Health, Happiness, and Capacity Building in the Amazon
SAÚDE E ALEGRIA (SA)
Organizational Vision
Citizen Base Strategy
How It's Working
Lessons Learned
SA promotes health and environmental education in isolated communities of Brazil’s Amazon region. Founded by Ashoka Fellow Eugênio Scanavino Netto, the organization first used theater and a "Health and Happiness" circus to generate excitement and promote its three main community-oriented objectives: community health; rural development; and education, culture, and communication. The combination of these three objectives culminated in SA’s ultimate goal of motivating communities to continue the work through self-organization.
SA helps communities improve their quality of life with concrete initiatives such as solar-based electrification, environmental education and access to IT, as well as by encouraging income-generating activities like agriculture and crafts. However, SA’s successes within communities reach beyond the direct results of these programs: access to clean water has dramatically reduced instances of water-borne disease; infant mortality has dropped; micro-enterprises have thrived; and communities have become more involved in protecting their environment against large agro-industrial corporations. Now working in more than 150 communities and well-known throughout Brazil, SA no longer needs a circus to spread its message. SA has already reached nearly 150,000 people with its successful health-promotion strategies, and strengthened countless communities throughout the Amazon.
Creatively spark community enthusiasm
During the organization’s initial development stage, SA staff traveled by boat to isolated villages with a team of teachers, physicians, engineers, and environmental experts, and partnered with local leaders to present a circus—each circus act playing out a health-related lesson. While the spectacle of the circus quickly engaged the community, the SA team, dressed up as clowns, highlighted healthy behavior and preventive healthcare. Following the circus, SA established "health patrols" in each community, training community members in basic primary healthcare. This proved an extremely effective intervention: in communities served by Saúde e Alegria, infant mortality was halved, and 100% of families received access to chlorine for treatment of drinking water, as well as information about why they should use it.
Actively encourage community ownership
Saúde e Alegria is highly committed to community ownership and increasing a
community’s self reliance. The organization actively promotes and encourages community participation in all aspects of program intervention, providing training to ensure that each village achieves self-sustainability. Up-front training reduces the organization’s costs, empowers community leaders and participants, and ensures long-term sustainability.
Ironically, it was a crisis of funding that forced Saúde e Alegria to put more power and control in the hands of the communities themselves. In the early 1990’s, the Brazilian government suddenly prohibited SA from extracting money from the bank; overnight the bank and the government trapped all of their funds. Left without any option other than to downsize and minimize costs, SA needed to give projects over to the community or face complete termination. The act actually strengthened the organization. As a result, communities made projects both more efficient by focusing on the most important needs and more sustainable at a very low cost because everything was done within the community.
Profit from demand for replication
With the growing success of Saúde e Alegria’s projects and a great demand for expansion into other areas, a number of organizations sought to replicate the SA model. Saúde e Alegria transformed the popularity into revenue by instituting consulting services for how to reproduce their methodologies, rather than simply giving away strategies and spending valuable resources teaching others. Expanding on this idea, the organization now includes programs for companies and other private sector organizations on corporate social responsibility. Saúde e Alegria saw the value in replication, not only to help spread the word and increase the social impact of their idea, but to help ensure the organization’s own sustainability. Currently 20% of Saúde e Alegria’s funding comes from event revenue and fees for services.
Cultivate a long-term plan
From its inception, Saúde e Alegria developed clear objectives and strategies for goal realization. Establishing a concrete long-term strategy kept the organization focused, allowed it to create and meet benchmarks, and promoted good managerial structure, as goals and policies were clearly outlined. Saúde e Alegria’s long-term strategy is as follows:
STAGE 1 (1987 – 1990) – Participatory Diagnostic and Community Mobilization
STAGE II (1991 – 1994) – Medium- and Long-Term Priorities
STAGE III (1995 – 2001) – Integrated Development and Training for Community Management
CURRENT STAGE (2002 – present) – Scaling-up and Expansion
The first phase of the extended project resulted in a diagnosis, with resident participation, of health in the region. The next focused on establishing specific health and environmental programs among the area's rural poor. The third phase was dedicated to solidifying programs and transferring the ongoing work to the communities themselves. In the final phase, SA is extending the project model to other communities.
- Saúde e Alegria’s quarterly immunization campaigns vaccinates 98% of those involved, and the organization regularly monitors roughly 600 children under the age of five.
- Saúde e Alegria and the communities have installed more than 70 radio systems, facilitating communication and the notification of emergencies between remote communities and urban centers.
- Saúde e Alegria has helped communities drill more than 150 semi-artesian wells for sites without running water.
- Work with a diverse team. Saúde e Alegria is comprised of a team of 49 professionals, including doctors, nurses, dentists, engineers, economists, social scientists, lawyers, artists, and educators. Their diversity strengthens both the organization’s mission and ensures that it gains support from various sectors of society.
- Make your message engaging. When SA first entered communities, it involved children and other community members in its circus, utilizing the engaging nature of music, drama, and joy.
- Replicate successful strategies learned from other organizations. One of SA’s most successful endeavors has been its supply of micro-credit, a well-known strategy for stimulating local production and increasing income. By providing financing of up to US$300 for sustainable small enterprises, SA provides economic opportunity and reducing the rural exodus.