台灣赴非志工旅遊之健康促進與反思-愛女孩計畫個案研究 - 政大學術集成

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(1)International Master’s Program in International Communication Studies College of Communication National Chengchi University. 立. 政 治 大. Master’s Thesis. ‧ 國. 學 ‧. Health Promotion and Voluntourism from Taiwan to Africa:. n. -. Ch. engchi. i n U. Student: Isabel Wang Advisor: Dr. Yi-Chieh Lin. 2016. 07. July 2016. 1. er. io. al. sit. y. Nat. A Reflexive Case Study of Love Binti. v.

(2) National Chengchi University International Master’s Program in International Communication Studies. Master’s Thesis Thesis Title Health Promotion and Voluntourism from Taiwan to Africa: A Reflexive Case Study of Love Binti. 立. Name. 政 治 -大. Isabel Wang. ‧ 國. 學. ‧. This is hereby certified that this Master’s Thesis has successfully passed the final defense. n. er. io. sit. y. Nat. al. Ch. engchi. 2. i n U. v.

(3) Acknowledgments Time has passed so fast that I could not believe my master study is coming to its end. Looking back from struggling with the thesis topic at first, to volunteer in Kenya for research study, it was still a dream for me. With two years filled of amazement and incredibility, IMICS has enlightened me academically as well as practically. Firstly, I would like to thank my thesis advisor, Professor Yi-Chieh Lin for guiding me along the way with patience and being the mentor not only to thesis writing but also in career searching. I would also like to thank my committee. 政 治 大. members Professor Mei-Ling Hsu and Professor Bradley Chen for the useful advices and support on my thesis.. 立. Secondly, since my thesis focuses on the Love Binti volunteer-tourists’. ‧ 國. 學. reflexivity experience from Taiwan to Africa, I had the opportunity to volunteer with. ‧. them and the organizers. Special thanks goes to the informants who spared time. y. Nat. taking my interview questions and delivering viewpoints for the nongovernmental. er. io. sit. sphere. Also, to the organizers from Step 30 and Love Binti that I have encountered within both Taiwan and Kenya. This thesis is also dedicating to my family members,. al. n. v i n C h me economicallyUand spiritually. Though casting especially my parents for supporting engchi doubts upon thinking of whether being a voluntourist in Kenya will be safe or not,. they still supported me wholeheartedly to listen to the inner voice and chase after what my heart goes to. Finally, I would also want to thank my classmates from IMICS for giving me suggestions on thesis writing and cheering me up when facing difficulties in between. You are the family members to me, a safe harbor where I know I can go to. Here is a quote to all of you: “Be fearless in the pursuit of what sets your soul on fire.”. 3.

(4) Abstract This study delves into a gender-specific health campaign in Kenya by Love Binti, a self-identified Taiwanese organized voluntary group. The campaign targets at transferring techniques of reusable sanitary pad making and teaching African women the correct knowledge about menstruation. Menstruation is a landmark event signifying the transition of young girls into womanhood; yet, the added complexity of the event occurring in a developing area remains understudied. Based on participant observation, this study is a qualitative analysis exploring the utilization of health. 政 治 大 itineraries to its target audiences 立 in the Kitale Province of Western Kenya. Besides. promotion strategies and analyzes the role of volunteer tourism via Love Binti’s. ‧ 國. 學. participant observation, the researcher also utilizes field notes, and in-depth interviews with Love Binti’s stakeholders (e.g. volunteers, organizers, funders). ‧. performing humanitarian aids in Kenya. Three probed levels include different factors. sit. y. Nat. that affect health communication: personal level (e.g. values, attitudes), social. al. er. io. structural (community, government), and cross-cultural levels. This study casts light. v. n. on the process of empowering the underprivileged African population in. Ch. engchi. i n U. community-based projects. While incorporating theories from volunteer tourism, the projects are established for the at-risk population of improving health, increasing life opportunities, and participating in the decision-making process.. Keywords: non-governmental organization, voluntourism, health communication, Kenya, participant observation. 4.

(5) Table of Contents Acknowledgments……………………………………………………………………i Abstract………………………………………………………………………………ii 1. Introduction………………………………………………………………….6 2. Literature Review…………………………………………………………...12 2.1.Definition of terms……………………………………………………….12 2.2.Love Binti Volunteered Country Portfolio: Kenya……………………….15 2.3.Alternative Development…………………………………………………...18 2.4.Volunteer Tourism/Voluntourism…………………………………………...20 2.5.Health Communication in Perspectives…………………………………24 2.6.Research Settings…………………………………………...……………….29 3. Methodology…………………………………………………………………...33 3.1 Case Study …………………………………………………………………...33 3.2 Participant Observation ……………………………………………………...37 3.3 Secondary data analysis………………………………………………………41 3.4 In-depth interview……………………………………………………………42 3.5 Research process and data collection………………………………………...48 4. Findings………………………………………………………………….............50 4.1.The practicality of voluntourists…………………………………………51 4.1.1 The purpose of volunteer trips………………………………………51 4.1.2 The role of voluntourists in Love Binti, Step 30………………………52 4.1.3 Voluntourists engagement in resource poor settings of improving health conditions…………………………………………………………56 4.2.Language and culture as hindrance? ………………………………………58 4.2.1 Imaginative “othering” of the voluntourists by the local community…59 4.2.2 The recreation of neo-colonialism by the voluntourists? ………62. 立. 政 治 大. ‧. ‧ 國. 學. n. er. io. sit. y. Nat. al. Ch. engchi. i n U. v. 4.2.3 The development of a sense of community…………………….…….63 4.3.Voluntourists’ responses to Love Binti……………………………………….65 4.3.1Voluntoursits complexity: volunteering or sightseeing?............…………66 4.3.2Voluntourists’ take on money spent to Love Binti…………………67 4.3.3 Voluntourists take on public relations of Love Binti……………………68 4.4 A call for bureaucratic attention…………………………………………...…70 5. Conclusion…………………………………………………………………...…72 5.1 Owing the community from within…………………………………….........72 5.2 Limitations and suggestions………………………………………………….77 References……………………………………………………………………….......79 Appendices…………………………………………………………………………86. 5.

(6) 1. Introduction Protecting the population’s health is not primarily a medical problem, but socio-political, cultural, and economic factors pose the major impediment to the poor accessing personal agency and interfere with abilities to access basic needs. Despite the globe has generally become “one global village” nowadays (McLuhan, 1989), and foreign aids has been transferred predominantly from rich countries to Africa, poverty created by economic inequalities and other reasons still prevent the poor from ameliorating diseases and increasing their wellbeing.. 政 治 大 as “the cradle of mankind,” the research also aims to stimulate discussion about an 立 To access to the poor and rural female population living in Kenya, Africa, known. alternative path of health communication from Asia to Africa that is different from the. ‧ 國. 學. West-dominated health communication campaigns. Scholars have raised questions. ‧. about Western culture’s focus on individualism and materialism potentially pose. y. Nat. hazards to health. They have also criticized on how “the resurgent scientific and. er. io. sit. political interests” have effects of the social environment on health, often associated with socioeconomic inequalities in health-especially with income inequality. al. n. v i n C h from influentialUAfrican researchers are given, (Eckersley, 2006). Similar criticism engchi such as Dambisa Moyo; the author of Dead Aid, Andrew Mwenda; the author and. co-author of other Africa-related journal articles. The realm of promoting international health communication, therefore, suggests to ‘give back’ to ‘needy’ areas. Light in the crack? Crack in the light? In Taiwan, there are only a small handful of initiatives concerning the economically disadvantaged people in the world’s most distressed sub-Saharan Africa, such as Step 30. International Ministries( 6. ), Amitofo.

