The creator of the Champa kit describes the process of putting together the sexuality and reproductive health package that has been used by hundreds of peer educators over the last 10 years, taking an issue that was in the domain of doctors and academicians to the people
On my first field visit to a village in South 24 Parganas, West Bengal, I was accompanied by Banidi, an elderly health worker with 21 years’ experience of working with communities. When we reached the village hut where meetings usually took place, she complained about her latest predicament. She had been instructed to take sessions on reproductive health with girls -- adolescents young enough to be her granddaughters. She fished out a crumpled single sheet of paper from a tin trunk on which was typed a list of topics that she was expected to educate the girls on. She admitted to me in a soft voice that despite her best intentions she had somehow never got round to discussing the issues with the girls -- it never felt like the right time, she said. When I nodded in empathy, she confided to me how she felt this “new requirement” was quite unnecessary. She had always gone beyond the call of duty -- but she also had her self-respect to consider. What would the village elders think? Talking about sex to teenage girls in a village!
Soon the young girls poured into the room -- some looked as young as 12 years old, others may have been as old as 16. “Most of these girls cannot read. They have never been to school or have dropped out so long ago that they remember nothing. How will they ever understand all this technical reproductive health stuff,”Banidi muttered to me under her breath.
I began to make friends with the girls and explore what their comfort levels were. We talked about many issues... their village, their routines, etc. When the subject of physical changes taking place in their body was raised, the girls giggled. Some put their heads down on their knees. Banidi left the room in shame. A male supervisor who had come to ensure that the session was on, left discreetly. One of the girls got up, tightly shut the wooden door and covered the cracks with a sheet. There was tension and expectation in the air.
Let’s play a game, I said, to break the ice. I pulled out some picture cards that I had carried along with me. The first picture was of a teenage girl with a little baby on her lap, looking wistfully at some other children playing. I held the card up and asked the girls if they could tell what was happening in the picture. Slowly the girls raised their heads. The giggles subsided and the group concentrated on describing the picture. One girl said the girl in the picture looked just like one of their friends who had got married when she was really young. Soon a hearty discussion was in progress on early marriage, social customs, etc.
The session was the beginning of my education, and I learned two useful lessons on that very first day.
Lesson number one: Social issues were a great way to break the ice. By starting from an area of comfort and knowledge for young people, they felt at ease and could easily participate in the discussion.
Lesson number two was the use of pictures. Evocative and intelligently constructed illustrations helped make the substantial leap into an issue that needed to be discussed. They also helped focus the discussion.
Later, when I asked the girls if they knew about how their bodies worked -- about body systems -- they looked completely blank. One of the girls mentioned that periodically a doctor visited their village and would give a lecture on “such things”. But they never really understood what she said and were too shy to ask.
This was my third lesson. I would have to develop a way in which the distance between the facilitator and learner could be reduced. The technical subject would have to be made accessible and friendly to non-literate girls, and the methodology had to have space for them to share their doubts and raise their questions.
At another session I learned about all the myths and ideas that the young girls had -- menstruation was the release of bad blood; girls were dirty and impure during those days; since women gave birth they were responsible for the sex of the child; women who were blessed and had good karma got sons, the rest had daughters; the number of children a woman had was destined by god, and so on...
I realised that because the female reproductive system was inside the body, girls had absolutely no understanding of any of the bodily processes. It was then that I realised the importance of using models; something that would help make the invisible reproductive system come alive...that was lesson number four!
On one of my field visits, the girls shared with me how their friend Champa was being pressured into an early marriage against her will, just like the girl you showed us in that picture...
I learned lesson number five that day -- having a character running through the teaching process could help build continuity and increase identification. I also realised that a series of graded sessions would be quite important for this education.
As a communications designer, the challenges before me became clearer. Over the next few months I journeyed between the village and doctors. At the village I tried figuring out all that the young girls wanted to know -- also the prevalent myths and stories. From doctors and development professionals I absorbed the gamut of problems that needed to be addressed, as well as the biological concepts and medical vocabulary that had to be decoded.
When determining the content of the curriculum, and later while field-testing the tools, there was a lot of debate. Village workers asked: Why should girls learn about boys’ bodies? Did they really need to know how a baby was born? What was the need to bring up STIs and HIV? Why would girls in our village need to worry about sexually-transmitted infections -- what was being implied?
Once a prototype of the reproductive health education kit was ready, I initiated an intensive field-testing process. While this was on, one group of village elders said discussing the concept of family planning was okay but there was no need to describe the specific methods. A senior health worker was uncomfortable about a picture showing the physical changes taking place in an adolescent girl’s body. Another younger health worker argued vehemently in favour of showing the pictures.
Sexuality was a subject where people’s comfort levels varied, and health workers who would eventually carry the message had to first come to terms with their own inhibitions. The journey was a difficult one. The lessons that I learned in my early days of field research were important building blocks and became the framework for the tool kit and methodology that was finally developed.
The idea was to create a generic tool kit on reproductive health that could be used by facilitators, even peer educators, to create a platform for discussion with non-literate young girls in villages and slums. Considering the sensitive nature of the subject, the challenge was to create a tool that even a fairly new educator could use with a group, with only minimal training. The tool would also have to work without any dependence on technology. Rather than be a one-way process, the objective was to make the entire subject come alive for young girls and relate to their reality, irrespective of their academic background.
The year-long development process resulted in the creation of an educational package of pictorial stories, games and models to discuss reproductive health with rural adolescent girls.
Through the story of Champa and her friends, various issues around reproductive health were raised. These stories were illustrated using watercolour drawings/paintings that were widely understood and allowed the girls to let their imaginations flow.
To break the ice and bridge the facilitator-learner divide, a card game showing social situations was introduced where the girls played as teams and challenged, argued and convinced each other on how different social situations influenced their lives.
To reduce inhibitions and clearly understand the biological concepts of menstruation, conception, sex-determination and the use of contraceptives, games and models were developed.
It has been close on 10 years since the kit was developed (1996). Since then it has been fine-tuned over a dozen editions, with changes introduced to accommodate specific needs as they emerged with use in the field.
I feel a sense of satisfaction to know that even today thousands of young people, aided by grassroots organisations, are discussing reproductive health using the kit. I am also happy to see that peer educators find the kit easy to use. An issue that was the domain of doctors and academicians is now in the hands of the people.
InfoChange News & Features February 2006