Q&A with Chelsea Whittle

Chelsea Whittle, who recently earned a Master of Science in Global Health at Duke, completed her thesis on the peer youth education model in Kibera, Kenya. Using the nongovernmental organization Carolina for Kibera as her case study, Whittle concentrated on the model’s effectiveness in promoting adolescent sexual health. The Chronicle’s Danielle Muoio sat down with Whittle to discuss the state of Kibera, Whittle’s research and broader issues within global health.

The Chronicle: Can you tell me what inspired you to work with Carolina for Kibera?

Chelsea Whittle: I needed a master’s project, so the way that the master’s in global health works at Duke is that everyone has a fieldwork component in the summer after their first year of curriculum. I really wanted to work with an organization as part of my fieldwork because that’s where I see myself heading as far as my career goes. One of the professors here... is connected with Carolina for Kibera, in that she sat on their board for a number of years and was one of the original people who put the organization together. I approached her, and it was a good fit. I met with the executive director of the organization and together, along with the program staff, came up with a project that would both meet my needs for needing a thesis and fieldwork experience, and also met a need of the organization as well. I really liked Carolina for Kibera in the beginning because they are really community-led—plus, all their employees are Kenyans, and they really do take the community-led development to heart.

TC: Working in a community where HIV/AIDS is so prevalent, what are some of the initiatives Carolina for Kibera takes to help members of the community?

CW: Carolina for Kibera has a number of initiatives that work toward helping those currently infected and also currently at-risk for infection. We don’t really know how many people in Kibera—the group area that I was working in—are infected. It’s probably somewhere between 10 and 20 percent of the population. The initiatives are things like education, school groups and working with younger people because almost half of the new infections happen within adolescents—working with adolescents in particular and spreading the word about different ways to practice safe sex and why that’s important. [Initiatives also include] things like working with people who have already been tested positive in a supportive way so that people understand it’s a manageable disease or that it is not as debilitating a disease as they may believe—maybe that will help with the stigma as well.

TC: How has the stigma of HIV/AIDS played a role in its prevalence in Kibera?

CW: In 2006 when the program that I worked with began, they did a survey of almost 1,000 adolescents, and about half of them thought they were at no risk of contracting HIV. What this really says is that people think it’s somebody else’s fault or somebody else will be at-risk and not them themselves. Maybe it’s a marginalized community and maybe it’s people who have transactional sex, like prostitutes, or drug users or people that just don’t really see themselves at risk. That goes back to the education piece where understanding that even your average 15-year-old can be infected. It’s difficult to talk to people about HIV because it’s a very sensitive topic for a number of reasons, but primarily because in general sexual health is a very touchy topic. Especially in Kibera, it’s just not done where adults talk to youth about sexual practices. So to have an organization try to talk them is also unusual and not expected. Although in Kibera there are a large number of organizations that are working toward helping people with HIV and helping people understand the risk of contracting the disease, it’s not as culturally practiced for people of authority to be telling the youth about HIV.

TC: What sort of initiatives has Carolina for Kibera taken to help the economic situation in Kibera?

CW: Carolina for Kibera is a broad organization with a lot of different initiatives. They have an economic department and one of their main initiatives is called the “War on Trash,” where they provide a place where people go into the community, pick up trash—primarily recyclables—and shred the recyclables. Then they can sell them by the kilo back to the recycling plant and make money that way. Another economic initiative is that they provide young women with prep skills, sewing skills or other skills that they may not have otherwise had. They also have another initiative as well—they are currently doing pilots for through [the University of North Carolina at Chapel Hill’s] school of social work, which is an effort to provide education about economic decisions, such as savings and long-term economic understandings—things that aren’t taught in school. So in those kinds of ways they are trying to help the economic situation, but then again Carolina for Kibera is just one organization in a community of over a million impoverished people, so they are doing what they can, but we really are fighting an uphill battle.

TC: Can you tell me about the Daughters United Center?

CW: The Daughters United Center is one of the older centers. They have a few different initiatives, but the one I am most familiar with is their safe space initiative. They train young women in different topics—women empowerment, HIV, early reproductive health—and these women go out into the community and create safe spaces within their own neighborhoods so that they meet on a regular basis. Young women come to these safe spaces on a weekly basis and talk about their experiences at home or their experiences with boys or their experiences at school, and have a safe space just to be supportive with each other and learn a new topic every time. And then girls come out of those safe space groups and become leaders of their own safe spaces, so it’s a continually growing initiative in all of Kibera. The idea is to provide a safe space for girls and young women to come and have a support system because sometimes they don’t have it at home or at school.

TC: What did you research tell you about the Carolina for Kibera peer youth education model?

CW: The program I worked with is the sexual reproductive health program. They primarily use peer educators to carry out their missions. Peer educators are, in this case, young adolescents who are identified by the community to be potential leaders. They get trained in a bunch of different content, [such as] leadership skills and one-on-one counseling. They go out into the community and do all different activities. So my research found that the model is working for Carolina for Kibera because the youth in the community really formed relationships with each other and are getting their information about sexual health from each other. Having peers with the correct information and with the right supplies and counseling skills really works well in that particular community. We also did a program assessment, which ended up in a series of recommendations for how to make the model even better than it is.

TC: What do you think can be done to make the model better?

CW: I think clearly defining leadership skills and having the peers understand what exactly their role is at Carolina for Kibera and in the community can make it better—also, having them understand what they can expect from the organization. On the Carolina for Kibera side, they can use the peers even more as eyes and ears in the community and gather information about what is going on in the community—what their needs are, what trends are going on, if there is a new way of delivering information or a new service that should be provided. The peers are really able to understand the community in a different kind of a way because they are also adolescents in the community.

TC: What do you see as the current biggest challenges facing global health?

CW: A prioritization by organizations to measure how their programs are actually working [is the biggest challenge]. There are a lot of people who give money to organizations, and they don’t really know how that money gets spent. Organizations certainly vary as far as reputation and the work they are doing, and whether they are working or not. So I think a big challenge is for the implementer to be sure that their work is doing what they want it to be doing. Another big challenge is funding and understanding globally that although places might be far away and very different from their own place back at home, it’s still an important investment to make. It truly is an investment because when you are investing in global health initiatives, you really are investing in your own future back in Durham. It’s difficult for us to sit in Durham and understand [what giving] $100 to an organization in Kibera does. The thing is, health impacts everything from security to education to whole country development, which [in turn] impacts everywhere [else]. The world is becoming a more globalized place and becoming more connected every day, so people’s well-being are important to your own [well-being,] even if it’s half a world a way. Carolina for Kibera’s tagline is “Talent is universal and opportunity is not,” which I think is a good way of saying that there are people who are talented, gifted and have cool ideas everywhere, and are deserving [of opportunities] but may be in a situation they are born into that they cannot help. Those are just two of the very many challenges.

TC: What did this program do for you on a personal level?

CW: It was a total privilege to be a part of the organization. I am still working with them, which is great since I made some pretty lasting relationships with the staff there. The fieldwork placement through the master’s program worked out really well for me in that I was both able to complete my master’s thesis but also develop myself professionally. It was really fun to be a fly on the wall and see how things work as far as organizations, leadership, communication and decision-making [goes]. I really learned a lot professionally about how things work in the field and how things don’t work in the field.