Monday, December 13, 2010

A Small Step with Skuma

Two girls in the READY program asked Vivan, a READY leader, to visit their “Step of Hope.” In Module 1, families, including youths, were given basic budgeting skills. Facilitators challenged families to find creative ways to invest small amounts of capital into income generating activities.

So yesterday, the two girls led Vivian and me us to a small plot of land near the lake, about a 20-minute walk from their homes. There, they pointed to a few rows of tiny sprouts – the beginnings of skuma wiki, a green leafy vegetable eaten daily in Muhuru households.

One of the girls, Dot (age 11, 4th grade), lives with her grandparents and asked her grandmother to give her a small piece of land. Because her grandparents are already busy in their own garden, she recruited her friend from church, Eva (age 12, 3rd grade), to help start a garden. Dot asked Eva because she said many of the other girls were skeptical about the success of the garden. Eva, though, was glad to help. As she lives with her cousin since her parents died, it worked out well for her to take a “Step of Hope” with a friend instead of her family. She said she is looking forward to making her own money.

Dot and Eva planted the skuma together and now tend the garden twice daily – once in the morning and once at night. They expect the first plants to be ready next week hope to sell them for a total of 50 Kenyan Shillings. They plan to give Dot’s grandmother the money for safekeeping until they need it. When they have enough, they plan to buy clothes and shoes for themselves. Dot acknowledges that some insects might cause some problems along the way, but assured us that they will take good care of the garden so that it can be even bigger in the future.

While READY provides only basic information about budgeting and investing in addition to activities focused on mental health and HIV prevention, other organizations, such as the Population Council
(http://www.popcouncil.org/topics/fl.asp) are increasing their focus on programs that build adolescents’ financial literacy, especially for girls.


*We obtained permission before posting this story and photo.

Saturday, December 11, 2010

Why Children are Afraid to Ask

The final module in READY is “Learning and Talking about HIV Together.” The goal is to gradually expose families to the experience of talking about sex and HIV so that parents can learn to support youths to make safer decisions. We hope to decrease the anxiety associated with these discussions by equipping families with communication and coping skills to make the conversations more pleasant and productive.

Last week, we asked youths to discuss their emotions related to discussing sex and HIV with their parents. We asked them to role play how they expect caregivers to react when they ask questions about these topics.

Here are 3 of the scenarios they wrote and acted out in their youth support groups (with youth acting out the parts of both the youths and caregivers).

#1 – “What is sex?”

Youth: What is sex?

Father: You cannot talk about that. I refuse to listen to this.

Child: I was playing at the lake and I heard people discussing this thing, and I didn’t understand.

Mother: You must be going with men. Maybe you are already even infected with a disease and that is why your hair is falling out.

#2 – “What is a condom?”

Girl: What is a condom?

Father [yelling]: Where did you hear that word?

Girl: From other kids at school

Mother: You are asking that because you are already knowing men. That is why you know words like that. You have already started sex – I can see it in your eyes.

#3 – “I shared a razor…”

Girl: I used a razor and then gave it to my boyfriend for him to use. If I have HIV, will he now get it also?

Mother: Where did you get money to buy a razor?!

Father: To get that razor, you must have gone out doing some bad things [transactional sex] to get money from some man.

Role Play in Girls' Support Group(Girl on Right is playing the father, girl in Middle is playing the mother, girl on Left is playing the child); Photo posted with permission from youths and their caregivers

Throughout the role-plays, the main theme was fear that parents will suspect them of having sex if they initiate discussions related to sex or HIV. This coming week, we will ask families to discuss the youths’ fears together, along with the fears and hesitations of the caregivers (e.g., feeling embarrassed or afraid when talking with youths about these things).

Tuesday, December 7, 2010

Reaching the “Head of the Household” (Posted by Eve with input from John)


“The man is the head of the household.” A readily accepted norm by both men and women in Muhuru. In focus groups, participants easily cited cultural and Biblical reasons that men – and their decisions – should be accepted, usually without question.

