COUNSELLING C A R DS
Tool for counselling children living with the human immunodeficiency virus
How to use this tool: This set of cards is a tool for counselling children living with the human immunodeficiency virus. It is meant for children from the age of 4, who are undisclosed, partially or totally disclosed about their diagnostic, and under antiretroviral therapy or not. The kit includes 43 cards, with images on one side, and themes and explanations on the other side. The whole set of cards may be bound by the top and used as a flipchart, in which case the comments of card 3 should be printed on the back of card 2. Or the cards may be kept separate, in which case, the comments of card 3 should be printed on the back of card 3. The cards cover various themes, without specific chronological order. The counsellor should not use all cards in one session, and should not give the cards to the child. He should show to the child the image corresponding to the theme he wants to work on, and ask the child about it. He will then explore the theme, following the indications on the other side of the card. Themes covered by the counselling cards: leisure activities; emotional and physical state; family; friendship; trust relations; personal hygiene; food; going to the clinic; adolescence; sexual relations; sexual violence, human body; the immune system; the CD4 cells; the human immunodeficiency virus; the modes of transmission and non transmission of the virus; the stages of the infection; the action on the body of the antiretroviral therapy; the side effects; adherence to treatment; resistant virus; second line treatment.
CONCEPTION: David GOETGHEBUER, Nazira NANGY, Wânia CORREIA DRAWINGS: Zacarias CHEMANE (Mozambique) TEXTS: Wânia CORREIA, Saar BAERT, David GOETGHEBUER ADAPTATION IN ENGLISH: David GOETGHEBUER July 2010 This material can be freely used, reproduced and distributed, if unchanged and in a non-profit context.
1
Card 1
Theme to introduce: Free theme (to make the child comfortable and express himself) How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: boys playing with girls, dog, fish, monkey, river, children eating...) - According to the answers of the child, ask for example: Do you like dogs? Would you like to have one? Do you like dolls? Would you like to have one? Why? - Ask about playing: What games do you see? Do you play like these children? What do you play? Where? Do you know other games? - Ask about the food: What are the children on the image eating? What do you like to eat? - Ask about the environment: How does it seem to you? Is it beautiful or ugly? Would you like to be there? If you were a boy (or a girl) in this picture which one would you like to be? Why?
2
Card 2
Theme to introduce: Emotions How to present the theme to the child: - Show the card to the child. - Explain that this picture shows children with different feelings like: bad, good, sleepy, clever, angry, afraid, sad, happy... - Ask the child to show you which child seems like him (her) today. - Ask why he (she) pointed to this child. - Ask if he (she) is like this child in the picture just today or everyday. - Ask why he (she) is feeling like that. - Ask the child to show what he (she) would like to be.
3
Card 3
Theme to introduce: The child, his family and his home How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: a mother, a baby, a girl, a boy, a father, a house, a tree, chickens, a family...) - Ask the child who does he (she) live with, how many people live with him (her), if he (she) has brothers and sisters, if his (her) parents are in the family, if not, ask if he (she) knows them. - Ask the child to tell you about his (her) family: Do you like your family? Are you happy living with your family? Why? What is lacking? - Ask the child if he (she) liked the picture, if he (she) would like to live with a family like this one and why.
4
Card 4
Theme to introduce: Friendship and who to trust How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: two children talking, children going at school, children playing...) - Ask the child if he (she) talks with someone, if he (she) has friends, if he (she) likes his (her) friends and why, if he (she) already told a secret to a friend, or if a friend told him (her) one.
5
Card 5
Theme to introduce: Personal hygiene How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: a girl washing her ear, a girl washing her hair, a boy and a girl brushing their teeth...) - Explain to the child that to be healthy it's necessary to have a good hygiene. Tell him (her) that we need to take a bath, brush the teeth, wash the hair and wash the body everyday. - Explain to the child how to take care with food : We have to wash our hands before meals and when food remains on the plate, we have to cover it and keep it in a safe place because of flies.
