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Thursday, February 28, 2019


Global Social Work 2019 
Midterm Question #1
 Imagine you were air-lifted into a village with one of the following problems:
  1.  Predatory money-lenders preying on impoverished persons
  2. Noise and envfronmental contamination endangering relaively disadvantaged citizen's health and safety
  3. HIV-infected persons suffering from stigma
  4. Sex trafficking of children         
  5. Female genital mutilation
  6. Fistulas and other damage due to problematic pregnancies in Africa
Drawing from the readings, what would be your approach as a global social worker?
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61 comments:

  1. Imagine you were air-lifted into a village with one of the following problems:

    1. Noise and environmental contamination endangering relatively disadvantaged citizen's health and safety

    Drawing from the readings, what would be your approach as a global social worker?

    My approach to this problem as a global social worker would echo the approach taken by the citizens of Vieques, Puerto Rico (Torres, 2005). According to Torres, their plan of action was rooted in the idea that health is a “fundamental human right.” To that end, it would be necessary to establish exactly what the negative impacts of the noise and environmental contamination were. Once that is established, there can be a unified message presented to those in power.

    Like the Viequenses, it is important for those experiencing the misfortune in our example to take a look at the rights that were lost by the actions taken against them. What liberties were lost due to the noise and contamination? This would then be used to build a consciousness within the community (p. 10), or to tap into a consciousness already present. This would be especially true if residents were forced to deal with illnesses such as cancer, death from those illnesses and associated grief which touches generations of family members.

    Furthermore, it is important that the action be community-led and community-centered. In other words, the residents must take charge, not the “experts.” The experts should be there to provide training and education to support the residents’ efforts (p. 10). Additionally, I would make an effort to involve the neighboring communities, just as the viequenses did (p. 10). According to Torres, they “welcomed thousands of visitors who witnessed the impact of the military maneuvers on people’s lives and then returned to their communities to disseminate their findings and to seek additional support for the goals of the Viequenses” (p. 10). This demonstrates the importance of community interdependence and solidarity. While it is difficult for a community to bring about social change in isolation, with the help of friends, it becomes more likely. This is also true on a smaller level with organizations and individuals who build coalitions to bring about change. This also echoes what they Viequenses did by bringing together faith organizations, unions, and other organizations in their effort (p. 10).

    The final and perhaps most important tool that could be used is the story. This means people standing up and developing and disseminating their personal testimonies about the effects of the noise and contamination on their lives and the lives of their loved ones (p. 10), as well as popular individuals who have a connection to the people via art, music, and television who can reach a wide audience with mass media. It also includes artists telling stories in the way that only they can through visual art and music, reaching multiple generations of people at many strata of society (pp. 10-11).

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    1. Hey, I agree with your statement, that the action should be community-led and community-centered. That is because in many cases the experts take the leading role and the voices of the majority, in this case community is unheard. So, again I agree that the residence must take charge and the experts should be there, to support the residents' efforts. Nice work!

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  3. Jack Kelley

    If I wanted to help an impoverished community confront the issue of predatory micro-lending, I would utilize theory regarding self-determination, both in regards to understanding and addressing the problem itself. From the reading by Ewalt and Mokuau “Self-Determination from a Pacific Perspective”, the idea of self-determination in the context of American social work is very much individualized in that it emphasizes points exclusively regarding individual decision making. Ewalt and Mokuau seek to decolonize the theory by broadening the definition to account for structural oppression and how self-determination for many is about building collective power. Using the perspective of Pacific Islander communities, Ewalt and Mokuau assert self-determination be defined as “values of collective affiliation rather than by individualism”, using the strengthening of community relationships to address shared obstacles to collective liberation and dignity (Ewalt and Mokuau, p. 170, 1993). In this instance, predatory micro-loans are actually maintaining and profiting from a system of poverty by setting the terms of what is owed back to the bank, affecting the ability for the recipients to truly self-determine their destiny. The bank will individualize the loans but wouldn’t make money if it wasn’t systematically distributing them to many poor people at once. The problem is thus realized as a shared one among many people with shared interests and characteristics
    From our readings and class discussion, there are a few things we know about micro lending practices. First, micro-lending targets the most poor and dispossessed, people who cannot find or participate in work for wages or for their own immediate sunstinance. They are the most subject to predatory loans because of desperation and pure survival. Secondly, relating to the first, we know that a majority of these recipients are women because of the nature of patriarchal social relations in cultures and economies around the world. Further investigation would be necessary in understanding the material conditions of the specific community I’m working with and their environment.
    With this understanding, my role as an American male social worker, someone far removed from the issues faced by the community, would be less directive and more investigative, focused on getting a better understanding about the problems through facilitating conversations and spaces for collective organizing among community members. I would gather the forces most affected by the predatory loans to come together in figuring out a solution, listen to what the problems identified by the community regarding, and make suggestions to how to proceed. Questions I would inevitably raise would be how do these loans affect the self-determination of this community, why is this community subject to this kind of practice, what is the source of the poverty and deprivation experienced by the community, and what is both possible and needed by the community in order to overcome the suffering they face? This issue would need to be addressed with creative solutions, ones that are determined by the community themselves. In the spirit of self-determination, the realization of the collective strength among the community would be the most essential piece in how to move forward in confronting this problem.

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  4. Before outlining my choise about my approach in HIV – infected persons suffering from stigma, I think it is important to expand understanding of the concept stigma. Stigma and discrimination are part of complex systems or beliefs about illness and disease that are often grounded in social inequalitics (Castro, A., & Farmer, P. (2005)). I chosen this approach , because in my opinion this approach is important not just in others countries, but also in Lithuania. First of all, people who are infected HIV are also humans, and they have their rights. I am social worker so I must to defend people‘s like they, rights. In my opinion, people in our days still afraid HIV infected people. So stigma is notice about HIV. If I will be social worker which will work with people who are infected HIV, for me these people will be just humans with some problems, which I could help to solve. It‘s important to say that fight to stigma is complicated, because definition of stigma remains unclear. Also I think, that if we want to solve this problem, first of all we need to work not just with people which is infected HIV, but also with their families even their friends or society. Maybe first of all we will need to present to society about HIV, how people lives or feels when they have this problem. If we want some changes, we need to work with all comunity, they play very important role is HIV infected people life, because they are one of HIV injected people ecological system part. From the readings throughout the semester, it is clear that it is doesn‘t matter what problems peoples have, they all have equal rights to live in society.
    So, what I will do if air-lifted into a village with HIV-infected persons suffering from stigma? First of all, I will talk with peoples, who have this problems. I will ask them what help they want to get, also I will say, that I want to help them that they could live a normal life. Also, how I said, I will communicate with village comunity. Of course, I will be ready to comunities rejection, but I will try talk to them, what they think about this problem in them comunity, how they appreciates generated situation. Also is important that comunity will understand, that HIV infected people also are humans and they want have equivalent life. In my opinion solving this problem also very important is to share people‘s who overcome this problem, examples like Samuel done. If I want to solve this problem I will need to think about treatment to HIV injected people. But in my opinion with treatment we could to help HIV infected people‘s to live, but we will not cure stigma with some treatment. So that I will work with comunities members. Talking about treatment to HIV injected people also I will try to write some projects and maybe I will get goverment financing to HIV injected people treatment. If not I will try to find some organizations, which would like to cooperate with me, and to help find funds for medications. Also it is important I will to offer to sick people‘s family members to create mutual assistance group in which they could to share they emotions, diffiulties and how solve these problems because as shown in reading about understanding and addressing AIDS-related Stigma, sometimes families members (wifes or even childrens) leaves peoples who are sick, alone.
    In conclusions, I think that this problem I could solve if all comunities members wil cooperate not just with me, but also with each others. Because HIV it is not just sick people problem, but problem of all comunity.

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  5. As stated in A. Castro's (2005) article, stigma occurs during social interaction. People are deliberately and unconsciously categorizing each other into certain categories that have certain characteristic attributes. However, the real characteristics of a person, its real identity, do not necessarily reflect those expectations or perceptions. So when there is a mismatch between these perceptions, sigma appears. Often, members of the public tend to believe that the stigma holder is not a full-fledged person. According to this provision, it is condemned to various forms of discrimination.
    Stigma is a belief in the mind, witch result from a lack of knowledge. The problem of HIV stigma is becoming more and more relevant, with many people both in Lithuania and worldwide. The main problem is weakness information and lack of attention to government.
    HIV-infected people who live in the village, in my opinion, suffer from two stigmas attributed to him. Firstly, that a person lives in the countryside and suffers from poverty. And secondly, the man is suffering from HIV. I am convinced that we need to look for solutions and necessary complex measures to address this issue, not only in health but also in social and educational policies, involving various organizations that are closest to these people. The Haiti experience suggests that improving clinical service can raise the quality of prevention effort, boost staff morale, and reduce HIV- related stigma (A. Castro, 2005). In this situation, social worker's role is fight for the rights of others and work to obtain needed resources by convincing others of the legitimate needs and rights of members of society.
    In my opinion, people living in the village do not apply for the league because they are afraid to be rejected. The one my approach would be developing interventions with people within these groups to minimize the impact of these negatives societal stereotypes and motivate people to start treatment. Another would be working with society and communities to increase tolerance for those with HIV

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    1. Samanta, I want to tell you that I think that you explained stigma very good. I also agree with you that stigma is categorizing each other but usually not on real characteristics of a person. Like I also wrote in my answer, I agree that stigma is a product of a lack of knowledge and I truly believe that we can eliminate it with educating people and with talking about it more and more so people will learn new things and will not have a reason to stigmatize anymore. Like you told at conclusion of your answer I think that solution is working with society and community. I think you understand stigma very good and you will be a very good social worker!

