Actors help teach medical students about stigma and HIV
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SAfAIDS Newsflash
"Many times, the physician has come to be perceived as all-powerful,
inapproachable, unquestionable. AIDS has bridged this distance and
demanded that the art of medicine be practiced at least as much as
the science of medicine."
(Ward & Papadakis, 1987)
On Monday February 19, 'Over the Edge', a group of professional actors
based in Harare, came from the stage to the lecture hall, to provoke
discussion about a doctor's role and responsibility in HIV preven-
tion. The four-person cast presented and improvised a role-play that
highlighted real life dilemmas faced by doctors in their care for
people at risk of HIV. Attended by fourth-year medical students at
the University of Zimbabwe, the session offered a unique opportunity
for the students to discuss and debate issues related to HIV and
AIDS.
Dr. Stan Houston of the University of Zimbabwe set up an innovative
three-session programme on HIV/AIDS. The programme included a discus-
sion on ethics, and community resources. In addition, the medical
students heard the experiences of practising physicians and testimo-
nies of people living with HIV. The programme aimed to impress a
sense of responsibility on future doctors and to encourage leadership
in HIV prevention. The role-play demonstrated the importance of pro-
viding clear information about HIV so individuals can make informed
choices about HIV and being tested.
For Craig Peter of 'Over the Edge', the session was an opportunity to
contribute to the discussion on HIV. Craig opened the session by giv-
ing a personal account of how HIV and AIDS have influenced his fam-
ily. He encouraged the medical students to be open to the diversity
of HIV/AIDS issues that influence individuals and their families.
In the role-play, the actors presented a situation where a woman
struggled to understand her recurring illness. While faced with her
own fears and frustrations, she was confronted by her husband's de-
nial and her doctor's refusal to openly discuss the possibility of
HIV. In a unique improvisation, the role-play portrayed the potential
silence that is created when patients assume the doctor knows best,
yet the doctor remains quiet and uncomfortable about talking about
HIV. Each character's feelings and worries were revealed in an at-
tempt to give the audience an understanding of the social and cul-
tural factors that block one's ability to be open about HIV.
When questioned about the role-play, one student described the situa-
tion as, "hopeless". Another felt that the woman had no power to con-
trol her own destiny. Recognising the barriers created by stigma,
shame and denial, the audience discussed how the doctor could improve
the advice given to the woman on HIV. With suggestions from the audi-
ence, the situation was re-played. The doctor took a new approach to
consulting and encouraging the patient to take an HIV test.
How did it end?
The role-play had no magical solutions and no 'Hollywood' ending, as
described by Craig. Instead, the students moved into smaller groups
to discuss their role as leaders in the prevention of HIV. The role-
plays provided a unique starting point for medical students to evalu-
ate how they can reduce the stigma and shame surrounding HIV/AIDS and
the programme encouraged open dialogue between doctors and patients
so individuals can make informed choices about being tested for HIV.
Voicing their opinions.
After the session, several of the medical students were interviewed
to find out how they felt about the programme.
"It [role-play] was "realistic",
"Practical"
"A unique way of presenting ideas",
"More interesting than our usual lectures",
"Great to participate",
"Good way to starting a discussion",
"Why isn't this a regular part of the curriculum?"
Our Analysis
The session used a role-play for initiating a discussion about the
role and responsibility of doctors, as health care leaders, to effec-
tively provide HIV information. The programme demonstrated the need
for doctors to be open about HIV, so their patients can make informed
choices about HIV.
* Multi-media - The use of diverse forms of media such as role-plays
enhance an individual's understanding of an issue. The use of media
such as role-plays, videos, radio can compliment ideas presented in
print format. Multi-media presentations allow ideas and perspectives
to be expressed, thereby enhancing the level and opportunity for an
individual to understand the issues.
* Fun: Role-plays, acting and humour are effective methods of captur-
ing the audience's attention. The impact of HIV and AIDS is a threat-
ening issue for many people. Information that is framed within a se-
rious or scary context tends to be shut out. However, an entertaining
and fun presentation will reduce the threat of discussing complicated
issues.
* Human approach: The role-play brought together many HIV/AIDS issues
in a single presentation. Because actors performed the role-play, the
audience could visualise, and identify with the situation, more than
if, it had simply been read in a text or presented by a lecturer.
With such an active presentation, the issues really come alive for
the audience.
* Audience participation: Participatory approaches are important for
keeping the attention of the audience. More importantly, audience
participation encourages individuals to actively evaluate the pre-
sented information and create solutions from their own perspective.
For more information:
SAfAIDS
17 Beveridge Rd.,
PO Box A509 Avondale
Harare, Zimbabwe
Tel: +263-04-336-193/4
Fax: +263-04-336-195
mailto:info@safaids.org.zw
http://www.safaids.org.zw
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