Theatre for a Change

Although there have been developments in recent years in the treatment of HIV, the number of people living with HIV continues to grow, as does the number of HIV deaths. In many regions of the world new HIV infections are heavily concentrated amongst young people aged 15-24 years of age. Sub-Saharan Africa continues to bear the brunt of the epidemic, with two thirds of all adults and children with HIV globally living in the region, with the epicentre in Southern Africa.

Theatre for a Change (TfaC) uses innovative strategies to empower vulnerable and marginalized groups through positive behaviour change and advocacy of gender and sexual equality.

Theatre for a Change equips socially and economically marginalised communities with the communications skills, knowledge and awareness to transform their lives and the lives of others personally, socially and professionally.

They provide child-centred training to pre-service teachers as a unique tool for positive behaviour change.

They empower young people to protect themselves from HIV and advocate for their gender and human rights.

They do this using a highly experiential form of learning. It is through participation that vulnerable and marginalised individuals generate the awareness and ability to implement practical and positive changes in their own lives and gain a voice in society as a whole.

Personal transformation is a goal at the centre of TfaC’s methodology. They want to change individual’s behaviour as well as educate them through the development of a sense of collective responsibility. For TfaC, choosing an appropriate location was very important. Lilongwe, the capital of Malawi is the hub of most of the project activity in Malawi, because it is well-connected by road and is the site of one of Malawi’s leading teacher training colleges. It is also an HIV hot-spot, with a prevalence amongst the urban population of 20%, and there are many sex workers in the district, around 60% of who rely solely on income from sex work to support themselves and their children (Kalanda 2010). Participants are selected through local recruitment drives. These are done with the permission and help of local community leaders, enthusiastic members of the target groups, and staff at teacher training colleges and medical centres.

Jack Taylor's report on his trip to Malawi

In November 2009, accompanied by Drama St Mary‘s lecturer Mark Griffin, Drama & Applied Theatre student Jack Taylor travelled to Lilongwe to observe Theatre for a Change in action and to gather information to report back to his fellow students.


“When the opportunity came up for a student from the Applied Theatre course to visit Malawi to be an ambassador for St. Mary‟s University College, I couldn‟t have been any more eager. How many students have this chance offered to them, and how could any student turn this opportunity down? After an interview with my lecturers and the Head of the Drama programme, I was overjoyed to be awarded the place. I was excited, but also a bit apprehensive. After all, before this trip, I had only ever travelled to Europe and Florida!
“I knew Malawi was going to be a completely different experience for me, and I wasn‟t too sure what to expect. As well as sorting out all of my jabs and tablets in preparation for the trip, I read lots of online resources and frequently checked in with my lecturer, to find out what I needed to know about the country and what to expect.
“When the time finally came to travel to Lilongwe, I headed to Heathrow airport still very excited, but even more nervous. Although I am a confident person, who enjoys meeting new people, I couldn‟t predict how I would manage in this country that I had never been to before and had only read about.
“My plane arrived at Lilongwe airport, and I looked out of the window; it was quite a large airport with grand flower arrangements. There were lots of people getting off the plane, and I wondered why they were coming to Malawi as I went through security and collected my baggage. I was still thinking, „What am I going to see in the next few days?‟
“As we left the terminal, we met the Theatre for a Change team. In the car on the way there, I got my first glimpse of Lilongwe proper: it was quite built up, there was a hospital and a bank, and there were many people sitting on the side of the road selling animals. I saw several billboards with the President‟s picture on them, and lots of open space.
“On my first day, we went to the crafts market, which was less than a five minute walk down the road from where we were staying. I was told to prepare myself for a lot of attention from sellers, and with good reason; it was like the stall owners knew where they could make a quick sale, and they all immediately headed my way. I had 10 people all around me, not intimidating me, just showing me objects from their stall, like jewellery, paintings and crafts, trying to make a sale. It was an experience I will never forget. They were so friendly, shaking my hand and asking me how I was. Even after I told them that I wasn‟t going to buy anything, they were still just as friendly and made me feel comfortable.
“We also made a trip to the local market, where it seemed as if you could buy just about anything you could wish for. When we arrived, I was fascinated by all the amazing fruit and vegetables on every stall. Some had things I recognised, such as tomatoes and lettuces, but some stallholders had vegetables that I had never seen before. The colours were extraordinary; I had never seen colours like this on vegetables before. They were much brighter than in England. This food was completely fresh, and, I realised, it was what I would be eating for the week ahead. I‟m not a huge vegetable fan – what 20 year old is? But I was excited at the idea of eating this beautiful food. I hoped to arrive home a little healthier than when I left.
“My sight-seeing done for the time being, it was time to begin observing and working with Theatre For A Change, and my chance to get started in Malawi with my favourite thing: Drama! I felt as if I fitted into Theatre For A Change‟s routine right away. They had a weekly plan for me ready and set, and my first port of call, for 3 days, was a trip to Kasungu Teachers‟ Training College. There I was able to see the work they were doing with training teachers first-hand, and I watched as some participants showed ways in which to avoid contracting HIV. These included how to handle situations where someone wants you to have sex, and you don‟t want to. The short devised pieces allowed me to witness these Trainee Teachers doing what they would do if they were faced with this situation in their lives. These participants were not Drama students, nor were they actors, but they were really keen to get up and participate in the improvisations.
“After Kasungu, I went back to Lilongwe and had the chance to work with the ABC Group – a group of former sex workers who work with TfaC. They meet every weekday morning and discuss ways of preventing HIV and how they can help other women who are stuck in the sex trade. All of these women were so friendly, and were very encouraging when I attempted to speak some Chichewa phrases. It was lovely to watch them performing, and passionately showing their work to the others. Their singing and acting were beautiful; they had all the skills they needed to be excellent actors.
“I was pleased to see the impact of Theatre for a Change‟s work in Malawi. They have really helped these women to find alternatives to sex work, and what‟s more, they‟ve also been trained to help others to escape the sex trade. By the end of my time in Malawi, I didn‟t want to go home! Yes, I missed my family – and yes, I needed to start my essays! – but I had only scratched the surface of the problems that Malawi is facing, and what Theatre For A Change is doing to help. I feel incredibly lucky to have started this relationship with TfaC. It is a wonderful privilege.
“When I return to Malawi in May this year, I hope to add to my knowledge of the country, of HIV, and of how to facilitate participatory theatre in a development context. I want to work with a school, and also re-visit the ABC group to find out how the work has developed since 2009. I‟m particularly looking forward to the trip because this time I will get to experience it with my peers, who are as excited as I am. I have told them all about what I learned on my first visit to Malawi, but I know that their own experiences there will actually be a hundred times better in real life than any of my descriptions.
“I am thrilled that we‟ll be taking our verbatim play, Turning Poison Into Medicine, to Malawi this year to perform to TfaC trainee teachers, staff and the local community. I am also looking forward to conducting interviews with Malawians for a second verbatim play about living with HIV in Malawi, to be performed upon our return.
“Malawi is a country that is eager to get stronger. Although at the moment it is facing great difficulties, the current government is committed to the development of better hospital care and a stronger economy. I hope that Drama St Mary‟s and Theatre for a Change can also help the people of Malawi in promoting equality between men & women, reducing HIV infections, and supporting the building of communities in which young people can grow up in safety and good health.”
Jack Taylor, February 2011