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    2. Samanta,
      I like your idea , that HIV-infected people, who live in the village, suffering from two stigmas. I think it‘s happening, because not everything they could get is easy to reach. In the small community is very difficult to stay unknown, there is lack of information, lack of social services, lack of opportunities. The government should be more involved and pay more attention to the problem solving in very small communities. Parallel the village community should work together and build up a strong community. People need to be active, but not apathetic.

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    3. Great ideas, Samanta! I agree with your opinion, that social worker's role is fight for the rights of others and work to obtain needed resources by convincing others of the legitimate needs and rights of members of society. But I also want to share with you, who was very surprised me when I was looking information about HIV infected people stigma‘s. Various articles, researches states, that in villages cases of HIV are on the rise. People with HIV are leaving the large urban centers and are returning home to live out their final days with their families of origin. Nevertheless, it turns out that in villages there are social workers who believe that there is no need to prepare themselves to work with clients whose lives have been impacted by HIV. In villages, often the assumption has been, "AIDS is not a problem in this community, so why should I learn about it?". This is horrible! It shows the need to focus not only on increasing public tolerance for HIV infected people, but also on increasing the motivation and professionalism of social workers. Services should be dedicated to the education of social workers in order to provide quality and professional services to HIV infected people.

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  6. First, as a global social worker, I would try developing a program to support women in a village that practices female genital mutilation, because it is really culturally sensitive and dynamic human rights issue. I had read the book ,,Desert Flower” (Dirie, Miller, 2012), which tells the story of a circumcised girl from Somalia. This book let me understand, that the world is changing, but some values remain, how it is in some African countries, where deep traditions in villages are above everything. This book examines a global, often hidden, public subject that hides the tragedies and destroys human destinies. Very often women are circumcised under anti-sanitary conditions using the most primitive measures: razors, knives, scissors, glass combs, sharp stones and even ... teeth. FGC, as a traumatic experience can be called trauma, because the tragic consequences of female genital mutilation includes mental disorders, frigidity, depression, AIDS or even deaths. Kasiram, Khosa (2008) define trauma as very serious and catastrophic event in person’s life, which threatened death or serious injury, influenced post – traumatic stress disorder effect in victims life. As a global social worker, I would try to apply community - family therapy through community agreement in trying to reveal the circumcision of women as a traumatic experience, in order to divert families and community into abandonment of female genital mutilation. Second, I try to keep respect of cultural values, where change will be accomplished by cultivating cooperation within the community, trying to educate all community. Tostan Model is an example, which showed efficacy in reducing the frequency of the harmful traditional practices, such as female genital cutting (FGC) and underline the empowerment of women and girls, and the importance of early childhood development practice in East and West Africa (UNICEF, 2008). By offering education, rather than condemning and outlawing female genital cutting, Tostan model remained respectful of the culture and upheld the families autonomy in making decisions. The approach was recognized by the Senegalese government as the only program with significant success in stopping female genital cutting in Senegal and was adopted nationally (UNICEF, 2008). The results shows, that Tostan programme helped the villages to develop a set of skills around how to bring about change: in knowledge, in the human and social order, and in the practical perceptions related to circumcision (UNICEF, 2008). Female genital cutting (FGC) abandoned more than 7,700 communities in eight countries (Djibouti, Guinea, Guinea - Bissau, Mali, Mauritania, Senegal, Somalia and The Gambia) and it shows, that changes can be seek in educating community (Diop, Ouoba, Congo, Melching, Banza, Guiella & Baumgarten, 2004). Finally, as a global social worker, I try to take a human rights practice approach working with female genital mutilation, as one of women rights as human rights violations. Social work is a human rights profession, where social workers promote the realization of human rights by upholding and defending the human rights of clients (Steen, Mann, Restivo, Mazany, Chapple, 2017). Amnesty International and other human rights organizations began calling attention to all the challenges that women were facing throughout the world (Gallagher, 2005). Despite this, the international consensus held that the family is private and out of the reach of the government, so, in many cases, women's human rights do not reach them, because cultural and social traditions were outside political laws. Governments that rely on these laws have - in favor of male citizens and a patriarchal social order - codified a sys - tem that treats women as perpetual legal minors under the eternal guardian - ship of their male relatives (Deif, 2005). Women/human rights education, knowledge of human rights and responsibilities is the foundation for learning and very important in trying to stop female genital mutilation practice (Diop et al., 2004).

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    1. Hey, I have also read the book you have mentioned, "Desert flower" and I think it is a really good and emotional book, which shows exactly what you have been describing about female genital mutilation. I think you made some good arguments in answering this question. Well done.

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    2. I agree with Indre and her thoughts. I also watched movie ,,Dasert flover" and fully recomend to everyone, who is interesting in this area. i also think that it is huge trauma for a mowen and it stays fro her all life - mentaly and physically.
      Talking about help, I think every woman, who face this, needs it. Even that girls, who lives in those countries and it is normal procedure - I think, some of them feels that something it is not okey. Also every girl may need different help and complex help.

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    3. Katja, Indre, thanks for Your observations, I really appreciate it !

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  8. 1) Imagine you were air-lifted into a village with one of the following problems:
    • HIV-infected persons suffering from stigma

    I think stigma and discrimination at the heart of the AIDS pandemic.
    ‘‘Most of those involvedin the movement to slow the spread of AIDS and to improve the quality of life with HIV view stigma and discrimination as human rights violations requiring redress. Both organizations and individuals have taken various actions to address stigma;however, these actions often have not been grounded in a broad biosocial understanding of stigma and AIDS-related discrimination. The Joint United Nations Programme on HIC/AIDS (UNAIDS) often refers to need to fight stigma in order to combat HIV/AIDS, but the definition of stigma remains unclear“.
    (Castro, A., and Farmer, P. (2005). ‘‘Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practise in Haiti“. American Journal, (95)1, p.53).
    In my opinion, people need to be constantly educated about HIV / AIDS. A broader approach is needed to create a new way of thinking and to reduce discrimination and stigmatization. It should also be possible to consult not only a person in the face of the disease, but the whole family. We need to move beyond current thinking towards a conceptual freamework that is the based understanding.
    ‘‘In the international arena, the division of people living with HIV into ‘‘blameworthy“ and ‘‘blameless“ categories reinforces the lack of will on the part of rich countries to finance AIDS treatment in poor countries. The funding gap, which reflects social inequalities between and among countries, is itself a reflection and source of structural violence contributing to AIDS-related stigma. Stigma and human rights violations deriving from it are often the only visible part of deep-rooted social inequality. Addressing the root causes of stigma will require addressing structural violence, including the symbolic violence perpetuated by shallow theories about AIDS-related stigma“. (Castro, A., and Farmer, P. (2005). ‘‘Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practise in Haiti“. American Journal, (95)1, p.58).
    In my opinion wrong local, cultural beliefs and lack of knowledge about HIV promote people's fear and distrust. Usually this is considered shameful, reprehensible because HIV is associated with drug use and homosexuality, so infected with HIV is afraid to be identified.
    I think that prevention is a prerequisite for tackling this problem. People need to be intensely educated about the consequences and ways to protect themselves. However, if HIV has not been avoided, family and social support must first be provided.
    I think that those who are stigmatized can take action to resist the forces that discriminate against them. Those who are marginalized can to build a new identity that redefines their position in society and thus seeks the transformation of overall social structure. This would include resistance through mobilization of movements, at community, national, and international levels, aimed at social change. I my opinion it should be created programs that aim to achieve social and community change rather than just individual behavior change, drawing on the experience of community mobilization and social transformation in other areas.
    Priority should be given to developing a legal and policy framework that protects the human and those affected by the epidemic and that helps to mitigate the impact of HIV/AIDS related stigmatization and dirscrimination.

