ABSTRACT Community health workers (CHWs) are neither a profession nor a volunteer group, but a hybrid professional group, receiving modest allowances that vary according to the reference authority (states or non-governmental organisations). Their identities are manifold, depending on whether their work brings them closer to the hospital, the population, or the municipality. Sometimes loyalist, sometimes rebel, CHWs oscillate between municipal clientelism (to gain access to employment) and illegal practices (surreptitiously selling medicines or even conducting clandestine abortions). It is such empowerment and professional frustration that justifies their organisation to preserve their activity. It goes from the creation of associations to negotiate with public authorities, via more radical mobilisations in parallel, up to protest, boycotts of health campaigns, or sit-ins for improved status.