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Sexual Health Exchange, 1998 - no. 2
Cambodia
In 199697, UNICEF commissioned Save the Children Fund UK to conduct research on sexuality among young people in Cambodia to gain a better understanding of the psychosocial factors that influence sexual risktaking behaviour. Based on this study and ongoing participatory research with key target groups, UNICEF is currently developing a series of interactive teaching video packages that model reallife situations. The video format was chosen because it is a popular and practical tool for helping young people learn how to manage the increasingly complex demands of interpersonal relationships. Most communities throughout the country have private video parlours that offer community educators broad access to this approach.
Minidramas present familiar reallife problem situations to target audiences of students, outofschool youth, housewives and husbands, commercial sex workers, beer promotion girls, nightclub dancing girls, migrant workers, military personnel, truck drivers, etc. The situations and scripts, including problemsolving strategies, have been developed together with the target audiences.
The videos can be used to facilitate group discussions on issues such as problem identification, problem solving, assessment of personal risk for HIV infection, and how to reduce HIV infection risks in situations similar to those in the videos. In this fashion, message formats are shifted to twoway communication for participatory problemsolving. Each video package comes with a facilitator guide that includes discussion questions, e.g., instructions to ask participants to consider what feelings each person (i.e., both boys/men and girls/women) in the video may have had. Flipchart versions, for use in areas without access to video, tell the story of each problem situation and model behaviour options with a series of pictures.
After viewers see the problem situation in the video, it is switched off and the group is asked: what would you do if you were in a similar situation? After discussion and role-plays on this and similar situations, the video is started again. The actors now model a range of options or decisions viewers might take, including what they might say or do to avoid or reduce risk. Some example responses given in the video include how to say no in an acceptable manner, how to delay sex to a later time to avoid the risk, and how to negotiate a safer solution.
Key principles underlying the interactive teaching videos used in Cambodia
move beyond awareness-raising to build confidence and competence for protection
move from one-way communication to dialogues for participatory problem-solving
use a popular and entertaining format
use real-life situations within which risk behaviours occur
personalize the issues and involve target audience members in developing materials
explore interpersonal relationships and socio-cultural factors contributing to vulnerability
ask people what they would do in a situation and why
model a range of realistic choices or options for safe and acceptable behaviour
use peer pressure/peer leaders to promote behavioural and social norm changes
seek to create an environment that promotes healthy lifestyles and renders unhealthy behaviour more difficult, more expensive and/or socially unacceptable.
The first situation, "Snooker Game", was produced for students, but it may also be used effectively with outofschool youth. This situation models how to recognize and avoid a risk situation, in this case, to manage peer pressure successfully and avoid going to the brothel. The sequel, "At the Brothel", reviews personal risk assessment and explores how one might reduce risk once having entered into a risk situation.
The young men in "Snooker Game" and "At the Brothel" were recruited from a snooker hall in Phnom Penh. In focus-group discussions, they described the very real problems they face in daily life, and role-played reasonable solutions, often using their own slang terminology. This is reflected through the character of the peer leader, who is portrayed as the most experienced person in the group. He is intelligent and concerned as he sets the positive image by dispelling common myths and ensuring that his friends use condoms.
Part Two of the student video package is entitled "The Quiet Place". It features two scenarios based on a theme familiar to all Cambodians, drawing on qualitative research into youth sexuality conducted in 1997. This series explores situations that require problemsolving within casual, trusting and sweetheart (non-commercial) relationships, and which often involve unplanned sex. The sequel involves a couple who have clearly decided that they want to have sex; their problem revolves around condom negotiation.
O ut of s c h o ol y o ut h fr o m a s q u at te r c o m m unity in Phom Penh viewed teaching videos and then listened down solutions to problems in small groups for a presentation to a larger group
Showing a problem can raise awareness and catalyze useful communication on the issue. Nevertheless, it is important to explore ways to empower married couples, for example, to actually solve problems. Another package being developed therefore portrays "The Vulnerable Housewife". It has been popular because it models the familiar dilemma of Cambodian housewives who know that their husbands go to commercial sex workers. The sequel, "The Drinking Scene", explores options for reducing a range of risks associated with male drinking rituals, including how to resist peer pressure.
The field-tested interactive teaching videos produced so far are extremely popular among Cambodian young people, teachers, teacher trainers, school administrators, community leaders and NGO community workers. The interactive videos and facilitator guides for "The Snooker Game", "At the Brothel" and "The Quiet Place" have been used to train curriculum writers, teacher trainers, nonformal educators and over 12,000 primary and secondary school teachers nationwide.
On the critical side, important concerns have been raised about the risks of focusing on real-life social norms and attitudes in Cambodia as portrayed in "At the Brothel", which was viewed by an international gathering at the 1997 AIDS Congress in Manila. Two specific points were raised: 1) the video gave a perception that commercial sex workers were being blamed for HIV; 2) the video reinforced male insensitivity towards women rather than modeling more positive attitudes.
It is true that showing life as it really is may reinforce negative, yet socially accepted attitudes (i.e., that sex workers are bad). However, the discussions that are meant to follow the video showings can facilitate opportunities to begin addressing and challenging social and behavioural norms and attitudes that lead to increased vulnerability or that violate human rights. It is also important to clarify to all audiences that the videos are tailored to specific groups in order to have the greatest personal meaning and impact. A key challenge for using the videos is therefore the need for facilitators to develop basic facilitation skills.
Jim Mielke, UNICEF, P.O. Box 176, Phnom Penh, Cambodia; Tel: 855-23-426-214; Fax: 855-23-426-284; e-mail: unicef_phnom_penh@unicef.org |