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  9. 1.  Predatory money-lenders preying on impoverished persons
    To start with, I would probably try to get in contact with local experts and other actors such as NGOs, who have an ambition to solve the same problem, rather than “to do everything alone or duplicate the efforts of others”. (cf. Seipel, 2003: p.16) Also I would try to get the impoverished people themselves involved in the development of a solution in order to figure sth. out that is actually appealing to the people I want to address. Anyway, networking is irreplacable in almost any effort related to poverty reduction and social work.
    Concretely, Mr. Mohammad Yunus tells us something about self sufficient systems of social business and 'social return of investment', which could be of importance here. One could think of several attempts to face the issue here. Micro-financing with low interest rates for poor people to create a small business (such as door-to-door merchandise) or agricultural efforts in order to make an income can be a good approach. (Yunus, M. /Grameen Bank, 1996: p. 4 ff.) (Similar (mostly public) approaches of development and fighting poverty in India and Indonesia from last mid-century until early '00s are described by certain south Asian research institutions (Society for Development Studies, India /Urban and Regional Development Institute, Indonesia, 2005: p. 30 ff.) Depending on the country I am air-lifted to, the conditions to start with something like that are quite different. In several countries of South Asia and sub-Saharan Africa an amount of 1000$ would probably be a good small-scale start, whereas in most of eastern Europe and South America a higher amount would be necessary, also political obstructions might occur. Though, an approach to that could be found in local public administration, which might me willing and free to get involved and give financial support on an innovative project for public well-being. Alternatively, NGOs or even big companies that are involved in local context might be available for that.
    However, the short term objective is to create a self-sustaining system of giving loans to people in need in order to broaden their opportunities in economic life and to empower them to create an income themselves and get the education they want. In my worldview, poor people often have a great potential but are deprived of the opportunities to realize ideas and use their resources properly. Furthermore, I believe that poor people, if they experience appreciation and get certain opportunities, they will pay the money back.
    On the long run, I propose to get people together to demand political intervention regarding poverty; From those, who are still looking for a way out of poverty, others who are already on their way to set up a small business, up to people with sufficient income /resources, many people have an interest in the reduction of poverty and an increase of public well-being. This also touches the issue of the political mandate of social work. Politics determine the distribution of economic resources and access to education and other aspects related to poverty. So, coming to an end here, creating political solidarity among the poor, organizing public action and articulating certain issues towards politics effectively would be an important part of the job here. (cf. Seipel, M., 2003: p. 17)

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    1. Hi Max, I like what you said, overall. I too, would base the amount of the loan on the location, since, as you say, a loan of $1,000 would be a good amount in some locations, but definitely not in others. It would also depend on the purpose of the loan. I would recommend creating a program not where individuals start businesses, but where groups of individuals start a cooperative business. This would provide an opportunity for funds to be pooled and for all individuals in the collective to have a stake in the business. It could be run democratically. This idea of group economics could also be expanded to housing. Micro-loans could be made for the purchasing of collective housing or perhaps a small-scale community center that everyone owns and can make use of. The profits of the co-op businesses can also be used to purchase housing or to build the community center.

      I also like your long-term idea of "people [coming] together to demand political intervention regarding poverty." Perhaps they could use some of the techniques discussed by Torres in regards to Vieques. Additionally, they could take a page from Grodofsky's playbook and discuss rights, as opposed to "the language of needs or interests" (2008, p. 52). It would make sense to discuss how much impoverished people need food, water, housing, and resources. However, what if it were framed in a different way. What if the conversation centered on how people's rights are violated by them being forced to live in poverty without basic necessities? Perhaps there would be more eagerness to address the issue than if it were framed as a needs issue.

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  10. Imagine you were air-lifted into a village with one of the following problems:
    HIV-INFECTED PERSONS SUFFERING FROM STIGMA
    My approach would originate from the ten commitments for community health education, from the article Organizing, Educating, and advocatin for health and human rights in Viques, Puerto Rico. I would like to emphasize some of the commitments. The first one I think it is widely connected to hiv stigma it is start where the people are. If something is stigmatized in this case, HIV infected people, we should try to change our mindset. I would try to spread people’s personal stories of how they got infected with hiv and how the cope with it. It can happen to anyone. I would also try to encourage hiv infected persons to speak out. At first I think it is hard for an individual to expose himself but there are always ways to get through this stigmatized environment he or she will fall in. The secon commitment is recognize and bouild on cummunity strenghts. People learn from young age what should be stigmatized from their parents and usually parents and later their kids aren’t even aware of their wrong doing. That is why I think it would be important to talk about hiv and aids on a local level in communities where old and young people with different ideas, come together and disccuss in this case about hiv. I think a lot of the talking should be done arround HIV related stigma and how it is a barrier to voluntary counseling and testing. Many people which get infected don’t choose to take the test, because they are afraid of being seen in public, just going there, I think they are afraid of some imaginary consequences which come to their mind only because of this stigma connected with HIV and aids. I think especially in small towns and villages people often decide to not go to the center or hospital where they can take the test, because they don’t want to be seen. In my opinion what can be done is to establish many small centers even in villages where you can take hiv test completely anonimously. From the article about understanding and addressing AIDS-related stigma I learned that different programs like HAART, which prevent transmission of aids from mother to child, can help getting rid of stigma. I think so, because people were getting to become familiar with programs like the one I have mention and on the other side they might start to understand that it is a must to have programs like that, and having aids or hiv shouldn’t be stigmatized but excepted. Above all that I have , I think it should be important also to discuss about what stigma really is. As it was written in an article:’’labeled persons are placed in distinct categories so as to acomplish some degree of separation of “us” from “them”. Labeled persons experience status loss and discrimnation that lead to unequal outcomes.’’ (Arachu Castro, Paul Farmer) The words us and them in our case as how I understand are meant for people that don’t have hiv and the word them for hiv infected people. Firstly we should ask ourself why do we make this labels. We are all people with our own shortcomings and we should stop stigmatizing each other. Nobody is perfect and with discussing about hiv and aids we should change our mindset and except differences among us.

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  12. At our faculty, I am very fortunate to have a lot of practice during our education. In my first year, I had my practice with drug addicts in the low-threshold program at the day care centre, where they could turn to help or simply come to socialize. In that year, I met many people who had socially stigmatized diseases - mostly different forms of hepatitis, some of which also had an HIV virus. Because of that I chose the topic how I would help HIV-infected persons suffering from stigma.
    Like it was written in article Understanding ad addressing AIDS related stigma: From Anthropological theory to clinical practice in Haiti, we propose structural violence as a conceptual framework for understanding AIDS-related stigma. Structural violence determines who has access to counselling, diagnostic, and effective therapy. Stigma and human-rights violations originating from it are often the only visible part of deep-rooted social inequality. Addressing the root causes of stigma will require addressing structural violence, including the symbolling violence perpetuated by shallow theories about AIDS related stigma (Castro & Farmer, 2005).
    Already when I was working my practice, I noticed that the society was very condescending to infected people, but when we started the debate, I found out, in fact, that they do not know much about this topic and therefore have mistaken arguments. When it comes to a question how I would help stigmatized people I instantly think about raising awareness between people about this disease. People usually stigmatize when they don`t know true facts, they don`t know how to act and all the now are some unverified facts and that is why they are afraid. I would try to help by organizing some free lectures and by encouraging people to talk about HIV and AIDS. In other article that I read - Organizing, Educating and Advocating for health and Human Rights iden Vieques, Puerto Rico they listed ten commitments for community health education. For me the most important are the first and the last one. First one it`s saying that we must start where people are. I think this is very important that we join them at the same level, that we do not think we are something more, but that we are always equal. Only than when we are at the same level we can start working and be effective. The last rule that I also find very important is work for social justice. I think all social workers must fight for social justice and use all the knowledge they have to help people (Torres, 2005).
    As it`s written also in Universal declaration of human rights all human beings are born free and equal in dignity and rights. To achieve equality, we must fight – we must talk about problems, we must support people, try to educate them (but very important – also educate ourselves!) and with the time this topic will not be so stigmatized anymore because people will know more about it and they will know that they have no reason to be afraid of it or no reason to judge people who got the virus.

    REFERENCE LIST:

    Castro, A., Farmer, P. (2005). Understanding and addressing AIDS – related stigma: From anthropological theory to clinical practice in Haiti. American Journal of public health vol 95, No 1

    Torres, M. (2005). Organizing, Educating, and Advocating for Health and Human Rights in Vieques Puerto Rico. American Journal of public health vol 95, No 1

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  13. HIV-INFECTED PERSONS SUFFERING FROM STIGMA
    HIV and stigma, have been companions for a long time now, and people from different countries still report having discriminatory attitudes towards people living with HIV. This discrimination and other human rights violations may occur in health care settings, barring people from accessing health services or enjoying quality health care. As we learnt from Haiti experience that improving clinical services can raise quality of prevention efforts, boost staff morale and reduce AIDS and HIV stigma. And also a lot of people which get infected by HIV don’t go to take a test, because of the fear which stigma brought. And this is a big problem. Some people are even shunned by their familis, peers and the wider community, while others face poor treatment in educational and work settings, erosion of their rights, and psychological damage (American Journal of Public Health, 2005).
    So my main approach would be for stigmatized people to get to understand which of their fears are based on attitude or perception (because of the stigma) and which are based on actual experience. By separating those two fears I think people would overcome a lot of their fears and also it could helped them to be prepared to lay out a strategy to protect themselves against possible, real acts of discrimination abuse (J. Myhre, D. Sifris, 2018). I would try to make sure that they wouldn’t be alone in this situation. I would make support groups for people with HIV, because sharing your fears and experiences with others can often put things into better perspective. I would also include seminars to educate them about HIV and teach them about their rights (under the law, work rights). Than I would try to push it on local level with education about HIV and encourage HIV infected people to speak out, share their stories and with that we would together fight for the solution, for their rights. I think it is very important to raise awareness to those kinds of problems, because I think that people often make stereotypes and stigmatized others without really knowing anything about that problem.

