Episode 7: Creative Communication for Better Health and Wellbeing
A YouTube channel, puppet shows, murals, music and even a comic book are the artistic tools being harnessed by communities to share information about the spread and prevention of Covid-19.
In the University of Portsmouth's podcast Life Solved, we hear how a unique cross-disciplinary approach to communicating vital health information is allowing researchers to both contribute and learn in international wellbeing collaborations.
We hear from Dr Cressida Bowyer and Dr Louis Netter whose diverse paths into research give them a unique outlook on how to use art to unpack and share potentially complex science messaging with the public.
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Collaboration for creative communication
Cressida and Louis originally got together with a network of other projects to address the problem of air pollution, working in an informal settlement called Mukuru in Nairobi, Kenya. This allowed them to understand the experiences of people living and working in the region and how issues such as sanitation and ventilation could present problems that weren't easy to overcome.
We started to build this really close and trusting relationship with individuals that we call ‘community champions’ in Mukuru.
But when the COVID-19 pandemic arrived in 2020, they were able to harness the relationships they had already established with communities to challenge issues ‘on the ground’. Where poor sanitation and little disposable income formed barriers to practises such as hand-washing and the purchase of face masks, it was crucial to understand the context.
It's really important for those messages to be very clear, very appealing, very appropriate for that setting.
ACT: The Action Against COVID Transmission Project
To encourage COVID-safe practises, the team began to work with individuals to create street murals and YouTube vlogs to share information. There was a puppet workshop on social distancing and – a particular point of pride for the group – a 32-page comic book was created to deliver health messaging in an interesting and creative manner that was both portable and represented the experiences and perceptions of people living in Mukuru.
The 4,250 comics were shared in schools, libraries and other educational institutions throughout Nairobi and Kenya, using art as the conduit to making important health messaging a part of daily life.
The team now hopes to transfer this model to other nations where social pressure means humanity’s problems – such as the plastic pollution crisis – are felt most keenly.
The Global South is a place that has a multitude of issues which are ripe for addressing. And it's an important place for all of us because, in a sense, it's a place where the West's rubbish recycling – our problems – fall on the global south the hardest. And so in some ways, it's also our global responsibility to try to address those problems.
John Worsey: Welcome to Life Solved. Thanks for listening. This is the podcast where University of Portsmouth researchers tell us about the ideas and insights that are emerging from their world-changing work. This is where the science, technology and practises of a future are created. And in Life Solved, we're aiming to bring you a snapshot of ideas in motion.
John Worsey: I'm John Worsey and today we're chatting to a team that's working across departments here at the university to help get information into communities quickly and effectively.
John Worsey: As the COVID-19 pandemic took hold in 2020, University of Portsmouth researchers worked with communications techniques that not only helped understand and address problems but which have offered long term tools as well.
Louis Netter: We are building a legacy in people and practices. That's one of the fantastic things about this kind of work as well.
John Worsey: Let's hear how art, creativity and digital communication are all being used to share information that benefits a community's health and wellbeing.
John Worsey: Dr Cressida Bowyer is a Senior Research Fellow working in the Faculty of Creative and Cultural Industries, as well as the Faculty of Science and Health. Her unique perspective is a result of a career working in the music industry before she returned to academia to study biological sciences and then a PhD in biomolecular pathways. She came to Portsmouth to help the University create connections between its different departments.
Cressida Bowyer: I kind of have a grounding in science. I have an understanding of science. But I also, because I have this background in the arts, I can speak the arts language as well, and I value both disciplines very highly. I was very keen to work across disciplines and use both my trainings for the work I'm doing now.
John Worsey: Dr Louis Netter is a Senior Lecturer in Illustration at the School of Art, Design and Performance.
Louis Netter: I initially started as an illustrator. So I was published in lots of publications, wide range in the US and in museum collections and so forth, but then getting into higher ed. I came over to the University of Portsmouth and have really sort of, I guess, grown my own interests and research activity in working on these interdisciplinary projects, engaging with people from different cultures and seeing how the arts is a very unifying force for communication, but also bringing sort of joy and engagement to break down sort of barriers to learning and understanding.
