Arielle Scoblionko Final Thesis

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Parsons BBA in Design + Management Senior Thesis Presentation Spring 2009. Student: Arielle Scoblionko, Faculty: Robert Rabinovitz, Associate Professor, School of Design Strategies, Parsons The New School for Design

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Arielle Scoblionko Final Thesis

  1. 1. HAU aids in ethiopia: born without rights a two step communication system arielle scoblionko
  2. 2. introduction navigation project introduction; spring 2008 design development; course overview 6 project topic exploration; brainstorm 8 project brainstorm; brainstorm inspiration 10 hiv/aids prevalence; demographics 12 hiv/aids prevalence; africa 14 hiv/aids prevalence; ethiopia 16 problem overview; understanding hiv/aids 18 project introduction; 2008-2009 school year senior thesis; course overview, 20 design development (spring 2008) review; inspiration 22 project topic exploration; childhood 24 project research; inspiration 26 introduction; problem statement 28 identifying the problem the epidemic; hiv/aids 30 hiv/aids; scientific overview 32 scientific overview; hiv/aids victims 34 hiv/aids victims; children 36 child hiv/aids victims; physical and mental effects 38 child hiv/aids victims; psychological and social effects 40 child hiv/aids victims; economic and political effects 42 child hiv/aids victims; global mortality effects 44 effects on children; mother to child transmission 46 mother to child transmission; breast feeding 48
  3. 3. aids in ethiopia: born without rights understanding the problem understanding the larger context; social environment and development 50 understanding the larger context; socialization 52 understanding the larger context; childhood 54 understanding the larger context; childhood in africa 56 understanding the larger context; motherhood 58 understanding the larger context; motherhood in africa 60 understanding the larger context; breast feeding 62 understanding the larger context; breast feeding in Africa 64 breast feeding; prevalence 66 breast feeding prevalence; femininity 68 breast feeding and femininity; motherhood 70 breast feeding and motherhood; cultural significance 72 breast feeding and motherhood; common practices 74 breast feeding practices; health 76 breast feeding health; hiv/aids relationship 78 child hiv/aids; in africa 80 child hiv/aids: in ethiopia 82 understanding the community ethiopia; country overview 84 ethiopia, cultural overview 86 ethiopian culture; family planning 88 ethiopian cultural roles; men 90 ethiopian cultural roles; women 92 ethiopian cultural; children 94 meet the people; personas 96
  4. 4. introduction navigation current solutions overview; hiv/aids, global 98 critique; hiv/aids drug treatment and scientific advancements 100 critique; hiv/aids outreach, and organizations 102 critique; hiv/aids shelter 104 critique; hiv/aids, volunteer services 106 critique; hiv/aids, breast feeding alternatives 108 critique; hiv/aids, abstinence 110 expanded research research opportunities; global needs 112 inspiration; human rights 114 inspiration; the big pictures 116 diseases; malaria 118 diseases; diarrhoeal 120 diseases; chytridiomyosis 122 diseases; simian immunodeficiency virus,feline immunodeficiency virus 124 prototyping opportunities; areas of intervention 126 selected area of focus ; prevention 128 inspiration; all of us the movie 130 inspiration; dr. mehret mandefro, ethiopian-american hiv/aids specialist 132 initial brainstorm; process 134 expert feedback; dr. mehret mendefro 136 solution; draft 1 138 expert feedback; dr. mehret mendefro and HIV-positive patients 140 solution; draft 2 142 solution; draft 3 144 solution; draft 4 146 expert feedback; dr. mehret mendefro 148
  5. 5. aids in ethiopia: born without rights intervention overview; problem 150 overview; context 152 supporting research; gift 154 supporting research; game 156 supporting research; adornment 158 supporting research; methods of change 160 supporting research; educational and verbal impact 162 overview; hau 164 hau; elements 166 hau; description, modified deck of cards 168 hau; description, pendant 170 hau; the system 172 hau; the complete s ystem, distribution 174 hau; future opportunities 176 project resources bibliography 178 images 180
  6. 6. project introduction; spring 2008 design development: course overview T here are many broadly applicable principles that can be used to enhance the design development process in any context. Design Development is a one semester course that addresses these fundamental principles in a conceptual as well as practical manner. The course encourages studying the ways in which design processes unfold from many perspectives which affords opportunities for developing the insight required to recognize critical junctures that offer opportunities for increasing creativity and efficiency. 1. 6
  7. 7. aids in ethiopia; born without rights Design Development(spring 2008): Identifying the Problem image inspired by “2.”
