I Have a Value Using Photovoice to Inform

“I Have a Value”: Using Photovoice to Inform Mental Health Care and Champion Access with Rwandan’s LGBT Population AMY SHIPOW UNIVERSITY OF NORTH CAROLINA, CHAPEL HILL HEALTH DEVELOPMENT INITIATIVE RWANDA NOVEMBER 2, 2017

Objectives: To engage and empower social action among members of the LGBT communities through photography. For members of LGBT community-based organizations (CBOs) to share their voices about the need for and content of a psychosocial support group. For members of LGBT community-based organizations (CBOs) to help inform sensitization trainings of other service providers

Participants 8 Members of the LGBT Community 7 who identify as male, homosexual 1 who identifies as a transgender female 5 CBOs represented: Health My and Rights Initiative Rights Alliance HOCA Safe Friendly Society Building Hope for Future

Photovoice Enrolment Met with 5 LGBT CBO leaders for key informant interviews on the feasibility and acceptability of such a project. These leaders helped recruit their own members and peers. An orientation session was held for interested LGBT participants and informed consent was obtained.

Photo Assignments Week 1: How do I feel when my rights are violated? Week 2: Where do I feel most comfortable/safe being my truest self? Week 3: What can I do to strengthen/advocate for my rights?

SHOWED Methodology Discussion of what was photographed Discussion of what to photograph

Results Contributing Factors -Religious intolerance -Family rejection/marginalization -Stigma, discrimination, harassment -Social isolation -Hiding identity Negative Coping Strategies -Substance use Emotional Wellbeing Positive Coping Strategies -Nature -Faith -Choosing Solitude -Collective Action -Legal Action -Educational Outreach -Internal Capacity Building

Contributing Factors to Distress Religious Intolerance Family Rejection DISTRESS Stigma and Discrimination Hiding Identity Isolation

Contributing Factors to Distress: Religious Intolerance P 3: “For us we know that there is many people who are using religion to criminalize homosexuality, because they said in the Bible, the Bible said this that, the reason why Eden was destroyed was because of homosexuality. ” P 4: “Where people they just attend church and the idea is to learn homosexuality is bad anywhere people have been raised up, and homosexuality is unacceptable. So he was saying that, it happens when people see, especially transgender, the way he or she is dressing, and in the mind, when try to reflect what you learned from the church or what you heard from community, that lifestyle of the transgender may provoke that person and they start to approach him/her negatively or maybe sometimes they can violate his or her rights because of that. ” [quote from interpreter translating Kinyarwanda]

Contributing Factors to Distress: Family Rejection/Marginalization P 5: “[The extended family] couldn’t imagine how he feel and how he’s behaving, and they chased him away because he was behaving like a girl and would do the work for girls […. ] And he tried but they always chased him, they couldn’t welcome him […] So up to now, they are still not really receptive because one day they had a funeral for his uncle and they didn’t invite him. When he went, they chased him. ” [quote from interpreter translating Kinyarwanda] P 4: “This photo just reveals especially family where sometimes I face such stigma and discrimination in the family. I just sit in the room, sit in the bed, thinking many options-uh, what can I do if my family rejected me? What will I do? What are my options? Always myself, no one can just ask you, just sit on my bed and start thinking. ” [quote from interpreter translating Kinyarwanda]

Contributing Factors to Distress: Stigma, Discrimination, Harassment P 3: This photo shows the how just sometimes I may feel when my rights are just violated in the public places, let me say, maybe in hotel areas or somewhere else, the roofs […] You hear some people saying, “have you seen that guy? He’s a gay. Why is such person come just among us? He’s a gay and he’s coming among us. So sometimes you feel you just can’t enter the room. ” [quote from interpreter translating Kinyarwanda] P 6: “Even at his work, he can go and make money where he used to work but uhh because he faced stigma and harassment from work environment, when I returns home, he takes such things about the harassment he faced before. So when he’s in the room, he can just think about it, analyze it, then when he goes out again, at least he goes with some power and measures to handle any harassment or just how to be patient with the same person he is going to face. ” [quote from interpreter translating Kinyarwanda]

Contributing Factors to Distress: Isolation P 3: “Because some problems we have as community, there are some members of community who have been, who are violated but are still isolated themselves. But I don’t know if they think, it can, they were born to be beaten, kind of that things” P 5: “He has never been free to himself or to his family. He has always been isolated. He gives himself stigma, he stigmatized himself and his family too stigmatized him, like he would, he would be isolated from other children in the family, being given advice to sleep away from other children at home and saying that he’s violating the culture and that other children would imitate his behaviors. ” [quote from interpreter translating Kinyarwanda]

Contributing Factors to Distress: Hiding Identity P 1: “He still decided to just go and try and do male work. And he started dating girls so that the other family would see him as a man and they don’t chase him away but that failed. And he also went to mechanical school, a school of mechanics, so that they would also see him as a man’s ability and that one also failed, so he came back. ” [quote from interpreter translating Kinyarwanda] P 2: “He always found himself a gay and he wouldn’t want anyone to find it, whenever to see him, to see him like a gay. So he wouldn’t want it that way. So he was always hiding his identity. ” [quote from interpreter translating Kinyarwanda]

Coping Strategies NEGATIVE POSITIVE STRATEGIES Nature and solitude Faith Collective Legal Action Educational Internal Outreach Capacity Building Substance STRATEGY Use

