Behind the Pandemic in Aboriginal Communities - Interagency ...

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Facilitator’s Note:It is possible thatone or more participantswill experiencestrong emotions whileengaged in the activity.This may include beingoverwhelmed by orangry about the numberand complexity of theissues. It is importantto have a strategy forsupport individuals andgroups to deal withthese emotions.Facilitator’s Note:It is important tocreate an opportunityfor participantsto process and makemeaning of their experienceduring the game.Once these immediateemotions, reactions,and thoughts have beendiscussed, you will likelyfind that participantsare better prepared toengage in more abstractor intellectualized discussions.Facilitator’s Note:Vulnerability refersto factors thatreduce a person’s abilityto control their exposureto risk. This includes bothstructural and systemicfactors that affect populationssuch as colonialism,racism, poverty, accessto housing, employment,and food. They alsoinclude life experiences- such as child abuse,addictions, and familyviolence.Play theActivity30 MinutesStage 4 - DebriefHot Debrief15 minutesSmall GroupWork onVulnerability10 MinutesHave players roll the dice. Whoever gets the highest number starts.Continue playing until a) someone reaches the 100 th square or b) yousense the activity has become repetitive.When players land on a rapid, give them a Vulnerability Card anduse the questions on the Facilitator’s Notes on Vulnerability Cards tofacilitate a group discussion.When players land on a canoe, give them a Resiliency Card and usethe questions on the Facilitator’s Notes on Resiliency Cards to facilitatea group discussion.Explain:60 Minutes• We are going to take some time to talk about what happened inthe game.Ask:• What were some of your feelings, thoughts, and reactions as youmoved across the board?• What happened that was most significant for you?• How do the issues raised during the game relate to your experiencesin the real world? What is similar? What is different?Give each group at least 2 pieces of flipchart paper and markers.Before splitting into small groups, explain:• You will create an Issue Exploration Tree on your flipchart paperbased on information in the stories you collected during the game,as well as your existing knowledge and experiences.• The roots of the tree represent the factors that contribute tovulnerability. Try to determine the root causes for each of theidentified factors by asking ‘but why?’ to understand what isbehind factor.• The leaves represent the impacts – or the consequences – ofHIV on individuals, families and communities.• The space around the tree represents the protective factorsthat enhance the resilience of the tree.An example of an Exploration Tree can be found on the next page.22
Box 2: Issue Exploration Tree - Analysis of a Vulnerability CardThe Issue Exploration Tree provides a visual tool to explore the layers of vulnerabilityand impacts of HIV in Aboriginal communities, and to begin to identify ways of creatingchange. In many HIV epidemics, a negative spiral is created with the impacts orconsequences of HIV creating greater vulnerability.ResultsR o o t C a u s e sP o v e r t yU n d e r h o u s e dC a n ’ t g e t a w e l l - p a i d j o bL o w e d u c a t i o n l e v e lS o c i a l a s s i s t a n c e a l l o w a n c e s a r el o w e r t h a n t h e c o s t o f l i v i n gL ack of social suppor tSocial isolationAvoids asking for helpFear of HIV stigmaH a s n o f r i d g e t o s t o r e m e d i c a t i o nD o e s n ’ t u n d e r s t a n d h o w t o t a k e m e d i c a t i o n sC a n ’ t r e a d i n s t r u c t i o n sS c a r e d t o a s kf o r h e l p w i t h r e a d i n gE m b a r r a s s e da b o u t n o t b e i n ga b l e t o r e a dDies earlyG ets oppor tunistic infectionsImmune system weakensMedications taken improperly or not at allH a s l i m i t e d r e a d i n g s k i l l sS e e s s c h o o l a si r r e l e v a n t &f e e l s l i k