Given this, I have been concerned about many women who are often attending READY without their husbands, though they enrolled in the program as a couple. John provided some cultural reasons this might be happening:

1.     The culture in Muhuru does not promote sitting next to your wife for long because it is a sign of weakness on the side of the man. A man should be out with other men doing “mens’ jobs.” Even in the normal church service, there are fewer men.
2.     Men in Muhuru like doing things that produce immediate results –monetary results. They often do not participate in any non-paying activities.
3.     Men are supposed to provide for their families, so they are expected to spend most of their time looking for ways to make money while the women spend time tending to children and attending church.

It seems logical to hypothesize that the families who attend without the husband/father may not benefit from READY as much as those who attend with all members. However, it is possible that these families may still benefit, though perhaps in different ways.

One woman who often comes without her husband agreed to discuss this issue. Here is part of our conversation (responses translated by John; she gave consent to post this). My questions to her are in bold, her responses in italics.

Who usually comes to the READY sessions?
Myself and one child. My husband only came once.

So in READY, we ask you to have a “Budho Makende.” Can you explain what that is?
That is a time when we are to discuss things together as a family – like how can budget together and work together. (Budho Makende literally means “special talk time.”)

Yes. So in your home, who attends your Budho Makende?
Myself, my husband, and one of our children.

Oh, so your husband participates in the Budho Makende but does not come to the sessions…can you explain more about this?
My husband drinks a lot. Most of the time when we have these READY sessions, he is out drinking ­­– or he may be at home but too drunk to come.

I see. But it seems that his drinking could also prevent him from being available for Budho Makende. How is he is able to participate in those discussions with your family?
Yes, for our Budho Makende, I choose to time it when he’s sober. Even this morning, we talked after breakfast, and yesterday also. When he is too drunk, I avoid bringing up these discussions. The timing varies. Sometimes it is after supper or lunch - it depends on his condition. Then I bring out the notes I take during READY and explain the things to him.

How does he react when you do this?
He’s normally cooperative when I tell him about having our discussions. What he enjoys most is the teaching about respect within the family. He also likes when I suggest to him that when we get some money, we should budget to buy some things for our children and then other things we need for ourselves . He has been very cooperative and takes those suggestions - and then he does exactly what we have talked about.

How do you feel during these Budho Makende discussions?
I feel happy and good when we have these discussions because in the trainings, I learn very helpful things, and I like to extend these discussions to my home…The discussions are very different from the normal discussions we had before. The topics are new. Now we can talk about HIV in the open. We also talk about respecting each other. We never used to discuss these issues in the family.

Even though your husband has not been able to come here to the sessions, have you noticed any differences in your family?
Yes, there is a difference. When we are talking together, my husband says, “This is a new thing. You must be learning this in that program, but I like it. You should keep learning them. They are good.”

So do you think he is open to hearing these ideas from you?
Yes, yes. Depending on how we have been relating of late, when I give a suggestion, we usually discuss it and he usually accepts.

Perhaps the women in Muhuru take on more leadership in their families than the outward customs suggest. And perhaps the men accept the women’s leadership and suggestions, at least on certain topics and when suggestions are presented at certain times, in certain ways. If this is true, women may be finding ways to bring new knowledge, ideas, communication patterns, and parenting practices into their homes in ways lead to family-level benefits ­– even if their husbands do not have direct exposure to the intervention. This is one question we will ask the data.


A picture of one READY session...look closely and you will note that most in attendance are women and children

Wednesday, December 1, 2010

About Me…and Why I Thought READY Might Not Work (Blogger: John)

I (John Ombajo) was born of a family with a humble background in 1976 in Muhuru Bay where I’ve lived for the better part of my life. My mother’s first husband died, and she was then inherited by her deceased husband’s cousin (as the customs dictate). My mother had 12 children in total, 3 with her first husband and 9 of us with the new husband. This new husband did not take a single care for us, and we had to struggle with our mother to survive. We went to school in tattered clothes and sometimes without school materials. Nevertheless, my mother was - and is still - a hardworking woman. She brewed local liquor (but did not taste it) to buy cows that she sold to fund our education. Today I have a Bachelors degree in Math and a Post Graduate Diploma in Project Planning and Management from the University of Nairobi. I’m planning to start my Masters and PhD program next year.

