Engaging a vulnerable South African community in TB and HIV prevention using a participatory approach (PEP-TB I)
Lead: Dr Gill Black
Project Coordinator: Bathulile Ntshingila
Funders and Partners: USAID TB Program South Africa
In partnership with Target Tuberculosis, Participate (Institute of Development Studies and Beyond 2015), the Delft Community Help Campaign and Hope 4 Destiny
The Project engaged the residents of Delft, a large South African township with the highest incidence of multi-drug resistant tuberculosis (TB) in the City of Cape Town. Through a series of Research and Learning, and Educational Theatre workshops – and in close collaboration with community leaders – a novel, multi-pronged and socially rational approach to TB awareness and prevention was developed. The approach was based on a well-researched understanding of specific community experiences of TB. As part of the overall strategy the Project built upon the capacity of an informal group of youth for TB prevention through the creation of dramatized sketches that were performed at events held in a range of venues in the township. News and updates about all Project activities were disseminated through social media including mobile phones, Facebook, Twitter and a dedicated website. Participatory processes were employed as channels for the youth to inform their wider networks about their involvement in TB awareness and about opportunities to know more or become actively involved. The duration of the Project was 12 months.
T-shirts were selected as a popular and effective way to get messages across in a community setting. The focus group wanted these t-shirts to illustrate both of their chosen TB/HIV prevention messages; the call for increased moral support for people living with TB and HIV, and recognition of the importance and challenges of treatment adherence. The catchy phrase ‘treat together beat forever’ was chosen to bring these two key messages together. The focus group agreed that orange is considered as a ‘cool’ colour by the youth, but that it also represents faith ‘And you need faith to complete your TB treatment’ (Linda Magobodi; DCHC focus group member). The campaign t-shirts were designed by a small working group from the DCHC and graphically designed by one of the focus group members (Mzo Tutuka).
Three different scripts were developed to highlight and present those TB/HIV related issues considered as the highest priority for community engagement by the DCHC focus group. The content and characters of these scripts were drawn directly from the personal stories (including the digital stories created through the Participate initiative) and experiences of the DCHC, and the group provided major contributions to script development and completion. Subsequently, the focus group members were trained in speech and drama techniques by professional actor, David Muller (the Merry Scholar), and they went on to become the actors and chorus line in their plays.
Play: Together We Can
The first play, ‘Together We Can : Put Support In Your Plan’, written and directed by David Muller, was produced in 2 different versions; full length and ‘chants only’. The full-length version of the play demonstrates how family support can make the difference between life and death for people who are HIV positive. The script dialogue is interspersed with short, repetitive chants using a question-and-answer approach as a powerful means of conveying and reinforcing TB and HIV-related facts to the audience. A ‘chants only’ adaptation of the play was produced for performances in noisy, unpredictable, and outdoor settings. The adapted version of ‘Together We Can’ was performed in 3 different venues across Delft, including an outdoor World AIDS Day event at Nelson Mandela Peace Park on the 2nd of December, to a total audience of over 800.
Play: The Beating
The second dramatic piece ‘The Beating’ is a play in one act written and directed by Nathi Tshabalala. ‘The Beating’ aims to increase awareness about multi-drug resistant TB, foster recognition of the challenges associated with treatment adherence for both drug-sensitive and drug-resistant TB, and demonstrate the need for the social acceptance of all TB patients. This play was presented in 2 distinct locations in Delft including a World AIDS Day event organized by Afrika Tikkun at the Nelson Mandela Peace Park and on the 6th of December at an event in the Delft South Library organized by SLF. The total number of people who watched ‘The Beating’ was almost 200.
Both the Youth and Women’s events aimed to strengthen family-based support for people living with TB and HIV and to increase awareness around the importance and challenges of treatment adherence. The two events reached over 150 Delft residents and created a platform for participants to share their knowledge and personal experiences of how TB and HIV had touched their families and lives. These events form part of a multi-pronged communication strategy for TB and HIV prevention that has been developed in close partnership with the Delft Community Help Campaign (DCHC) focus group.
The Delft Community Help Campaign Women’s event was held on 8th August and showcased a number of digital stories told by Delft residents. The stories, dealing with direct experiences of TB and HIV, roused the multi-cultural audience to speak openly, demonstrating strong views within the community about the rights of children to be better informed about HIV.
The Yebo Youth event was held at the Hague Centre for Community Development in Delft on 7th August 2013. Hosted by SLF in partnership with the Delft Community Help Campaign TB/HIV prevention focus group, the event represented countless hours of discussion and planning. Featuring a dance competition, open mic session, and Q&A discussions, the event fostered a lively and engaging atmosphere that showcased the talent of Delft youth while providing attendees a space to express themselves and their thoughts concerning TB/HIV.