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3.1. Die globalen Probleme des modernen kulturellen Prozesses
Emelda Ngufor Samba (University of Yaounde 1)
In the last three decades or so, the world has been overwhelmed by the rising HIV/AIDS prevalence rates in mainly poor and developing countries. The Results of the Third Demographic and Health Survey (National AIDS Control Committee) on HIV/AIDS indicate that the national HIV/AIDS prevalent rate in Cameroon is 5.5% with a prevalent rate of 6.8% among women and 4.1% among men. Between the ages of 15 and 19, while two girls out of every 100 are HIV positive, one boy out of every 100 is HIV positive. Between the ages of 20 and 24, 8 girls out of every 100 are HIV positive while 3 boys out of every 100 are positive. And between the ages of 25 and 29, while 10 girls out of every 100 are HIV positive, 5 boys out of every 100 are positive. These figures are an indicator that HIV/AIDS still remains a great threat to the Cameroonian socio-economic growth.
About 55% of Cameroonians live in the rural areas with an adult literacy rate of below 40%. This also represents the number of people that have access to written material. More than 80% of the rural areas in Cameroon lack access to electricity, and consequently TV and Radio. Inaccessibility to mass media makes it impossible for most people to access concrete and updated information on recent world developments, HIV/AIDS included.
The fight for the eradication of HIV/AIDS in Cameroon is multifaceted. Every government ministry has a branch that is involved in this fight. The National AIDS Control Committee (N.A.C.C.) has extended its activities to rural areas by assisting in the creation and running of Local AIDS Control Committees (L.A.C.C.) that are committed to the fight against HIV/AIDS. Not only do L.A.C.Cs provide counselling to HIV/AIDS infected and affected persons, but they also provide support to orphans of HIV/AIDS victims. District Health Centres also carry out regular campaigns to this effect. The failure of these campaigns stem from the methods of communication used. The top-down method, which consists in health experts and social workers disseminating information to the people and telling them what to do to prevent HIV infection, has often been used. This, to an extent has influenced the lives of Cameroonians in general and rural people in particular, nevertheless more and more people, especially women and youths, continue to be infected. This has called for more creative and experimental strategies to reach out to many more communities with information about the AIDS pandemic.
In addition to one-to-one counselling sessions, focus group discussions, lectures, banners and placards, radio and TV slots, N.A.C.C., through L.A.C.Cs and other private sectors, is now exploiting indigenous art forms like songs, poetry, dance, story telling, drama, and theatre to actively involve entire communities in this fight.
Arts and culture have often played a fundamental role in bringing to the fore a people’s perception of their history, their present reality and their future perspectives. Through art, communities have come to express and understand their hopes, desires, and fears. Its dual role of expressing what society is and what society should be has given it credence as an expressive mode for rather enigmatic issues in the society. The past ten years in Cameroon has witnessed an increase in performing artists’ constant exploitation of the potentials of art as a communicative medium to bring to the fore the devastating effects of the HIV/AIDS pandemic. The International Day of HIV/AIDS, December 3rd often gives schools and theatre troupes ample opportunity to produce plays that they perform to large audience.
Mainstream theatre and participatory theatre have been exploited in the eradication of HIV/AIDS. While in the first, theatre troupes take ready-made plays to audiences in theatre halls, in the second, community members, under the coordination of facilitators, collectively create plays that may or may not be performed to an audience. These two types of theatres have functioned differently to serve the needs and interests of different groups and with different results. This paper will however focus on the use of participatory theatre that engages communities to identify, analyse, and propose solutions to AIDS related issues. I will attempt an analysis of the contribution of culture in the spread and/or elimination of HIV/AIDS in Cameroon and the role arts, specifically, theatre arts, is playing in the fight for its containment and eradication.
