Monday, December 13, 2010
A Small Step with Skuma
Saturday, December 11, 2010
Why Children are Afraid to Ask
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.
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)
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
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
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?
Monday, October 4, 2010
HIV prevention in churches?!
Scheduling survey times |
Zilpa and Jessica scheduling |
Tuesday, September 28, 2010
Introducing Research Staff and Future Blog Contributors
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
Saturday, September 25, 2010
Learning something new - easier in your own accent
Wednesday, September 22, 2010
A New Survey Team...Practice Underway
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
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"
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
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
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?
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
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.