John Worsey: The team created by Louis and Cressida is now collaborating on health and wellbeing projects all around the world, using creativity as a form of communication. For them, the core of the work they do is about tapping into local knowledge and custom and working in partnership with communities.
Cressida Bowyer: So I'm really interested in how we can democratise the research process and really involve the people who are going to be impacted by research projects, make sure that they are involved in the design of the research, in the research process itself.
Louis Netter: And it's not sort of top-down. It's really seeing what the different commun-- communities sort of see as valuable in terms of how they communicate to each other, but also what they see as sort of valuable expressions of their own creativity or artistic practise and so forth. So it's kind of-- it's really tapping into that.
Cressida Bowyer: It brings so much. You hear a completely different dialogue. You're talking the right kind of social and cultural language, and you're constantly checking in with your community members that what you're doing is on track and on point, and that ultimately the aim is to make sure that the research that we do actually does have impact in the future. And when we say impact, basically we mean to make a real change in society.
John Worsey: For nearly four years, the group has been working with an informal settlement in Nairobi.
Cressida Bowyer: Mukuru has a population of about seven hundred thousand people living in quite challenging conditions. There's very little infrastructure around anything, around sanitation, around waste management, housing, there's job insecurity. Those people face a lot of challenges in their daily life.
Cressida Bowyer: I first started working in Mukuru as part of something called the Air Network, which is a project that was funded by the Medical Research Council and the Arts and Humanities Research Council. And the aim of that project was to explore how best to carry out participatory research in those communities. What languages worked well? What languages didn't work so well? And the focus of that particular project was air pollution. And we explored the use of theatre, of music, of digital storytelling and various other disciplines and started to build this really close and trusting relationship with our, we call them our community champions, in Mukuru.
John Worsey: The team first built relationships with the community and then used art projects to understand problems in context, as well as deliver and share messages and knowledge around air pollution.
Cressida Bowyer: One of the main sources of air pollution in informal settlements is indoor air pollution, which is caused by cooking, lighting and heating using biomass fuels, which give off a lot of heavy fumes. I remember before I went, you know, people-- a couple of people commented, well, you know, why don't people ventilate their homes a bit more when they're doing their cooking or why don't they send their children out to play?
Cressida Bowyer: Now, when you go to these places, you find out that these homes don't have any windows, they don't have any chimneys. The children can't be sent out to play when their dinner's cooking because it's not safe for the children to go out to play. So you start understanding all these other elements that definitely have to be taken into account if you're trying to design interventions to solve some of those problems.
John Worsey: Cressida also saw how the burning of plastic was contributing to air pollution problems in the community. And this has inspired further research by the University of Portsmouth to help tackle the plastic waste problem at its source.
John Worsey: Fundamental to all of the teams' projects is this two-way dialogue. This both helps researchers understand global problems on a community scale and allows ideas and wider research to be shared with people in a language and context they can relate to. When 2020 brought the coronavirus pandemic to homes around the world, understanding and preventing the spread of the virus was key to tackling it in the early stages. That's where a working group called ACT, for Action Against COVID Transmission, was formed.
Cressida Bowyer: We wanted to work with community champions in Mukuru to build capacity and develop and co-make public health messages using creative means. Now, this is something that already goes on in these communities. And, you know, our partners do it extremely well in these communities. They use things like murals and they use music to spread public health messages. It's quite well recognised form of health messaging in the global south. It's been used in campaigns against Ebola, for instance, HIV transmission, cholera, you know good practise to avoid cholera transmission, things like that. So we really wanted to grasp this opportunity to work with some of our collaborators in Mukuru to develop public health messages around combating the spread of COVID within those communities.
