Why do we need to swim upstream in healthcare research?

The answer comes from a parable that's very common in the public health community. This is a parable of three friends. Imagine that you're one of these three friends who come to a river. It's a beautiful scene, but it's shattered by the cries of a child, and actually several children, in need of rescue in the water. So you do hopefully what everybody would do. You jump right in along with your friends. The first friend says, I'm going to rescue those who are about to drown, those at most risk of falling over the waterfall. The second friend says, I'm going to build a raft. I'm going to make sure that fewer people need to end up at the waterfall's edge. Let's usher more people to safety by building this raft, coordinating those branches together. Over time, they're successful, but not really, as much as they want to be. More people slip through, and they finally look up and they see that their third friend is nowhere to be seen. They finally spot her. She's in the water. She's swimming away from them upstream, rescuing children as she goes, and they shout to her, "Where are you going? There are children here to save." And she says back, "I'm going to find out who or what is throwing these children in the water." From Rishi Manchanda’s TED talk: http://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream/transcript?language=en#t-520480

An ideal community health worker may need all the three attributes described in the parable above?

Current day modern medicine and all our medical education is mostly Hospital Based and focused on Rescue and this is one of the characteristics we can expect in most of our community health workers but again training them to the desired levels can be challenging though not impossible especially with the help of technology one can see this being ushered in through 'home-healthcare?

Rescuer Attributes/Myer’s Brigg’s Typologies: Sensory reflexes, Feeling

Raft building in healthcare has been delegated to administrators, policy makers and politicians but raft building needs to begin in the community and the CHW is well positioned to initiate it again with the help of technology that has the power to connect him/her with decision makers?

Raft Builder Attributes/Myer’s Brigg’s Typologies: Extroverted, Sensory, Thinker, and Judgmental.

Upstream swimmers in Healthcare are very few and are generally thought to be taken up by people labelled health activists but this is a role often left to patient’s relatives or even patients themselves. The role of a CHW here is perhaps paramount?

Upstream swimmers Attributes/Myer’s Brigg’s Typologies: Intuition, Thinking, Feeling, Perception

I have used Myer Brigg's typologies and anyone wishing to figure out their own typology can just click on this link:http://www.humanmetrics.com/cgi-win/JTypes2.asp#questionnaire There are 72 yes/no questions but once you answer them it may be fun to diagnose your own typology and see what kind of community health work you are suited for?