(7) Care Center(. ), Heart for Africa, Taiwan(. ),. Madufafa in Uganda. In early February of 2016, the annual volunteers gathering of Step 30 and Go To Give Power community (GO. ) was organized to give the. public more knowledge about the women-centered project-Love Binti (. ). This. forum provided an opportunity for me to carry out an intimate conversation with Yu-Jen Yang(. ), the founder of newly formed NGO Step 30, and his Canadian. wife, Kara Remley, the founder of its project Love Binti. Established and run by women, for women, Love Binti is dedicated to helping African female regain their. 政 治 大 other issue-specific projects of Step 30. 立. rights and dignity through proper menstrual hygiene management, along with many. Until nowadays, there are still many girls’ being denied for education owing to. ‧ 國. 學. lacking of sanitary facilities, poor transportation access to school, and restricted social. ‧. norms that deprive girls of pursuing their fundamental rights. United Nations. y. Nat. Children’s Emergency Fund (UNICEF) states the fact that menstruation affects girls’. er. io. sit. school participation and performance for feeling stressed and ashamed of being “dirty” in the occurrence of the monthly period, especially those in sub-Saharan Africa. The. al. n. v i n symptom leads to the prevalentCphenomenon that one h e n g c h i Uout of ten African schoolgirls skipping or dropping out of school when suffering from the monthly period. Many. African females, without the correct knowledge of menstruation and incapable of affording proper menstrual products, rely on crude, implausible materials (e.g. toilet paper, animal skin, old clothing, foam mattress) to manage their period. Besides, locals perceive menstruation as “problems,” which is utterly unhygienic, ineffective, and uncomfortable. Lacking education and resources has resulted in that 4.5% of Kenyan girls in slums are cheated into engaging in transactional sex or sexually exploited to earn money for basic feminine supplies like pads, which increases the risk of HIV and pregnancy (Step30; 2016). 7.

(8) Halting the spread of HIV/AIDS was set to be one of the eight target goals in the United Nations’ The Millennium Development Goals (MDGs) by 2015, and it is further ratified in the United Nations’ The Sustainable Development Goals (SDGs) Target 6.2, which also acknowledges menstrual health requirements as a major issue. SDG emphasizes “adequate and equitable sanitation and hygiene for all” with “special attention to the needs of women and girls.” This study aims to conduct a qualitative analysis of how Love Binti utilizes health promotion strategies and arranges the itineraries for the volunteer tourists to. 政 治 大 analysis during the process of volunteer tourism to analyze the different factors that 立. offer guidance for women-centered NGO projects. This study provides a reflexive. affect health communication at the personal level (e.g. values, attitudes), social. ‧ 國. 學. structural (community, government) and cross-cultural levels. Theories from. ‧. volunteer tourism are further incorporated to understand how to empower the. y. sit. io. er. population.. Nat. underprivileged Kenyan women in community-based projects created for an at-risk. Health Communication and Promotion. al. n. v i n C h should be U “communication” explained engchi. The meaning of. first before defining. “health communication.” Communication appears when information is imparted then shared with others. It is defined as the information transferred between the source and receivers; a set of common rules used; a process of sharing meanings (Northouse and Northouse, 1998). Communication is important to the promotion of health because information helps to make informed decisions, provides knowledge and understanding. It gives patients the power and confidence to engage as partners with their health service (Department of Health, 2004). Health communication concerns all aspects of human communication related to health. Rogers (1996, p. 15) defined health communication as “any human communication whose content is concerned with 8.

(9) health,” focusing on health-related transactions and factors that make the impacts. Health communication in the 21st century however, is considered as an integral part of most public health interventions to improve health conditions through fostering behavior modification and social change (Bernhardt, 2004); full understanding and involvement of the target audiences are relied upon its comprehensive approach (Schiavo, 2013). Health promotion, on the other hand, generally means any event, process or activity that facilitates individuals, groups, communities or populations’ protection. 政 治 大 formal definition offered by WHO, is “the process of enabling people to increase 立 and improvement of the health status (Marks et al., 2000). Health promotion, in the. control over, and to improve, their health. It moves beyond a focus on individual. ‧ 國. 學. behavior towards a wide range of social and environmental interventions.” To pursue. ‧. more effective health promotion, school health programs can be proven as the most. y. Nat. cost-effective investments a nation makes to advance education and health. er. io. sit. simultaneously. Not only WHO are promoting school health programs to reduce health risks among youth, numerous forms of organizations have seemed to make. n. al. efforts to engage education. i n C h that can eventually sectors engchi U. v. change the educational,. economic, political, and social situations that cause health risks. Contested Voluntourism When acting of health-motivated projects in and out of nations, terms like “tourism,” “outsourcing,” “migration,” and “exile” are frequently adopted by media, political, and academic studies. Medical voluntourism, a growing trend of volunteer vacations or “voluntouring,” is a hot topic in the Western countries. The estimated market share volunteer tourism contributes is US$2 billion annually to the world economy (TRAM, 2008). Under growing phenomenon in Taiwan through recent years, laypeople in voluntourism in communicating health remained neglected in the 9.

(10) academic field. Undoubtedly, as a volunteer, all the benevolent gestures are perceived as bringing the local communities positive influences, and the feel-good bursts of service give the volunteer pleasure without contesting the relationship between voluntourists and host community or the impact toward the host community. It is important for a voluntourist being constantly attentive to detail and reflect on purposes of volunteering and one’s motivations. Kenya, as the Taiwanese NGO volunteered destination, is often portrayed by media as a “victimized” country, where massacre, blasts, political conflicts, and poverty remain consistent issues waiting for. 政 治 大 appearance of Kenya’s major cities (Nairobi, Mombasa, Nakuru, Kisumu, Eldoret) 立 rescue. However, with abundant of foreign aid flooding to save the country, the. has transformed majestically. As Kenya is becoming more of a developing country,. ‧ 國. 學. all NGOs should reflect on adopting new ways of cooperating health communication. ‧. with Kenya while the voluntourism industry is booming. Hence, through my desire. y. Nat. for understanding and further challenge voluntourism in health communication, the. er. io. sit. itinerary designed especially for laypeople volunteering, this work aims to illustrate a thoughtful analysis on health voluntourism as a complex industry involved. al. n. v i n C h relations byUraising three sets of research sub-culture ethnicities and cross-cultural engchi questions as followed:. Research Question Set 1. In general, what are the characteristics of the actions of Taiwan-based NGO Love Binti (. ) in terms of health communication. delivering to the target group in Kenya? What are the factors that influence the communication of the Taiwanese voluntourists with the beneficiaries in Kenya at the interpersonal level (e.g. value, identity, emotions, cultural belief, attitudes)? Research Question Set 2. In terms of cross-cultural communication, how does Love. Binti utilize health communication messages and strategic health. education to adapt to the local contexts in Kenya? What are the cultural barriers 10.

