PROPOSAL FOR NETWORKS OF COMMUNITY WORKERS IN POOR RURAL AREAS

Executive summary
The outline proposal
Footnotes on background/context
Case studies detailing potential response to community social problems
The Budget

Summary

Romania’s programme of institution closure reportedly aims to close most child and adult institutions by 2007. There are still 50,000 children in institutions, 70% of whom come from rural areas.

Many will be reunited with their families in areas of extreme poverty where no social support exists.

Such re-integrations are highly likely to fail without the appropriate support and lead to increased numbers of homeless children, suffering, child abuse, ill health, infant abandonment etc.

Existing structures are inadequate. There are impressive looking plans on paper. But the reality is that the fundamental community support mechanisms that are supposed to be in place simply do not function. (See note i)

An urgent intermediary plan is needed to boost support to the families of children and adults who are returned to the community after years – often a lifetime – in an institution. (See note ii)

We have over 12 years experience of rural community support and are proposing a new discipline – the Mobile Community Worker. They will act as a much needed missing link bringing the various existing community services (state and non-governmental) together. (See note iii)

A network of 10 Mobile Community Workers will cover 10 ‘communas’ (i.e. each serving 10 – 16 villages.) They will be co-ordinated from a regional central office in the area itself.

They will effectively act as a rapid reaction force in an otherwise sluggishly bureaucratic environment - speedily addressing families’ many social problems before things spiral out of control.

We have an outline proposal for a two year pilot project which we hope will lead to a national programme.

In the first year we can set up a network of 10 Community Workers for a population of 36,000 in the poor rural region of Podu Turcului, SE Bacau. (Budget £196,000.)

In the second year, the project could extend to the whole of rural Bacau. (Estimate cost £1,400,000.)

In year three, the plan would be ready to go national (Estimated cost around £1,000,000 per county x 42 counties). At lesser cost, the project could be targeted at extremely poor rural areas e.g. Moldova in the NE and Bargan/Targu Jiu in the south.

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Aims of the project

- To provide an emergency template project for social support in deprived rural areas.

- To prevent failed family reintegration for children and adults from institutions under the present rapid closure programme in the absence of existing social services.

- To create a completely new network of Community Workers for the target rural communities that is independent from the routine tasks of the mayors’ social assistance departments.

The outline proposal

A pilot project in a targeted deprived rural area known as the Podu Turcului region in SE Bacau county. This region of Moldova is poor even by Romanian standards. There is little employment and most families survive by subsistence farming on small plots of land which may be many miles from their home.

The target area has a population of 36,000 being 6% of Bacau’s total population of 600,000 and representing 9.5% of the rural poor of the county.

2004: Implement a network of Community Workers in 10 “communas”. Budget £196,120

A communa is a rural administration centre in larger villages which serve 10 – 16 satellite villages. They are under the jurisdiction of local mayors. The average communa population is around 3,000. Each communa is served by a doctor and community nurses. However, not all these posts are filled and many communas have no medical services at all. The communa head villages all have a church and schools.

§ Community workers will be recruited from suitable applicants in the caring professions, nurses, teachers etc and they will receive a basic 5 day training course and continuous training throughout the project. ( See note iv)

§ 10 Community Workers will report to a regional office and administration centre.

§ The Project Coordinator will supervise the activity and conduct statistical analysis of the social problems, the measures taken, the needs of the area and the cost.

§ The CW will identify all children and families at risk, perform home visits and a needs assessment. An Intervention Plan will be agreed with a Social Committee comprising key local representatives. This committee will meet monthly and report to all stakeholders.

§ The CW and her management team will access grants, distribute social grants of the project and gain access to the resources, disability living aids, community projects, family planning services and volunteer help that are available. They will promote and support new community support initiatives such as Day Centres and Community Centres for the disabled and elderly.

§ All grant applications will be centralised in the region and be handled by an Administrator/Grants officer. The project will liaise closely with the Mayor’s office but will maintain operational independence. Every effort will be made to train, motivate and assist the mayors’ Social Assistants where this is not detrimental to the project activity.
(See note v)

§ The CW’s will be active in the community on a daily basis. They will not be based in an office but see all clients in their own environment or at the local schools and dispensaries.

§ The teams will meet weekly at the regional office.

§ The following government and local authority grants will be accessed by the project for their clients:

Law 34: Ministry of Social Protection grants for food, clothing and resources for poor families

Law 17: local council grants for the elderly

The Personal Carer Scheme:

Law 416: guaranteed minimum income.

Community Social Committees will be set up in each communa with c. 10 representatives of the church, school, dispensary, mayor’s office etc. They will make joint decisions on interventions proposed by the CW. They will motivate their communities to offer volunteer help, in kind donations, and resources. They will raise awareness of a sense of community, collective responsibility and involvement.

