An+Ocean+Between+Us

Brendan La Cava n7518498 tutor: Judith Meiklejohn

=An Ocean Between Us=

__Artefact:__
This artefact is one advertisement in a series for AIDES, a community based European HIV/AIDS non-government organisation. AIDES aim is to bring people with this affliction together and to fight for and defend the rights of people affected with this disease. These advertisements were finalised by artist James Jean, who was given sketches from an artistic director from an advertising company, TBWA\Paris, and then asked to do a few ‘spin offs’ in his own style. The ad contains a female ‘exploring’ a world under the sea, encapsulated by a condom. All the under water flora and fauna have been drawn and designed to depict penises and tongues.

__Public Health Issue: __
The public health issue being addressed in this artefact is safe sex in general, but targeted more so towards HIV/AIDS prevention. As previously mentioned, James Jean was given guidelines by TBWA\Paris; however he could add his own artistic style and flare to the ads. The sketches supplied to him were ‘an impressive package, thoroughly researched and tested across the board’ (Jean, 2008). These ads were targeted towards Europeans (and all the cultures that are within Europe), and designed by Europeans. Although this advertisement is targeted towards Europeans, it is a great example. Whilst these ads may not be plastered all over billboards and bus shelters, they were popular on the internet, with Jean winning an art award for the advertisements.

__Literature Review: __
Culturally diverse and equal sexual education and healthcare is one of the most important aspects of public health, as Sexually Transmitted Infections (STIs) are one of the easiest forms of infection to prevent (in HIV transmission, safe sex practises reduce the risk by four or five times (Vitinghoff, Douglas, Judon, McKiman, MacQueen & Buchinder, 1999)). With 22.2% of Australians born overseas (Australian Bureau of Statistics, 2006), action must be taken to ensure culturally appropriate and equal sexual health care and education for all Australians, no matter the culture. Sanjakdar (2009) states that how and who teaches Muslim students sexual education is greatly debated in the Muslim community. Whilst this is only one community, it shows the unjust nature of the inequality and the disregard of culturally diverse sexual health care and education. There was a study conducted by Griffiths, French, Patel-Kanwal & Rait in 2008, surveying 36 Bangladeshi young people and 25 mothers in the United Kingdom. The young Bangladeshi faced similar problems as identified by the mothers, saying that the teachers spoke of and taught protected sex (safe sex) and risk of diseases and infections, rather than what was culturally appropriate to the Bangladeshi, such as losing your virginity before marriage and losing honour (Griffiths et al., 2008). This journal article provides extra evidence that this problem is a global issue, and if the politicians of Australia handle this situation correctly and implement appropriate policy, we may be one of the first countries to have a multicultural sexual education program. A big issue of multicultural sexual health care is cervical cancer screening, or the Pap smear test. The attitude towards the Pap smear test is greatly affected by cultural beliefs and norms (L. P. Wong, Y. L. Wong, Low, Khoo, & Shuib, 2008). Kapsalis (1997, as cited in Schick, 2010) states that ‘Gynaecological exams require that women make public an area of their bodies that they are conditioned to believe is private and oftentimes shameful’. This shameful exposure of the private parts and inappropriate (or no) cultural training of the doctor or gynaecologist in this area creates an issue which is uncomfortable for the patient. From this negative experience, the patient may refuse the test and/or never having a Pap smear test again, which could potentially detect abnormal cells. Loomis, Pastore, Rejman, Gutierrez, & Bethea (2009) undertook some research in cervical cancer in vulnerable pregnant women, and recognised that ‘empowering women may begin to reduce disparities through the development of educational programs that reduce cultural and linguistic barriers to screening and awareness that socioeconomic factors may be impediments to care and adherence’. In Samoa, Mishra, Luce & Baquet (2009) introduced a cervical cancer education program tailored to the Samoan population in a research effort to increase the rate of Pap smear tests in the selected Samoan communities (46% initially). Those who attended the cervical cancer education classes were more likely to have a Pap smear test done (Mishra et al., 2009). To sum up the research used in this literature review, it is clear what needs to happen in terms of equal, culturally appropriate sexual education and health care. Sanjakdar (2009) looked into how teachers of a Muslim school in Victoria ere in great heat over how the sexual education should be taught, and who taught it to the children, catering for the specific need of the community. The study conducted by Griffiths et el. (2008) focused on a Bangladeshi community in the United Kingdom. The group surveyed 36 young people and 25 mothers, with the mothers saying that the sexual education needs to be more diverse in what it teaches, to conform to Bangladeshi cultural beliefs. Loomis et al. (2009) found that their study was implicated by lack of educational programs about cervical cancer and Pap smear tests that reduced the cultural barriers. The research conducted in Samoa by Mishra et al. (2009) revealed that those who attended a tailored education program for the Samoans, cervical cancer screening rates went up. While it may not seem plausible, programs for individual cultures need to be set up to better educate these different cultural groups so that they may have a better understanding of cervical cancer and the screening process, so that they may make a better informed decision when it comes time to have a Pap smear test.