(11) the Taiwanese voluntourists have to face while doing voluntary works in Africa (e.g. social norms, cultural differences, structure or pressure from communities)? Do they perform shared decision making with the local communities? Research Question Set 3. How are the difficulties resolved by Love Binti and its Taiwanese voluntourists with the target groups when in Africa? What are the adopted resources, skills, opportunities, and abilities? What are the outcomes of the ‘voluntoursim’ of Love Binti as a path of an alternative development in terms of improving the communities’ health condition abroad (perceived by. 政 治 大 communication designs and different channels to deliver knowledge and increase 立 voluntourists)? What are their message features? What are the interactive. health literacy?. ‧ 國. 學. Thus, to pursue the answers to the research questions, field research and. ‧. in-depth interviews are the primary research methodologies on the subject matter. The. y. Nat. study aims to discuss delivering efficient health communication, promotions, and. er. io. sit. problem-solving strategies through developing hands-on voluntourism observations; discovering how Taiwan’s NGO project team travel to the developing world in the. al. n. v i n C hincrease life opportunities, hope of helping to improve health, and regain the African engchi U under-privileged population’s rights of participating in decision-making.. 11.

(12) 2. Literature Review This chapter aims to review the precedent theories and literature most frequently used to guide program design, implementation or develop evaluation measures in making this study of a solid base. Theories and models in health communication promotion can guide program design or implementation or select program measures (Trifilentti et al., 2005; 299). Separated into four domains of how to culturally appropriateness in achieving health communication, this chapter first offers dispositions of terms appeared in the study, followed by a contextualization of. 政 治 大 development that steers the attention to the new practices, actors, and networks of 立 Kenya’s profile. The chapter then discusses voluntourism as an alternative path of. preference of its research settings and audiences.. Nongovernmental organization. y. Nat. 2.1.1. ‧. 2.1 Definition of terms. 學. ‧ 國. global health promotion. Health communication in perspectives is followed by the. er. io. sit. NGO is an abbreviation for the nongovernmental organization, sometimes regarded as the synonym for “nonprofit organizations” or vice versa. The distinct. al. n. v i n Clatter difference of these terms is the a wider range of organizations and U h e nincludes i h gc institutions like the museum, hospitals, and universities; whereas the former is. significantly committed to advocacy. Traced back to 1945 is the time when the term “NGO” was first coined, created by the United Nations for the purpose of approving specialized international non-state agencies granted as observer status at UN’s assemblies and side meetings. Thereafter, the clearer definition of “International NGO” (INGO) is first illustrated in resolution 288 (X) of United Nations Economic and Social Council (ECOSOC), articulated as “any international organization that is not founded by an international treaty.” (Tkalac, A., & Pavicic, J. 2003). 12.

(13) The purpose of NGOs can be different from its focus domain including subject matters of agriculture, education, women rights, environmental protection, health, and general development closely bind with our daily life. Although NGOs are often criticized of being Utopian, antagonistic to governments, and potentially obstructions (Dichter, 1999); however, they do succeed in resolving cases governmental institutions or governments considered “too hot to handle,” such as human rights, ecology, international democracy and so on, where most of the scenario-unwilling to involve. The term NGO states for private, non-partisan and non-profitable. 政 治 大 cultivating public awareness of certain topics, and to further having the public to 立 establishments to implement humanitarian functions. The functions of NGOs are. support or involve in the social activities.. ‧ 國. 學. 2.1.2 Humanitarian Assistances. ‧. Humanitarian aids in international arena seeking to save lives and alleviate the. y. Nat. suffering of a crisis-affected population. Crisis result from natural or man-made. er. io. sit. disasters that the sovereignty of States has no resilient capacities to rebuild. As stated in General Assembly Resolution 46/182 of United Nations, humanitarian assistance. al. n. v i n must be provided in accordanceCwith the basic humanitarian principles of humanity, hengchi U. impartiality, and neutrality. In addition, the UN seeks to provide humanitarian. assistance with full respect for the sovereignty of States. However, the principles of conducting international humanitarian assistances should be emphasizing on “assistance” and “support” differing from what the local needs and teach them to help themselves instead of passively receiving the aids and assistances from the aid-providing countries. 2.1.3 Menstrual Hygiene Management (MHM) and Human Rights. 13.

(14) Menstruation is the natural monthly occurrence in healthy adolescent girls between the ages of 8 and 16 and pre-menopausal adult women, resulting in averagely about 3,000 days of menstruation in a woman’s lifetime. Menstrual hygiene is fundamental to the dignity and wellbeing of women and girls, and their access to basic hygiene, sanitation and reproductive health services remain critical. However, menstruation, in negative cultural attitudes linkages, is vastly considered taboo. Menstrual hygiene management (MHM) is defined as “women and adolescent girls use a clean material to absorb or collect menstrual blood, and this material can be. 政 治 大 using soap and water for washing the body as required; and having access to facilities 立 changed in privacy as often as necessary for the duration of menstruation period,. to dispose of used menstrual management materials” (UNICEF and WHO, 2012).. ‧ 國. 學. Human rights have long been the focal point of the UN’s agenda when. ‧. formulated, and the successful raising levels of respect for many of the individual. sit. y. Nat. right as defined in the 1948 Universal Declaration. "If there is one message that. io. er. echoes forth from this conference, let it be that human rights are women's rights and. al. women's rights are human rights, once and for all,” said by Hillary Clinton in the. n. v i n Ch United Nations Fourth World Conference Women i U in Beijing, 1995. The World e n gonc h. Conference on Human Rights reaffirmed clearly that “the human rights of women throughout the life cycle are an inalienable, integral, and indivisible part of universal human rights.” Breaking the silence on issues surround MHM requires great devotions breaking the social norms, taboos, cultural habitations and deliver communication in health promotion successfully as well as efficiently.. 14.

(15) 2.2 Love. Binti Volunteered Country Portfolio: Kenya Cradle of mankind The Republic of Kenya locates in Eastern Africa: Ethiopia to the north, Somalia to the northeast, Tanzania to the south, Uganda to the west, and Sudan to the northwest, with the Indian Ocean traversing its southeast border. Kenya’s official languages are Kiswahili and English, while other unofficial indigenous languages are still being spoken. With an estimated population of 44.03 million, Kenya consists of 42 ethnic communities and is the forty-seventh largest country in the world. In term of. 政 治 大 that around 11.1 percent of the population adheres to Islam, while the rest still 立 religion beliefs, a large majority of Kenyans are Christian (82.5%), but it is estimated. practice indigenous beliefs widely. Kenya is also rich in pre-historical heritage that. ‧ 國. 學. holds evidence of man’s earliest settlement, preserve most fossil human remains, and. ‧. sites scattered along the Rift Valley (north to south) and western Kenya.. y. Nat. Political and economic profile. io. sit. Ruled by British from 1890 to 1963, Kenya had regained its full independence. er. on December 12th, 1963 when the Kenya African National Union (KANU) won the. al. n. v i n election in May same year, andC has enjoyed a stable governance since then. Although hengchi U there are some riots occurred against the one-party dominant situation, overall, the. power is transferred peacefully from the single party to a new coalition party. According to Freitag, A. R., & Stokes, A. Q. (2009), the more stable the government, the greater opportunities for the dialogic communication that characterizes contemporary practice. Kenya’s capital, Nairobi, is a regional commercial hub for trade, communication, and finance in East Africa. The economy of Kenya is the largest by its annual gross domestic product (GDP) in East and Central Africa. Agriculture is a major employer; the country traditionally exports tea and coffee. The service industry is also a major. 15.

