Art in Health
Communicating Non-Communicable Disease
In light of response to the NCD crisis global health promotion efforts aimed at promoting wellness define by the World Health Organisation (WHO) as "A state of complete physical, mental and social well-being, and not merely the absence of disease" have expanded. Particularly in the Pacific Islands where populations show some of the highest risk factors such as obesity and physical inactivity in the world.
Traditional training and employment schedules in the Pacific mean health professionals are the primary agents in health promotion though they are trained primarily on the medical background of health conditions with varied levels of inter and intra personal communication skill development. While many Ministries of Health now employ graphic designers to help design information, education and communication (IEC) materials strict guidelines and limited funding allocation can stifle creativity.
The erosion of traditional customary practices means we’re losing two key elements of our cultural identity- our healthy island lifestyles and unique artistic and performance customs. Growing recognition of how effective communication can motivate positive behaviour change provides an opportunity to rejuvenate both elements through health promotion. There are two key avenues through which artists can contribute to health promotion:
“What we hear, we forget;What we see, we remember;
what we do, we understand.”
A Growing Evidence Base
The arts present a promising entry point for health discussions promoting national and household dialogue around health. Through creativity and innovation employment of the arts can address the complex factors needed in effective health promotion to motivate the public into positive behavioural change.
There is growing evidence that different art forms can have a positive impact in a clinical setting. For example visual art and music have been used to effectively reduce anxiety and depression in chemotherapy patients. In the cardiovascular unit music has even been found to significantly reduce blood pressure and heart rates and reduce length of hospital stays in the intensive care unit. Small studies have also found that arts can be used to change people’s perceptions, for example in Ireland a drama performance was used to effectively raise the audiences knowledge, and support of breastfeeding while in Colombia audience members of the play “the Gift of Life” showed a favourable shot term change in attitude towards organ donation.
Currently art participation programs greatest impact appears to be on mental health. Creating art provides an opportunity for personal expression, positive social interaction and enhances self-esteem while experiences different art forms can increase people’s social connectedness as well as reduce feelings of stress and anxiety in high-pressure situations. Poor mental health is both an NCD, and an NCD risk factor as it can cause lifestyle risk factors such as alcohol abuse, poor nutrition and lack of physical activity as well as result from these lifestyle risk factors. This means improving mental health is a crucial step in improving NCD risk factors, particularly in the Pacific, which faces worrying mental health and suicide statistics as well as major service shortages to address the issue. Examples of arts working to promote mental health include Fiji’s Crop (Community Recovery Outreach Program) which uses art to help psychiatric survivors express themselves, and the in Samoa where the ‘Moving On’ project helped children use art as a therapeutic catalyst in recovering from the psychological trauma following the 2009 Tsunami.
As it is a young field of research, evidence of the arts effectiveness in improving lifestyle risk factors such as body weight, physical activity levels, tobacco use and diet in the prevention of NCD’s is limited and requires further investigation. However, in a 2012 review of the evidence prepared for the Arts and Health Foundation in Australia found the following benefits on health and wellbeing through participation in the arts:
- Personal development (improved confidence, knowledge, identity, empowerment, and quality of life)
- Increased physicality through dance, singing, musical instruments etc to maintain cardiac function, fitness and brain health
- Social engagement which builds social support and networking to assist in coping
- Raised awareness of issues and improved health literacy
Guide for Artists Working in Health (Draft Version)
This is a quick guide for artists who are already working in health, or are looking to do so. It includes information about Non Communicable Diseases, key health messages and effective strategies in health promotion.
Click here to download.
Connecting with Artists
Fiji Arts Council
Fiji Arts Council work to ensure a vibrant, innovative, distinctive creative scene in Fiji and has all the links and advice you need for working with local fashion, performing, heritage and visual artists.
Telephone: + (679) 3311-754
VOU is a contemporary Fijian dance company that engages over 300 community members of all ages in physical activity through dance. As well as regular classes they also arrange impressive performances incorporating traditional dance and costumes to raise public awareness of important issues such as domestic violence and global warming.
Phone: (679) 3100 611
On the Spot - Tonga
One the Spot is a Tongan arts association that showcases and celebrates the work of local artists. Running workshops, creating artistic spaces and hosting exhibitions- On the Spot particularly excels at engaging youth in art and performance.