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    1. I totally agree with you - you talked about important and sensitive objects by working on HIV stigma reducing. I would like to agree with you, that its is important to separate fears and prove fake facts wrong, let people understand actual facts, because, many people have lack of knowledge about AIDS and HIV. Second, for those, who are HIV infected, support is very important, because people might feel excluded, afraid to talk about their problems even with the closest ones, so I really agree about you self-support groups, individual consultations, also family members and close friends could take a part in, to increase their education. Last thing, in my opinion, to reduce stigma people need to speak it loud, because, in my personal opinion, somethings people a unreasonably afraid of things, just because they had never faced it.

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  14. Noise and environmental contamination endangering relatively disadvantaged citizen's health and safety

    Living in unsafe conditions might bedangerous mentally and physically as well. There is many wars or communities living in car conflicts conditions, which always has to be ready to fight, and never can feel safe. They live in permanent stress conditions, which may cause depression, unconscious fears and other mental problems, but as well it can cause physical problems such as cancer, stomache or headache and etc. Everything is related. And conditions I mentioned before violate Human Rights and makes World Health Organization to be concerned.
    As global social worker I would like my work be based on Human Rights, first of all it is dignity, safety, opportunities to live valuable life and get all health services human needs. I can only imagine, so hard it is to think about Human rights, when you have to live war conflict conditions, but in this case I would try to you strength perspective, to unite citizens of community, as Vieques did in Puerto Rico (Torres, 2005) to work for one main goal or as we, lithuanians, did 13th January, 1991, when we united and fought for our freedom by protecting our Television tower.
    The second step, I would take I would try to speak loud as possible about problems people have - show up the world, what is facing, that people need help and support. To help people in these conditions I would look for different types of help, such as charity, donations, medical volunteers.
    Further I would work on strength perspective, to motivate people, empower society for changes, that they are able to change, to blow away depressed thoughts, and try to change minds. But it is not only my good wishes matters, people have to be educated, to know their rights, what they deserve to have, so that's w would be further step - spread information about Human Rights, to rise up politely dissatisfaction of citizens. Because it is important to show up calm, that you want bring your dignity back peacefully, without setting war fires on.
    To sum up, as following Puerto Rico (Torres, 2005) and history of Lithuania experiences, in this specific case, as social worker, I would try to unite people, to set one main goal, and no to be afraid to speak loud about problems we have, because someone will hear it. To reach goal also it is important to educate people about their rights, to let them understand what they deserve and what they have to get. This case also ask to show up people their strengths and positive sides of consequences and that is worth to work for.

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    2. Gintare,
      I Absolutely agree with your idea, that we need to speak out loud about existing problems, not to be afraid to defend their rights. The more and more we speak about it, the better the extent of this problem. I think you give very good examples in answering this question !

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  15. Noise and environmental contamination endangering relaively disadvantaged citizens health and safety

    If I would be air-lifted into a village as a global social worker, I would apply for the knowledge I learnt from Torres and also about self-determination.
    First of all, I would like to mention that not appropriate health conditions are already violation of human rights. Article 25. (1) states:
    Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (Universal Declaration of Human Rights, 1948)

    In order to achieve the task I would use ten commitments for community health education (CHE).
    I would concentrate on some of those commitments, through which the situation could be solved.
    I believe that high level community participation as well as individual and community empowerment are of great importance in a situation of health endangerment.
    “Fostering high level community participation,” the best tool used in Vieques was to further link self-efficacy to collective efficacy by reaffirming that every participant’s contribution was important for the success of the campaign. Reflecting this philosophy was the name Todo Puerto Rico con Vieques (All Puerto Rico With Vieques) given to the broader solidarity coalition established outside the island-municipality. This dynamic coalition succeeded in creating an action-oriented movement of the civil society from very distinct, and in some cases oppositional, social agendas and ideological orientations”
    “Foster individual and community empowerment,” the Viequenses transformed the legacy of colonized perceptual and cognitive behavior,” expressed in a belief system of powerlessness that prevented individual and collective action, to produce an antidote of cultural affirmation, personal and political efficacy, supportive structures for knowledge and skill building, and motivation to protect health and well-being at the individual and collective levels. The synergy of all these elements combined in this Viequense concoction produced a powerful response of human agency by island residents and other participants in the campaign to end the bombings, one that asserted the individual and collective ability to mobilize the resources necessary to change environmental conditions jeopardizing health and quality of life. (Torres,2005)
    Here, I would mention that each and every person is important and that their small contribution can lead to positive outcomes.
    Additionally, through empowering and cooperation between the people as it was in Vieques example, the sense of powerlessness would be relatively low and the residents of this village could feel their strength, in uniting and raising their voices.
    In this case the authorities of this mentioned village would also use methods and strategies to reach for a better, healthier, more quality life.
    To conclude, I would like to say that using these commitments should not be solely one time but must continue in practice for the ongoing process to restore the healthy environment.

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  16. As a woman, it is an interesting theme for me. According to the World Health Organisation, 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated. Also, genital mutilation mostly carried out on young girls between infancy and age 15. It is huge numbers and if you are working in those countries, it is a big possibility that you will meet women or girl, who had genital mutilation. Acording Uwer (2007), FGM is the cutting of the clitoris of girls in order to curb their sexual desire and preserve their sexual honor before marriage.“ Power is talking that most girls after cutting bleed to death or die of infection. Even the girl survive, this action is traumatizing to her and later she can suffer adverse health effects during marriage and her pregnancy. Supposedly it is connected with religion, but not all the time. This thinking is common in small village.
    Female genital mutilation action not just breaks the law, but also violates human physically, emotionally, psychologically and put in a risk her life. According to research results, female genital mutilation is associated with a high rate of posttraumatic stress disorder (PTSD) (Alsibiani, 2010). Because of FGM, the United Nations started to act and were fighting against female genital mutilation. It has been a top priority for United Nations agencies and nongovernmental organizations. This fight took long for almost three decades. Just in 1952, the U.N. Commission on Human Rights adopted a resolution condemning the practice (Uver, 2007). After that, the World Medical Association also condemned female genital mutilation (Gebelle, 1995). According to Unicef data, numbers of FGM is falling in some countries, but around 1 in 3 girls aged 15 to 19 in 30 counties today have undergone the practice versus 1 in 2 in the mid-1980s (Unicef, 2018).
    Another huge problem is that in those countries FGM topic for society is tabu (Uwer, 2007). Looking at this century, it will be more and more often to meet for social workers women, who face this violence, because more and more women, girls come to Europe. Unfortunately, there is a lack of knowledge on this subject (Abdulcadir, 2011). As a social worker, I should fight for those women, because FGM is a violation of human rights. There comes counseling because, in such traumatic events, you have to help with all emotions, memories, feelings, thoughts, values, relationship with other people and etc. Sometimes you can be just the only one around her, who will understand and support in a difficult time. Other cases, you have to protect the child from their parents or relatives. A social worker or other institutional person has to decide, is the child at risk. It depends on social worker thinking and values. I can imagine that in Lithuania female genital mutilation for sure would violate action and you can decide that child is at risk. According to Debelle, such action would be "significant harm" to the child and FGM case took care, police and social services investigation and case conference and her name should be put on the child protection register. This alerts social workers and others, allocates a key worker, and requires a review case conference their suspicions to the social services department “ (Debelle, 1995). Expectually, if the social worker is working in a small village, in many cases people are not educated or do not interested in global world news and living their life like they are used to. Some of them are close to each other, follows tradition or religious and etc. It means that female genital mutilation can be like a normal and frequent action and the social worker is that person, who can explain, teach, help or safe girls life.

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  18. HIV-infected persons suffering from stigma.
    To some, stigma is compared to raining stone falling on the body. Yet deep down, it makes one’s heart suffer more than physical pain they feel. According to Ban Ki Mon, Secretory general of the United Nation, stigma causes anxiety and fear for people living with HIV/AIDS to disclose their status to the public. Many do not have the courage to seek treatment despite the presence of symptoms beyond the extent they or their family can cope with. Stigma has made AIDS the “silent killer”.
    In the article “Understanding and Addressing AIDS – Related Stigma” says that when HIV was first identified, people didn’t know how it spread from person to person, which created a lot of fear. Even today, there is still misinformation about how HIV is spread. HIV stigma can impact people’s everyday lives in many ways. The public’s lack of knowledge on how HIV is spread means that some people may be afraid to be served food made by HIV positive people or use the same bathrooms as them. People living with HIV are often discriminated against when it comes to housing, employment, health services, and more. HIV stigma can also impact the mental health of HIV positive people. If people around you think negatively about you, it can make you feel negatively about yourself. Sometimes, even one loud person saying negative things is enough to hurt. HIV stigma can contribute to depression, which can further exacerbate HIV-related symptoms.
    The problem is particularly evident in small towns and villages where everyone knows each other and people are afraid to be open even with their doctor, and not everyone has the opportunity to go to a bigger city. Patients facing to the lack of effective treatment, lack of social services, lack of confidentiality. Stigma and human - rights violation deriving from it are often the only visible part of deep-rooted social inequality. Addressing the root causes of stigma will require addressing structural violence. In my opinion the society don't have to be afraid to speak loud about HIV and AIDS. Social workers must to inform people about sickness, especially people from the villages. Very important to create a good services for those people, and not to hide the problem.

