Shock visual tactics prove successful in AIDS education

BOTSWANA: Shock visual tactics prove successful in AIDS education


"Don't Worry—Only a Few Sticks": A slide used to show that we only see a handful of patients with symptomatic HIV

JOHANNESBURG, 9 Feb 2005 (PLUSNEWS) - An HIV/AIDS education project introduced to Botswana about 15 years ago, labelled at the time as "radical and insensitive" by the Ministry of Health, is now an invaluable tool in combating the disease.

The project daringly provoked discussion and highlighted the need for change in sexual behaviour through the shock tactic of using explicit AIDS images, courtesy of the London-based NGO, Teaching-aids At Low Cost (TALC).

Launched at Athlone Hospital in the Lobatse region of Southern Botswana by the facility's then chief medical officer, Edwin Mapara, workshops included slide shows depicting clinical manifestations of HIV/AIDS such as Kaposi's sarcoma (a type of skin cancer common in the advanced stages of AIDS infection) and other sexually transmitted diseases.

Mapara told PlusNews that at first there was a strong outcry over the use of such stark and realistic images, as HIV/AIDS information and education in Botswana had mainly adopted a "luke-warm approach" that was not aggressive enough.

"Some elderly or community leaders felt insulted by the materials that were used. As the team leader, I was fined chickens on several occasions by local chiefs and elders for the 'crime' of showing these graphic TALC slides," Mapara said.

However, by persisting beyond the initial repugnance, 10 years later the programme was documented by the United Nations Development Programme as one of the best practises in Botswana, where an estimated 36.5 percent of the 1.6 million population is currently living with HIV and AIDS.

"It was this recognition that reflected some of the good outcomes from the programme, which ultimately resulted in the government's decision to replicate it in every district," Mapara commented.

The programme has broadened the knowledge base at all levels of the community, and: increased voluntary counselling and testing; health-seeking behaviour; discussion of sex and 'good dying'; the referral of patients from traditional doctors to health facilities and the formation of support groups.

Also among other successes attributed to the project was the ease with which the country's mostly "picturate" community were able to relate to the visual images, rather than literature about the pandemic.

According to Mapara, the use of the explicit, if not sometimes shocking, visuals had indirectly brought relief to the educators and health care workers distributing written materials in parts of the country where a strong preference for oral communication still prevailed.

"Not only have these pictures proved to be an effective strategy for opening up a community to discussion about difficult or taboo issues, they have also successfully targeted scores of illiterate people, often forgotten in the distribution of written education materials," Mapara concluded.


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