Making Waves: NALAMDANA
Stories of Participatory Communication
for Social Change
TITLE: Nalamdana
COUNTRY: India
FOCUS: Maternal & Child Health, AIDS/HIV
PLACE: Urban, peri-urban and rural Tamil Nadu
BENEFICIARIES: Tamil population of Tamil Nadu
PARTNERS: Society for Natal Effects on Health in AdultLife, India (SNEHA), Cancer Institute, Tamil Nadu State AIDS Control Society, India (TNSACS), Integrated Rural Development Trust (IRDT) and other regional NGOs
FUNDING: Ford Foundation, Actionaid, UNICEF-Chennai, TNSACS, AVT Group of Companies
MEDIA: Theatre, audio and video cassettes
Every morning Lingesan opens "shop" in the Vysarpadi slum: he is the owner of a mobile ironing cart, a board on wheels that sports an iron box fuelled by pieces of charcoal. Every morning he collects pieces of clothing to be ironed from houses in the area. As he irons away the wrinkles of the neighbourhood's garments he often ponders the wrinkles in the lives around him. And as the day goes by he keeps his spirits up by composing songs in a style called "gana" that is unique to the urban slums of Chennai. He sings while he irons, sometimes to gatherings of people.
He heard one day about Nalamdana's street performances from a friend. On his friend's urging he paid a visit to Nalamdana to offer his talents. He was surprised to learn that Nalamdana already used gana songs to communicate messages for social change to the people of the slums and villages. Nalamdana invited him to compose a song on HIV/AIDS. He had heard of AIDS but discussing it with staff at Nalamdana he gave thought for the first time to the perception of AIDS patients in society. He was moved and set about writing his song on care and protection of those infected.
He was invited to record his song, and to his great surprise he was told he was going to sing it himself! Nalamdana was recording 10 songs specially created on HIV/AIDS as part of their ongoing Information, Education, Communication (IEC) material development. Top playback singers from the popular Tamil film music world had been persuaded to sing at concessional rates to create a popular, marketable tape with AIDS awareness messages.
Lingesan recorded his song with only a tabla (rhythm instrument) to accompany him. Not used to studio recording, he was allowed to have the tabla in the same room so that he could sing without the usual headphones,which he found uncomfortable to use. He sang non-stop in a single 'take.'
At the launch of the tape there were the galaxy of playback singers, music directors and special invitees on stage. Lingesan was a proud special invitee.
Lingesan continues to iron everyday, and as he does he continues to compose and sing and work with Nalamdana in his spare time.
Excerpt written by NALAMDANA staff
Nalamdana means, "are you well?" in Tamil and is also the name of an organisation started in 1993 by young people of various professional backgrounds with a common interest in theatre. Nalamdana believes that entertainment can be used to communicate information about socio-emotive sensitive issues. Nalamdanas mission is to provide health education and promote preventive behaviours through entertaining methods: street theatre, discussion groups, and songs with messages.
The logo represents the focus on health and the community based approach: a simple "kolam" or "rangoli", a pattern that symbolises the typical routine of every housewife in a traditional Tamil home cleaning the house's front yard and decorating the front steps with the pattern drawn with rice-flour. This is the first sign of welcome a visitor sees on entering a Tamil home. It also signifies the basic need for cleanliness, health and hygiene of the entire family. Beyond this, it also represents the power of bringing people together with a common vision.
Nalamdana's efforts are focused on two areas: a) widespread communication of preventive health messages to help people make informed decisions about their health, and b) development of local leaders who can harness the cooperation of the critical mass needed for visible change.
The group is involved in:
- Researching, scripting and performing community drama to increase awareness of key health and social issues and positive behaviour change; Development of television dramas on social issues;
- Development of Information, Education and Communication(IEC)materials for awareness and behaviour change;
- Conducting workshops on awareness about STDs and HIV, especially for illiterate men and women;
- Facilitating fundraising for and the dissemination of Nalamdana Scholarship Funds;
- Building up resources by training college students in street theatre.
Nalamdana has used innovative communication methods to deliver key health messages on HIV/AIDS to semi-literate audiences in inner city slums and villages in Chennai. In order to effectively reach the target population, it has developed a unique style of street theatre that is shaped in the popular film styles of Tamil Nadu.
Street plays draw mixed audiences, ranging from 700 to 1 people of different ages, sex and occupation. Nalamdana has developed three shows on HIV/AIDS in its repertoire, and has also performed shows on suicide prevention, cancer, literacy, hygiene and general health. Between November 1996 and May 1998, Nalamdana performed in more than 111 slums covering a total audience of 200,000 people. It is likely that half a million have attended Nalamdanas performances altogether.
Nalamdana recruits many of its actors and actresses from the communities. During a street play local people are given the opportunity to demonstrate their talents on the makeshift stage. This draws the community closer into the effort because having actors from communities like their own allows delivery of the message in a style and manner that is specific to their micro-culture. It also gives Nalamdana the opportunity to develop its message strategies with a closer understanding of the more subtle beliefs and issues of the communities.
The audiotape is a new communication tool Nalamdana has introduced to reinforce other methods. Half of the 4,000 copies of the first tape had been already distributed a few months after its release. People from the community wrote the lyrics while Nalamdanastaff and top artists from Tamil Nadu performed the songs.