Phone: +676 7736888
Facebook: ON THE SPOT- arts initiative
Contact the Samoa Arts Council. The council promotes awareness and appreciation of artists and the value of creativity in the Samoan Community. They provide access to training for artist as well as facilitating networking and exchanges.
Phone: +685 7772993
Facebook: Samoa Arts Council
In French Polynesia health promotion teams employ local artists for a variety of campaigns. These include the creation of “Ute Areasrea” a music video featuring popular local artists to promote a healthy lifestyle as well as organising “No smoking, go ori deck day” which encouraged kids into dancing while raising awareness about the dangers of smoking.
Forum Theatre is an interactive style of performance designed to raise awareness and coping skills for different life situations while sensitizes them to health topics. It breaks traditional theatre rules by requiring impromptu acting, introducing discussion pauses and encouraging the audience to interrupt the performance. The Pacific Company/ Pacifique et Compagnie is using this form of theatre to enact social change and help high school students anticipate and respond to situations that may affect their mental, physical or social health.
Actors and comedians team up with health professionals and run interactive classes which encourage discussion around issues such as addiction, sexuality and violence to provide teenagers with practical coping mechanisms. Based in New Caledonia the Pacific Company has now spread their work to Wallis and Futuna, Tonga, American Samoa and Fiji.
In Fiji the Community Theatre Group is also using forum theatre in outpatient clinics to dramatize practical approaches in dealing with illness and diabetes prevention while people wait for their appointment. This approach came about after research found people seldom read pamphlets and brochure about diabetes which are currently distributed, as well as witnessing the long waiting period’s people had at outpatient clinics. Currently running in the northern division of Labasa, the project is funded by the International Diabetes Federation and evaluation is due in Dec 2014.
The Conch’s ‘Stages of Change’ theatre group in the Solomon Islands is also using forum theatre as a vehicle for reducing violence against women. After developing a performance with local women in Honiara they now perform all around the Solomon’s with additional radio clips and creative training workshops for survivors of domestic violence.
Pacifique et Compagnie
Wan Smolbag Theatre Group- Vanuatu
Wan Smolbag Theatre group (WSTG) is a ni-Vanuatu non-government organisation which employs local actors, graphic designers, film and radio technicians as well as nurses and uses drama to inform, raise awareness and encourage discussion on a range of health issues in Vanuatu. Their popularity and success has helped them expand into many different areas including producing the first ever locally produced television series ‘Love Patrol’. Love Patrol is a soap opera with a serious message, educating young ni-Vanuatuans about HIV and AIDs. A random street poll found that over 90% of people in Port Vila were watching every episode and it’s become a “smash hit throughout the Pacific”. Most importantly though the show has helped break down the barriers around HIV and helped people feel comfortable talking about sexual health to ensure the preventative message spreads.\
WSTG have also expanded their services into NCD prevention and now run a nutrition Centre which acts as a community hub and source of information and education on health and nutrition. Through their community garden they have created both an income generation scheme for young people and an affordable way to provide their volunteers a complementary lunch.
Whether you require community engagement, scriptwriting and directing for radio, theatre or video, IEC development or community play projects – Wan Smolbag are the place to go in Vanuatu Contact
Email: Michael Taurakoto firstname.lastname@example.org
Drama in Health Promotion
Youth led theatre groups have been one of the most successful strategies in promoting AIDS/STD prevention since the early 90’s and are now being used to combat NCD’s to similar effect. Small mobile theatre groups allow spread of messages to remote and hard to reach Pacific locations and fits well with the oral and performance traditions of Pacific Islanders. Drama helps to overcome literacy issues to increase understanding while the injection of Pacific humour helps engage audiences; address sensitive issues and overcome the ‘fear factor’ commonly associated with health.
Drama can be a vital tool in health promotion to pave the way for honesty, ownership and frankness among peers and within families to acknowledge and address health issues. Youth lead theatre also gives a voice to younger generations who often don’t have the same right as adults to say what they think and are a notoriously difficult group for health professionals to effectively engage with.
