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									                           EPISODE 11
      Maryknoll World
Study Guide and Educator Notes

                   EPISODE 11
                 Health Care
                   for HIV
                  Maryknoll Lay Missioner
                          Charlotte Cook
Nairobi, Kenya


 Lake      NAIROBI
Victoria         q

                                Indian Ocean
      Tanzania                                     AFRICA

       Official name: Republic of Kenya
       Population: 28,337,071 (1998)
       Age distribution: (%) <15: 43.6; 65+: 2.7
       Population density: 126 per sq. mi.
       Urban: 30%
       Ethnic groups: Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%,
                          Kamba 11%, others including Asian, Arab, European.
       Language(s): Swahili, English (both official) numerous indigenous
       Religion(s): Protestant 38%, Roman Catholic 28%, indigenous
                      beliefs 26%
       Area: 224,961 sq. mi., slightly more than twice size of Nevada
       Capital: Nairobi
       Government: Republic
       Currency: Shilling
       Gross domestic product: $39.2 billion, $1,400 per capita (1996)
       Life expectancy at birth: 47.0 male; 48.1 female
       Infant mortality: 59 per 1000 live births
       Education: Free and compulsory ages 6-14
       Literacy rate: 78% (1995)
       National holiday: Jamhuri Day, Dec. 12

Objectives (Part 1):
   • To acquaint students with Kenya and its capital city, Nairobi.
   • To explain the migration from rural to urban Nairobi.
   • To explore a missoner’s work with AIDS victims in Nairobi.

Focusing Activities Before Viewing:
   • Have students locate Kenya and Nairobi on a globe or map.
     Ask students to research the demographics of Kenya.

Exploring Activities After Viewing:
   • Kenya was a British protectorate in late 19th century and a colony in
     early 20th century until it achieved independence in 1963 and became a
     republic in 1964. Although Kenya is the most industrialized nation in East
     Africa, its economy remains predominately agricultural. Kenya has one of
     the world’s highest population growth rates. Ask students to research and
     report the effects of the escalating population upon Kenya and its economy.
   • Located just south of the equator, Nairobi is the trading center of a fertile
     agricultural region. Villagers in rural Kenya are subsistence farmers. Many
     villagers are migrating to urban Nairobi because the countryside lacks
     sufficient farmland to support the growing population. Ask students
     to recall where most of the migrating people are forced to live in the city
     of Nairobi.
   • Charlotte Cook, a Maryknoll Lay Missioner, and Benta Aoka, a health-care
     worker, aid and comfort sick people in Nairobi’s slums. More than half the
     city’s population lives in the huge slums where disease, especially AIDS, is
     rampant. Assign students to write a paper describing some of the
     extraordinary attributes characteristic of Charlotte and Benta and other
     health-care volunteers in Nairobi.

Objectives (Part 2):
   • To further explore the squalid conditions in Nairobi’s slums.
   • To examine the impact of the AIDS relief program in Nairobi.
   • To understand the epidemic of AIDS worldwide.

Focusing Activities Before Viewing:
   • Review with students the acronyms AIDS (Acquired Immune Deficiency
     Syndrome) and HIV (Human Immunodeficiency Virus).

Exploring Activities After Viewing:
   • The people crowd into makeshift housing in the slums, lacking the
     infrastructure for running water, electricity, garbage or sewage removal.
     High unemployment in the city negates opportunities for work. The
     unemployed have no means of support. Ask students to reflect on
     the future of children growing up in the slums. Are the circumstances
     of children living within slums in the U.S. any different? How?
   • Volunteers in an AIDS relief program in Nairobi take some six months
     of training in the causes, treatment and prevention of AIDS and other
     diseases. They provide education, counseling and in-home health care to
     patients, and access to low-cost medicine and care at the government clinic.
     Ask students what the patients’ situation would be without health-care
   • AIDS, a worldwide epidemic, is most prevalent in developing countries.
     The U.N. and World Health Organization estimated that by 1997 more
     than 30.6 million people worldwide were living with HIV/AIDS; 11.7
     million died. Among Kenya’ s population of more than twenty-eight
     million people, one million people are HIV positive; in Nairobi’s slums,
     the estimated rate of infection is about fifty percent. AIDS was first
     identified in the U.S. in 1981. Have students research and report on
     what the U.S. is doing to treat and find a cure for AIDS.

Objectives (Part 3):
   • To examine some unrealistic fears related to AIDS.
   • To comprehend the compassion of health-care workers.
   • To examine hope and coping in the face of hopelessness.

Focusing Activities Before Viewing:
   • Review with students the fact that there is no known cure for AIDS today.

Exploring Activities After Viewing:
   • Before Benta’s health-care training, she shared the fears of others who
     shunned AIDS victims and believed casual contact with the victims could
     make them sick. Another reason for not helping needy neighbors relates
     to the culture in home villages. Ask students to recall the reason and the
     role of extended families in home villages.
   • While Charlotte works with the entire staff of the AIDS relief program,
     Benta trains new health-care workers who bond with patients. What
     motivates the healthcare workers to continue their service to AIDS
     victims when they know the inevitable outcome?
   • Charlotte and Benta learn to cope with the difficulties of their chosen
     ministry. A worldwide focus will hasten an AIDS cure. While the deaths
     of loved ones in the Western world may remain high-stress factors, Africans
     will continue to accept death as a natural part of life. What does this tell
     about African culture and endurance?