Theatre for Development workshops are basically participatory. The workshop products, the plays, emerge from a collective effort of the participants who go through the process of problem identification and analysis, story creation, rehearsals and performance. A majority of those who take part in these workshops are either infected or affected victims of HIV/AIDS. They draw from their personal experiences or those of others to build the story that is eventually rehearsed and performed to an audience. With the freedom and power that comes with participatory theatre, even the most inhibited individuals in the community have been able to raise their voices and narrate personal experiences of their encounters with HIV/AIDS as either infected or affected victims. The question has often been asked why theatre practitioners persistently use theatre to raise awareness on a socio-medical problem that continues to devastate, to a larger extent, poorer and developing societies. Another recurrent question is why NGOS, government organizations and some embassies continue to invest large sums of money in an endeavour that has hardly succeeded to produce concrete measurable results. Through an analysis of the process and implications of one of these workshops, I will attempt answers to these and other questions.
The AIDS Education through Theatre project in Ndop was carried out from 23 rd to 27th March 2004. Sponsored by the United States Embassy HIV/AIDS Task Force, it was facilitated by two theatre practitioners whose objective was to empower the then Association of Women’s Information and Coordination Offices(2) (A*WICO) Ndop to challenge standard methods of disseminating information on the acquisition, prevention, and the management of HIV/AIDS cases.
Ndop is a rural town in the Ngoki-Tunjia Division in the North West Province of Cameroon. It is one of the main stop over towns for traders and drivers travelling to and from Nigeria. The North West province has the highest HIV/AIDS prevalence rate in the country: 8.7% as opposed to the Far North Province which has the lowest: 2% (National AIDS Control Committee). Though a rural town, Ndop is the residence of people from different parts of Cameroon and Nigeria who are involved in all sorts of trades. It is therefore not surprising that it has a high HIV/AIDS incidence. This was one of the reasons for the choice of Ndop for the workshop.
Though the name denotes an all female group, A*WICO members are male and female. Among the participants were two HIV/AIDS infected women who had come to the workshop with the hope that through group dynamics, they would be able to find solutions to their problems. Their expectations included the following:
To know how to protect uninfected persons
To be able to support HIV/AIDS infected persons
To acquire knowledge on how to live with HIV/AIDS
To acquire the capacity to convince the local population about the existence of HIV/AIDS
To acquire skills to initiate youth programs on HIV/AIDS
1. The workshop process
Each working session began with theatre games initiated by the two coordinators. The participants, when asked what they normally do during their free time, introduced dances from Cameroon’s rich cultural heritage. Subsequently, every working session began with the introduction of new games and dances by the participants.
i. Information gathering
It became important for the participants to exchange notes on their understanding of HIV/AIDS. Asked if they were aware of the existence of AIDS, a majority acknowledged the presence of AIDS in their community, but a few demonstrated a lack of conviction about its existence. Many still believed it was just an American Invention to Discourage Sex. Others understood AIDS as the result of any prolonged and untreated disease. For instance they explained that when an illness degenerates into long standing stomach ache, headaches, vomiting, and skin rashes, then the person is an AIDS patient. In spite of this, quite a number of the participants intelligently explained the various modes of transmission and prevention. They however had some apprehension when reminded that although AIDS education was taught in schools, the HIV/AIDS virus has continued to spread among youths and adults alike in their community. This, they attributed to the following factors.
Lack of education: Very little information filters into the community and even when it does it is distorted when handed down from one person to the other orally. Because a majority of people in rural areas are not literate, it is impossible for them to access written information.
Poverty: Poverty, they said, pushes young girls to accept sex with casual partners without condoms if the men insist, especially in cases where they would accrue some financial benefits. The 2005 statistics on the prevalence of AIDS indicates that 60% of women have sex with casual partners without condoms while just 46% of men have sex without condoms (NACC). Related to poverty is the problem of malnutrition and poor hygienic conditions. People in rural areas live largely on carbohydrates with very little complements of fruits, vegetables and proteins to boost their immune systems. Their systems easily collapse when their anti bodies are attacked. More so, their poor hygienic conditions expose them to opportunistic diseases like cough, tuberculosis, and dysentery.
