Dialogue-based communication for HIV risk reduction

[Ash Pachauri]

We have been working with truck drivers (and allied community members) on HIV and STI risk and vulnerability reduction using a number of dialogue-based methods. These methods employed by and for truck drivers themselves, include interpersonal communication (IPC) and a form of participatory theatre called "Magnet Theatre" (MT). You can read more about this form of theatre here: http://chp.community.officelive.com/Documents/Theatre%20for%20Dialo... To request a video on MT, please write to me.

A dear friend and colleague Madiang, who is based at PATH in Kenya is a master trainer in magnet theatre; and is one of the key trainers of the truck driver community that we work with here in Delhi. Members of the community have now taken up MT on their own; and continue to conduct performances across Delhi and at Sanjay Gandhi Transport Nagar (SGTN) where some of our trained MT peformers and CHP's team members are based. I will post details inviting all of you to the next MT performance to be held in Delhi soon.

MT is a great way to bring to the surface issues that are close to the community, and which may not even come out during conscious dialogue. One very interesting finding made through MT performances and dialogue within the community during and after MT, is that male-to-male sex is very common among truck drivers; in fact MSM activity is very common among the ustaad (driver) and chotu (helper). What makes this behaviour difficult to identify is that truck drivers themselves do not consider this sexual or MSM activity.

I look forward to continuing this important dialogue initiated on AIDSCOMPETENCE.

[Ash Pachauri]

Dear Rituu,

Thank you for the important questions you have raised.

Once an MT intervention is off the ground, the costs remain fairly static and low. Typically community members (average troupe size is 8 people or so) will be compensated a nominal amount for their time spent on script development, practice, peformance and feedback (MT is a fairly time intense process). Expenses tend to remain low as there are no real stage costs and MT practice and performance takes place in community settings/DICs etc. Theatre trainers and professionals are not required on a full time basis once the intervention has rolled out and initial skills are built (experts may only be pulled in to provide specialized inputs on a time to time basis).

Once MT was rolled out with truck drivers, we found a number of truck drivers, helpers and allied community members expressing an interest to join the troupe. Trained troupe members easily pulled in and trained new community members who have since actively taken up MT. Though very few newly inducted troupe members have taken on more specialized facilitation roles.

Depending on the effectiveness of an MT performance and even more importantly facilitation, dialogue generated from MT can be very powerful, emotional and even life changing for some community members. At times community members share very personal stories and health/medical conditions and cirumstances. The facilitator needs to be deft and sensitive in dealing with them. The level of trust generated and the resulting willingness of audience members to share will depend a lot on the quality of the performance and facilitation. In some instances, audience members may not be comfortable to openly share at the MT venue; they may approach troupe members/ facilitator outside the performance. This is where the troupe members' acceptability and accessibility to the community (selection criteria) and their interpersonal communication skills and product/service knowledge become particularly relevant.

It would be great to have you at the next performance. I will let you know when the next one is being scheduled soon.

Thank you so much again for connecting us with this wonderful platform!

Warmly,
Ash

[Rituu B. Nanda]

Dear Ash and Madiang,

What a wonderful introduction to MT! I am waiting to attend the next show in Delhi.

I was wondering what does it all cost? What is the sustainability of the initiative? Do the allied community members become master trainers and go and train others at different halt points? What makes it easy for the community member to reach out to the MT troupe members for their medical queries? How do you build this trust?

Another interesting thing I found was the probing questions you use in MT to encourage community members to share their experiences. Stimulate is an integral part of SALT approach of ACP, its DNA.

Wonderful to have you with us here.

Warm regards,

Rituu

[OLUOCH-MADIANG']

Thank you very kindly Ash for sharing so competently and fully about Magnet Theatre and your experiences with implementing this communication tool with long distance truck drivers. I am eternally proud to have come over to India and facilitated the initial trainings with IDUs, MSMs, Truck Drivers and other CSWs. My experiences in Ongole, Hyderabad, Bangalore, Manipur and Mumbai continue to inspire me as we proceed with the Magnet Theatre (MT) travels.