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  19. Female genital mutilation
    In my opinion, in many of the countries where female genital mutilation is performed, it is a deeply entrenched social norm rooted in gender inequality. The reasons behind the practice vary. In some cases, it is seen as a rite of passage into womanhood, while others see it as a way to suppress a woman’s sexuality. Many communities practice genital mutilation in the belief that it will ensure a girl's proper upbringing, future marriage or family honor. Some also associate it with religious beliefs, although no religious scriptures require it. Most governments in countries where female genital mutilation is practiced have ratified international conventions and declarations that make provisions for the promotion and protection of the health of women and girls. According, the Universal Declaration of Human Rights has five articles which together form a basis to condemn female genital mutilation: article 2 on discrimination, article 3 concerning the right to security of person, article 5 on cruel, inhuman and degrading treatment, article 12 on privacy, and article 25 on the right to a minimum standard of living (including adequate health care) and protection of motherhood.
    Secondly, female genital mutilation can have complications and consequences (phobias, depression, suicide or sexual dysfunction). According, the article “Trauma and PTSD symptoms in Rwanda”, PTSD is associated with flashbacks triggered by reminders of the traumatic event. Besides, female genital mutilation expressed various emotional difficulties and psychosocial problems, including loss of trust within the mother-daughter relationship. Also, if circumcision takes place in an older girl or when the woman is old enough to be fully aware of what is being done to her. On the other hand, we need to stop female genital mutilation. I think that education is amongst the most important ways to stop female genital mutilation. Make regular home visits to the families of girls at risk and hold small awareness raising meetings. Speak out about the risks and realities. Spread understanding that religion does not demand. Also support gender equality and girls and women’s rights. Another example, I would work with community leaders, both formal and informal, to understand the village problem from their perspective and explore possible prevention and/or intervention programs.
    To sum up, talking with girls or women’s requires sensitivity and understanding of the strength of the cultural expectations on them. For most, it’s a private and unquestioned matter. Many women will have never have spoken about it, may not know or understand what was done to them, and will be unaware that it is illegal.

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    1. I like that you are open with your opinions on female genital mutilation in this forum. Your post was very educational and clear on the points you were trying to make. I agree with the ideas you presented in your post. I think that it is important for social workers to understand that many people who are practicing female genital mutilation may not understand that it can be harmful because of the religious and cultural implications it holds. You supported your ideas well with identifying the specific human rights that are violated in girls that are forced into female genital mutilation. Educating girls and women is one of the most important ways to empower women and girls to not practice female genital mutilation, as some may not know that it is even illegal! I think it is extremely important that we consider the cultural values and sensitivities regarding female genital mutilation as well. Like we spoke about in class, as social workers we do not want to tell these women and girls that what they experienced is traumatizing as they may not believe it as such. Putting our belief regarding the practice on the other culture creates a shame and stigma that we do not want to add to. Therefore, clearly female genital mutilation is a violation of human right, and as social workers we also must create an education around the topic that does create a since of judgement, traumatization, or shame onto women and girls who have experienced female genital mutilation.

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  20. Noise and environmental contamination endangering relatively disadvantaged citizen's health and safety

    First of all, I can say that these phenomena are violations of Human rights. Every person has right to live in healthy society with favorable environment. The nature influences for us, our health (physical and moral). For example, when there is sunny day we have a good mood and much powers. Also some people has problems with health so they need really clean and calm atmosphere, environment. They shouldn’t suffer and harm your health. So first of all I would like test people, their condition. I think there are a lot of them who will need a medical help. We can realize it on place by volunteers. Every international organization has them. Doctors can provide inspection, take blood for analyses. There are some problems can be but we will know general condition. A local authority should be notify and participate in every events because their citizens are a state itself actually. Also UNEP can help. In that there are violations of human rights we can ask this department to help by resources, persons, technologies.
    Other important aspect is sources of noise and environmental contamination. It’s keys in this situation. So I would like looking for them. If can eliminate it, we (social workers) will make everything is possible for this. Need to fight with phenomena because of them people suffer. Social worker cannot stay aside. Also we can involve the authority because they responsible for themselves citizens. To conclude, I just say:” life saving is the main aim for all us”.

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  22. I have recently been given the opportunity to work with an organization in the US who is focusing on female genital mutilation (FGM) and the complications that surround this issue. What I have learned in my conversations with this group is that education is a key component to handling this situation and that education goes far beyond simply educating the people who have been involved in this practice, personally. What I am helping this group to do, is create seminars where health professionals will be offered education on this practice and how they as professionals can be prepared to handle any patients that may present with having gone through this practice. These health professionals will hopefully walk away from these seminars with further understanding about how to identify a patient who has undergone this act, and also how to approach this topic with the patient without judgment, and in some ways without concern. We want to help guide the health professionals through the right language so that they can help the patient understand that the healthcare professional is asking questions not to be triggering or potentially alarming for the patient, but to understand how the practice was performed, and how the patient is reacting to the procedure. The goal of educating health professionals is to widen the network of understanding when and where these acts are being performed so that this group that I am working with can then begin to find these communities to educate them on the potential harm of the practice.

    Though, to some, it may seem outrageous that this is not illegal; to many cultures this is a right of passage, so to speak, and it could be more harmful for an outsider to come in and accuse the cultural practice of intentionally causing harm. By this, what I mean is that someone telling someone else that they were abused, if they do not view the abuse as abuse, may leave the conversation having caused the “abused person” to now view themselves as an abused person as opposed to not having experienced the abuse as abuse prior to the conversation. Now this person will need care for the abuse that they recognize, when they could have potentially continued their life without ever truly “experiencing” the effects of the abuse. The approach to a new community that I may have been flown into where I recognize FGM as a common occurrence would likely be similar to how we are beginning to infiltrate the North side of Chicago with this type of information. It must be done gently and in the right scenarios and with a lot of careful consideration about the language used when attempting to educate.

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    1. Emily,

      I love what you contributed with your knowledge and work with FGM. I think that you bring up some incredibly relevant points about Cultural Relativism that Healey describes in her later chapters. We need to approach these incredibly complex situations with sensitivity in order not to induce trauma that did not previously exist while also understanding that these practices should not be viewed as “okay” simply because they are a cultural phenomenon and something that we do not see in our Western culture. We cannot adapt the “when in Rome” idea and pass along these practices as okay when they are a clear violation of human rights by more universal standards. Our discussions about FGM remind me a lot about the experience of Memory and the way she had to educate her peers and community about these issues before expecting any real change. Being an outsider, it is not always our place to facilitate the change, in order to avoid introducing additional harm, and instead we can work as a support.

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  23. Female Genital Mutilation (FGM), which is the removal of the clitoris from the female sex organ, is among some of the outmoded socio-cultural practices prevalent in some countries around the globe. Practices that are consistently recognized as very harmful include, among others, Female genital mutilation (FGM), early marriage, honour killings, tokosi and dowry-related deaths (Radhika, 2002). In Ghana, FGM is practiced by several ethnic groups in the northern part of the country. Figures of the Ghana Statistical Service survey conducted in 2008 with support from the UNICEF put percentages of females under the age of fifty (50) who has experienced some form of female genital mutilation in the Upper West, Upper East and Northern regions at 49, 20, and 5, respectively (Ghana Statistical Service, 2008). Ghana enacted into law in 1994 to FGM. Since then, successful prosecutions of persons preforming the practice has been reported. In 2007, the parliament of Ghana further strengthened the law against FGM and increased the maximum penalty to ten years (United Stated Human Council, 2008). My approach as a global social worker on this matter will be creating awareness about FGM and also educating the people on the effects of FGM, because some die out of the process by bleeding to death, some get infections including HIV/AIDS and some even get psychological trauma due to the pain they grow through. This has been a cultural practice in Africa which is really making women suffer especially during delivery of their babies. I will educate them by telling them the side effects of FGM, and how people have been dying out of it. I will also empower the women in that community and tell them they have a right as human beings so they should forget about this cultural practices which have always bring sorrows to their people. Also I will let them know that, they can get infected by HIV/AIDS and other infectious diseases so they should put a stop to it because they are women and they shouldn’t suffer on their own land. I will also create awareness so that FGM will be stopped in other for the women in the community to enjoy their rights as human beings. Women are always the center of the pain which is very bad so I will convince the key informants in the community for them to be by my side in order to get a successful outcome because women who undergoes FGM really suffers when they tell their stories. I will also allow them to share their experiences so that people in the community will learn something from it and put a stop to it. I will also advocate for the women for this awful act to be stopped.

