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Brooke Collison
Oct 31, 2012

A Counselor Educator in Kenya: Blog #14—HIV/AIDS and More

I received a student assignment today which blew me away. It came by email from a distance learning student—one of those who meet one day on campus, do the rest of the work on their own guided by a printed set of resource materials, then returns to campus in December to take a final exam. I’m not thrilled about the format, but I try to provide some personal contact via email exchanges.

The assignment was pretty standard: “Describe a learning theory you have studied and explain how it fits you. Indicate how segments of the theory apply to the persons you work with.” I inherited the course material from previous instructors. I had modified the assignment to try and work in some personal application rather than a “compare-and-contrast” assignment.

The paper began in a pretty standard manner. The writer liked Erickson and wrote about psychosocial theory. Then the application section began with statements like, “The people I observe are children HIV positive. Erickson has only dealt with the well child living [sic] behind the unwell child.” The writer explained that children with chronic illness don’t develop on the same schedule as the well child. What they develop is malnutrition which “interferes with growth and development.”

The writer described Erickson’s “identity vs. role confusion” stage in adolescence, then explained that children at this age who are dealing with AIDS “are despairing at this stage and age. As they think about their identity they also reflect on their health.” The writer further explained that adolescents in chronic illness stages often decide to not take treatment for chronic diseases [and they decide to not take] preventive measures for other sexually transmitted infections and HIV re-infections.”

At this point in the paper, the writer identified a personal problem with spelling which is traced back to a teacher in primary school who bullied her about spelling a word wrong and continued the shaming and bullying for much of the school year. In her words: “This changed my attitude completely towards those who wrong me or makes a mistake. I always belief in being empathetic and supportive.” [In my email response, I said that I hoped that person was no longer teaching.]

Coming from a strict home, the writer explained that if given an assignment, there is no excuse for not doing it and she had developed the attitude that “everything is possible once you are positive about it. I do initiate and implement anything I feel will be of help to the community I serve despite others being skeptical. I feel I don’t need their approval to serve. I usually have confidence that it will be successful.”

The writer returned to Erickson and talked about the orphans she works with. “They seem to have low self esteem.” She explained why some don’t interact and isolate themselves because they don’t want to do anything bad or to hurt someone. One child believes that whenever she is around, something bad happens [with the belief starting from the statements of a relative]. I could envision the writer’s interactions—being a person who believes everything is possible working with children who believe that anything they do will be negative. What a challenge!

There is a strong degree of fatalism among the orphans with AIDS that the writer works with, relating how it is not uncommon to hear someone say, “Why should I take the medication, I’m going to die anyway.” She points out that it was very difficult to instill hope in this person. Others don’t trust the drugs and become hopeless about their own lives.

The children come from worlds quite different than most of us. There tends to be a fair amount of police corruption in Kenya, and one boy said he wanted to get well so he could be a police traffic officer who could stand in the road and get 50 shillings from each car that goes by [this is a practice that I have observed when I’ve ridden in a taxi or a matatu—a 14-passenger van that will carry as many as 26 people in it, just like the one my wife and I rode in on Saturday]. The young man hopes to earn enough that he can buy a car for his mother.

The writer is troubled by other things she sees. She writes about adolescents assessing information about sexually-transmitted infections, HIV, drug use, and pregnancies and continue to engage in risky behaviors. “They ignore the risk reduction strategies. Others are able to determine their own sense of life despite peer pressure they pass this crisis comfortably without risk exposures.”

She writes about a young child, one of several from a single parent who tried to find a husband to love her. The child has AIDS, making the mother less likely to find a spouse. As a result, the child is mistreated, even denied drugs and food. The mother rejects efforts by peer educators. What to do?

The writer concludes her paper with a bit of a theological dilemma—how does she work with non-believers who are near death when she has a strong belief about religion and life after death?

I wrote to tell her that I ignored the problems with spelling and gave her a strong grade on the power of the images she presented and the effectiveness of how she had explained a theory and then pointed out how it didn’t fit the group with whom she works. Each time I read a paper from one of the Kenyan workers who are on the front line of human development, counseling, medicine, education, or social services, I am amazed and overwhelmed. People are in dire straits; and, helpers are working in dire circumstances and doing a fine job.

I do get a little cynical at times—thinking about how we used to pride ourselves about the substantive discussions we would have in a counseling class about response to client conditions, about social justice issues, about programmatic needs and developing a response. Then I think about the paper I read today and realize that the gap between some of our academic discussions and the nitty gritty real world is much wider than a 36-hour airplane flight to get here. This is where “it is happening.” [Check Blog # 11 for another example.]

I wonder what a practicum or internship would be like in one of the settings I find my students in at the moment? Anyone want to give it a try?

P.S. I corrected the spelling on a couple of words in the quoted sections above, but left those which I know you can interpret. I left sentence structure alone in the quoted sections.

Brooke Collison is professor emeritus of counselor education and a former president of the American Counseling Association. He will be a visiting professor at Kenya Methodist University in Meru, Kenya during the September trimester. Joan Collison will be a volunteer with children in a social service agency during their four-month stay in Kenya.

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