Before I add a few cents here and there, I would like to inform all here that on 28th may 2007, the PATH Kenya Communication team, specifically C. Y. Gopinath and myself were feted at the 2007 Award for Excellence in HIV and AIDS Communication in Africa during which MT was declared the Best Folk Media Initiative. I thus like these days to refer to MT as an 'AWARD WINNING' communication tool! Hahahaaa! It may interest our colleagues to note that MT has been adopted in many and diverse health and peace projects in Uganda, Tanzania, Rwanda, Djibouti, Democratic Republic of Congo, South Sudan, Eritrea, South Africa, India and Nepal amongst other countries.

Laurence asks a very pertinent question: How do you move from Fiction to Reality? Ash has done a wonderful job to respond to that and particularly stated that MT has a Facilitator who links and bridges experiences, fears, attitudes and suggestions of the participating audience. I would like to inform all that MT ONLY deals with the issues that affect the particular target audience and hence, from the outset, bases itself on reality in developing fiction! The issues grid is a precursor to identifying the Key Population's (KP's) - or target audience if you like - issues that drive put them at risk of infection or conflict. The fictional drama created is then a direct response to these issues, with the Facilitator helping the audience arrive at self-initiated, self-serving solutions and practical behaviors and attitudes towards combating the issue.

Recently, in an effort to help trainee MT facilitators navigate the process of moving from the audience interrogation of the dramatic fiction to uninhibitedly discussing and sharing real life experiences, I have developed the Magnet Theatre Facilitator's FACILITATION ONION whose substance is to tactfully prepare the audience to face their individual, collective and communal real life issues in the open. The success of MT is measured by the extent to which real life issues of the target audience are dealt with. The fictional drama's role is to stimulate deeper reflection and critical dialogue amongst those facing the issue. Indeed, MT is structured into various steps/elements, the most important of which is audience participation.

The next question Laurence asks is whether or not the audience shares their real life experiences. By now you can deduce the answer to be a definite YES! Magnet Theatre has as one of its principles the MAGNIFICATION of positive behavior change which entails providing a forum for those who have dropped risky behaviors and adopted a new, healthy one to voluntarily share their experiences. In the course of participation, the MT Facilitator also consciously prods the audience to relate their suggestions and attitudes provoked by the drama to real life occurrences...without defaming others!

Gatson asks about training and dealing with a mobile community! Ash, again, wonderfully responds to that. I may stress the fact the the 'halts' and rests that truckers take provide a good opportunity and forum for MT. In our project with truckers in Eastern Africa, we have striven to make known truck stops a Safety Stop and have succeeded in involving truckers and the communities within which they impact on social, health and economic life to reflect deeply and engage in dialogue about HIV and other behavioral health risks.

As I do not have much time, let me attach some documents here by myself which might give you more insight.

As always, i am open to your enquiries and questions. i may not respond immediately as I am perpetually short of time, but I would plead patience for ultimately, I will.

I am very happy to be a part of the India-Kenya initiative.

Best regards,

Oluoch-Madiang'.

Magnet Theatre Award Info.doc

Magnet Theatre presentation Oct 3 2007.ppt

[Ash Pachauri]

Dear Gaston,

Many thanks for your email and interest in MT with mobile communities. Thanks also for the very pertinent queries you have raised.

We have conducted MT with a number of communities including other key population groups (e.g., injecting drug users, MSM/transgenders, sex workers), but as you rightly noted, identifying and training truck drivers and mobile communities raises specific challenges (and opportunities).

Typically, a set of criteria (including time, availability, interest in theatre, some acting skills, acceptability among peers) are followed in the process of selecting members of the community for an MT intervention. In the case of truck drivers, we linked closely with members of allied communities (e.g., mechanics, dhabha wallas – i.e., tea and food stall owners) since they are more static and yet belong to the truck driver community (current or in the past). Many allied community members also travel less frequently (than full time truck drivers).

We also made an effort to identify specific locations to recruit truck drivers and implement our MT interventions. E.g., we selected trucking halt points which are source and destination points rather than transit points, implying that truck drivers spend more time there between trips. These factors together allowed us greater time and contact with selected MT troupe members as well as the wider community (i.e.., truck drivers are likely to return to source and destination points as repeat audiences). Further, in the case of MT with truck drivers, we typically selected more truck drivers (than would otherwise be selected) as at any point in time (e.g., during training workshops or regular MT performances) some members of the troupe would be on road.

