Health initiatives involving local people are helping to improve the quality of lives even where there is disadvantage and poverty. Pádraig O'Morain reports
'We will develop a programme that will suit you," says Mr Tony Fitzgerald. "If this is what you feel you can achieve, then this is what we will do."
From this, it would be easy to get the impression that Mr Fitzgerald is the manager of an extremely up-market fitness centre.
In fact, he is chairman of a community health project, which is making a difference to the lives of many people in the Knocknaheeny/Hollyhill area of Cork city.
That project is one of 13 that are part of the Combat Poverty Agency's "Building Healthy Communities" programme. Other projects include the Women's Health Forum in Clondalkin, Dublin, and the Lifford/Castlefin Primary Care Initiative. The latter project aims to enable these Co Donegal communities to have a say in how GP, nursing, physiotherapy and other health services will be provided locally.
"We would argue that people have a right to have a say in the policies that affect their lives," says Ms Liz Sullivan, who manages the Combat Poverty programme. "Services are better and provision is better where people have a direct say."
Today, representatives of the 13 projects meet in Portlaoise to exchange information on the work they do across the country.
In Cork, the Northside Community Health Initiative (NICHE) began in 1998. Its five community health workers organise an impressive range of activities, which local people take to with enthusiasm.
While women are generally good at supporting health initiatives, NICHE has managed to persuade the men to come in as well for aromatherapy, Tai Chi, massage and other health activities.
"The key is that it's provided by local people," according to Mr Fitzgerald. "Most of the community health workers are local.
"The people who do the massage are trained by the project. Some of the masseurs are people who used to be recipients of the service. They are now professional masseurs themselves. They do it within the project and privately if they want to."
Last week, 30 women signed-up for the Lifestyle Challenge programme run in conjunction with the Irish Heart Foundation.
"It's a 12-week programme and they will take part in regular exercises at levels that suit them," says Mr Fitzgerald.
It will include walking, cycling, swimming, jogging and aerobics. People will go through the programme at different activity levels, depending on their ability.
"The key is to be in tune with the needs of the participants," he says.
NICHE also runs a summer programme for children and teenagers and gets local kids involved in camogie and hill climbing. It also provides support to a community café where young people can get healthy food.
"The Southern Health Board is the main source of funding," Mr Fitzgerald says. "Chief executive Seán Hurley has taken a personal interest in it."
So has Minister for Health and Children, Mr Martin. "He has visited the centre numerous times."
NICHE is based on the concept of Healthy Living Centres in the UK. It has a voluntary board of management made up of people from the community and of invited representatives of the Southern Health Board and University College Cork.
Ms Sullivan would like to see a greater use of community workers by the country's 10 health boards in promoting health.
"Health boards themselves haven't used them [community workers\] very well when it comes to consultation with the community."
There are striking differences between the health of people on the highest and lowest income levels. A 2001 study for the Institute of Public Health in Ireland found, for instance, that people on the lowest income levels were over three times more likely to die from diseases of the circulatory system than those on the highest incomes.
Ms Sullivan's message is that, while people have to take responsibility for their own health, it is not the whole story. Social and economic factors also contribute. Poverty, shortage of GP services and bad living conditions all increase ill-health and shorten life spans.
The aim of the groups meeting at today's conference is to do what they can to promote healthy communities within the wider conditions that influence those communities, while seeking to influence the policymakers who can change those conditions.