Peer educators, behavior change and my first chance to facilitate a training.

I finally got a chance to lead part of a training while with Ben and Douglas at a multinational automotive company Tuesday and Wednesday. We spent both days training a group of 25-27 employees coming from various departments from the plant where we were training and another one about 40 kilometers away. We were supposed to have around 50 people to train as peer educators but for a variety of reasons ended up with a smaller group which is unfortunate as it means that less people will feel the impact of the training we were doing and will continue next week. Normally the peer educator training is done over a six day period with a seventh day for written exams, presentations and other activities to test the knowledge, confidence and ability of the peer educators so that they can receive certification before beginning their work as peer educators in their places of employment, communities, families and more. Our training will be done over four days with the fifth day being our exam and presentation day.

Peer educators are not just trained in HIV/AIDS (which is more properly referred to as HIV and AIDS so as not to further confuse and conflate the two as being one in the same) like we are doing at ETC but also trained to provide other information to their peers. The definition for peer educator that we use is “someone who is trained to inform his/her peers about a particular subject so that they can make informed decisions about the subject”. We focus mainly on HIV and AIDS, related diseases, the varied socio-economic conditions that people living with HIV/AIDS (PLWHA) find themselves in, how HIV and AIDS plays a role in the lives of those who are infected as well as affected by it and many more important topics related to HIV and AIDS.

The idea is for those that go through the peer educator training with us to share the information they have learned with their coworkers, families, churches, etc. and to be a positive influence for change in the lives of others. We don’t want them to keep this information to themselves or just better those in their close circle of friends and family but to be open and willing to share with anyone at anytime. A key distinction to make is that during this particular training we are not training peer counselors. We do offer a 10-15 day course for those who want to be trained as peer counselors but do not cover all the necessary skills for this in our peer educator course.

One of the biggest components of the training that we do and the work that these peer educators will be doing after being trained is behavior change. They first must go through a change in behavior (if they are still practicing unsafe sex, living a risky life, etc.) and then encourage the same in others. We are not out to change cultural or traditional practices (unless these create unsafe situations) but rather to get people to better realize the impact of the various decisions they make and be more responsible with their lives and the lives of others. It is important for each individual to take responsibility for their own actions and to see how what they do can and affect others. In a future blog I will discuss behavior change in more depth and detail as it is one of the components of the work that we do that I find the most interesting and crucial.

There are 12 modules plus the assessment (exams, presentation, etc.) that make up our peer educator training. I spent most of the time with Doug’s training group and near the end of the first day I began facilitating Module 3. This module includes defining health and disease, discussing the four components (bio, psycho, socio/spiritual) that make up the whole human being, discussing the nine foundations of health and talking about germs and how they get into the body. Due to limited time I wasn’t able to cover all of this at the end of the first day and thus concluded on Wednesday. The module took about 105 minutes from start to finish and went well considering that this was my first time training for ETC. I enjoyed participating in the training with the rest of those who were going through it but it was nice to finally be up in front leading discussions, sharing information and facilitating learning. I am looking forward to facilitating two or three other modules next week when we return for further training. I will definitely have more to share on this specific experience after next week.

A final thought is that it was good to have Doug there to lend support as my medical knowledge and history is very limited and thus certain questions were beyond my realm of experience and Doug was able to help. It is challenging and interesting to be involved in this work as a Christian Scientist but I think it can be rewarding as well. I will also return to this topic in future blog entries. Have a great weekend.

Myths, beliefs and stigma.

This is in follow up to my last posting where I started to tell about HIV Committee Development Programme training that Linzi led last week and I participated in and as well as giving feedback and ideas to Linzi. I mentioned attitudes, perceptions, questions and ideas from the group of 11 participants and I want to share some of these with you. Before reading further you should know that some of these descriptions are quite graphic and unpleasant, but also necessary and education, so read at your own risk.

Many of the ideas that came up were similar to ones I had heard in Mozambique while I lived there from friends, colleagues and my students. Ideas such as when you use a condom you get HIV because it is being put in condoms to infect Africans, HIV is a punishment from God to sinners (yes, to these people, this does include babies, people who receive blood transfusions, as they are getting it because of “sins of the father” or something like that) and you can cure yourself of HIV if you sleep with a virgin or young child/infant. Yes, these are ideas that some (not all) of the participants either believed in or had heard, these “old wives tales” and many more where shared during the two-day training These are the backwards, contradictory and controversial beliefs that we are facing in this work and part of the reason that HIV is spreading so quickly and easily throughout much of Africa and the rest of the world.

It was clear from early in the training that the participants all had awareness of HIV/AIDS. Awareness in this instance purely meaning that they knew that it existed, created health problems and eventual death for many people and can be spread through sexual activities, blood transfusions, intravenous drug use, breast feeding, etc. Not all of the awareness that they had was correct or up to date but at the very least they had awareness. This means that the newspapers, radio programs, TV, schools, etc. had done their job of bringing awareness of the problem but awareness by itself doesn’t change behavior and lead to the necessary results to move forward and fight this terrible pandemic. Our real challenge as HIV/AIDS Consultants is to increase the knowledge of the participants, help them gain the skills and knowledge to make an informed decision about changing their behavior (and hopefully influence their family, friends, etc. to likewise change their behavior) and give them the incentive to do so. I will return to behavior change in a later email and explain more about how it is absolutely critical that this happens for the battle against HIV to be won.

One final thought to leave you with is about smokers, their reasons for smoking and reasons to not stop. I know many intelligent, well educated and informed people who smoke. These people have most likely read the packaging on cigarettes that says smoking is bad for their health, seen ads on TV and in magazines to quit smoking and lead a healthier life and maybe even known someone that has died of cancer or other smoking related illnesses yet these people continue, why? They are aware and informed but this on its own isn’t always enough to change their behavior and thus later we will return to the topic of behavior change.