Coping Strategies: Substance Use P 5: “For me, that picture shows me that the person who was there, after thinking about his life, about his challenges in life, he began to drink, he drinks to a certain time getting drunker and he started to break one part of his table. But, after some moments, he began also to think about himself, to think about what he is doing, and at that moment, he joined to the other part of the table, he joined his book, and he started to read his book. And after reading the book, he came down; he became a little bit calm. And what shows me that after reading the book, he came down, he became calm, the part of the table opposite the book, the table is good, and the table is not broken. ” P 8: “He’s saying that choosing the alcohol sometimes can just bring more troubles than you think because you may be fighting because you are taking alcohol or sometimes people can have suicide themselves because they have many problems and they also is bringing another beer. Just with that, losing balance can even suicide yourself. Again, sometimes beer or alcohol can bring you to take a decision or reaction which is very dangerous for your life long-term when maybe you can be brought in jail because of that after reacting negatively. But a book, if you just take a book and read, especially the book that you like, it just brings strength in you. You find strength in the book when you are reading and your mind’s refreshed, you just find the strength in that book. That is why he prefers to read the book or just to have the book than taking alcohol. ” [quote from interpreter translating Kinyarwanda]

Coping Strategies: Nature and Solitude P 6: “I like the place where I can’t see anyone else. Maybe after that, if I’ve maybe solved my inside problem, I can go up and talk to others about my situation after feeling comfortable with myself. ” [quote from interpreter translating Kinyarwanda] P 2: “There are so many people to visit at the lake, but I don’t prefer to join others. I like to be myself there. I know, when just you are stressed, and you are together with many people, sometimes instead of solving your stress, those people may also add to what you have. So it’s better to go and stay myself and think about me and find solutions myself. ” [quote from interpreter translating Kinyarwanda]

Coping Strategies: Faith P 1: “It is in the religion belief that we are all creatures of God, it is God who created us, and again, um, we are all children of God, which means, if I am created by God, and also each other God, it is not me who is made to be like this. So I have that hope and courage that people can accept me, that I know I am a creature of God, He is the one who created me to be like this. So that is the reason, the courage you can get from religion. ” [quote from interpreter translating Kinyarwanda]

Coping Strategies: Faith P 5: “The reason he just joined this church, before he was Muslim, and when he was just Muslim, as you know in the book, they just separate, the man, the men go there and the women was there, so and sometimes he was not feeling good in the men because he himself hasn’t find himself as man. So, he wanted to join the women, but it was forbidden to just be with the women. But when he just went in this church, he found that men and women can mix together so at least there he can just sit in the church and feel now calm. […] sometimes, there are people in the church that are not there, especially the people, sometimes who are not against his lifestyle. He just feels comfortable praying with them. He just prefers to go to the church quiet, without other people, sitting with himself. ” [quote from interpreter translating Kinyarwanda]

Coping Strategies: Collective Action P 3: “One thing is those associations because some people, for instance, me, when I was young, I am the only gay in this world. But, when I understand there is LGBTI organization, I go internet to read about that. Oh! I was impressed, there is another people like me. That is one thing that motivated me to join the others. ” P 5: “It wasn’t easy for him but as he went on going to the meetings with other LGBTI organization members, he felt he was not alone and he has other people besides who can understand him and they would also go hand in hand help each other. ” [quote from interpreter translating Kinyarwanda] P 1: “When we are together, there is a strength, there is a power, everyone can support each other as we do, as we do an association. And we can see how we can work, how we can develop each other. ”

Coping Strategies: Legal Action P 4: “Sometime when just the local authority, nothing else happens to just intervene. So he was just thinking is it safe to go there again? ” [quote from interpreter translating Kinyarwanda] P 7: Regarding discrimination at the sector or cell office: “It’s not everyone, the officers, or sector admins who are friendly, who can be friendly to the community. Yeah sometimes we can find some of them who are homophobic, but it’s not most of time. ”

Coping Strategies: Educational Outreach P 3: “I went there I was trembling somehow to see other people including homophobia and, but, I was stand with my reality and I spoken everything about how we live, how we are born this way, there is discrimination, different stigma and the reason why we advocate for our rights. And I told them, don’t continue to think this is culture from Western, Belgium. That, like, human being. After that, it was like 200 people, youth, in that audience. Most of them now, we are friendly. Some of them, they come here to visit us and they changed their mind about the community. ” P 3: “Even us, we have to work with those preachers in defense workshops to train them about the reality homosexuality, and to make debate between us. That can change that spirit and it can also make the people, the LGBTI people to help educate other people to helping their church think about stigma and discrimination. ”

Coping Strategies: Internal Capacity Building P 3: As long as people using these tools, things can change. Even the violation cases can be reduced ‘cause people they must know their rights. If the other people would approach them want to beat him or harass him, they can defend themselves because they read those books because they know those things.

Rwanda’s LGBT Population: A RESILIENT COMMUNITY!

P 8: “Maybe I should just do something myself, accepting myself, and start finding solutions myself. Though he was just not, though he was somehow isolated, but he didn’t want just to be there all the time. He wanted to show the family that he can do anything, he can just perform, he can just be a child like others. So he just continues to do, what he can do […] yourself, you can do something to find the solution. So, life style. He said the most important is the hope. If you still have the hope, you will succeed. ” [quote from interpreter translating Kinyarwanda]

P 3: “Even if, when I pass in the street, at the school, sometimes I hear some people who talk, “that guy he’s a gay, that guy he’s a gay. ” Those things sometimes they make me trouble, somehow. But when I stand in the front with those delegates, for instance in the hall, I can say, oh, I have a value, even if the people, some people look, consider me in the street as something with no value, there’s other people who can give me a value to stand in the front and to present that things. ”

Areas for Improvement Provide transcripts in Kinyarwanda to participants Have participants involved in coding the transcripts Any others?

Future Directions Psychosocial support group? Training of mental health providers for better referrals? Livelihood Capacity activity? building of LGBT CBOs? Advocacy for LGBT rights?

THANK YOU! Health Development Initiative Photovoice Participants and their Member Organizations: Health My and Rights Initiative Rights Alliance HOCA Safe Friendly Society Building Health for Future