Customs and traditions: Some aspects of the people’s customs and traditions also foster the spread of AIDS. Polygamy came out strongly as one of the reasons for the spread of HIV/AIDS in the Ndop area. Because men are allowed multiple sexual partners in marriage, their wives do not receive satisfaction from their husbands and are therefore tempted to have casual sex partners. This predisposes them to the infection. Death celebrations and funeral ceremonies that go deep into the night predisposes both men and women to indulge in excess palm wine, thus drunkenness. Some traditional ceremonies demand that women dance half naked. In their tipsy states, men are easily aroused by these half dressed women.
Absence of Dialogue: In most cultures in Cameroon, sex is still considered a taboo subject in the family circle. Parents still do not feel comfortable to discuss sex with their children. Lack of dialogue with parents and/or adults therefore exposes children to inadequate information that they get from uninformed friends and schoolmates.
Witchcraft: The belief in witchcraft has been the easy way out for infected and affected victims. Even when they are informed they are sero-positive, relatives take them from one traditional doctor to the other who point accusing fingers at their friends, neighbours and relatives. Thus, this refusal to belief in the existence of AIDS makes it impossible for the people to take precautions against possible infection.
After identifying and analysing the problems, the participants moved to the story creation phase. Oral literature, though fading, is still common among rural folks. It was therefore not difficult to make the women relate personal experiences of sick relatives. Most of the narratives dealt with denial, dejection, rejection, frustration and abandonment. There were stories of suffering, lamentation and distress. Relatives moved from hospital to hospital hoping that the results would be different. When this did not happen, they changed to traditional doctors who gave them the desired hope. Relatives, friends, and colleagues became the victims of accusation by traditional doctors. This did not however go without gifts of palm oil, bags of salt, rare coloured fowls and goats to pacify the ancestors and gods. Thus, relatives became more impoverished in the process of seeking a solution to their problems while their condition became worse. The narratives were put together to form three separate skits that were performed to the audience.
In the first skit, the participants seek to answer the question ‘What is AIDS?’ It begins with two women, Agatha and Mami Wirba on the farm. One of their friends has just died and it is rumoured that she died from the complications of AIDS. Agatha is hearing about this virus for the first time and asks Mami Wirba to give her more information about it. Mami Wirba who is half informed of the virus shares the little knowledge she has. To her anybody who has resistant rashes is HIV/AIDS infected. These rashes, zona, are generally called ‘cam no go’ because no matter how hard people try to eliminate them, they remain resistant. Other symptoms of AIDS that Mami Wirba knows are persistent vomiting and dysentery, cough and leanness. Agatha in turn draws the conclusion that all the people who had those symptoms in the village were AIDS patients. The timely intervention of two health workers helps to clarify the misconceptions about AIDS. The health workers make it clear that although the illnesses indicated above are symptoms of HIV/AIDS infection, not all those with these symptoms are HIV positive. Only an HIV/AIDS screening test can provide proof that somebody is infected. This information was received with much acclaim by the spectators who had been (maybe falsely) stigmatised as AIDS patients simply because they had resistant rashes.
The participants developed another skit that brought out the socio-cultural reality of the people in the Ngoki-Tunjia area. It begins with two married women going to visit their boyfriends. Following their tradition, during death celebrations, women prepare special dishes and take them to their boy (men) friends, whose wives in turn have supposedly gone to visit their boyfriends. One of them is half dressed. This, she says, is to entice her man friend. At the celebration, they eat, drink and dance together with other villagers. Hours later, they withdraw to some secluded areas to have a quiet time with the women. As the women leave, one of the men withdraws and says this poem:
I am AIDS
I can never cry like you
Bodies hunched into a knot of pain
And the body defence mechanism
Breaking into a thousand pieces
Young and old, full blossomed, loins more
Fertile than the banks of the Nile
Involved in risky intercourse
You are my target.