(16) economic driver. In addition, Kenya is a member of the East African Community trading bloc. Although the country reaps the benefits of rapid economic growth credited to the remarkable political stability since independency; however, Kajwang (2002) criticizes that the country’s economic growth is limited owing to the weak commodity prices, endemic corruption, low investor confidence, meager donor support, and political infighting. More than half of Kenyans still live below the poverty line, with a high unemployment rate of 40 percent and a huge public debt of 51 percent of the GDP. The quality of life in Kenya is low, with a life expectancy at. 政 治 大. birth of 47.5 years and a GDP per capita (PPP) of USD 1,140 (Mbeke, 2009). Socio-cultural profile. 立. According to Greet Hofstede (2001), who coins “the theory of cultural. ‧ 國. 學. dimensions” to understand society differences in power distance (the extent of less. ‧. powerful organization and institution members accept and expect power is equally. y. Nat. distributed), uncertainty avoidance (the degree of a society tolerating uncertainty and. er. io. sit. ambiguity), and individualism/ collectivism (how well individuals are integrated into groups and the sense of belongings), African societies are high in power distance,. al. n. v i n C hbelong to collectivist high in uncertainty avoidance, and cultures. Edward Hall (1959), engchi U. a prestigious cultural anthropologist, also introduces the high and low context cultures. where African countries are shown to incline to the former. This means that many African societies rely much on nonverbal and implicit messages that need a profound understanding of the society to understand better. Kenya is well known for the decent tourist infrastructure and a lot of beach resorts along its coastline. Despite being under the official Travel Warning list in several countries including Taiwan, R.O.C. for its continuing and recently heightened threats from terrorism and the high rate of violent crime in some areas; mostly near the boarders or coasts side, Kenya remains a testament to its many natural attractions that tourists continue to visit.. 16.

(17) Urban-rural Disparity Upon being the most favorable country performing flying colors on several development indexes among the East African countries, poverty alleviation remains an agenda since more than three-quarters of the Kenyans are living in the rural areas. Under such premises, most UN agencies and international NGOs and multilateral monetary organizations are not only making presences in those areas delivering monetary aids but also establishing programs related to capacity building of making the rural Kenyans running smallholder household business, which takes accounts of its majority agricultural output. Sex and Gender. 立. 政 治 大. Women are central to the entire development process. Kenya's women have been. ‧ 國. 學. subjugated to consistent rights abuses while shouldering overwhelming amount of. ‧. responsibilities than men throughout the country’s history. Kenyan women provide 80. y. Nat. percent of the country’s farm labor and manage 40 percent of the country’s. er. io. sit. smallholder farms, yet they own only roughly 1 percent of agricultural land and receive just 10 percent of available credit (USAID Support for Gender Equality in. n. al. Kenya Fact Sheet, 2015).. v i n C h and young people Women have engchi U. great potentials for. contributing to economic development and social progress if they are able to fulfill their potential. They are the de facto in improving Kenya’s rural-urban poverty, yet received. limited. rights. and. often. underrepresented. in. decision-making. positions. What’s worse, women living in rural Kenya spend long hours collecting water and firewood; interfering with school attendance keeping them to be educated at a mediocre rate to their counterparts, which results in women’s increasing reliance on men. No matter which social class, religion, or ethnic group the women belong to, throughout Kenya, they are still restricted from owning, acquiring, and controlling property. If attempting to assert property rights over men or in-laws, women are often. 17.

(18) ostracized by their families and communities. Rural women are especially vulnerable to the disease because they do not have equal access to social and economic resources as men, which leads to lower knowledge level and less freedom of making their own sexuality-related decisions. Although the number of AIDS-related deaths in Kenya has dropped drastically by 32% to 58,000 in 2013, compared to 2009 (AVERT, 2014), rural areas remain a concern, with potential for a further rise (Guwatudde et al., 2009; Tumushabe, 2006). The challenges for uncircumcised men living in the Africa’s AIDS belt increase. 政 治 大 acquired immunodeficiency syndrome (AIDS). AIDS belt indicates areas with highest 立 greater risks for women suffer from infectious diseases, raise the impacts of HIV/. percentages of HIV cases: Botswana, Burundi, Central African Republic, Kenya,. ‧ 國. 學. Malawi, Rwanda, Southern Sudan, Uganda, and Zambia. The UN Human. ‧. Development Report (2014) indicated women make up more than half of the nearly. io. er. 2.3 Alternative Development in Kenya/ Africa. sit. y. Nat. 37 million people worldwide living with HIV, most of them in hard-hit Africa.. Alternative development, redefining the goals of development, is people-centered and. al. n. v i n Ch participatory as mainstream development is originally identified with the growth of engchi U gross national product, rise in personal incomes, industrialization, technological. advances, or social modernization. However, high inequality and the restrictions among people lead to the concept of “alternative development.” As Sen (1999) mentioned, removal of major sources of confinement is what alternative development can offer. It can be caused by “poverty as well as tyranny, poor economic opportunities as well as systematic social deprivation, neglect of public facilities as well as intolerance or over activity of repressive states.” Inclusive of public participation, social welfare, benefits for community and minority come first before economic growth (Sen, 1999). Rather than conventional development agents such as. 18.

(19) the state or multilateral institutions, the agents of alternative development are usually considered to be grassroots associations and NGOs, and local people themselves (Bebbington and Bebbington, 2001) Alternative development primarily looks at development from the local and grassroots’ viewpoint; it “looks at development along a vertical axis, from a bottom-up point of view” (Pieterse, 1998). In Africa, ever since its decolonization in the 1960s and 70s, the region has struggled economically. Previous studies have shown that some of the ethnically diverse societies have slower economic growth and are more prone to corruption and. 政 治 大 lack of cooperation across ethnic groups, in which hinders national growth (Mauro, 立. political instability than ethnically homogeneous societies due to political conflict and. 1995; Knack and Keefer, 1997). In sub-Saharan Africa, ethnic diversity has had a. ‧ 國. 學. particularly negative impact on economic outcomes which has suffered from a series. ‧. of destructive ethnic conflicts in recent years and is the most ethnically diverse and. y. Nat. the poorest region in the world, argued by Easterly and Levine (1997). The. er. io. sit. resource-poor regions suffer from this cause are facing ill health, which deepen the rural dwellers believe in religion that studies of health communication strategies need. al. n. v i n to be culturally constructed forC its appropriateness (Kreuter h e n g c h i U et al, 2003, p.139). It is. encouraged that health educators should recognize and build on the specific religious. or spiritual aspects that caters to each individual or community interests and needs (ibid). Another impediment of advent alternative development is language and cultural barriers interfered with respectful engagement (DeCamp, 2007; Pinto &Upshur, 2009; White &Cauley, 2006). Since this study is related with the Western Kenyan women’s menstrual management, McMahon (2011) has concluded influential factors are mainly culturally affected (see Figure1). Without an understanding of the cultural context, evidence in Pinto &Upshur (2009) proves that misunderstanding may. 19.

(20) end up with offense, mistrust, or misdiagnose (e.g. a volunteer recommends the use of condoms or sex education without knowing the cultural context).. 立. 政 治 大. ‧. ‧ 國. 學 y. Nat. al. (McMahon et al., 2011). er. io. sit. Figure1. Factors affecting Menstrual management by schoolgirls in western Kenyan. n. v i n Ch In the face of alternative development through volunteer tourism; an immerging engchi U. spectrum of global citizens embark on the health service group as Butcher and Smith (2010, p.30) mentioned voluntourism, and it becomes the product of contemporary ‘life politics’ and the making of “morally justifiable lifestyles.” 2.4 Voluntourism, the power to do good and harm Volunteer-tourism, often at short duration, is an increasing form of alternative travel that attracts research attention in recent years. Combining volunteer and tourism, it refers to activities in which “tourist…volunteer in an organized way” and “undertake holidays that might involve aiding or alleviating the material poverty of some groups in society, the restoration of certain environments or research into. 20.