Related Activities/Suggestions:
   1. Assign students to track the worldwide epidemic of AIDS.
   2. Research health-care time lines in the history of the U.S. and compare
      them with those in developing countries.
   3. Research any local programs that empower care for sick people.

Educator Notes
Part 1
Kenya lies in the heart of Africa’s safari country. In the Nairobi National Park
zebras, gazelles and giraffes roam freely. Just a few miles away is the skyline
of Nairobi, the capital city and home to nearly two million people. Nairobi’s
population is growing rapidly as rural Kenyans leave the countryside in search
of work in the city.

More than one hundred ethnic groups live in Kenya. The Luo tribe is one of
the largest. Benta Aoko, a Luo woman, and her husband left their village years
ago to seek their fortune in Nairobi where her husband found a job.

Kenya is largely an agricultural country about twice the size of Nevada. The
population is growing so fast that there isn’t enough farmland to support the
families in the countryside. People migrating to Nairobi end up in huge slums
that house over half the city’s population. Thousands of people with jobs walk
several miles each day to work downtown. Many more are unemployed and live
in desperate poverty.

Slum communities are crowded with makeshift housing. There is no infrastructure
for running water or electricity and no system for removing garbage or sewage.
Unhealthy living conditions and widespread malnutrition contribute to diseases
that thrive on poverty: dysentery, tuberculosis, malaria and AIDS. HIV infection
is widespread in Kenya. In a population of 28 million people, more than one
million people are HIV positive. In the slums of Nairobi the estimated rate of
infection is as high as fifty percent.

When the AIDS relief program began in 1987, Benta was one of the first to
be trained as a community health-care worker and later became a teacher in the
program. Charlotte Cook, a Maryknoll Lay Missioner, works with the entire AIDS
relief team and knows the importance of Benta’s role. Health-care volunteers take
a six-month course in home care, anatomy, common diseases and medicines to
treat the diseases. The focus is on AIDS: how it’s transmitted, how it’s prevented
and how to care for someone who has AIDS.

Part 2
Most of the people in the slums fear visiting a person with AIDS. They don’t know
how the HIV infection occurs and believe they can get sick from casual contact.
Benta had the same fear before her training. People are also reluctant to help
neighbors if they aren’t related. In home villages, people belong to large extended
families, called the Jamaa, who take care of them when they are sick.

The health-care workers support nurses and social workers in the AIDS relief
program. They connect patients with services such as low-cost treatment in
the local government clinic. They deliver medicines and do domestic chores
for patients. These health-care workers get to know and form strong bonds with
patients. There is a terrible sense of loss when the disease inevitably claims their

Africans say, “You cannot save one who’s going to die.” They accept death as
the next stage and natural part of life. Ancestors who have died and gone before
them are greatly revered. Charlotte and Benta see their ministry as “helping to
ease the dying process and to help a person to die with dignity.” They have chosen
a difficult path, but each has found her way to cope.

Part 3
The routine of family life is a comforting buffer to Benta’s work outside the home.
Her neighbors know about her health-care training and come to her when they
need help. Benta’s attention strengthens bonds in her neighborhood and reinforces
the sense of community.

When Charlotte leaves her flower garden at home to work in the slums, the
contrast cuts deeply into her sense of justice. She copes by seeing past the poverty
of the slums into the beauty in the people and the dignity with which they live
their lives.

As a new group of students graduates from the training program, the mood is one
of hope and of new beginnings. Charlotte and Benta are recognized for their work.
Within themselves, they discover the strength to meet the challenge of the work
they’ve chosen.

Selected Bibliography:
   Hubley, J., The AIDS Handbook, 2nd ed. (1995).
   Huxley, E., comp., Nine Faces of Kenya (1991).
   Mann, J., and Tarantola, D.J., eds., AIDS in the World ll (1996).
   Miller, N., and Yeager, R., Kenya, 2nd ed., (1993).
   Ochieng, W., ed., Themes in Kenya History (1992).
   Widner, J.A., The Rise of a Party-State in Kenya (1992).
   Paterson, A., Women in the Time of AIDS (1987).
   Orbis Books, Maryknoll, NY 1-800-258-5838
   The Third World Resource Directory (1994-1995)
   The World Guide 1999/2000, New Internationalist Publications Ltd.
Related Videos:
   Making the World Better (12 minutes, 1997) $12.95 with Discussion Guide
   Depicts teenage volunteers working with AIDS patients and
   the mentally handicapped.
   Maryknoll World Productions: 1-800-227-8523
   From Sunup (28 minutes, 1987) $14.95
   Portrays the strength, courage and determination of African women in Tanzania.
   Maryknoll World Productions: 1-800-227-8523
AIDS Task Force:
   Maryknoll AIDS Task Force, PO Box 311, Maryknoll, NY 10545-0311,
   914-941-7636 ext. 5727

                           Maryknoll World
                         P.O. Box 308
                   Maryknoll, NY 10545-0308
                      FAX: 914-762-6567
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