I will wait for you in your
Extra-marital and risky sex
I will cause you grief
Like a Sharpeville bloodbath
I must live with my grief
I am AIDS (Forba Abraham)
Months later, she is diagnosed HIV positive and decides to consult a traditional doctor. The traditional doctor asks for money, goats and other food items that she claims will energise her as she prepares concoctions for her. As the patient leaves, the traditional doctor gets into a dance of triumph, rejoicing for swindling money from another fool who refuses to heed the doctor’s advice.
The third skit offers information on the modes of prevention. An elderly married man is on a drinking spree late in the evening. He is hoping that a woman will come by with whom he can have sex. Not long after, his dreams come true as a young woman comes to the bar and sits next to him. He offers her a drink and asks if she will accompany him to his house. Just before they leave, an AIDS social worker stops by and warns them against late nights out and alcoholism. She offers them the male and female condoms and teaches them how to use them. When the social worker leaves, the man throws away the condom with the argument that sex with condoms is not as fulfilling as sex without condoms. Months later, the woman is diagnosed HIV positive. She contemplates suicide and moves from one hospital to another hoping that her results will be different. The doctors counsel her, informing her that she can live with HIV if she feeds well, lives in hygienic conditions and abstains from unprotected sex.
3. Performance and post performance
Performances took place outdoor on market days at squares, in market places and bus stations. Before each performance, participants moved round the market singing and carrying placards, condoms and stage props. The song ‘Theatre is shaking Ngoki-Tunjia’ informed the community that there was going to be a theatre performance and invited its members to follow them. In another song, the participants give the themes that will be treated in the play.
Some sick don come for Ngoki-Tunjia
These songs and others attracted traders and passers-bye that followed the team to the performance ground anxious to watch the play for various reasons. As prelude to the performance and to attract many more people, songs the participants often sing in their njangi(3) groups and into which HIV/AIDS messages had been injected were sung. The play lasted 45 minutes, long enough to hold spectators attention.
During the post performance discussions, the audiences raised concerns that were similar to those the participants had raised at the beginning of the workshop. Most of them wanted to know where the disease came from, what could be done to eliminate it, what its symptoms are, how it spreads and if children born of HIV/AIDS infected mothers could be free from the virus. Some secondary school boys wanted to know why mosquitoes that transmit the malaria parasite through blood could not transmit the HIV virus. Some testified they cried during the performance because they saw their lives being enacted on stage. Others could barely watch the play to the end because it brought back sad memories of suffering and distress in their attempt to safe the lives of sick relatives. Others testified that watching people whom they know in the community acting out community concerns brought them closer to their reality. For the first time, some could see the link between their culture and the spread of AIDS. There were still others who confirmed that some traditional doctors were quacks and swindlers. They were happy that the play had exposed such fake traditional healers who often deceived patients into believing that they could treat all diseases. They hoped that those who had watched the play would learn a lesson from it and be wiser each time they visited traditional doctors.
Their most urgent concern was what they could do to stop the spread of HIV/AIDS in a community where palm wine was cheap and people easily got intoxicated and went out of control. What were they to do with the numerous wives tradition permitted them to have? They all knew condoms could be used with casual partners but were sometimes shy to buy from stores in a community where everyone knows each other. In the play, a health worker uses an artificial penis to demonstrate the use of the male condom. She also demonstrates the use of the female condom. The community was seeing the female condom for the first time and the young women found this discovery a step ahead since they could wear condoms if their male casual partners would not wear them. Because issues on culture were sensitive, the facilitators threw back some questions to the audience. It was not the task of the facilitators to change the customs of the people but to create a forum for the community to revisit these customs and relate them to their present realities. Through dialogue and reflection, they were to take responsibility for what ever decisions they made. For instance, they were to choose between overcoming shyness and buying condoms or having unprotected sex and stand the risk of being infected by HIV/AIDS and other STDS.