St Mary’s University College and Theatre for a Change

Drama & Applied Theatre students at St Mary’s University College
(SMUC) have now been involved with Theatre for a Change (TfaC)
for three years. During this time they have been studying TfaC’s
drama methodology via workshops, and running fundraising and
advocacy events. They have also attended a Guardian Media event
and other conferences to raise awareness about TfaC’s work in
Malawi.
In November 2009, Year 2 student, Jack Taylor, accompanied by
Drama St Mary’s lecturer, Mark Griffin, travelled to Lilongwe in
Malawi to observe TfaC in action and gather information to report
back to his fellow students. During this trip, he made a video that
included interviews with participants and with the management
team.
In May 2011, 18 Year 3 students will visit Lilongwe together to work
alongside participants and TfaC, delivering workshops and
recording their experiences. This will be a transformative experience
for the students, most of whom have not visited an African country
before. The visit is embedded in the Drama St Mary’s curriculum;
the Theatre for Development module will be assessed through the
‘in-the-field’ involvement with TfaC. This is a unique module which
equips up to twenty young applied theatre practitioners each year
with the skills and initial experience of advocating and using drama
methodology in a development context.

Some of the participants’ comments on HIV gleaned from the baseline surveys conducted by Theatre for a Change, Malawi

I would rather die not knowing than knowing I have a shameful disease.

It’s none of my business that you are HIV positive. You deserved it for being promiscuous.

Sex is not an issue to be discussed anyhow.

It is a woman’s duty to satisfy a man sexually. One shouldn’t be denied any sexual favours, especially a man.

Women do not have the right to say no to sex with their husbands. It’s against our cultural values.

I think I would commit suicide if I found out I was positive.

(Theatre for a Change National Teacher Training HIV Baseline Survey Malawi 2009)

The term AIDS....

The term AIDS will not be used in this blog due to the fact that, according to a variety of sources including the National Health Service in the United Kingdom, ‘AIDS was first used by doctors when the exact nature of HIV was not fully understood. However, the term is no longer widely used because it is too general to describe the many different conditions that can affect somebody with HIV.’ (National Health Service 2011).