In many countries the formation of drama groups has helped up skill and employ youths in areas where youth unemployment is high. Throughout the Pacific these groups are gaining popularity and recognition as an effective form of health promotion. As Health Professionals we can support the movement by engaging with such groups for the development of health projects as well as supporting the evaluation of art and theatre programs to build an evidence base which showcase’s their impact.
“ Theatre groups are prime examples of Pacific youth on the move to strengthen their identity and self-esteem…using a culturally appropriate approach to protect their inheritance”
- Patrician Sheehan , Pacific Health Dialogue
Filitonu, which translates to ‘Right Choice’, is Tonga Family Health Associations drama group made up of 9 volunteers who have been helping engage audiences to spread health messages since 2000. Originally the group was formed as part of the Adolescent Reproductive Health Project and focused on family planning and sexual health messages however their success in this area has helped them expand and team with Tonga Health to promote healthy lifestyle messages.
Their work includes dramas delivered to schools to promote health messages such, public stunts such as an aerobics flash mobs and cooking competitions and television ads that put a Tongan spin on health topics such as smoking avoidance and sugar sweetened beverages. They’ve also joined Tonga Health in the Mai-e-5 campaign visiting every primary school to promote eating and growing local fruits and vegetables. For health professionals, children and adolescents pose a particularly difficult target group as while we can help develop policies towards healthy environments- creating awareness and enthusiasm in younger populations is crucial to their success and requires innovative programs. Filitonu fills this gap using humour, drama and relatable role models to engage audiences and spread messages.
Youth to Youth in Health - Marshall Islands
Founded by Marshallese activist Darlene Keju in 1986, Youth to Youth health (YTYH) is an NGO who works in collaboration with the Ministry of Health to provide training and community activities for young people to make them active participants in determining their health and future. The organisation trains youth health workers to work as peer educators throughout the Marshall Islands. Their strategy to health promotion includes the use of drama to convey messages, nurturing traditional Marshallese cultural practises and promoting the growing and harvesting of foods to create sustainable livelihoods. YTYH creates a safe place for youth to learn about and discuss issues that affect their lives to empower them in becoming proactive influencers in the development of their community and nation.
Through the creation of songs, skits, radio spots, theatre and TV spots YTYIH’s work in the area of sexual health was credited with increased use of contraceptives and 26% reduction in teen pregnancy between 1988 and 1992. Many former members of the group have gone on to work in health and education as a result of their participation in YTYH.
Contact: +692 625 3098
PO Box 3149, Uliga, Majuro Atoll, 96960, Marshall Islands
Solomon Islands Development Trust (SIDT)
SIDT is an NGO founded in 1982 that works to promote community empowerment in governance, eductaion, health, environment, natural resource management and disater risk management. Their Community Action Theatre Group helps spread important health and environmental messages through humour, drama and role play to the community with great affect in even rural villages were oraliy is valued. The use of theatre has been particualrly effective in the Solomon Islands to overcome literacy issues and use of humour to enegage audiences.
The program has a achieved great results in the area of health and nutrition. For example in Weather Coast a theatre program designed to educate mothers on the importance of feeding their children regular, nutritious meals has lead to a noted reduction in the ammount of chidlren reporting to the heart clinic who have skipped meals.
Similarly a group of peer educators with the Kiribati Family Health Association use drama as a way to convey messages about sexual health and reproduction to at risk youth groups. Visit their website here.
Tuvalu Family Health Association
A 2010 survey found over 10% of population made use of the organistaions services with 30% of the organisations activities focusing on peer education including theatre/role play eductaion and media production.
Phone: +688 2 0411
Daniel Kelin is an international recognised Fullbright scholar, writer, director, actor, storyteller and published author with years of experience in theatre production and training. His work spans India, Japan, Marshall Islands, Hawaii and America where he strives to shocase and protect cultural element of each country. With a focus on using drama as a way of learning Daniel is available as a consultant, manger and trainer for theatre eductaion projects. Visit his website here.
Larry is the co-ordinator of the regional media centre with the Secretariat of the Pacific Community (SPC) and has wealth of experience as a writer, eductaor and film maker in the Pacific. Larry has been involved in the start up of radio, theatre and film productions around the Pacific. You can contact Larry at LarryT@spc.int