I have been working with READY as a member of Community Advisory Committee since its inception and helped in the formulation of the intervention. Currently I’m a Research Assistant on the project, supervising our survey team, translating materials, entering data, and assisting the intervention team with ideas and feedback during their preparations.

At first I thought the people of Muhuru were not going to embrace the READY program. Why?


1. The people here like doing things individually, and READY asks people to work together with their families and communities. In Muhuru, the times you see an emphasis on the importance of family and community is when one member of the community is seen to be rich. Those are the only times you will see people coming together – usually with people coming to ask assistance from the person who has money. Even within families, they typically only come together when there is a very big problem to solve; however, during normal times, family members tend to ignore things and to keep issues and problems to themselves until they get out of hand.


2. Teaching families how to communicate and to talk about emotions in Muhuru is something new. It has never been tried here. Also, culture poses a challenge since a man is not supposed to “waste time” talking to his wife for long. This is viewed as a weakness on the side of the man and they expect to always have their way in all discussions. So I thought bringing them together to participate in a group and with their families was not going to be easy.


So, is it working?


We will need some more time to know. However, despite the challenges I expected, participants in the churches have shown some positive signs. First, they attend – many of them week after week. Second, they participate in discussions and debates. Third, when the families sit together, they share much more intimately than I expected. For example, we asked them to tell each other when they felt loved by one another. One woman said, “I felt loved when my husband appreciated my cooking.” And her husband said, “I felt loved when she [my wife] bought a shirt for me.” As they shared this with the larger group, they were both smiling and seemed genuinely happy to have heard this from one another.

I am still concerned that people have the tendency of going back to their original ways when not watched. Therefore, we will continue to watch what happens.

Wednesday, November 17, 2010

Talking about Economics

Across cultures, talk of money often creates unease and conflict. But how do you talk about money when there is little or no money to discuss? We just finished our Economic Empowerment module, where we encouraged our study participants to budget, prioritize, and if possible, save for the future. Consisting of three sessions, we started off our first session with an introduction to the program and an overview of ways to maximize local resources in order to become economically empowered. Our second session focused on prioritizing, spending money wisely, and taught basic skills of budgeting. The last session of the Economics module taught participants how to save and included a local loan representative to answer any questions from the audience as well as assist anyone who wished to open an account or apply for a loan.

And the overall reaction to our program has been a success! Despite the limited resources, individuals have been receptive to the skills we are teaching. The concepts of prioritizing and spending on needs versus wants are skills that incorporate all members, regardless of how limited their income might be. However, the idea of saving for the future creates more of a problem when asking those who are struggling to pay for basic of needs to cut back even more. Despite this, those with very limited income are still interested in learning about savings, applying for loans, or opening a bank account. I believe this interest is rooted in the hope that at some point in their lives, they will have the resources and then be able to use the skills they are learning.

While attendance during our second session was limited due to a village funeral and a “harambee” (local fundraiser), our attendance for the third session on economic empowerment was very promising. Several participants who missed the second session expressed regret and requested copies of our budgeting sheet handouts so they could practice budgeting at home on their own. This example of interest and initiative really give us hope for the upcoming two modules on Emotional Support and Learning about HIV/AIDS as a family.

We believe one of the most engaging and valuable aspects of each session are the family skits, which model negative and positive family interactions, as well as family communication activities. The skits give families the opportunity to see that while negative interactions may be taking place in their homes now, we are teaching skills that if practiced, could make their families happier. We are lucky that our logistics coordinators also happen to be very skilled actors! The family communication activities then give our participants to opportunity to practice using these kills to improve their household interactions. Education through modeling is an important teaching method throughout READY and we’ve had feedback from participants that they can’t believe how closely our skits reflect their family interactions. Most likely because they are developed and acted by community members themselves.

This is an English translation of one of the skits we use to begin a discussion on the ways in which gender roles and culture influence finances and family relationships.


These next two weeks will focus on giving and receiving emotional support -- how to share feelings and to be supportive within your family, and skills to cope with stress. We’re halfway there in climbing our ladder of family communication.