(21) aspects of society or environment” (Wearing 2001, p.1). As Guttentag (2009) mentioned, the practice of voluntrouism has multiple functions and purposes since voluntourists may arrange an alternative trip with assistance from a range of organizations (i.e. private companies, charities, schools, religious organizations, and NGOs). Many associations, especially NGOs, depend heavily on volunteers to facilitate their operations and as a means of cost down since voluntourism insinuates paying to volunteer abroad. Therefore, carefully constructed media campaigns of delivering sensational, exciting, and exotic are developed in the content of these. 政 治 大 Voluntourism is portrayed as only available to the elite who can not only afford the 立 voluntourist programs, from the travel brochure, news specials, to the websites.. ‘make differences’ in the world (Kass, 2013).. 學. ‧ 國. luxury of paying everything, but also exclusive to ‘truly altruistic people’ aspiring to. ‧. Volunteers’ work performances, compared to paid employees, require fewer skills. y. Nat. or specialized training and are more efficient in completing assigned work in gaining. er. io. sit. proper recognition for the good work they have done (Dunn, 1986). Philip Kotler (1982) contends that “training and work experience is a major motivation for many. al. n. v i n Cstudents especially volunteers h e n gandc hwomen i U. types of volunteers,. who have been. homemakers but intend to reenter the workforce.” The main reason of volunteers volunteering others typically involves altruism to improve the lives of others and potentially notice the opportunity for personal growth and development can be offered (Sin 2009; McIntosh and Zahra 2007). Furthermore, the desire for self-gratification, to travel, and to build a resume are additional motives for voluntourism activities as well (Guttentag 2009, Fischer 2013). Counter arguments for voluntourism have been proposed that voluntourists can be positioned of potentially doing good but create harm to the recipients. Jessye Kass. 21.

(22) (2013) vividly elucidates the ethical challenges of being the voluntourist in Kenya after successfully creating an HIV-positive support group within one week: …there were several problems with its creation in the first place. First of all, as a volunteer, an outsider, what right or authority did I have in creating such a group? Though my intent was to help, I could have done more harm. I was in a position of power where people listened to me because I was a guest, was white and held knowledge of western culture that was idealized by locals in many ways (primarily in being a white savior with wealth). Yet,. 政 治 大 power to preach what I believed was best for the Kenyans I was working 立 by reinforcing western norms, such as support groups, I was using my. with, a notion which could definitely do harm to both their culture and. ‧ 國. 學. tensions between foreigners and locals. Additionally, after beginning the. ‧. group, patients continuously asked me for money. The help they needed. y. Nat. more than a support group was most likely financial, but that was not what I. er. io. sit. was able or willing to give. Yet, they knew I had money, in order to be there, and I could have potentially been reinforcing stereotypes of greedy, rich,. al. n. v i n C hto the needy and thus whites not giving money further jeopardizing mutual engchi U understanding. Though on the outside an HIV-positive support group. sounds nice, it was not without concerns. Where some could argue I created positive social change, others would argue it was not my place to do so, and that I could have or did harm the community. Though this example happens to be outside of Ghana, it still holds the same relevance in terms of an ability for volunteers to harm communities, even if intents are to do good (Kass, J., 2013, p42). Similar to the volunteerism model, voluntourism is more episodic, dynamic,. 22.

(23) task-based, with high turnover rates (Hustinx, 2010) and “loose connections” (Wuthnow, 1998). In such context, recruitment for similar projects mostly takes place online and participants receive little orientation in acquiring practices in the local cultural or health context before performing their mission to improve the health conditions in the served communities. In previous research, cross-border voluntouring faces difficulties toward:(1) ambiguity resulting from discrepancies between volunteers’ own ideology and those of the organization; (2) frustration when the organization lacks the necessary resources for ongoing activity; (3) problems in. 政 治 大 beneficiaries (Fisher & Schaffer, 1993; Kulik, 2007). Guttentag (2009, p537) further 立. coping with beneficiaries’’ suffering; (4) a sense of being unable to help the. explains the concerns as a neglect of locals’ desires caused by lack of local. ‧ 國. 學. involvement; a hindering of work progress and the completion of unsatisfactory work. ‧. caused by volunteers’ lack of skills; a decrease in employment opportunities caused. y. Nat. by the appearance of volunteer labor; a reinforcement of conceptualizations of. er. io. sit. ‘othering’ and rationalizations of poverty caused by the intercultural experiences; and an institution of cultural changes caused by the demonstration effect and actions of. al. n. v i n C h of voluntourismUon both the tourist and the host short-term missionaries. The impacts engchi. community in Table 1 are addressed from literature in abundance depicted by Wright. (2014).. 23.

(24) 政 治 大. Table 1. Impacts of volunteer tourism (Wright, 2014).. 立. A proper learning planning and facilitate in communication between the organization. ‧ 國. 學. and voluntourists is mandatory; moreover, the collaboration with local communities to decide which needed services will be valuable as well as ensure the volunteers see. ‧. the experience in the proper sense, i.e., as an exploratory process (Guttentag 2009).. y. Nat. io. sit. 2.5 Health Communication in Perspectives. n. al. er. Communication in health can be defined in much the same way as. Ch. i n U. v. communication has generally been defined: a transactional process (Corcoran, 2013).. engchi. Communication plays a critical role in promoting healthy choices through message delivery. However, what health communication is most dissimilar from the traditional communication is it being issue-specific, integrating fields from mass media, interpersonal network, public health, social psychology and development, medical science (. , 2008). Centers for Disease Control and Prevention (CDC, 2007) and. The National Cancer Institute (2002) define health communication as ‘‘the study and use of communication strategies to inform and influence individual and community decisions that enhance health.’’. 24.

(25) Kreps (2003) summarizes that adding ‘health’ into communication definition as a ‘resource’ allows health messages, such as prevention, risk or awareness, to be used in the education and avoidance of ill health. It is also important to remember that health communication always takes place in a social and cultural context. Hence, health communication should be understood as a process viewed as a chain from the sender to receiver, with different situations within that may amplify or attenuate risks. Such situations can be social (e.g., news media), individual (e.g., attention filter), or institutional (e.g., political and social actions).. 政 治 大 wide range of science and disciplines find the common goal of health communication 立 Imposing public health challenges, the studies by scholars and practitioners in a. and social marketing practices is creating social change by altering peoples’ attitudes,. ‧ 國. 學. external structures, and/ or modify as well as eliminate certain behaviors if necessary. ‧. (2007). What distinct health communication from other communication research is. y. Nat. that field experiments are applied as a basic research design that include field. er. io. sit. experiments and focus group interviewing (Rogers, 1994). Health communication targets to improve not only understanding health problems, but also health. n. al. improvement. This main. v i n C h guides schools discipline of engchi U. researches of health. communication promotions and practices, specifically in fighting AIDS, conduct effective strategy within multiple perspectives: human rights, governmental diplomacy, interpersonal network and community based studies. In UNICEF’s human rights approach to programing, communication is explicitly acknowledged both a right and a means to claim other rights. Health communication from a human rights perspective is especially relevant to HIV/AIDS programming (Ford & Chorlton, 2003). The change could benefit local people (claim holders) in taking less risky ways of sex or safer means of parental care for infants. To Ford& Chorlton (ibid), dialogues are chosen by claims holders for effective health. 25.