e h ed o e s n ' t b e l o n gS c h o o l s o v e r l o o k A b o r i g i n a lc u l t u r e & e x p e r i e n c eD o c t o r m i d u n d e r s t a n d sr e a l i t y o f p a t i e n t ’s l i f eM e d i c a l s c h o o l d o e s n ’ t f o c u s o n t h eD e t e r m i n a n t s o f H e a l t h a n dB r o a d e r D e t e r m i n a n t s o f A b o r i g i n a l H e a l t hL e f t s c h o o l e a r l yH a r d t o s t u d y w i t hc h a o t i c h o m e l i f eF a m i l y & c o m m u n i t y f e e ln e g a t i v e l y a b o u t s c h o o lP a r e n t s a d d i c t e d t o a l c o h o lP a r e n t s f o r c e d t o a t t e n d r e s i d e n t i a l s c h o o lExample: Fred’s StoryFred lives in a roominghouse in a small city.His doctor put him onanti-retroviral therapya few months ago. Fredis too scared to askthe doctor to repeatthe instructions aboutwhen and how often heis supposed to take hismedication, so he relieson what he remembersfrom that day. Hedoesn’t want to ask anyof the other roomersfor help because thenthey will know he can’tread and that he is HIVpositive. On top of this,he needs to figure outhow to keep his medicationcool now that theweather is warmingup. The room he rentsdoesn’t have a fridge sohe’s kept his medicationsjust outside his window.U n d e r l y i n g I s s u e sS y s t e m i c r a c i s m U n r e s o l v e d i n t e r g e n e r a t i o n a l t r a u m a C o l o n i z a t i o n23
Page 6 and 7: Facilitator’s Materials..........
Page 8 and 9: What is this Educational Resource f
Page 10 and 11: experienced traumatic life events s
Page 12 and 13: Getting Ready to Facilitate this Ed
Page 14 and 15: Table 1: Potential Audiences and Ad
Page 16 and 17: Overview of Workshop AgendaOutlined
Page 18 and 19: WorkshopEtiquette(Social Norms)5 Mi
Page 20 and 21: Fred’s Story:LandscapeThinking(co
Page 24 and 25: Facilitator’s Note:Resiliency mea
Page 27 and 28: Participant MaterialsActivity Mater
Page 29 and 30: Individual LevelIndividual LevelInd
Page 31 and 32: Family LevelIndividual LevelFamily
Page 33 and 34: Family LevelFamily LevelFamily Leve
Page 35 and 36: Community LevelCommunity LevelCommu
Page 37 and 38: Community LevelCommunity LevelCommu
Page 39 and 40: Systemic LevelSystemic LevelSystemi
Page 45 and 46: Systemic LevelArmand’s StoryArman
Page 47 and 48: Activity Materials: Resiliency Card
Page 49 and 50: Community Healing and Self-Determin
Page 51 and 52: Cultural ContinuityYou live in a co
Page 53 and 54: Building Community CapacityEveryone
Page 55 and 56: GIPA and ResearchA few years ago, t
Page 57: Handout #1: HIV Basics 11CATIE. 201
Page 62 and 63: 10/21/2010Activity Purpose• Incre
Page 65 and 66: 9/27/2010Activity InstructionsActiv
Page 67 and 68: 9/27/2010Questions for Vulnerabilit
Page 69 and 70: 9/27/2010Fred’s StoryHas no fridg
Page 71 and 72: 9/27/2010Understanding Health Inequ
Page 74 and 75:
9/27/2010Root Causes: BroaderDeterm
Page 76 and 77:
9/27/2010Broader Determinants ofAbo
Page 80 and 81:
Facilitator’s Note:These backgrou
Page 82 and 83:
Gender and Gender Inequalities• G
Page 84 and 85:
approach must be undertaken with in
Page 86 and 87:
through collaboration and shared re
Page 88 and 89:
Diagram 1: Factors that affect HIVv
Page 90 and 91:
Card Key Issues Affecting Vulnerabi
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Individual LevelIssue Exploration T
Page 99 and 100:
Card Key Protective Factors Suggest
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Card Key Protective Factors Suggest
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Glossary
Page 105 and 106:
Gender norms refer to the expectati
Page 107 and 108:
About the AuthorsLia De Pauw, MHSc,
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Bouey, Paul D., and Betty E. S. Dur
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Public Health Agency Health of Cana
Page 113 and 114:
Mill, Judy E., Randy C. Jackson, Ca
Page 115 and 116:
Scanlon, K., Travers, R., Humberto,
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