Today with a billion people, India, along with sub saharan Africa, are the only regions in the world where over 50 percent of the deaths are still caused by infectious and wholly preventable diseases. Among the highest statistics in the world, 53 percent of the children under the ageof five suffer from malnutrition, 53 percent of the population lives in absolute poverty, and little more than half of India's population can read.
Chennai is the capital of Tamil Nadu. It has a population of 6.6 million, of whom nearly 3 percent reside in slums located along the city's polluted waterways and railway tracks. The influence of television and cinema has been so overwhelming in Tamil Nadu that four of its Chief Ministers had their roots in the film industry. Chennai is also the headquarters of at least four Tamil satellite channels that telecast Tamil programmes, 24 hours a day. Given this interest in film and related media, Nalamdana decided to use theatre to reach its target audience.
Uttara Bharath founded Nalamdana in 1993 with a seed grant from the Echoing Green Foundation in New York. R. Jeevanandham, an actor from Madurai, participated in an experimental performance of a street play for general health. The response was so overwhelming that Jeeva moved from Madurai to join Uttara and form Nalamdana Since then Nalamdana has reached over half a million people through street theatre and many more through mass media.
An evaluation of Nalamdana theatrical activities showed that a significant increase in HIV/AIDS-related knowledge occurred as a result of watching the drama. Before the play, audiences had relatively high levels of accurate knowledge about HIV/AIDS, but lower knowledge levels of common HIV/AIDS misconceptions. The drama reduced these misconceptions and also increased the level of reported intentions to treat HIV-positive individuals more kindly.
Considerable misinformation existed with regard to HIV/AIDS knowledge. The pre-test sensitisation analysis showed that the pre-test may have accounted for no more than four percent of this inaccurate knowledge increase. Importantly, there were differences in baseline HIV/AIDS knowledge such that certain low-income areas had lower levels of HIV/AIDS knowledge. These lower knowledge areas had greater increases in knowledge and thus the drama served to reduce this knowledge gap. The knowledge gap that exists between lower and higher SES groups can thus be reduced with interventions, such as community-level drama that appeals to the audience and communicates information in a manner that is understandable.
Theatre can play a key role in reducing knowledge gaps associated with low levels of formal education. Drama can find wide applicability in many settings. Although sustained behaviour change resulting from this increased knowledge is harder to measure, accurate knowledge and awareness of where to go for further services like testing and counselling are the essential steps to behaviour change. The interactive street theatre performances facilitate this link.
The drama also changed self-reported attitudes concerning treatment of individuals with HIV. This self-reported attitude change is important given the stigmatising nature of HIV, particularly in low-income areas such as the ones studied here. It may be that theatre brings the audience members closer to taking a pro-action approach to problems since it decreases the amount of discomfort associated with discussing AIDS.
Mass media channels can inform people about HIV/AIDS; however, given the stigmatising nature of HIV they may be less effective at persuading audiences to treat HIV-positive individuals kindly because they may not be as effective as personal contact in appealing to the emotional components. Moreover, mass media programming is not interactive and may not be adapted to local community needs.
Street drama has been a popular folk art in India for centuries. Traditionally, street theatre was used to dramatise mythological and religious stories. Later this technique was modified to address political and social issues. Abstract and symbolic styles evolved in different regions. Nalamdana has evolved a unique style of street theatre based on the popular Tamil cinema style to ensure maximum impact.
A strong argument can be made for street theatre as a medium to communicate information about health and sensitive social issues. Plays can be adapted to be culturally appropriate and context-sensitive. Theatre provides a public and non-intrusive forum for communication. In addition, plays are ideal to reach target groups and facilitate immediate feedback.
Community performances by Nalamdana have followed a formula of pre-play entertainment to gather the crowds, followed by a street play. The performance is followed by random interviews and counselling by the actors (who are specially trained in HIV/AIDS counselling). Information regarding the nearest counselling and testing centres for HIV is also provided. The drama productions are particularly effective when accompanied by interpersonal counselling.
Caste plays a very significant role in Tamilian culture and often the staff arrives at a remote village only to find it mired in caste conflicts. The results are sometimes directed violently towards Nalamdana staff, who need to be ready to improvise at any time to make the most of the situation and still get their messages across. In urban slums the problems are outbursts of violence related to alcoholism and local rivalry. Since Nalamdana primarily reaches out to illiterate slum and village audiences, the group decided to create simple, direct and contemporary scripts. The stories had to be credible everyday situations that the audiences could relate to easily. Their effectiveness is entirely dependent on the quality and skills of the actors involved. Where sensitive health issues are being promoted, the actors also need to be sensitised. Finding such skilled and committed actors can be challenging.
Another challenge faced by Nalamdana is sustaining funding for the intervention programmes for a period long enough to document and measure the amount of behaviour change resulting from the programme.
Information provided through e-mail exchanges by founder Uttara Bharath with Nithya Balaji and Tara Thiagarajan.
An Evaluation of the Use of Drama to Communicate HIV/AIDS Information by Thomas W. Valente Ph.D. and Uttara Bharath, MHS. Johns Hopkins University.
Evaluating Drama That Imparts Information by Uttara Bharath, MHS., Nithya Balaji, B.Sc. and R. Jeevanandham, M.Com.
Also, Nalamdana web site.
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