All the world’s a stage for malaria-busting researcher

Children dressed as mosquitoes for a drama performance in a Cambodian village. Photo by Nicky Almasy. COMMUNITY
Children dressed as mosquitoes for a drama performance in a Cambodian village. Photo by Nicky Almasy.

A novel project using drama, art and music workshops has helped to educate remote Cambodian villagers about the importance of taking anti-malaria pills.

Dr Renly Lim (right), pictured with Sanaan Nou from the Mahidol Oxford Tropical Medicine Research Unit in a Cambodian village. Dr Renly Lim (right), pictured with Sanaan Nou from the Mahidol Oxford Tropical Medicine Research Unit in a Cambodian village.

UniSA researcher Dr Renly Lim, along with a team of international researchers from the UK, Thailand, the Netherlands and Cambodia, trialled a highly unusual but effective method to increase the uptake of mass drug administration (MDA) in 20 remote villages in the South East Asian country.

Dr Lim, a Research Fellow in UniSA’s School of Pharmacy and Medical Sciences, was the only Australian researcher to take part in the project, initiated by the University of Oxford.

By engaging villagers in a series of drama workshops, the researchers helped them weave together entertaining stories using caricatures to drive home the dangers of mosquitoes and convince locals to receive treatment.

While malaria rates are declining overall in Southeast Asia, transmission is still high in many rural areas, due in part to illiteracy, lack of health services and education, and lack of trust in officials.

“Many villages have limited infrastructure and electricity, poor access to potable water, sanitation and irrigation systems, and minimal education,” Dr Lim says.

“It was important to travel to each village and reach people who might not have access to health education.”

Meetings were held with local stakeholders to help recruit and train drama performers on key malaria messages and the best ways to impart them through acting, art and music.

“The MDA uptake following the visits averaged 84 per cent – exceeding the target and resulting in some very positive feedback from the villagers,” Dr Lim says.

The key messages reiterated the need to use insecticide-treated bed nets and repellents, the importance of early diagnosis and treatment and the risks of forest-acquired malaria.

The project also combined traditional entertainment with the modern; using drones to film the villagers and sharing photos and videos on Facebook across the province.

Across the villages, attendance rates at the drama performances averaged 66 per cent and led to an increased willingness among locals to do blood tests, Dr Lim says.

“This was heartening on two fronts. Some villagers believe in spiritual and psychic mediums to cure their illnesses and in the past have rejected blood tests and vaccinations.

“Also, in 2014, an unlicensed doctor infected more than 200 people with HIV in a Cambodian village, leading to the deaths of 10 people. This raised concerns and rumours that healthcare personnel came to the villages to collect their blood and sell it,” she says.

The researchers hope to roll out the project across Cambodia to promote high MDA coverage, although this is contingent on funding.

Their findings have been published by the London-based Wellcome Trust, which funded the project, and resulted in Dr Lim being named one of 10 Fresh Scientists for South Australia in June.

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