The training itself entails capacity building in dialogue with the community to identify community issues and real life dilemmas, mobilizing the community, scripting performances, performance and acting, facilitation, monitoring and reporting and so on. Most MT performances are also followed up with interpersonal communication (IPC), so MT troupe members are also trained in dialogue-based IPC. Training workshops are conducted at trucking halt points (i.e., in locations that are natural to the community and where the community is likely to interact with peers, dialogue around issues and mobilize the community in the process). In the case of the MT intervention which we implemented with key populations in India, 2 local theatre trainers each were also identified to support troupes in theatre skills. A national training of trainers (ToT) was conducted with the theatre trainers who then went into the field to train the community and continue in-field handholding. MT program staff remained close to the entire process and master trainers, including Madiang from Kenya were key trainers at the national ToT as well as experts to guide planning and selection processes and implementation from start to end.

Often times, MT performances will raise a number of issues around access to services (e.g., HIV testing, STI treatment) and products (e.g., condoms). MT troupe members are trained to support this dialogue and are typically able to indicate to community -- where, when and how products and services are available and accessible across the local geography (as well as on the road). A good facilitator will also be able to suggest practical means of accessing products and services. E.g., if a truck driver expresses fear of accessing an STI service because of the stigma associated with a nearby clinic, the facilitator will be able to inform him of other accessible clinics and services; as well as communicate with staff of the STI clinic what community perceptions are and also possibly ways to position the service differently.

Please let me know if you have any further queries.

I would love to learn more about your experiences.

With many thanks & kind regards,
Ash

[Gaston]

Dear Ash,

Thank you for sharing. This sounds really interesting and I like how you call it a dialogue-based tool. I have three questions:

1. How do you train the community members who will set the theatre up? What does a training entail?
2. We have worked with truckdrivers in both Asia and Africa, I am wondering how you apply this to these mobile groups? They are always 'on the road' and do not have a long time to engage in a theatre play, let alone prepare it or involve their own (geographical) community.
3. I like what you say in point 5. It needs to be supported with product and service availability. Can you elaborate a bit more on how you achieve this, both in geographical communities and mobile communities.

Looking forward to learn more from you,

Thanks,
Gaston

[Ash Pachauri]

Dear Laurence,

Thank you for your interest in magnet theatre. This is a dialogue-based tool which is put in the hands of the community so the intervention is ultimately led by and for the community itself. The scripts are developed by trained community members and are based on real-life community situations. Typically the script injects humor, pain, tumoil etc all based on the everyday life of the community, so that the audience relates to it in full. The actors are from the community. MT uses little theatre make-up and so on, so the the community 'actors' and stage are not separated from the audience. Finally, the script builds up to a compelling dilemma (very real life). At the point of dilemma the theatre freezes and a trained facilitator on the troupe comes in to facilitate dialogue on possible "solutions" with the audience. The idea is to compel the audience to think critically about the issue rather than pin point right or wrong answers. Members of the audience may be called up to play out the part/solution they propose, which allows practical analysis of the solution.

There are trained documentation/monitoring members of the troupe that make note of the issues and ideas raised by the audience and during discussions. All these are tied into the subsequent scripts. Typically monitoring processes also keep track of repeat aundiences, follow up discussions, number of men, women etc. All these elements help develop next scripts which are also based on community realities.

Magnet theatre is called so, because it attracts community members back to it. The defining characteristics of this form of theatre are:
1) MT is conducted by and for the community (therefore, the gap between the actor and audience is limited/eliminated);
2) It takes place at the same time and place so it can pull the audience back (MT also has a mobilization element at the start of each performance - typically employing music etc relevant to community situations and interests);
3) MT is facilitated by a trained community member (facilitator on the troupe);.
4) Scripts and dilemmas are based on community issues (and are developed based on active dialogue and community discussion inside and outside of MT performances);
5) MT is effective if supported with product and service availability.

I have a film on MT which I would be glad to share with you.

With many thanks again,
Ash

[Laurence Gilliot]

Dear Ash,

Thank you so much for sharing your inspiring experience. I see clearly how Magnet Theatre could fit into the Community Life Competence Process, as a playful tool to stimulate the communities ownership of any life concerns.

My question is: How do you move from an imaginary situation or character to a discussion that addresses the real situation in the community? Do people discuss about their own life as well (how the issue affects their own life)?

Thanks for your response.

Laurence