There is the sound of an ambulance nearing. They are ready with the stretcher. Ali is shifted in to the hospital within a few crucial seconds.
Narration appears – “Today, it is Ali. Tomorrow it can be any one of us. Is there any one who can give him two units blood? Is there any one?”
A young man walks ahead, “Come Doctor, the poor man’s life is precious. Doctor, take my blood.” The lights go off.
When the lights are lit again, Ali stands up a healthy man with his arms stretched across this young man’s shoulders. Both of them together- “Donating Blood is donating life.” Music plays in the background.
It might be misleading to someone!!
Around 100 people assembled in front of the Institute of Social Pediatrics, Govt Stanley Medical College to watch this street play- old and young, men and women. I looked into their faces – they were blank. Some children were happy seeing music play and some old women were telling their daughter-in-laws that the people who were acting were all young doctors. They took it with awe. I was searching for the glitter in their eyes, the one that invariably follows enlightenment. I looked up through the crowd to the crimson sky – it was preparing for the sun set.
The Govt and the NGOs in the developing world spend a huge amount of money to raise awareness in the public about the various health related issues. People who work on this often feel it is an easy task, and miss taking these challenges in the correct perspective. The above play failed badly in its motto of conveying the importance of blood donation. Donating blood is donating life, but why should I donate life? I am no God. If I donate my life, what will I be left with? I have a family to look after; I will not do that. I looked down at their faces. The little awe that was there had almost faded away and it was getting dark.
We went in a group to interact with people about what they learnt from the play, where my feel of having failed in conveying the message was only getting reinforced until we met Radha. Radha is in her twenties, with a child (will be around a year old) in her arms. She wore a little, dirty, torn saree and there on the street, she was bare footed. Radha shared with us this story she heard from an old physician who came camping to their village when she was a kid. The old man said- “Our body is like a spring. The more blood you draw out of it, the more does it replenish with the fresh reserves.” There was a spring by Radha’s village. Every time she went near the spring, she internalized this lesson. Radha has shared this lesson with her neighbours, her children.
The famous experience that the behavioral economist from Harvard, Senthil Mulainathan, shares is extremely insightful.
This community in a remote Indian village never improved on diarrhea and dehydration-related deaths until the behavioral economists found that the mothers in this village never gave their children ORS when they had diarrhea. Remarkably, this is is due to the working image of a leaky bucket that they had in their minds. – there is no point pouring water into a leaky bucket. Therefore, in their eyes there is no point giving fluids to a child running it out in diarrhea.
In order to raise the community compliance, it is thus vital to understand the culture of the developing world, and develop appropriate socio-cultural and behavioral content. As polio nears eradication, we can not afford a few sects to believe that the vaccination causes sterility, and keep children away from the mass immunization. Apart from all the back-end initiatives that the govt takes, the best way to realize the one big health dream of providing “people’s health in people’s hands” is to deliver the health lessons appropriately and make the community sensitive to its own health. We beckon Social Scientists and Behavioral Economists to work in close association with doctors, public health enthusiasts and policy maker.
Saurav Das