Sunday
Saturday
Friday
Thursday Wednesday
Tuesday Monday
RICE
RICE
6
Monday
RICE
How to present the theme to the child:
Thursday Friday
RICE
Saturday
Balanced diet
Sunday
Theme to introduce:
Wednesday
Tuesday
Card 6
- Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: fish, meat, banana, pineapple, a boy and a girl eating a coloured meal...) - Explain to the child that to be healthy we need to have a balanced diet. - Explain to the child that to have a balanced diet, we have to eat at least one food from each colour/group which is on the card. - Explain to the child the importance about varying food. If his (her) mother can give more than one food of each group, he (she) should eat it. - Explain to the child about each food group and insist that we have to eat accessible food according to the location and season. - Explain to the child that his (her) mother doesn't have to buy nonseasonal food just because TV said so, because there are many kinds of food. - Explain to the child that if his (her) mother gives milk, he (she) should drink it also. The milk must be boiled before drinking.
7
Card 7 Theme to introduce: The visit at the hospital How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: the doctor hearing the child's heart, a bird kissing the boy's arm, the counsellor happy because the girl painted the "pathway of life", the educator teaching children, many children playing, a mother going to the pharmacy to get a lot of good things for the boy‌) - Explain to the child that when he (she) comes to the hospital, he (she) goes through different places: * the reception to measure the weight and height, to know if he (she) has eaten well and grown; * the doctor who checks his (her) health; * sometimes the laboratory, to collect blood and count the number of green policemen in his (her) blood; * the counsellor to discuss how the treatment is going and to get the "pathway of life"; * the pharmacy to collect the pills to be always strong. - Tell the child that in the hospital he (she) can wait in the children's room, where there are toys, games, movies and music.
To tell or not to tell?
No disclosure
I know something is going on
I have to help them
Partial disclosure
8
Full disclosure
Card 8 For use with the care-taker of a child, NOT with the child himself
To tell or not to tell?
I know something is going on
I have to help them
Theme to introduce: Progressive disclosure How to present the theme to the care-taker:
No disclosura
Partial disclosure
Full disclosore
- Show the card to the care-taker. - Ask what he (she) sees on the picture. (Possible answers: a minibus, a child and some adults sitting in a minibus, a child and some adults looking worried, ‌) - Ask what is the worry of each person in the bus. - Ask what questions their child is asking about coming to the hospital and taking drugs. How do they answer those questions? Explain that these questions are normal. - Ask how do they feel about discussing with the child about their status. (Possible answers: he is too young, he will think that he will die, he will talk around, I am afraid to talk, I feel guilty, I don't know how to do, ‌). Explain that all these fears are normal and that many caretakers find it difficult. - Explain that telling a child about his HIV-status is like going on a bus journey. We move on little by little and make some stops along the road. At the start we give simple explanations on health, how to stay healthy, then on diseases and drugs. Later on we explain the HIV infection without naming it, and the importance of the treatment adherence. On another day we name the infection and go more in details. When entering adolescence, we discuss relations and how to avoid transmission of HIV. - Explain that child feels when we hide something and he worries about it. The best way to disclose is to follow the rhythm of the child's questions and not to lie. Generally children between 7 and 12 can understand HIV, if well explained. Children who know about their status mostly take drugs easier and have fewer worries. - Explain that progressive disclosure should be done by the care-taker, and that you will help.
9
Card 9 Theme to introduce: Growing up as an adolescent How to present the theme to the adolescent: - Show the card to the adolescent. - Ask what he (she) sees on the picture. (Possible answers: a girl and a boy looking at each other, a naked girl/boy looking at her/his body, a girl and a boy holding hands, ‌) - Ask what changes are happening with him (her) for the moment. - Explain that as we grow up, our body changes and we become like adults. Boys have a deeper voice, get pubic hair, ‌ Girls develop breasts, pubic hair and start having their monthly periods. All these changes are normal and happen to every teenager. - Explain that like the changes of our body, our feelings also change: we feel attracted to other teenagers. - Ask the adolescent if he (she) feels attracted by someone. Did he (she) notice other new feelings?
