PEER SUPPORT: A WORLD VIEW
Circling the Globe with Peer Helping

by

Rey Carr

While peer helping has expanded rapidly in North America, the development of peer programs is also increasing world-wide. In this article I will profile a recent international conference and describe a few peer program initiatives from around the world.

Vancouver, British Columbia was the site for the 1995 International Congress on Adolescent Medicine held in conjunction with the International Youth for Youth Conference. Two thousand medical practitioners, health professionals, educators, and social service personnel as well as youth from around the world met for four days to examine and discuss a variety of issues relating to adolescent health.

The professional and the youth programs of the joint conference scheduled a number of sessions on peer helping. In addition, poster sessions and exhibitor displays included a variety of peer-based program descriptions and representatives. While I had the opportunity to attend all sessions, I also coordinated a panel discussion about peer work in North America and I looked after our Peer Resources booth in the exhibitor's area. The booth worked out to be a hub for meeting people as the nutritious breakfast and delicious lunch buffets were just a few steps from our booth area. Many people from around the world stopped at the booth to learn about peer support and share peer ideas and techniques used in their country.

Peer Education in Romania
Dr. Irina Dinca and her colleague, Alexandru Negut, of the Youth for Youth Foundation in Bucharest came to the Congress to let participants know about the work they are doing in peer education. The new freedom in Romania has opened the health field to stronger efforts in prevention, but the lack of trained professionals hampers the success of such efforts. Peer education is a way to involve young people in educating each other about sexual roles, contraception and birth control, HIV/AIDS, life planning, and communicating about sexuality.

Dr. Dinca led an interactive workshop which used experiential learning techniques to demonstrate to participants both the content and the training methods they have developed for peer education. Through a series of handouts and activities, participants learned about their own sexuality issues (and ignorance), had a chance to ask questions about the dilemmas associated with peer education in Romania, and shared some information about their own peer programs. (Contact Dr. Irina Dinca, Youth for Youth Foundation, Box 66-121, Bucharest, Romania)

Peer Health in Australia Another session at the Congress was co-led by Damien Becker and Aaron Steinke, out-patients at the Royal Children's Hospital in Parkville, Australia. Their workshop detailed the Chronic Illness Peer Support (CHIPS) program which operates at the Centre for Adolescent Health. CHIPS is open to young people aged 13 to 24 with a chronic illness such as asthma, diabetes, cystic fibrosis, epilepsy, haemophilia, and as they say in Australia, "a whole swag of others." Participants in the program meet one afternoon a week across an eight week period to discuss themes such as medication and its side effects, hospitals and their side effects, doctors, parents, brothers and sisters, school (teachers, kids that are your friends, and kids that aren't), relationships, dealing with pain, and feelings of isolation and fear.

A unique part of the CHIPS program is that it is entirely run by peer helpers. While there is a social worker coordinator to maintain program consistency over time, the participants, including the persons who train the peer support leaders, are themselves participants in former peer support groups. Both Aaron and Damien shared their own stories and let workshop participants know about the stories of anguish from other team members that led some to consider suicide. While the eight week program isn't all that is needed to help young people come to terms with their illness, many gain confidence, identity, enhanced perception, and understanding. (Contact Centre for Adolescent Health, 2 Gatehouse Street, Parkville, Victoria 3052, Australia)

A display in the exhibitor section of the Congress facility showcased CANTEEN, an Australian service that was created to help teenage cancer patients support each other. According to CANTEEN Chief Executive Officer, Christine Rowel, teens participate in all levels of the program, including the National Board. The service provides teenagers with opportunities to develop skills and explore individual strengths and potential. By talking and meeting with each other, these teenagers are better able to cope with the uncertainty of cancer, with their treatment, and with hospitalization. (Contact CANTEEN, GPO Box 3821, Sydney, NSW 2001, Australia)

Another Australian peer connection, but not present at the Congress, is the Kids Help Line, a community service run by Boystown National Community Projects. The service receives 25,000 to 30,000 calls a week, and a majority of these calls are about relationships. The Help Line uses more than 80 volunteer counsellors most of whom are young people trained to help each other. In addition to the Kids Help Line, the service also runs a parallel line for parents. (Contact Kids Help Line, Box 376, Red Hill, Queensland, Australia, 4059)

