Culture and HIV/AIDS

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Title of project

Participatory theatre in sexuality and reproductive health education for young people

Organisation

World Population Foundation and David Glass Ensemble

Country/region

Vietnam

Photo 1: The Hanoi troupe use rap music as a vehicle for engagement and fun (Courtesy Paul Zetter)

Project focus

The aim of the project was to improve young people’s knowledge and attitudes about sexual reproductive health issues, including HIV prevention; and to encourage healthy behaviour related to sexuality and reproductive health of young people and adolescents in Hanoi and Nghe An. The project used participatory/interactive theatre as the basis for creating a community based forum for adolescents and young people to share correct knowledge, attitudes and behaviours on safe reproductive health practices, and to actively promote the roles of young people in meeting their own needs in sexuality and reproductive health education.

Background

Sexual reproductive health (SRH) and its attendant issues, such as HIV and AIDS, are still considered taboo subjects in Vietnamese culture. Theatre provides an avenue through which subject matter can be aired in public without threatening cultural sensitivities. Although the subject matter is depersonalised, the story lines can still resonate with the lived experiences of the audiences and provide an avenue for the dissemination of accurate information about sensitive issues that would not otherwise be available to many disadvantaged groups.

Interactive theatre depends on interaction between performers and the audience. The audience is involved in the story line and in subsequent discussions. Thus, they can receive accurate information and can also be engaged in a process that encourages them to develop their own solutions to everyday dilemmas associated with SRH.

Level of cultural intervention used in the project

Culture as context: is evident in this project through its analysis of current Vietnamese youth norms and the SRH information needs of young people in both urban and rural settings.

Culture as a process based method: has been used in this project at two levels. One involves the personal and professional development of the actors (project participants), and the other involves the audiences (project beneficiaries) in a participatory, interactive method that invites young people to explore and share (or process) their knowledge, views and concerns about SRH issues, behaviours and practices.

Photo 2: At the end of a forum theatre piece, members of the audience are asked to become actors and explore their own scenarios and reactions (Courtesy Paul Zetter)

Activities

Two interactive theatre troupes were established, one in Hanoi with 14 members and one in Nghe An with 11 members. All troupe members are between the ages of 14 and 23. Although the numbers of members has varied over time, the aim was to have approximately 12 in each troupe and also to try to maintain an even gender balance.

For the Hanoi troupe, there was an extensive audition process carried out by David Glass Ensemble (DGE) and World Population Fund (WPF). The target group for this process was not actors but ordinary youths who would be representative of the kind of audience they would eventually be performing to/with both in terms of education, age and geographical location.

With the Vietnam Stage Artist's Association (VSAA) as co-facilitators, DGE UK designed and carried out a comprehensive range of training for the members of the theatre troupes on: Creative methodology and process; Team building and group support behaviour; Story and story structure; Acting skills; Participatory and forum theatre methods; Masks and puppets; Music and rap skills; Performance skills such as use of props/sound effects/staging; Mime; and Show content and production.

Interactive theatre was then used by the troupes to contribute to increasing awareness of reproductive rights and minimising reproductive and sexual health risks, including HIV and AIDS, in adolescents and young people in Nghe An and Hanoi. Over 200 performances have been conducted and the equivalent of more than 27,900 young people have attended performances and accessed sexual reproductive health (SRH) education at schools, and in community hamlets, through this interactive communication medium, in one year. In addition, there have been 12,372 SRH related leaflets distributed to audiences.

The project has been comprehensively evaluated by an external consultancy team (Consultation of Investment in Health Promotion, Hanoi).

Photo 3: Hanoi Interactive Theatre Troupe (Courtesy: Paul Zetter)

Outcomes

This project is innovative as a “cultural approach to HIV and AIDS” for a number of reasons:

1. It is dealing with a culturally sensitive subject through engaging with youth culture: HIV is not tackled head on but forms part of the dialogue about what it means to be an adolescent. Placing HIV and AIDS into context is perhaps the most powerful part of the approach. Most HIV and AIDS prevention approaches are based on information provision and have a tendency to increase fear and stigma rather than reduce it.