Ovulation
Conception
Menstruation
10
Card 10 Ovulation
Theme to introduce: Female reproductive system
Conception
Menstruation
How to present the theme to the adolescent: - Show the card to the adolescent. - Ask what she (he) sees on the picture. (Possible answers: a naked girl, the private parts of a girl, the womb of a girl, pills, condom, a girl getting an injection,‌) - Explain that the girl private parts look like this from the outside: * A little bubble, called clitoris, that when touched, can make the girl feel pleasure. * A small hole under the clitoris, called urethra, where urine comes out. * A bigger hole, called the vagina, where the blood of monthly periods comes out. That is the place where the penis of a boy enters in when having sex. It is also where the baby comes out when a woman delivers. * And a hole called anus, where the faeces come out. - Explain that several things happen inside the private parts: * Ovulation: All girls are born with a lot of eggs. Every month one egg matures, pops out and makes its way through the tube to the womb. * Conception: An egg lives for two days after it pops out. When a girl has sex with a boy, his sperm comes into the womb of the girl. If the sperm encounters the egg, this forms an embryo. * Menstruation: The womb prepares itself every month to welcome the egg. When there is no conception, the egg dies, and the womb let it go with blood and other material. This is the bleeding of the monthly periods. - Explain that once a girl starts having her monthly periods, she is mature and can get pregnant when having sex with a boy, without protection. When a girl is pregnant she will not have her monthly periods. - Explain that a girl can protect herself from getting pregnant, and from HIV and other STI's by using the female condom during sexual intercourse, or asking her partner to use a male condom. - Explain that girls can also avoid getting pregnant by using other family planning methods like the pill or quarterly injections, but those methods do not prevent HIV or other STI's.
11
Card 11 Theme to introduce: Male reproductive system How to present the theme to the adolescent: - Show the card to the adolescent - Ask what he (she) sees on the picture. (Possible answers: a naked boy, the private parts of a boy, a condom,‌) - Explain that this is how the private parts of a boy look like. - Explain that all boys have a penis and can get erections. When in erection, the penis becomes hard and big and rises up. A penis can get in erection when a boy gets excited, but this can also happen without any reason. - Explain that at the climax of its excitement, sperm comes out of the penis. This is what we call ejaculation. This can happen when making love, or by self-touching the private parts, but also while he is asleep. - Explain that from the moment a boy has ejaculations, he is mature and can make a girl pregnant. - Explain that a boy can avoid the girl getting pregnant, by using the male condom during sexual intercourse, or asking his partner to use a female condom. Condoms also avoid transmitting HIV and other STI's.
12
Card 12 Theme to introduce: Sexual intercourse How to present the theme to the adolescent: - Show the card to the adolescent. - Ask what he (she) sees in the picture. (Possible answers: a boy and a girl in bed, a couple about to make love, ‌) - Ask if he (she) has already thought about having sex, has already some experience or not, and what are his (her) views about it. - Explain that some teenagers have sexual intercourse while others decide to wait. It is their right to decide what they want, nobody may force them. - Explain that being HIV-positive, they should use condoms when having sexual intercourse. This will avoid passing HIV to their girl/boyfriend, get reinfected or get other sexually transmitted diseases. It will also avoir girls to become pregnant. - Explain that talking about their HIV status with the boy/girlfriend can help both of them, to plan for better protection of STI's and unwanted pregnancies, or to plan a pregnancy. - Explain that HIV positive girls have the same right to have babies like other women. They can avoid transmitting the virus to the baby by following specific recommendations.
13
Card 13 Theme to introduce: Sexual violence How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees on the picture. (Possible answers: a man trying to hurt a girl, a man willing to rape a girl, a girl trying to run away,…) - Explain that sometimes, an adult may want to do things the child does not like, such as touching the child’s private parts, taking off the child’s clothes, forcing the child to touch him,… - Explain that this can happen everywhere: at school, on the road, at home,… - Explain that this can happen with a girl or a boy. - Explain to the child that he has the right to say 'no', because this is wrong. - Explain that it is not his fault if this happens, and he should not be ashamed. - Explain that whenever this happens, he should tell this to somebody he trusts. - Explain that if it happens with a girl without protection (condom), there is a danger for the girl to get STIs, and to become pregnant (if she has started menstruations). - Explain that if it happens with a boy without protection (condom), he can get STIs.
