The Covid-19 pandemic has been characterized by anguish and a sense of loss and precariousness, but a year and a half after it began, it has also clearly shown a remarkable structuring power: this is evident both in its socio-emotional implications as a traumatic wound for the community and in the fragmentation and vacuums that it has revealed in terms of health services and health promotion. Local communities, for their part, have shown the potential of their resilience: there is a widespread desire to look to the future with optimism and hope, and to contribute to the reconstitution of the social fabric – made of individual bonds and networks of relations – that was put under severe stress by the pandemic, and which emerged as a protective factor by distinctive aspects like mutual trust, sense of belonging, relational exchange, and solidarity – from which to start anew after the emergency. And Integrated Community Care provides a useful and meaningful framework for this new start.

Wounded communities

Etymologically speaking, trauma is a wound, a lesion produced in the organism following a sudden violent event that brings with it modifications that are sometimes irreversible. In this case, a lesion of the social organism has touched and troubled individuals and entire communities. Therefore, trauma marks discontinuity: a fracture not only in time, between a “before” and an “after”, but also in terms of disconnection and isolation, separation, and physical distancing.

This awareness is a good starting point to address as a priority the role of local communities in health promotion and care, which needs rethinking, placing special emphasis on the specificities of local territories, their needs, and resources. These wounded, broken communities are yearning to mend ties and restore the protective role of the community itself. For practitioners, social and care workers, and policymakers, it may therefore be useful to reflect on the perception that local communities have had concerning the availability of services, institutions, opportunities, and also concerning the community itself as a network providing support and inclusion. In this sense, asking people about their perception of which resources they felt have been available could represent a crucial step towards a “community diagnosis” and an authentic process of co-creation of interventions and paths.

Resilient communities

Against this backdrop, it is essential to address a community that is both traumatized and potentially resilient by promoting forms of collective processing and moving towards new possibilities of collective empowerment: for example, structuring ritual opportunities to process what happened and providing spaces for creativity and dialogue where it is possible to plan the future together.

What seems to emerge from this scenario is a strong need for a future: the need to look ahead at what is to come with optimism, transforming the crisis into a turning point. A survey by the Luigi Bobbio Center of the University of Turin on the social representations of development in a large sample of Italian citizens, which was repeated after two years in June 2021, indicates that the future imagined by Italians for the next decade is more positive today than it was before the pandemic (Ramella, Sciarrone, 2021)[1].

Inhabiting complexity

The community, therefore, appears to be also a protective factor and a boosting factor in the face of an emergency: it is a context of belonging, of identity constructions, a social fabric made of exchanges and relationships, a space of inclusion/exclusion and a place of risk and opportunity. In addition to being the beneficiary of policies and interventions and the bearer of needs, the community can thus be viewed as an active, resilient subject with transformative potential, as a social system that citizens, groups, associations, and organizations experience and “inhabit”, weaving a complex fabric whose relational dynamics can make the difference also when facing an emergency.

The starting hypothesis is that the ability to live with and “inhabit complexity” (Ceruti and Bellusci, 2020) helps us feel better, both at an individual and a collective level. For Edgar Morin (1990), complexity is a tension and a commitment to counter reductionist logic that tends to seek simplifying solutions, to weave connections into a systemic vision, accepting the uncertainty of paradox and dealing with contradiction without dissolving it. The pandemic is an emergency that has confronted us with this challenge, all the more so in light of the strong temptation to reduce complexity to more reassuring solutions: “We hope we can all simplify, plan, anticipate with calculations…” (Ceruti, Bellusci, 2020, p 13).

With the pandemic, we have frequently witnessed a tightening of protocols and greater fragmentation of interventions, services, spaces, and pathways of care/health promotion: some parts of the system suddenly closed off, limiting and compartmentalizing interventions, exacerbating discontinuity. Now, a growing need to recompose this fragmentation is emerging on several fronts, embracing a comprehensive and complex perspective, careful not to become trapped in dichotomies (e.g.: person-centered vs. community-centered interventions; focus on safety needs vs. relationship needs).

Providing care of the relations between the “nodes” of the network that are part of the community system could be an instrument to live with and dialogue with complexity: community action should work with and on these nodes (whether they are individual or collective actors), giving them space and attention, recognizing them as dynamically complementary in a dialogical relation, as parts of the same context that they contribute to creating at the same time. A con-text is always com-plex: an interweaving of parts that belong to a whole and at the same time participate in its construction. Therefore, taking care of contexts means taking care of this interweaving and the possible relations between the parts.

In this sense, the co-creation of dialogical spaces between public institutions, health, and social workers and citizens, emerges as a generative opportunity to engage in relations with a curious and open mind, to promote processes of effective empowerment and involvement of the community, which is not only a target of interventions imposed from above and bearer of needs but also a carrier of resources and solutions.

The sudden appearance of the pandemic on the scene has further highlighted the need to renew the forms of community and place-based care, underscoring the relevance of issues like public health, inequality, and social cohesion (Ripamonti, Boniforti, 2020). Therefore, today more than ever, we need an effective public sector, an efficient private sector, an energetic civil society, and active and informed citizenship, interconnected through shared governance (ibid).

Seizing the challenge of complexity allows us to look at the interconnections, enhancing the protective and empowering role of the community as a system of actors, organizations, and specific contexts, engaging in a non-simplifying dialogue that is capable of taking care of relations and promoting change.

[1]  More than two-thirds of respondents see the current moment as one of great transformation that can create many opportunities, in terms of confidence in technological change and advances in public health, education and environmental sustainability.

References

Ceruti M., Bellusci F. (2020), Abitare la complessità, Mimesis, Milan.

Morin E. (2005), Introduction à la pensée complexe, Edition du Seuil (first edition 1990).

Morin E. (2017), La sfida della complessità, Le Lettere, Florence (first edition 2011).

Ramella F., Sciarrone R. (2021), “Il futuro è tornato”, Rivista il Mulino, 5 July 2021: La rivista il Mulino: Il futuro è tornato

Ripamonti E., Boniforti D. (2020), “Metodi collaborativi – Strumenti per il lavoro sociale e di comunità”, in Animazione Sociale, supplemento al n. 337/2020.