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  24. If I were air-lifted into a village with HIV-infected persons suffering from stigma, I would first take some time to make sure I understand the stigma, where it comes from, why it exists, and how it is affecting the people who have HIV. Castro and Farmer (2005) talk about this issue in Haiti. The authors discuss how HIV and AIDS-related stigma negatively affect people who are living with HIV by acting “as a barrier” to crucial services such as testing, medical help, and counseling (Castro & Farmer, 2005, p. 53). The stigma also promotes discrimination against people with HIV, which carries another set of issues. People with HIV are often shunned, judged, and rejected. Castro and Farmer (2005) discuss structural violence as a conceptual framework for examining the stigma, which I think is an extremely valuable way of understanding it. “Every society is shaped by large-scale social forces that together define structural violence. These forces include racism, sexism, political violence, poverty, and other social inequalities that are rooted in historical and economic processes that sculpt the distribution and outcome of HIV/AIDS (Castro & Farmer, 2005, p. 55). These societal forces influence the way people with HIV are treated. People with HIV living in impoverished areas, for example, already experience inequalities compared to those living in affluent areas, so it likely that they face greater barriers to services.

    To address the stigma in the village that I was air-lifted into, I would work to educate about and normalize the illness. The stigma arises when misinformation is spread about the illness and how the illness can be transmitted from person to person. Since HIV and AIDS affects countries all over the world, it should be viewed as a global issue (Healy, 2008). It should not be something to hide; rather it should be discussed openly. With an open dialogue about the illness, people with HIV will face fewer barriers to the services that they need to stay healthy. Because sex is a taboo topic in some countries, I would remain mindful of the country’s values about sex. I would not impose my views and values about sex upon the people in the country that I was air-lifted into. Rather, I would work to create the open dialogue about the illness and how the stigma can be dangerous for people who have HIV. I would work to break down the barriers to services for the people who have HIV. I would also work to spread awareness and education about the illness itself.

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  25. If I was air-lifted into a village facing the problem of female genital mutilation, I would first assess how many girls and women are at risk to assess the expanse of the problematic practice. By providing protection for those at risk, Healy’s (2008) “principle of indivisibility” becomes plausible, which is a “holistic view of human rights that holds that human dignity cannot be assured unless all generations of rights are protected and provided, including economic, social, civil, cultural, and political rights, and the global context in which these are possible” (p. 68). Risk assessment will aid in the basic protection of the human rights of women and girls in the area, allowing for further steps to be taken in terms of education and treatment.
    As discussed by Pashaei et. al. (2016), “understanding the factors associated with FGM behavior might help in the designing of appropriate intervention strategies to change this behavior” (p. 2). As participants of a Western school of thought, topics like the practice of female genital mutilation may appear horrendously obvious to disengage in. However, this harmful tradition holds powerful meaning in countries that culturally permit FGM, with the main reasons for its practice “are prevalent social norms, the suppression of female sexuality, aesthetic preferences, social cohesion, and religion” (Pashaei et. al., 2016. p.2). As a social worker in a village that performed this practice, I would offer to educate women on the medical risks and harms involved in such a procedure. Educating the mothers and other female family members of the severe trauma and medical problems resulting from FGM could encourage them to alter their practices, or even cease the procedure entirely. Mentioned by Parshaei et. al. (2016), short term side effects include “severe pain, hemorrhage, and abscess from unsterile instruments,” while long term effects are increasingly more harmful; “recurrent infections, keloids, fistulas, pain during sexual intercourse, menstrual problems, and even infertility” (p. 2). In many cultures who practice FGM, child bearing is an important, necessary part of life. By mentioning the risk of infertility in their daughters or other female family members, this could aid the cessation of FGM by mothers. FGM causes a range of mental health problems as well, noted by Parshaei et. al. (2016) as being associated with “serious psychological and emotional difficulties including anxiety, depression, stress, insomnia, eating disorders, and impaired cognition” (p. 2). Through the education of women and practitioners of FGM alike, the village’s inhumane practice can be at the least reduced, if not eventually eradicated.

    Healy, L. (2008). International Social Work: Professional Action in an Interdependent World. New York: Oxford University Press.
    Pashaei T, Ponnet K, Moeeni M, Khazaeepool M, Majlessi F (2016) Daughters at Risk of Female Genital Mutilation: Examining the Determinants of Mothers’ Intentions to Allow Their Daughters to Undergo Female Genital Mutilation. PLoS ONE 11(3): e0151630. doi:10.1371/journal. pone.0151630

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  27. If I were airlifted into a village with noise and environmental contamination, I would use an approach similar to the one used in Vieques, Puerto Rico. Torres (2005) describes the actions taken in Puerto Rico to demilitarize the community as a “textbook case” of mobilizing a community to demand policies that reflect the best interest of the community. In the village I am working in, I would first collaborate with the community to identify the cause of the noise and environmental contamination as well as the key players involved. I would then meet the village where they are with any current or previous organization and advocacy plans, and begin to incorporate their human rights into their existing structure if they are not already included. As was important to the campaign in Vieques, the assertion that health is a basic human right will act as a foundation to make change in this community. Also central to community organizing around health and safety are education and the connection of different networks. Linking multiple sectors to educate, involve, and inform community members throughout the campaign will be vital in demanding change. As a global social worker, helping the village organize in a productive way is one way to promote their health and environmental justice.

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  28. Across the world, at least 2 million women and girls are estimated to live with vaginal fistulas, with up to 100,000 new cases each year (Gatwiri & Fraser, 2017). Yet, the magnitude of the problem is likely to be much higher, given this figure is only based on the number of women who seek treatment in hospitals, while so may of the women who suffer from them live in remote areas where access to health care is very limited or not accessible at all (Gatwiri & Fraser, 2017).
    Women with vaginal fistulas often report physical irregularities in the genital areas, such as foul-smelling pus and blood in their urine, which can cause infections (Banke-Thomas et al., 2013). Incontinence is also common among women with fistulas, which can dramatically diminish self-esteem and alter women’s relationships to their own bodies. Though these symptoms are often not likely to be life threatening, they are overwhelmingly devastating, and lead to many socio-cultural and economic consequences (Gatwiri & Fraser, 2017). Most women who suffer from vaginal fistula are incapacitates by these consequences, which make it nearly impossible to perform daily activities such as farming, socializing and sexual intimacy (Gatwiri & Fraser, 2017). Inadequate and inaccurate reproductive sexual health education is one of the many reasons this problem occurs. Because girls and women with vaginal fistulas are often unable to control their bodily functions, they may be mistakenly thought to have venereal disease, which is interpreted as a sign of infidelity. This then leads to them being divorced by their husbands, shunned by their communities and unable to work or care for their families (Gatwiri & Fraser, 2017). A few studies have reported that with additional social support and counselling, women living with vaginal fistulas can successfully reintegrate back into their communities following a fistula repair (Ahmed and Holtz, 2007). However, this will take a lot of work, including educating communities in the causes, which are primarily childbirth and sexual abuse, and symptoms of vaginal fistulas, removing the misinformation that discriminates against sufferers, and allowing family members, friends and communities to support rather than shunning those afflicted (Gatwiri & Fraser, 2017). On an even greater scale, injuries and deaths caused by complications during pregnancy and child birth, including fistulas, claim one in every thirteen women in Sub-Saharan Africa (Healy, 2008).

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    3. As a global social worker, I would first heavily advocate for affected women to be linked with treatment, counseling, and other resources necessary for them to access health services. I would cultivate community education surrounding injuries related to childbirth and their prevention. Part of this education would be to humanize the process as much as possible, to avoid causing more psychological pain than clients are already experiencing. Recently, the Kenyan government has initiated a program where local social workers identify traditional birth attendants working in remote areas to be trained in basic birthing practices, including how to manage birthing complications. Reducing the risks of labor is important because doctors and hospitals are largely inaccessible for women living in remote villages and who experience complications in their labor (Ministry of Health and UNFPA, 2004). To ensure the safety of the women and their children, further work is still needed to ensure that traditional birth attendants do not provide inaccurate advice or rely on antiquated practices that carry additional risks of developing a vaginal fistula (Ministry of Health and UNFPA, 2004). For example, traditional birth attendants often advise women struggling in labor to drink a lot water. This does not help with the delivery of the baby, but can lead to the rupture of the bladder, making vaginal fistula more likely. In the Democratic Republic of the Congo, HEAL Africa is one of the three referral hospitals and provides a lot of community development efforts surrounding healthcare for women and children in Africa.
      Ahmed, S. and S. Holtz (2007) ‘Social and Economic Consequences of Obstetric Fistula: Life Changed Forever?’, International Journal of Gynecology & Obstetrics 99: S10–5.
      Banke-Thomas, A.O., S.F. Kouraogo, A. Siribie, H.B. Taddese and J.E. Mueller (2013) ‘Knowledge of Obstetric Fistula Prevention Amongst Young Women in Urban and Rural Burkina Faso: A CrossSectional Study’, PLoS ONE 8: e85921.
      Gatwiri, G., & Fraser, H. (2017). Putting vaginal fistulas on the international social work map: A critical perspective. International Social Work, 60(4), 1039-1050.
      Ministry of Health and United Nations Populations Fund (UNFPA). (2004) ‘Ministry of Health Division of Reproductive Health and UNFPA Kenya Needs Assessment of Obstetric’, Available online at: http:// countryoffice.unfpa.org/kenya/drive/Fistula_Assessment_docs.pdf
      Highly Recommend checking out this website about public and community health intuitives in the Democratic Republic of the Congo- https://healafrica.org/

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    4. My post was too long so I split it up in the comment section! Sorry for any confusion.

