Can a facilitator give information on HIV?

[Laurence Gilliot]

Dear friends,

Can a facilitator of Community Life Competence Process give information about HIV during the process on demand of the community if linking is not working out? Will it jeopardize its role?

 

This is a question we ask ourselves here in DR-Congo. RDCCompetence worked on a partnership with UNOPS in the East of Congo. The Terms of Reference demanded sensitization amongst road communities along a newly constructed highway. RDCCompetence responded, but demanded they would do it ‘their way’. They won the selection process.

 

So they selected facilitators, transferred the approach, practiced in communities together, established 2 good SALT teams. After facilitating self-assessment in a number of communities, they also conducted sensitization sessions with the wider group of communities that demanded more knowledge. Most of the facilitators of RDCC are trained peer educators as well. Actually, that’s how they got to know each other.

Can a facilitator wear two hats? Is it desirable or not? 

Our experience in Papua New Guinea showed that communities demanded sensitization sessions, but the Linking with NGOs didn’t work. All the NGOs said: “we don’t work in that area” or other reasons. So Goroka still didn’t get an awareness session….Should our local team of facilitators have done it if they had the capacity to do it?  

 

What do you think? 

Laurence and Gaston

[Laurence Gilliot]

That is exactly the 'L' of Linking in SALT. We link the community to a person or organisation that can give more information.

[John Piermont Montilla]

Hahahah

I remembered one of my staff working as field worker for prostituted women.

Her work should provide counselling and condom education, but suddenly her client was mauled by the customer. So she stopped her work and went to the police and helped the woman in every need of the moment. The scenario got worst when the wife of the man appeared, getting more worst the woman was found to be a prostitute (something that we do not expose to avoid criminal liability) and worst, the bar was being accused of trafficking women. She spent all day on the incident and controlling all the damage that is taking place.

When I asked her to make a report for her required outputs, she has nothing to submit because she saved the girl but instead got mad and yelled "will I leave the client for that output"? So, I asked her for an alternative report documenting the incident of the mauling and she yelled again "how I can document when your in an urgency?". So I asked her, if you do not have a report and evidence of your story, do you deserved to be paid? She replied "of course, i have my effort rendered". I asked her for the last time, are you paid for your work or for helping that woman? And she went out.

Now our organization seems to be disliked by "costumers" one of our clientèle group because we lost our objectivity is working in the field. This does not mean we are tolerating abuse, our contentions is the way we should work and handle things as skillful as possible especially during urgency. A SALT facilitator is equipped with sensitivity to adapt in every situation and objectivity to see things with a purpose.

What we can do is stop, analyse, look and listen = SALT so that every scenario has a story to be told and we can explore every side of the coin and apply appropriate measures without being carried away of our emotions. Lets improve our social capital too, so that every time we encounter problems not in our field of work, we can immediately refer them for appropriate services.

For HIV information as an urgency, we need first to do research. How can we mitigate risk if we do not know the danger zone. How can we put warning signs in a highway if we do not know the level of awareness and knowledge and behaviors of the drivers at-risk of having an accident and worst if the drivers does not understand the messages of the warning signs.

We have one case here of a health worker who was asked by a married man on how to use the condom in order to prevent her wife to have her 12th pregnancy. The health worker was not proficient for family planning but because of the urgency she demonstrated the use of condom using her fingers, without a dildo.

Months later, his wife got pregnant and was mad at the health worker. The worker ask what did you do. And the man replied "just what you have told me". The worker was confused, and after a long discussion, it was found out that the man put the condom on his finger every time he is having sex with his wife.

My goodness!!!! the story became an ice-breaker in every family planning seminars here.

The moral of the story is that sometimes there is a danger in urgency, instead of processing our immediate actions in our cerebrum, we allow our amygdala to be in control.
http://serendip.brynmawr.edu/exchange/node/1749

[John Piermont Montilla]

Hi Calle!

I agree with you that knowledge "saves" lives. But in SALT, it is the community that saves their own lives, not the facilitator. The facilitator is like Jesus Christ drawing out love in each others heart in order to give life to each members - but sadly until today, the Christ was perceived to be the savior instead of one dicovering the power within him/her and save him/herself from life issues. Even among us, we community workers are often perceived as saviors of communities once we visit them.

HERE I AM AGAIN...... getting off the course, anyway, to explain and provide knowledge is in the field of "instruction" not "facilitation".

Laurence provided a classic example of facilitation when she mentioned:

"I then encourage the girl who ask the question to respond what she knew and then I asked the other girls to complete the information"

Here we see a skill of the facilitator of stimulating community dialogue and sharing of knowledge that comes from the community and not from the facilitator. When the discussion is kept on its tract, many issues will arise particularly those you mentioned "being avoided talking about".

If Laurence for example changed her hat as an instructor or educator, the process of drawing out every suppressed issues that needs to be evoked has been interrupted and defeats the purpose of the dialogue. The scenario would be like a researcher doing assessment of knowledge and the research participant is asking what are the right answers and the researcher provided the correct answers - this is a no-no in research practice where the research is therefore biased and you will not know what steps to take in the future.

A good community visit involves a deeply engaging dialogue and see to it that after each SALT, education can be provided from a peer educator or a community health worker the community trust - so that the community's perception of the facilitator will remain s/he is a facilitator.

thanks

[John Piermont Montilla]

Calle

I share you dilemma

Knowledge in the community should be managed because these knowledge has their own history and learning and change facilitators should explore the history of these community knowledge in order for him/her to understand its beginnings and explore the appropriate ways of thinking, feeling and working to assist the community to have a deeper inquiry of the roots on the way they behave.