Jessica & John

Monday, October 18, 2010

The Ladder to Family Communication

If there's one thing that is straightforward in psychology, it's treatment for phobias. If a child (or adult) is scared of a dog, we help them create a hierarchy of anxiety-provoking stimuli related to dogs: 1) picture of a dog, 2) looking at a dog in a cage, 3) petting a dog....etc. They can then climb the "bravery ladder" to conquering their fear of dogs. This process of exposure usually works because the individual gradually habituates to the feared stimuli such that they no longer need to worry about or to avoid the feared experience (or animal).

It's the subtle frightening tasks in life that are a bit more difficult to conquer - a shy adolescent boy asking someone out on a date, a people pleaser saying no when she's feeling overwhelmed. It's often the difficult aspects of communication that are most frightening in our relationships.

Exposure is one central intervention strategy in READY. We are attempting to guide participants to climb a "bravery ladder" towards more open, effective family communication about topics that are often avoided - finances, emotions, and sexuality (including issues related to HIV/AIDS). We begin with very brief family communication exercises that emphasize expressing positive thoughts and feelings about family relationships. We then progress to more difficult conversations throughout the intervention.

Jessica Pian, our research coordinator, taught our intervention team about exposure therapy and its relationship to the READY intervention.

 This week we had our first READY session that emphasizes the importance of family communication and begins discussion of financial issues in families. Here are some families beginning to climb the ladder.











Saturday, October 9, 2010

Reflective Listening...Does it translate?

In my clinical psychology training, I spent hours learning how to listen and how to show others I am listening. My classmates and I role played, we were videotaped with clients, we received detailed feedback on tone of voice, posture, and word choice.

In our READY intervention, we teach listening and communication, largely through our facilitators modeling reflective listening when instructing families together and when facilitating the youth and caregiver support group components. So our first week of facilitator training looks a bit like my first year of graduate school – listening instruction, practice, feedback…repeat.

This is a video of two facilitators practicing restatement, reflection of feelings, and validation of feelings.




There’s only one catch. I train them in English – but the intervention occurs in Luo (the local language).  How easy is it to apply newly learned clinical skills in another language? Do direct translations work? What are the best Luo phrases for letting someone know you understand and empathize? What is it like to discuss sex and HIV risk in Luo? I typically ask the team to practice first in English and then in Luo. Afterwards, I asked them some of these questions. 

These are a few of their comments about aspects that are easier in their own language, but words related to sex and HIV that are sometimes a bit too strong in their native tongue. 




Monday, October 4, 2010

HIV prevention in churches?!

When I describe the READY program to colleagues, they are often surprised that we chose churches as our site for the intervention, especially when they learn that READY promotes condom use. "Will they let you talk about that?!" Yes.

We chose churches for several reasons: (1) Our formative surveys showed that most adolescents attend church regularly, (2) Churches are the most organized social structures we identified in Muhuru that include women and youth (e.g., community meetings held by Chiefs and other social gatherings are often attended by men only), and (3) Pastors and other church leaders are widely respected as role models and sources of social support in the community. 

When we piloted the program in February, churches showed willingness and openness to HIV prevention education in their churches. We allowed the church leaders to decide whether or not we could include information about condom use. To facilitate conversations about this and other issues where religious beliefs could conflict with the content of READY, READY includes church leader discussion groups each week before the session. These discussions relate to the topics planned for the week, and leaders are encouraged to debate and think through the issues and to decide what can be presented to their church. These discussion groups are led by a pastor from the community who is also a trained READY facilitator. 

Many leaders were reluctant to talk about condoms at first, but all came to the conclusion that they wanted to face the reality that many youths are not remaining abstinent - and that condoms were a good option in order to save their lives. After pastors decided to allow teaching about condoms, we also asked them to be the ones to introduce the topics to their churches. We are hopeful that church leaders will reach the same conclusions in the full intervention trial we are starting now. 