Our Canadian Peer Contingent
One of the first non-school based peer programs for adolescents in Canada was highlighted at the Congress in the Exhibitors' area where the team members from the Adolescent Peer Support program at British Columbia's Children's Hospital displayed posters, brochures, videos and information. Created several years ago by Nationally Certified Peer Trainer, Diane Stanford, the "3F Rap Group" (so named because it takes place on the third floor or adolescent unit of the hospital) is one of the peer services provided by the hospital. The group provides an opportunity for adolescents to interact with each other on a variety of educational, psychosocial, and health issues. (Contact 3F Adolescent Unit, B.C. ChildrenŐs Hospital, 4480 Oak Street, Vancouver, B.C. Canada, V3H 3V4)

Peer Education in Africa
From another continent, Nelson Agyeman from Youth for Population Information and Communication in Ghana was available at the Congress to discuss the peer-based program to assist street children throughout West Africa. The program started in 1987 and now has more than 3000 peer volunteers covering the 10 regions in Ghana. Volunteers receive training to help young people with healthy development, including the prevention of STD, HIV/AIDS, pregnancy, drug and substance abuse and other high risk behaviours. They also help peers with life planning, decision-making, confidence building, family planning, family life education, skills training for job creation, community development, and environmental protection. (Contact YPIC, Box 4941, Kumasi, Ghana, West Africa)

Although not part of the Congress, Elder Udo Anwana at the University of Uyo in Nigeria wrote to the Peer Resources office in Victoria to describe his efforts at initiating peer support for adolescents in his country. Elder Anwana believes that adolescents are generally misunderstood by adults, and he, like other Congress participants, is very interested in how to initiate a peer program for youth. Elder Anwana started a youth association to involve young people in dealing with drugs and related problems. The association struggled at first, but was revived when parents were informed about the seriousness of drug use amongst youth in the community. Working in rural Nigeria where resources are severely strained, Elder Anwana has been relying on his own funds to keep the peer program afloat. (Contact Udo I. Anwana, Department of Educational Foundations, University of Uyo, Akwa Ibom State, PMB 1017, Nigeria)

Health Peer Programs in the U.S.
One of the poster sessions at the Congress was designed by Sue Hammerton of the ChildrenŐs Clinic in Fort Collins, Colorado. Sue has been working with peer counselling for three years in an acute care medical setting. The peer counsellors provide more than just peer education. They are involved in the multidisciplinary team approach that provides services to low income teens, and they conduct 10-30 minute risk assessment interviews with each client. SueŐs display provided peer counsellor job descriptions, training and hiring procedures, protocols on confidentiality, and copies of media publicity. (Contact Sue Hammerton, Healthy Choices, 2930 Middlesborough Court, Fort Collins, Colorado, 80525)

John Sciacca, the Editor of the Peer Facilitator Quarterly, was one of our panel members for a Congress session on peer helping. John outlined the research associated with health-based peer programs and told the audience about some of the issues involved in peers delivering health services. The creator of the U.S. Natural Helpers program based in Seattle was also a member of the peer panel and he helped the audience learn about the origins of peer work and the importance of sharing feelings and finding ways to help young people take action to meet their needs.

One of the Congress keynote speakers, Joy Dryfoos, spoke to an audience of more than 750 people about how to modify risky behaviors of young people. She included the importance of peer helping and provided some examples of successful peer interventions, but pointed out that there was not as much evaluative support demonstrating the effectiveness of peer work. However, in a conversation with Joy after the Congress session, she learned that in Canada we have a broader definition of peer helping than she had referred to in her talk. She acknowledged that the Canadian version of peer helping has a much larger positive evaluation database.

Peering in the Caribbean
Our most recent contact with the West Indies is from Sherryl Walcott in Barbados. Sherryl is a member of the Family Life Club, which is the youth arm of the Barbados Family Planning Association. The Association conducts family life education and peer counselling classes in an effort to equip youth in the community with skills and information. The graduates of these classes continue the work, going out into other communities and educating both the children and adults through lectures, video presentations, and rallies. The Association is now setting up peer support groups and would be interested in gaining resources from other peer support programs. (Contact Sherryl at #18 Golden Mile, St. Peter, Barbados, West Indies)