abare Ship) that, making regular rounds from community to community, approached people with an interdisciplinary team presented as the Mocorongo Great Circus. This taught people how to take care of their hygiene and prevent diseases using fun, participatory games. Personnel from the boat also offered basic medical and dental care, family planning training, minor surgeries, adapted technologies such as micro-systems for the provision and treatment of water, house filters, wells.

Its success resulted in its absorption by the Brazilian Ministry of Health and in its escalation at State level in 2010. The organization ended its health mission arguing that it had achieved its objective, and that the State’s delivery and funding capacity was bigger.

Its current director says that its mission is to create replicable development models that can be scaled by agents capable of implementing and funding them sustainably, for which it also works on strengthening the links between the communities and partners from abroad. Models that serve as demonstrative references for the State (not the – rather unstable – government) or the private sector so they learn better and cheaper ways to design and implement public policies and adopt them. Once this mission is achieved, the organization changes its role from implementing the programs to creating management capacities in the communities to oversee their continuous persistence and quality.

The Territorial Development Program is the basis of the social and political support of all of Health and Joy Project’s work. Its work enables people to manage their own development by strengthening their self-management capacities and adapting the program to local conditions.

One of the main initiatives within this program is the Sustainable Entrepreneurship Program. Amazonian communities live in a vulnerable region where land occupation and resources mismanagement prevail. On top of this, government conditional cash transfers development model Bolsa Familia have resulted in the disappearance of local production and led to extreme dependency on external subsidies.

Photo by: Emilia Szekely

In education, Health and Joy Project’s used to focus on complementing schools’ activities. Now however, their focus is a pilot project developed in partnership with a few schools, a foundation, and the local government to make education more locally relevant. They make use of a participatory mapping technique which allows them to identify the elements of the local context that are significant for the children and their communities, and so customize the teaching-learning materials.

Although the model is allegedly cheap, it relies heavily on external funding. As such, ensuring financial sustainability is one of the organization’s main concerns and where it devotes a great extent of its time and energy. As a consequence, the Health and Joy Project is now discussing the creation of a parallel for-profit enterprise that will fund its social objective. Also, as with the other organizations, it has been careful to ensure transparency in the management of the funds to facilitate donors’ support, for which it usually hires an independent auditing service.

The Project emphasises the comprehensive character of its interventions, recognizing that community life is integral itself; that all age sectors must be attended to, and that one area can support another because it is frequently the same people that are involved.

However, this level of integration is difficult. Many factors work against it: the responsibilities of Health and Joy Project’s staff are distributed by area. Each area is accountable for its own programs to ensure maintaining donors support (whose funding criteria are not integral and they expect concrete results in concrete areas). While all personnel are encouraged to get involved in all areas of work, this can only be superficial because they must concentrate on their own projects.

To counteract these effects, Health and Joy Project has established an Area of Institutional Integration. This links the organization’s programs and determines institutional articulations and policies so that they can share their human, infrastructural, financial, and other resources. It also plans the dissemination, expansion, and replication of its model, ensuring its sustainability. The area uses strategies that include:

Using celebrities to attract funding – that is, working on the models’ advocacy capacity and visibility.

Diversifying sources of financial support.

Allowing online donations of materials, or equipment.

 Offering consultancy and advisory services to the public and private sectors, including NGOs and social movements (capitalizing on its experience).

Working in partnership with foreign communities and institutions that have diverse development agendas. This helps expand the communities’ access to a wide variety of social programs that support one another, and benefits foreign partners because they can use the Health and Joy Project’s experience, know-how, and credibility in the region to access it. The partnerships with the communities create or strengthen local organizations that, being independent of the Health and Joy Project itself, require less of the latter’s financial and administrative support.

♣ Promoting the beneficiaries’ ownership of its programs — creating programs through a participatory mapping methodology.

Training “multiplier” agents, that is, local leaders that can manage and disseminate its programs independently.

Assuring and promoting that all of the organization’s initiatives work transversally — by using PMES annual cycles (Planning, Monitoring, Evaluation, and Systematization) or the circus, for example. The latter is another key resource for the Project, because it integrates the way people learn, conceptualize, and appropriate the initiatives created to improve their quality of life using different languages (dancing, singing, talking).

♣  Developing a multi-annual strategic plan to scale-up the project’s model, strengthening the integrative character of its practices, and the organization’s inter-institutional agreements. Exploring the means for the model’s sustainability and scalability and the Project head office’s future retrieval from its management.