  8. 8. project introduction; spring 2008 project topic exploration; brainstorm 8
  9. 9. aids in ethiopia: born without rights
  10. 10. project introduction; spring 2008 project brainstrom; brainstorm inspiration 10
  11. 11. aids in ethiopia: born without rights
  12. 12. project introduction; spring 2008 hiv/aids prevalence; demographics A Global View of HIV infection; 30-36 million living with HIV, 2007 ADULT PREVALENCE (%) 15.0% - 28.0% 5.0% -< 15.0% 1.0% -< 5.0% .5% - < 1.0% .1%-,< 5% <.1% No data available UNAIDS global report on the HIV epidemic, 2008 12
  13. 13. aids in ethiopia: born without rights 4. Cameroon Project, AIDS orphan 6. AIDS orphan; South Africa Young girls effected by HIV/AIDS. 3. Stanley, HIV positive and malnourished; Upendo Village, Kenya 14. 7. Mekdes is being dropped off by her aunts at an AIDS orphanage in Addis Ababa, Ethiopia
  14. 14. project overview hiv/aids prevalence; africa A Global View of HIV infection; 30-36 million living with HIV, 2007 ADULT PREVALENCE (%) 15.0% - 28.0% 5.0% -< 15.0% 1.0% -< 5.0% .5% - < 1.0% .1%-,< 5% <.1% No data available Africa,2007 UNAIDS global report on the HIV epidemic, 2008 14
  15. 15. aids in ethiopia: born without rights South Africa’s Department of Health estimates that 18.3% of all African adults (15–49 years) were living with HIV in 2006 (60:3). 8. Villagers in Masogo, Kenya attend a funeral for a suspected AIDS victim.
  16. 16. product introduction; spring 2008 hiv/aids prevalence; ethiopia A Global View of HIV infection; 30-36 million living with HIV, 2007 ADULT PREVALENCE (%) 15.0% - 28.0% 5.0% -< 15.0% 1.0% -< 5.0% .5% - < 1.0% .1%-,< 5% <.1% No data available Ethiopia,2007 UNAIDS global report on the HIV epidemic, 2008 16
  17. 17. aids in ethiopia: born without rights Of Ethiopia’s 77 million people, 3 million are HIV-positive, each day birthing 1,000 new infections (61) . 43. Francois, 4 months old here, and weighing 3 kg (6 lbs 9oz). He was born in an isolated village in west senegal, weighing very little, but otherwise healthy. Some volunteers stumbled upon his village, “at that point he was quite near death and weighed only 1.4 kg (3 lbs 1 oz). they worked tirelessly one on one with this baby’s mom for 3 weeks to reestablish breastfeeding and offer supplemental high-calorie feedings. On the day this photo was taken, [the photographer] trav- eled with [a] friend who had worked closely with [the] family...[he was] still very tiny for his age, but the most he had ever weighed in his life. [They} learned he had also recently gotten over malaria, which by all laws of medicine and common sense should have been the end of him. he was quite anemic, but nonetheless thriving.”
  18. 18. project introduction; spring 2008 problem overview; understanding hiv/aids HIV:and like all viruses replicates insideVirus) is a retrovirus, HIV (Human Immonodeficiency host cells. A retrovirus is a genetic material composed of ribonucleic acid (RNA), and uses an enzyme, reverse transcriptase, to convert RNA to DNA. HIV reproduces by invading other cells. Upon cell invasion the virus produces more infectious particles by converting viral RNA into DNA and then making many RNA copies. The switch from RNA to DNA and back to RNA makes combating HIV difficult because each switch offers opportunities for error and viral mutation (mutation means that the virus can outwit human response). Once viral copies are made they break out of the cell, destroying it and infecting other cells (62: 22-23). 10. Healthy white blood cells 11. HIV virus infecting cell; image by Jeff Johnson 18
  19. 19. aids in ethiopia; born without rights AIDS: T cells whichthe immunethe body’s overall primarily CD4 HIV attacks organize system, immune system. After infecting a CD4 T cell (by penetrating the cell’s wall) the virus becomes part of 12. White blood cell infected with AIDS the immune system, disabling full expulsion of the virus. The body attempts to produce more CD4 cells but once their number declines to a certain level the immune system shuts down. These later stages of HIV are referred to as AIDS (Acquired Immune Deficiency Syndrome) (62: 22-23). 23. AIDS viruses budding from a white blood cell's membrane: Image by Matthew Christopher 13. AIDS positive cell
  20. 20. project introduction; 2008-2009 school year senior thesis: course overview S enior Thesis is a two semester course intended to draw upon and test competencies developed in previous courses. By employing and refining skills of research, analysis, explanation, persuasion, and presentation this project demonstrates an intimate understanding in the emerging field of Design Research. AIDS In Ethiopia; Born without Rights represents four years of study, channeling unique talents to understand, communicate, research and design for unfamiliar people in unfamiliar places. Photograph by Harold Davis 20
  21. 21. aids in ethiopia: born without rights Senior Thesis (2008-2009): Intervention/Innovation image inspired by (2).