Peer education is a model of peer-to-peer instruction and done by individuals, peer education is not the work of a learning facilitator BUT facilitating peer education is the task of a learning facilitator where learning within peer groups are stimulated. the facilitator can act as a referee so that the dialogue would surface members of the group who have correct information who can share and those who have wrong information who can learn. If none has the competency, the facilitator should stimulate members to discuss of the alternatives until they arrive into seeking an external resource.

In agree that knowledge should have its own self-assessment and own river diagram and forms part a self assessment that cover knowledge, attitudes, skills and practices so that peer educators can assess their own competencies on knowledge, attitudes, skills and behaviors if they are really telling the right thing and being a role model of what they preach. Otherwise they should not be peer educators and the peer group would be the jury while the facilitator can act as the moderator.

Health workers should also have their own self assessments because there is much credence in what you say that they themselves are stigmatising. So whats the role of the facilitator in addressing this dilemma among health service providers?

[Taufiq M.A.]

I think the facilitator can wear two hats... it just about how them wear it in any situation..
of course need a courage to do this because this is not an easy part!!!

wearing two hats is desirable in some situation, especially situation where there is no other or minim resources in some place. So, if the situation possible to wearing two hats, why not??

warm regards,

Taufiq

[Joma]

The role of a facilitator is vast, like a counselor a Facilitator too need to posses informative and sensitive issue like the counselor. It is very important that the FACILITATOR should be in the condition to answer questions on HIV.

[Bazo]

Anybody who knows about HIV and AIDS, TB or any other disease must must share their knowledge with people who wants to know about it. We are human beings first after that the other hats comes. But whoever is giving the information must give correct information to the people with the local knowledge like where to get services such as HIV Testing facilities, ART, DOTs, etc. And also whom to contact for follow up if they need further queries. why deny them that, that information could be saving lives.

[Matt]

to be brief... facilitators don't give the information, and I don't think we should. WHAT DO WE BELIEVE? We believe that the answers lie within, that the knowledge exists in the room - we believe that, so draw it out. Consider the question, what if knowledge does not exist in people, but in between people instead? the dialogue creates knowledge as different values, experience and understandings are negotiated and shared, in effect bringing about new knowledge in the 'in between' space. A facilitator can share a personal experience to add to that dialogue, but I DO believe that people possess the answers to their own questions - conversation is needed - and patience is required - and accompaniment, perhaps beyond the room where you may be facilitating - and I need to model that belief in my facilitation. Ok, there's tonnes more going through my head, but i'll leave it there for now.

Greetings from Melbourne to all of you.

[Laurence Gilliot]

Hi friends,

Sirinate is sitting next to me :) Here is what I learned from her:

- We should make sure that people have a basic understanding about HIV otherwise they cannot participate in the discussion. BUT as a facilitator we do not give a lecture or give information on HIV. We ask people in the community to discuss and share their knowledge and experience.

- If the community does not have the basic information about HIV, we can share our experience.

Sirinate pointed out that we can integrate the SALT approach in everything we do, especially in our work with communities. If we are peer educators, we can change our usual way of doing and ask questions rather then lecture/teach. Same for counselling or other community work. We do not have to wear separate hats, we need to integrate SALT and facilitation into what we already do.

Thanks Matt and Sirinate for sharing

Laurence

[Geoff Parcell]

When I saw this discussion I was keen to jump in. But I was busy and I didn’t, but now I am glad I didn’t. But I had a conversation with Phil today and now I want to offer my experience and thoughts. I am preparing to run a workshop on facilitation soon. It won’t be easy! I found a model which I quite like that describes facilitation as a spectrum of ways of working - from remaining content free to presenting knowledge and information. Here is a picture based on work by Donovan & Townsend:

Simply it recognises that we can vary the amount of contribution to content of the discussion we can make, and the amount of interaction with other participants we have. ‘Socratic direction’ by the way, is the art of asking questions to lead the participants to an answer. I think we all do that without realising it much of the time.
Which of these modes we select depend on a number of criteria:
• Time available
• Participants’ current knowledge
• Whether we are looking to share knowledge or change attitudes
• Many or only one option
• Involvement
• Facilitator’s skill level.
But this challenges the way I think about facilitation.
When we make SALT visits we start with the belief that people have strengths which they can use to help themselves. If I intervene with a solution then I become the expert and people may stop thinking for themselves.
People have talked about wearing two hats. I often wear two hats but not at the same time. But I do need to signal that to others. I take off an invisible facilitator’s hat and put in its place a participant’s one. I ask permission to do so. Then I replace it before I start to facilitate again.
I might also finish the meeting I am facilitating and offer to start another one where I am sharing something that already exists on the internet. If people take up my offer then I consider it a request for information. My role is different.
Phil offered me a distinction today. We can provide information on HIV/ AIDS statistics that will assist people in thinking about the issue. That is very different from offering advice or solutions or advocacy. People can determine their own actions.
So do we think that presenting is facilitation or does that stretch our model of the world too far?

[Peeters Fongeh]

Hello L and G, Good you are a Facilitator, but i will give it another name Animator and you must be very flexible in that position.
i think if you see it very necessary that the community need Sensitization you should do it, but you need to know the level of involvements by the people of that community, since you have another position or another duties you can use approaches like you go and train community leaders then they will do the work in their community. then you only go there once in a while to share with them their difficulties and experiences.