14
Card 14 For children that are already disclosed about their HIV status Theme to introduce: Transmission of HIV How to present the theme to the child: - Show the card to the child. - Explain that we get HIV through these ways: * when the mother is pregnant and has HIV, she can transmit the virus to her baby during pregnancy, at birth or during breastfeeding. But this risk is reduced if she follows the doctor's recommendations on prevention; * through sex without any protection, i.e. without condom; * by sharing sharp materials that had contact with HIV infected blood; * when an adult sexually abuses a child; - Ask the child if he (she) understands the way HIV is transmitted. - Point to a picture and ask the child what is the way of transmission. - Ask the child if he (she) knows how he (she) got HIV. If he (she) says yes, ask how he (she) knows. If he (she) says no, explain: You got HIV when your mother was pregnant. At that time, we did not know much about this disease, and there was no access to the test. So your mother transmitted the virus to you without intention. But you don't have to be angry at her, if your mother had known she would for sure have avoided the transmission.
15
Card 15
Theme to introduce: Ways HIV can not be transmitted How to present the theme to the child: - Show the card to the child. - Explain to the child that you don't transmit HIV by : * playing, kissing, hugging someone who is HIV positive; * eating in the same plate, having a bath with someone who is HIV positive, etc. - Explain to the child that there are people who still do not know about this, and they discriminate against others. This is wrong, we can't isolate anyone because he is HIV positive.
16a
Card 16a (boy)
Theme to introduce: The human body How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy, a boy surrounded by a border) - Explain to the child that this picture represents the human body, from the outside.
16b
Card 16b (girl)
Theme to introduce: The human body How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl, a girl surrounded by a border) - Explain to the child that this picture represents the human body, from the outside.
17
Card 17
Theme to introduce: Blood circulation How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: the heart inside the body, a tree inside the body, green and red lines inside the body...) - Explain to the child that this picture represents the inside of the human body, with blood circulating everywhere.
18
Card 18
Theme to introduce: Blood's composition How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: green kings or green puppets inside the arm) - Ask the child if he (she) knows the instrument that shows the green characters. - Explain to the child that it is the lens of a microscope, "magic eyes" that allow people in the laboratory to see what there is inside our blood. - Explain to the child that in each drop of our blood, are our friends, the green policemen that protect our body against the diseases.
19a
Card 19a (boy)
Theme to introduce: The immune system How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy surrounded by a lot of green kings and some kings are beating yellow monsters and a mosquito...) - Explain to the child that his body has green policemen, responsible for his protection. These policemen are always on alert, for any invasion. If a germ enters the blood to cause any disease, the green policemen will fight against it, so that he can remain healthy.
19b
Card 19b (girl)
Theme to introduce: The immune system How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl surrounded by a lot of green kings and some kings are beating the yellow monsters and a mosquito...) - Explain to the child that her body has green policemen, responsible for her protection. These policemen are always on alert, for any invasion. If a germ enters the blood to cause any disease, the green policemen will fight against it, so that she can remain healthy.
20a
Card 20a (boy)
Theme to introduce: The infection with the red germ How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy sleeping with many policemen around him, a boy sleeping with yellow diseases willing to enter, but the policemen protect the body, a red germ...) - Explain to the child that the red germ is the one in his body, and this one is different than the yellow germs. - Explain to the child that when the red germ enters the blood, it attacks the green policemen. - Explain to the child that when the soldier cannot fight anymore, the child becomes sick.
20b
Card 20b (girl)
Theme to introduce: The infection with the red germ How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl sleeping with many policemen around her, a girl sleeping with yellow diseases willing to enter, but the policemen protect the body, a red germ...) - Explain to the child that the red germ is the one in her body, and this one is different from the yellow germs. - Explain to the child that when the red germ enters the blood, it attacks the green policemen. - Explain to the child that when the policemen cannot fight anymore, the child becomes sick.