The project will aim to train and assist the mayors’ social departments to become much more effective with the help of the Social Committees. The emphasis will be on early intervention to prevent future child abandonment, run-aways, educational failures etc.

The project will work closely with the local health care workers and schools and identify generic solutions such as disability workshops and community centres.

Case studies with proposed interventions are below.

2005: extend the project to the whole of Bacau county rural areas – a total of 70 communas.

The early intervention pilot project can be spread regionally and nationally by personnel from other areas coming to “shadow” the staff of the pilot project before designing the set up of a new regional project.


Relief Fund for Romania
Registered Charity Number 1046737

18 Fitzhardinge Street
London
W1H 6EQ

Telephone: 00 44 20 87 61 22 77
Fax: 00 44 20 87 61 00 20

e-mail: mail@relieffundforromania.co.uk
website: www.relieffundforromania.co.uk

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NOTES – CONTEXT AND BACKGROUND

Note i : The supposed social support mechanisms

Mayors supposedly have budgets for community social support and designated social assistants.

Departments of Child Protection have family assessment and follow-up plans.

But in fact, the mayors’ social assistants are bogged down with administration and have scant knowledge of families at risk in their communities.

Areas of high unemployment have no social assistance budget because of poor fiscal revenues. Departments of Child protection have no budget to buy petrol for rural visits.

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Note ii: What should be happening

The National Action Plan (National Institute for Care and Protection ) 2.4.1. “Prevention and development of alternative services” outlines the policy of “Closing the front door” of institutions.

“De-institutionalisation should be a carefully planned and gradual process. Leapfrogging from institutions to communities should be avoided…especially if alternative, community based services and support … are not yet in place”.

But, this is precisely what is happening.

The paper goes on to describe the policy called “Opening the back door” on personal planning for de-institutionalisation.

So we could say that while the front door is being closed, the back door opens onto a wasteland.

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Note iii Experience

Relief Fund for Romania/Fundatia de Sprijin Comunitar (FSC - our main service delivery partners) have many years experience of delivering health and community support services in programmes of:

Mobile Health Care, Health Education, Home Care of the Elderly and Disabled, street children’s Refuge, Return to Work/School Programmes and Arts Therapy for the Disabled for special needs children and adults.

In addition to a record of long-term success in direct services, FSC has developed a reputation for quality “train-the-trainer” courses in elderly health care, health education and play therapy, a history of cooperation with local agencies and other NGOs, extensive experience managing large grants and a reputation among international funding agencies for exemplary book-keeping.

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Note iv Training

Following recent health care reforms, many rural nurses were made redundant. Young people have been encouraged to qualify as psychologists but there are limited job opportunities. It is likely that such factors will contribute to a suitable recruitment pool.

Though the initial intensive training will be only one week, training will be continuous. Experience with the training of community Home Carers has demonstrated this to be an effective method, especially for mothers with families, who cannot afford long periods of study with no income.

FSC have recently been accredited by Open College Network UK (OCN) as an approved training organisation. The first such approval in Romania as part of OCN’s extension into Europe.

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Note v: Social Assistants - past experience of working from within the mayors’ offices

Until recently, there had been no social worker training in Romania since the early 1970’s, Romania being portrayed as an ideal society with no social problems. Social workers are now being trained but not at a rate that can address the huge national need.

NGO’s have attempted to train existing rural social workers (called "referenti sociali" in Romanian if they have no training in social work). They aimed to motivate them to become more efficient in assisting families in need in their areas. The project failed because the trainers themselves ended up dealing with an overload of paper work re Law 416 (re. the minimum guaranteed income) and other tasks in the mayors' offices.

Another reason for failure was a lack of resources allocated for the social protection department. No budget, the payment of the minimum wage, no transport or facilities led to poor motivation and performance.

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CASE STUDIES

The examples analysed below show possible ways of intervention by a Community Worker. The illustrations refer only to critical situations when poverty, domestic violence, alcoholism, lack of services, etc. are at risk factors that adversely affect the reintegration processes.

Case Study 1. Child of 10 years old reintegrated with family after 7 years of institutionalisation.

Family situation:
- 5 other smaller brothers and sisters by new husband
- mother remarried
- father works on a very small salary, often drinks and beats the family

Plan of intervention:

§ Our CW is informed /consulted by the DPC about the possibility of reintegration

§ The CW visits the family and assesses their situation and needs: incomes, family relationship, risks, etc.

§ The CW organises visits of the child to the family, 2-3 short visits of the child accompanied by CW and social worker of the institution followed by a longer visit 1-2 weeks when the CW checks daily on the general situation.

NOTE: visits by the family to the institutions are very difficult to organise because of small children at home, long distance from village to city and father working long hours on road work.


§ The CW informs the community committee of the integration and presents a plan for support for the family:

This plan includes:


§ counselling of the family especially for the husband (who is not the father of the reintegrated child), find him a better job if possible; the members of the committee will help with the counselling especially for the drinking problem.