  22. 22. project introduction; 2008-2009 school year design development (spring 2008) review; inspiration Sudan - almost 500,000 children refugees caused by violence and civil war 5. These children are born without rights.They Ghana - 3% of the population endure the from 15-49 are currently infected with the AIDS virus 5. consequences Ethiopia - this country of of their parents’ Uganda - more than 940,000 children are orphaned due to 70 million has more than 5 million orphans, their actions. the AIDS pandemic 5. parents lost to famine, disease, war and AIDS 5. Zambia - 47% of the population is younger than 15 with only 7% receiving aid of any kind 5. 5. 22
  23. 23. aids in ethiopia: ethiopia; born without rights The rapid spread In many ways, scientific research has delineated of HIV is a global the means by which mother to child epidemic. transmission In developing can be prevented. The countries, up to primary challenge now 50% of infant facing the HIV community is how to implement, in contraction is arange of settings, due to breast the benefits of these feeding (63: 1). discoveries. 18. 16. AIDS orphan, Uganda
  24. 24. project introduction; 2008-2009 school year project topic exploration; childhood “In biology, survival is the ultimate criterion of adaptation, achieved not only through spawning and protection of the newborn but also indirectly through the social processes involved in the provision of food, sharing of information, and maintenance of social order - in all animals. A[n understanding] of child[hood] care in any human population must begin with how adaptive functions are socially and culturally organized in the local environment of the child” . (44:12-13) 24 21.
  25. 25. aids in ethiopia: born without rights Perceptions of childhood vary amongst cultures, demographic regions, time periods, religions, and races. Despite childhood differences, all 17. 44. people are connected by the common inability to bypass the early biological stage of life, childhood. Therefore, all children are entitled to the basic human rights that ensure a healthy physical, mental and spiritual development. However, many children are denied these fundamental human rights due to social, cultural and environmental constraints. As a global society bound by our biological commonalities, it is our responsibility to protect future generations and ensure the continuation of human existence. 45. 18. Photographer: E. Obi-Akpere; Buhona, Ethiopia
  26. 26. project introduction; 2008-2009 school year project research; inspiration 22. “ Newsweek magazine announced, in its 1997 special issue on children, that breast feeding may boost a child’sintelligence. But the New York Times warned of the dangers of HIV infected mothers passing the virus to their infants through their milk (Meier 1997). And Time magazine told the story of a female Army pilot, Emma Cuevas, who asked to be released from the service to breast feed her baby after her six-week maternity leave was up. She was denied this option, though experts on her behalf claimed a constitutional right to breast feed” . (64: 1) 26
  27. 27. aids in ethiopia: born without rights 22.
  28. 28. project introduction; 2008-2009 school year introduction; problem statement C urrently fourteen percent of children in Ethiopia are stripped of their human rights due to HIV/AIDS exposure, 33 – 50% of which contract the fatal virus through their mother’s breast milk. Ethiopia faces unique HIV transmission challenges due to the societal significance of breast feeding, which secures a woman’s role and rights within a community. Globally we have battled the HIV/AIDS epidemic through governmental interventions, volunteer services, antiretroviral treatments, education, sexual protection, and scientific and medical advances, all of which are compatible within the first world countries in which they were created. In order to restore human rights to children, there is a desperate need to implement, in a range of settings, the benefits of these discoveries. 24. Blumenfeld, David: Ethiopia, Tshay Tefera, 2 yrs 28
  29. 29. aids in ethiopia: born without rights 26. Johannesburg, South Africa. Child Living with HIV/AIDS at Nkosi’s Haven 27. Otwandani Orphanage: Soweto, South Africa. Ishmael 2 yr old AIDS orphan reaches up to be held. 25. Bati, Ethiopia: Relief Centre. Child awakened to make sure she is alive.