We completed recruitment in the 4 randomly selected churches this week. All of the churches welcomed us, and we spent a lot of time singing and dancing with them in addition to registering families into the program. Spending time with these congregations made me excited about starting the intervention in a couple weeks! Here are a few pictures from our visit to a church this weekend. 
Giving the Luo translation of what READY means
Scheduling survey times
Zilpa and Jessica scheduling
Beautiful view on our walk back to the car
Posted by Picasa

Tuesday, September 28, 2010

Introducing Research Staff and Future Blog Contributors

I would like to introduce two key members of the READY research team. First, Jessica Pian, is our Research Coordinator. Jessica is from Bethesda, Maryland and graduated in 2007 from the University of Maryland with a degree in Psychology. She then spent two years as a research assistant at Boston University. Now we are lucky to have Jessica at the Duke Global Health Institute working with the READY Project in Muhuru. Jessica plays a large role in project planning, staff training and supervision, data management, and just about anything else that comes up. Jessica will be sharing her perspectives on READY throughout the year as a contributor to this blog.



John Ombajo is our Research Assistant who is taking a leadership role with our local research team. John is currently completing a post-graduate diploma in Project Planning and Management from Nairobi University. He is from Muhuru Bay and therefore has an excellent command of the local language and culture. John is an invaluable member of our team, and I have asked him also to share his observations on this blog in the future.

Sunday, September 26, 2010

Introducing the READY Study to Churches

This weekend, we visited two of the four randomly selected churches for the intervention trial. We first reviewed the benefits we hope the program will provide for participants and then explained the purpose of the research study. In the video, you can see part of my explanation. I think the most illuminating part of the video is the number of people, mostly women, on the right side of the church who had never heard of "research" before. It is difficult to explain the ways that a research design effects participants in a way that qualifies as actual informed consent when some potential participants have never been exposed to the ideas of testing a hypothesis through research. For example, it is a bit complicated to understand the purpose of random selection - that randomly choosing participants increases the probability of a representative sample. While complicated, it was important for everyone in these churches s to understand the rationale since we were planning to draw names out of a bag to participate if more than 25 families, or 120 people, were interested. Otherwise the process could be confusing and may seem exclusive and unfair. I haven't devised the perfect explanation yet, but the strategy that seemed most effective was to allow my research assistant, John Ombajo, who is translating in the video, to explain the process in the local language as often as possible - instead of asking him to translate directly. He emphasized that the random selection process protects against unfairness and bias and that it makes sure we have a variety of types of families and individuals in the program. We also emphasized throughout the ways that participating in research can be beneficial to your own community, as well as other communities.

Saturday, September 25, 2010

Learning something new - easier in your own accent

The survey enumerators for our project are learning to enter survey data electronically on pda devices, thanks to programming help from Eric Green . One of the most difficult things in teaching such a detailed process is that our American accents seem to disguise some words, even with enumerators who speak excellent English. Jack, one team member, is always reminding us, "Shape your mouth more clearly so I can understand what you are saying." My research coordinator, Jessica Pian, discovered that asking one of our team members to explain some of the steps was a more efficient way of making sure everyone is on the same page - or screen. This is Hellen, one of our team members, who caught on quickly to the pda. She is explaining to the others how to input the correct identifying information of an interviewee.

Wednesday, September 22, 2010

A New Survey Team...Practice Underway

This is training week for the new survey enumerators for the READY project. We have a strong team of men and women from Muhuru, and they have been spending this week practicing interviews they will conduct with youth and their caregivers in the community. Their work will be a large part of how we evaluate the READY intervention.

Here is just a glimpse of our practice today. We have community volunteers here so that the interviews are a bit more realistic. (Both have agreed for this video to be put online, and the volunteer is playing a role - not answering questions about his own life).

Tuesday, September 14, 2010

Random Selection...from a trash can

We are beginning a randomized controlled pilot trial of the READY intervention - a family and church-based program to prevent HIV and improve mental health of youth in Muhuru. Only 4 out of the 57 churches in Muhuru will receive the intervention, so we needed to be careful how those were selected. So yesterday we invited the Chiefs from across Muhuru to participate in the random selection by drawing slips of paper with the church names. After my explanation, they understood and accepted the process - but they were not at all satisfied with our carefully prepared envelopes from which we asked them to draw. These envelopes, they explained, would not allow us to "mix them thoroughly." I had to agree. So the head chief looked around the room for an acceptable container and decided the trash can was perfect. He emptied it and it indeed allowed us to mix thoroughly, thereby making sure the process was fair.

