What Colombia Taught Me About Community Health

Written by: Mubashshirah Desai

When I began my exchange semester in Colombia as part of my Master of Science in Global Health, I entered the experience hoping to contribute to meaningful community health work. Like many students who are interested in global health, I was motivated by the idea of being involved with advancements in health equity and contributing to positive change. Central to my experience and an important lesson I learned was that community health work does not mean arriving with preconceived notions and solutions or even expecting to see the immediate outcomes of your work. It requires building relationships and understanding the community first, specifically its priorities, existing strengths, challenges, and the perspectives of the people who know it best.

During my exchange at Universidad del Rosario in Bogotá, I studied community health and participated in fieldwork in Tabio, a town located just outside of Bogotá. Alongside other students from McMaster University (Canada), Universidad del Rosario (Colombia), Universidad de La Sabana (Colombia), and Maastricht University (Netherlands), I worked with community members and local organizations on projects identified as important within the community. One of our main projects involved supporting the development of Casa de la Mujer (Women’s House), a community-based centre intended to support women and their families. Our group was tasked with helping develop recommendations for the programs and services that would be offered through this space, including support related to intimate partner violence (IPV), mental health, legal resources, economic empowerment, and community connection.

Through these experiences, I learned that before developing programs or even assisting with interventions, there must first be a significant amount of time and effort invested in understanding the underlying circumstances that shape people’s lives and the factors that influence what types of support will actually be meaningful. Below are some reflections from my experience and lessons that I learned along the way.

Understanding and community knowledge come first

One of my main projects in Tabio involved supporting the development of Casa de la Mujer (Women’s House), a community-based centre intended to support women and their families. Our group was tasked with helping develop recommendations for the programs and services that would be offered through this space, including support related to intimate partner violence (IPV), mental health, legal resources, economic empowerment, and community connection.

Initially, it was tempting to approach the work from the perspective of what we thought a women’s centre should look like or provide. We were used to working independently and researching evidence-based approaches, but we quickly realized that our understanding of the project had to be shaped by the priorities and realities of the people who would ultimately use these services. For instance, during one of our conversations with local partners and community representatives, they emphasized that women needed more than crisis support; it would be critical to create a space where women could access information, build skills, connect with others, and receive support before reaching a point of crisis. This changed our understanding of the project from simply creating responsive services to developing a space proactively focused on empowerment and long-term wellbeing.

This experience changed my view of the role of global and public health professionals. Their role includes supporting communities in shaping decisions that affect their own health and wellbeing. Effective community health work involves recognizing that communities already have knowledge and strengths that are foundational and must remain central to the work. Through this process, I also learned that complex health and social challenges require multifaceted interventions. Supporting women affected by IPV, for example, requires more than addressing the violence itself. It involves considering the many factors that influence safety and wellbeing, including access to information, financial independence, social connections, and pathways to additional resources.

Looking beyond the project and seeing the bigger picture

Another important lesson came from a part of our fieldwork that initially felt disconnected from our main assigned project. In addition to contributing to the development of Casa de la Mujer, our group spent time supporting activities at a local school in Tabio. At first, we questioned how this connected to our work on Casa de la Mujer. We had limited time in the community, and we wondered whether our efforts would be better spent focusing only on tasks directly related to the centre. However, over time, we realized that being present in different areas of the community helped us better understand the broader context in which our work existed. Additionally, we were helping out in activities deemed important by the community itself, even if we had not initially seen the extent of its value.

Through conversations with students, teachers, and school staff, we learned about challenges affecting students in Tabio, including gaps in sexual and reproductive health education, mental health concerns, and barriers affecting students’ ability to attend school regularly. Some students participated in weekend-only programming due to employment responsibilities, transportation barriers, or other circumstances preventing them from attending school during the week. This gave us an understanding of how social determinants are connected, shaping opportunities and lifetime outcomes. Access to appropriate education, family responsibilities, employment opportunities, transportation, and available support systems all influence the opportunities people have throughout their lives. Understanding a community requires looking beyond one single issue or at one population group and recognizing how different factors intersect to create people’s realities.

This was why participating in activities outside of our main project became such an important part of our experience. Valuable learning happens through observing, listening, and developing a nuanced understanding of an issue at multiple levels. These interactions helped us understand the community holistically, outside of a single program, and allowed us to better appreciate what residents valued, what challenges they faced, and what future initiatives might be most useful.

Redefining what progress looks like

One of the most challenging parts of my experience was learning to be flexible and adapting my expectations. Coming from a structured, academic environment, I was used to a different style of working. However, due to the nature of fieldwork, plans changed frequently, meetings were delayed or cancelled, and activities did not always happen according to our original plan.

Initially, this felt frustrating. With only a few months in Tabio, my group worried about whether we would accomplish everything we had hoped to complete and were concerned that we were not “doing” enough. However, through reflection and conversations with our supervisors and mentors, we began to understand that the pace of community work is shaped by many factors. For instance, many decisions involved consultation with multiple community leaders and stakeholders. Although this process required patience, it also ensured that projects were grounded in community perspectives rather than being created from an outside viewpoint.

Over time, our understanding of progress evolved. Unlike what we initially thought, our productivity was not defined by the number of documents we were able to present or tasks we completed. The operational plan developed for Casa de la Mujer represented just one aspect of our contribution. What was equally important was the relationships we developed, the perspectives we gained, and the strong foundation built for the future students and community partners who would continue this work and ensure its sustainability. These aspects were not separate from the work; they were the basis of it.

Why relationships are part of the work

Although I arrived in Colombia as a student hoping to meaningfully contribute to a community, I quickly realized how much I had to learn from the people around me (and what a privilege that was). Navigating a different language and culture while working in unfamiliar environments pushed me outside of my comfort zone. I found myself relying on people I had just met, from community members and local partners to classmates and mentors.

Despite any differences, I experienced how small moments of connection with strangers could create a sense of belonging. A conversation with a neighbour, a shared laugh with classmates, or a simple gesture of kindness from someone I had just met reminded me that relationships are at the centre of community work. For instance, I remember speaking with a woman who shared advice about making the most of new experiences, which made me feel welcomed and encouraged. That interaction stayed with me because it showed me how a sense of openness can create connection and make people feel welcomed, even when they come from different backgrounds and experiences.

Through my time in Colombia and my brief journey in global health thus far, I have learned a few overarching lessons. First, community health requires humility, curiosity, and patience in building relationships. It requires recognizing that we will most likely not achieve a full sense of understanding (of another person’s experiences or of a situation), but we can continue learning by asking questions, listening and observing, and being open to perspectives different from our own. Second, it requires building trust, slowly but surely, and working alongside communities toward priorities that matter to them. Finally, the most meaningful contributions in community health may not always be immediately visible. Sometimes they involve strengthening relationships, supporting ongoing efforts, and laying the groundwork for future efforts and work that continues beyond our own involvement.

While I began my exchange experience in Colombia hoping to contribute to a community, I left recognizing how much the community had contributed to my own understanding of what effective global and public health work looks like.

About the author:

Mubashshirah is currently based in Hamilton, Ontario, where she is pursuing a Master of Science in Global Health at McMaster University. She is passionate about community-based approaches to health, health equity, and women's health, and recently completed fieldwork in Colombia as part of a Community Health specialization. At The HER Network, she is a member of the Recruitment and Partnerships team, where she supports outreach efforts to build collaborations with universities and organizations across Canada. Beyond her academic and volunteer work, she enjoys spending time in nature, exploring local coffee shops, and perfecting her latte-making skills.