NOTE: alcohol rehabilitation programmes do not exist.

§ improve home conditions: cleaning, repairs, possible extension of the house

§ integration of the child in the school, support by the teachers for catching up if necessary; assure the necessary school supplies;

§ facilitate enrolment with the family doctor

§ family planning services for the mother

§ visits by the CW monthly for 6 months and quarterly for 1-2 years after the reintegration

The plan of intervention can be re-adjusted if new factors occur: major crises, serious illnesses of the children or parents, loss of job, etc.

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Case Study 2. Very young single pregnant woman at risk of abandoning her child at birth.

Early intervention in such situations is quite rare, as the circumstances are normally kept hidden by the mother.

There are situations when the pregnant women are thrown out of their homes when conservative, strict parents find out about it.

The CW finds urgent accommodation in the village and pays a monthly rent.

The community committee summons the parents of the pregnant woman and discusses the situation with them, alternatives, solutions, etc. If family reunion fails the plan of intervention can include:

§ referral to the maternal centre of DPC in Bacau
§ mother support after childbirth: advice, clothes, baby food, medical care, etc.
§ child care and job placement
§ family planning advice

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Case Study 3. Family with a young child with disability

Family at risk of abandoning a child with disability shortly after birth:

§ the CW will facilitate the access of the family to information regarding the problems and the special needs of the child (from Internet or other organisations)

§ the CW will facilitate the access of the family to primary and special health care services

§ the CW can find ambulatory rehabilitation services for the child with an existent service in a neighbour area

§ the CW can obtain information about the rights/benefits of the family according to the legislation

§ the community committee can suggest and be active in finding various forms of support for the family: access to education (visiting teacher), access to special equipment, sanitary and cleaning materials, etc.

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Case Study 4. Family with numerous children

The situation when children live in unhealthy environments and suffer from: malnutrition, neglect, verbal and physical violence and children who work from early ages, etc.

Even though the children from such situations have never been in an institution they are at risk and the community should do something to improve the quality of their lives in the view of the "rights of the children convention".

The CW can evaluate the families and present the cases to the community committees (CC), the plan of intervention being a result of a collective decision:

§ counselling
§ family planning services
§ job offer
§ endowment with plots of land and animals
§ building, cleaning materials (for their houses)
§ school supplies, clothes, etc.

The CW establishes the steps in the plan of intervention and monitors/helps the family to go through all the stages. If the family fails to improve their condition in spite of all the efforts and the children continue to be at risk, the children should be removed from the family and placed in an institution and then a new plan established for the families.

In this circumstance the local police should be more active and put some pressure on the family.

The CW should continue to monitor the case for 1-2 years after a successful resolution by periodically collecting information about the children from neighbours, school, and dispensary.

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Case Study 5. Reintegration of adult person with handicap with elderly parents

Such situations can occur as a consequence of the new national strategy. The CW can facilitate/state the decision against the reintegration by:

§ assessing the needs of the person with handicap against the situation of the family where the person will be reintegrated

§ in case the reintegration doesn't look hopeful the CW / FSC makes a report to the authorities which will be asked to find another solution

§ if there are hopeful chances for reintegration the CW makes a plan of intervention and together with the CC decides on the best solutions

The plan can include:

§ informing the families about the special needs of the persons

§ giving support in creating house facilities: ramps, beds, mobility equipment, lifts, etc.

§ facilitating the access of the specialists (physiotherapists, psychologists, nurses, etc.) to the families for skill transfers: nursing, lifting procedures, feeding, occupational therapy, communication, etc., skills necessary for the families to cope with the special needs of the new member

§ facilitating the access of the person to the community: church, public places, etc.

§ if suitable help the person with special needs to start a small, lucrative activity: basket making, knitting, weaving, etc.

§ if the family of the reintegrated person consists of elderly parents an outside personal carer should be trained and employed to help

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Case Study 6. Dependent, suffering, homebound elderly

The CW should be proactive in the community in identifying groups that need help: elderly, people with handicap, single mothers, poor families, etc.

The CW evaluates the situations and sets up individual plans of intervention. The CC will decide on how to spend the existing resources and will attract new ones.
For the dependent elderly the solutions can be:

§ find local volunteers, train them and use them to assist the people in need: wood collecting and chopping, water carrying from wells, shopping, cleaning, etc.

§ the churches can help with food, clothes collection

§ the local medical personnel can become more active, do more home visits

§ the CW can facilitate their access to medical care and buy drugs for them

§ the CW can obtain benefits on their behalf

§ refer the case to FSC home care programme


In general the community worker can generate local application of solutions, access information, pressurise the authorities, represent the beneficiaries, assure concrete help: drugs, food, clothes, facilities, etc.

 

Case studies by

Gabriela Achihai
President
FUNDATIA DE SPRIJIN COMUNITAR (FSC)




The Budget

This is available on request

 

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