One of the highest level critical thinking skills is to evaluate - that is, to judge the validity of something and back up your opinion. For one of our last groups together, I wanted to push the patients in my Health Literacy class to accomplish the difficult objective of evaluating a piece from the New York Times. I explained that reading health articles in newspapers and magazines is a great way to maintain the health literacy skills they learned in my group. I chose several recent articles relating to HIV/AIDS, and had the patients answer three questions about the articles:
1. What is the main point of the article?
2. Do you think the main point of the article is correct?
3. Why or why not?
One of the articles I chose for the group to practice with is an Op-Ed by Desmond Tutu called "Obama's Overdue AIDS Bill". The piece calls for Obama to devote more funds to the fight against HIV/AIDS in Africa. Before I taught this class last week, I anticipated that the patients here would unanimously agree with the article, since I assumed they would always be in favor any efforts to eradicate AIDS from this world. My prediction could not have been more wrong.
I gave the patients a few minutes to read this article silently to themselves, then to write their answers to the three questions on their papers. I then asked one of the patients to present their opinion of the article and back it up. She told me that she did not agree with the article, because there are enough people suffering from HIV/AIDS in the United States. This patient's opinion was echoed by many others in the group. Obama needs to take care of the problem at home first, one said. With all of the diamond mines in Africa, they should spend that money to solve their own problems, said another. The United States is just one country, why should we have to provide for a whole other continent?, another patient asked. There was one person in the group who did agree with the article, and she bravely voiced her opinion that since the US has a lot of money, it should contribute to fight AIDS all over the world. However, she was outnumbered by all of the other patients who fiercely disagreed.
I was so stunned after this discussion. How could I have predicted they would all agree with the article, when in fact the opposite occurred? I expected that the patients here would identify with and feel a connection with the people living with AIDS in Africa, but for some reason, they don't. It seems like the patients view the epidemic in the US as distinct from the epidemic in Africa, not as a global pandemic. Maybe the patients feel as though they have been abandoned by the US government, and our country should not be taking care of people in Africa when they themselves have not been taken care of. Unfortunately, the reality is that AIDS is a global problem, which may never be solved unless different continents can work together cooperatively.
Even though the patients didn't react as you anticipated you clearly did get them to read the article and evaluate it. They may not be expressing the opinions that you expect, but they are performing the skills that you've taught them. Great job!
ReplyDeleteHi Marianne,
ReplyDeleteI'm going to suspect that one reason that the patients don't really identify with the broader HIV/AIDS treatment issue is that they personally identify less with the broader HIV/AIDS community and more with the communities that they come from. I realize that I don't really know about your community from what you've written, but I can guess that the people that go to PSI are generally of a lower social economic status and coming from a minority background. With the amount of hardship that they see in their peers and their families, is it any surprise that they see a need to look at AIDS issues closer to home first before looking abroad?
Even as someone not coming from that background (and not an AIDS patient) but having worked with this "underserved" population within the US borders before, I find myself struggling with this concept of working for our immediate community vs. going abroad. I realize that there are great needs there, but I also can't ignore what's going on in the community around me.
How do we bring this together? How will plans to address AIDS in Africa help your clients here in the US?
Well, this is a tough situation all around. Your students want to see their country and their community receiving funding and assistance from the United States and they are very concerned. In terms of funding for AIDS, the article that you provided a link for states that funding from the Obama Administration is down from the Bush Administration for AIDS in Africa to around $333 million per year. It was around 1 billion per year with the Bush Administration. Also, domestic spending in the United States is around 800 million per year or more to combat and prevent AIDS. So, to address the concerns of your students, the United States is addressing the problem at home and abroad. Fighting this disease must occur in all regions of the world, as the areas with the greatest need deserve international support.
ReplyDeleteCollin, thank you so much! I'm very proud of the work they have accomplished this summer.
ReplyDeleteEmily, many thanks for your comment. I think you are absolutely correct in your explanation of why the patients here don't identify with people with AIDS in Africa. And similar to you, this is something I have struggled with too. I don't feel the need to study medicine abroad when I see the vast needs of those living here in NYC.
Chris, I completely agree with you. Just fighting AIDS in our country won't put much of a dent in the global pandemic. There is probably no way to divide the funds among the US and internationally that will make everybody happy.
"Unfortunately, the reality is that AIDS is a global problem, which may never be solved unless different continents can work together cooperatively. "
ReplyDeleteI disagree with this statement. In mathematical terms, you have posed a problem and assumed the existence of a solution. This assumption may not be valid.
It assumes that we can help people in other countries. Sometimes yes, sometimes no. Sometimes people have to get their on their own. For example, one of the highest ranking and politically influential South African politicians made headlines when he claimed it was impossible that contracted HIV from a woman with whom he had sex, because he took a shower after they had sex. When the most powerful men of a country still spread around such horrible lies, there comes a question about the efficacy of such methods.
It is very, very, very hard to get people to change their ways. Imagine growing up in a village in which EVERYONE you know and love and respect has taught you that only homosexuals get HIV. Imagine some person, from a culture (the West) which historically subjugated and extorted your village and everyone you know, comes to "educate" you. They tell you everything you know is wrong. They tell you everything everyone has ever taught you is wrong. They tell you that everyone you knew is wrong, but they're right.
I think the existence of the solution is limited. Efforts about HIV education in South Africa, despite recent setbacks, is improving. I don't think we can do anything about Nigeria right now. I don't think we do anything about Zimbabwe right now. I think success in South Africa, eventually, will sow the seeds that neighboring African nations will change...by success I mean even having the same HIV awareness as Americans do right now (which obviously could be improved in its own right)
I think globalization, in and of itself, and the Internet, have the greatest ability to increase HIV education globally. Email and facebook made the Iranian protests about Ahmidinijad (sp) possible; I think that as wealth grows, and the Internet spreads, education about HIV will improve most dramatically. That is to say, people have to come to believing these things on their own, in their own time.