It was at a festival of street arts when Dr Nicola Veitch first considered using performance art to raise awareness about a deadly but neglected disease. “There were different types of street theatres and one of them specifically had a medical theme to it,” she recalls of the 2019 Surge Festival in Glasgow, Scotland.
A parasitologist at the University of Glasgow, Veitch wanted to educate people about African sleeping sickness. She’d been doing outreach at local science centres and schools, but knew she had to take a more creative approach to really cut through.
Bringing together team members from Surge – the company that ran the Surge Festival – and colleagues at her institution, Veitch launched Parasite Street Science, an interactive street-theatre performance about the cause and symptoms of African sleeping sickness.
Since then, the team has performed at street fairs and football stadiums, in local venues in Scotland and rural villages in Malawi. Veitch hopes to reach many more people in the coming years.
Building it up
With initial funding from the University of Glasgow’s public engagement fund and the Microbiology Society, a non-profit organisation in the United Kingdom, Veitch and her team developed a routine for Parasite Street Science with the help of Surge’s director, Alan Richardson. They tested it at the 2021 Surge Festival and were encouraged by the crowd’s response. “We had a team of people from various backgrounds – undergraduate students, PhD students, early-career scientists, lecturers – all working with professional performers,” says Veitch.
A typical performance consists of 10 performers and runs for 10–15 minutes. One performer is dressed as a tsetse fly, which carries the parasite Trypanosoma brucei that causes African sleeping sickness. Selected people in the audience are given red t-shirts to wear, representing the bloodstream. Into this setup, the performers let loose several beach balls that represent the parasite entering the bloodstream after an infection. “All of this is associated with a dance and loud music to draw a crowd and get people involved,” says Veitch.
As the show progresses, performers dressed as scientists in white lab coats enter the scene to catch the beach balls (the parasite) in nets, which represent antibodies – a protein component of the immune system that circulates in the blood. At the very end, a large net is brought out that traps the tsetse fly. This net has real-life significance: in Malawi, healthcare workers hang specialized nets on trees to bait the flies, but they are inadvertently taken down by the locals, says Veitch. “Through the performance, we wanted people to understand the point of the tsetse nets and why they were up in their communities,” she says.
Having ironed out the kinks through several local performances, the team decided to take the show to Malawi.
Adapting it to the local context
Veitch reached out to colleagues at the Kumuzu University of Health Sciences, Malawi and invited four of them to Scotland to collaborate on the performance. “Their experiences were invaluable in developing a show that would work in Malawi,” says Veitch. They piloted the Malawi project at a football stadium in Glasgow, and once they had perfected it, Veitch applied for the ScotPEN Wellcome grant in 2022 to fund their tour. “We spent a lot of time developing a show that would work for the local communities that we were going to in Malawi,” says Veitch.
Veitch and her team partnered with a street-theatre organization called Voices Malawi to understand the local context better. Based on the advice they got, they changed the name of the performance from Parasite Street Science to Talk About Tsetse, as people in Malawi knew the word “tsetse” better than “parasite”. “Voices Malawi knew where the disease was, and they were really important in us considering which communities we should be working with,” says Veitch.
Talk About Tsetse toured rural villages in two districts in northern Malawi that surround the wildlife reserves of Vwaza and Nkhotakota. As tsetse flies are transmitted via animals, people living near game reserves are at high risk of African sleeping sickness infection.
Each of the six performances attracted roughly 1,000 people, says Veitch. After the show, local scientists – including clinicians, nurses and community health organizers – were invited onto the stage to answer questions from the audience.
Based on audience feedback, it was clear that community members were open to interacting with scientists and asking them questions. “There was a really high response rate for that,” says Veitch. That was one of the overarching aims of the project – to build trust between scientists and the public and create a two-way dialogue between them.
A lack of trust in scientists and healthcare professionals, along with limited access to healthcare, is part of the reason why African sickness goes underdiagnosed and undertreated in rural communities of Malawi, says Veitch. By way of the performance, she hopes to educate people about the disease, including how best to protect themselves and how to identify early symptoms so they can seek treatment.
Measuring impact
It’s difficult to truly assess the impact of the performance, Veitch admits, but if more people than usual are admitted to the hospital for diagnosis after the performance, it could be a sign that Talk About Tsetse is having a positive effect. “We’re still in touch and collaborating with the hospital and the public health team there, and we can ask them that question,” she says. “But it’s going to be hard to directly see that link.”
Only about 10% of people in Malawi own a smartphone, which means street theatre and other outlets, such as radio programmes, are extremely important for health messaging, says Veitch. “After the performance, we used local radio shows to have an open phone-in line, and we would have scientists in the local community answering questions.”
Veitch’s team has filmed the performances in Malawi, and hopes to hold screenings in local community cinemas across Malawi from late 2023. These cinemas have a unique setup, with a large screen attached to the back of a vehicle, which makes it easy to move it to different audiences. “It’s kind of leaving a ‘digital legacy’, which can be used in some way over there,” says Veitch.
Veitch credits the success of the project to its collaborative effort. “There was a real bond [between team members] and everybody really brought a massive richness to the project,” she says. The project has led to spin-off projects and consolidated other research collaborations, she adds. “So, there are lots of other benefits from having done this work.”
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Story by Pratik Pawar
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