  30. 30. identifying the problem the epidemic; hiv/aids “In Ethiopia 1,000,000 children under the age of 14 have lost at least 1 parent to AIDS.That makes Ethiopia the country with the most HIV positive 32. children” . (22) 30
  31. 31. aids in ethiopia: born without rights 33. African child 31. HIV positive children, Africa
  32. 32. identifying the problem hiv/aids; scientific overview TRANSMISSION ROUTES MYTHS HIV requires a host cell to HIV is found in body fluids 1. Once a person becomes stay alive and replicate. To and cannot live long outside infected with HIV he will die replicate, the virus creates the body. In order to new virus particles inside a transmit HIV, body fluid 2. HIV can be cured host cell and those particles must be passed from an HIV carry the virus to new cells. positive person to an HIV 3. HIV positive people Once infected, the T-helper negative person. engageing in sexual activity, cell turns into a HIV do not need a condom replicating cell. T-helper cells primary transmission routes: play a vital role in the body’s 4. HIV only affects gay men immune response. There are 1. Sexual contact (anal, and drug users typically 1,000 T-cells per vaginal, or oral) one millmeter of blood. HIV 5. People over 50 can’t get will slowly reduce this 2. Sharing needles/syringes HIV number until a person’s count drops below 200. 3. Mother to child: labor, 6. HIV is the same as AIDS When this happens, a person delivery or breast feeding. has progressed from HIV to 7. Once infected with HIV, a AIDS. 4. Blood transfusions women can’t have children 35. Healthy Red Blood Cells 32
  33. 33. 1 HIV homes in on the aids in ethiopia: CD4+ T cell born without rights 2 HIV RNA chain 6 New envelope is converts to DNA assembled with HIV virus 1 inserted 6 2 Outer 2 envelope is removed 3 HIV RNA chain converts to DNA 5 DNA 3 commands 5 Diagram of HIV attacking 4 chromosomes inside nucleus 4 HIV DNA to make more CD4+ T cell and reproducing penetrates cell nucleus cell nucleus HIV CD4+ T Cell 7 HIV bursting 7 from the cell 36.
  34. 34. identifying the problem scientific overview; hiv/aids victims In 2007,68% of “Every day, over 6,800 persons all new HIV become infected HIV and over 76% infections and with 5,700 persons die of all deaths from AIDS” . (66: 10) due to AIDS occured in sub-Saharan Africa . (66: 12) 15. This child was born ten weeks premature and is HIV positive. 19. An HIV positive orphan, Nairobi, Kenya. 46. An HIV-infected man lies on a hospital bed in Jakarta, 30 November 2007. 34
  35. 35. aids in ethiopia: born without rights In sub-Saharan Africa , the estimated number of children (under 18) orphaned by AIDS more than doubled between 2000 and 2007. UNICEF estimates that by 48. HIV-positive children 2010 there will be 18.4 The WHO estimates that in 2015 AIDS million children will cause one in six deaths in sub-Saharan Africa in Africa (62: 21) . 47. Cambodian HIV positive woman Mut Dem San, 29, lies on the floor of the health center orphaned by AIDS . (62: 66)
  36. 36. identifying the problem hiv/aids victims; children “From the beginning of the HIV pandemic through 2002, four million children under 15 years of age worldwide became infected” (64: 3). 37. Ethiopian boy In 2007, globally, 2.5 million children The World Health Organization estimates that (under the age of 15) were living with 500,000 children under the age of 15 died HIV/AIDS. (66: 7) 38. Children at an Outpatient Treatment Center; Lerra village, southern Ethiopia. Photo: AFP/GETTY from AIDS or related causes in 2003 alone. 36
  37. 37. aids in ethiopia: born without rights Most children Ethiopian children ages are infected with the virus 5 to 14 are called ”windows of hope” because the duringpregnancy, future is in their hands (67:16) . delivery or while breast feeding. About 50% of infants who get HIV from their mothers die before their second birthday. 39. Women wait to get treatment for their malnourished children at an Outpatient Treatment Center 37. A mother holds the hand of her malnourished boy at a Red Cross Red Crescent centre in the Wolayita region in the South of Ethiopia.
