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Talking to the Streets for Health: Street Theater as a Public Health Tool

Prior to coming to Delhi, I did not have much exposure to the power of the theater as a mode of dissemination of public health messages. It does sound strange when I put it that way because Kolkata, where I hail from, is a city with a vibrant theater culture. However, I just never got
around to enjoy this particular form of the arts. It was not until I landed in UCMS, New Delhi that I realized what a powerful medium theater can be. And especially, street theater.  I find several facets of the concept of street theater very attractive. One of them, of course, is the fact that this is
a bare-bones method of presenting one’s ideas and thoughts. This means that there should be enough clarity in the message so that the audience can get it. The other is the challenge aspect of the whole concept. Without props, sound augmentation, or the guarantee of an appreciative audience, the performers need to take their actions to the next level in order to get through to the audience.

Titled Dastak – Ek Pukar (A Clarion Call), the focus of the show was on breast cancer awareness. Today’s show was presented by Confluence – the meeting point of medicine and humanities – as a part of the activities of the Medical Humanities Group of the University College of Medical Sciences. This is one of the first institutions in India to have established a humanities group and though I am not very involved with the functioning of the group, the student members seem to be very actively involved in it. Often, in the evening, on my way out of the hospital, I run across groups of students rehearsing their moves. In a system of education where the only marker of your excellence as a student are myopic numerative assessments, it is indeed refreshing to see that students are actively involved in such extra-curricular activities.

The theme for today’s play, as I said before, was breast cancer awareness. The message was that there is no need to feel ashamed about going to a relative or a doctor with the problem if one sees it. The students represented a few of the major lifestyle risk factors for the disease and wove them into the story-line quite convincingly. The best part was that the focus was not paternalistic one, where they took a higher seat and showered advice on the audience, but, a rather participatory one. While watching them execute the idea, one felt convinced that they were a part of the solution if they wanted to be.

Though the power of mass media and information portals are undeniable, experts are of the opinion that such impersonal and generic messages lack the persuasiveness of an audience-tailored informational intervention.(1) Street theater can well be such a mode for introducing information about culturally sensitive issues like breast cancers, safe sexual practices and family planning methods, and the impact can be maximized by an a priori understanding of the demography of the likely audience.

One may argue that the other side of being up, close and personal is that the mode may be viewed as intrusive and culturally insensitive, especially by the orthodox members of the audience. There also remains the worry that since street theaters are a method of digesting and then presenting information in an aesthetically pleasing format, the information may be delivered in a non-standardized form. Although we are still grappling with the idea of trying to find out the best balance of the different aspects of information delivery, the exact dynamics are difficult to compute in this regard, since a major human factor comes into play. Keeping these limitations in mind, a group of researchers from Johns Hopkins conducted a study in Peru to estimate the efficacy of a street theater based intervention in reducing the load of misinformation regarding family planning at the community level.(2) They noted that the customized, culturally acceptable mode of street theater intervention actually helped to reduce the burden of misinformation, despite the presence of all the limiting factors.

So, the advantage to the audience is clear, but I would like to conclude with some interesting information coming out from a group at the School of Public Health at the University of Minnesota. (3) They found that involving high school students in a theater-based intervention program (which they called “Ready! Set! ACTION!”) led to some interesting outcomes. Now, this was mainly a feasibility study, so the behavioral impact assessment may be a little flawed. They found at impact assessment that involvement in the theater program led to better understanding of the need for behavior change although the program itself was not very successful at instituting the behavior changes. So, by doing these street plays and humanities activities, I believe the students are not only obtaining remarkable soft skills that they shall treasure all their lives but also are imperceptibly incorporating the health messages that they are spreading into their own lives as well. The Minnesota group studied children from diverse ethnic origins and low income parents. Compared to them, the medical students staging these plays are more open to health information and I believe that they are not just doing enormous community awakening with their plays, but also, in the process, healing themselves.

What was especially heartening was the fact that the play was presented by some of the youngest people out there – students from the 1st and 3rd semester. One can only hope that with such wonderful and empowering environment around them, they turn out right, unlike this Bond meme that is doing the rounds:

A special shout out for Dr. Satendra sir, who, very kindly allows me to steal the pictures of almost every event I write about, and also for mentoring and guiding the Humanities Group. Here’s hoping I can contribute more to it in the future than online memes.

Oh, and yes, have a safe and Happy Diwali.

References:

1. Communicating to the general public: different audiences, different needs. Netw Res Triangle Park N C. 1987 Spring;8(3):4-5. PubMed PMID: 12268491.

2. Valente TW, Poppe PR, Alva ME, De Briceño RV, Cases D. Street theater as a tool to reduce family planning misinformation. Int Q Community Health Educ. 1994  Jan 1;15(3):279-90. PubMed PMID: 20841245

3. Neumark-Sztainer D, Haines J, Robinson-O’Brien R, Hannan PJ, Robins M, Morris B, Petrich CA. ‘Ready. Set. ACTION!’ A theater-based obesity prevention program for children: a feasibility study. Health Educ Res. 2009 Jun;24(3):407-20. Epub 2008 Jul 11. PubMed PMID: 18622011; PubMed Central PMCID: PMC2682640.

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6 comments on “Talking to the Streets for Health: Street Theater as a Public Health Tool

  1. Above everything that you have said, there is nothing more heartening than to see ‘medical’ students doing something more than ‘medicine’ in the accepted sense of the discipline.

  2. As you have pointed out, it must be a wonderful experience for the medical students getting involved with this street theater programme to disseminate medical awareness organized by your institute. I think in this age of information overload and decreasing attention span, where we read articles “at a glance” and surf between channels, a lot of preaching and sane advice fall on deaf ears. Theater, on the other hand, is a strong medium that strikes a chord with the audience and its power as a tool to spread awareness is immense.

    • Beautifully put! I have not encountered much in the way of theater culture, and I must say I think the public health potential for this mode of communication is immense!

  3. greetings sir
    just read your article….i must say that im really impressed. Im a 5th sem student of ucms and u might not be knowing, but our dramatics society, ‘Manchayan’ has actively performed at various other public forums as well. Being associated with manchayan for 2 years now….I sincerely believe that street theatre specially can really serve as a medium for these messages. Last year also we performed in the gynae opd in front of real audience about domestic violence on women and before that when I was in first year we performed in anna hazare’s rally at jantar mantar on corruption.
    I was under the impression that nukkad natak is something restricted to colleges. in india. Im really enlightened to know that there are other countries as well which support street theatre. Hoping to read more of your views on nukkad natak.
    happy diwali.
    sincerely
    Aheed khan

    • Aheed,
      I am from Kolkata and in all the years in medical school, I did not encounter such a wonderful endeavor. All our plays and shows were aimed at entertaining ourselves. This exercise in using cultural tools to expand the horizons of awareness is indeed a wonderfully enthusing affair. I hope to get to know all of you at Manchayan better and be a part of this unique group.

      Keep up the great work!

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