The theatre process avoided outright lectures and propaganda on HIV/AIDS. As with Participatory Rural Appraisal, the facilitators/participants did not attempt to tell the people what was good for them but they focused on their needs and potentials. As a people-based theatre approach, the workshop began with building on the participants’ perceptions and experiences rather than with an imposition of the facilitators’ understanding of HIV/AIDS. Alice Welbourn (1998:134) considers this the most effective way of changing community attitude. She however acknowledges that ‘changing ones behaviour is extremely difficult for any man and particularly any woman without the support of others in their community.’ The audiences, at the end of the play, brought out all the alternatives and took the responsibility to map out their destinies. The play creation process and performance gave the people of Ndop the possibility to express their fears and worries about a pandemic that was claiming lives in the community. Rather than listen to medical doctors’ ready-made solutions to the problem, the community reflected on the issues and suggested possible and realizable solutions in accordance with their cultures. Oral poetry, story telling, song and dances that are aspects of the people’s culture were therefore instrumental as vehicles of communication.
Oral poetry, a product and expression of culture, was used to bring out the ideas, concepts and values that characterise the society. From every indication the spread of AIDS in the Ngoki-Tunjia region is influenced by such traditions as polygamy, Country Sundays(4), funeral ceremonies and death celebrations. The participants did not advocate an end to these traditions but simply exposed to the people the dangers that go with them.
The poems on AIDS set out to either expose its devastating effect on the community or to warn against its dangers. In the poem ‘I am AIDS’, Forba Abraham gives the HIV/AIDS virus human qualities in order to bring it as close as possible to his audience. Aware of the lived situation in the community, he addresses the situation with directness. His concern is not with the unmarried, which so far has been the concern of most people. He calls the attention of the married, those who are supposedly less exposed. This group has often been neglected, with the result that they have become victims as well.
Story telling, an art form handed down from generation to generation has the potential to hold an audience spellbound if the storyteller masters its techniques. In the Ndop workshop, stories that had been narrated by participants were integrated in the play. Such extra-linguistic features like mime, facial expressions, gestures, sighs etc, did not only enhance the communicative skills but also served to bring the messages as close as possible to the people. Some of the stories were lived experiences in the community and the community could therefore easily empathise with them. Telling their own stories in their own languages and voices gave participants power and control of the entire process. Singing, dancing, weeping and lamenting freely while telling their stories and dramatising their poems was an indication of the degree of internalisation of the various situations.
The conflicts in the sketches arose from the community’s inability to comprehend new problems in the society or those that had been lying salient for a while. These conflicts became more discernible during the post performance discussions as the audiences expressed their fears.
In the last two skits, the infected women attribute their illness to witchcraft, the reason why they seek assistance from traditional doctors. This theme of witchcraft runs through many plays on HIV/AIDS that have been produced in Cameroon. Balbina Ebong’s Some Witch Man must Die, and Emelda Samba’s The Boomerang (CRTV 2005) are clear examples. In the former, Emade’s mother accuses the entire village for bewitching and killing Emade’s son and husband while in the latter, Frank blames his uncles for killing his mother and father by witchcraft due to a land dispute.
Some Witch Man must Die was conceived by the Bakosi Women Association for Development, Douala branch to educate their less informed sisters in the village on the existence and ramification of HIV/AIDS: Village folks had been pointing accusing fingers at each other with every inexplicable death. The absence of equipment to test for HIV/AIDS in district hospitals and the fear to inform patients of their HIV/AIDS status complicated the issue even more. Doctors adopted the avoidance strategy and told relatives their patients died of a fever. In yet another play, ‘AIDS, the Dancing Masquerade’ (Emelda Samba, Unpublished), Therese is accused of killing her husband to inherit his property. Her in-laws go as far as forbidding her to mourn her husband. The recurrence of the theme of witchcraft indicates something in the perception of village folks, a response to that which they cannot comprehend.
From the above, it could be concluded that TFD workshops are situated within the context of local culture. Reusse Eberhard asserts that for any work promoted by the interventionist paradigm to be successful, facilitators should acquire a deep understanding of the local culture of the community involved before launching an intervention. In the case of theatre that is primarily transformative in intention, this paradigm becomes more significant if the plays are to be relevant to the community in question. It is for this reason that most plays on HIV/AIDS centre on witchcraft, traditional doctors, scarification, misconceptions, fatalism and stigmatisation.