__Social Analysis: __
The social theorist that relates to this issue the most would be Max Weber. Weber saw society becoming more rational in the way we did things, for example becoming more conscious about profit margins, efficiency and cost saving, which concerned him. If this theory is put into practice in the modern day public health system, where everything is about being efficient, saving costs and making profit, do we lose touch or exclude those groups that make Australia the multicultural country it is today? By making the public health system all about being efficient and profitable, we may break the very moral of being Australian, which is giving everyone a fair go. It would be very costly to research and develop an individual sexual education program for every culture in Australia, but in doing so, the general population (specifically the cultural communities) and the public health system would be better off, as all cultural groups would be getting educated on sexual health specific to them, possibly heavily reducing the incidence of sexually transmitted infections (STIs). In an ideal world, patients undergoing a Pap smear (or any other invasive test) would have the option to have the same sex practitioner perform the test and if needed, a translator and/or cultural consultant. However, in the real world this option more likely than not be available in terms of a same sex practitioner and translator and/or cultural consultant. Having such staff on a retainer would cost the health system too much for the times they are being used, therefore being inefficient.

As with any public health issue, certain groups will be more affected than others. With this public health issue in particular, females (sexual health care) and high school aged students, parents and perhaps even the community (sexual education) would be the most affected. Kapsalis (1997, as cited in Schick, 2010) states that gynaecological examinations may sometimes be shameful, which is fully understandable as a women is revealing her most private parts to a total stranger. If this gynaecologist is a male, it may make the female patient feel very uncomfortable, especially if there is a history of sexual abuse. There are a lot of online forums and blogs in which females very strongly suggest that they would prefer a female to do gynaecological examinations, as they feel males may be doing more than their job and taking advantage of the situation. Sexual education is being taught to prevent the transmission of STIs and unplanned pregnancies; however this may not apply to certain cultures as they believe in celibacy, or sex only within marriage. These cultures find the sexual education programs do not cater to their needs.

To focus on fixing this public health issue, the government should hold community forums to fund out what the communities think are the issues and the solutions they come up with, instead of coming in to a community, knowing nothing and throwing money in all the wrong places. During these community forums, doctors and health workers (sexual health workers preferably) should be invited along also as to hear the problem straight from the horse’s mouth so they may be able to implement small changes in the way they practise certain procedures like the cervical cancer screening.

__Analysis and Reflection:__
In the initial paragraph, the ad was basically described. This paragraph will break this picture down and analyse it. At first glance of the picture, the focal point is directed to the centre of the picture, with the full naked female encapsulated condom. As previously mentioned, all the underwater flora and fauna have been depicted as penises and tongues. Also, note the starfish on the testes of the octopus representing genital infections. The message in the bottom right hand corner of the ad reads ‘Explore, just protect yourself’ boarded by (as Jean puts it) ‘splooge’ (slang term for semen). The central theme in this picture is safe sex, and is also a play on words with the female in the condom ‘exploring’ the underwater world in the protection of her condom (the condom is a symbol for protection), as one would perhaps explore sexuality, hence the meaning ‘Explore, just protect yourself’.