21a
Card 21a (boy)
Theme to introduce: The first phase of the infection (no symptoms) How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy playing, many green policemen fighting against the red germs, red germs wanting to play with the child but the policemen do not allow them...) - Explain to the child: when you have the red germ in your blood, in the beginning the policemen can fight it, and you feel well. You can play and go to school.
21b
Card 21b (girl)
Theme to introduce: The first phase of the infection (no symptoms) How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl playing, many green policemen fighting against the red germs, red germs wanting to play with the child but the policemen do not allow it...) - Explain to the child: when you have the red germ in your blood, at the beginning the policemen can fight it, and you feel well. You can play and go to school.
22a
Card 22a (boy)
Theme to introduce: The second stage of the infection (a few symptoms) How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy having headache, a sad boy because the red germ is attacking his body, a sad boy because he's losing his policemen...) - Explain to the child: with time, the green policemen become tired of fighting against the red germ, who becomes stronger. So the policemen start to die. - Explain to the child: when some green policemen die, your body stays unprotected, and then you can feel bad, have headaches, fatigue, lose weight, etc. - Explain to the child: when a lot of green policemen die your body gets very weak, and you can get other diseases.
22b
Card 22b (girl)
Theme to introduce: The second stage of the infection (a few symptoms) How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl having headache, a sad girl because the red germ is attacking her body, a sad girl because she's losing her policemen...) - Explain to the child: with time, the policemen become tired of fighting against the red germ, who becomes stronger. So the policemen start to die. - Explain to the child: when some green policemen die, your body stays unprotected, and then you can feel bad, have headaches, fatigue, lose weight, etc. - Explain to the child: when a lot of green policemen die your body gets very weak, and you can get other diseases.
23a
Card 23a (boy)
Theme to introduce: The third stage of the infection (illnesses) How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy sleeping, a boy sleeping with many red germs, a boy sleeping on the ground surrounded by defeated policemen...) - Explain to the child that with time, the red germs destroy the green policemen more and more, leaving the body without protection. - Explain to the child that then, the diseases, which earlier could not enter, now can enter the body easily. - Explain to the child that when the green policemen are defeated, the body doors are open, the diseases enter, and the child is continuously sick.
23b
Card 23b (girl)
Theme to introduce: The third stage of the infection (illnesses) How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl sleeping, a girl sleeping with many red germs, a girl sleeping on the ground surrounded by defeated policemen‌) - Explain to the child that with time, the red germs destroy the green policemen more and more, leaving the body without protection. - Explain to the child that then, the diseases, which earlier could not enter, now can enter the body easily. - Explain to the child that when the green policemen are defeated, the body doors are open, the diseases enter, and the child is continuously sick.
THE PATHWAY OF LIFE
24a
Card 24a (boy) THE PATHWAY OF LIFE
Theme to introduce: The beginning of the treatment How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy taking a pill, a clock on the table, a picture on the wall, a picture coloured with a car, the sun, a heart, flowers...) - Explain to the child that these pills are the drugs he will need to take. They are new soldiers that will help the green policemen in the fight against the red germs. - Explain to the child that, if he takes the pills everyday at the right time, the new soldiers will ensure that the red germs remain asleep. - Explain to the child that the picture on the wall is called the "pathway of life". This picture will be given to him, to be completed each time he takes the pill with the new soldiers. - Explain to the child how he should colour in the picture, and when the pathway is coloured all the way to the hospital, it is time to go there to get more pills. - Explain to the child: you are going to start the treatment, to fight the red germs.
THE PATHWAY OF LIFE
24b
Card 24b (girl)
Theme to introduce:
THE PATHWAY OF LIFE
The beginning of the treatment How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl taking a pill, a clock on the table, a picture on the wall, a picture coloured with a car, the sun, a heart, flowers...) - Explain to the child that these pills are the drugs she will need to take. They are new soldiers that will help the green policemen in the fight against the red germs. - Explain to the child that, if she takes the pills everyday at the right time, the new soldiers will ensure that the red germs remain asleep. - Explain to the child that the picture on the wall is called the "pathway of life". This picture will be given to her, to be completed each time she takes the pill with the new soldiers. - Explain to the child how she should colour the picture, and when the pathway is coloured all the way to the hospital, it is time to go there to get more pills. - Explain to the child: you are going to start the treatment, to fight the red germs.
