FHI - Participatory Dramas Spur Behavior Change in Mozambique

OCTOBER 2007 — My Husband's Denial is a 20-minute video that is well worth watching. It offers a skillfully made and fascinating look at participatory performances of a grassroots theatre troupe called O Teatro do Oprimido that encourage behavior change—in this case, to persuade men to go for HIV testing. In the process, we glimpse people and scenes in the city of Quelimane, Mozambique, and learn about the vital work FHI is doing to reduce the high rates of HIV infection in Zambézia Province.

Why and how the video was made
Country Director Silvia Gurrola Bonilla invited O Teatro do Oprimido to support FHI's programs in 2005 because she knew the company's participatory performances would memorably convey vital messages about HIV and AIDS in a country with a low literacy rate. She conceived the idea of making a video after she saw visitors from USAID, the US Congress, and the Office of The US Global AIDS Coordinator moved to tears by the performances of the troupe and community reactions to them.

Bonilla ensured that the low-budget, USAID-funded video complied with PEPFAR, USAID, and FHI principles; Associate Country Director Elisabete Inglesi made certain that technical issues on HIV/AIDS were properly addressed.

The need to convince husbands or partners of HIV-positive, pregnant women to go for HIV testing is reflected in the statistic that over 28,000 women were tested within FHI's prevention of mother-to-child transmission (PMTCT) services, compared to only 1,728 men. Inglesi said that gender issues "just popped out" during the filming, and noted that "the film persuasively empowers women without threatening men."

The video is a Força Maior Production, directed by Rogério Majate and entirely made in Mozambique. Alvim Cossa, director of O Teatro do Oprimido, provided advice on the group's methodology.

My Husband's Denial: A synopsis
The video opens with members of the troupe deciding on the topic for their next presentation, which will be offered free of charge in the community and advertised by word of mouth. They select the refusal of men to go for testing when their pregnant wives are known to be HIV-positive.

The troupe's charismatic facilitator guides the deliberations. During the skits, he has the role of stopping the action and asking the audience to define the problem. He then asks whether anyone can come up with a better solution, and he invites anyone who wants to propose one to step into a role and propel the skit toward a different conclusion.

The video's footage of the theatre troupe acting out domestic dramas is intercut with genuine scenes of pregnant women being tested for HIV infection and receiving their results at the 17 de Setembro Health Center, one of the key locations for FHI's PMTCT program. Several of the women refer to their husbands' reluctance to be tested, and they recount the excuses offered.

In the video, we also hear from a FHI behavior change specialist, who relates that over 100,000 people have been reached by Teatro do Oprimido presentations, including 60,000 women of child-bearing age.

Couple from "My Husband's Denial" Gradually, the camera settles on a calm, smiling woman whose actual experience provides the main counterpoint to the theatrical presentation. She is HIV-positive and pregnant. Her husband says he hasn't the time to go for the test; she suspects the real reason is that he is afraid of getting a positive result. She recalls how they met and fell and love, and we are introduced to her husband—an appealing, soft-spoken man—as he reminisces about the same period. Between the two, there is empathy and absence of blame.

After she witnesses a skit by the theatre troupe, she gently convinces her husband to attend another skit being put on under a mango tree the next day. He sees in the drama a man like himself, who is in denial about his possible HIV-positive status. But unlike him, this character is angry and unreasonable: he accuses his wife of bringing misery and misfortune and threatens to throw her out of the house. The character also berates his sister, who has taken his wife's side and accompanied her to the test. The dialogue addresses the validity of HIV testing, compared to cleansing by a traditional healer.

When the action is stopped, audience members acknowledge their familiarity with the scenario. A man in the audience volunteers to take the role of the sister, and dons a headscarf and wrapper to do so. He and an older woman who takes this role later provide telling arguments that audience members can probably use when confronted with this scenario, but the stubborn character in the play is unmoved.

But the actors and the community dialogue have worked their magic on the husband watching the play. The camera follows him home, where he tells his wife that he has decided he will go for testing. She is thrilled. A moving sequence shows him getting dressed to go for the test and going to the health center.

Yes, he says to the health provider, he will be able to look at his results. She explains the process, draws some blood, adds a drop of reagent, explains how negative and positive results look, and….

View a four-minute clip of the video (subtitled in English).

If you'd like to order an English-subtitled copy of the 20-minute DVD, please email publications@fhi.org with My Husband's Denial in the subject line. If you would like a copy of the Portuguese-language version, please write O Meu Marido in the subject line.

— Hilary Russell

PHOTOS:

(Top) A crowd in Quelimano watches the sketch by O Teatro do Oprimido. A man in the audience has donned a headscarf and wrapper to play the sister of the man who refuses to go for testing. The woman playing his pregnant wife is on his left.

(Bottom) The couple seen in the video: he agreed to be tested for HIV infection after seeing the participatory skit presented by O Teatro do Oprimido about a husband who refuses to be tested after his pregnant wife tests positive.