  38. 38. identifying the problem child hiv/aids victims; physical and mental effects failure to thrive* fever * fatigue * rash * prone to infection * respriraatory manifestions * haematological manifestations pheumocystis carinii pneumonia * viral infection * lymphoid pulmonary lesion * delayed mental development * sore throat A malnourished boy is portrayed at a feeding 25. centre in Damota Pulassa, southern Ethiopia. 38
  39. 39. aids in ethiopia: born without rights psychological effects * central nervous system manifestation * headache * gastrointestinal symptoms The first symptoms of HIV infection can resemble symptoms of common cold or flu viruses * swollen lymph nodes * social alienation Eleanor Bentall/Tearfund, 13-month-old Abusch 91. A malnourished HIV+ child with tuberculosis. 23. Demisse Mada is one of tens of thousands of severely malnourished children in Ethiopia. Picture: Eleanor Bentall/Tearfund.
  40. 40. identifying the problem child hiv/aids victims; psychological and social effects The impact of HIV/AIDS on children is seen most dramatically in the rising numbers of children and adolescents orphaned by AIDS. UNICEF estimates that over 15 million children, 12.3% of all children in sub-Saharan Africa, have been orphaned by AIDS, and the number is rising. Orphans who grow up “unloved, uncared for, and unsocialized [are] thought more likely to become criminals.” The growing number of orphans presents a pressing public issue regarding child care because the dependency rates increase, placing demands on the government and society to provide education, health care, and social support (62: 90). African Orphans. 40
  41. 41. aids in ethiopia: born without rights As young adults (ages 15-25) fall ill Africa The burden of family is at risk of loosing an entire care increasingly generation. “The loss of falls on the maternal older people means skills and knowledge grandmother are not passed on - ‘institutionlal as the pandemic grows. memory’ is lost” (62: 83) . Child & Grandmother. Property of VOA news. “The burning question is what happens when today’s grandmothers die; AIDS means the next generation of grandmothers Fatuma Hillow and her grandmother Batula Guha Property of Nkoni Cameroon Women Group. Grandmother on Kanazi Island. Property of Helmi Maria, travel writer. will be absent” . (62: 83) Chronicle photo by Michael Macor
  42. 42. identifying the problem child hiv/aids victims; economic and political effects HIV/AIDS greatly decreases worker productivity which affects agricultural development and related labor, consequentially leading to famine. Malnutrition, resulting from famine, increases risk of transmission and intensifies active viruses. “Day in the Life of Africa.” Photograph by Pictopia. 42
  43. 43. aids in ethiopia: born without rights The increasing dependency “It is in the interest of on government aid the nation state, for “adversely affects economic growth by depressing healthy mothers the national savings rate and to supply the next reducing future generation of domestic resources workers and citizens” (64: 2). available for investment” (62: 64). 42. Magwa Tea Field Workers, South Africa. “... disease creates poverty and despair and erodes institutional capacity...” (62: 92). 40. Ethiopian landscape. 41. 49. Farmer Mekonnen Shumbulo stands with his son, Mule, 2, in his maize field
  44. 44. identifying the problem child hiv/aids victims; global mortality effects “Population growth decreases through premature deaths; a reduction in fertility; and changing sexual behaviors. As the HIV/ AIDS epidemic progresses there are fewer women of child-bearing age. HIV- positive women are less likely to conceive and carry the Children affected infant to term” (62: 61). And, while by HIV/AIDS suffer condoms and abstinence can protect against diseases, from poverty, they also decrease fertility rates (contributing to decreasing homelessness, 34. populations) in many African communities where children discrimination, are essential to societal and early death. functioning. 50. Ethiopia: Three children’s bodies lie in a makeshift morgue at the South Oromia clinic. 44
  45. 45. aids in ethiopia: born without rights “Increased deaths in young adults are the most measurable effect of AIDS.” By 2010 life expectancy could fall to under 27 years of age in some areas of Africa. “How will this affect societal ability to function?” (62: 57-61). Maso Aliyi mourns his dead child, Shibre Aliyi, at his home in Ethiopia. Image sourece: LA Times. HIV/AIDS leads to rising infant and child mortality, falling life expectancy, changes in the population size, growth, and structure all of which have enormous effects on national psyche, economy, and social welfare. 51. Archived from “Bombs fall on Babylon.” 52. Relatives mourn over the the body of a one year old child who died of malnutrition. Darfur,
  46. 46. identifying the problem effects on children; mother to child transmission mother to child transmission HIV transmission from an “The overall risk of MTCT of hiv-positive HIV is substantially increased by maternal factors: high mother to her child can viral load in plasma, a occur during pregnancy, low cd4+ cell count, and labour, delivery or AIDS, by vaginal delivery “MTCT” breast feeding. or prematurity...” . (63: 1) Photograph by Niall Crotty 53. Photograph by World Health Organization An Akiye woman and her baby. August 19, 2008. Photo by Pernille Bærendtsen 46
  47. 47. aids in ethiopia: born without rights MTCT can be The risk of reduced from 15-25% to under 2% by combining administration of antiretroviral prophylaxix during pregnancy and delivery, elective ceasarean avoidance of section and breast feeding. 54. 55. 56. 57.