THE PATHWAY OF LIFE
25a
Card 25a (boy)
Theme to introduce: The beginning of the treatment (inside the body) How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy taking a pill, soldiers inside the body fighting against the red germs, green policemen that fight against the diseases, a clock on the table, a picture on the wall, a picture coloured with a car, the sun, a heart, flowers...) - Explain to the child that when he takes the pills, the new soldiers follow the red germs in his body and beat them. - Explain to the child that when this happens, the green policemen are happy and they can multiply to protect the body again. - Explain to the child that when he takes the treatment, he has to complete the "pathway of life" according to the day and time, and he may colour the other characters on the picture.
THE PATHWAY OF LIFE
25b
Card 25b (girl) THE PATHWAY OF LIFE
Theme to introduce: The beginning of the treatment (inside the body) How to present the theme to the child: - Show the card to the girl. - Ask what he (she) sees in the picture. (Possible answers: a girl taking a pill, soldiers inside the body fighting against the red germs, green policemen that fight against the diseases, a clock on the table, a picture on the wall, a picture coloured with a car, the sun, a heart, flowers...) - Explain to the child that when she takes the pills, the new soldiers follow the red germs in her body and beat them. - Explain to the child that when this happens, the green policemen are happy and they can multiply to protect the body again. - Explain to the child that when she takes the treatment, she has to complete the "pathway of life" according to the day and time, and she may colour the other characters on the picture.
26a
Card 26a (boy)
Theme to introduce: Effect of the treatment: starting to get better How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a boy waking up, a boy seeing the soldiers fighting against the red germs, green policemen fighting against the diseases, a boy getting better...) - Explain to the child that when he starts the treatment, little by little the red germs go to sleep, and the green policemen get strong again, they multiply and are ready again to defend him. - Explain to the child that when the green policemen protect him against the diseases he can get well.
26b
Card 26b (girl)
Theme to introduce: Effect of the treatment: starting to get better How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a girl waking up, a girl seeing the soldiers fighting against the red germs, green policemen fighting against the diseases, a girl getting better...) - Explain to the child that when she starts the treatment, little by little the red germs go to sleep, and the green policemen get strong again, they multiply and are ready again to defend her. - Explain to the child that when the green policemen protect her against the diseases she can get well.
27a
Card 27a (boy)
Theme to introduce: The importance of adherence to the treatment How to present the theme to the child: - Show the card to the boy. - Ask what he sees in the picture. (Possible answers: a strong boy smiling, many policemen surrounding the strong boy, many red germs sleeping because of the pills, the green policemen who are friends of the soldiers, a boy taking the pills at day time, at night time,...) - Explain to the child that when he take the pills at the right time, morning and evening, he stays healthy. - Explain to the child that the green policemen are strong because he is taking the pills every day, in the morning and again at night. - Explain to the child that when he takes the pills, the red germs stay asleep. The red germs do not die but they sleep and can no longer attack the green policemen. - Explain to the child: It is very important to prevent the red germs from waking up again because they are bad and could beat the green policemen. You should never forget to take the pills everyday at the right moment, morning and evening.
27b
Card 27b (girl)
Theme to introduce: The importance of adherence to the treatment How to present the theme to the child: - Show the card to the girl. - Ask what she sees in the picture. (Possible answers: a strong girl smiling, many policemen surrounding the strong girl, many red germs sleeping because of the pills, the soldiers who are friends of the green policemen, a girl taking the pills at day time, at night time,...) - Explain to the child that when she take the pills at the right time, morning and evening, she stays healthy. - Explain to the child that the green policemen are strong because she is taking the pills every day, in the morning and again at night. - Explain to the child that when she takes the pills, the red germs stay asleep. The red germs do not die but they sleep and can no longer attack the green policemen. - Explain to the child: It is very important to prevent the red germs from waking up again because they are bad and could beat the green policemen. You should never forget to take the pills everyday at the right moment, morning and evening.