Cressida Bowyer: Now, informal settlements face particular problems when adhering to guidelines around handwashing, social distancing and face mask-wearing. Because people don't have running water in their homes, people live in very close proximity. It's extremely hard to put those guidelines into practice. And face masks, you know, money is in short supply. It's more important for people to feed their children than to spend money on face masks or sanitisers. So it's really important for those messages to be very clear, very appealing, very appropriate for that setting.
Cressida Bowyer: We also wanted to make sure that those public health messages were grounded in science, which is kind of where the UK expertise side of it came in, really. So we did two things. We delivered some workshops on using different methods like digital storytelling. Louis delivered some workshops on creating a comic, making a logo, how to make a really strong logo. Another colleague of ours, Dr Matt Smith, delivered some fantastic workshops around making puppets because, again, you know, we used puppets in the project to demonstrate things like social distancing. We work with artists, youth activists, community volunteers, teachers, church people, people who often have quite important roles in the community.
John Worsey: Louis told us how the teams approach helped make a difference.
Louis Netter: The arts were also used as a means of exploring lived experience as well, which I think is a very effective sort of application of sort of artistic practises as well. Getting an understanding, an intimate understanding of people's lives, using tools such as cell filming and so forth, which is one of the things that was used and also in drawing your own comics and so forth.
Louis Netter: In the specific context of a place like Mukuru, the arts is a sort of way of breaking down some of these-- these barriers to communication. I think even photography can be quite problematic. So the-- the arts is sort of portable and effective way of people telling their own stories. And this has been evidenced through... It's particularly, I think, the sort of comic making, which I think was an interesting form for capturing people's unique perceptions and that they had to sort of construct those perceptions using the comic form, which I think is an interesting process unto itself. But things like puppetry and the comic and focusing on this idea of logo developing a kind of identity, visual identity. These were relatively new things that we sort of introduced in this particular project. So-- so that was something. And I think also the expansion cell filming and digital storytelling was certainly something that was quite robust in this particular project.
John Worsey: Working within local COVID guidelines also meant finding a way to communicate whilst observing social distancing. The project included funding to promote digital storytelling, which included laptops for this purpose. The project included funding to promote digital storytelling, which provided laptops for this purpose. These examples are from Jared and Peris community contributors.
Jared: So in Mukuru, we have various sources of getting information of COVID-19. Mostly we get the information on the TV, radios, our local station, radio station, every day still assessing on COVID-19. We also have a magazine called Magazine. So it is a youth magazine, talks about comic.
Peris: COVID has broad effects in my community. And this has made most activity like people, businesses to have low market. Most residents depend on casual jobs in the hand-to-mouth mode of living. And through this pandemic, most residents have lost their jobs and their source of income they depended on for them to earn a living.
Louis Netter: The comic was certainly something that we hadn't tried before, which was really essentially sort of taking the personal narrative and giving them a construct, the construct of the comic, where they could sort of start putting that together, learning some new skills about narrative construction and so forth. The reception has been pretty amazing to the-- to the comic.
John Worsey: The project is printed over 4000 comics, distributing them to schools, universities, community libraries and youth groups in Nairobi and other parts of Kenya.
Cressida Bowyer: We work closely with local musicians who wrote and recorded two songs for messaging of COVID safe behaviour. Music is a powerful and visceral method of communication, and if refrains are catchy and repetitive, they can become memorable public health earworms.
John Worsey: It was essential for the team to keep up to date on the science messaging around the projects, too. As information emerged, art became the conduit through which research around the world could find expression and communication in daily life. So how do you measure if it works? The ACT team carried out work to train practitioners or champions how to measure and evaluate the success of their work.
Louis Netter: All the outputs demonstrate a tremendous amount of community buy-in and ownership. All of the outputs were also sort of highly individual and diverse, which is a very good sign from-- from sort of our perspective, because in some ways that it didn't have the feel that we were sort of pushing them into a sort of specific kind of messaging, specific kind of narrative.