Good thing we called the chiefs together, as random selection resulted in only two of the four geographic locations of Muhuru represented among the churches. I will definitely do it this way again in the future - I will just bring along a big enough hat to pull from.

Monday, August 30, 2010

"A Brand New Kenya"

“It is time for a new brand of a brand new Kenya,” said Caroline Nderitu
in her poem at the promulgation ceremony for the new Kenyan Constitution. Even I could feel the excitement as I watched through my apartment television a few miles from Uhuru Park. I was amazed by the enormous crowd as the camera showed sections of people breaking into excited dancing and others climbing trees to catch a glimpse of the excitement.

All weekend since the ceremony, I’ve been asking cab drivers and Kenyan co-workers how they feel about the new Constitution…

“We are so happy – you will now find us all smiling here in Kenya.”
“Now we are really happy – there are so many good changes. Now even a normal Kenyan can finally get something.”
“Now we can go and see our Ministers, tell them what we want.”

In each response – hope, optimism, empowerment.

I rarely see direct, concrete examples of how structural-level change at the policy level can truly affect individuals’ mental health and well-being. But I think that this Constitution has the potential to do that in a very tangible way. People are waiting and hoping for increased support from their leaders – and this hope is already translating into improved moods and renewed motivation to reach goals in individuals and families.

I am traveling to Muhuru Bay again this week and I will be excited to hear what they have to say.

Thursday, February 18, 2010

Observations from our Family-Based Approach

We have now delivered READY Sessions #2 (Emotional Support in the Family) and #3 (Learning and Talking about HIV as a Family). In both sessions, we used role play and discussions to open up a dialogue about some of the cultural factors that influence families' abilities to both provide emotional support to each other and to talk about sexuality and HIV with youth.

Overall, participants are responding positively to the family-based approach. These are a few observations my research team and I have made over the past two sessions:

(1) Male caregivers are very interested in communication skills...Since the first session in which male caregivers were reluctant to talk with their wives about money, they have become surprisingly receptive to the idea that family communication is one of the most important factors in helping their youth. In addition, without prompting by facilitators, they asked to learn about communication within their marriages because the noticed that tension between parents can be stressful for youth.

(2) Female caregivers have concerns about relationships with in-laws. In Muhuru, when women get married, they usually go to live with their husband's family. Therefore, when we go to churches, often the women are attending with their husband and members of the husband's families. Many of the mothers have said they cannot be open and comfortable to practice communication with their husbands and children because their mothers-in-law are also there, and they are typically the female authority in the family.

(3) In our sessions on economics and emotional support, caregivers participated freely and youth needed more encouragement. This completely switched during the third session that focused on HIV education. Activities asked families to play games answering questions about HIV facts and to discuss questions they have about HIV. The youth were the ones answering all the questions. We clearly saw that the youth are learning HIV facts in school, but lack of adult HIV knowledge is a big barrier to encouraging family communication and problem-solving about issues related to sex and HIV.

Saturday, January 30, 2010

1st READY Pilot Session

We piloted the first session of the READY program today at a Seventh Day Adventist Church in Muhuru. We focused on Family Communication in the context of Economic Empowerment. Our Community Advisory Committee felt strongly that economic issues should be discussed FIRST because poverty is a main source of family stress and also an underlying factor related to HIV risk.

Fifty people attended - half youth and half adults. Most came together as families, which was important for the emphasis on family communication. It was clear that asking families to talk with one another during a group program was a new approach, but families participated and reported they enjoyed it. Families talked together to plan "small steps of hope" related to making an economic plan for their family.

Men among the participants brought up an interesting issue several times during the discussion. They expressed reluctance to share the amount of their salaries with their wives, saying that their wives may "plan big budgets" if they are aware of the amount of money available. The facilitator for the male caregivers said that there was some disagreement on this point, however, which opened the door to discuss the possible benefits of having open communication about money within a marriage.