  48. 48. identifying the problem mother to child transmission; breast feeding replacement feeding is “When acceptable, feasible, affordable, sustainable and safe, HIV infected mothers should avoid breast feeding completely” (63:1) . 58. 59. 48
  49. 49. aids in ethiopia: born without rights “The impact of HIV infection on infant feeding practices is a significant public-health issue, for two reasons: 61. malnutrition is “Where breast feeding is an underlying cause of common and prolonged, 60% of child deaths, transmission through and underweight breast-feeding may account is the leading for up to half of HIV underlying cause of infections in infants and disability and 60. young children” (63: 1) . 62. illness worldwide” (63: 3).
  50. 50. understanding the problem understanding the context; social environment and development understand how “To children grow up under varied environmental conditions, one must “Patterns of be willing to go to where social organization conditions already those exist, to examine them and behavior such 67. Chinese mother and child as mating patterns and respect 34. Ethiopian mother and child 66. Hippo mother and child with and emotional display rules, in detail, and to change one’s assumptions in the face of which vary across new observations” (44: 9) . species in much of the animal kingdom, vary across populations in 63. Elephant mother and child 64. Menaksi temple, dreaming in mother’s 65. Gorilla mother and child homo sapiens” . (44: 11) arms 50
  51. 51. aids in ethiopia: born without rights HIV and AIDS are causing untold human suffering. In some countries, the virus is reversing decades of developmental 69. Photo by Kevin Fleming/CORBIS progress. “While the epidemic’s evolution has varied across regions, there is one common 68. denominator: HIV and 67. Geoffrey Owino, the youngest of Christine Kanga’s five children, is HIV- AIDS are increasingly a positive. Christina used to run a successful tailoring business but has not been able to work for a long time. Instead she gets disease of the young and up for short periods each day to teach her eldest son how to sew - an attempt most vulnerable, particularly girls” (65). to pass on vital skills to her family’s next generation. © World Food Program, Vanessa Ethiopian mother & child. Sebastian Rich Photo. Vick. Sebastian Rich Photo. 69.
  52. 52. understanding the problem understanding the larger context; socialization 71. 72. 73. 74. Socialization is, “the process through which individuals acquire the knowledge , skills, and dispositions that enable them to participate as more or less effective members of groups and the society” . (44: Foreword) 80. 76. 75. 77. 78. 79. 52
  53. 53. aids in ethiopia: born without rights “A population tends to share an environment, symbol systems for encoding it, and organizations and codes of conduct for adapting to it...Human adaptation...is largely attributable to the operation 81. 82. of specific social organizations...following culturally prescribed scripts... No account of ontogeny in human adaptation could be adequate without inclusion of population-specific patterns that establish pathways of behavioral development of children” (44: 12). 84. 83.
  54. 54. understanding the problem understanding the larger context; childhood 70. The nature of childhood in any human population begins with how adaptive functions are socially and culturally organized in the local environment . (44:12-13) 54
  55. 55. aids in ethiopia: born without rights 86. 85. Africa, Photographer: Alastair McNaughton 85. 88. 87.
  56. 56. understanding the problem understanding the larger context; childhood in africa The model of African childcare is referred to as the pediatric model, “because its primary concern is with the survival, health, and physical growth of the infant... The American [model] is the, “pedagogical , because its primary concern is behavioral with the development and its preparation for educational interactions” (44: 25). 89. 90. 91. 56
  57. 57. aids in ethiopia: born without rights The fundamental differences in child rearing prohibit the implementation of medical, scientific, and social advancements thathelp a country economically, politically, and socially thrive. In order to improve the quality of life in third world nations, design must be conducive to the culture in which it will exist. If advances penetrate youth culture, improvements will sustain the aging of generations. 92. 93.