(26) communication process. And all the conversations should be continued extending to level up national forums for greater influences. Another way to fortify health communication in a diplomatic perspective is foster government’s health diplomacy. Rely heavily on medical and monetary aids caused by political conflicts, Kenya has received HIV/AIDS care, treatment, and education from the United States (Cook, 2006). The WHO provided reports to help identify countries in need for help since determining what countries are in need and which countries could support the help sending country’s interests for good diplomatic relationship establishment is also. 政 治 大 implementing and monitoring such activities are crucially important by involving 立 important to boost health communication (Kumar & Karl, 2009). All levels of. communities, nongovernmental and civil society organizations and individuals in the. ‧ 國. 學. planning.. ‧. The United Nations Population Fund (UNFPA) stressed that “it is men who. y. Nat. usually decide on the number and variety of sexual relationships, timing and. er. io. sit. frequency of sexual activity and use of contraceptives, sometimes through coercion or violence.” To form a healthier and gender-equal society, ensuring women and girls’. al. n. v i n C hhealth services andUprotection from gender-based access to sexual and reproductive engchi. violence can be facilitated more efficiently by involving men and boys. Sexual and. reproductive health topics can be highly stigmatized and charged with emotion, shame, and fear among families or couples (Kumar, Hessini, & Mitchell, 2009) In Kenya, women have little to no decision-making power with their lives and health historically; the use of family planning rest mainly with husbands and in-laws; let along women’s perceived nature “to give birth to children” by men. Henceforth, Rao and Svenkerud (1998) listed six concepts that are most relevant to prevent HIV/ AIDS in interpersonal network lens: Communication (channels of how message is transmitted from one to another), the innovation-decision (an over-time sequence process of how. 26.

(27) target audiences adopt the change), homophily (the extent of the two or more people who communicate perceive themselves to be similar), an attribute (characteristic of the innovation either to be positive or negative), adopter categories (classifying groups based on relative time they spent on adopting a new idea, technique, or process), and opinion leaders (people being respected for their knowledge and reputation on certain topic). Health communication involves modifying cultural tradition, which may differ from each community, including ways of thinking, behavior, and practices-social,. 政 治 大 whereas villagers or political leaders do not think of anything goes wrong (Pillsbury, 立. economic, and political-that are deeply ingrained in the vast majority in the culture,. Mayer, 2005). Limitations NGOs faced in community-based health communication are. ‧ 國. 學. limited capacity to communicate effectively about the problems. “Grassroots and. ‧. community-based organizations have relied on a various form of “traditional”. y. Nat. media-from posters, brochures, and newsletters to folk drama and t-shirt, to get their. er. io. sit. messages out to local and rural audiences” (Pillsbury, Mayer, 2005). Insufficient and imprecise research is conducted to understand what people in different communities. al. n. v i n believed or the reasons of theirC behaviors. This leadsUto the failure of evaluation for hengchi how well the target group understood or changed with the desired effect. A given. example explained the abovementioned circumstance well, If a donor gave money for work on HIV/AIDS, an organization might design a poster or brochure telling people not to have unprotected sex. Often this poster or brochure was printed without finding out what people really knew and thought about AIDS or pregnancy, and without studying what would convince people to accept new information or think about changing their behavior. As such, these materials were not relevant and did not resonate with the local community. Far too often they ended up stacked on shelves in clinics or used for everyday. 27.

(28) needs such as wrapping purchases in a market (Pillsbury, B., & Mayer, D. 2005). Appropriate means to design media campaigns, referred in communication research, can affect knowledge, attitudes, and behavior (Graeff, Elder, & Booth, 1993). Thus, to know what the target audience believes is critical of making a persuasive argument. Having target communities participate in the design and implementation of campaign matters much as well since the authoritative top-down campaign activities is often ignored by the target communities (2005). The collaboration between health communication scholars and marketing. 政 治 大 research topics in its health applications. Social marketing (SM), the most widely used 立. specialists has provided important ideas in communicating health and numerable. strategy, is a planning framework that ‘‘applies commercial marketing technologies to. ‧ 國. 學. the analysis, planning, execution, and evaluation of programs to improve the personal. ‧. welfare of intended populations’’ (Andreasen, 1995). By providing tailor-made. y. Nat. marketing plan in a systematic way, SM is applied by plenty of NGOs, NPOs’ health. er. io. sit. promotion campaign to boost attitude or behavior changes in preventing diseases. The frequently used social-marketing strategy in health communication is segmentation,. al. n. v i n Csub-audiences partitioning a total audience into U each relatively homogeneous h e n g c hthati are in the segmentation variable (Evans, 2006). The core concept of SM contained 4P:. Product, Price, Place, and Promotion, (Positioning or Partner) is also borrowed into health communication applications (Corcoran, 2013), like the testimony of an experienced voluntourists shared in supporting HIV-positive sufferers accepted in the Kenyan community: We put flyers around town and called patients of the clinic who were HIV-positive. Within a week, our free HIV-positive support group was up and running. I would speak in English and my supervisor would translate into Kiswahili so that discussions were held in Kiswahili in order to increase. 28.

(29) participation and comfort. I ran the meetings similarly to a group-therapy model, geared toward fostering support. To relieve stress and cultivate friendships between group members, we played a game of volleyball. Laughter and smiles filled the courtyard and at the time I was very pleased with the results (Kass, J., 2013, p41). More effective health messages can be created for each audience segment than for the entire audience. In recent years, health communication scholars have used focus groups to pretest communication messages, to design health communication. 政 治 大. interventions, and to evaluate the effects of health campaigns. Furthermore, Africa’s. 立. health systems are designed with a bias toward primary care leading to the difficulties. ‧ 國. 學. of coping with the cost and complexity of AIDS treatment, especially in rural communities. To mitigate and overcome the barriers socially, culturally, and legally. ‧. allows more Kenyans, especially women and girls, the key affected groups from. Nat. sit. y. accessing correct information, to increase the provision of HIV prevention via. n. al. er. io. efficient and effective health promotion. Hopefully in the near future, more efforts of. i n U. v. sustainable methods will be developed for reaching both the top-down and bottom-up. Ch. engchi. communicative channel that could also reduce the country’s reliance on keep exhausting international donating funding. 2.6 Research Settings Settings of promoting health are first explained in the Ottawa Charter for Health Promotion, WHO (1986). Besides from stressing the nature of caring, holism, and ecology in developing strategies for health promotion by saying “health is created and lived by people within the settings of their everyday life; where they learn, work, play and love” (WHO), the settings for providing health education are important to deliver programs, and provide access to specific populations and gatekeepers. Glanz, Lewis,. 29.