Louis Netter: Speaking of a specific example, I guess the comic itself, we were able to create a 32-page comic with about five different artists working on the comics. They have a range of different themes from myth-busting, which seemed to be something that also came into the cell filming, which in the community we've sort of found that there were a lot of misperceptions, superstitions and perhaps sort of faulty ideas, faulty science, even conspiracies around Coronavirus and so forth. So the comics addressed aspects of that. But also the comics were sort of slice of life conversational, a sort of ear to the street. And this was really valuable as well, sort of getting a sense of how people were talking day to day, how some of these myths and some of these ideas came up and so forth and debates about wearing face masks and everything. So the comic really, I think, became this invaluable insight into what was really the-- how people were sort of feeling and navigating life during this peak of kind of coronavirus in Mukuru.
John Worsey: As for the four public murals, it's estimated that half of Mukuru would have seen them. That's 150,000 people. And the music videos have had more than 1500 views on YouTube. The ACT projects tools have meant that there have also been unexpected but useful insights and applications even beyond the project duration.
Cressida Bowyer: We find that unexpected angles are revealed or unexpected findings are revealed, and stigmatisation of people who were either infected with COVID or suspected to be infected with COVID. You know, that came up was a really, really strong theme as one of the issues around COVID. Some of our teachers who were involved in the ACT project, they've gone on-- not only are they disseminating the ACT output's and the ACT findings to their pupils, but they're also utilising the creative methods training for their teaching. And that has been absolutely joyous to see actually. You know to hear one of our teachers Rose, reporting back that, you know, she was using puppetry in one of her art classes.
Louis Netter: And some of the champions also are taking it upon themselves to take bigger roles as well. So they started as maybe an arts facilitator in one project and then they might even go to, you know, be helping project management to a certain extent in the next project. So we are building legacy in people and practises. And I think that's-- that's, you know, one of the fantastic things about this kind of work as well.
John Worsey: The team are also collaborating on innovative approaches to removing plastic waste in the environment.
Cressida Bowyer: Bangladesh banned plastic bags in 2002 and were the very first countries in the world to do so. Kenya banned plastic bags in 2017. They've recently banned all single-use plastics in conservation areas and they have just announced an extended producer responsibility law, which means that any manufacturers or companies that are utilising single-use plastics for their products have to do a kind of waste management offsetting. So they're going to be obliged to invest in waste management infrastructure. So that then creates a real opportunity for small scale social enterprises in waste recycling to start up. These countries are way ahead of us! So again, it's a knowledge-sharing project.
John Worsey: Going forward, Louis explained why the team will continue to focus on the global south for these learnings.
Louis Netter: I think the motivation for particularly ACT, I think, was definitely because we had an established group of collaborators to work with. And I think that is invaluable, really, particularly because we were doing this work virtually and we weren't able to deliver the work in person. I think if you were to start working in a new location, you could do that. But in person would be essential to, I think, build the trust, as Cressida had mentioned before. But I think the global south is a place that has a multitude of sort of issues ripe for addressing. It's an important place for all of us because in a sense, it's a place where the West's rubbish recycling, our problems fall on the global south the hardest. So in some ways, it's also our global responsibility to try to address those problems.
John Worsey: Trusting, powerful two-way relationships forged by art, digital communication and on the ground-contacting communities. By using cultural activities as a communications medium, researchers and community advocates have been able to exchange information about their experiences and knowledge in a way that's immediate and effective. You could watch the Action Against COVID Transmission Project's YouTube channel by searching for ACT that's A.C.T Nairobi on YouTube.
John Worsey: The team are now looking at the many ways in which they can use this framework to tackle issues that need global participation, such as in fighting the global plastic waste problem. We hope to bring you another update on their projects very soon. For now, thanks for listening.
John Worsey: Life Solved will be back next week with a new topic from research at the University of Portsmouth. We'll be joined by Dr Wendy Sims-Schouten to hear about her work and challenging bias towards the most vulnerable people in society.
Wendy Sims-Schouten: The key thing that motivates me is to make the world and that sound simplistic, but to make the world a better world for-- for everybody, and to be inclusive in the way we approach things.
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