This advertisement, I found, was a very good cultural artefact to analyse. Despite my uncomfortableness towards staring at all the penises, this ad is new-wave, fresh and it makes you really appreciate the artistic flare provided by Jean. This is my third or fourth assessment on sexual health and education with regards to cultural issues, so I already have a decent amount of knowledge in this area. During this assignment, I did learn more about the inequalities of sexual education, particularly in school children. In all honesty, knowing all the information on cultural inequities with regards to sexual health care and education will not be very helpful in my future career as a paramedic. That being said, it probably will be something I do remember down the track at university, or even after I graduate, and it is something I won’t forget anytime soon.

__References:__
Australian Bureau of Statistics. (2006). Person Characteristics. Retrieved October 28, 2011 from: [] <span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Griffiths, C., French, R. S., Patel <span style="font-family: 'Cambria Math','serif'; font-size: 16px;">‐ <span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Kanwal, H., & Rait, G. (2008): ‘Always between two cultures’: young British Bangladeshis and their mothers' views on sex and relationships, Culture, Health & Sexuality, 10:7, 709-723. doi: 10.1080/13691050802213571

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Jean, J. (2008, June 19). Aides posters [Web log post]. Retrieved October 27, 2011 from: []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Loomis, D. M., Pastore, P. A., Rejman, K., Gutierrez, K. L., & Bethea, B. (2009). Cervical cytology in vulnerable pregnant women. //Journal Of The American Academy Of Nurse Practitioners//, //21//(5), 287-294. doi:10.1111/j.1745-7599.2009.00407.x

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Mishra, S., Luce, P. H., & Baquet, C. R. (2009). Increasing pap smear utilization among samoan women: Results from a community based participatory randomized trial. //Journal of Health Care for the Poor and Underserved, 20//(2), 85-85-101. Retrieved October 28, 2011 from: @http://search.proquest.com/docview/220589894?accountid=13380

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Sanjakdar, F. (2009). 'Teacher talk': the problems, perspectives and possibilities of developing a comprehensive sexual health education curriculum for Australian Muslim students. //Sex Education//, 9(3), 261-275. Retrieved October 29, 2011 from: EBSCO//host//.

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Schick, V. R. (2010). //Examining the vulva: The relationship between female genital aesthetic perceptions and gynecological care.// Psychology). //ProQuest Dissertations and Theses,// Retrieved October 29, 2011 from: @http://search.proquest.com/docview/305202807?accountid=13380

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Vitinghoff, E., Douglas, J., Judon, F., McKiman, D., MacQueen, K., & Buchinder, S. P. (1999). Per-contact risk of human immunodeficiency virus transmission between male sexual partners. //American Journal of Epidemiology//, //150//(3), 306-311. Retrieved October 30, 2011 from: []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Wong, L. P., Wong, Y. L., Low, W., Khoo, E., & Shuib, R. (2008). Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a Pap smear: a qualitative study. //International Journal Of Behavioral Medicine//, //15//(4), 289-292. Retrieved October 29, 2011 from: EBSCO//host//.

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Comments:

Comment on Tahni Streeter's wiki I enjoyed reading your wiki page. It’s no secret that sex sells, so it is understandable why the media and TV companies broadcast employ such tactics. However, I do agree with you when you say that the female sporting stars are misrepresented. In this past month, I have seen 3 women’s sporting games (free to air TV). One of the games (female hockey) was aired on Channel 7. In all 3 games, the footage wasn’t sexualised, but this could have been a rare occasion. I do agree with your views on sexualisation of women’s sports and the health impacts it may have.

Comment on Tara Mills's wiki It is good to see you have considered translators and cultural consultants in situations such as death, understanding an illness, as this would be a difficult time for families/friends, especially if English was not the primary language spoken. I liked how you listed the relevant cultural issues with regards to death in the pre-hospital/hospital setting, as this highlighted the issues and really helped me understand these issues in a more clear sense. It is good to see there is specialist staff that look after the terminally ill, however on that note, it is a shame (as you mentioned) that there are no specialists to deal with deaths whatever the culture may be.