(30) & Rimer (1990) stress the seven major settings that will be most relevant to contemporary health education: “schools, communities, worksites, health care settings, homes, the consumer marketplace, and the communication environment (see Table 2).” To encourage partnership working and program diffusion, community-based models of health improvement, particular settings be accompanied by non-formal work in the community are shown to develop best practice in promoting and communicating health (Hunter et al.,2000, Tones& Green 2004, p.318). To Whitelaw et al. (2001), settings implied “top down’ models of implementation, particularly when aimed at. 政 治 大 more effective than taking orders from a leader or minority group. 立 Types of Settings Descriptions. imposed outcomes, tend to be ineffective since letting claim holders to participate is. ‧ 國. 學. Schools. Health education can be taught in classrooms, training teachers, and changes in school environments that support Social relationships and organizations are heavily relied to. y. Nat. Communities. ‧. healthy behaviors (Luepker et al., 1996; Franks et al., 2007).. sit. reach large populations via media and interpersonal strategies.. er. io. Community interventions are conducted in churches, clubs,. al. v i n planners C to h gain more supportUand design engchi messages (Glanz et al., 2002). n. recreation centers, and neighborhoods, which enable program. Worksites. effective health. Since people spend much time at work, the workplace is both a source of stress and of social support (Israel and Schurman, 1990). Effective worksite programs can harness social support as a buffer to stress, in order to improve workers’ health and health practices. Nowadays, even enterprises provide health promotion programs for their employees (National Center for Health Statistics, 2001).. Healthcare settings. Health care can be greater level nowadays including high-risk individuals, patients, their families and the surrounding community, as well as in-service training for health care. 30.

(31) providers. Health education in these settings focuses on disease prevention and detection. Homes. Health behavior change interventions are delivered to households through traditional public health means such as home visits or multiple communication channels and media like Internet, telephone, or mail.. Consumer. Social marketing is used by health educators to fortify the. Marketplaces. salience of health messages and to improve their persuasive impact. Theories of Consumer Information Processing (CIP) provide a framework for understanding how consumer health information is being digested.. Communication. 學. ‧ 國. Environment. 政 治 大 media changes (i.e. tabloids, blogs, social media sites) to 立 personalized and interactive media (i.e. smartphone, Usage of new communications technologies from mass. animation, games, audio). These channels are not “settings” per se but can be used in any of the settings described earlier;. ‧. however, they are gaining uniqueness and specialization,. y. Nat. providing opportunities for intervention; they also require. sit. evaluation of their reach and impact on health behaviors. n. al. er. io. (Ahern et al., 2007).. v. Table 2. Research Settings Type and Descriptions. Ch. engchi. i n U. The research setting in this study is Kitale Province, situated between Mount Elgon and the Cherangani Hills in Western Kenya, at the elevation of 6,000 feet. Household economies in the province are supported by agricultural farming. The main cash crops in the area are sunflower, coffee, tea, seed beans, and maize. In fact, Kitale is prompted by growing the largest portion of Kenya’s total maize quantities. It is reported that in the region, 87.4% of homes have no electricity and 70% of homes is made up of earth, sand, and dung (Kenya Demographic and Health Survey, 2014, p.15). Kitale is populated by different ethnic groups from the local Luhya, Kalenjin, Kuo, Kikuyu, Kisii, Teso, Turkana and the international communities include Asians,. 31.

(32) Britains, Americans, and Sudanese from Southern Sudan. Suffer heavily from AIDS prevalence, Kenyans in Kitale fall victim into broken homes, slum life, single parenthood, drug addiction, prostitution, poverty, sexual and domestic violence, or gangs.. 立. 政 治 大. ‧. ‧ 國. 學. n. er. io. sit. y. Nat. al. Ch. engchi. 32. i n U. v.

(33) 3. Methodology After reviewing precedent literature on health communication and the newly observed field of voluntourism, this chapter draws out an appropriate methodology matches the qualitative nature of the study and explains why case study research methods are chosen as the most suitable methods, based on the organization features and the research goals. Observing and participating simultaneously, the researcher utilized secondary materials and conducted semi-structured interviews with informants appeared in the voluntary visit with Love Binti project, Step 30 for gaining. 政 治 大. insights in health communication promotion. 3.1 Case Study. 立. Case study tends to be the main method in qualitative research for understanding. ‧ 國. 學. human affairs since it is down-to-earth and attention-holding. Various sub-methods. ‧. were used: interviews, observations, document, and record analysis, work samples,. y. Nat. and so on (Gillham, 2000). Though Yin (1984) argued that there are various forms of. er. io. sit. case studies, and most of which do not involve participant observations however, the methodology of participant observations generally is carried out as a form of case. al. n. v i n C h and analysisUof an individual case (Becker, study, which involves detailed description engchi. 1968, pp.232-38). Merriam proposed the four characteristics of case study (Wimmer. & Dominick, 2013): 1.. Descriptive: detailed collected descriptions are used as qualitative data research report.. 2.. Narrowly focused: A case study offers a description of only a single individual, and sometimes about groups.. 3.. Combines objective and subjective data: All are regarded as valid data, despite objective or subjective, for analysis, and as a basis for inferences within the case study.. 33.

(34) 4.. Process-oriented: The case study method enables the researcher to explore and describe the nature of processes, which occur over time.. Stressing the holistic examination of phenomena, the subjects being studied as the cases may be a culture, society, community, subculture, organization, group, or phenomenon (e.g. beliefs, practices, or interactions) and all aspects of human existence (Jorgensen,1989). In terms of a research problem, case studies realized by participant observation aims to describe comprehensively and exhaustively of a phenomenon. Moreover, a common discrepancy appears between what people say. 政 治 大 health education where assumption predicting if people know more about health risks 立. about themselves in contrast to what they actually do. Similar situation appeared in. and healthy living, they will change their behavior (Gillham, p. 14).. ‧ 國. 學. A variety of case studies are described in different terms by Yin (2003) and. ‧. Stake (1995). Yin categorizes case studies as explanatory, exploratory, or descriptive,. y. Nat. he then further differentiates single, holistic case studies and multiple-case studies;. definitions of the case studies types are listed in Table 3.. n. al. Ch. er. io. sit. while Stakes pinpoints case studies as intrinsic, instrumental, or collective. Clearer. i n U. v. Type of Case Study. Definition. Explanatory. Seeking an answer to a question that sought to explain the. engchi. presumed causal links in real-life interventions, of which are too complex for the survey or experimental strategies. (Yin, 2003) Exploratory. Exploring situations where the intervention being evaluated has no clear, single set of outcomes (Yin, 2003).. Descriptive. Describing an intervention or phenomenon and the real-life context in which it occurred (Yin, 2003).. 34.

(35) Multiple-case studies. The researcher is able to explore differences within and between cases. The goal is to replicate findings across cases. Since comparisons will be carried out, it is imperative that the cases are chosen carefully so that the researcher can predict similar outcomes across cases, or predict contrasting results based on a theory (Yin, 2003).. Intrinsic. Researchers who have a genuine interest in the case should use this approach when the intent is to better. 政 治 大 because the case represents other cases or because it 立. understand the case. It is not undertaken primarily. illustrates a particular trait or problem, but because in all. ‧ 國. 學. its particularity and ordinariness, the case itself is of. ‧. interest. Understand some abstract construct or generic. y. io. sit. neither the purpose (Stake).. er. Nat. Accomplishing something other than understanding a. al. v i n C h situation. It provides particular e n g c h i U insight into an issue or. n. Instrumental. phenomenon is not the purpose. Building a theory is. helps to refine a theory. The case is of secondary interest; it plays a supportive role, facilitating our understanding of something else. The case is often looked at in depth, contexts scrutinized, ordinary activities detailed, and helps pursue the researcher’s external interest (Stake, 1995). Collective. Collective case studies are similar in nature and description to multiple case studies (Yin, 2003) Table 3. Types of Case Studies and its Definitions. 35.