2. It recognises young people’s rights to accurate information about sexual reproductive health and their right to make their own informed decisions and choices about their future SRH behaviours.

3. It uses participatory theatre that encourages dialogue and engagement. In this respect it gives Vietnamese youth a voice through engaging them in an experiential learning process.

4. In choosing young people from the target group and training them, instead of choosing professional actors, it generates openness and empathy.

Access to information: The evaluation team noted that the project has increased access by young people to information and communication about SRH issues through using a peer education approach where troupe members are selected from the target community. Young people were involved throughout the process, and the project developed "safe settings" in which young people can feel confident.

Young people found that the SRH information provided through theatre was easier to follow, understand and remember, compared to obtaining information through written documents and IEC materials, or through formal training in schools.

Increasing engagement, openness and confidence: The performance style, with its humour and liveliness, made participants interested in the dramas, and gave them the confidence to join in, discuss and express their opinions.

The use of stories based on common youth dilemmas by the project had given young people opportunities to see themselves and their situations portrayed as the focus of the dramas. Several said the dramas were close to their lives and expressed their interests, concerns and needs.

Young people became more open and confident about discussing sensitive issues such as using condoms and sexual relations. Evaluators witnessed higher levels of openness and confidence. It helped that peer educators were from the same age group and came from the same communities as the troupes.

The use of small-scale theatres (especially in Hanoi, where a performance is normally conducted with 50 to 100 people) helped develop a feeling of affinity with troupe members. Several participants noted the openness and friendliness of such 'peer educators' and considered that was one of the key factors that made them feel comfortable to talk and participate in discussions.

Impact on troupe performers: Troupes developed a good reputation and were invited to perform in public events outside the project framework. Several members of the troupe have gone on to use their theatrical skills outside the project and are continuing their professional acting and earning income from it.

More importantly, the project has created a core of young people who have become catalysts for change and whose life direction in nearly all cases has been positively affected by the experience of being part of the project. The personal and group effectiveness and impact of the troupe has been a central part of the success of the project.

Negative outcomes: Despite the positive resonance with respect to many topics, some respondents still considered homosexuality as a disease, and/or reported still being fearful of people living with HIV and AIDS and their relatives. Nonetheless, evaluators recognised positive expressions of sympathy and non-judgmental attitudes among other interviewees.

Audiences for performances in community settings sometimes caused difficulties. Parents and elders often attended community performances as well as young people. From one perspective, such a mixture of people could be seen to increase access to information. However, young people in these settings were not as comfortable to talk about SRH issues. In certain cases, peer educators also felt embarrassed when confronted with unexpected reactions from adults. Appropriate ways of managing and resolving cross-generational differences need to be developed to ensure that both generations can be heard and understood by each other.

Beneficiary feedback (reported)

“The play on HIV and AIDS helped us understand the routes of HIV infection. Now we know that everybody would be infected, so we should not discriminate HIV positive people” (Focus Group Discussant, Nghe An)

“These performances create a cheerful and comfortable atmosphere, and the story is so real. Thus we have feeling that we are a part of the play” (Male student, 16 years old, Ha Noi)

Free listing of youth’s impression about ITT performance: “Useful”, “Interesting” “Informative”, “Delicate” “Funny”, “Humorous” “Friendly” (Female Focus Group Discussant, Ha Noi)

“We have opportunities to ask them in person our questions and concerns during or after performance” (Girl, 21 years old, Nghe An)

"This kind of education is more appropriate because it allows us to interact and explore deeper information. We cannot have this benefit when we learn from text book or in class room. Even though our teachers are good, we are still too shy to ask" (Girl, 17 years old, Ha Noi)

Sources

Carin van der Hor, World Population Foundation
www.wpf.org

Paul Zetter, David Glass Ensemble, Vietnam. paul@ensemblecreative.org
The international arts in development work of the David Glass Ensemble now goes under the name of Ensemble Creative Training and Development. www.ensemblecreative.org

Nguyen Minh Duc, (2005). Final Evaluation of: "Using participatory theatre for reproductive health and sexuality education for young people" project. Consultation of Investment in Health Promotion, Hanoi.

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