  58. 58. understanding the problem understanding the larger context; motherhood 94. 95. 99. When functioning as the primary caregiver, mothers of all species and cultures “are motivated by a 97 concern for the health and survival of their infant” (44: 23) . 96. 98. 58
  59. 59. aids in ethiopia: born without rights “Some experts liken the sensual tie between mother and child to the exclusivity of the monogamous marriage bond” . (64: 6) 100. 102. “The cultural variation in beliefs about pregnancy begins with beliefs about the causes of conception, which 103. can express meanings and values central to the identity of a 101. culture” (59: 1). 104.
  60. 60. understanding the problem understanding the larger context; motherhood in africa “In virtually all the social and cultural contexts of indigenous Africa, childbearing is necessary for moral virtue, spiritual continuity, and material well-being; the more descendants one has, the better off one is considered to be” (44: 33). 106. 107. pregnancy encompasses physiological, psychological, spiritual, The experience of and socio-cultural dimensions. Because the future of any given culture depends heavily on women’s procreative abilities, these abilities carry strong social significance. Thus, every culture takes upon itself the regulation and management of women’s pregnancies (59: 1). 105. 60
  61. 61. aids in ethiopia: born without rights barren woman “A or childless man is [Africa’s] image of the worst possible fate: an incomplete person who has not attained the foothold necessary for full adulthood and spiritual continuity . In some African socieites, such people are 108. pitied and feared” . (44: 32)
  62. 62. understanding the problem understanding the the larger context; breast feeding “In the United States, maternal Universally, a woman’s breast feeding has biological purpose long been advocated as a key to good mothering, womanly is to reproduce. Gaining honor, and even to women’s respect as a mother 109. citizenship...The notion of breast feeding as a mother’s obligation requires a commitment to both her child and the larger to breast feeding social body extends from the because it personally colonial days, when nursing was and publicity solidifies a a mother’s sacred duty” (64: 9). woman’s maternal status. Breast feeding, which is often considered the measure of the mother, 112. physically and 114. spiritually, literally and metaphorically, represents the transference of mother to child. 110. 111. 113. 115. 62
  63. 63. aids in ethiopia: born without rights 116. “Breast feeding plays heavily into our notions of “good” and “bad” mothers, which touches on one of the dominant emotional issues 119. of the twenty first century: “Mother’s bodies, female sexuality, and the act of feeding at the relationship the breast embodies anxieities addresing whether women’s between breast feeding bodies are “pure” or “dangerous.” The questions surrounding breast feeding “provides a lens with which to sharpen our focus on the and motherhood” (64: 1) . 117. 118. conflicts shaping and dividing women’s lives” (64: 1-2).
  64. 64. understanding the problem understanding the larger context; breast-feeding in africa In traditional Ethiopian societies women often refuse breast feeding alternatives because they fear stigmatization family and the by the community. If a woman does not breast feed, it may be assumed that she is HIV-positive, exposing her to the 59. Himba Mother and Child. 121. Young Himba Girl. physical and emotional “A woman's worth is measured in terms of her abuse associated with role as a mother and wife,” status of which are the virus . (70) 59. Young Himba Woman. 120. reinforced through the act of breast feeding (45: 114). 64
  65. 65. aids in ethiopia: born without rights “The HIV [breast Ethiopian women are expected to breast feed for it is safe, nutritious and ensures infant-mother feeding] story is so bonding, which is an important element of the powerful because it native culture (71: 84). literally and metaphorically tells us which mothers have dangerous bodies” (64: 2) . 122. HIMBA MOTHER AND CHILD 3 , Artist: Michael Sheridan. Redbubble.com 122.
  66. 66. understanding the problem breast feeding; prevalence 126. “Up to 94% of infants in the world 123. are estimated to be ever breast fed, 79% continue at one year, and 52% at two years, with an estimated median duration of breast feeding of 21 124. months” (63: 3) . 125. 127. 66
  67. 67. aids in ethiopia: born without rights 128. 131. “Nearly all infants in Globally an estimated developing countries 41% of infants under four months of age and 25% are initially breast fed, under six months are and most continue exclusively breast fed; until at least six months of in sub-Saharan Africa 23% of infants under six months age but often into the of age are exclusively second year” (63: 3) . breast fed” (63: 3). 129. 130.
