To make global health truly participatory, the world’s health institutions must adopt a radical approach to listening to everyday people. Listening must become global health’s lynchpin.
With emerging practices like narrative medicine and participatory action research, clinical health care spaces, therapeutic environments, and nonprofit workplaces have begun to embrace radical listening as a discipline. The driving idea is that people closest to a problem are best positioned to find solutions, which health professionals can help implement by providing resources and critical technical capabilities.
A commitment to radical listening would transform global health for the better. Consider the experience of communities in Borneo — an island that’s home to poor, rural villages scattered throughout one of the world’s major rainforests, threatened by deforestation. Before attempting to implement any interventions, a team led by the nongovernmental organization Alam Sehat Lestari worked as a local partner with the international nonprofit Health In Harmony, which one of us founded. The team conducted more than 400 hours of listening sessions with nearly 500 community representatives, including farmers, religious leaders, teachers, women’s groups, and other community members.
Those listening sessions revealed a problem common across the region: Despite depending on their precious forests, residents often resorted to illegal logging to pay for access to basic health care. This insight led communities to design a holistic solution for themselves. They invited health professionals to help establish nearby health facilities, with a brilliant incentive: The cost of care would be discounted for communities that halted or reduced illegal logging. People could also barter for health services with seedlings or manure, to be used for forest restoration and farming.
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