(36) After the researcher’s trip back from Kenya, in-depth interview toward Love Binti as the main case study was carried out. The advantage of in-depth interviews, as stated by Keats (2000), allowed the interviewer to adapt the questions by meeting the informants’ expertise, backgrounds and languages and a valuable trust and empathy between researcher and participant was easier to build. Keats also indicated that this method facilitates a more controlled situation where questions can be rephrased, and that reluctant or anxious respondents can be helped by given encouragement. Accordingly, the questions covered were left deliberately broad to create and develop wider dialogues. Research Unit Profile. 立. 政 治 大. Love Binti, Step 30 International Ministries(. ). ‧ 國. 學. Step 30 International Ministries was initially a campaign called “Used Shoes. ‧. Save Lives” to encourage people sending their unwanted footwear to African. y. Nat. countries i.e. Kenya, Uganda, and Tanzania. Overwhelmed by the positive feedbacks. er. io. sit. from Taiwanese, the campaign transformed and renamed as NGO Step 30 International Ministries in 2015. Love Binti was a new project launched by Step 30 to. al. n. v i n CinhKenya and had sent promote health issues awareness three groups of voluntourists engchi U. from Taiwan to Kenya to date. As a Taiwanese female-organized voluntary group. prompted by the pressing need to girls in Kenya’s rural and low-income areas who cannot afford disposable sanitary pads, Love Binti had accomplished in helping 400 African girls to stay at school and continue their education in 2015.The numbers is still adding up as the project goes on. This initiative enabled the poverty cycle decomposed in Kenya by forbidding African girls from skipping schools and empowering women there to pass down the self-love conscious. Based on humanitarian principles, Love Binti targeted at giving love and care to African. 36.

(37) women, committing to transmit techniques of making pads, and teaching African female the correct menstrual conception. 3.2 Participant Observation Participant observation, in the qualitative research paradigm, is appropriate for studies of almost every aspect of human existence. The observation process enables researchers to learn about people’s activities under study in natural settings not only through observing but also participating in those activities, which provides the context for sampling guidelines and interview guides development (DeWalt & DeWalt, 2002).. 政 治 大 process of learning through exposure to or involvement in the day-to-day or routine 立. Schensul, Schensul, and LeCompte (1999) define participant observation as "the. activities of participants in the researcher setting" (p.91). By conducting participant. ‧ 國. 學. observation, the researcher can possibly describe “what goes on, who or what is. ‧. involved, when and where things happen, how they occur, and why-at least from the. io. er. (Jorgensen, 1989; Znaniecki, 1934; Spradley, 1980). sit. y. Nat. standpoint of participants or insiders-things happen as they do in particular situations”. Jorgensen (1989) explained the methodology of participant observation contains. al. n. v i n principles, procedures, methods,Cstrategies, and techniques h e n g c h i U of research. In terms of its seven basic features:. 1. a special interest in human meaning and interaction viewed from insiders or members’ perspectives of people in particular situations and settings; 2. the foundation of inquiry and method is based on location in the here and now of daily life situations and settings; 3. a form of theory and theorizing accentuating interpretation or understanding of human existence; 4. a logic and process of inquiry that is open-ended, flexible, opportunistic, and requires constant redefinition of what is problematic, based on facts gathered. 37.

(38) in concrete settings of human existence; 5. an in-depth, qualitative, case study approach and design; 6. the participant role’s performance involves establishing and maintaining relationships with natives on site; and 7. direct observations as a primary data-gathering device. The researcher adopted the participant-as-observer role in this study as gaining access to be a part of the setting by virtue of leading a natural and non-research reason. Different. from. being. a. complete. observer. or. observer-as-participant,. 政 治 大 that theirs is a field relationship” (Gold, 1958). The most frequent role of this is in 立. participant-as-observer indicated that “both field worker and informants are aware. community studies or health care settings, as observer spend more time in. ‧ 國. 學. participating and develop relationship with informants through time (ibid). In an. ‧. ethical manner, I had informed the purpose for observing is to document the. y. Nat. stakeholders’ activities.. er. io. sit. Fieldwork is required in doing participant observation research method. It involves "active looking, improving memory, informal interviewing, writing detailed. al. n. v i n C h patience" (DeWalt field notes, and perhaps most importantly, et al., 2002). More of an engchi U experience for doing research, fieldwork is viewed as an experience of vision. exploration activity that the researcher performed a self-reflective process through capturing the subject matters. It is exactly like what Glaser and Strauss (1967) claims that “in field work…general relations are often discovered in vivo; that is, the field worker literally sees them occur” (p.40). In this study, the researcher volunteered to be the Love Binti group traveling to Kenya for the twelve-day voluntary works (see itinerary in Table 4).. 38.

(39) Date. Itinerary. 12/03/16 Departure20:10. Date. Itinerary. 18/03/16. Jigger. TPEàBKKàNBO. cleaning. at. Mount. Elgon& Love Binti campaign. Kenya airway KQ861 13/03/16 Arrival 06:25. 19/03/16. Maasai Mara National Park. A day in the slum-to experience with local dwellers. 14/03/16 Maasai Mara National Park&. 20/03/16. Maasai Tribe. Church day& donation goods sending at private schools. 政 治 大Love Binti 30 base (stop by Kisumu for church 立. 15/03/16 6.5 hours to Kitale town, Step 21/03/16. market&. slum. at. Mount 23/03/16. io. Departure23:05. Elgon& Love Binti campaign. n. al. Ch. Meeting with Ecopost founder. er. cleaning. sit. y. Nat. visit to Precious Kids Centre 17/03/16 Jigger. Love Binti campaign at Matisi. ‧. ‧ 國. 16/03/16 tour the town center& local 22/03/16. 學. resting). campaign at the. engchi. iv n U Kenya airway KQ 860. Table 4. Love Binti third group voluntary itinerary The voluntourism program (see location in Figure2 ) contained sightseeing in the Maasai Mara national reserve as well as the Maasai tribe, performing jiggers 1 treatment for infested Kenyans in rural Mountain Elgon, visiting the shoe container converted to community schools, sending donated goods to Precious Kids Center, a 1. Tunga penetrans (chigoe flea or jigger) are small sand fleas mostly found in Sub Saharan climates,. and are prominent during the dry season. Being the parasitic burrowers, jiggers live in soil and sand but feeds on warm-blooded hosts (i.e. animals and humans). They burrow in humans’ hands or feet. It is estimated that over 1.4 million people affected by jiggers in Kenya, especially for those in rural areas. (https://www.killthejigger.org/what-are-jiggers/). 39.

(40) Community-Based Organization (CBO) serving disabled children, spending a day with families in the slum-Matisi, and sending donation goods from Taiwan to rural villages near Kitale. Kitale town was where Step 30 based in the Western part of Kenya. Last but not least, the trip’s primary goal entailed teaching Kenyan school girls, women dwelling in communities and slums how to make reusable cotton pads as alternatives to costly disposable ones.. 立. 政 治 大. ‧. ‧ 國. 學. n. er. io. sit. y. Nat. al. Ch. engchi. i n U. v. Figure 2. Map of location (reproduced from https://joshuaproject.net/countries/KE) The researcher will be analyzing and writing up the data as the itinerary proceeded. Besides from the data mentioned above (i.e. interviews, secondary. 40.

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