HIV in Malawi

According to the World Health Organisation (WHO), the impact of HIV has been enormous in Malawi(WHO 2011). The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. HIV is transmitted through unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding (WHO 2011). Despite recent developments in the preventative and treatment methods for HIV, the number of people living with the virus continues to grow. HIV-related illness is the leading cause of death in Malawi, where the average life expectancy in the country is just 43 years. According to Theatre for a Change, HIV affects all sectors of the Malawian population, but has a much more severe impact on some groups than on others:

· HIV prevalence is highest among sex workers, at nearly 71%.

· Female police officers have the second-highest HIV prevalence, at over 32%.

· The third-highest prevalence is amongst male primary school teachers, at just over 24%.

· Currently there is an HIV prevalence rate of 17% in urban areas of Malawi, and almost 11% in rural ones

· In 2009, there were 120,000 children living with HIV.

· 65% of people living with HIV in Malawi are aged between 13 and 24.

(Stevenson 2009:6)

Malawi ranks 153rd out of 169 countries on the United Nations Human Development Index. It scores particularly poorly on nutrition and food security, education, health provision, and gender equality. Two thirds of the population of 14.2 million live below the national poverty line, and 51% of the government budget comes from donor aid (Human Development Reports 2011). There is also a severe shortage of medical staff in Malawi, with only two doctors to every 100,000 people – one of the worst doctor-patient ratios in the world (NationMaster.com 2011). This is largely due to the ‘brain drain’, whereby Malawians with the highest levels of education, and particularly medical qualifications, tend to leave to work in the United Kingdom and other Western countries where they receive better wages.

Another challenge is presented by gender inequality. 60% of adults living with HIV in Malawi are women, and prevalence amongst women aged 15–24 is around 9%, compared with 2% amongst men of the same age (AVERT 2009). According to the WHO, male-to-female HIV transmission during sex is about twice as likely to occur as female-to-male transmission because women are physically more susceptible to HIV infection due to fact that they have a greater anatomical exposure to the virus (WHO 2011). A women’s social and economic inferiority is a further contributing factor in this disparity due to the fact of their lower social status means that most are unable to negotiate for safer sex practices (Theatre for a Change 2011). In an article for The Guardian newspaper in the United Kingdom, Dr Tariq Meguid, an obstetrician who works in the hospitals of Lilongwe, argues that the shockingly low status of women is at the heart of the HIV epidemic. He says, ‘In the end there is little doubt that women die in Africa because they are poor – really, really poor – and voiceless. They say absolutely nothing. It is a huge, huge scandal’ (Boseley 2008). Most women are taught to believe that they do not have the right to say 'no' to sex with their husbands, and nearly one in five women 15–19 year old, report that force or coercion was used against them in their first experience of sexual contact. In a survey of trainer- teachers, it was found that over 30% of participants believed that men should be in complete control of all sexual activity, while nearly 90% of female participants claimed they were unable to reject men's sexual advances in workshop improvisations (Stevenson 2009:16). Also, some communities in Malawi practice ‘wife inheritance’, where a widow is married to a relative of her husband after his death. This increases the risk of HIV transmission, especially in cases where the death of the widow’s husband was caused by HIV. The practice in some rural communities, of non-sterile female genital mutilation also contributes to transmission. There is a lot of stigma against people infected with HIV in Malawi, and there are prevalent negative opinions about sex workers, and any people, particularly women, who have multiple sex partners or who have sex outside of marriage. For example, a survey of training teachers found that over 80% believe that sex outside of marriage is immoral, and 54% believe that immorality was a key factor in HIV infection, with nearly 85% demonstrating stigmatising behaviours towards people living with HIV in workshop improvisations (Stevenson 2009: 15). A 2003 qualitative research study into Malawian cultural factors that affect positive living amongst those living with HIV found that sarcasm and back-biting were prevalent, and that this often caused HIV-positive people to isolate themselves from their communities (Jana 2003).

Because homosexuality is illegal in Malawi, drawing a prison sentence of up to 14 years, statistics for HIV prevalence amongst men having sex with men are likely to be inaccurate; however, a 2009 estimate suggests a prevalence rate of 21.4% (USAID 2009: 1). As well as the risk of legal repercussions, widespread cultural homophobia in Malawi makes it yet more difficult for men having sex with men to access information, treatment, and resources. As a result of these stigmas, most people living with HIV in Malawi are reluctant to make their status known. Treatment and prevention resources are underused; many people are unwilling to find out their HIV status because of the risk of persecution and potential prosecution and, because HIV-positive people usually keep their status a secret, it is difficult for support groups and home care organisations to reach them. People are unlikely to discuss HIV with their families, and some support groups are unable to meet openly (AEGiS 2004).