One of the real ‘breakthroughs’ in a more liberating approach to health education this year has been in the field of Child-to-Child. Child-to-Child, at its best, is an approach to help school-age children learn to take practical action to meet the health needs of their younger brothers and sisters (and other children in their communities). When introduced into schools, Child-to-Child can help make schooling more relevant to the immediate needs of the children and their families. Also, the discovery-based ‘learning-by-doing’ methodology of Child-to-Child can contribute to the desperately needed transformation of the educational process from authoritarian rote learning to a more participatory, problem-solving approach. Thus it can help prepare children to become active agents of change rather than passive recipients of the charities and cruelties of an unjust system.

Unfortunately, this more liberating approach to Child-to-Child has not been put into practice universally. Many of the programs as practiced in different countries have used more standard, ‘do as you’re told’ methodologies typical of the authoritarian classroom.

In Latin America, however, the approach to Child-to-Child has been much more inspiring. Much of the initial impetus for Child-to-Child has come from Project Piaxtla in Mexico. In the early 1970’s, the Piaxtla team of village health workers helped to develop and conduct early trials of many of the original Child-to-Child activities. Since then, through a series of ‘educational interchanges’ with community programs in Central America, Piaxtla workers helped to disseminate the more liberating, learning centered approach to Child-to-Child. Members of the Piaxtla team introduced the methodology in Nicaragua in the early ‘80’s, and recently Martin Reyes and David Werner helped to lead a nation-wide Child-to-Child ‘trainer of trainers’ workshop in Managua, coordinated by CISAS, a politically progressive health education association closely linked with the IPHC and HealthWrights.

A Village Health Worker Gains International Position in Child-to-Child

Twenty five year ago, Martin Reyes, when he was 14 years old, began working with Project Piaxtla. In time he became a leader, first of that program, and later of PROJIMO (Program of Rehabilitation Organized by Disabled Youth of Western Mexico).

Over the years Martin has remained creatively active in Child-to-Child. In 1993 he won an ASHOKA fellowship to further extend the ‘discover-based’ approach to Child-to-Child throughout Mexico and Central America. In January, 1994—under the sponsorship of CISAS, the Regional Committee of Community Health Programs of Central America, and the international Child-to-Child headquarters in London—Martin was appointed Latin America coordinator of Child-to-Child, with sufficient funding to help him introduce the progressive approach to Child-to-Child throughout Latin America.

Martin was appointed Latin America coordinator of Child-to-Child

So far, Martin has conducted workshops in Mexico, Honduras, El Salvador, Nicaragua, Ecuador, and Bolivia. In all of these workshops, the ‘trainers of trainers’ learn the methodology by actually working with groups of children (not just school children, but also non-school children and street children, all learning together.) The first activity is always a ‘community diagnosis’ in which the children define and prioritize the health-related problems that most affect their own lives and those of their families. This open-ended, learner-centered approach is a revelation for many of the participants, especially the teachers. The response has been enthusiastic. Many of the new Child-to-Child initiatives are going strong and being extended to neighboring areas.

Martin now has more requests than he can fill. Fortunately,some of his earlier trainees have also become trainers and the multiplying process continues to spread. One such person is Celene Wosnicka, a Maryknowl sister who was involved in the first Child-to-Child workshop in Nicaragua. With Martin, Celene helped launch an extremely successful Child-to-Child initiative in Oaxaca, Mexico, which in turn has served as a training ground for other areas (and countries).

Child-to-Child reaches the Third World within the USA

At last Child-to-Child is now being introduced into the United States, in poor communities where older children often do a lot of the caretaking of the younger children while their parents are at work. The initiators of these US programs are mostly persons who have been involved in Mexican and Central American programs facilitated by Piaxtla workers. In a depressed area of Chicago, Celene Wosnicka (who studied with Martin in Nicaragua and later initiated a very successful Child-to-Child initiative in Oaxaca, Mexico) has begun a program. There she is finding that—much more so even than in Mexico—many of the health needs as defined by the children relate to violence, substance abuse, broken homes, and other social problems.

Another group with experience in the Mexican programs David Werner has worked with is starting a Child-to-Child initiative in East Palo Alto, California (the poor Mexican Black side of the city, where recently the murder rate was with highest in the USA). Persons who have worked with PROJIMO and HealthWrights are advisors to both these US projects.

Internationally, the more liberating approach to Child-to-Child is also making headway. Ann Peterson, a film-maker, has produced a short Child-to-Child video for UNICEF. In the process she became so excited by the revolutionary approach used in Mexico that she has raised money independently to make a longer film. In this film, now nearing completion, children themselves explain the empowering dynamics of Child-to-Child. For years the World Health Organization has known about Child-to-Child but never backed the approach very seriously. Then, during a consultancy with WHO in Geneva, in October 1993, David presented slides on the Mexican version of Child-to-Child. The WHO staff involved in Schoolaged Children’s Health became so excited by the possibilities of using Child-to-Child to help make schooling more relevant to children’s lives and wellbeing, that they voted to give Child-to-Child top priority. WHO has asked David to help write a booklet for Third World school teachers, suggesting ways to introduce Child-to-Child activities into the standard curriculum. Although David has at times clashed with WHO over health care strategies, he has accepted this offer because it may be an entry point for a more meaningful and humanized approach to education of children. If it helps enough children begin to look at their health-related needs more analytically and critically, who knows where it could lead!