Using arts as a force for change

Could combining medical research with the arts help develop effective health interventions? Dr Cressida Bowyer, Senior Research Fellow in the Faculty of Creative and Cultural Industries at the University of Portsmouth, is figuring out how to combat harmful air pollution in a community in Sub-Saharan Africa using wonderfully creative means.  

The AIR Network is supported by the Arts and Humanities Research Council and the Medical Research Council Global Challenges Research Fund Global Public Health: Partnership Awards (grant number AH/R006059/1).

Cressida Bowyer and Rafat Chizi on behalf of the AIR Network:  William Apondo, Cressida Bowyer, Patrick Büker, Cindy Gray, Matthew Hahn, Fiona Lambe, Miranda Loh, Alexander Medcalf, Cassilde Muhoza, Kanyiva Muindi, Timothy Njoora, Heather Price, Charlotte Waelde, Megan Wainwright, Anna Walnycki, Jana Wendler, Sarah West, Mike Wilson and residents of Mukuru informal settlement

Mukuru river, Nairobi (Image copyright: Air Network).

Air pollution is a global issue, contributing to the ill health and premature death of millions of people. Health impacts are vast, including chronic lung disease in adults and pneumonia in children. Those living in poor urban environments are especially likely to be exposed to dangerous levels of air pollution, with nine out of 10 related deaths occurring in low and middle-income countries.

Challenges in Mukuru

Mukuru, an informal settlement, or slum, in Nairobi, Kenya, is a community of over 300,000 residents. Living quarters are small metal shacks, tightly packed together, surrounded by busy main roads and industry. Access to even the most basic of resources – including water, power and toilet facilities – is minimal. Common health challenges include respiratory diseases, miscarriages and neonatal mortality.

Cooking and heating are major sources of indoor air pollution due to a lack of access to clean energy, resulting in people burning fuels like coal and kerosene inside their homes. The burning of waste and industrial emissions are responsible for most of the local outdoor air pollution.

Mukuru street (Image copyright: Dennis Weche)

Ngugi, a resident of Mukuru, explained: “Mukuru sits on a hillside below the factories that make up the industrial area of Nairobi that emit heavily to the surrounding community. Heavy rains carry toxic pollutants through the community, pouring into Ngong River. Once fresh and clean, the river now runs opaque; sewage and garbage clutter its banks.”

Breaking down barriers

The AIR Network (Action for Interdisciplinary Air Pollution Research) is a multidisciplinary partnership of African and European researchers, led by the Stockholm Environment Institute at the University of York, together with community members from Mukuru. The network was established to engage with the people of Mukuru, to build relationships and trust, and to explore how best to involve local people in making effective community-driven solutions to the issue of air pollution. A new approach is desperately needed as urban air pollution continues to increase, despite efforts to reduce levels in Sub-Saharan Africa.

We knew that it was crucial to the success of the project to identify methods of communication and dissemination which would work well in this community. We wanted to break down the barriers between the academics and the community partners. To go beyond previous top-down initiatives and tackle exposure to air pollution differently. It was important to get the community involved in the research process from the start so that any future proposals or solutions would be culturally acceptable, relevant and realistic. Exposure to high levels of air pollution is experienced daily but options to reduce exposure are limited.

Communication through music

Early on, Mukuru residents identified music as a powerful tool for communication and engagement. There’s a long history of protest songs, civil rights movement and anti-racism anthems, charity records and benefit concerts which have had a significant and long-lasting impact.

Hood2Hood artists (Image copyright: AIR Network)

So, we asked musicians, MCs, DJs and filmmakers from the community to compose and record songs and videos to spark interest and debate around the issue of air pollution. We used other creative methods too – including film, photography, murals and storytelling. We also held a community arts festival called Hood2Hood to promote the work of the AIR Network, which was a huge success and was attended by around 1,500 local people.

One of the songs written and recorded for the AIR Network is Mazingira (Swahili for the environment) by Mukuru Kings (#Rafatchizi and Evadredi). Mazingira is being played on Citizen Radio and Radio Maisha, two of the biggest radio networks in Kenya, and the Mukuru community radio station Ruben FM. Using music as a communication tool has opened up new routes for public engagement and targeted social groups that may otherwise be hard to reach.

Rapper, activist and founder member of Mukuru Kings Rafat Chizi, explains the message of the song and video: “Mazingira is a letter to the president and the people involved in making a change to society, telling them to take a walk in the slums and see what people face daily. From the poor sanitation in the ghetto to no ventilation in the poor man’s house. From no education to no nutrition on the poor man’s table. How we have polluted the air beyond repair – it’s an alarm!”

Mukuru mural (Image copyright: AIR Network)

The Mukuru community is marginalised, residents have few rights or regulations in place to protect them. Air pollution is part of a much bigger picture related to social and economic inequalities. We came into the community with preconceptions about the leading causes of air pollution. But by using creative methods and giving the community space to contribute, we uncovered other perspectives.

We were often not talking specifically about air pollution itself, but instead about dangerous and unregulated working conditions, failing urban design and bad smells. Lack of infrastructure for sanitation, waste disposal and fighting domestic fires were identified as significant factors. Through working with community members in the AIR network, we learned that environmental health issues cannot be considered in isolation and that the context is key.