Germany (Deutschland)
Bochum
Report from the SMAPL Townhall Meeting July 2024 in Bochum
Christiane Falge
In July, the Bochum team organized the first SMAPL Town Hall Meeting with 20 participants from politics, science, other stakeholders and the community. The meeting started with four presentations on different perspectives on the pandemic which were then discussed in working groups and wrapped up with a plenary discussion about the role of communities in future health-related support options for poor, migrant neighbourhoods. The event was organised by HS Gesundheit, the municipal integration centre and the Bochum health department.
In her introduction, Christiane Falge explained how, in the wake of growing social inequality, politicians have recognised the need for innovation in the area of public health promotion, but still pay too little attention to the important role of communities in successful primary care and resilience. She emphasized that the global North could learn from the global South, e.g. learnt the SMAPL team in 2023 during a visit to Brazil, about the Parapaisopolis communities important contributions to overcoming the pandemic. She referred to the importance to discuss about the question of support options for vulnerable communities using community resources in Germany as well.
The perspectives of the Bochum health authority:
As part of his presentation, Michael Sprünken from Bochum’s public health department presented analyses and results on the distribution of incidence figures in relation to higher incidences and mortalities in poor and population dense districts and influencing factors such as access to health information and vaccination services. Sprünken emphasised the role and importance of vaccination scouts during vaccination campaigns. They reached hard-to-reach target groups through their good knowledge of the neighbourhoods and their structures, culturally sensitive and native-language approaches and the provision of quality-assured health information (vaccination advice). Strikingly enough, the public health department does not have any small-scale data. Community Research can provide this data.
Community perspectives on the coronavirus pandemic – Elham Youssef, Nahera Ahmad, Dilbuhar Amin (Stadtteilabor Bochum)
The community researchers presented the results of their community research, which they conducted as part of the SMAPL project together with students of the HS Gesundheit and researchers from October 2022 to October 2023. As part of this research, 26 interviews were conducted and nine media ethnographic projects were created that presented the community’s perspective on the pandemic.
This perspective differs fundamentally from the stigmatising discourses and media representations of mainstream society. In the lecture, they shed light on the situation in Hustadt 2021, which was characterised by public order controls rather than an outreach information policy in the foreground in view of very high incidences. They described how they, as part of the city district laboratory and together with the QUERgesund project of IFAK e.V., organised vaccination awareness-raising and low-threshold vaccination offers in Hustadt. Based on their research results, they showed that geographical proximity, multilingualism and the involvement of neighbourhood researchers, most of whom lived in the affected neighbourhood themselves, and the trust that went with this, were among the main factors in the good uptake of the offer. The presentation of the neighbourhood researchers can be found here.
Research findings from Hustadt – Laura Siebert (University of Münster)
Laura Siebert’s presentation presented research findings from Hustadt, which were produced as part of a master’s thesis. Two central questions were addressed: What lessons can we learn from the COVID-19 pandemic and how can we better counter future pandemics?
The research was carried out in collaboration with the City Lab. Using a collaborative research approach, 13 interviews were conducted in tandem with four community researchers with stakeholders from social institutions, politics and the Hustadt community. The results show that controls were very present for Hustadt residents during the pandemic, while support services were perceived as insufficient in some cases. Communication and information structures often did not reach people sufficiently during the pandemic, which sometimes led to misunderstandings and uncertainty.
Impulses for dealing with future pandemics were derived from the research results. It was emphasised that the resources already available in the community should be better utilised and supported. This includes the social organisations based in Hustadt, which have done valuable work during the pandemic. Another important aspect is the development of long-term health services, multilingual information structures and diversity-sensitive participation structures. Close collaboration with the community is crucial for future interventions. This can also take place, for example, in cooperation with the community researchers of the City Lab as important multipliers.
Pilot report – Serhat Sönmez (doctor and head of the Wattenscheid vaccination centre) & Ibi Eser (Gemi e.V.)
In their presentation, Mr Sönmez and Mr Eser report on the pilot work in Wattenscheid, which reduced vaccination barriers by providing low-threshold information and appropriate vaccination support and took place at shopping centres, mosques and schools between February and March 2022. Information about vaccination options and supposedly common and serious complications was also provided at the mosque before and after Friday prayers.
Most of the guides were members of a community organisation, which has made the integration of migrants its core task since 2017. Continuous training was organised to ensure that the guides were kept up to date with the dynamic vaccination situation. These meetings were also used to discuss difficult vaccination consultations and to jointly develop new approaches to reach vaccination sceptics at a subtle, low-threshold level.
Exchange in working groups: Review and outlook for the pandemic
The presentations were followed by a dialogue in three working groups made up of mixed groups of stakeholders from the areas of community, practice, city, politics and science. All groups had the task of discussing the two key questions 1) ‘What resources have you brought to the table?’ and 2) ‘How can we better utilise/support community resources?’ based on their pandemic experiences and the presentations.
The answers to the first question about the resources contributed by the participants during the pandemic focused on outreach community-based vaccination campaigns, the role of neighbourhood researchers as health guides and the topics of schools and digitalisation. The second part on the use of community resources focused on the distribution of administrative resources during health crises, the role of communities for neighbourhood health centres as structures for poor neighbourhoods, and the central importance of community resources when considering diversity, networking and digitalisation.
Working group 1
Moderation: Theresa Martens and Laura Siebert
Working group 2
Moderation: Lisa Kamphaus
Working group 3
Moderation: Christiane Falge
Results from the working groups
The key points of the results identified in the working groups were presented in the plenary session. The focus was on the realisation that numerous resources were available and used in the district. Depending on the composition of the working groups, different resources were named, such as the important role of the school or the local social organisations as personal contacts. All working groups recognised that the communities in the Hustadt and Wattenscheid case studies made an important contribution to overcoming the pandemic. Both in the implementation of culturally sensitive vaccination offers and as vaccination guides and in the course of neighbourly solidarity.
With regard to this work, it was critically mentioned that it is often not regularly funded. There was consensus that these resources should be utilised and funded for future pandemics. There was also agreement on the recommendation to transfer the good neighbourhood work from the Hustadt/Wattenscheid case studies to other districts. All three working groups saw the establishment of community-based health-promoting structures (e.g. neighbourhood health centres) with the involvement of the communities as an important contribution to reducing health inequalities. Reaching the so-called ‘hard-to-reach’ could be made possible with the help of communities/ community researchers. The funded involvement of communities as cultural and language mediators should take place both in these structures and in overarching neighbourhood work. For future pandemics, the provision of small-scale statistics was also recommended, as socio-spatial differences are not visible in the current statistics of the public health bureau.
Conclusion and outlook
At the end, Christiane Falge invites all participants to work together on the development of Community-Based-Health-Care (CBHC) for health promotion in poor neighbourhoods in Bochum and with the university as a strategic partner. The representative of Bochum’s public health department emphasised the importance of structurally anchored financial support for the involvement of communities in healthcare and for future pandemics. The participants agree with this. A few weeks later, the head of the Municipal Integration Centre of the City of Bochum invited Christiane Falge to plan a funding application for the establishment of community-based health care in Bochum in cooperation with the city and the stakeholders present at the THM. This is an important achievement for the SMAPL team.