Saturday, January 23, 2010

READY Workshops to Develop Intervention


This week, the READY advisory committee and other community members – men, women, and youth - have been meeting in evening workshops to develop the first sessions of the READY program. We have 3 intervention development groups: (1) Building Strength in Sexuality and Relationships, (2) Building Economic Strength, (3) Building Emotional and Family Strength.

One advantage of a participatory approach to program development is that examples and activities are more likely to be relevant. Another is that people from the community know the appropriate limits in discussing sensitive issues - they know how and when to push new ideas.

Three ideas from the workshops:

#1 Challenge to use Local Resources

The economic empowerment group asked participants to list local resources and posed the question, “Are we REALLY poor?” They asked families to choose a local, free resource and to generate ideas for taking small steps to make money with that resource.

#2 Role of Fathers in Supporting Healthy Sexuality

One group presented a skit in which two young girls try to share with their fathers a song about private body parts they learned in school. One father rejected and dismissed the child, while the other took the opportunity to teach the child that sexuality can be positive within the context of a loving relationship – and after finishing school.

#3 Fish Net Illustration for Family Communication

Muhuru is a fishing community. One group worked on the session, “Building Encouraging Families.” They drew posters of two scenes in which groups of people were trying to pull in the two sides of a very large fishing net. In the first, trees were blocking the fishermen from communicating as they pulled in the net – therefore, the net was uneven and the fish escaped. In the second, the men were able to communicate easily and they caught many fish. The lesson: Families who communicate to solve problems together can reach their goals.

Sunday, January 17, 2010

Families and Churches...Are they READY?

Our Community Advisory Committee (CAC) has met twice since I've been back in Kenya, and we have developed a plan to pilot a church-based intervention for families with three main goals: (1) Prevent HIV risk behavior among youth, (2) Improve mental health and coping among youth, and (3) Provide caregivers with skills to provide positive support for youth.

We are now forming intervention development teams to contribute to specific intervention content. Teams include our CAC members paired with caregivers and youth from the community. I'll share more on our teams' progress this week.

Our name for the program:

READY
- Resilience Education And skill Development for Youth and Families.


The READY Community Advisory Committee working on intervention strategy ideas.

Monday, January 11, 2010

The Pilot Metaphor

On Saturday, I met with Madame Beatrice, the Chairlady of the Community Advisory Committee that has been working on our HIV prevention research while I was in the U.S. We planned to discuss the logistics of the group, but instead talked for four hours about her ideas for supporting youth in the community to protect them from HIV.

Psychologists and public health professionals often talk about ecological systems theory (developed by Urie Bronfenbrenner) that emphasizes the ways that a child's development is influenced by both proximal and distal factors in his or her environment -- from the immediate family to the economic climate of the environment.

Madame Beatrice is not a psychologist and has no public health training, but she shared with me a metaphor she developed that's surprisingly like Bronfenbrenner's theory.

She said, "We must tell youth they are the pilot of their own life." (Sidenote: tons of kids here want to be pilots when they grow up) Then she went on to describe others' roles:

Caregivers = the geographer sitting beside the pilot to show them the map

Teachers = the fuel that provide the energy and resources for the pilot to fly

Community Members = the parts of the plane that work together to fly with the pilot

Community Leaders and Pastors = the weather that can provide either a good or bad environment for the pilot to fly (i.e., the cultural and religious climate of the community)

I think she’s developed one of the first parts of the introduction to our intervention.

Saturday, January 9, 2010

WISER School Opened


On Friday, WISER – the host NGO for my research in HIV prevention – officially opened a secondary school for girls in Muhuru Bay. In Muhuru, girls’ education has not been prioritized. Most girls drop out of primary school to get married or finish primary school with grades that are much too low to qualify for a good secondary school education. WISER worked with the students to increase their test performance and then accepted girls with passing marks.

The opening ceremony was inspiring. As the girls’ names were called, they each ran forward, literally surrounded by their parents, teachers, and village chiefs – all jumping, hugging, and screaming. It was clear they all shared in their girl’s joy and recognized their role in supporting her to earn this opportunity.