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  29. If I were airlifted into a village with HIV-infected persons suffering from stigma, I would take a few different actions.
    First, I would take time to understand as fully as possible what HIV is, how people are affected by it (directly or indirectly), any possible courses of treatment, and finally what the stigma is and where it comes from. As social workers, our job is to help individuals, families, and communities cope with problems they are facing in an attempt to improve their lives—this is not work that can be done in ignorance. Only by educating myself on the problems facing patients will I be able to potentially, and hopefully, improve their quality of life.
    Next, I would work to educate the village about the illness as a way of normalizing it. Castro and Farmer write in their study of AIDS-related stigma in Haiti that, “[s]tigma and discrimination are part of complex systems of beliefs about illness and disease that are often grounded in social inequalities” (2005). The key word in that statement is “beliefs”. Stigmas and discriminatory actions come into play when false ideas or concepts of a group of people or a disease are popularized, often out of fear or lack of education. Unfortunately, many underdeveloped or impoverished countries lack the proper literature needed to understand (1) the source(s) of infection, (2) the implications of the infection, and (3) treatment methods. The confusion leads to “barriers” in introducing test and treatment centers, leaving those infected with nowhere to turn (Castro & Farmer 2005 p.53). Since HIV and AIDS affect such a large population of people worldwide, they should be discussed openly, especially in areas such as this village where there is such a high prevalence. It would be important to keep in mind though that many small villages or Eastern countries view sex and sexually transmitted diseases as forbidden topics and can be part of the reason for the lack of education on topics such as these. In situations similar to this, I would still stress the importance of being educated on safe sex and push to educate the people of this village about HIV/AIDS as a way of reducing the stigma, but I would approach it strictly in an informational manner, keeping out any discussion about my own or Western views of sex.
    Castro and Farmer found that in Haiti, quality care of HIV, including social services, led to a reduction in the stigma, encouraging more people to be tested for the disease (2005). I think that this shows the importance that conversation can have on issues that seem so large and maybe even impossible to enact change for. HIV/AIDS are preventable and treatable diseases and I believe that introducing proper education and conversation can allow for reduction of stigma as well as HIV itself.

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  31. I tried to imagine myself being brought by plane to a remote village full of different problems. From all the problems I had chosen one, which seemed to be solvable. The problem – HIV infected people who suffer from shame. Being a social worker my aim was to use a proper method to help people there.
    As the basic of my help I had chosen a scientific article ”Understanding and Addrestanding AIDS –related Stigma: From Anthropological Theory to Clinical Practise in Haiti”. I strongly believe that on the basis of real practice, done in Haiti, I can try this method to help my clients.
    For the past several years, diverse and often confused concepts of stigma have been invoked in discussions on AIDS. Many have argued compellingly that AIDS-related stigma acts as a barrier to voluntary counseling and testing. Less compelling are observations regarding the source of stigma or its role in decreasing interest in HIV care.
    It is obvious that HIM/AIDS influences the discrimination of the ill people. That’s why UNO (United Nations Organization) show necessity to fight against stigma in order to fight against HIV/AIDS. Nevertheless, the description of stigma is not cleared out. Stigma and discrimination are part of complex systems of beliefs about illness and diseases that are often grounded in social inequalities. Indeed, stigma is often just the tip of the iceberg; because it is visible and generally accepted in public health discourse without further qualification.
    The story tells about a man, who was counted as poor but used to have a shop. All this 4 children could attend school. He even was helpful to other families and his own sister. After he got ill the situation had changed: his children had to quit school because his wife couldn’t afford to pay for school and after all this his wife left him. After his physical status had changed (Samuel started coughing, lost a lot of weight, could not swallow food) people stopped buying goods in his shop. And having used all his savings for treatment, he made his life quality better, regained his physical strength, normal skin color. Even he managed to return his family and job back.
    According Samuel’s experience we can state, that medical treatment can help people live normal life even being infected by untreatable illness, when it is under control. More than 25 years ago HIV diagnosis was equal to death penalty. A great curing passion had been achieved: anti-rethroviral treatment effectively suppresses reproduction of virus .So that people infected with HIV can have possibility to live almost full rate life. There are the links mentioned by Samuel: proper HIV care can transform a disfiguring and consumptive disease into a manageable condition that is invisible to one’s consociates. Integrating people living with HIV into the workforce of a community health program—around 5% of our current staff are persons living with HIV—permits them to receive comprehensive care, send their children to school, and earn steady wages. Further, the demonstrably favorable response of Samuel and others to HAART has sparked interest in voluntary counseling and testing. Together, these processes have contributed to lessening the impact of the AIDS stigma).
    Being a social worker and wanting to help HIV infected people in the village and to lessen bullying, I should educate all locals, that HIV ill people are not dangerous to them. They are the same people as others, having the same rights to full life. I would try to make local feel the same as those infected ones, in order to understand, how awful it is to suffer from bullying and discrimination because of the illness. It might have effect on understanding, how cruel is their behavior against the ill people.
    My other goal should be to make all ill people help themselves finding each other in orders to discuss their life problems, experiences, advise how to fight and control the illness. I should involve people who had managed to stabilize their illness to become volunteers as Samuel did.

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  34. HIV infection is not only a medical, but also a psychological, social, economic, legal problem, because the main way of spreading in society is associated with a certain number of reprehensible behaviors and lifestyles. Infected with HIV are confronted with psychological problems, various limitations, constraints and losses, which have a significant impact on their quality of life, causing depressive states. The majority of the public believes that it is possible to avoid this disease if a person behaves morally, so the attitude towards the proportion of people with HIV infection is particularly stigmatizing and negative.
    Stigma, the concept of which was introduced by Goffman (1963), is such a phenomenon where a person has some physical, psychological or social sign of devotion, a sign, and that sign (stigma) is distinctly different from culturally established norms. Society members are unwilling to contact stigmatized groups and reject them. According to Berger, Ferrans and Lashley (2001), two factors contribute to the stigma of HIV: the individual's perception of the public's attitude towards HIV and the perception that he / she is living with HIV. The authors claims that, the main perception of HIV stigma is how a person infected with HIV accepts the possible social exclusion, restriction of opportunities, and settles with negative changes in social identity. Infected with HIV, their relatives, carers and caregivers are often rejected, disregarded by health care, the social environment and the community forced to leave their homes or work, and become victims of violence.
    Every day, 14,000 people are infected with the virus and 8,000 people die of HIV every minute. HIV is most prevalent in Africa, which is below the poverty line. One of the factors behind the rapid spread is that negative public attitudes, religious beliefs and other cultural and ethical attitudes reduce the effectiveness and efforts of HIV prevention, as well as the lack of preventive measures, which represent the lowest percentage of vulnerable groups in the world (Assembly, UN Declaration of Commitment on HIV / AIDS).

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  35. As a social worker, I would like to work with the principle of subsidiarity, based on a holistic approach to the person, with respect for dignity and worthiness, when working with HIV patients. Applying this principle, each person's (client's) problems are solved individually, avoiding scrambling and anonymity. The client is viewed as a whole, without distinguishing the person from his immediate environment. The most important and essential aspect of the application of the principle of subsidiarity is the protection of the dignity and natural rights of a person (Petružytė, Girdzijauskienė, Gvaldaitė, 2015). Providing people with support and counseling services will not take into account their age, gender, sexual orientation, nationality, lifestyle or social status. Counseling is not an attempt to force a person to obey certain "acceptable" standards and lead them in life. It is a faster process where the client faces a daunting task - to honestly review their values and behaviors and decide how they can change.
    I would seek cooperation with rural health and mental health care providers to provide uninterrupted health care, ensuring all health-related preventive measures to ensure the well-being of the physical and mental health of the sick person. Also, I would defend and represent interests in state institutions, seeking to integrate people into society. I prepared individual or group therapies with support, continued listening, and helping people express their thoughts. If necessary, I would focus on mutual assistance groups, where they would also receive support and strength. Mutual support groups and networks allow you to experience a sense of personal solidarity and understanding that you may sometimes feel unaware of from other professionals. Members of these groups have the opportunity to share experiences and discuss issues openly, which compensates for the feelings caused by exclusion, fear and despair. It is also possible to involve not only the HIV infected people themselves, but also their relatives in the activities of the mutual assistance and support groups. In order to reduce the spread of HIV, I organized community lectures, discussion forums during which I informed members of the rural community about HIV, and its effective prevention, and I would deny the rumors of widespread disease in the general public.