  68. 68. understanding the problem breast feeding prevalence; femininity The Tempest, Giorgio Barbarelli da Castelfranco. Birth of Venus, Sandro Botticelli The female sex is globally recognized through the presence of breasts. 68
  69. 69. aids in ethiopia: born without rights Spirit Spouse. Virgin and Child, Jean Fouquet. Le Dejeuner Sur L’Herbe, Edouard Manet. The breasts, across space and time, embody the essence of female sexuality.
  70. 70. understanding the problem breast feedng and femininity; motherhood the essence of woman lies in reproduction Motherly differences aid in defining relationality within society. Motherhood creates a heirarchy 133. amongst women, separating mothers from “other” women deemed less moral. Motherhood is essential to the Motherhood is a class making and marking duty (64: 11) . creation of female identity. The act of motherhood physically differentiates women from men . (64: 52) 131. 132. 134. 70
  71. 71. aids in ethiopia: born without rights Woman who “see child primary rearing as their responsibility in life, and one that is ultimatley theirs alone ” is what sociologist Linda Blum refers to as “exclusive motherhood” . (64: 5-6) 135. 136. 93.
  72. 72. understanding the problem breast feeding and motherhood; cultural significange By Maitum Information Office, August 2007 “Breast feeding has long been advocated as a mothering, key to good womanly honor, and even to women’s citizenship... 137. “Breast feeding baby in Ethiopia.” According to sociologist Pam Carter, breast feeding is The notion of breast-feeding as a“conversation about femininity” and a mother’s obligation to both her child and the larger “obligations of the maternal body to the larger social body” (64: 2). social body extends from the colonial days, when nursing was a mother’s sacred duty...when it was considered a mother’s civic duty to the growing republic” (64: 19). 138. 93. 139. 72
  73. 73. aids in ethiopia; born without rights To be respected as a mother a women is expected to properly raise her child, which requires a commitment 143. to breast feeding. The “lens [on] breast feeding reveals the In the current era, breast feeding has become collision of public and private “the measure of concerns with the maternal body” (64: 7). motherhood. This issue [of motherhood] confounds the gender basis of citizenship 140. and obligation to [society]: women serve the nation through motherhood, and men, through the military” (64: 3). 141. 93. 142.
  74. 74. understanding the problem breast feedng and motherhood; common practices 144. 145 According to the World Health Organization states that “the optimal feeding pattern for overall child survival is exclusive breast feeding for the first six months, and continued breast two years and beyond, with feeding for up to 148. complementary feeding from age six months” . (63: 5) 146. 74
  75. 75. aids in ethiopia; born without rights In Ethiopia, approximately 96% of infants are breast fed at some point. 147. 148. “Breast feeding can range from a six-week dose of bonding ‘ ’ to an intense, several year relationship” (64: 3). 148. 149.
  76. 76. understanding the problem breast feeding practices; health Exclusive breast-feeding enables children to achieve optimal growth, development and health. Ethiopian children welcome an aid convoy. Photograph by Crispin Rodwell. 76
  77. 77. aids in ethiopia: born without rights Nursing is an important part of overall maternal and child health. It may reduce a mother’s risk of ovarian cancer and osteoporosis while promoting weight loss, child spacing (less than 2% risk of becoming pregnant) and a fast return of the uterus 151. to its prepregnant state. A lack of exclusive Breast milk provides breast feeding optimum nutrition, during the first six months stimulates psychosocial of life contributes to over and neurological development, and strengthens one million a child’s immune system. Breast feeding may avoidable child also heighten IQ, increase visual acuity, condition deaths each year . (1) the body to better process fats and cholesterol, prevent obesity, and enhance facial, dental, and speech development (9: 4) , (63: 3). 150. 151.
  78. 78. understanding the problem breast feeding health; hiv/aids relationship “Available interventions can substantially reduce the risk of transmission during pregnancy, labour and delivery, but not yet during breast feeding” . (63: 3-4) 153. 154. For HIV-positive mothers, the decision about breast feed can be difficult. Many whether or not to women are reluctant to get test for HIV due to the wide spread associated stigma. So, with unknown status women must weigh the risk of breast feeding, exposing the child to HIV, against using replacement feeding, which increases the likelihood of death from other infections and diseases. According to UNICEF, “babies who do not breast feed are six times more likely to die from diarrhoea or respiratory infections than babies who do breast feed” (63: 3-4). 67. A young HIV-positive mother holds a photo of herself and her two children. She will die prematurely 152. leaving her children as orphans. Photography by Andrew Petkun, sourced from AVERT.org. 78

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