Lessons from public health-poetry workshop at an Assam indigenous school

How to bring innovations to public health communications is an ideation process that many practitioners across the world are working on. The behavioural change communication that we so dearly speak of, is a process of culture building that happens over time. The fact that it will take time should not deter public health practitioners from adapting ingenious methods of culture building for better health. 

One such initiative was the poetry workshop undertaken for students of the Eklavya Model Residential School, Dalbari, Baksa, on November 15, 2022. The school is run by the Ministry of Tribal Affairs, Government of India. This day also marks the Janjatiya Gaurav Divas or Tribal Pride Day.  

Anamaya- tribal health collaborative team and the ‘Strengthening NCD Services in Assam’ project team of Piramal Foundation, supported by the World Diabetes Foundation, conducted the workshop. 

The Public Health-Poetry Workshop 

Non-communicable diseases (NCDs) such as diabetes and hypertension are chronic metabolic diseases. They occur due to a combination of risk factors, some of which are non-modifiable (such as age and family history). Others are modifiable and lifestyle-linked (such as unhealthy diets, physical inactivity, harmful use of tobacco and alcohol, and stress). Recent trends point towards early exposure to risk factors and early onset of disease, across geographies and socio-economic strata. This poetry workshop aimed to improve the student’s knowledge and attitude towards NCDs and their risk factors while also attempting to induce lasting behaviour change among them using creative writing and poetry as a medium. The workshop began with a detailed-yet-simplified presentation and discussion on diabetes and its risk factors for the school’s senior students. The presentations were in Assamese, Hindi and English. 

The students enthusiastically participated, asked questions, and reflected on our changing lifestyles during the technical session. This was followed by presenting to them the idea of arts, imagination, and poetry. The process of writing and poetry was presented interactively to the students and how arts could be used for social change was elucidated to the students. 

The students were made to form groups and themes to write poems were given to the students to document what they think about issues such as well-being, nutrition, addiction, physical activity, and doctors. This could in a way be seen as a qualitative method of documenting their thoughts on the subjects through poetry. 

The idea to form collaborative groups is also important in such instances and needs to be highlighted so that they are less inhibited to express what they feel, instead of asking them to write individually. There is a need to keep in mind that we are working with tribal students from some of the most interior areas, from financially disadvantaged families, and in most cases are first-generation, high school students. 

To quote one of the students, Gobardhan Boro, who approached the workshop team in a heartfelt manner and said, ‘This poetry workshop has been a life-changing activity and we have never experienced anything like this. Please come and do interactive exercises more regularly.’ 

One of the outcomes of the workshop is to document the thoughts on the given themes of public health, through the written word in the form of poetry. Certificates were also handed out to over 60 participants in the workshop. An e-book will be created from the poems written by students and will be shared with the school. It will also be released at a conference organized by the World Diabetes Foundation project team on 19-20 January 2023, under the theme- ‘tribal health & non-communicable diseases and the sub-theme, art, culture and health.’

Some key pointers that emerged as an experience from carrying out such a workshop have been summarised briefly as follows:

Knowledge Exchange and Behavioural Change Communication 

Such workshops provide an opportunity for sharing knowledge on diabetes and other lifestyle diseases directly with the younger populations of the tribal community, who in turn communicate and intercept high-risk behaviours in their communities. They need to be seen as changemakers who absorb their learnings on public health and influence their and their family’s choices. 

For example, while writing about tobacco, one student expressed that they understand from their elders that tobacco use is good for digestion. 

Working with diverse indigenous populations incessantly influenced by globalisation, one needs to be reminded that there are considerable local practices and foods that may be healthier choices to make in the long term. 

The workshop also allowed for discussions that locally available foods are much more enriching than packaged foods and foods with added sugar and preservatives.  

Culture building Opportunity 

The students in such remote tribal schools, generally, are on a secluded campus and they may not have enough opportunities to interact with experts and stakeholders from elsewhere other than the regular cohort of few teachers. This makes such interactions extremely valuable for them to see the outside world through a new pair of eyes, which is off the curriculum but simultaneously quintessential for their future health and well-being choices. The workshop presents us an opportunity to make the students aware of good food choices, and better nutrition and lifestyles. 

Imagination and Writing  

The passé idea that information sharing is where one is the messenger and the other the passive receiver, propagates ineffective communication. In this age of social media, communication is more democratic. People of all ages like to put forth their views along with receiving information. Especially, given the cultural dynamism in this indigenous school, there is much to hear from them as well regarding the practices in the households, and their hamlets/villages. 

The interactive method makes the students attentive. They are aware that they get to participate, to create something later in the event. The poetry workshop encouraged students to write (in form of poems) their ideas on given public health themes. The outcome of this will be an e-book of poems on public health by the tribal students. 

Interdisciplinary 

The children from the tribal residential school seldom have the opportunity for such interdisciplinary interactions. The crossover of public health and poetry creates an exciting new paradigm to understand what these tribal children think, and learn from their surroundings and how they express themselves. Some of the lines written by the students explicitly are from their own culture and are unique perspectives. Such interdisciplinary activities need to be carried out and documented more often to see what results they may bring out and in the long term possibly influence public health policymaking. 

Stakeholder Inclusivity 

Partnering with schools with all tribal students like Eklavya Model Residential School in Dalbari, Baksa may ensure inclusivity of the young and vulnerable populations that may be missed out while working in communities. These model residential schools are long-term stakeholders in creating social change. The principal, Sri Angelus Baxla, was extremely enthusiastic about the workshop, along with participating teachers. The WDF and Anamaya field team including Nripen Kalita, Aminur Zaman, Gagan Bhagawati, and Dhruba Dutta Goswami, who work tirelessly in these tribal areas to make communities aware of the aspects of public health, actively participated in the poetry workshop through individual discussions. 

Madhu Raghavendra leads the Centre of Excellence, North East India at Anamaya, the Tribal Health Collaborative. He is a public health practitioner, poet, and curator, and emphasises leveraging arts and culture for social development.

Dr Radha Valaulikar is a doctor with a specialization in community medicine and a keen interest in performing arts. She is the Chief Manager and project head of ‘Strengthening NCD (diabetes and hypertension) Services in Assam’ project, which is funded by the World Diabetes Foundation and implemented by the Piramal Foundation across 33 districts of Assam.

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