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  36. HIV infected persons suffering from stigma
    HIV infection is not just problem of the person who get infected by the problem of the society as a whole. It is a sensitive issue to be handled with a lot of care and planning. The issue of HIV infection is prevailing among all communities irrespective of the life style they are engaged in. but the ways in which each one of them approach it looks entirely different according to their living standards. But the stigma faced by the persons with HIV infections prevails in all the groups of people. It is common to all countries and needs to be addressed in all ways possible. Being a social work this issue can be addressed by taking out the possibilities of harms these stigma can cause the society with negative impacts. The person who fears to be stigmatized for being HIV infected may sometimes makes him not to reveal his condition ending up to worsen his condition as well as increasing the chances for spreading the same to many more people. This stigma can also make an individual hesitant to go for treatment. Stigmatizing people for the health condition they are going through is also the violation of the human rights of that particular individual. The person can also end up to be a social threat if the revenge of spreading this it all people possible buds in him out of the stigma he faced in the society. Taking all these issues into account and concerning about the wellbeing of the family of the person infected with HIV the intervention can be planned accordingly. Public sensitizing programs can be conducted on all the aspects of the HIV infection to make the people free from the false beliefs they maintain regarding HIV/AIDS. The family of the HIV infected is utmost important person to sensitize so that they are made capable to support the patient to overcome the psychological issues followed with the knowledge of being infected and to provide the same support throughout for the treatment. Family intervention will help in making the person infected to maintain normal life making him much more motivated and encouraged to live forward. The family intervention is also important to prevent any whether infection in the family. Taking all these concerns and issues into consideration an intervention can be planned in any part of the globe which can spread over to all the society around to make this world a better place to live.

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  37. 1) Imagine you were air-lifted into a village with one of the following problems:
    HIV-infected persons suffering from stigma
    In order to understand what stigma is and how we can apply it to global social work we should first understand the definition. According to Merriam Webster stigma is an identifying mark or characteristic. Stigma is something that takes away from someone's character or reputation. An example might be if someone can no longer get work because use of drugs. Often this negative stereotype leaves an individual shamed and humiliated. What can be done? How can a social worker mitigate and facilitate change from a global perspective?
    According to Understanding and Addressing AIDS-Related Stigma: From Anthropological Theory to Clinical Practice in Haiti article just having aids related stigmas act as a barrier to counselling and testing. Some suggestions the article presents with is quality care that can lead to the reduction of stigma. This includes access to voluntary HIV centers. According to the article research suggest looking at "perceptions and attitudes on a broader perspective and such approaches should seek to improve HIV and AIDS education and to enhance sensitivity and empathy training." Allowing for treatment to be affordable, improve on infrastructure, and create effective ways so individuals who get treatment stay with treatment can help to avoid these same barriers that most villages deal with. Lastly improving clinical experience are all indicative of what a social worker can do to help someone dealing with HIV/AIDS stigma. More participatory workers going to the villages to help and increase awareness.

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    1. Angela Palmer,
      I do support the interventions you have mentioned to remove the stigma related to HIV/AIDS in the society. Along with public sensitization and creation of empathetic view among them, the point you listed out about the affordable treatment and improved infrastructure can all be considered as a resourceful intervention in this account. Above all of these the committed participatory involved of the workers as mentioned by you is also a clearly acceptable criteria for the mere success of the concept to remove the stigma on HIV/AIDS. The part the practitioners as well the service providers had to play regarding the issue in which the person with HIV infection is motivated with friendly and favorable behavior from the service providers. The holistic view you shared here can be considered as a resourceful aspect.

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  38. Usually, if something has a stigma attached to it, there are negative connotations. As an outsider, I would need to know people perceptions of HIV, how much they know about HIV, when did the stigma start and why? etc. I know that in the United States HIV/AIDs was first seen as the gay disease ( it had a double stigma), but as time went on and heterosexual people start getting it too, it made people pause. Today we know much more about the disease and how it spreads. That narrative might not be the case for another county. I would need to do some research on when HIV first became prevalent, what people thought about it and how that has changed over time. I would then talk with people infected with HIV to see how it has affected their life, self-esteem, image, mental health, etc. Once I understand the problem and all of its aspects then I could move more towards potential finding a solution. Which is easier said than done, but not impossible. I would talk about treatment options, lifestyle choices and healthy habits that could improve their quality of life. Creating emotional support( mental health services) for those infected and their families, educating the public on the disease and what it is really like to live with it ( put a face to the disease to create empathy) and trying to change the narrative, mindset, and perceptions of people infected with HIV is also very important. This could be done through conversations, the arts, and media to “normalize” it. One of the greatest reason why there are stigmas is because of ignorance. I believe that education, advocacy, and spreading awareness will be the biggest tools used to create solidarity in the community. I also think that having a safe space where people who are infected can come and just relax is important.

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  39. As I spend more and more time in Honduras and Central America, I can’t help but to think about the ways that economic circumstances and limitations strip many people of basic freedoms and create barriers to necessary resources. In a larger conversation about Development as Freedom, Amartya Sen describes how “The freedom to participate in economic interchange has a basic role in social living” (1999, p.7). The exclusion from this freedom, also called economic unfreedom, is case for most people in Honduras as they have no access to the formal market or formal banking systems. This economic unfreedom breeds social unfreedom, “economic unfreedom, in the form of extreme poverty, can make a person a helpless prey in the violation of other kinds of freedom” (Sen, 1999, p.8). Due to the lack of jobs or opportunities to enter the formal market, these circumstances are cyclical. Folks in these circumstances are not able to build credit, build wealth, save money, grow small businesses, and therefore have limited or no access to resources like medical facilities or higher education.
    How exactly do these people become “helpless prey”? Some quite literally, are preyed on by loan sharks. Many of the small business and the main sources of revenue for folks living in poverty are in outdoor vending markets and food stands. Banks will not offer these small business loans as they are seen as “risky” and “unsafe.” The loan sharks then take advantage of the fact that they have no competition for the micro loans, and charge interest at a criminal rate, usually 20% daily. Aside from robbing the small business owners, these rates never allow small businesses to build credit or build wealth; they do not have opportunities of upward mobility and often end up in debt to these criminals.
    I believe that the freedom of peoples in Honduras will increase if they are given the opportunity to grow economically. Making credit more readily available to people will help to grow their economic freedom. Additionally, people need the opportunity to get out from under the oppressive money lenders. The way for this to happen is by increasing the competition in the micro lending market and introducing more and more legitimate micro lending platforms. If there are more money lenders and more competition, the conditions and rates will get better and be more fair. Lifting restrictions for this process is not always the answer. It can benefit for the process to instead become more formal, in order to eliminate the criminal loan sharks in the informal market. All of these efforts however, fall mostly under the business sphere.
    So where do social workers play a role? I think that there needs to be far more education around safe money lenders, lending platforms, and resources for growing a small business. I think that social workers can play a role in this education by means of case management in a social services office that offers advising, consulting, or pro bono legal aid to low income people. It could be staffed by lawyers and social workers. This way people can be protected from getting robbed by predators in the informal market and can have concrete steps to building a legitimate business that can enter the formal market, help them to grow personal wealth, start saving, and eventually aid them in economic and social freedoms.

    Sen, Amartya. (1999). Development as Freedom. New York: Random House.

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    1. The following is a link to my partner’s micro lending business in Tegucigalpa, Honduras. He started a company that offers loans to small and medium businesses with 6-7% monthly interest (0.2% daily) as compared to loan sharks at 20% daily. They give longer loan repayment periods (loan sharks offer one month) while they offer six. They are primarily focused on helping woman owned small businesses. So far, they have helped hundreds of Hondurans enter a safe and formal lending platform that allows them to build credit and provides them with steps to enter to the formal banking system, save money, have autonomy, and encourages their growth. Some of the success stories can be seen on the website!
      https://www.quipucredit.com/historias-de-xito

      “El acceso a capital es vital para el desarrollo económico. En Quipu nos dedicamos a abrirle las puertas a las pequeñas y medianas empresas. Ellas forman el núcleo y motor de nuestra economía. Por eso, le apostamos a su crecimiento.”

      “Access to capital is vital for economic development. At Quipu we dedicate ourselves to opening doors to small and medium-sized businesses. They form the nucleus and engine of our economy. Therefore, we bet on your growth.”

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    2. “As it happens, the rejection of the freedom to participate in the labor market is one of the ways of keeping people in bondage and captivity, and the battle against the unfreedom of bound labor is important in many third world countries today…The freedom to enter markets can itself be a significant contribution to development” (Amartya Sen, 1999, p. 6).

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