It is widely asserted by theatre practitioners that theatre for conscientisation is the most radical, most empowering to the people, and holds the greatest potential. This is because, with theatre for conscientisation, participation and control increase as facilitators withdraw from the process and the audiences move from being dramatic actors to social actors. Considering that it is almost impossible to assess tangible benefits that accrue from play productions, one can only depend on theatre’s power to transform people from a state of naïve consciousness to one of critical consciousness (Augusto Boal, 2000). As a community event, it opens up avenues for free talk and expression during the play creation process and the post performance discussions.
The potential of theatre for conscientisation to hand over the dialogue and play creation process to local communities has prompted NGOS, government organizations and some embassies in Cameroon to engage in theatre in the fight against AIDS. The theatre experience leaves the participatory audience with a desire to carry out a revolution in real life situations. Theatre therefore becomes a language that HIV/AIDS victims can use not only to articulate their oppression by AIDS and those who stigmatise them but also their liberation from them. Through self-questioning, the Ndop community came to a more critical consciousness of the existence of AIDS, its modes of transmission, and prevention. The origin of HIV/AIDS ceased to be an issue to them and their concerns became more pragmatic: how to manage HIV/AIDS in their community and how to minimise its economic and social repercussions.
© Emelda Ngufor Samba (University of Yaounde 1)
(1) Parts of the Ndop workshop process has been documented in Road Trip, a docu-drama by Cynthia Henderson and in a detailed workshop report written by Emelda Samba and Mercy Neba.
(2) The Ndop workshop happened thanks to the U.S. Embassy HIV/AIDS task force that sponsored it. Cynthia Henderson, a Fulbright scholar from Ithaca College, New York, in collaboration with Emelda Samba carried out this project in partial fulfilment of her grant. Also present at the workshop was Mercy Neba a then Level II student of the performing Arts Section of the University of Yaoundé I and Dr. Eloundou of the District Hospital in Ndop who joined the participants once in a while to give expert information on the HIV/AIDS Virus.
(3) These are peer groups that meet monthly or twice a month with the intention of raising money to assist one another in times of difficulties. It serves as insurance companies. During such gatherings, members share information about the community and about one another and also entertain themselves with food, drinks and traditional dances.
(4) A day in the week that is dedicated to merry making. On such days, people are not allowed to work on their farms. It gives women a chance to rest from their routine farm work.
Boal Augusto.1979. Theatre of the Oppressed. London: New Edition, Ploto Press, 2000.
Ebong, Balbina. ‘Some Witchman Must Die’ Play U: Douala 2001.
Ness, Immanuel and James Ciment, edts. Encyclopedia of Global Population and Demography. Chicago, London: Fitzroy Dearborn Publishers, 1999.
Reusse Eberhard.. Interventionist Paradigm and the Ills of Aid: An Intersection Model of Pathological Processes in the Generation and Implementation of Development Policies. Munchen: Olzog-Verlag, 1999.
Samba, Emelda Ngufor. The Boomerang Cameroon Radio and Television Cooperation, 2005
‘AIDS, the Dancing Masquerade’ Play U 2002
Samba, Emelda Ngufor and Mercy Neba Mafor. 2004. HIV/AIDS Education through Theatre. 23 rd to 27 th March 2004. Edt, Cynthia Henderson. Workshop Report U, 2004.
Talla, Abraham Kashim. Orature in Africa, Canada: University of Saskatchewan press, 1999.
Welbourn, Alice. ‘Gender Participation and HIV: A Positive Force for Change’ in The Myth of community: Gender Issues in Participatory Development. Eds. Irene Guijt and Meera Shah. Forword by Robert Chambers. London: ITDG, 1998.
3.1. Die globalen Probleme des modernen kulturellen Prozesses
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