Flourishing as a collective art

Dr Connie Junghans Minton, GP at Millbank Medical Centre and senior research fellow, Westminster and Imperial College, tells us about her journey with Community Health and Wellbeing Workers

“When I started out on the first pilot of Community Health and Wellbeing Workers based on the Brazilian Family Health Strategy in the UK I thought like a Clinician. I thought of them as problem-solvers in a community consisting of problems. Low vaccination rates, low screening uptake, high morbidity, you get the picture.

But somewhere along the way, they began to show me something quieter, something older than problem and solution. Their hands didn’t rush to fix, they reached to feel the weave. Each conversation, each act of noticing, was a thread drawn carefully through a tear in the social cloth. CHWWs are artisans in a time that forgot the value of craft. They stitch dignity into the seams of everyday life, reminding those of us trained to diagnose that healing is an act of composition, of pattern, patience and presence. A new acquaintance recently summed it up beautifully: “Medicine is an art, informed by science and grounded in trust and relationships.”

My work with the CHWWs led me to Brazil, where I visited a GP practice. They work in reverse to us – not waiting for problems to arrive at our door, but Community health workers go out and visit 8 households a day, each agent has around 120 households in a defined geography they visit once a month or more if needed. They promote health, support with social issues and chronic disease. Supporting a first time Mum to breastfeed, holding the hand of a dying elderly, listening to grief and frustration over a cup of tea. They know everyone in their households from baby to grandmother and everyone in between. When they notice that someone is off colour they explore. They meet the GP in the morning and prioritise together those they think need them most for a visit that day, at the end of the day they share with the GP who they think needs to be seen on the joint day the GP goes out in the community and visits with the CHWWs. Anyone acutely unwell makes their way to the practice where they see the nurse or doctor, who are not busy. Because when they arrive it is short-hand for someone already well known. It made me realise that in the UK, we try to build rapport with strangers, figure out what ails them and get a sense of their life all in 10 minutes. 28 times a day.

When the fabric thins, CHWWs don’t lament its fragility, they lean closer to the light that finds its way through. And in that glow, flourishing stops being an outcome to measure and becomes a texture we can feel, one thread, one story, one neighbour at a time. And where I saw problems I now see resourcefulness, humanity, beauty and grit. I enjoy sharing the care with CHWWs, widening the gaze beyond my consultation room down the road to the geography I now know so much better and feel connected to in a way I never expected.

Watching CHWWs in the day to day, I learned that the social fabric does not fail because people are broken but because the threads between us loosen. Flourishing is the landscape that emerges when we tend to one another. These civic artisans remind me of something a sage consultant once said to me: “People don’t care what you know until they know that you care.” What was once transaction in my mind now becomes a texture, what was once a service becomes a shared act of making.

And when the light finds its way through those stitched seams, uneven, we see that the fabric was never meant to be flawless. It was meant to be lived in, worked on and woven together.”

You can find out more about CHWWs here www.napc.co.uk/chww

Sage Practices Team Reflection

Connie’s reflection reminds us that true care begins in relationship - in the quiet, skilful work of mending what holds us together. Her words speak to a kind of medicine that listens before it acts, that values presence as much as intervention. They also point to a deeper truth: that healing is not something delivered by clinicians alone, but a collective act of participation, a weaving of dignity, attention and trust that depends on us all. In a world that can so easily turn towards blame or division, this story invites us back to our shared capacity to tend, to listen and to take part in the ongoing work of repair. At Sage Practices, we recognise in this the essence of flourishing as a shared art, sustained through the everyday gestures of care that bind communities together.

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