28
Card 28
Theme to introduce: Side effects of the treatment How to present the theme to the child: - Show the card to the child. - Ask what he (she) sees in the picture. (Possible answers: a boy running to the toilet, a girl scratching her arm, a boy having a headache, a boy vomiting...) - Explain to the child that sometimes when taking the drugs, we can feel diarrhoea, or pain in the stomach or other symptoms. - Explain to the child that these reactions are normal. It happens because the treatment is strong and the body is not used to it. - Explain to the child that these reactions will go in time, when the body adjusts to the treatment. - Explain that this does not always happen with all children, it depends of the body of each child. - Explain to the child that he (she) cannot stop the treatment because of these reactions. When the reactions are too difficult, he (she) has to go to the doctor.
29a
Card 29a (boy)
Theme to introduce: Treatment resistance How to present the theme to the child: - Show the card to the boy. - Ask what he sees on the picture. (Possible answers: a sad boy because the red germs are attacking his body, green policemen being afraid of the red germ, red germ changing colour, blue soldiers unable to attack the red germ, a red germ attacking a green policeman, yellow germs coming in the body,‌ ) - Explain that if he does not take the pill with the blue soldiers, twice a day, morning and evening, the red germ wakes up, and as he is smart, he turns itself into a purple germ. - Explain that when he takes his drugs again, the blue soldiers do not recognise the purple germ, and they don't manage to put him asleep. This purple germ is called resistant. - Explain that when the purple germ is not attacked by the blue soldiers, he can then attack the green policemen. - Explain that if the green policemen are attacked, they cannot protect the body anymore, and the diseases come back. - To avoid that, it is necessary to take the pills with the blue soldiers, every day, morning and evening, so they can keep the red germ asleep and impeach him to change colour and become stronger.
29b
Card 29b (girl)
Theme to introduce: Treatment resistance How to present the theme to the child: - Show the card to the girl. - Ask what she sees on the picture. (Possible answers: a sad girl because the red germs are attacking her body, green policemen being afraid of the red germ, red germ changing colour, blue soldiers unable to attack the red germ, a red germ attacking a green policeman, yellow germs coming in the body,‌ ) - Explain that if she does not take the pill with the blue soldiers, twice a day, morning and evening, the red germ wakes up, and as he is smart, he turns itself into a purple germ. - Explain that when she takes her drugs again, the blue soldiers do not recognise the purple germ, and they don't manage to put him asleep. This purple germ is called resistant. - Explain that when the purple germ is not attacked by the blue soldiers, he can then attack the green policemen. - Explain that if the green policemen are attacked, they cannot protect the body anymore, and the diseases come back. - To avoid that, it is necessary to take the pills with the blue soldiers, every day, morning and evening, so they can keep the red germ asleep and impeach him to change colour and become stronger.
30a
Card 30a (boy) Theme to introduce: Second line treatment How to present the theme to the child: - Show the card to the boy. - Ask what he sees on the picture. (Possible answers: a strong boy smiling, blue soldiers holding a shield, blue soldiers keeping the purple germ asleep, strong and happy green policemen,‌ ) - Explain that the drug he was taking was not able to fight the purple germ and set him asleep. - Explain that he now receives another drug, with stronger blue soldiers. These stronger soldiers do know how to set the purple germ asleep. - Explain that he should always take the pills every day, as recommended by the doctor. This is to avoid that the purple germ becomes resistant again, because if it happens, there are no other blue soldiers that could help him.
30b
Card 30b (girl) Theme to introduce: Second line treatment How to present the theme to the child: - Show the card to the girl. - Ask what she sees on the picture. (Possible answers: a strong girl smiling, blue soldiers holding a shield, blue soldiers keeping the purple germ asleep, strong and happy green policemen,‌ ) - Explain that the drug she was taking was not able to fight the purple germ and set him asleep. - Explain that she now receives another drug, with stronger blue soldiers. These stronger soldiers do know how to set the purple germ asleep. - Explain that she should always take the pills every day, as recommended by the doctor. This is to avoid that the purple germ becomes resistant again, because if it happens, there are no other blue soldiers that could help her.